lisa_michelle
Member
Hello,
My 17 yr old cat Bitsy has a history of Pancreatitis. The last major episode was Oct 2023 (throwing up lots, poor appetite). She had full senior panel done, sent home injectable Cerenia and Mirtazapine tabs, I gave her S/C fluids at home. Labwork confirmed Pancreatitis. After a few days she was fine. She began throwing up again in December so back to Vet. Labs showed Glucose was slightly elevated but thought to be likely due to stress. Because of her history of pancreatitis, I know that puts her more at risk for developing Diabetes (I used to be a regular in this group, years ago had a diabetic kitty x 6 years) so I would check her BG at home. Back in Dec or Jan one evening it was quite elevated at 333 and she seemed a little less bright, drinking more, peeing larger clumps. Took her back to Vet, showed him the readings I was getting at home (that were elevated). He believed that because the lab's glucose range, normal is up to 180, that home glucose meter readings of 10 or a bit over are "normal" also (which of course goes against everything I read about feline diabetes.....everything I read says normal home testing values are below 120. I had them run a Fructoasmine level which came back with her within the normal range. Over time her glucose at home was better/normal so I attributed the previous increases due to Pancreatitis again.
Fast forward to Oct 12/2024....she started throwing up again several times, not as bright, drinking more water, loose poops and I saw her straining in the litterbox then throwing up clear liquid in the litterbox right after straining. Was concerned about possible UTI. Saw a different Vet at same cliinic. Told him about her history of Pancreatitis. Had him do xray of abdomen and microscopic urinalysis. Xray fine. Urinalysis was totally normal, plus no glucose, no ketones, negative for everything. Sent home w/ injectable Cerenia and some Mirtazapine tablets (2mg), had one shot of Cerenia that evening and she was back to her usual self. Poops quite soft still so started adding FortiFlora to her canned food daily which helped.
On Oct 18th I decided to check her BG at home and since. To note, she gets canned food twice a day (she nibbles at it all day) and a bit of dry here and there (some kind of Purina Naturals....cheap crap but it's the only kind she likes).
Oct 18:
noon - 243
5:30pm - 252
Oct 19:
08:45am - 260
3:00pm - 234
(NOTE: this day I started her on Purina DM dry food from the Vet, for the odd time she nibbles dry in between her main meals of canned, as it's lower carb than the regular dry)
Oct 20:
07:00am - 270 (as she'd been drinking more, I decided to give her 50cc of S/C fluids)
noon - 156 (figure the s/c fluids that morning caused this improved BG)
7:00pm -187
Oct 21:
08:30am - 253
9:00pm - 189
Oct 22:
06:30am - 266
2:30pm - 176
9:00pm - 183
Oct 23:
8:30am - 122
10:30am - 162
9:30pm - 217
Oct 24:
09:15am -135
9:30pm - 183
Oct 25:
06:00am - 228
Oct 26:
07:00am - 208
7:00pm - 157
Oct 27:
7:00PM - 205
Oct 28:
09:00am - 228
7:30pm - 270 (NOTE: I decided to take away the Purina DM dry food, will feed only wet)
8:30pm - 274
11:30pm - 266
Oct 29:
09:00am - 248 (this was after not eating any low carb fancy feast pate since midnight)
I will no longer feed any dry food at all. I am trying to feed the low carb varieties of canned though she's fussy and loves her gravies and sauces (eg: Fancy Feast Florentine Tuna and Salmon). She is not the kind of cat to eat canned twice a day, she nibbles off and on all day.....which obviously doesn't really give her BG a chance to lower after meals because she's constantly eating/grazing.....but this is just the way she is and at 17 I don't think I can change that.
the Meter I use is a new One Touch Verio Reflect
As you can see from her above readings, they're not terribly high and some are much better than others....so I'm a little nervous about starting insulin. I do have a Vet appt at noon today. I don't see much value in doing another Fructoasmine level given that I've been monitoring her for the past 10 days or so. I'm sure he'll say "well when we did her Urinalysis on Oct 13 it showed no glucose or ketones but that was then, this is now.
She does have a very good appetite, which is common w/ diabetes. She's not drinking tons of water but enough that it's a little more. She had a full senior panel in March 2024 and kidneys perfect, everything perfect. In very good health for her age, given this Pancreatitis/?diabetes stuff. You can tell she's not quite feeling herself as she's not as active and that totally correlates with how high her BG is. No diarrhea, no vomiting.
Would you start insulin if you were me? I just have this feeling that Vet is going to say "her numbers aren't terrible" and that we should do nothing. I don't want to jump the gun should her elevated BGs be due to maybe some inflammation to the pancreas again but I don't think she's got Pancreatitis at this point as no vomiting and appetite is good and she always throws up a lot when has Pancreatitis.
My hope is to start her on a very low dose of insulin, like 1/2 a unit.....start low, go slow......because as you can see from some of her numbers above, some are pretty decent so I don't want to worry that insulin will drop her too low. My kitty years ago did wonderfully on Levemir insulin and even though I know that ECID, I like the way Levemir works......nice flat curve versus huge peak. What are your thoughts about my plan that I'll discuss with Vet? I don't know what I'll do, however, if he says he doesn't think we should start insulin yet.
