New member - Question on strange blood sugar readings

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Jcoasternut

Member Since 2022
One of my cats, Flame, had suddenly lost weight. February 9, 2022 he was diagnosed with diabetes and started on 1 unit of Prozinc twice a day. His glucose was 418 on that date. He had a glucose curve on February 17, 2022. The initial reading was 70 at 8:15am. At 9am it was 68. It went back to 71 at 10am. By 4:30pm it was 142.The vet then cut his insulin to 1 unit once daily.

On March 27, 2022. He was acting very strange and unable to walk without stumbling. Gave him sugar water and dry food. It was a Sunday afternoon. The next day, I held his insulin and was seen by a different vet at the same office. His blood sugar was in the high 400s. The flea preventive he is on has a component that is known to on occasion cause seizure type activity. She prescribed phenobarbital.

He had another glucose curve on March 30,2022. His initial three readings were 64, 62, and 69. By 4:30pm his reading was 125.
When he was first diagnosed the vet recommended I discontinue all dry food, which I did. After the second glucose curve his vet recommended discontinuing insulin totally. I suggested trying to allow him dry food once again to see if that made a difference, as he was fond of dry food.

On April 4, 2022 a Monday evening he became listless after acting fine all day. Once again thought of low blood sugar and gave sugar water. It made no difference. Just sleeping but alert when his name called. The next morning I took him in to the vets office as soon as they opened. He had 105 temp.

Vet suspected pancreatitis or a cancer as a cause of his issues particularly since his blood sugar was in the high 400s again. He spent Tuesday, Wednesday and Thursday on IV therapy at Vets office. He had many lab tests. Toxoplasmosis amoung other diseases was ruled out. Labs indicated possible pancreatitis. After the first day o IV therapy and an injection of dexamethasone he temp was 101. He spent the night at home as was almost back to normal. Following Wednesdays IV therapy he was initially ok. He didn't receive the steroid as vet said it masked symptoms and wanted to see how he would do overnight without it. By Thursday morning he was back to be as bad as at the beginning. He fever was once again 105. Thursday besides his IV therapy, he recived the steroid again. His fever was now 99. He was sent home with Prednisolone 5mg to give daily beginning the next morning. He returned Friday morning, his feved still 99 and he was eating and acting normal. He didn't stay. His blood sugar was in the high 400s.
Vet has recommended trying a novel protein diet for possible IBD as maybe he stomach is not absorbing enough nutrients and that is causing issue s stabilizing his blood sugar. Getting ready to start this. Vet said give insulin if he eating. I am very leery of giving the full one unit of Prozinc and wanted to try giving 1\2 unit. Although not a standard dose, I want to try it.
Any thoughts are welcome particularly on his wild blood sugar fluctuations on minimal insulin.
Also please note he had been on antibiotics for a month when he came down with fever. He had a urinary tract infection which is now cleared up.
 
99 degrees is a normal temperature for a cat (so is 101 for that matter). I have some questions: Has he been checked for ketones? Do you have bloodwork that you can share from his vet visits? I hope so. Was he put on antibiotics? Through the IV? Were you given any to continue at home? The high fever indicates infection and that puts him at risk of diabetic ketoacidosis. What was his BG when he was diagnosed and was there a fructosamine test done and what was the number? Also, when you first started insulin, did you first change hos diet before starting the insulin or did you do both at the same time? It is not recommended to do both at the same time. So e cats only need a switch away from high carb food (like kibble) in order to be a diet controlled diabetic- low carb food can lower their BG dramatically and that’s why we recommend only making one change at a time. Are you home testing. That’s very important to keep your kitty safe.
 
Honestly, nothing about your vets approach makes much sense..

A GI panel would help point to possible IBD or SCL. I would do that before wasting time and money on novel protein.

An infection is the likely cause of fever...my cat has had pancreatitis a few times and never a fever. No antibiotics? Steroid may help with any inflammation, but it is not the proper treatment for pancreatitis.

His blood sugar isn't well controlled because of the simultaneous diet change and I suspect he was very overdosed on insulin to begin with. additionally, an infection or other issues will raise BG significantly (into diabetic range) - so I have all the same questions as Suzanne about fructosamine, how he was diagnosed, etc. He may not even be diabetic but cannot say either way.
 
I agree about being overdosed initially with insulin— add that to a simultaneous diet change (which is what this sounds like) and it’s a dangerous situation.
 
