Portia's urine glucose is 1000mg/dL

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portiarita

Member Since 2013
Hello,
My name is Rita and I'm writing on behalf of my wonderful kitty, Portia. She was diagnosed with pancreatitis last December and has been struggling with it since. She had hepatic lipidosis in February of this year and has pulled through. However, since then her spec fPl has been elevated and has only now started coming down. A week or so ago, I noticed that she was urinating a little more frequently (3-4 times a day instead of her usual twice) and she also started sitting next to her water bowl, although she never drank from it. So I ordered the Bayer diastix and measured her urine glucose today and it indicated that her level was 1000mg/dL. The members of the feline pancreatitis support group directed me here to get some insight on next steps. I will try and see the vet tomorrow and have her blood glucose and urine analysis done. In the meantime, I would like to know more about whats about to happen.

She currently eats hills z/d canned only.

Her medication is as follows:

Prednisolone 2.5mg BID
Metronidazole (flagyl): 62.5mg BID
Pepcid a/c: 2.5mg BId
Ondansetron 1mg BID
Ursodiol 50mg SID
Miralax: 1/4tsp SID
Buprenorphine as needed
cyproheptadine as need.

Any feedback or thoughts on her urine glucose levels would be greatly appreciated.

Thanks in advance.
Rita and Portia
 
Hello and welcome here. You've been dealing with a lot with your kitty.

Once your vet has the blood test results, if there is a high blood glucose value then he/she may suggest a fructosamine test which will provide a two week average of the blood glucose value. Many cats will often have elevated blood sugar values at the vet, so a one time test at the vet may not be conclusive. Which is why we encourage people to learn how to do home blood sugar testing. You can use regular meters that people use. Testing at home will save you money and is safer for the cat if you have to give insulin. Testing urine is a good start, but sugar ends up in the urine long after the blood so doesn't give you kitty's current sugar level. Urine testing is a good skill to have, you'll also want to test for ketones.

Is there a reason that Portia is eating the Z/D food? It is very high in carbs. There is a very good website on feline nutrition, http://www.catinfo.org. On that site there is a food chart that lists the protein/fat/carb %'s of most off the shelf and veterinary foods. For diabetic cats, we suggest low carb wet food or raw diet which is less than 10% carbs. Z/D is 34% which we consider very high carb food. And you don't need veterinary foods, many commercial canned foods are just as good or better quality ingredients.

If your vet diagnoses diabetes and suggests insulin, we recommend one of lantus glargine, levemir or PZI/Prozinc insulins that work well with cats. Your vet should show you how to give shots. Progressive vets will also show you how to do home blood testing. If not, there are videos we can point you to, or perhaps there is someone here that lives near you and can show you. Where do you live?

Let us know how it goes with your vet. There is a lot of knowledge on this board.
 
Hi Rita. I saw your email on the Pancreatitis group. We would recommend having the fructosamine done. This test, as Wendy said, will tell you what her blood glucose has been over a period of time. Some cats can have high BG temporarily because of a stress, so you want to know if her BGs have been elevated for longer while, or not. Good luck with the vet visit.
 
Chances are good that with the steroid and high carb food, she may have developed diabetes. If you are stuck with the food due to allefgies, IBD, etc, and stuck with the steroid to treat her condition(s), you may need to give insulin to control the high glucose fallout.

Yes, that adds one more thing to the list of treatments, but if she seems like she is otherwise happy and not suffering, there's a good chance you can continue to manage her and keep her stable.

Insulins for cats which work well include Lantus, Levemir, ProZinc and PZI.
Refuse Caninsulin/Vetsulin, and Humulin/Novolin as they generally do not last 12 hours and good glucose control often means dosing every 8 hours.
 
Hi everyone,
Thanks you for your quick response. To answer some of your questions, Portia is getting Z/D because we thought her chronic pancreatitis may be driven by food allergies. How likely is it that she has diabetes? Does glucose in the urine a 100% of the times signify diabetes? I have an appointment at 5:30 pm so I guess we'll find out. I have a couple of questions:


1. If (somehow) it turns out that her BG is normal today, is urine testing a good method to periodically check her since she does have pancreatitis and is on a high carb diet? I would like to avoid pricking her if possible and was wondering if urine testing would be ok just for screening? I guess Im still hoping that she doesnt have diabetes and that this was just anomaly.

2. The other question I had was that do all diabetic cats pee and drink a lot? Portia's urination only slightly increased last week and is now back to normal even though her urine has glucose (as per the diastix test). Is it normal for a diabetic cat to have near normal urination and drinking or did I just catch the diabetes early before any overt symptoms began?

Thanks for your help and I will keep you posted on how the vet visit goes.
Thanks
Rita
 
If you read over my signature link Secondary Monitoring Tools, you will see that urine monitoring only reflects what has happened since the previous void and is not very precise.

It is superior to do blood glucose testing before every insulin injection because you cannot tell by looking how low the glucose is.

I went to Jo's after 2 weeks on about 1.5 units ... he was 31 mg/dL and about to have a hypoglycemic attack which could have killed him. She wasn't able to test due to severe arthritis and poor vision.
 
