Prednisone question, high BG number drop to a very low number

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rawia

rawia

Member Since 2017
https://felinediabetes.com/FDMB/thr...r-10-days-on-clindamycin.234977/#post-2641038

Hi everyone again,

will our journey with this mouth infection still not ended, Again i had to take Meme to the vet as she did not tolarate the new antibiotics will as with every other kind we tried, after some fluid and anti nausea and appetite stimulation medication i agreed to use Pred for the moment if this is my last choice till the Biopsy result come back ( the antibiotics alone did not work, we tried more than 3 kinds).

As i told her BG will rise very high and i should adjust the insulin dose ( she is on pred 10 mg 1/4 twice daily) as we are going to try the low dose.

will her BG go up to 300 and more ( i adjust her i insulin from 1 unit to 1.5). At the first day she stayed high all the day but the past 2 days she dropped to a very low numbers ( around 26 ) three times, i had to give her honey and stayed around as the numbers go up and dropped back after 3 hours.

Dose anyone has experience with this medication, how it works and why from very high number it dropped suddenly to a very low numbers. Once was at +6 and two times was on her next shot time.

dose this medication wear off after few hours or how it works?!

the problem is not handling the low numbers but the effect of it, she stays all the day sleeping and with no intrest in food.
 
Hello,

My cat is treated with Prednisolone, currently 5mgs PM only.

Every cat is going to be different due to how they metabolize the drug. I typically see a rise in my cats BG approximately 3 hours after being given the Prednisolone and it typically peaks around 6 hours after it was given and then the BG starts to fall again. So, the challenge is, while I understand the focus and concern with trying to bring the highest BG down, you don’t want to be too aggressive with the insulin dosing that when the effects of the Prednisolone start to subside, you end up with BG that is too low. So, this is similar to when you are determining dosing without Pred, you have to base the dosing on the lowest # in a cycle vs the pre shot or highest # you see.

The other important consideration with dosing with Prednisolone & an illness/medical issue is that you have to factor in the effects of inflammation. Inflammation will increase BG and as the inflammation is treated, you will see BG decrease. Therefore, you have to be careful and in some cases, just be patient and live with some transient, time limited higher numbers as inflammation is treated. Otherwise, if you push the dose too high and inflammation begins to decrease and BG follows, you end up in a situation where you have too much insulin and low BG.

With all this being said, with some time, a determination has to be made regarding the use of Prednisolone in each persons cat and dependent on the specie issue/diagnosis and treatment options. In some cats, even with DM, like my T, it is manageable and not an issue. In other cats, that may not be the case & a Plan B may have to be considered if the DM becomes difficult to manage using Pred.
 
Not sure if this helps but I had something similar with a cortisone shot. (this shot lasts for a month or more) The BG went thru the roof. But if you gave a Prozinc insulin shot the number would plummet 100 points every hour reaching the 70's in 4 hours. If you look on my ss, the 1st day is a curve done at the vet with 2 units. 2 units!! The BG sank like a stone. Vet told me to back it off to 1.5 units at home. This was a Friday. I looked at the paper and told the vet it might be better to just do 1 unit since it would be the weekend and the office closed. I didn't want to end up at the ER vet clinic. So 1 unit it was...and a darn good thing too. Just look at the ss. With a food change and shot wearing off Emma was starting to get BG under control on her own and we would have been wrong.

I'm glad that you are focusing on her BG numbers. Please be careful of giving too much insulin. I read on this site, "better to have 1 day of high numbers than 1 minute of too low". It helped me make the right choice for our cat that weekend, even though we had to kind of talk our vet into it.

I wish you and your kitty all the best. I know how hard this is for you both.
Sue
 
Hang in there! I know it is SO hard to see those spikes in BG. I had it happen with a flare in the past and it is instinct to want to act on those higher numbers!
rawia said:
Thank you all for the helpful information, I will be more careful and not trying to give too much insulin and see how it is going.
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Please let us know how the biopsy results go. Prayers and thoughts with you while you wait :bighug:. I hope the Prednisolone helps in the meantime and just keep monitoring so that if something seems off....you see #s go even higher or it is difficult to manage them at all, you can let your vet know. Again, hopefully the Pred helps and as it helps, those BGs come down.
 
Tomlin said:
Hang in there! I know it is SO hard to see those spikes in BG. I had it happen with a flare in the past and it is instinct to want to act on those higher numbers!


Please let us know how the biopsy results go. Prayers and thoughts with you while you wait :bighug:. I hope the Prednisolone helps in the meantime and just keep monitoring so that if something seems off....you see #s go even higher or it is difficult to manage them at all, you can let your vet know. Again, hopefully the Pred helps and as it helps, those BGs come down.
Click to expand...
This infection is hard to deal with, nothing worked even after an extraction of 5 teeth it get worse, tried different antibiotics but did not work, it is hard to see her in so much pain, Tramadol and Gabapentin even make her sicker, we are struggling since January with this infection. Vet thought it is Stomatitis and calicivirus maybe the underlying cause. She is vaccinated and she stays indoor only. I hope that she is wrong and it is not a virus infection.

They thought that she had a renal failur because this infection elevated her kidney value but after a couple of tests values are coming down to normal.

I am just scared and counting days for the Biopsy result.
 
I would see if there is a veterinary dentist is your area. You may need a specialist. Alternatively, if there isn't anyone nearby, ask your vet to consult with a veterinary dentist. You could even call Cornell's cat clinic. They do phone consultations. Also, make sure that x-rays were done after the dental procedure if Meme had any teeth extracted. If a shard of a tooth was left, it may be causing the infection.

Please check to see if you're prescribed prednisone for prednisolone. They are a little different and prednisolone doesn't have as much of an effect on BG numbers.

Pred can be helpful with reducing inflammation. However, it also acts to lower the immune response. It can make your kitty more vulnerable to infection. The headache is that most of the anti-inflammatory drugs (NSAIDs - non steroidal anti-inflammatory drugs) if used more more than a short time can have a negative effect on the kidneys.
 
I wanted to give you some links for locating a Board Certified Vet Dentist in your area like was recommended in the last post as well as the info for Cornell’s Camuti Feline Health Line in case you want to do a consult :):

1) Board Certified Pet Dentist Locator:

https://avdc.org/find-vet-dental-specialist/

2) Cornell Camuti Consultation Service:
(*Due to Covid they request that you email vs call to request the consult. They take requests on Monday, Wednesday & Friday from 10-12 & 2-4. Typically you email info to them & fax or email records and then the consulting vet calls the next day)

https://www.vet.cornell.edu/departm...ealth-information/camuti-consultation-service
 
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