How do I post a pdf of his lab work?
Flame was on convenia for two weeks for a urinary tract infection which was cultured for susceptiblity to antibiotics. After two weeks he was retested and still had infection. Another culture and sensitivity was done, his infection should have responded to convenia but didn't. He was then put on Zeniquin 25 mg daily for three weeks. Infection appeared to be gone, but another culture and sensitivity was done to verify. It was clear. He only stopped the Zeniquin the first day he had the 105 fever. I know 99 and 101 are normal temp but those are the temps that they got him down to have three days of IV therapy and steroids. The one day he received no steroids his fever went back up to 105. I will post labs when I figure out how. Supposedly GI labs were included in his lab work. Right now I have started him on Royal Canin Selected Protein dry and canned food.
So basically for over a month before the high fever he was on two different antibiotics. The past several weeks he has had access to all the dry food he wants to eat as well as canned. His sugar is in the 400s without insulin, but gets dangerously low when given one unit once per day of Prozinc. What has helped the most is the steroids for whatever reason, a tumor of some sort is a possibility. When I try to upload a pdf of labwork it tells me I do not have permission.
 
Zeniquin lowers the seizure threshold in cats. If the vet suspects seizures, I would stay away from that antibiotic in the future. I’m not against Zeniquin at all and have used it successfully in my cats, I just thought I would mention the lowering of the seizure threshold in your case though.
 
I believe this is what was in the ivs. Cobalamin/folate/TLI/PLi TAM.
He received Cerenia as well on those days. He also received buprenorphine daily.
He received a b12 injection once.
I am not doing home testing. I agree that it needs to start.
Right now he is doing great, butbI am afraid of the fever returning. The office I use has 6 vets and they have all been trying to figure out.
 
His ketones were negative.
Here are the lab values that weren't normal.
WBC 18.25
Neutrophils 14.61
Monocytes 0.80
Eosinophils 0.09
Glucose 438
Globulin 2.7

He also received clindamycin 150mg per ml 0.40 on two days just in case of toxoplasmosis. Toxo test came back negative on Friday.
 
What were the results for the cobalamin and folate tests? Was Flame having diarrhea/constipation or vomiting regularly? If not, I don't know why the vet thought IBD might be the issue. If not an issue, I don't think the Royal Canin foods will be helpful, and they are very high in carbs. In fact, most dry food is not appropriate for diabetes, if that's what he has. Which Select Protein are you giving, some flavours are higher carbs than others. There are also commercially available novel protein options, both lower carb and cheaper to buy.

Steroid shots can trigger diabetes.
 
They also did xrays which were negative for any obvious abnormalities. He is about 10. Tested negative for felv and fiv as well.
 
What were the results for the cobalamin and folate tests? Was Flame having diarrhea/constipation or vomiting regularly? If not, I don't know why the vet thought IBD might be the issue. If not an issue, I don't think the Royal Canin foods will be helpful, and they are very high in carbs. In fact, most dry food is not appropriate for diabetes, if that's what he has. Which Select Protein are you giving, some flavours are higher carbs than others. There are also commercially available novel protein options, both lower carb and cheaper to buy.

Steroid shots can trigger diabetes.
He was not vomiting nor did he have diarrhea or constipation. She thought maybe ibd had his gut so inflamed he wasn't absorbing nutrients well. His version is duck.
 
What were the results for the cobalamin and folate tests? Was Flame having diarrhea/constipation or vomiting regularly? If not, I don't know why the vet thought IBD might be the issue. If not an issue, I don't think the Royal Canin foods will be helpful, and they are very high in carbs. In fact, most dry food is not appropriate for diabetes, if that's what he has. Which Select Protein are you giving, some flavours are higher carbs than others. There are also commercially available novel protein options, both lower carb and cheaper to buy.

Steroid shots can trigger diabetes.
He wasn't on any steroids until this past week. As a matter of fact he had zero issues before February. He has lost about 1.5 pounds. He weighs 9.8 today.
 
I believe this is what was in the ivs. Cobalamin/folate/TLI/PLi TAM.
That sounds like the GI panel itself. What values are listed?

When did the original UTI start?

I'm not exactly convinced the steroid is the solution here. IBD/SCL take some time to respond to steroids, and wouldn't be causing a fever as far as I know. Steroids are known to suppress fevers but it's not solving the underlying issue. Bloodwork does seem to point to some sort of an infection/immune response.

FLUTD perhaps? Wendy and Suzanne will probably be much more helpful than I here.

