Introduction--and a question--

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cronkiteshuman

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Hi there. My name's Cassie, and my cat Cronkite was diagnosed with diabetes this last September. His blood sugar was around 600 when I took him to the vet, concerned by his suddenly and dramatically increased water consumption. She prescribed lantus (2 units twice a day), and I switched him to varieties of Fancy Feast I found through links from felinediabetes.com (from strictly controlled portions of dry food beforehand)...and he did okay with that for a while... but it was too high a dose. It was reduced to 1 unit about a month later.

Two weeks ago now, after being on 1 unit twice a day for several months, Cronkite went hypoglycemic (and I was really glad that I'd bought the meter I hadn't yet had the guts to use...) and I ... basically stayed with him for four days straight, testing him every couple hours and figuring out that he appeared to be having a honeymoon, or maybe even just to be a very lucky cat whose condition can be controlled solely with diet.

When he was hypoglycemic that first day, he basically just lay down with his head on his paws, not moving or looking as I went by, with his tail straight out behind him. He wouldn't purr when I sat down and pet him, and this is a cat who purrs at the approximate volume of a chainsaw when you look at him across the room, say his name, or even accidentally walk too close to him. This was about an hour after he ate breakfast. I when I tested him at that point, his blood glocose was at 79--and maybe he could feel it going down further from the insulin in his system, but this seems kinda high, from the data I've seen, for him to have gotten so very lethargic.

Now, he's been insulin free a while, and I've shown my spreadsheets of his levels to his vet and she's looked at him, and he is usually around 84-90 before dinner, and I haven't been poking his poor beleaguered ears much more often than once a day. This morning, however, he was at 80 a few minutes after I fed him--which I know because he went into the same lethargic, non-purring, non-responsive lying down state next to his food bowl without even finishing.

Cronkite weighed around 35 pounds (he's now 14-point-something--he's a Maine Coon) when I adopted him at the age of 6, 6 years ago--he's, er, very into food. He wails and laments the unfairness of my not giving him all the food his little orange heart desires every day. He does not stop eating until he's checked ten times that no food has been overlooked. Sometimes he tries to break into the garbage, even. So this was odd. I gave him a couple spoonfuls of his old dry food (I still have some) and coaxed him to eat it, and he bounced back almost instantaneously.

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This is Cronkite, after having been subjected to the horrors of the dreaded lion cut.

I guess my question is, what the devil is going on here? Do other people's cats show symptoms of hypoglycemia with blood glucose levels as high as 80? Do other people's cats who aren't currently on insulin manage to produce so much insulin themselves to work themselves into a state of showing signs of hypoglycemia? It just seems really weird, and I haven't read anything about anyone else's cat doing this and would like to know if it's normal.

Thanks from both human and cat.
 
80 is normal BG. Without insulin with that BG he is not going hypo.
How fat has he been loosing weight. You said he went from 35 to 14 lbs. Losing weight too fast can cause problems. Has Cronkite had any blood work/vet visit since the lethargicness started?
 
He lost all the weight in the first year I had him--and was done more than 5 years ago. The diabetes didn't happen for a long, long time after that. He sees his vet for checkups at least twice a year.

After he stopped needing insulin, I made him an appointment to see his vet--he was just there the day before yesterday. They did do bloodwork. Everything appears to be fine. He's been almost this low (between 84-89) a couple times before today, but when he gets right around 80, as weird as it sounds, he starts acting hypo. His vet shrugged and said every cat's unique. I just think it's odd that he'd get that low under his own insulin-making power.

His blood sugar has been slightly elevated in stressful situations (as often happens) for years. I wonder if his body's not overcompensating for the stress of being at the vet the other day or something. He is literally so frightened of being removed from home that every time he is he becomes incontinent. But his level was only around 167 (two hours after breakfast; two hours after breakfast today, he's at 96) at the office.
 
as stated, he's not hypoglycemic if he's at 80, so something else is going on. You say his blood work was normal the other day but was anything near the upper or lower end of normal? Have you tested his urine for ketones at all?
 
