PLEASE HELP ME!!! posting most recent separately

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Sara and Buttercup

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hypert, ibd vs. small cell lymphoma, diabeitc in remission cat (remission about a year or so i think) started budesonide/entocort (steroid) about 2 weeks ago for chronic diarrhea. BG was 159 on day 11. on day 5 it was 106. predrug it was about 70. at what point do i start her back on insulin? prob going with glargine again if i have to. it's been so long i don't even remember the rule about when to start. i think 159 is too low but what's the criteriia for starting insulin again and also, if the higher blood sugar is steroid induced which it is, then how does that effect the insulin dosage/protocol/prognosisn, etc.
thanks very much.
 
Re: On steroids, when do i start insuline again?

Dearest Sara, and, of course you, too, sweet Buttercup,

What a great name! I just love her name!





Okay, zooming back to your reality, you hometest, right? And, you do.

My very humble suggestion is to start when you feel comfortable starting. You're the one with her precious records. You're the one who hometests... You're the one who's going to know. Look at the whole Buttercup!

Must confess I never understood Lantus. But, that said, I do like your thinking. And, have treated diabetic cats on steroids -- usually for their ears...

My very humble suggestion is that you continue testing -- bless you, Sara! -- and, you maybe start with a minimal dose of insulin to see if that helps Buttercup; but, do keep watching for those impending signs -- too much peeing, too much drinking -- before you shoot. Keep testing and post your numbers on both the Lantus and Health boards here. Does that sound like a plan?

Diabetes sounded like the end of the world, didn't it, way back when? But, it's one of those health issues you can shoot around, if you need to.




You have a lot on your plate, dearest Sara, and so does Buttercup -- who's name just makes me smile!

And, I'm probably not the person to be responding to you both; but, and sometimes buts are good, I can always supply you both with hugs!


Much love and as many hugs as you both can handle,
Deb and Nikki -- and, Giz, forever whispering in my heart, you needed Nikki...

Please check in with the Lantus board and keep posting here, as they can help you more than me... But, I'm proud to be your humble hugster!
 
Re: On steroids, when do i start insuline again?

For now I would recommend testing your cat's BG once a day. It is hard to predict how the steriods will effect BG but in most cats it will raise it at least on a temporary basis. You might consider starting insulin again if you start getting numbers above 150 a few days in a row. If you do have to start insulin again at least you will have some data and you already know the routine..

I am a little puzzled why nobody else has reponded to you. Maybe if this gets bumped up you will get some more responses. Come back and let us know how buttercup is doing!
 
Re: On steroids, when do i start insuline again?

This is way over my head. But a bump up the threads may get more attention?
Good luck Sara.
jeanne
 
Re: On steroids, when do i start insuline again?

Budesonide is supposed to stay in the digestive tract, so may not raise BG at all. I second the recommendation to test once a day. IMHO, I would not give insulin until you see three or more consecutive raised numbers. BG flucuates all the time, so acting on one raised number is premature. For Angus, my cutoff was 140. But, he was on PZI.
 
Re: On steroids, when do i start insuline again?

thanks everybody. here's an update.
2/25 bg 203
2/26 bg198
2/27 bg 194
there is now sugar in her urine also.
she is on 1 mg per day of budesonide/entocort. i am sure that the budesonide is raising her sugar even though it is not supposed to it sometimes does.
i am going to local vet today. he is unbelievably ignorant. i am also waiting to hear back from specialist in another town who precribed the budesonide about what to do.
i know these numbers are not real high but it worries me that she is above the renal threshold. sugar in her urine today and yesterday.
i think my choices are
1. lower dose of budesonide to 1/2 mg a day and wait awhile to see what happends with the bg
2. lower dose of bude. to 1/2 mg and add insulin
3. take her off the bude. and see what happen
4. take her off the bude. and add insulin
5. keep bude. dose the same and add insulin
i personally like option one or two best but i have no idea.

i'm going to ask for a prescription for glargine today so i have it on hand if needed. i'm pretty rusty. she has been in remission for over a year it has been wonderful

has anyone used budesonide/entocort here beofre and lowered the dose. if so, how did you go about that/

thanks for any help.
if i go back on insulin, i'll be posting here a lot i'm sure.

do you think it will hurt her much to be in the mid to low 200's for a week or a week and a half or so while we figure this out?
 
Re: On steroids, when do i start insuline again?

Before lowering the dose of the steroid, seriously consider the potential ramifications. If you lower the dose too much in the hopes of lowering bgs, what happens if she gets sick? If she needs the steroid, then work the insulin around it. Period.
 
PLEASE HELP ME!!!

i was told by a specialist to lower the dose if her levels got too high. it wasn't my idea. and if 1/2 mg works as well as 1 mg it's better for her to use that.

i just got back from another incredibly frustrating appt at the vet's office. i showed him the numbers that we climbing into the lower 200 to mid 200 and that she has sugar in her pee and he said do nothing, no insulin, no lowering the dose of the steroid. just leave it there. i asked about the potential for damage to the pancreas and he said there wasn't any. i wasn't even able to get a prescriptoin for glargine.

so i have no insulin and a cat consistently over the renal threshold. we were talking about glargine a little bit and he said that "it's a 24 hour insulin" even though he new i gave it to her with success as a twice a day against his advice. i brought in my old speadsheet from this site to show him that i had started giving it to her and was giving it to her in the mid to upper 100's and he wouldn't even look at it or glance at it. he is obviously threatened by my and COMPLETELY CLOSED MINED.
could you guys please guide me in what to do????

i will post her numbers here every day and IF THERE IS SOMEONE OUT THERE THAT HAS OR HAS HAD A CAT ON STERIODS AND INSULIN AT THE SAME TIME, COULD YOU PLEASE POST OR WRITE TO ME.... IT LOOKS LIKE I AM GOING TO HAVE TO GO AROUND MY EFFEN VET again AND RELY ON THE INTERNET for medical advice.
THANK YOU ALL VERY MUCH.
and how am i even going to get a prescription for glargine if he won't give it to me?
 
I can totally understand your frustration. The first thing I would do is get a new vet! Aside from that I am new here so I can't help you to know when to start but my kitty was on Pred for IBD and that is what made him diabetic. He had a raging bout of pancreatitis which at the time I thought was a flare of IBD. We immediately took him off the pred and in the process of working up the diabetes, he went without ANY treatment for IBD for almost three weeks and it didn't hurt him in the least. I am suspecting that his IBD has somewhat resolved now that we are on all wet food but I want to get the diabetes under control before we address that. He is currrently on 2 ml of budesonide but there have been nights when I have skipped it. I would concentrate on his BG and keep doing what you are doing. If you feel you need to lower the budesonide a little i am sure you will be fine. They say it doesn't raise BG but you just never know. Welcome and take a deep breath, you are doing great!
 
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