If he is actually diabetic that is a big cause for weight loss, they do not process food fully/in the same way. But at this point I wouldn't trust a fructosamine either because he had the infection for so long.

How's his appetite?

My cat had a fever of unknown origin end of last year, so the vet prescribed a course of Veraflox and metronidazole to kind of cover the main bases. I'm not sure which worked, but one of them did.

I noticed the vet cut him to 1 unit once daily, gah. That's not...how ProZinc is prescribed (check the insert that comes with your vial, it's twice a day dosing 12 hrs apart). The better move would have been to reduce to something like 0.5U twice a day. So it course the second glucose curve yielded the same results - he was still getting the same dose, just once a day. He would go low, then without the second shot just climb right back up and stay high. The twice a day dropped him too much and he jumped back up because he bounced (liver panics, dumps glycogen and such to spike BG back up)

So, priorities:
I would start home testing a few times a day just to see where he's at.

I would get him on a low carb wet diet.
 
That sounds like the GI panel itself. What values are listed?

When did the original UTI start?

I'm not exactly convinced the steroid is the solution here. IBD/SCL take some time to respond to steroids, and wouldn't be causing a fever as far as I know. Steroids are known to suppress fevers but it's not solving the underlying issue. Bloodwork does seem to point to some sort of an infection/immune response.

FLUTD perhaps? Wendy and Suzanne will probably be much more helpful than I here.

If he is actually diabetic that is a big cause for weight loss, they do not process food fully/in the same way. But at this point I wouldn't trust a fructosamine either because he had the infection for so long.

How's his appetite?

My cat had a fever of unknown origin end of last year, so the vet prescribed a course of Veraflox and metronidazole to kind of cover the main bases. I'm not sure which worked, but one of them did.

I noticed the vet cut him to 1 unit once daily, gah. That's not...how ProZinc is prescribed (check the insert that comes with your vial, it's twice a day dosing 12 hrs apart). The better move would have been to reduce to something like 0.5U twice a day. So it course the second glucose curve yielded the same results - he was still getting the same dose, just once a day. He would go low, then without the second shot just climb right back up and stay high. The twice a day dropped him too much and he jumped back up because he bounced (liver panics, dumps glycogen and such to spike BG back up)

So, priorities:
I would start home testing a few times a day just to see where he's at.

I would get him on a low carb wet diet.

If that was the GI panel, I don't have the results.
His UTI was diagnosis February 9, 2022, the same day as diabetes.
His appetite when he isn't feverish is ok. Not as robust as several months ago, but adequate. He is playful and played with one my other cats all night as last which is a good indicator as he hadn't done that in at least a week.
 
If that was the GI panel, I don't have the results.
His UTI was diagnosis February 9, 2022, the same day as diabetes.
His appetite when he isn't feverish is ok. Not as robust as several months ago, but adequate. He is playful and played with one my other cats all night as last which is a good indicator as he hadn't done that in at least a week.
Ok. I am suspicious of the diabetes diagnosis then, since infections raise BG quite a bit. My cat for example - he's been in remission for quite some time, got that nasty infection I mentioned earlier, 200s and 300s, I did actually get a 400+ just didn't bother logging it. After a few days of antibiotics, back to normal.

So I think they key is figuring out what's really causing the issue. Unfortunately I don't know what the protocol is for insulin in this type of situation, hopefully Wendy has some ideas
 
I agree with all that has been said. First priority is diet - low carb food - next is home testing or to get a Libre sensor put on that you can scan. That will give you two weeks of data on him. Bloodwork indicates infection or inflammation. So that still needs to be addressed. Convenia, by the way, is not a very good antibiotic unless it’s for a skin infection (which is what it is approved for). Convenia also carries serious risks and once it’s been injected you cannot take it out (as you would stop an oral antibiotic if there was a negative reaction to it.)

Insulin is dosed every 12 hours and not once every 24 hours. When you restart after you have a way of tracking what the insulin is doing to his glucose, you will start with a small dose. It is quite possible that the wild swings in BG were caused by him dropping very low and his body compensating as a means of self-protection- this is what we call a bounce where his BG then goes very high.
 
If they suspect IBD, I am surprised that they haven’t suggested an abdominal ultrasound.

p.s. to all of this…. I hope your sweet Flame is going to be okay! I’m happy to hear that he’s playful and eats well (when there’s no fever.). You and he have been through a lot recently.
 
