Hello, all! I now have a decent sampling of my cat's, Puddin, glucose readings and am requesting some insight on everything. Additionally, Puddin is still very thristy, peeing outside of the litter box, and becomes very vocal (yowling) at about +2 - +3. We had one day that Puddin tested in the low 200s and he was a completely different cat - very happy and content. Otherwise, he still seems miserable most of the day. Dosage has remained at 8u twice per day, as suggested by vet. I'm assuming he will need to increase since the levels aren't low or stabilizing. He has, since birth, been on a low carb wet food diet and even zero carb at a point in life, so this diabetes situation doesn't make sense to me. Thank you.
Hi there. Thanks so much for all the spreadsheet data that you have input on his sheet. I would say that since the lowest numbers you have seen so far are mid-yellows, you can go ahead and increase to 8.5 units. I can’t remember if I asked you this before, but has your vet mentioned testing Puddin for Acromegaly or Insulin Auto-antibodies? And did we talk about him having any other conditions that might make him insulin resistant— and whether he’s had recent bloodwork (CBC and chemistry panel?)
https://felinediabetes.com/FDMB/threads/next-steps-suggestions.286385/#post-3152259 Here is a link to your previous post. When we start a new thread on this forum, we ask that you include a link to the previous thread for ease of referring back to it if necessary. I went back and scanned the previous thread. I see he was put on antibiotics and had perked up - and that he had previously had an elevated white count? If he still has an infection, that could definitely cause him to be insulin resistant.
It just seems like something is still off with him. I went ahead and increased to 8.5u for his evening meal. Overall he doesn't seem like he's improving and I just keep thinking how high these dosages are. We have gone through 2 rounds of antibiotics since December 2023 - I thought he perked up with this second round, but I'm really not sure because if he did it was only for 1 day. I will look through his previous bloodwork later today. The vet mentioned Acromegaly but he didn't see other signs of it; I , however, do see signs according to what I've read online... noisy breathing on the inhale, the high insulin dosage, the actual reason for the onset of the diabetes (an unknown reason why because food has always been LC). I haven't heard of Insulin Auto-antibodies, but I will ask my vet. I am also going to question this Acromegaly. Puddin has no other health issues in his past, this is this first and only and it has come out of nowhere. Thr only other thing I can point out about him is he's always had noisy breathing...we joke that we can hear him breathe from across the house. Thank you for the insight and care!
I would not hold his dose too long. If he doesn’t show improvement in 6 cycles, I would increase by another .5 units. Many cats with Acromegaly do not show the physical signs in their outward appearance. I remember looking up photos and thinking, “my cat doesn’t look like that.” The testing for acro IGF-1 (insulin like growth factor) is done at Michigan State University Veterinary Diagnostic Laboratory on Wednesdays. They can also do the IAA test. It would be good to get some answers at least, so you could explore options going forward.
And you are right about the breathing. It can definitely go along with acromegaly and some of our members with acro cats have reported that symptom. There can be other causes though (nasal polyps, congestion, asthma are a few that come to mind.).
And please forgive me if I asked you this before, but are you testing for ketones? Most people will track ketones on their spreadsheets (I added a column for ketones- after Mr. Darcy had DKA.) I used the blood ketone meter. Is Puddin eating well?
I called the vet today to discuss Puddin's situation. Firstly, he didn't seem interested in the fact that I have been checking Puddin's blood glucose levels. He believes it's not accurate...this was quite defeating to hear. He suggested increasing to 8.5u (I didn't tell him I had already increased as it had only been 2 days since the increase). On Monday I'll let him know how the 8.5u does and he said he'd increase to 9u if 8.5u isn't doing anything. I mentioned the Acromegaly - he said he'd test around the 10-12u mark. I mentioned the noisy breathing and he suggested Zyrtec. And lastly, he's pondering another round of antibiotics.
I have not tested ketones yet. I will look into this, as well. Puddin eats very well and would eat constantly.
You are doing your very best for Puddin’ right now. Don’t let the vet get you down. Your story is not uncommon (with regard to the attitude of your vet.)
https://felinediabetes.com/FDMB/thr...and-diabetic-cats-a-primer-on-ketones.239971/ Here is some information on ketones. Unfortunately, I didn’t know about testing for them until my cat was in DKA (I wasn’t on this Board yet.)
Hi. Just checking in on Puddin’s spreadsheet. He really reacts strongly to yellow numbers by spiking up, doesn’t he. There’s not much we can do about that except to keep on with the insulin and increases as needed. Gradually, as he spends more time in yellow and hopefully blue (greens in the future) he will hopefully smooth out. With these high numbers, I think we could fast track Puddin a bit so as not to hold the dose too long and let him settle in the high numbers. I would like to reevaluate the dose after six cycles and see if he should go to 9 units.
Thank you! He seems to be in the yellow fairly consistently with the 8.5u; that's very promising! I think his excessive drinking has lessened, as well. I will continue to update and we'll see how he's doing after the full 6 cycles...my guess is we will end up increasing to 9u. Thank you so much for the care, love, and wisdom you've provided me.
