Renee2602
Member Since 2024
Spreadsheet:
https://docs.google.com/spreadsheet...41YVIvwAJVc5kyPgVZuuM6FeotXSRJ#gid=1303057560
Brief backstory: Pancreatitis, 11 years old from Melbourne Aus, 3 months into palliative care for a large pituitary adenoma, diabetes started once we increased prednisolone for brain inflammation.
Hi all. We have now increased Oscar's insulin toujeo from 5 units once daily to 3 units twice daily as of today. His internal medicine specialist has just informed us he will be away for the next month, which has us really anxious as we honestly don't know what position we will be in in a months time, given things are changing so rapidly in palliative care and we know he has declined a bit recently. We will still have the support from the other members in the internal medicine team but they don't know Oscar like our specialist does, and when they said over the phone 'it would take hours to read up on his history so we had a brief look' and didn't know how to answer my questions on cabergoline, it made me feel deflated. I've cried to Oscar's specialist several times, and he always brings me back to the big picture - is he eating, drinking, using the litterbox okay? And that has helped. He's never made me feel crazy for all my calls and questions and we check in every 3 days or so, so I'm just feeling a bit lost at the moment with him on leave for so long. Our local vet has told us we need to start considering quality of life since his vision loss has progressed and we are still trying to get the diabetes under control.
So an update and looking for advice please. We have just now switched from 5 units once daily to 3 units twice daily of toujeo, we do it with a solostar pen. He got his Libre off so we have no way to test him at home currently - this decision was made based on trying to maintain his quality of life with all the stress of poking and prodding at the moment. I have ordered a freestyle lite glucometer just in case though if we need to check urgently. Since he has never been low or even in normal range we are monitoring using ketodiastix, which have never showed anything below 3+ at all. We will likely look at getting another Libre placed but are trying to reduce the amount of vet visits for his stress, and want to give the skin time to heal before placing it in the same spot and we REALLY want to avoid shaving his other side.
How quickly would a cat adjust to going from 5 units once daily to 3 but twice daily with a glargine? I can tell he's struggling more tonight - urinating even more, sleeping next to his water fountain so he can keep drinking, much hungrier tonight, less comfortable. Both his urine sample before and after his second dose tonight came back 4+ glucose. Will it likely take a few days or are we risking things being to low a dose for him?
I'm also not sure if we are having issues with the solostar pen. My mum does the injections and we have not felt any wet fur and I didn't think I could smell insulin...until I realised what the insulin smells like and I have been smelling it all over his fur recently when I sniff him. When I pat him, my hand will be slightly sticky and smell like insulin. But as I said we don't feel any wet fur and the smell and sticky is still there even 12 hours after his injection. We thought we were injecting correctly but now we are worried. He also does whimper for a sec when the injection is done, I don't know if he's just gotten hypersensitive or if we should be concerned. My mum swears she is doing it in the skin of the scruff not the muscle.
Finally, the cabergoline arrived today. We aren't starting it for a few days since we just changed the insulin and don't want to change too many factors all at once. I did put it on some of his food to see if he would accept the taste and he didn't hate it but I'm not sure if he will regularly eat his food with it either, so I'm a bit nervous. We got it compounded chicken flavour but it doesn't smell very chicken-y. We add it to his plain chicken as he can't have any wet food due to his pancreatitis and ibd, so I don't know if there's any possible way to mask it. We really can't be forcing more medications down him at the moment. At the moment we are also starting on 0.7ml where 100mcg = 1ml, 48 hours dosing...I know daily has been more effective but with our specialist on leave I'm not sure what the plan was for increasing frequency. We don't exactly have the time to wait and see but with his history of GI issues I also don't want to trigger that and am quite nervous at the moment.
Other questions I have:
- Is a cat considered in DKA if a urine test comes back as 1+ for ketones?
- Will a cat with diabetes keep losing weight until the diabetes is completely stable or does weight loss usually only happen in the ketone stage where they have no insulin yet?
-Will liver values in a cat keep being concerning if their glucose is high but they are receiving insulin and negative for ketones?
