In remission for years, now running high. Thoughts?

learjetta

learjetta

Member Since 2019
Boris was diagnosed as diabetic in April 2019 (likely steroid induced) and went OTJ by September 2019. Since then, we’ve continued to monitor him, though less frequently over time. Whenever I checked his BG, it was consistently in the 80–90 range.

Over the past month, we’ve noticed some concerning changes: increased appetite and thirst, larger urine clumps (with “concrete paw”), and more interest in the other cats’ food. At the end of March, we checked his BG and got a reading of 245, but the test strip was expired. We bought a new meter and strips on 4/1 and have been checking him about twice a day when we believe he’s fasted. His BG readings have been in the blues (100–199).

Because he has a history of DKA, we checked for ketones on 4/1 (negative), but haven’t checked again since.

I suspect a few contributing factors:
  • Severe osteoarthritis with poor pain control (currently on gabapentin; we are working on improving this)
  • Chronic constipation, which is now resolved with 1/8 tsp psyllium husk powder twice daily in his Friskies pâté
  • Dry food had crept back into his diet but has now been eliminated
  • Weight gain, which is difficult to address right now
  • Age. We assume Boris is at least 14 years old.
My main question: are BG numbers in the blues considered diabetic or prediabetic? When I look at his IDEXX lab results from December, the normal range went up to 175, and his BG at that time was 98 (which seemed good, especially under vet stress).

We’re planning a vet visit to address his osteoarthritis and adjust his pain management, but I’m unsure what else to do. Should I expect that he may need to go back on Lantus to bring his numbers down again?
 
My vet says as long as numbers are under 200, she would be happy. I would see if you can get his pain under control and then go from there. My 18 year old is on Solensia and it has helped his arthritis pain tremendously, if that is an option for you.
 
learjetta said:
Boris was diagnosed as diabetic in April 2019 (likely steroid induced) and went OTJ by September 2019. Since then, we’ve continued to monitor him, though less frequently over time. Whenever I checked his BG, it was consistently in the 80–90 range.

Over the past month, we’ve noticed some concerning changes: increased appetite and thirst, larger urine clumps (with “concrete paw”), and more interest in the other cats’ food. At the end of March, we checked his BG and got a reading of 245, but the test strip was expired. We bought a new meter and strips on 4/1 and have been checking him about twice a day when we believe he’s fasted. His BG readings have been in the blues (100–199).

Because he has a history of DKA, we checked for ketones on 4/1 (negative), but haven’t checked again since.

I suspect a few contributing factors:
  • Severe osteoarthritis with poor pain control (currently on gabapentin; we are working on improving this)
  • Chronic constipation, which is now resolved with 1/8 tsp psyllium husk powder twice daily in his Friskies pâté
  • Dry food had crept back into his diet but has now been eliminated
  • Weight gain, which is difficult to address right now
  • Age. We assume Boris is at least 14 years old.
My main question: are BG numbers in the blues considered diabetic or prediabetic? When I look at his IDEXX lab results from December, the normal range went up to 175, and his BG at that time was 98 (which seemed good, especially under vet stress).

We’re planning a vet visit to address his osteoarthritis and adjust his pain management, but I’m unsure what else to do. Should I expect that he may need to go back on Lantus to bring his numbers down again?
Click to expand...
Sorry to hear of higher BGs, a non-diabetic cats' glucose level is between 50-120, so he might be falling out of remission, I will tag a member that has great knowledge on Feline Medical issues, she might be able to give you better light on your concerns:bighug:
@Sienne and Gabby (GA)
@Wendy&Neko
 
Many members use Cosequin or Dasequin for the arthritis. If you use Cosequin, the specific one that seems to work best is the one with Boswellia Cosequin® for Cats Plus Boswellia | Joint Health Supplement

Solensia and other injectable medicines can be done by the vet.

There is also something called Synovetin OA. It's an injectable that is given directly into a joint. The procedure would require sedation if not full anesthesia and is minimally invasive. Synovetin OA® | Canine Osteoarthritis Management It's mainly for dogs but can be given to cats.
 
Get your vet to run a blood panel/urinalysis and also to check inside his mouth. Dental issues are one of the most common reasons cats fall out of remission. Keep checking his blood sugars daily to see if he starts trending up.
 