I would greatly appreciate your input before we head off to the Vet in 45 minutes ,please and thank you
Lisa in Canada
My 17 yr old cat Bitsy has a history of Pancreatitis. The last major episode was Oct 2023 (throwing up lots, poor appetite). She had full senior panel done, sent home injectable Cerenia and Mirtazapine tabs, I gave her S/C fluids at home. Labwork confirmed Pancreatitis. After a few days she was fine. She began throwing up again in December so back to Vet. Labs showed Glucose was slightly elevated but thought to be likely due to stress. Because of her history of pancreatitis, I know that puts her more at risk for developing Diabetes (I used to be a regular in this group, years ago had a diabetic kitty x 6 years) so I would check her BG at home. Back in Dec or Jan one evening it was quite elevated at 333 and she seemed a little less bright, drinking more, peeing larger clumps. Took her back to Vet, showed him the readings I was getting at home (that were elevated). He believed that because the lab's glucose range, normal is up to 180, that home glucose meter readings of 10 or a bit over are "normal" also (which of course goes against everything I read about feline diabetes.....everything I read says normal home testing values are below 120. I had them run a Fructoasmine level which came back with her within the normal range. Over time her glucose at home was better/normal so I attributed the previous increases due to Pancreatitis again.
Fast forward to Oct 12/2024....she started throwing up again several times, not as bright, drinking more water, loose poops and I saw her straining in the litterbox then throwing up clear liquid in the litterbox right after straining. Was concerned about possible UTI. Saw a different Vet at same cliinic. Told him about her history of Pancreatitis. Had him do xray of abdomen and microscopic urinalysis. Xray fine. Urinalysis was totally normal, plus no glucose, no ketones, negative for everything. Sent home w/ injectable Cerenia and some Mirtazapine tablets (2mg), had one shot of Cerenia that evening and she was back to her usual self. Poops quite soft still so started adding FortiFlora to her canned food daily which helped.
On Oct 18th I decided to check her BG at home and since. To note, she gets canned food twice a day (she nibbles at it all day) and a bit of dry here and there (some kind of Purina Naturals....cheap crap but it's the only kind she likes).
Oct 18:
noon - 243
5:30pm - 252
Oct 19:
08:45am - 260
3:00pm - 234
(NOTE: this day I started her on Purina DM dry food from the Vet, for the odd time she nibbles dry in between her main meals of canned, as it's lower carb than the regular dry)
Oct 20:
07:00am - 270 (as she'd been drinking more, I decided to give her 50cc of S/C fluids)
noon - 156 (figure the s/c fluids that morning caused this improved BG)
7:00pm -187
Oct 21:
08:30am - 253
9:00pm - 189
Oct 22:
06:30am - 266
2:30pm - 176
9:00pm - 183
Oct 23:
8:30am - 122
10:30am - 162
9:30pm - 217
Oct 24:
09:15am -135
9:30pm - 183
Oct 25:
06:00am - 228
Oct 26:
07:00am - 208
7:00pm - 157
Oct 27:
7:00PM - 205
Oct 28:
09:00am - 228
7:30pm - 270 (NOTE: I decided to take away the Purina DM dry food, will feed only wet)
8:30pm - 274
11:30pm - 266
Oct 29:
09:00am - 248 (this was after not eating any low carb fancy feast pate since midnight)
I will no longer feed any dry food at all. I am trying to feed the low carb varieties of canned though she's fussy and loves her gravies and sauces (eg: Fancy Feast Florentine Tuna and Salmon). She is not the kind of cat to eat canned twice a day, she nibbles off and on all day.....which obviously doesn't really give her BG a chance to lower after meals because she's constantly eating/grazing.....but this is just the way she is and at 17 I don't think I can change that.
the Meter I use is a new One Touch Verio Reflect
As you can see from her above readings, they're not terribly high and some are much better than others....so I'm a little nervous about starting insulin. I do have a Vet appt at noon today. I don't see much value in doing another Fructoasmine level given that I've been monitoring her for the past 10 days or so. I'm sure he'll say "well when we did her Urinalysis on Oct 13 it showed no glucose or ketones but that was then, this is now.
She does have a very good appetite, which is common w/ diabetes. She's not drinking tons of water but enough that it's a little more. She had a full senior panel in March 2024 and kidneys perfect, everything perfect. In very good health for her age, given this Pancreatitis/?diabetes stuff. You can tell she's not quite feeling herself as she's not as active and that totally correlates with how high her BG is. No diarrhea, no vomiting.
Would you start insulin if you were me? I just have this feeling that Vet is going to say "her numbers aren't terrible" and that we should do nothing. I don't want to jump the gun should her elevated BGs be due to maybe some inflammation to the pancreas again but I don't think she's got Pancreatitis at this point as no vomiting and appetite is good and she always throws up a lot when has Pancreatitis.
My hope is to start her on a very low dose of insulin, like 1/2 a unit.....start low, go slow......because as you can see from some of her numbers above, some are pretty decent so I don't want to worry that insulin will drop her too low. My kitty years ago did wonderfully on Levemir insulin and even though I know that ECID, I like the way Levemir works......nice flat curve versus huge peak. What are your thoughts about my plan that I'll discuss with Vet? I don't know what I'll do, however, if he says he doesn't think we should start insulin yet.
I would greatly appreciate your input before we head off to the Vet in 45 minutes ,please and thank you
Lisa in Canada
