New Member - testing low to normal without insulin intervention

[Carla Mary]

Hi all!
My Cat (named Cat) was diagnosed with diabetes this past Wednesday. She became critical on Monday evening with vomiting and lethargy and was unable to stand correctly or coordinate her movements to get to the bathroom and stopped eating and drinking. I took her to the vet the following morning and they took blood and gave her fluids, an antibiotic, and an appetite stimulant.
Upon taking her home she improved a bit and started drinking water but throughout the night did very badly with the same symptoms as well as twitching and seizures. However, by Wednesday at 4 am she perked up and started eating and drinking. Now basically back to normal. Her vet called to confirm that she had a blood sugar greater than 400 and was indeed diabetic. He suggested that if I was comfortable to start to test at home and get Novolin N insulin.
I purchased a Contour next meter and the insulin and started a blood glucose curve. My big concern is that she seems to be testing in the normal range or a bit low - so I have not given her insulin. I started testing her Wednesday night around 5:00 pm (location is NY U.S.A.) with her sugar being 80 and tested every 2 hours with it steady going down, this is even after she ate. I was only able to get 2 readings Thursday as I have a hard time getting enough blood from her paws or her ears, and she doesn't tolerate me sticking her more than twice. However, the readings were normal at 73 and 57 (I think these are normal from what I read).
She is not acting ill other than she seems to be constantly famished and begs for food. I am feeding her Fancy Feast classic pates, chicken, and beef flavor and give her plain boiled chicken snacks in-between cans. She has gained some weight back after being very underweight but is still on the lighter side.
Is it possible she is in remission? I called her vet but he is in surgery until Monday.

 

[Carla Mary]

I also did an at-home Ketone urine test, and it showed "trace" amounts of glucose in her urine. Any ideas would be greatly appreciated as I keep having anxiety that I am not doing the right thing by not giving her insulin. Thanks in advance.

 

[JaxBenji]

Hi! Yes, those numbers sound normal - I was told normal range is 50-120 (though, ideally less than 100) on human meter 70-150 on pet meter. Any chance you could test her before she eats breakfast (or dinner) and then test her 2-3 hours after she has her meal? This would also show us if her pancreas is working (though with the numbers you've cited, sounds like it is!).

It would be ideal if you could plug her numbers into a spreadsheet (breakfast and dinner would be 12 hours apart at the AMPS/PMPS cells and then every cell after that would be the offset from breakfast or dinner...so if you fed breakfast at 7 AM, 8 AM would be your +1, 9 AM would be your +2, etc.). Check out these instructions - HOW TO CREATE A SPREADSHEET

As for feeding, when are you feeding? Kitties do best with several meals/snacks a day - I fed Jax a larger meal at breakfast/dinner and then snacks at +2 hours, +4 hours, +6 hours from his meal (every cat is different! and I used an auto-feeder...and Jax was actually on insulin but still the frequent/smaller meals are a good idea). If she needs to gain weight, perhaps add another snack or two. FWIW, I fed Jax the same amount of food in the AM and in the PM (but again he was on insulin and at his ideal weight).

If, for some reason, you need to start insulin in the future, Novolin is not an ideal choice; the (2018) AAHA Diabetes Management Guidelines for Dogs and Cats recommends using Lantus or Prozinc to manage feline diabetes - could be worth the discussion with your vet should Cat need insulin in the future (click that link for the paper).

"trace" amounts of glucose in her urine

Excellent job testing for ketones! It is my understanding, trace is a concern only if there are accompanying symptoms. Above trace is a concern even without accompanying symptoms. More info here - Ketones, Ketoacidosis, and Diabetic Cats: A Primer on Ketones

Hope that helps a little bit

 

[Carla Mary]

Thank you both! I try to test her before dinner and 2 and 4 hours after she eats and I go to bed. I am feeding her 1 can of Fancy Feast classic at 8 AM and another at 6 pm. My roommate also gives her plain, boiled, cubed chicken as a snack throughout the day. She doesn't get more than 2 oz of the chicken. I think I am going to start to look into timed food dispensers as one of my jobs entails 12-hour shifts. I am very lucky to have a great roommate that can keep an eye on her!

I am glad these are normal readings, I have done a lot of reading on it and I thought they were, but it is so nice to have someone else confirm it so I have a little peace of mind!

 

[Dyana]

I would do another ketone test this evening, and twice a day for a couple of days. The not eating, lethargy, and throwing up recently concerns me with trace ketones in the mix. Also, just to be sure, try testing your own BG to check the meter.

 

[Sienne and Gabby (GA)]

I would keep an eye on your kitty. If. you see some of the same symptoms, please get a test. You want to be sure that what you were seeing wasn't the result of your cat pumping out her naturally occuring insulin in a large enough amount to cause her blood glucose levels to drop low. Should that be the case, use honey or corn syrup that you can rub on her gums or you can add it to food if she'll eat. It will bring her levels back up. If it happens, call your vet.