Squeakycats
Member Since 2017
Hi, all--long time no see! My kitty Misha was pretty well regulated on Lantus until last fall, when I moved across the country. Since then it's been struggle, but his numbers were usually below 250, and his curves weren't too dramatic (I'm sorry--I wasn't keeping a spreadsheet, just a log). In the last month or so, though, he's been much worse. He is pretty routinely in the high 200's or low 300's at PMPS, and in the mid to high 300's at AMPS--but his nadirs, especially at night, have gone as low as 50, at which point I've doled out the high-carb food until he settled. He has sometimes dropped almost 200 points in 2-3 hours. I was worried that he was bouncing and tried reducing his dose significantly, but then he just stayed consistently in very high numbers and seemed to feel quite ill.
He was diagnosed with pancreatitis two weeks ago--probably chronic (his symptoms haven't been severe). He's on buprenorphine and Cerenia, and I think we've got those doses adjusted to where he's comfortable but not overly sedated. He nonetheless spends the entire day sleeping in a closet. He'll eat if he's offered food. His levels tend to stay in the 300's. At night he perks up considerably and comes out to hang out with us, and his numbers are lower--sometimes dramatically, suddenly lower. I'm awaiting the results of some blood tests to see whether he's making any progress on the pancreatitis front and whether he might have a B12 deficiency or markers of IBD--but whatever else is going on, I just can't get his blood sugar under control, and he clearly feels lousy during the day.
He's only been to this vet a couple of times, but she's at a fancy cats-only practice and seems to care deeply about her patients; she's put a ton of work into reviewing his medical history and meeting with me to strategize. But her proposal to me right now makes no sense. She wants me to stop his insulin cold turkey! She says she's done this with another cat in a similar situation and it's working well, albeit slowly. She has an almost cult-like belief that if a cat is put on a truly species-appropriate diet, it WILL go into remission--unless it has had several rounds of steroid injections, which he never has. The thing is, Misha has been on a low-carb diet for years now. What she objects to is any kind of vegetables whatsoever being included in food--as they often are in the raw freeze-dried foods he likes best. Since his pancreatitis diagnosis two weeks ago, he's been exclusively on a food she approves of--as he was about six months ago for several weeks, right before RadCat shut down (he loved their venison flavor!). He didn't magically go into remission then, but of course he was on insulin the whole time. (He *has* been in remission twice in the past, once for almost a year.) My best guess, based on what she's said during our visits, is that she thinks the insulin is making his pancreas "lazy" and is concerned that as the magical diet does its work, he will become hypoglycemic. She would strongly prefer to have him run high numbers for a few weeks rather than have a hypoglycemic episode.
I have written her a very lengthy email explaining my thoughts about this. He's been diabetic a long time; I monitor him carefully and know how to handle hypos if they arise. My husband is between jobs right now, so Misha is rarely alone for more than a few hours. In about a week, we'll be moving to another state, after which I will be the between-jobs person and will be able to stay with him. While his diet has changed, the carbohydrate level really hasn't, so this doesn't seem analogous to the situation with a newly-diagnosed kitty whose diet has just been radically altered and/or whose caretakers don't know how to manage things yet. I've expressed my concerns that taking him off insulin will just damage his pancreas further and make him sicker--when he was first diagnosed, he wouldn't eat and was very, very ill, so that's my image of what he's like when he's untreated. However--it's true that I'm not having a lot of success doing what I'm doing now, and I'd be willing to try just about anything if it would help him, so if she can explain to me why stopping the insulin might be expected to help him improve, I might try it, though I think I would be overwhelmed with anxiety the whole time.
I have wondered whether rather than stopping insulin it might be worth experimenting with a different one--perhaps something shorter-acting like ProZinc that might make it easier to manage the different between his nighttime and daytime response and/or help me be able to move faster to get high numbers down. But I have read that ProZinc can also drop kitties pretty hard and fast, which is already weirdly happening with the Lantus.
I'm sorry this is such an epic post. My questions are basically these:
(1) Has anybody heard of this whole "stop the insulin and the pancreatitis and blood glucose levels will improve" theory before? Does it make any sense to you?
(2) Does anybody have advice about possibly switching from Lantus to ProZinc (or another insulin)? Might that be worth experimenting with?