They wanted stool and urine samples Wednesday when he was in, but as he had an accident on the way, there was none of either to be had (er, he was unceremoniously dumped in the exam room sink and cleaned up when we got there, for which he may someday forgive me). I'm going to bring samples in next week. And I did talk to his vet for half an hour this morning, after I last posted--he could just be, well, not himself entirely because, even if he isn't on the juice anymore, he IS sick. As a result of age or the diabetes, he's recently gotten a heart murmur, and he also can't get knocked out to get his (notoriously yucky) teeth cleaned anymore. He's always been slightly prone to UTI's (though his urine has never tested positive for sugar or ketones) and his ears might be getting yeasty again. Or he might sense that he's going to be spending time with his Uncle Jason this weekend because I'm going out of town to see my fiance (which I am now horribly wracked with guilt over). I had to go to my office today but plan to leave work early and whisk him off to his vet's office if he's the same or worse... but I hope I'm just overreacting. There is a definite correlation between his blood sugar getting as low as 80ish and his having hypo-like symptoms, though, which stumps both his vet and me. If such things continue, she said we should ultrasound his pancreas and make sure nothing else is wrong.
 
Welcome Cassie and Cronkite!

First question: what brand/model glucose meter are you using?

I am prediabetic and have had problems with hypoglycemia in the past. Since my day-to-day blood sugar is elevated, my body is used to a higher level than normal. Even though normal fasting BG in humans is 65-99, I can TELL when mine is below 85 or so. I start getting symptoms like sudden drop in energy level, grumpiness, foggy thinking, even in the 70s and low 80s. I can't do low carb diets for this reason - in ketosis my BG is usually between 70-90.

Not sure if this holds true for cats but it's a data point you can use. Without insulin, there's no risk of severe hypo, but he could still be feeling rotten because his body is not used to "normal".

Also keep in mind meters can be off by 10 points or so - do two readings right in a row and you'll see the variability.

HTH,
Lori
 
Have you checked the heart murmur with an ultrasound scan of the heart.

I have two heart kitties.

Here is Donna last year, 1 ½ year old http://felinediseases.weebly.com/heart-vsd.html We found her and her siblings outdoors at 2 months old. And when we went to the vet 2 monhts later when she was 4 months, he heard a very noisy heart murmur. So when she was 1, we did the ultrasound scan of her heart, and found that she had a small hole in her left chamber wall, called VSD. After that she had one ultrasond visit left and we did that last fall whe she was over 1 - sometimes these can grow away by themselves - but when they measured she had a 10th part of a hole of the aorta, which is a small hole, and the prognoisis was that it was so small she wouldn't show any clinic signs and be a normal happy kitten. We did these tests to put our mind to ease what was going on with her little heart. She doesn't need medication for this

Then my Gustav, 16, also got heart problems last year http://felinediseases.weebly.com/blood- ... rophy.html with high blood pressuer and hyperthropy, a thickening of the left chamber wall. No heart murmur though since he has no holes. He takes Norvasc and Fortekor for the high blood pressure, and we go on to the vet hosptial to measure his blood pressure. Besides that he lives a normal life.


The letharticgt was Simba tho, in 2007, when he was 11. http://felinediseases.weebly.com/pancreatitis.html Here is in great pain from a severe pancreatitis, hiding, and not responsive. The Texas FPLI blood test showed he had 301 in level, should be 2.0-6.8 and the ultrasound scan showed a highly inflammated pancrea.
 
Hi Ann-- his vet is monitoring his murmur, and he's going to be in at least once a month for the foreseeable future, and she says it's really really minor-sounding and didn't think any further testing was necessary at this time. If that changes, I'll be the first to jump up and get it done. This murmur business makes me nervous.

Lori-- that is really, really, really profoundly helpful. I didn't think he'd feel anything when he was just getting low, just when he was really low, if that makes any sense. I wish he were capable of communicating this stuff like a human diabetic. Cronkite's meter is a Bayer Contour. Maybe he is just feeling a little crabby (that's how he acts, certainly) when his levels dip around 12 hours from his last meal, especially since he knows he isn't getting any more food for a while and it takes a bit for his sugar to go up after he eats things. I hope that I'll go back to my apartment in a couple hours and he'll be dandy again and this is all there is to it.
 
Does the murmur preclude him getting the dental done?

I understand that this is scary and frustrating, but stick to your instincts and if you think that there is something going that you need to get the bottom of then push, ok? You are the mom, you know when something is wrong.

Jen

ps test for ketones at home
 
Yeah, the no dental thing is the murmur's fault. Blargh.

I am pleased to report that he seems to be regaining his capacity to purr. I also ordered some home urinalysis strips (oh joy!). So hopefully, all will be well.
 
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