New user hello & remission question

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CEllse

Member Since 2013
Hello!

I'm an owner of a 10 year old male kitty named Smokey that had been in remission from diabetes for 3 years – we just found out last week that unfortunately his diabetes is back. I was pretty devastated at first, but now am trying to be proactive to seeing what I can do to maybe get him back into remission again.

The first time around I can't remember for certain, but I think it was only a few months of having him on insulin before we had him in remission. During this time we switched both our kitties (two males) over to wet canned food only, and I'm very strict about only using food with no/low carbs (usually stick with Fancy Feast classic chicken, liver, or salmon). The only thing I can think of that maybe would've provoked him from coming out of remission is that sometimes when I'd work from home, the two of them would cry and beg for food and eventually I'd give in... so the last few months they've been getting some extra food during the day. I realize now I should've been more strict about only giving them their breakfast and dinner with nothing in between to keep him regulated... I can't help but think that maybe this is way the diabetes came back (if I was unintentionally increasing his blood glucose levels too frequently)?

Anyways, our Smokey was on PZI before but we can't get it now (it's off the market for vet use, I guess?) so we're using Lantus glargine. He hasn't been on it even for a full week yet, but I've been in frequent contact with our vet and let her know how proactive we are and have experience home testing and were anxious to start up again. We did a small BG curve today to see how his numbers were responding and it looks like we have to bump him up to 2 units twice a day (he's starting out at 1.5 units twice a day).

My question is, if you're already following the wet food only, no/low carb diet – how likely is it that you can get your cat into remission a 2nd time? I asked my vet even though I know that answer... you just never know, but I was wondering if anyone on here had experience getting their cat into remission again?

Many thanks for reading! Any advice/feedback is so appreciated.
Colleen
 
Just wanted to say welcome Colleen. There are a lot of experienced folks here to help out. I'm not one of them yet. Ive had a sugar cat for about a year and a half and for most of that time I did not home test. I was lucky that I did not harm my cat!!! Home testing is going to be the first thing you need learn to do. And I just wanted to let you know that I use PZI (Prozinc) and have no problem getting it from my vet.
I know someone will be along shortly to answer all your questions.
Nice to meet ya
Terriy
 
Lantus is a great insulin for cats, although I am a bit biased because that's what Mikey is on. ;-)

As to a second remission, the chances of it happening do decrease, but it is still possible. Some cats are also transient diabetics, meaning they can fall in and out of remission. There can also be other factors at play that can cause temporary or prolonged hyperglycemia, such as dental issues, infections, and steroids. If there are no other underlying problems, then it's pretty much a "wait and see" on whether or not Smokey can achieve remission a second time. You've already got him on good food and good insulin; now it's just a matter of getting him regulated to help spur his pancreas back into action, hopefully to the point of where he no longer needs insulin. :-D
 
With regard to the feeding: I really think it is more beneficial to feed several times throughout the day to keep blood glucose levels steady.
 
CEllse said:
...We did a small BG curve today to see how his numbers were responding and it looks like we have to bump him up to 2 units twice a day (he's starting out at 1.5 units twice a day)....
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Hi...sorry I didn't introduce myself in my previous comment. I'm Kat and Gobbles is my 11 year old sugar-cat-in-remission. He's a gorgeous gray tabby and my VBFF (very best fur friend). Anyways, 1.5 units may be a somewhat high starting dose for Lantus if your cat is normally an "average size" cat. What should your cat's ideal weight be? Lantus dosing is based on the cat's ideal weight.

Here's the formula for a starting dose of Lantus: The formula is initial dose = 0.25 x ideal weight in kilograms. For example, a healthy weight of 10 pounds would be a starting dose of 1 unit every 12 hours.

And a 1/2 unit increase can be dangerous. Really. Insulin increases are based on the cat's nadir (lowest point in the insulin cycle--usually 5 to 7 hours after a shot). I'm not trying to scare you, but you do not want your cat to go hypo. And it can take longer than a week to see if the current dose is working. I know it is hard to be patient, but you want to keep him safe. You'll do great. We are all here to help you.

And please understand: I'm not berating your vet, to be sure. A lot of us here eat, drink and sleep FD and have tons of combined experience. Hang in there :) and please ask, ask, ask away--ANY questions you may have.
 
