If your sugar kitty gets hypoglycemia when sick…

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Daphne and Aida

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Hi all!
I wanted to share something I figured out with the help of my *new and amazing vet!

Aida had a pancreatitis back in November, during which her BG readings were way lower than normal.
It was completely unexplained and it baffled all the vets I went to, as well as some members here. It baffled me as well. The fact is that, when sick, Aida wasn’t getting the normal reaction with higher circulating sugar.

She was at the time diagnosed with hyperthyroidism, and I started treating her with methimazole mid-December.
Her BG has sharply decreased, she’s mostly in the greens now, even when she has a bite of Feloro’s HC food. She currently gets MC food (I’m concerned with high phosphorus levels in LC foods, and as long as her diabetes is controlled I’m not sure - or rather, I haven’t yet been convinced that I should risk her kidneys’ health to get her in remission. I’m planning to talk about it with the vet on Monday, because I clearly haven’t understood something!)

We went this week to check her T4 and renal values, and I had a chance to talk to this vet. I had also read a study about the impact of thyroid on insulin uptake.

It turns out that, when sick, the T4 drops. That’s a fact. When T4 drops, the insulin gets it easier to do its job. And therefore, Aida being sick, her T4 lowered and her BG lowered as well. And because I’m only monitoring her BG, not her T4, it was impossible to have the whole picture.

So, if your cat ever gets sick - hopefully they won’t - and their BG doesn’t rise, or even drops, check the thyroid.
 
Daphne, thanks for sharing. I don’t have anything to add regarding T4, but I often wonder about phosphorus levels in LC food.

I did some light research and the conclusion I came to was it sounds like their kidneys can typically handle the phosphorus. Think about the wild cats and their protein intake, and phosphorus does have good benefits for their body. But if there is reduced kidney function going on that’s a different story…

I’m curious what your vet thinks or if any members stop by.
 
Daphne -

For many cats, the presence of infection or inflammation causes a rise in blood glucose numbers. Illness is a source of stress which activates corticosteroids which raise blood glucose. One thing we often see is that for a cat that has gone into remission from diabetes, dental issues -- which often involve inflammation of the gums -- will throw the cat out of remission. Your point about being observant of issues that seem atypical is a good one, though. Not all cats, like humans, react the same way or you need to be a good detective.

We also have seen cats that are stressed by vet visits don't always have higher blood glucose levels at the vet's office. Some cats experience lower numbers. Clearly, not all "rules" apply all of the time.
 
It is called euthyroid sick syndrome. Neko once had low T4 numbers, but wasn't hypothyroid. I had been concerned because going hypothyroid was a possible side effect of her SRT treatment. Turns out it was a temporary condition caused by something else.
 
I’ve seen euthyroid sick syndrome as well. Many vets only run a T4, which can be deceiving. Sometimes you have to “right the ship” with other medical issues before you can fully evaluate whether there’s a thyroid problem present. It can also be helpful to run a full thyroid panel (T3, T4, free T4, TSH) rather than just a T4 in order to get the big picture.
 
Thanks for the feedbacks about euthyroid sick syndrome, I guess I was grossly misunderstood, I apologize, English isn’t my primarily language!

I was not talking about the thyroid.
I was talking about a cat, in a stressful situation, that didn’t have the typical response of elevated BG.
Stressful situation=sickness here.

The point I was trying to make is that, if a cat is sick, and the BG doesn’t rise as it would normally, then one should consider that something else is going on that affects the entire system.
And it turned out, with Aida, that she has hyperthyroidism.
Hyperthyroidism leads to some sort of resistance to insulin.
In case of sickness, the circulating T4 gets lower - that’s the euthyroid sick syndrome. When that happens, insulin can function again normally, and the circulating glucose gets where it should go and the BG gets lower.
And that’s what was going on with Aida, during her pancreatitis episode, full on sick but with super good BG numbers.

I hope that my point can come across more clearly now!
 
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