Hi BJM,
Thanks for your response. I read the link you directed me to and it makes complete sense. If she does have diabetes, then there is no way around pricking her ear routinely (everyday before giving insulin,etc). However, if it turns out that she doesnt have diabetes, then would checking her urine periodically be a good way to screen for it. I know it isn't accurate and probably wont test positive unless her BG is over a certain threshold. However, as a screening tool for the presence of diabetes, would you recommend it?
Rita
 
If urine is negative for glucose and there are no other symptoms of diabetes like excessive urination/drinking, the it is likely the cat is not diabetic. However, that is not for certain since you get glucose in the urine when blood glucose is over between 160 to 240 mg/dl. Note the a blood glucose reading in mg/dl is not directly comparable to urine reading.
 
Thanks!That makes sense. Finger's crossed that she doesnt have diabetes even though she has very high glucose in her urine right now :(
Rita
 
Hi all,
So I just heard back from the vet about Portia's blood work. Her fasting glucose is normal (130) but her urine glucose is 2+ which confirms the home test I performed.She is stumped as to what can cause such glucose in her urine. There was no protein and USG was otherwise normal. Have any of you seen this with your cats? Any thoughts on what can cause this or how we should proceed?

Rita
 
Hi Rita,
what a difficult challenge you're facing. How fresh was the urine you tested at home? Immediate test is best. Your vet's office, how fresh? If I ever waited longer than 30 minutes, I threw out the results & redid the test. The older the urine, the darker the strip gets (shows sugar or, if using Keto-Diastix, also ketones). If the strips are expired, box open for more than 6 months, kept in too low/high temperature, tests might be useless.
Best wishes, Sophie
 
Wendy&Tiggy said:
Did the vet do a fructosamine test?

Wendy
Click to expand...
Hi Wendy,
My vet mentioned perhaps running on fructosamine test but said she needed more time to think about it. She said she would get back me to today about how she wanted to proceed but I havent heard from her as yet. The test did say there was no ketone in her urine though. The urine test I performed at home was fresh within 2 minutes of peeing and at the vet, Im not sure. But hopefully it was fresh too. its always something right?!?! Im just glad its not diabetes, atleast I hope not!
Rita
 
If the BG is normal but the urine strips are showing positive, it may be one of the medications she is on.
Some drugs passed in the urine will give false positives or negatives on the urine strips, they react with e chemicals on the strips funny and give you a false reading. I dont know exactly what drugs do that, but that's something you can look into.
 
portiarita said:
Wendy&Tiggy said:
Did the vet do a fructosamine test?

Wendy
Click to expand...
Hi Wendy,
My vet mentioned perhaps running on fructosamine test but said she needed more time to think about it. She said she would get back me to today about how she wanted to proceed but I havent heard from her as yet. The test did say there was no ketone in her urine though. The urine test I performed at home was fresh within 2 minutes of peeing and at the vet, Im not sure. But hopefully it was fresh too. its always something right?!?! Im just glad its not diabetes, atleast I hope not!
Rita
Click to expand...

Why does your vet need to think about the fructosamine test? What's to think about? The test result is an average of your cat's BG over the last 10-14days. If you want the test done, tell the vet to run it.

What you also want to do, if you are worried about your cat having diabetes or being bordeline, is to switch to another lower carb wet food because z/d is more for allergies and is very high carb.... the food's adding to your cat's high BG.

What is your vet doing for the pancreatitis issues? I looked at your list of meds, but did not see any mention for sub Q fluids or B12 injections. One of my cats had quite bad flares and the B12 helped a great deal with inflammation. If the appy stimulants are to get yr cat to eat, it's not going to do much if the nausea is present.... I am guessing you are giving the nausea meds first and then the appy stim later?

I was also wondering if both the pepcid and ondansetron were needed?
If you start giving the B12 shots, and continue the pepcid, I know you need to give them 2hrs apart.... not sure about the ondansetron though.

Gayle
 
Hi Gayle,
So my vet did run the fructosamine and it was elevated suggesting that she does in fact have diabetes even though her BG reading at the vet was normal. I will be posting this as a separate thread in a few minutes.

As for the pepcid and ondansetron, Ive tried taking her off the ondansetron (which is for nausea) and the two times I've tried she stopes eating and looks miserable even though she doesnt actually throw up. So Im guessing nausea is an issue for her. She gets the cyprohetpadine (appetite stimuant) only every 3-4 days. I dont why she needs it because Im treating her nausea and pain but Ive never been able to take her off it completely. If I do,I need to start spoon feeding her which is a giant pain and impossible on week days. Maybe she doesnt like z/d or maybe she's jsut generally not feeling great.

I havent given her any fluids because I dont think she is dehydrated. She gets only canned food with lots of water in the food. We ran her B12 levels in January and they were well within the range so my vet dint want to supplement it with shots.

She's on z/d because the vet thought that her chronic pancreatits maybe driven by IBD (even though we dont know for sure that she has IBD or not since her Ultrasound has always shown normal intestines). So she thought changing her to a hypoallergenic food might control the IBD which in turn could help the pancreatitis. She's been on it since June and fPL values have dropped significantly. This is ofcourse, not to say that the food has *caused* her pancreatiits to become better but since the fPL values have begun to drop we just havent wanted to change anything.

Sorry for the rather long post.

Rita
 
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