Hi Colleen and Smokey! Welcome to the FDMB message board. My name is Deb and my sugarhunk is Wink. He has been OTJ for 3 months now and I'm hoping to keep him there longer.

My question is, if you're already following the wet food only, no/low carb diet – how likely is it that you can get your cat into remission a 2nd time? I asked my vet even though I know that answer... you just never know, but I was wondering if anyone on here had experience getting their cat into remission again?
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There are no statistics or studies that I know of that show second remission rates.

I do know you need to be more aggressive with your dose changes and not hold the same dose for too long. The longer acting insulins like Glargine (lantus) or Levimir are better for a second remission attempt.

Did you set up a google spreadsheet here last time for Smokey?

Would you be willing to do that to provide us with some BG numbers?
 
Hello there!

I agree with everything said above but I would be looking for a cause for his falling out of remission. Given you have been diligent about the classic fancy feasts I am wondering about another cause

1. how are his teeth? No dental issues?
2. any sign of a urinary tract infection? or ear infection
3. has he been on steroids recently?
4. no way he can be getting into contraband dry? or dry treats or anything?


Wendy
 
Hello Colleen!

Welcome! My name is Sophie & my DM kitty Is Pudge. I wonder if a contributing factor to Smokey's coming out of remission was eating only twice a day. Perhaps, his pancreas finally said 'enough or too much food at a time.' We may never know, but as Kat wrote small meals several times a day are best for diabetic kitties - in remission or not. My Pudge recently went into his 2nd remission. First one was on ProZinc, 2nd on Levemir (I switched because I was out of ProZinc but had Levemir flexpens available). I believe that ProZinc is available but don't know about PZI. In my opinion, if eating only twice a day contributed to his falling out of remission, then, that's something to hang your hope on for a 2nd remission which I wish for Smokey with all my heart. My Pudge fell out of remission due to a terrible diarrhea & my feeding him dry kitten food once he refused everything else.
Best wishes, Sophie
 
Hello everyone!

I'm so sorry, I didn't even realize anyone had responded! I thought I had signed up to be notified once I got a response, but I guess that didn't work...

Anyways, Smokey is doing okay but I've been a little more frustrated this time around trying to get him regulated. I think the first time we found out he had diabetes, he got regulated more quickly and I think was in remission in just a matter of months. I'm not sure if it was because back then he wasn't on the right food and once we changed his diet it helped him quickly, or maybe it was because he was on PZI, or maybe a combination of both.

Previously we were doing small meals throughout the day but just recently switched to putting down only breakfast and dinner, although he's getting 2 cans at both (which in the end is the same amount that he would get before, just spaced out). He cannot eat it all at once, so he ends up grazing for the few hours after we put the food down and for the most part seems to be doing better (not constantly asking for food like before.. but then again, he wasn't on insulin before). I read somewhere that depending on the type of insulin your cat is on, will determine if having 2 meals a day vs. grazing all day is best for them (long acting/short acting). The 2 vets that I've worked with (one of which was amazing and helped us get Smokey into remission before) said that the 2 meals a day is better for his blood sugar levels.

This time around (getting diabetes again after remission of 3 years), he's on Lantus (*my vet assured me that PZI was off the market...) and his numbers have been high. We do home test and have done several curves but some days Smokey tries his best to deal with us pricking his ear, and then other times he runs under the bed and refuses to do anymore... so we're going to have to start keeping him on the first floor from now on during a curve. The first curve we did was 363 (before breakfast and insulin at 5:45 am), 367 (8:15 am), 309 (10 am), 320 (12:20 pm)... I called the vet that day and she told me since he was already on the incline to not keep testing him, since she mainly wanted to see how long the insulin was lasting. The other few numbers we've been able to get are mostly the same (Smokey has yet to go under 300). Doing curves this month is really tricky because my husband is adjunct faculty at a college and for the month of July picks up a bunch of summer courses and works 6 days a week, and there is no way I can do a curve without him... so this month has been frustrating to say the least. My vet did say if we're able to try doing a single blood check, to check at a previous time when he was lowest and he was able to be at 300 at 12:45 pm (which was a little better than before).