One last note: all this moving has been very stressful for Misha; I've done everything I can to mitigate that, including renting a house instead of an apartment so things will be quieter and putting pheromone diffusers absolutely everywhere, but I know it's probably not helping. But I wouldn't expect this level of stress to have an impact quite this dramatic. Hopefully things will truly settle down after our move next week! Thank you in advance SO MUCH for any suggestions!!!!
He was diagnosed with pancreatitis two weeks ago--probably chronic (his symptoms haven't been severe). He's on buprenorphine and Cerenia, and I think we've got those doses adjusted to where he's comfortable but not overly sedated. He nonetheless spends the entire day sleeping in a closet. He'll eat if he's offered food. His levels tend to stay in the 300's. At night he perks up considerably and comes out to hang out with us, and his numbers are lower--sometimes dramatically, suddenly lower. I'm awaiting the results of some blood tests to see whether he's making any progress on the pancreatitis front and whether he might have a B12 deficiency or markers of IBD--but whatever else is going on, I just can't get his blood sugar under control, and he clearly feels lousy during the day.
He's only been to this vet a couple of times, but she's at a fancy cats-only practice and seems to care deeply about her patients; she's put a ton of work into reviewing his medical history and meeting with me to strategize. But her proposal to me right now makes no sense. She wants me to stop his insulin cold turkey! She says she's done this with another cat in a similar situation and it's working well, albeit slowly. She has an almost cult-like belief that if a cat is put on a truly species-appropriate diet, it WILL go into remission--unless it has had several rounds of steroid injections, which he never has. The thing is, Misha has been on a low-carb diet for years now. What she objects to is any kind of vegetables whatsoever being included in food--as they often are in the raw freeze-dried foods he likes best. Since his pancreatitis diagnosis two weeks ago, he's been exclusively on a food she approves of--as he was about six months ago for several weeks, right before RadCat shut down (he loved their venison flavor!). He didn't magically go into remission then, but of course he was on insulin the whole time. (He *has* been in remission twice in the past, once for almost a year.) My best guess, based on what she's said during our visits, is that she thinks the insulin is making his pancreas "lazy" and is concerned that as the magical diet does its work, he will become hypoglycemic. She would strongly prefer to have him run high numbers for a few weeks rather than have a hypoglycemic episode.
I have written her a very lengthy email explaining my thoughts about this. He's been diabetic a long time; I monitor him carefully and know how to handle hypos if they arise. My husband is between jobs right now, so Misha is rarely alone for more than a few hours. In about a week, we'll be moving to another state, after which I will be the between-jobs person and will be able to stay with him. While his diet has changed, the carbohydrate level really hasn't, so this doesn't seem analogous to the situation with a newly-diagnosed kitty whose diet has just been radically altered and/or whose caretakers don't know how to manage things yet. I've expressed my concerns that taking him off insulin will just damage his pancreas further and make him sicker--when he was first diagnosed, he wouldn't eat and was very, very ill, so that's my image of what he's like when he's untreated. However--it's true that I'm not having a lot of success doing what I'm doing now, and I'd be willing to try just about anything if it would help him, so if she can explain to me why stopping the insulin might be expected to help him improve, I might try it, though I think I would be overwhelmed with anxiety the whole time.
I have wondered whether rather than stopping insulin it might be worth experimenting with a different one--perhaps something shorter-acting like ProZinc that might make it easier to manage the different between his nighttime and daytime response and/or help me be able to move faster to get high numbers down. But I have read that ProZinc can also drop kitties pretty hard and fast, which is already weirdly happening with the Lantus.
I'm sorry this is such an epic post. My questions are basically these:
(1) Has anybody heard of this whole "stop the insulin and the pancreatitis and blood glucose levels will improve" theory before? Does it make any sense to you?
(2) Does anybody have advice about possibly switching from Lantus to ProZinc (or another insulin)? Might that be worth experimenting with?
One last note: all this moving has been very stressful for Misha; I've done everything I can to mitigate that, including renting a house instead of an apartment so things will be quieter and putting pheromone diffusers absolutely everywhere, but I know it's probably not helping. But I wouldn't expect this level of stress to have an impact quite this dramatic. Hopefully things will truly settle down after our move next week! Thank you in advance SO MUCH for any suggestions!!!!