Thank you
https://docs.google.com/spreadsheet...41YVIvwAJVc5kyPgVZuuM6FeotXSRJ#gid=1303057560
Brief backstory: Pancreatitis, 11 years old from Melbourne Aus, 3 months into palliative care for a large pituitary adenoma, diabetes started once we increased prednisolone for brain inflammation.
Hi all. We have now increased Oscar's insulin toujeo from 5 units once daily to 3 units twice daily as of today. His internal medicine specialist has just informed us he will be away for the next month, which has us really anxious as we honestly don't know what position we will be in in a months time, given things are changing so rapidly in palliative care and we know he has declined a bit recently. We will still have the support from the other members in the internal medicine team but they don't know Oscar like our specialist does, and when they said over the phone 'it would take hours to read up on his history so we had a brief look' and didn't know how to answer my questions on cabergoline, it made me feel deflated. I've cried to Oscar's specialist several times, and he always brings me back to the big picture - is he eating, drinking, using the litterbox okay? And that has helped. He's never made me feel crazy for all my calls and questions and we check in every 3 days or so, so I'm just feeling a bit lost at the moment with him on leave for so long. Our local vet has told us we need to start considering quality of life since his vision loss has progressed and we are still trying to get the diabetes under control.
So an update and looking for advice please. We have just now switched from 5 units once daily to 3 units twice daily of toujeo, we do it with a solostar pen. He got his Libre off so we have no way to test him at home currently - this decision was made based on trying to maintain his quality of life with all the stress of poking and prodding at the moment. I have ordered a freestyle lite glucometer just in case though if we need to check urgently. Since he has never been low or even in normal range we are monitoring using ketodiastix, which have never showed anything below 3+ at all. We will likely look at getting another Libre placed but are trying to reduce the amount of vet visits for his stress, and want to give the skin time to heal before placing it in the same spot and we REALLY want to avoid shaving his other side.
How quickly would a cat adjust to going from 5 units once daily to 3 but twice daily with a glargine? I can tell he's struggling more tonight - urinating even more, sleeping next to his water fountain so he can keep drinking, much hungrier tonight, less comfortable. Both his urine sample before and after his second dose tonight came back 4+ glucose. Will it likely take a few days or are we risking things being to low a dose for him?
I'm also not sure if we are having issues with the solostar pen. My mum does the injections and we have not felt any wet fur and I didn't think I could smell insulin...until I realised what the insulin smells like and I have been smelling it all over his fur recently when I sniff him. When I pat him, my hand will be slightly sticky and smell like insulin. But as I said we don't feel any wet fur and the smell and sticky is still there even 12 hours after his injection. We thought we were injecting correctly but now we are worried. He also does whimper for a sec when the injection is done, I don't know if he's just gotten hypersensitive or if we should be concerned. My mum swears she is doing it in the skin of the scruff not the muscle.
Finally, the cabergoline arrived today. We aren't starting it for a few days since we just changed the insulin and don't want to change too many factors all at once. I did put it on some of his food to see if he would accept the taste and he didn't hate it but I'm not sure if he will regularly eat his food with it either, so I'm a bit nervous. We got it compounded chicken flavour but it doesn't smell very chicken-y. We add it to his plain chicken as he can't have any wet food due to his pancreatitis and ibd, so I don't know if there's any possible way to mask it. We really can't be forcing more medications down him at the moment. At the moment we are also starting on 0.7ml where 100mcg = 1ml, 48 hours dosing...I know daily has been more effective but with our specialist on leave I'm not sure what the plan was for increasing frequency. We don't exactly have the time to wait and see but with his history of GI issues I also don't want to trigger that and am quite nervous at the moment.
Other questions I have:
- Is a cat considered in DKA if a urine test comes back as 1+ for ketones?
- Will a cat with diabetes keep losing weight until the diabetes is completely stable or does weight loss usually only happen in the ketone stage where they have no insulin yet?
-Will liver values in a cat keep being concerning if their glucose is high but they are receiving insulin and negative for ketones?
Thank you
