It's me again, Margaret...

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DD & Smokey & Sissy

DD & Smokey & Sissy

Member Since 2020
Hello all,

It has been some time since I was active on the message board because Smokey has done really well. That has changed and I need some advice. His BS has risen to a level that is extremely out of the norm for him (between 154 and 204 in the last 24 hours; he is typically between 60-80 on a ReliOn human meter). He has developed neuropathy in his hind legs. He is eating and I took him to the vet and he received a B12 shot yesterday. Vet said he did not have a temp and looked to be physically healthy. I was able to check keytones last night and the stick had a negative result. My question is, is this the point we go back to insulin? We discontinued insulin almost 3 years ago (to the day) because he had two hypo episodes. Thank you in advance for any guidance you can give me. *FULL DISCLOSURE - As long as he was doing well, I did not check his BS as often as I should have. I know that was not right, but as long as he was ok, I was ok. I did take it on occasion and, as I said, it was rarely over 80.*

Thank you again for any advice -

Deana
 
I have also updated his spreadsheet with all the values I have on the ReliOn. I was lazy with his testing, but not as much as I thought. (And no, I'm not patting myself on the back.)
 
Hello Deana,
Did the vet check Smokey’s teeth when he was at the vet? Also does he have any symptoms of a UTI? These are too things that can throw a kitty out of remission. Has he only been eating a low carb diet?. Could he have got into any high carb food?
Those numbers are creeping up.
If he needs to go back on insulin, would you want to stay with Prozinc or look at Lantus.?
What did the vet say about the BGs?
Il tag @Suzanne & Darcy and @FrostD as they are Prozinc users to get their comments
.
 
Two vet related questions --
  • Did the vet get labs and run a fructosamine level?
  • Did the vet check Smokey's teeth?
As I'm sure you know, the fructosamine will let you know if Smokey's numbers have been elevated for several weeks. The other issue is teeth -- the need for a dental is the most frequent reason a cat falls out of remission.

The neuropathy suggest his numbers have been higher than desirable for a while. Unless there's some medical reason for his numbers to be high, I'd be considering insulin.
 
I would take BG before feeding and then 4-5hrs after feeding. W/o insulin the lowest BG should be before food wheil the 4-5 hr BG should show rise due to food.
The 205 yesterday is not good by t the vet visit may have contributed to being that high.
Are you sure it is neuropathy? With the BGs that low I would not suspect neuropathy. Did the vet say it was neuropathy?
Anything change in the household? Is s\Smokey still eating the say with respect to amount and how fast he eats?
 
Hello all, and thank you for your replies. My vet tried to check his teeth, but Smokey is VERY sensitive about his mouth. We didn't get labs yesterday, but he did mention neuropathy as did my MIL who cared for a sugar cat for many years. I have a video of him walking, but it's not great. He's been lethargic today and when I feed, he eats, and eats good, however, doesn't go back and eat any more like he normally does. I am not against Lantus, or any other insulin, as I've seen that it is "preferred" by most on here?? I called today to see if I could get some insulin and they were unable to get me an answer before they closed. To be honest, I'm terrified of insulin because he had two hypo instances when we first started all this. He was on insulin for two weeks and we went OTJ. He has been relatively stable until yesterday, when everything went haywire.

Changes: Smokey was diagnosed right after the pandemic started, so I've been home with him, pretty much non-stop, for almost 3 years. My job requires travel and he is very much a "momma's boy". He POUTS when I leave, even though my mother, whom he is very well acquainted to and knows, is here caring for him. I have only been able to leave town on small vacations twice since March 2020. Both times he pouted, the second requiring him to go to the vet for liquids because he refused to eat. Taking him with me is not an option. He is NOT a good traveler. I started traveling again this week. Not traveling is not an option with my job and another job is not in the cards either!! I'm fearful of what the future holds. :(
 
I thought I'd answered everything, I've not seen any signs of uti. I haven't smelled any strong ammonia smells, but Smokey's bladder was empty yesterday and we couldn't do the keytone test. (I was able to get a stick tested around 1-1:30 this morning which was negative. I'd upload the pic but it says I don't have permission to do so.) Smokey also acts as if maybe one of his back legs hurts, but I'm not sure on that because he only chirps at me irregularly. I'm so lost on this one. (And I'm assuming my vet didn't want to do labs because it was almost closing time and they worked him in.) I have to leave town again Monday, but I'm going to make an appointment and have my mother take him in for labs. And ask for Lantus if possible.
 
The ‘upload a file’ does not work, but you can copy and paste it in to here.
I’d try and get a daily ketone test if possible, especially if he is lethargic.
If one of his back legs hurts it may not be neuropathy but something else…such as arthritis, injury.
I’d make sure he is eating plenty of food.
 
