Moe coming out of remission

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Erin and Moe (GA)

Erin and Moe (GA)

Member Since 2019
Hi all -
Not sure if this is the right forum to post in, it's been a while since I've posted on the board. Moe was diagnosed last September, went into remission beginning of October with diet change and small doses of basaglar. We called it official mid-October and he has been OTJ since then.

Recently he's been acting a little "off" and had loose stools, so I took him to the vet on 2/7 for a physical and full blood work. Everything came back normal. Stool sample revealed no parasites, so vet recommended Proviable probiotic and then Flagyl for two weeks. Stool has improved.

However...BG has gone from the low and mid 100s in early February, to high 200s the last two days, and then this morning before breakfast, 527! I'll be doing a full curve tomorrow when I'm home all day but wanted to get this out here and get some thoughts about what could possibly be going on. I will be consulting with my vet, of course.

Also: I still have a vial of Basaglar from when we were still shooting. It was first opened September 1, and has been refrigerated since. Is it still okay to use, or should I get a new vial?

Thanks for any thoughts.​
 
I don't know Basaglar. Call the vet and ask them what they think of the vial. I know with my ProZinc, the vet said keep it, and it wouldn't hurt Billy to give it if it was past date, but that it might not be as effective.

Sounds like Moe had some sort of infection, and that can certainly raise his blood sugar. His numbers could drop back down when the infection clears up, but the sooner he's back on insulin, the better his chances of going back into remission.
 
Hi Erin, you're in the right forum. Feline Health (Welcome & Main) is the best place to be for either new or returning members. More "eyes" here to see your posts. Sorry you and Moe had to come back here for "round #2" in the boxing diabetes ring, but at least you know some of the basics.

1. Your Basaglar should be fine, as long as it has been properly stored. You're kind of reaching the 6 month limit on viability of insulin, but you never know. Some people use insulin for up to a year after it's opened. Please, check your vial closely for floating particles, mold, black spots. The insulin could have spoiled in the past few months. If it looks good and has been refrigerated, protected from light, not frozen, etc. you are good to go. Basaglar is biologically similar to Lantus (glargine) insulin. Made by a different company than Lantus (Sanofi) vs basaglar (Eli Lilly).

2. Sure hope there were no sugar or carb ingredients in the version of the Proviable probiotic you used. Looks to me like the dog paste version has 2 kinds of sugar. Cat version has yeast, a carbohydrate. That could have thrown Moe out of remission.

Sienne & Gabby swear by S. boulardii " S. boulardii is a probiotic that is very helpful with diarrhea. I use ReNew brand. Others have used Florastor. Both are available on Amazon. You start with 1/4 of a capsule x2/day and can gradually increase to 1/3 or 1/2 capsule x2/day.

Any probiotic and antibiotic have to be given at least 2 hours apart. Else, the antibiotic will kill off the probiotic bacteria.
https://www.ibdkitties.net/supplements/probiotics/

3. I see you have started to update Moe's SS again. Thank you.
You may want to strongly consider adding a new tab for the current year to the SS. Takes forever to scroll down to the relevant data when the SS includes multiple years.
Directions here.
**2020 Spreadsheets--PLEASE READ **

Marje and Gracie are not available for help in doing this right now. Give a holler and I'll tag someone else if you can't add a tab for the new year yourself.

4. Pancreatitis, diet changes, infection or inflammation, bad teeth, steroid use, other medications with sugar ingredients are the most common reasons for a cat in remission to come out of diet controlled status.

Hoping the probiotic did not cause the issue. Too late to "close the barn door after the horse is out", if it was.

You go on from where you are. Trying for a second remission.

:bighug::bighug::bighug:
 
Thanks everyone for your replies.
Deb & Wink - answers specifically to you:
1. Basaglar looks fine to me...clear and nothing floating about. I will check with my vet to see what she says about using it until I can get a refill.
2. I'm using the Proviable DC, which was recommended by my vet. However, I see the first ingredient is Fructooligosaccharide. Google says that it's non-digestible so it doesn't have an effect on blood glucose levels. IDK. I did NOT know about separating the probiotic and the antibiotic, but that makes complete sense. Derp. I'll separate the dosing going forward.
3. I'll add a new sheet for Moe's 2020 spreadsheet and transfer the data. I'd stopped tracking because I was testing rarely. Just sort of followed the numbers as they are saved in my tracker.
4. Moe is due for a dental and vet thinks he's got some resorptive lesions going on, plus lots of buildup. She wanted the diarrhea resolved before doing the dental work.

The somewhat good news is that this afternoon, Moe's BG was at 401; nice to see red instead of black on the spreadsheet.
 
The Proviable paste is the one with the sugars.
Proviable capsules looks better. but the maltodextrin is a form of sugar. Fructooligosaccharide is also a form of carb, but not sure if it affects the BG levels.
 
Found you @Erin and Moe! If you need eyes on your post and want to post on FB, it helps to put the link to your forum thread so people don't have to try to find you. Just copy the address in the address bar and paste it into your post on FB.

From Facebook:
Well, I just don't know what to think about this. Moe's glucose was rising all of last week. He was sick all weekend, throwing up all day Sunday, and BG in the mid to upper 500s Friday, Saturday and Sunday. I restarted insulin Saturday night with 0.5 unit basaglar.

Moe's AMPS today was 517. At +10 this afternoon it was 119!! The only thing I can think is that he had some sort of infection?

And now I'm afraid to shoot in a couple of hours. I'm worried he'll go too low overnight
____________________________________________________________________________

As long as you're able to test and have all the supplies you need (strips, HC and MC food and can test as long as necessary tonight), you can shoot those blue numbers. Get a +1 and +2 so IF you need to intervene, you can do it early.

You do need to make sure you don't feed Moe in the two hours before shot times though. When you do your Pre-Shot tests, you want a number that's not influenced by food.
 
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