Hi, I'm Michelle, Oudi is my sugarboy, diagnosed back in 15/10/24. We live in Malaysia. Here's some info on his condition, my apologies because the post is lengthy as he has other concurrent issues.
During his first vet visit on 15/10 due to his PU/PD/ravenous of food and weight loss, CBC/Bio chem/proBnP/fPL2/heart UT/TT4/Electrolytes were done to check his overall health status. Belows are some important indications:
Glucose 497 mg/dL
ProBnP 179.3 pmol/L
Heart UT/Echo Mitral valve insufficiency
fPL2 5.5 ng/mL
TT4 normal
BP normal
From the tests, vet started insulin, 0.11ml glargine and diamel for diabetes, IV fluids and meloxicam for pancreatitis. Vet's plan was to control Oudi's diabetes first and will address his heart issues later. He was then sent home for monitoring. After 3 days, he was hospitalized due to my incompetency to monitor his BG at home. 7 days of hospitalized to get his BG curve and he was discharged on 25/10, sent home medications were diamel and meloxicam, and insulin 0.4ml BID. His fPL2 was 4.5 ng/mL, showing improvement in pancreatitis.
About the dosing of insulin, from the reading in feline diabetes fb group, I found that members are talking about u100 or u40 syringes and everyone is measuring the insulin in units. I was confused, hence I got back to my vet and asked about this, she said they are following the instructions from supplier in the preparation of insulin. I trust my vet, and Oudi was doing ok, no hypo, PU/PD improved significantly, appetite ok. She then told me 0.4ml = 2iu. For the time being, I stick to the treatment plan.
Follow up one week after hospitalization, fPL2 up to 7.6 ng/mL. Vet thought Oudi might not be responding to meloxicam, hence fentanyl patch was used for his pain management. The next follow up was a week later, his fPL2 shoot up to 9.6 ng/mL, and this round Oudi was prescribed tramadol. I monitored closely for any adverse effects, the first 3 days was ok. The fourth day after tramadol, Oudi lost his appetite, he only ate some. I was not sure whether he was in pain or nauseous. The next day, I noticed he had increased breathing rate and he was lethargic.
Sent him to vet the next morning, he was hospitalized for 3 days, blood test/ProBnP/x-ray was done. ProBnP was 384.2pmol/L. X-ray showed pleural effusion, echo showed enlarged, thickening ventricle wall and enlarged atrium indicating hypertrophic cardiomyopathy causing congestive heart failure. Thoracocentesis was performed and removed 175ml of fluids, and 50ml fluids the next day.
After 3 days of hospitalization, he was sent home with pimobendan, clopidogrel and furosemide for CHF. His fPL2 sky-rocketed to 13.6 ng/mL this round. Vet stopped tramadol and prescribed budesonide for the pancreatitis. As budesonide can interfere with insulin sensitivity, hence his routine for the last 3 days was 0.35ml/0.15ml/0.35ml/0.15ml to see how the BG reacted, and the reading was not good, his numbers were +/-200mg/dL in nadir and +/-500mg/dL or HI preshot.
For now, I confirmed that the glargine is diluted. Vet told me it is diluted in "special solution" to 5 units/ml. My dilemma now is I want to give Oudi undiluted glargine, and I actually has scheduled an appointment with another vet last week before his CHF episode. But due to his hospitalization I had to cancel the appointment.
Should I stick to the current vet treatment plan or it's better for me to seek second opinion? The diluted glargine is very expensive, and for the past one month I'm both mentally and financially stressed. Oudi's medical costs are very high. I would like to hear inputs from the experienced members here, be it regarding diabetes, pancreatitis or CHF. A member in fb group suggested "animal essentials plant enzyme & probiotics" for his pancreatitis flare up, anyone has luck with it?
Thanks in advance and sorry again for the long post!
During his first vet visit on 15/10 due to his PU/PD/ravenous of food and weight loss, CBC/Bio chem/proBnP/fPL2/heart UT/TT4/Electrolytes were done to check his overall health status. Belows are some important indications:
Glucose 497 mg/dL
ProBnP 179.3 pmol/L
Heart UT/Echo Mitral valve insufficiency
fPL2 5.5 ng/mL
TT4 normal
BP normal
From the tests, vet started insulin, 0.11ml glargine and diamel for diabetes, IV fluids and meloxicam for pancreatitis. Vet's plan was to control Oudi's diabetes first and will address his heart issues later. He was then sent home for monitoring. After 3 days, he was hospitalized due to my incompetency to monitor his BG at home. 7 days of hospitalized to get his BG curve and he was discharged on 25/10, sent home medications were diamel and meloxicam, and insulin 0.4ml BID. His fPL2 was 4.5 ng/mL, showing improvement in pancreatitis.
About the dosing of insulin, from the reading in feline diabetes fb group, I found that members are talking about u100 or u40 syringes and everyone is measuring the insulin in units. I was confused, hence I got back to my vet and asked about this, she said they are following the instructions from supplier in the preparation of insulin. I trust my vet, and Oudi was doing ok, no hypo, PU/PD improved significantly, appetite ok. She then told me 0.4ml = 2iu. For the time being, I stick to the treatment plan.
Follow up one week after hospitalization, fPL2 up to 7.6 ng/mL. Vet thought Oudi might not be responding to meloxicam, hence fentanyl patch was used for his pain management. The next follow up was a week later, his fPL2 shoot up to 9.6 ng/mL, and this round Oudi was prescribed tramadol. I monitored closely for any adverse effects, the first 3 days was ok. The fourth day after tramadol, Oudi lost his appetite, he only ate some. I was not sure whether he was in pain or nauseous. The next day, I noticed he had increased breathing rate and he was lethargic.
Sent him to vet the next morning, he was hospitalized for 3 days, blood test/ProBnP/x-ray was done. ProBnP was 384.2pmol/L. X-ray showed pleural effusion, echo showed enlarged, thickening ventricle wall and enlarged atrium indicating hypertrophic cardiomyopathy causing congestive heart failure. Thoracocentesis was performed and removed 175ml of fluids, and 50ml fluids the next day.
After 3 days of hospitalization, he was sent home with pimobendan, clopidogrel and furosemide for CHF. His fPL2 sky-rocketed to 13.6 ng/mL this round. Vet stopped tramadol and prescribed budesonide for the pancreatitis. As budesonide can interfere with insulin sensitivity, hence his routine for the last 3 days was 0.35ml/0.15ml/0.35ml/0.15ml to see how the BG reacted, and the reading was not good, his numbers were +/-200mg/dL in nadir and +/-500mg/dL or HI preshot.
For now, I confirmed that the glargine is diluted. Vet told me it is diluted in "special solution" to 5 units/ml. My dilemma now is I want to give Oudi undiluted glargine, and I actually has scheduled an appointment with another vet last week before his CHF episode. But due to his hospitalization I had to cancel the appointment.
Should I stick to the current vet treatment plan or it's better for me to seek second opinion? The diluted glargine is very expensive, and for the past one month I'm both mentally and financially stressed. Oudi's medical costs are very high. I would like to hear inputs from the experienced members here, be it regarding diabetes, pancreatitis or CHF. A member in fb group suggested "animal essentials plant enzyme & probiotics" for his pancreatitis flare up, anyone has luck with it?
Thanks in advance and sorry again for the long post!
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