Thank you, I see I didn't answer the food question, I apologize. He eats only fancy feast pate and gets the Friskies hand flaked treats. He might eat some green lettuce from time to time and on rare occasion some sandwich turkey or ham, but that is very rare. When he was diagnosed my MIL told me no more dry kibble of any kind and only dry treats when he was low or as a once a year treat (which I admit to, one dry treat once a year). I also feed him every 3-5 hours. He shares the food bowl with 3 other cats so when it's empty, I add more food. None of them gorge themselves and only eat what they want. I'm going to go ahead and take him tonight to have him checked for UTI. I know those can get bad quickly in humans and I'm sure cats, too.
 
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Bron and Sheba (GA) said:
Let us know how you get on at the vet
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Just got back home. His white blood cells were elevated but not critically. Temp was normal, but vet thought as you guys and we treated him with Covenia and a steroid. (Or maybe the covenia is the steroid and he got an antibiotic). Nonetheless, everything else was good, BG was elevated at 300+, but being at the vet, that is somewhat expected. His last reading at 8:30 was 221 and I said nope, we're going to the Emergency clinic. Glad I did and his wobble seems to be *almost* non-existent?? Praying it was arthritis or something. He does have arthritis in one of his front legs, so maybe he has in back now. Thank you all again for your kind assistance. It means the world to me. ❤️
 
DD & Smokey & Sissy said:
Just got back home. His white blood cells were elevated but not critically. Temp was normal, but vet thought as you guys and we treated him with Covenia and a steroid. (Or maybe the covenia is the steroid and he got an antibiotic). Nonetheless, everything else was good, BG was elevated at 300+, but being at the vet, that is somewhat expected. His last reading at 8:30 was 221 and I said nope, we're going to the Emergency clinic. Glad I did and his wobble seems to be *almost* non-existent?? Praying it was arthritis or something. He does have arthritis in one of his front legs, so maybe he has in back now. Thank you all again for your kind assistance. It means the world to me. ❤️
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Convenia is an antibiotic.
Why did he give the steriod? That will send the BGs up higher.
What did the vet think about starting insulin?
 
Bron and Sheba (GA) said:
Convenia is an antibiotic.
Why did he give the steriod? That will send the BGs up higher.
What did the vet think about starting insulin?
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The vet thought giving the steroid would help in taking care of the UTI. It may be a regional thing, every time I take one of my cats in for illness, they give a steroid. Sissy (Smokey's sis) got a tooth extracted, they give a steroid to "back up" the antibiotic. I knew it would make his BG higher as my dad is diabetic and we learned the hard way with him. The vet did not say anything about resuming insulin. He did tell me lets see how the next 24-48 hours go and then I'll take him to my regular vet. So, I'm going to test, wait, and watch. He is still eating well, and is really interested in the rotisserie chicken I was deboning earlier. He eagerly took what was offered!!

I was almost sure the covenia was the antibiotic, but I was tired.
 
DD & Smokey & Sissy said:
Sissy (Smokey's sis) got a tooth extracted, they give a steroid to "back up" the antibiotic
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That seems crazy since steroids suppress the immune system. Not exactly what you want when fighting an infection. It will reduce inflammation so may have some palliative effect on your cat and may even make the arthritis (if it is arthritis) feel better for a while.
 
Hopefully the Convenia injection will help and his BG will come back down. I also can’t understand giving a steroid to a diabetic cat who has been in remission! In addition to the immunosuppressive nature of the steroid, it will elevate BG.

I would take regular daily tests and see how his BG is and hopefully it will get better because of the antibiotic shot.
Was it a steroid injection also? Because if it was, that will stay in his system for 4 - 6 weeks.
 
Suzanne & Darcy said:
Hopefully the Convenia injection will help and his BG will come back down. I also can’t understand giving a steroid to a diabetic cat who has been in remission! In addition to the immunosuppressive nature of the steroid, it will elevate BG.

I would take regular daily tests and see how his BG is and hopefully it will get better because of the antibiotic shot.
Was it a steroid injection also? Because if it was, that will stay in his system for 4 - 6 weeks.
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It was an injection I'm glad you said how long it would be in his system because I'm sick. His BG at 7:00 was 291. My mom is also here so he knows I'm leaving, his stress level has increased. I have to leave town tomorrow for work and she was getting the BG test example again (It's been a while for her). He does suffer from some arthritis, I know for a fact in his front foot/leg. And when we got home last night he ran into the house. No sign of a limp or wobble at all. Today he has had a limp, but its been because of his front foot. I think he may have laid wrong, or his little friend (one of my other cats) may have laid on him wrong. She HAS to be next to/around him. I honestly think when we lose him she will take it harder than I will.
 
Hang in there. Let’s hope that the Depo Medrol shot (steroid) will help the arthritis and the Convenia will help the suspected UTI and that he will improve. We will try to be positive. How long will you be away? How nice that your mother can help like this. What a blessing.
 