If they suspect IBD, I am surprised that they haven’t suggested an abdominal ultrasound.

p.s. to all of this…. I hope your sweet Flame is going to be okay! I’m happy to hear that he’s playful and eats well (when there’s no fever.). You and he have been through a lot recently.
Yes, it has been quite challenging. We have five cats. One has inoperable breast cancer. Another is FIV and has megacolon. Another has a seizure disorder, IBD, and last month had a skin tumor removed that was a maliginant adenocarcinoma. Another also was diagnosed as diabetic in December 2021. Flame was the only cat who had no issues. My spouse is a severe diabetic and has advanced Parkinson's disease. I am retired and trying to juggle all of this on my own. We have spent over 7000 in vet bills since September 2021. 2000 in the last week. I am in fair health, but have heart disease. I will turn 70 this year.
 
Yes, it has been quite challenging. We have five cats. One has inoperable breast cancer. Another is FIV and has megacolon. Another has a seizure disorder, IBD, and last month had a skin tumor removed that was a maliginant adenocarcinoma. Another also was diagnosed as diabetic in December 2021. Flame was the only cat who had no issues. My spouse is a severe diabetic and has advanced Parkinson's disease. I am retired and trying to juggle all of this on my own. We have spent over 7000 in vet bills since September 2021. 2000 in the last week. I am in fair health, but have heart disease. I will turn 70 this year.
They tried to refer us out to an out of town clinic hours away so he could have 24 hour care. There is no way with the other 4 cats and spouse and I will not take him somewhere and just abandon him. This was on the first day of his fever last week. Euthanasia was also hinted at.
 
He is one of three cats that in 2015, a neighbor 3 doors down moved off and abandoned. We already had two cats, but I couldn't stand them becoming feral and brought them inside. They are all sweethearts and I would do it again.
 
He is one of three cats that in 2015, a neighbor 3 doors down moved off and abandoned. We already had two cats, but I couldn't stand them becoming feral and brought them inside. They are all sweethearts and I would do it again.
Oh, I love hearing this. That’s just something I would do.
 
Yes, it has been quite challenging. We have five cats. One has inoperable breast cancer. Another is FIV and has megacolon. Another has a seizure disorder, IBD, and last month had a skin tumor removed that was a maliginant adenocarcinoma. Another also was diagnosed as diabetic in December 2021. Flame was the only cat who had no issues. My spouse is a severe diabetic and has advanced Parkinson's disease. I am retired and trying to juggle all of this on my own. We have spent over 7000 in vet bills since September 2021. 2000 in the last week. I am in fair health, but have heart disease. I will turn 70 this year.
Oh boy. My heart goes out to you! I understand having multiple cats with medical problems. Well, we are here to help and support you as much as we can. We care and we don’t want anything bad to happen to Flame (like a hypo event.)
 
May I ask you a question about your cat with breast cancer? How did you discover it and how was it diagnosed? I have a cat with a few swollen mammary glands. The vet thinks it’s from something left behind when she was spayed (which was back in 2018). I find it strange that there would be this long of a period of time between when she was spayed and when these mammary swellings appeared. She’s only five years old. She doesn’t behave as if she were under the influence of hormones at all.
 
She had a tumor removed about a year and a half ago that was in her abdominal area but not a breast. She was spayed before I got her from a shelter. She is almost 16. Despite watching for a possible reoccurance of her cancer, her breast cancer was not discovered until a six month check up. The vet said it was large enough to be considered in operable and at her age to have all of her mammary glands removed would be far too traumatic on her and probably wouldn't buy her anymore time. We are just monitoring her closely for any pain or other problems until it is time to let her go. She is the only female of the five cats and she is the sassy one and will quickly put the others in line if she thinks they are doing anything she doesn't like. Wish I could be of more help.
 
She had a tumor removed about a year and a half ago that was in her abdominal area but not a breast. She was spayed before I got her from a shelter. She is almost 16. Despite watching for a possible reoccurance of her cancer, her breast cancer was not discovered until a six month check up. The vet said it was large enough to be considered in operable and at her age to have all of her mammary glands removed would be far too traumatic on her and probably wouldn't buy her anymore time. We are just monitoring her closely for any pain or other problems until it is time to let her go. She is the only female of the five cats and she is the sassy one and will quickly put the others in line if she thinks they are doing anything she doesn't like. Wish I could be of more help.
Thank you for sharing this!
 
A new awful test result has comeback, it appears Flame may have FIP. The vet's office is not yet open. I have tried do some research. There is a treatment but not FDA approved. His FCV titers were positive at 1:400 and 1:1600 This would explain fevers and neurological symptoms. From what I gather most cats only live a few weeks before the need to be euthanized. Very devastated.
 
