Out of Remission?

Marie & Red

Marie & Red

Member
Hi,
My boy, Red, has been in remission since June 2022, thanks to this board. He went to a new vet this past Friday for a wellness check and for a sore on his paw. I let the vet know he was a diabetic in remission. Because there was bacteria in the sore, he was given an antibiotic injection (Convenia) and a steroid injection for the inflammation/itching (20mg Depo-Medrol). I did not know steroids can lead to insulin resistance until I came home and read up on it :mad: Because I noticed his excessive thirst, I started testing frequently this week and found his BG numbers to be around 300. I called the vet and she wanted to wait a month to see if his numbers would come down once the steroid leaves his body. I didn't want to wait that long so she agreed to give him ProZinc, which is what he was on 3 years ago. I am picking it up tomorrow morning.

My questions: Is it best to start him on ProZinc tomorrow or wait? If I should start, how much would be appropriate to start with? I am not sure what she will prescribe yet. I do know Red's old vet started him on a high dose when he was diagnosed, but I quickly reduced it with guidance from this board. His updated spreadsheet is linked below.

Needless to say, I am very frustrated that after 3 years of remission, this injection has spiked his levels so high.

Thank you for your guidance!
 
Bron and Sheba (GA) said:
What a shame the vet gave the steroid. She should have known better.
I am going to tag @Suzanne & Darcy as she is a Prozinc user re the dose.
Hopefully the BGs will go back down when the steroid goes out of his system.
See what Suzanne thinks.
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Thank you!
I agree, the vet should have known better. And I blame myself too for not knowing & not asking more about the steroid. I learned my lesson! I'm hoping the steroid reduces quickly from his body 🙏
 
Hello, Marie! I’m so sorry this happened to your cute boy. Keep getting a few tests between now and when you get the ProZinc. Post over on the ProZinc forum so I will be sure to see it. Let’s then take a look at his spreadsheet and decide. Right now, looking at the tests you have on there, I would be inclined to start with a small dose like .5 units. Yes, that is small, but in my opinion we should proceed with caution considering everything…. especially since the Depo Medrol injection’s action will be gradually waning over the coming weeks. I believe you are right to begin the ProZinc because you don’t want to let the high BG damage his pancreatic cells. If we can support him with a little insulin right now, hopefully he will get back into remission very quickly.
 
Suzanne & Darcy said:
Hello, Marie! I’m so sorry this happened to your cute boy. Keep getting a few tests between now and when you get the ProZinc. Post over on the ProZinc forum so I will be sure to see it. Let’s then take a look at his spreadsheet and decide. Right now, looking at the tests you have on there, I would be inclined to start with a small dose like .5 units. Yes, that is small, but in my opinion we should proceed with caution considering everything…. especially since the Depo Medrol injection’s action will be gradually waning over the coming weeks. I believe you are right to begin the ProZinc because you don’t want to let the high BG damage his pancreatic cells. If we can support him with a little insulin right now, hopefully he will get back into remission very quickly.
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Thank you! I'm on my way to pick up the ProZinc.
 
Suzanne & Darcy said:
Hello again, since you were not aware of the potential consequences of giving a steroid injection to a diabetic cat, and I noticed that Red was also given a Convenia injection, I wanted to link this piece about the potential risks of Convenia. I don’t want to alarm you, but just for you to be informed in case Convenia is suggested in the future.

Convenia- long term antibiotic: Is it worth the risk?
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Wow, thank you for that info! I'd much rather give a daily dose than a long lasting dose.

Quick question - is it Test, Feed, Shoot? I know testing is always before injection, but wasn't 100% sure about feeding.
 
Just to offset a bit of the information about Convenia, it is indicated for skin infections. This may be the one time I've seen a vet prescribe it for the right reason. They will often prescribe it so the caregiver doesn't have to be bothered with giving daily doses of an antibiotic and they will prescribe it for all sorts of problems that aren't skin infections.
 
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