Jessica & Indy said:
My vet says as long as numbers are under 200, she would be happy. I would see if you can get his pain under control and then go from there. My 18 year old is on Solensia and it has helped his arthritis pain tremendously, if that is an option for you.
Click to expand...
How long has your 18-year-old been on Solensia? Do you have to take him to the vet for the injections, or are you able to give them at home?

I’ve read about some concerning side effects, so I’m still unsure about trying it. We would need to be able to order the medication by mail and administer it ourselves. We’ve been traveling full-time in our motorhome since September 2019, so we don’t have consistent access to the same medical providers—for either ourselves or our cats.

ETA: We do spend 3 months or so in our home town over the summer, so we do have a single vet we use for our cats primary care. We just don't have access the other 9 months out of the year, and primarily rely on Vetco Total Care hospitals when we can, or local vets when there are no Vetco's close by.
 
squeem3 said:
Many members use Cosequin or Dasequin for the arthritis. If you use Cosequin, the specific one that seems to work best is the one with Boswellia Cosequin® for Cats Plus Boswellia | Joint Health Supplement

Solensia and other injectable medicines can be done by the vet.

There is also something called Synovetin OA. It's an injectable that is given directly into a joint. The procedure would require sedation if not full anesthesia and is minimally invasive. Synovetin OA® | Canine Osteoarthritis Management It's mainly for dogs but can be given to cats.
Click to expand...
Thanks for the info! I'll read up on Synovetin to see if that might be a good choice!
 
learjetta said:
How long has your 18-year-old been on Solensia? Do you have to take him to the vet for the injections, or are you able to give them at home?

I’ve read about some concerning side effects, so I’m still unsure about trying it. We would need to be able to order the medication by mail and administer it ourselves. We’ve been traveling full-time in our motorhome since September 2019, so we don’t have consistent access to the same medical providers—for either ourselves or our cats.
Click to expand...
Oh, he has been on it for I want to say 3ish years? Maybe longer, I have lost track. It is not an injection that can be done at home. It is given at the vet's every 4 weeks. It is a tech appt though, so not super expensive. Wondering if there would be vets that would be willing to work with you since you are on constantly on the move.
 
You might want to consider Adequan as an option. Although not used as frequently now, it was the go to before Solensia came out. And you can get a vial of it and give it yourself at home. Canada has a semi equivalent called Cartrophen. I could but didn't get a vial of it, cause it was expensive and didn't last long once opened and at the dose I was giving I'd waste over half the vial. I used to just pop by the vet and get prefilled syringes. Adequan was much cheaper than Cartrophen.

There is a warning on the Solensia that it has to be given at the vets. Getting Solensia accidentally into you is a bad thing. Depending on the cat, you can lengthen the time between shots out a little bit.
 
Wendy&Neko said:
Get your vet to run a blood panel/urinalysis and also to check inside his mouth. Dental issues are one of the most common reasons cats fall out of remission. Keep checking his blood sugars daily to see if he starts trending up.
Click to expand...
Boris had a dental procedure last summer with his primary vet, during which a few teeth were removed. At a follow-up visit in December with a different vet, we were told he needs another dental, and they identified additional teeth that should be treated. We had originally planned to handle this in July.

Since September 2019, we’ve been living, working, and traveling full-time in our motorhome. Boris does have a primary vet, but we’re currently about 2,000 miles away and relocating every 1–3 weeks. If his dental issues could be contributing to elevated blood sugar, we may need to address them sooner rather than later.

We’re leaving here tomorrow, staying six days in Winslow, AZ, followed by a long weekend at the Grand Canyon. Las Vegas—about two weeks from now—seems like the most practical place to schedule the dental. I can start contacting clinics there to arrange an exam and procedure during our stay, ideally in the first week so we have time for any follow-up in the second.

Does anyone have advice on the best way to ask for vet recommendations in Las Vegas? I can also post in the Feline Diabetes Facebook group to see if anyone has a provider they trust.

Just saw your other post - I can definitely inquire about Adequan!

ETA name of Facebook group for clarity.
 
You must log in or register to reply here.
Back
Top