Hi,
I'm having problems with my goggle accounts, so may have to attach files for a while.
Xuxu (Xoom-Xoom, pronounced ZooZoo), is a 14 yr old, Bluepoint Birman neuter. He was a breeding male (Grand Champion!) until Aug when he was neutered. His blood work at that time was fine, liver enzymes just a smidge high but BG was right in the middle of normal. But a month later, he had gone from 10.5 pounds to 7.5. He was in a coma with DKA within hours of our realizing he was seriously ill. If my husband had not gone home at noon to check on him while I tried to get a vet appt, he would have been dead when we came home that night. We had another older cat with respiratory problems at the time, and I'm afraid we were paying more attention to him than to Xuxu. But Xuxu has our attention now. He was diagnosed with pancreatitis via Ultrasound, which also confirmed no cancer.
I posted his situation on the main Feline Health board under topic :Yoyoing Can't get him regulated. I'm using the AlphaTrak2 BG monitor. Xuxu was going off the scale at Hi and LOw, (<20 and >750). He would stay HI for days, then all of a sudden crash to 20. He nearly went into comas several times at both ends. After 2 months, we do seem to be getting a sort of handle on how he is reacting to Lantus (he was on R at first, then moved to NPH), although I don't think he can be considered regulated as yet.
We've had Xuxu on Orbax (antibiotic), famotodine (antacid for nausea), Tumil K (potassium supplement), cerenia (pain) and we are supplementing with 100 cc Ringer's Lactate fluid at night. Since he's never vomited or really shown signs of nausea, we've recently stopped the famotodine. It appears that his pancreatitis has calmed down substantially, and he doesn't appear to be in pain now, so we stopped the cerenia. He does appear to have a liver infection now (probably because of the high sugar for a while), and some kidney problems possibly starting. So we started a 2nd antibiotic, Zithromax concurrent with the Orbax, a OTC antioxident supplement with Vit E, and Denemarin for his liver. We also have him on mirtazapine which has really helped his appetite.
He was in such bad shape at first, we wanted to know if it was cancer. With the pancreatitis diagnosis, and recommendations that he could fight it off, we started trying to control his BG. But when his levels stayed high (750+), after 2 months we did another ultrasound to make sure we hadn't missed any cancer, or any infection. That's when we found the liver infection. He also has one kidney a bit large, and one a bit small, so we will need to start paying attention to that.
Both Xuxu and I are getting to know the effects of his BG levels. I can tell when he seems tired, and when he's bored because he's feeling better. He always knows when it's time for a test and a shot, and he lays down and stays still until I'm done. He has a specific cry that tells me when his BG is hi, and he will even wake me in the middle of the night to tell me.
We've made a lot of progress in the last 2 months, much with the help of members of this board. I've been on support groups for my own health problems, and so went looking immediately online for one when i found out Xuxu was DM. I'm so happy FDMB exits.
I know it's controversial, but I'll warn all and sundry that I am "diluting" the Lantus. When he was staying above 750 for days and started going into DKA again, I was ready to try something different. Our vet radiologist doing the ultrasound is a diabetic himself. He had seen situations where the insulin would just sit in a pocket under the skin and not be absorbed, especially with older cats with tough skin. He felt that is what was happening with Xuxu, so he stayed HI for days, then would all of a sudden crash when he became more active or we massaged him, thus releasing the reservoir of built up insulin at one time. So he suggested finding someway to dilute the Lantus and flush it out of a subq pocket to be absorbed. I tried a couple of methods, including drawing up a sterile fluid after the Lantu, separated by a bubble so the two don't mix in the syringe. (There is no problem injecting a bubble subq or even IM, it's only a problem with IV). What I've settled on is to inject the Lantus and leave the needle under the skin, pull out the plunger, shoot some sodium chloride solution in the syringe, replace the plunger and push it in. This gives the Lantus a few seconds to mingle with the body fluids before the 2nd solution flushes it out from the skin layer.
Yes, I know Lantus is not suppose to be diluted due to pH. At first we tried sterile water, which had a pH of 7, and it stung a lot when injected. But oddly, it didn't seem to negate the Lantus, his BG still went down on a normal curve. Since the sting hurt so much he tried to bite me, I looked for something else. So then we looked at sterile sodium chloride, which has a pH of about 4.5, much closer to the Lantus at 4.0, and it doesn't sting. That also seems to be working well over this past weekend. My vet gave me a whole drip bag of the sodium chloride which will probably last well past it's expiration date. Fortunately it's inexpensive and easy to get. The main reason I'm willing to stay on this dilution method is because Xuxu has gained half a pound in the last week that he's been on it and he seems to be feeling very good.
Xuxu was raised for 14 years on Iams dry food. We had to force feed him at first, but have recently gotten him on Fancy Feast Seafood Classics. I don't think he's thrilled about it, but he will eat it. We also put down Science Diet D/M dry. He finally started eating that as well. I think he likes that better than canned. But if we let him out of the bedroom, he makes a beeline for the Iams dish of the other cats. We have to watch him like a hawk, and try only to let him out when he's already eaten something.
So I'm going to do a curve with this method on New Years Day and will post his readings then.
I'll keep trying to get all the paperwork done and posted. and keep you up on his situation. I've read enough on this site and other places to still hope we can resolve his BG. Thanks in advance for all your responses, helpful suggestions, and most of all for sharing all your experiences.
DebH and Xuxu.
