New diabetic and kidney, hyperT, need help stabilizing

[ahzryn]

Before I forget, thank you so much for this forum!!!

My husband's cat is a 15 year old flamepoint siamese. He was diagnosed with hyperthyroid last year, which we have under control now with oral medication. Recently he started loosing weight, eating a ton, etc. again so I took him back to the vet for blood work on Friday figuring he needed his dosage adjusted, but when the results came back on Monday, it was diabetes. I honestly can't remember if the vet said his sugar was 600 or 900... but either way it was VERY high. His kidneys are no longer within normal either, BUN was 51 and creatine was 2.8. All labs from December were fine.

My vet, who I now love even more, recommended your site. I started reading here, filled his prescription for Lantus and dropped him off Tuesday morning for the initial curve, and picked him up Tuesday evening after he responded very well.

And, of course, then the problems started.

I thought I had read enough and had a good handle on it, but his first BS reading at home last night was 63. I checked it again and got 65, checked myself and got normal, so pretty sure the meter is fine (Relion micro). Given how low it was, with no historical data to back it up, and questioning whether the receptionist was incorrect and he might have already had his shot for the night, I fed him dinner and did NOT shoot. I rechecked it again 2 hours later and got 129, so I left him alone for the evening and just woke up every few hours to check on him.

This morning it was 478, so I gave him his normal dose the vet started him on (1.5u) and fed him breakfast. I just came home over lunch to check on him and get the nadir reading, and it was 471, not what I was expecting!

So now I'm sleep deprived and worried and thinking I don't know what I'm doing after all. We have three cats who were previously eating free choice Chicken Soup dry with occasional Fancy Feast moist, so one of the first things I did was pick up the dry and switch to 100% canned for everyone, 2x/day. The diabetic cat and one other are thrilled with the change, and I am pretty sure the one holdout will come around.

Am I doing anything wrong, or are the readings just strange in the beginning? I have a call in to my vet , but I figured i wouldn't hurt to check in here as well.

 

[Ry & Scooter]

Re: Newly diagnosed, worried and frustrated

You're off to an awesome start, fortunately you seem to have one of the better vets out there Did you know about the Diamond pet food recall? Some of the Chicken Soup dry foods were recalled.

The high numbers today were likely a result of what we call a bounce, and the lack of insulin the night before.

A bounce happens when a cat goes lower than their body is used to. Say before your cat was diagnosed, his numbers were in the 400-600 ranges. That became the body's "normal", even though that's not normal. So when you started giving insulin, his numbers dropped outside of that "normal" range. His body panicked, thinking he was going hypoglycemic, and dumped a bunch of hormonal hypo countermeasures into his bloodstream to "save" him, which will elevate his BG. It takes a few cycles for those bounces to clear.

Also, because Lantus works on a shed, when you skip a shot, it drains the shed and can make the next few days wonky. If you're finding he drops really low in the day and you can't give the PM shot due to low numbers, you need to reduce the dose so you can shoot consistently 12/12 and not keep skipping shots.

 

[ahzryn]

Re: Newly diagnosed, worried and frustrated

Ok, that actually makes sense. The vet said his numbers came down to normal during the curve, so you're probably dead on. When they bounce like that, what's the correct thing to do? Do you shoot them anyways even if it's low? I was afraid he'd hypo overnight.

And yes, I was aware of the recall, though our bags (dog or cat) were not involved thankfully.

 

[Blue]

Re: Newly diagnosed, worried and frustrated

I think my biggest suggestion would be to edit your first post to change you Subject to read something like "New diabetic, hyperT, and recent kidney issues, need help"

That way, you can catch the eyes of others who have additional health issues like your cat, and they can let you know what they did and are doing to treat everything.

 

[Julia & Bandit (GA)]

so one of the first things I did was pick up the dry and switch to 100% canned for everyone, 2x/day.

Removing the dry food can drastically reduce a cat's insulin needs, and sometimes even cause spontaneous remission. 1.5u is not a crazy high starting dose, but it is on the high side. It is likely too much insulin, especially now that you have removed the dry food. Most cats on a low carb canned diet do not need much more than 1u of insulin.

When cats go too low, their bodies respond by releasing glucose into their bloodstream and giving you very high numbers. This is what we call "bouncing."

I would lower the dose down to 1u or less, and continue your excellent job of testing!

Until you have enough data to support your decision to shoot, I would not shoot a number below 200.

See my comments at the end of this post for advice on a kidney and diabetic friendly diet. There are foods out there that are good for both conditions: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=69779&hilit=+crf

 

[ahzryn]

Ok, I got the numbers from the vet's office for his initial curve (kinda skinny curve, imho, wish I had tested more once I picked him up), and there are some more tracking numbers in there as well. I didn't see the post about taking the dose down to 1u until after I shot him last night, and dh had him shot this morning before I got the meter put away and the ss updated and got back into the kitchen.

I was able to arrange to work from home tomorrow, and I am home for the night now. Given the way his numbers look, should I try 1u tonight? .5u? I am not sure I'll get a full curve tonight, but I fully intend to spend tomorrow testing every 2 hours to try to get a handle on what's going on.