I think Kiwi is out of remission.

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Kiwi F

Kiwi F

Member Since 2012
I'm not new to FDMB...my cat, Kiwi, needed help in early 2012 when he was diagnosed with diabetes. After switching him to Wellness Turkey/Chicken, and starting Lantus insulin, he became diet controlled very quickly. He went OTJ after a few months. I monitored him regularly since then, to make sure all was well...and until recently he was.

Unfortunately, in April, he had a few high numbers (200s), but they were followed by better bg numbers (and I found a few different things that he was getting into, which seemed to explain all of these incidents...so I thought we were okay. A couple weeks ago, he started hitting some 300s, and he wasn't always bouncing back (although there were still occasional readings in the 100s (but not many). Due to my own health problems, and a severe lack of funds, I kept hoping and praying I would find something else he was eating...but now that a couple weeks have passed, I feel that I need to take him to the vet (I will be calling first thing in the morning), and I feel horrible that I didn't do something sooner (please no lectures...I feel terrible already).

One thing to note, however, is that he doesn't seem sick, like when he was first diagnosed...except, for a very small increase in water intake and urination. He's perky, running around, good appetite, comes when I call him, sleeping on the bed...all the normal stuff. I'm hoping that means its not to late to help him, as long as it happens now.

Is this the way cats tend to go out of remission? (Spotty high numbers, but increasing over time? What about an infection? Does that look any certain way? Does anyone have any vet advice for me? Last time, our vet's advice wasn't very good. I have heard to bring our home testing machine to compare to theirs, which I plan to do. Anything else? Is Lantus still the best way to go for remission? Some of his vaccinations are behind...is it dangerous for him to get any of them now, since his bg is high...in case they suggest it?

One other thing...a friend donated a lantus pen. It had been used. It was originally sent with an icepack, but was warm when I got it. Is there a way to tell if its still good? If it got too warm, or shook up in the mail, would it hurt him, or just not work well? Does anyone have advice about that?

I have updated Kiwi's spreadsheet. There is a new tab for this year. His old data from last year are still there, on the second tab.

My brain is spinning from trying to remember so much information, but I've been reading like crazy, trying to refresh my memory. Its better than the first time, at least.


I appreciate all of your help.

Thanks,
Kiwi & Kim

P.S. does anyone else out there have a debilitating illness (I have MS, and a vision problem), and know what its like to take this on while dealing with your own health issues? I'd like to talk. I did develop some strategies, but I'd like to hear how others handle it.
 
Larry and Kitties said:
he only way to see if the Lantus is good is to try it and see what happens to the BG
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But it won't hurt him to try it? (Just making sure)
 
Is this the way cats tend to go out of remission? (Spotty high numbers, but increasing over time? What about an infection? Does that look any certain way? Does anyone have any vet advice for me? Last time, our vet's advice wasn't very good. I have heard to bring our home testing machine to compare to theirs, which I plan to do. Anything else? Is Lantus still the best way to go for remission? Some of his vaccinations are behind...is it dangerous for him to get any of them now, since his bg is high...in case they suggest it?
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I can't give you any good answers on some of these questions.

Yes, an infection, think teeth or urinary tract, can cause a cat to fall out of remission.

BJM has some vet interview topics in his signature. You might want to look at those. Here they are:
Vet Interview Topics
You'll want a vet who:
1) supports home testing of blood glucose and is OK about using a human glucometer
2) supports feeding a low carbohydrate over the counter cat food, or raw low carb food
3) is either up to date, or willing to do the homework to become up to date on feline diabetes and common comorbidities.
4) if up to date, is familiar with the use of ProZinc, PZI, Lantus, and/or Levemir IN CATS; ask how they determine initial dosing and how often the dose is given. This may be based on lean body weight (verify it if they say based on weight as some vets forget this, per Dr Pierson) or may start low at 0.5 units. Dosing should be twice a day.
5) has pricing you can live with - check office visit fee, vaccine fee, CBC and chemistry fee, etc. Ask how often they have you bring the diabetic cat in and for what reasons (if you are home testing, you can do curves and averages at home, and the cat doesn't get 'regulated' at the vet office where stress makes the numbers unreliable)
6) if currently treating diabetic cats, ask how long they usually survive (should be several years, barring other conditions)
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I can think of two recent cases of members who have rejoined because their cats went out of remission. I am sure there are others.