I'm having problems with my goggle accounts, so may have to attach files for a while.
Xuxu (Xoom-Xoom, pronounced ZooZoo), is a 14 yr old, Bluepoint Birman neuter. He was a breeding male (Grand Champion!) until Aug when he was neutered. His blood work at that time was fine, liver enzymes just a smidge high but BG was right in the middle of normal. But a month later, he had gone from 10.5 pounds to 7.5. He was in a coma with DKA within hours of our realizing he was seriously ill. If my husband had not gone home at noon to check on him while I tried to get a vet appt, he would have been dead when we came home that night. We had another older cat with respiratory problems at the time, and I'm afraid we were paying more attention to him than to Xuxu. But Xuxu has our attention now. He was diagnosed with pancreatitis via Ultrasound, which also confirmed no cancer.
I posted his situation on the main Feline Health board under topic :Yoyoing Can't get him regulated. I'm using the AlphaTrak2 BG monitor. Xuxu was going off the scale at Hi and LOw, (<20 and >750). He would stay HI for days, then all of a sudden crash to 20. He nearly went into comas several times at both ends. After 2 months, we do seem to be getting a sort of handle on how he is reacting to Lantus (he was on R at first, then moved to NPH), although I don't think he can be considered regulated as yet.
We've had Xuxu on Orbax (antibiotic), famotodine (antacid for nausea), Tumil K (potassium supplement), cerenia (pain) and we are supplementing with 100 cc Ringer's Lactate fluid at night. Since he's never vomited or really shown signs of nausea, we've recently stopped the famotodine. It appears that his pancreatitis has calmed down substantially, and he doesn't appear to be in pain now, so we stopped the cerenia. He does appear to have a liver infection now (probably because of the high sugar for a while), and some kidney problems possibly starting. So we started a 2nd antibiotic, Zithromax concurrent with the Orbax, a OTC antioxident supplement with Vit E, and Denemarin for his liver. We also have him on mirtazapine which has really helped his appetite.
He was in such bad shape at first, we wanted to know if it was cancer. With the pancreatitis diagnosis, and recommendations that he could fight it off, we started trying to control his BG. But when his levels stayed high (750+), after 2 months we did another ultrasound to make sure we hadn't missed any cancer, or any infection. That's when we found the liver infection. He also has one kidney a bit large, and one a bit small, so we will need to start paying attention to that.
Both Xuxu and I are getting to know the effects of his BG levels. I can tell when he seems tired, and when he's bored because he's feeling better. He always knows when it's time for a test and a shot, and he lays down and stays still until I'm done. He has a specific cry that tells me when his BG is hi, and he will even wake me in the middle of the night to tell me.
We've made a lot of progress in the last 2 months, much with the help of members of this board. I've been on support groups for my own health problems, and so went looking immediately online for one when i found out Xuxu was DM. I'm so happy FDMB exits.
I know it's controversial, but I'll warn all and sundry that I am "diluting" the Lantus. When he was staying above 750 for days and started going into DKA again, I was ready to try something different. Our vet radiologist doing the ultrasound is a diabetic himself. He had seen situations where the insulin would just sit in a pocket under the skin and not be absorbed, especially with older cats with tough skin. He felt that is what was happening with Xuxu, so he stayed HI for days, then would all of a sudden crash when he became more active or we massaged him, thus releasing the reservoir of built up insulin at one time. So he suggested finding someway to dilute the Lantus and flush it out of a subq pocket to be absorbed. I tried a couple of methods, including drawing up a sterile fluid after the Lantu, separated by a bubble so the two don't mix in the syringe. (There is no problem injecting a bubble subq or even IM, it's only a problem with IV). What I've settled on is to inject the Lantus and leave the needle under the skin, pull out the plunger, shoot some sodium chloride solution in the syringe, replace the plunger and push it in. This gives the Lantus a few seconds to mingle with the body fluids before the 2nd solution flushes it out from the skin layer.
Yes, I know Lantus is not suppose to be diluted due to pH. At first we tried sterile water, which had a pH of 7, and it stung a lot when injected. But oddly, it didn't seem to negate the Lantus, his BG still went down on a normal curve. Since the sting hurt so much he tried to bite me, I looked for something else. So then we looked at sterile sodium chloride, which has a pH of about 4.5, much closer to the Lantus at 4.0, and it doesn't sting. That also seems to be working well over this past weekend. My vet gave me a whole drip bag of the sodium chloride which will probably last well past it's expiration date. Fortunately it's inexpensive and easy to get. The main reason I'm willing to stay on this dilution method is because Xuxu has gained half a pound in the last week that he's been on it and he seems to be feeling very good.
Xuxu was raised for 14 years on Iams dry food. We had to force feed him at first, but have recently gotten him on Fancy Feast Seafood Classics. I don't think he's thrilled about it, but he will eat it. We also put down Science Diet D/M dry. He finally started eating that as well. I think he likes that better than canned. But if we let him out of the bedroom, he makes a beeline for the Iams dish of the other cats. We have to watch him like a hawk, and try only to let him out when he's already eaten something.
So I'm going to do a curve with this method on New Years Day and will post his readings then.
I'll keep trying to get all the paperwork done and posted. and keep you up on his situation. I've read enough on this site and other places to still hope we can resolve his BG. Thanks in advance for all your responses, helpful suggestions, and most of all for sharing all your experiences.
DebH and Xuxu.