I'm glad to read everyone asking about health issues because I called the vet this week (*I feel like I call the vet every week! I'm sure they think I'm crazy) about his urinating habits; it almost seems like it had increased and the cat box has smelled horrible, and it turns out his white blood cell count was high so he just went on antibiotics this week for a UTI (which I do remember him having when he initially had diabetes 3 years ago). His teeth are good although the vet does want us to brush them because the wet food only is affecting his gums a bit (although my other cat's gums need it more). We got those little baby silicone finger brushes, thinking they'd be better, but they still seem huge for their little mouths. Does anyone know if you should use cat toothpaste when doing that? I was worried with Smokey's strict diet about what was in it and figured for now at least brushing his teeth (without cat toothpaste) to remove plaque and tarter is better than nothing. Other than that, he's in good health. No steroids at all, and I've been crazy about making sure he only gets Fancy Feast Classic (chicken or salmon, usually) and doesn't have access to any other food. Since he's been on the antibiotics this week, we're going to try and do a curve this Saturday (my husband's next day off) and we've got our fingers crossed for better numbers (she said the UTI could have been affecting his consistently high numbers).

Quick question for you all: not sure if anyone lives in MA, but we're suppose to go away with my entire family in August and I can't seem to find anyone that I trust to watch our cats and give Smokey his shots. Yes, I could easily just find someone online but I'm really skittish of having a stranger in our home or relying on them to give his shots at the right times (6 am and 6 pm). I'm contemplating not even going away with my family, but I know that it would break my heart and my family's. Any advice? I've yet to call the vet and ask for their recommendations although I know I need to do that. I guess I'm just overall skittish to leave Smokey for a week with him on insulin and not regulated yet.

Thank you all for your thoughtful and kind replies! It is SO wonderful to have people understand your stress and worry over your cat. I've had a few friends that I've tried confiding in about the whole situation give me the craziest looks (a few said things that I was shocked about) and I'm glad you guys have been there too.
 
It's likely the UTI caused him to slip out of remission, and not your feeding schedule. Infection and/or pain increases BG and can cause the cat to come out of remission, and it's very important that you're monitoring him closely and adjusting the dose frequently because it's likely that once the antibiotic clears the infection, he's going to go right back into remission. Bandit needed insulin in 2011 for about a month because he had dental surgery; once everything was healed up he went right back into remission. How frequently are you testing? With Lantus, you want to get at least 3 tests a day--once before each shot to make sure it's safe to give insulin, and then a test about halfway through one of the cycles to see how the insulin is affecting his blood sugar.

I am going to disagree with your vet on the twice daily feedings, though. Diabetic cats do best with more frequent feedings (Bandit eats at least 4 small meals a day). Cats' metabolisms are twice as fast as people and dogs, so they really need to eat about twice as often, but in smaller meals. This is especially true for diabetics because they need to minimize the impact of food on their blood sugar--that's why they tell human diabetics to eat several small meals a day rather than one or two big meals. It's the same for cats, except it's even more important that they eat frequent meals because of their faster metabolisms. Feeding frequent, more regular meals creates less dramatic spikes and drops in blood sugar and help with regulation.
 
Check with your local church, high school, and youth groups (4H, Scouts, etc) for someone interested in veterinary medicine who would like to learn about the care and management of feline diabetes. You'll train the person (might be good to have some backups) before you go and then hire them to care while you're away. Do it like a job - check the references!

You might also see what a vet tech from your vet's office or other vet offices nearby would charge.

Boarding is an option if they will follow instructions on giving insulin and will test.
 
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Yep it was probably the UTI that caused the remission lapse. Sooner you get that cleared up the better. I also prefer mini meals through the day as I think big meals tax the pancreas too much.

Also you might want to set up a spreadsheet, update your signature and then start posting on the tight regulation board ASAP. Second time around its a LOT harder to get the cat into remission and a lot less likely so you need to be more aggressive. They will be able to help you over there with dose and its a great sense of community!

- How to do a spreadsheet http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
- Update your signature - add the insulin, dose, food you are feeding, and key dates ie date of diagnosis followed by the remission dates / the date he fell out of remission
- Tight regulation board http://www.felinediabetes.com/FDMB/viewforum.php?f=9


Wendy
 
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