Need Advice with normal Fructosamine but High BG's

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Jason & Belle (GA)

Jason & Belle (GA)

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Initial post: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=34315

Hey all,

I am looking for some advice on how to move forward with Gracie, my 3 legged 4 year old girl. A few weeks ago I notice she was drinking more than normal, which seemed like a lot to begin with. I took a random test and her BG was in the high 200's. It got into the mid to high 300's so I took her to the vet. Two weeks ago, a fructosamine test came back in the normal range, so we know that she hasn't been high for long. Because of that, we decided a change in diet to wet(Fancy Feast Classic) should be tried for awhile before considering insulin. She did have a steroid shot 6 weeks or so ago, so we were hoping that she might get back to normal in time.

It's been a couple of weeks, and her spot checks are in the mid to high 200's. I'm thinking she needs to be on insulin, but I want to avoid it if at all possible. Her weight has maintained and she is acting fine, but I don't want to let things go too long. My plan was to keep tabs on her weight, BG's and drinking through the weekend, then take her in for another fructosamine if things stayed as they are now.

Do you guys have any advice on my plan of action, or any other feedback? With Belle, because of her diet and daily pred, I was happy to have her regulated in the mid to high 200's, so I'm not really sure how concerned I should be with Gracie.

Thanks in advance for the help,

Jason
 
A couple of things

1. why is she on steroids? Sometimes they can't be avoided but often there are options
2. why not insulin? 200s means there is some damage being done, so personally, I'd opt for a very low dose twice a day of either lantus or levemir

Jen
 
It was just a single steroid shot for allergies/sneezing/inflamed tear duct. I am not a fan of steroids(Belle was a steroid induced diabetic from IBD/asthma treatment) but expected one shot to be harmless. It helped clear up the issues she was having, and it may not have anything to do with her BG's.

We didn't start insulin because the vet wasn't comfortable diagnosing diabetes with a normal fructosamine test. She was either diabetic for only a few days or the High BG's were caused by something else(steroid shot). We were hoping a change in diet and the addition of fiber(Vet's Best Digestive aid) bring her BG's down.

Right now, I am leaning towards .5 to 1U of Lantus, but I'm thinking another fructosamine is in order to confirm a consistent issue. I've spot tested sporadically.

Jen & Squeak said:
A couple of things

1. why is she on steroids? Sometimes they can't be avoided but often there are options
2. why not insulin? 200s means there is some damage being done, so personally, I'd opt for a very low dose twice a day of either lantus or levemir

Jen
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Jason,

Are you feeding FF flavors that are in fact low-carb? There are great fluctuations in the different kinds insofar as carb values. It sounds like you know what you're doing, but I wanted to ask anyway.
 
Larry and Kitties said:
Just wondering what the value was for the "normal" Fructosamine.
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I asked the doctor and I didn't get the actual range, but it was like 430 which, according to his lab was "normal". I did some checking online, and according to what I could find, labs vary quite a bit and can go as high as 500 and be considered "normal". I don't understand the testing procedures and if the value actually varies by lab or just their interpretation of it, but my vet seems to consider anything in the normal range set by the lab as normal.
 
SaraJaye said:
Jason,

Are you feeding FF flavors that are in fact low-carb? There are great fluctuations in the different kinds insofar as carb values. It sounds like you know what you're doing, but I wanted to ask anyway.
Click to expand...


I do have experience with diabetes, but since my other cat wouldn't eat wet, not much with the food. I'm feeding the Fancy Feast Classic varieties which are mentioned in numerous places online. I hope that information is correct.
 
Larry and Kitties said:
This site gives some Fructosamine to BG conversions. They are consistent with your measured BGs.

http://www.sugarcats.com/infirmary/fructosamine.asp
Click to expand...

I don't understand how 350 or 400 could be considered normal with the numbers they give. Either way, the BG is at least 200. Even with the possibility that my vet's lab goes to 500 as normal, 430 would still be above what is typically considered acceptable. I'm just going to have another fructosamine done and if the spot checks continue to be high and the test is borderline, I'll start Lantus ASAP. 3 months ago, her BG was 90, so hopefully regardless we've caught it soon enough to get her into remission.

Jason
 
Hi Jason-

Just wanted to say I think your plan makes sense. I have heard (on here) of cats who had one shot of a steroid and became diabetic. Seems crazy, huh? Boomer never had a fructosamine so I'm not too experienced with that other than what I've heard here...but it seems that the next one will give you valuable information. My old vet told me not to give insulin if Boomer was 200 or below. I'll be curious to hear what your vet says. Hang in there!!!
 
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