Pam & Hoot. Higher numbers caught starting 5/17/13. Testing was sporadic until 5/27 when Pam started testing daily. Hoot needed a dental. Pam did not start him back on insulin for about 3 weeks after the numbers started to trend upwards. And not until after the dental work was done. He started on insulin 6/9 and is getting better numbers.

Mariko & Lucy. Lucy fell out of remission about a month ago. She is on prednisolone (steroid) so that could have been the cause.

If your cat does come out of remission, you need to stay on top of the dosing changes. Making adjustments quicker and being more aggressive with the dose increases and decreases. It is more difficult to get a cat into remission a second time but it is possible. People tend to test more it seems during a second attempt to get their cat to OTJ status.

lantus is still a very good way to go for remission.
Don't know on the vaccinations. I'll let someone else speak about that.
 
You will need to be more aggressive this time as the timeframe is short and liklihood of remission is less this time.

Its key to take a trip to the vet to see if there is any reason why kiwi fell out of remission. And I would move immediately to the lantus tight regulation board where the experienced dosing members can help to advise.

Do you have syrup, high carb food, strips etc? If so, I would start the insulin ASAP, maybe 0.5 units but see what the other board advises. What about ketone strips?


Wendy
 
Wendy&Tiggy said:
You will need to be more aggressive this time as the timeframe is short and liklihood of remission is less this time.

Its key to take a trip to the vet to see if there is any reason why kiwi fell out of remission. And I would move immediately to the lantus tight regulation board where the experienced dosing members can help to advise.

Do you have syrup, high carb food, strips etc? If so, I would start the insulin ASAP, maybe 0.5 units but see what the other board advises. What about ketone strips?


Wendy[/quote

I've got all our supplies, other than a new bottle of lantus. If our window is short, I'm wondering if we should start with a new bottle so that we don't waste time with weak insulin. Hopefully the vet can see us today.

Thanks for your help, everyone
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I was thinking that too although the old bottle is probably fine... Keep the old bottle as a backup.

When my Tiggy fell out of remission I waited too long thinking he would go back in, and he didnt. that was a year ago so now I say do whatever you can as soon as you can and hopefully it will be enough.

Also I am wondering about taking the % carbs of your food down more. Tiggy used to eat Wellness.. its 8% carbs but recently I have started 1% and am seeing a difference.

Wendy
 
Wendy,

Where did you find 1% Carb food? That sounds worth looking into (I would think the second remission is harder because they are already on a good food this time, so we don't get that huge, fast improvement we got with that initial diet change).

We did go to the vet. We don't have the test results back yet, but his teeth looked good, and he didn't show any obvious signs of damage from hyperglycemia. He has gained back a few pounds, and the vet thinks that might be what caused this. His bg was about what I expected it to be. Our meter was 50 points higher than theirs. Is that a normal amount for it to vary from theirs?

Do meters wear out? Should we be replacing it occasionally? If so, how often?


Thanks, everyone, for your help.

Kiwi & Kim
 
Home glucometers are 'good enough' for home use, and lab equipement is much more precise.
The FDA allows glucometers to read +/- 20% and be sold.

A recent Think Tank post notes that post marketing data shows some meters to be substantially worse due to production changes after FDA approval.
 
I do not think that glucometers 'wear out'. They can be damaged by dropping them onto a hard surface. Or damaged by dropping them into the cat's water dish. Or having a small child stuff food into the test strip slot.

The electronics inside can fail, computer chips do fail after all. You would usually get an error code that indicated a fault with the meter if this was happening.

If none if these circumstances have occurred with yours, meter is probably still ok.

Human diabetics replace meters when there is new technology that has improved the meter. Smaller blood drops for testing were a big reason many human diabetics changed meters for instance.
 
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