In addition to a member here on our board whose cat has recovered from FIP, I have a personal friend that I go to church with who has a kitty who also had FIP. She did the treatments and her cat is fully recovered. Please don't give up on Flame. By law, the vets are not allowed to tell you about this treatment because it is not FDA approved, some vets will hint at it and some will tell you to go to the Facebook group.

I know that my friend would be willing to talk with you. She, unfortunately, is having knee replacement surgery today. I can contact her in a few days.
 
Okay, here's the link to the member whose cat recently recovered from FIP. Her name is @Cindy loves Tansi

I have just tagged her above and hopefully she will reply. I do not know how much she is on the Board though since Tansi has been healed of FIP. He is no longer diabetic. It seems the FIP made him diabetic. I do know that those FIP Warriors 5.0 group (my friend said that is THE GROUP to join and not the others you see on FB) will help you though. That's what they're all about.
 
Here is a link to one of Cindy's last posts about her kitty Tansi after 12 weeks on the FIP treatment. There are a few more after it (like his OTJ party when he went "off the juice" officially.) If you do a search in the search box where it says "posted by member" and type in Cindy loves Tansi (well, a box with her name and kitty's photo will pop up and you click it) you should be able to find all of her posts.

I am so hoping that all this info will help. I'm supposed to be in the shower now! I've got to run my son to school and run some errands so I will be off the Board for a few hours, but you have lots of things to research now and get started (if you are going to be able to.) I will check in with you later. HUGS HUGS HUGS
 
Here is a link to one of Cindy's last posts about her kitty Tansi after 12 weeks on the FIP treatment. There are a few more after it (like his OTJ party when he went "off the juice" officially.) If you do a search in the search box where it says "posted by member" and type in Cindy loves Tansi (well, a box with her name and kitty's photo will pop up and you click it) you should be able to find all of her posts.

I am so hoping that all this info will help. I'm supposed to be in the shower now! I've got to run my son to school and run some errands so I will be off the Board for a few hours, but you have lots of things to research now and get started (if you are going to be able to.) I will check in with you later. HUGS HUGS HUGS
Thanks so much!!! You have been such a great help and a lifesaver!!
 
I have been approved for the FIP Warriors 5.0 Facebook group. My first post about Flame is pending review. I have read through some of cindy loves tanzi posts particularly those where she was first investigating the possible treatments at the beginning of Tanzi's FIP diagnosis. Once again thanks so much for your help. The vet Flame sees is off today. He has an appointment for 8am tomorrow. I am feeling so overwhelmed.
 
I have been approved for the FIP Warriors 5.0 Facebook group. My first post about Flame is pending review. I have read through some of cindy loves tanzi posts particularly those where she was first investigating the possible treatments at the beginning of Tanzi's FIP diagnosis. Once again thanks so much for your help. The vet Flame sees is off today. He has an appointment for 8am tomorrow. I am feeling so overwhelmed.
You can do this! I hope you will get support from your vet (although, as I said, they're not allowed to refer you for the treatment, but you can still tell him, when it is time, that you are investigating treatments for FIP on your own and that you plan to try to save Flame, etc.) I guess I mean that I hope he/she will be willing to give Flame any supportive care that he needs for now and that he will not try to recommend euthanasia at this point since you are trying to save Flame. Hugs to you, Cat Mama! You are wonderful!
 
Vet does not believe it is FIP. She thinks he has pancreatitis, ibd and diabetes. Right now going to try 1/2 unit of Prozinc twice a day. What meters do you recommend?
 
Vet does not believe it is FIP. She thinks he has pancreatitis, ibd and diabetes. Right now going to try 1/2 unit of Prozinc twice a day. What meters do you recommend?
Relion meters from Wal-Mart are reliable and inexpensive. You can get a lot of strips for a low price
 
Vet does not believe it is FIP. She thinks he has pancreatitis, ibd and diabetes. Right now going to try 1/2 unit of Prozinc twice a day. What meters do you recommend?
I also questioned the FIP diagnosis. It’s kind of a process of elimination- diagnosing FIP. But the vet should not say pancreatitis and IBD without at least doing an ultrasound or at the very least the Texas A&M GI Panel. What were the results of that? Do you have them? Didn’t they do that panel? Unless I am mixing you up with somebody else, we talked about this yesterday. Also, what about a specific test for pancreatitis (and not the snap rapid test) - the Spec fPL.
 
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