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Suzanne & Darcy said:
Hang in there. Let’s hope that the Depo Medrol shot (steroid) will help the arthritis and the Convenia will help the suspected UTI and that he will improve. We will try to be positive. How long will you be away? How nice that your mother can help like this. What a blessing.
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UPDATE: my mother was unable to get a BG reading this week because the meter went wonky. (Was giving the E01 error). I looked it up but she was stressed out and Smokey was and I told her don't worry about it. He was eating and eating good so I felt better. (Because he didn't eat a doggone thing Sunday and his BG shot up over 400). I just took his BG and it was 90. I've never been so happy to get that number. Thank you all for your guidance. You guys are really angels on Earth. ❤️
 
I am happy for you. But can you please keep getting regular tests on him. There are some normal numbers on his spreadsheet but there are some numbers that are definitely higher than normal numbers. I just want to make sure that you know whether or not he needs insulin or is okay without.
 
Suzanne & Darcy said:
I am happy for you. But can you please keep getting regular tests on him. There are some normal numbers on his spreadsheet but there are some numbers that are definitely higher than normal numbers. I just want to make sure that you know whether or not he needs insulin or is okay without.
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I will definitely do better on testing him; the only kink there is, I'll be gone quite a bit w/ work and I'm in hopes my mom will be able to get more comfortable with testing.
Also, what numbers on his spreadsheet jump out to you as higher than normal? (I'm genuinely curious, not be snarky or anything).
 
Keep in mind that “normal” blood glucose levels for a healthy non-diabetic cat would be in the range of 50-100… perhaps as much as 120 soon after eating. Some of my non-diabetic cats spend time in the 40s. These are human meter numbers like your ReliOn. So anything above that range is a little too high.

275 on February 6 caught my eye. 260 of February 5. 191 and 171 on February 4. And there are other numbers. Many of the blue numbers are also outside of the normal BG range. I’m absolutely not trying to be a party pooper, I promise! I just want to make sure that your Smokey is going to be all right. Sometimes there are cats who only need a small amount of insulin for a while - to help them into a strong and lasting remission.
 
Suzanne & Darcy said:
Keep in mind that “normal” blood glucose levels for a healthy non-diabetic cat would be in the range of 50-100… perhaps as much as 120 soon after eating. Some of my non-diabetic cats spend time in the 40s. These are human meter numbers like your ReliOn. So anything above that range is a little too high.

275 on February 6 caught my eye. 260 of February 5. 191 and 171 on February 4. And there are other numbers. Many of the blue numbers are also outside of the normal BG range. I’m absolutely not trying to be a party pooper, I promise! I just want to make sure that your Smokey is going to be all right. Sometimes there are cats who only need a small amount of insulin for a while - to help them into a strong and lasting remission.
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I'm with ya. On the February dates for this year, those are his numbers from last weekend when this string started. A probable UTI and him being stressed because he knew mamma was leaving (again). When this adventure began, i remember reading on one of the forums that 50-150 was the 'acceptable' range for the ReliOn meter. That may have changed, if so, I will be more cognizant. He is occasionally above 100 (see 2021 & 2022), but very rarely. His numbers are typically between 50-85. And as I said previously, when we began the insulin, he had two hypo events. And I'll be the first to admit, they both traumatized me. I am very reluctant to resume insulin unless and until his numbers go up and cannot be tied to illness (UTI in this case) or some other triggering event.
 
You are right that a UTI can definitely raise numbers. If his numbers do stay within 50-85, I would say he is in remission. About the "normal" numbers (almost exclusively green numbers: There's a difference between regulation and remission. Remission means they are not currently on insulin due to being in normal numbers without insulin.... and regulation means that they are in normal numbers while receiving insulin (and of course regulation is something you will often see broken down further by saying "tightly regulated, "well regulated" ... some vets consider a cat "well-regulated" in yellow numbers... I would say they are out to lunch on that one!

I can definitely understand the trauma if your baby experiences symptomatic hypos or had to be hospitalized due to a hypo! Hypos can be deadly and we take them very seriously around here and that is why so many safety measures are built into the protocols for dosing. I was just recommending that you keep monitoring at this point and admitting that some of the numbers outside of normal cat BG had me a little concerned. It would be great to see the numbers after the UTI is cleared. Two weeks in normal numbers (which would be green for the most part) and he would be considered in remission (a diet-controlled diabetic cat) and then you could just test periodically to make sure things are still okay.

I'm going to post the stick "What is Regulation" from the Health Links / FAQs about Feline Diabetes for you to look at for your information. Lots of love to Smokey!
 
Yes!! Thankfully, and thank you!! His numbers have returned to 'normal' and he hasn't been back above 100. I'm going to continue keeping an eye on him and getting BG numbers. Thank you again for your guidance!! I am so thankful for this forum!!
 
DD & Smokey & Sissy said:
Yes!! Thankfully, and thank you!! His numbers have returned to 'normal' and he hasn't been back above 100. I'm going to continue keeping an eye on him and getting BG numbers. Thank you again for your guidance!! I am so thankful for this forum!!
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That is fantastic news. I'm really happy to hear this :-)
 
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