Recent diagnosis with questions

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oslo

oslo

Member Since 2017
Hi all,
Our dear 6-year-old cat Oslo was diagnosed with diabetes in early June. His main symptoms were excessive thirst and urination and major weight loss. Since then, we've switched from dried food to canned only (Friskies pate, 1 can a.m./1 can p.m.), started him on Novolin (starting at 2 units 2x/day) with a dosage increase to 3 units (no change in glucose levels), then switched to Lantus (2 units 2x/day). He is still his normal, playful, affectionate self, but his appetite is out of control - he wants food pretty much all the time, and he will eat anything that he can find, including a banana! He's down to 9 pounds and needs to gain weight (his ideal weight is 14-16 lbs.), but it doesn't seem to be happening no matter the amount of food. We do periodic curves at home using the AlphaTrak2 meter, and they've all been kind of crazy...either high numbers throughout the day or starting low/normal at fasting, then rising to 500+ by the day's end. At first diagnosis in June, the vet also detected an UTI and Oslo did two rounds (2 weeks each) of antibiotics (amoxicillin) for that. At a re-check in late July, bacteria was still present in his urine so they did another round of antibiotics (zeniquin). Oslo was in last week for another recheck...vet still saw some bacteria in urine so ordered a culture. The culture came back with nothing growing, but the vet wants to do another 2 week round of antibiotics since there was some bacteria present in the office (even though the lab culture showed nothing). This will be the fourth round of antibiotics in 3 months....is this typical? I realize that infections and other imbalances can affect the ability to regulate a kitty, but this seems like a lot of antibiotics that aren't doing anything. His thyroid checked out ok, and no ketones were detected, though liver enzymes were slightly elevated. What else can we do to regulate him? Is there anything else that we should check out?
Thank you for your time and your thoughts!
Susan
 
did they do a culture and sensitivity test to find out which antibiotic would be the most effective? They should have ordered one at the first visit.
It sounds like your dose may be too high and causing a lot of high bounces quite honestly. If you could fill out one of our spreadsheets and add it to your signature that would really help.

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

When diabetic cats are unregulated they are often hungry all the time. this is because their body can not utilize the nutrients properly. Once you get her bg under control the hunger should go back to normal . In the meantime I would give more food.... Just no food prior to the preshot test. YOU SHOULD BE TESTING every preshot to make sure it's safe to shoot. I'll let the lantus experts speak more to dosing suggestions.
 
Hi and first of all Welcome!!

You've arrived at a great place where there are people with a lot of experience that can help you.

They will need some information though to be able to help:

What are your kittie's glucose levels?
What is your kitty eating?

It is "normal" for a cat with unregulated diabetes to be always hungry and not gain any weight because the high levels of glucose in his blood do not allow his body to use the nutrients in his food properly so basically is like he hadn't really eaten properly .

UTI is also quite common and is normal that it takes a long time to heal, they will usually need from 15 days to a month of antibiotics and they will have to be tested once a month for least 3 months consecutively and that you get your results negative to consider they are finally out of the infection, and in this 3 month period is also common that they may need more antibiotics to ensure the infection won't come back
 
Welcome Susan and Oslo!
Looks like your first round of questions have been addressed by Veronica and Janet so I'll just give you the instructions to setup your Signature. It's also where your Spreadsheet (SS) link will be posted :).

Not trying to damper your spirits but just keep in mind there are some kitties who don't even get regulated. They just regularly stay unregulated :smuggrin:. With that, their BG's are still in better control than they would be without insulin therapy.

Has Oslo been checked if he has FLUTD? (Feline lower urinary tract disease)
 
Thanks so much, @Yong @Veronica & Babu-chiri and @JanetNJ . Oslo had a urine culture done at his last check-in with the vet (about 10 days ago)...she left me a message saying that the lab didn't find any bacteria growing although they had seen bacteria at the vet office. I'm waiting for a call back from her and will ask about the sensitivity test and if FLUTD is a possibility, as well as 2u possibly being too high. I uploaded a spreadsheet to my signature and will plan to do a curve tomorrow and will fill in that information (look for another post from me after I do that!).
So if I were to pretest and the number was low, would I skip the shot and wait the 12 hours and test again? Do anything in the meantime? I've printed out the very helpful info on hypoglycemia.
I feel so bad for our buddy and also feel frustrated with his not being regulated, but it make me feel less like I'm failing him to hear that there are some kitties who just don't get regulated, but that they're still better off with some insulin. But I'm determined!
Thanks again! :)
 
oslo said:
Oslo had a urine culture done at his last check-in with the vet (about 10 days ago)...she left me a message saying that the lab didn't find any bacteria growing although they had seen bacteria at the vet office
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The problem could be that he was on antibiotics.....the reason it's important to do the C&S at the FIRST visit is because once there are antibiotics on board, it can skew the results.

To truly know what's going on with a UTI, you need to do the C&S when they haven't had any AB for at least 7-10 days
 
oslo said:
So if I were to pretest and the number was low, would I skip the shot and wait the 12 hours and test again? Do anything in the meantime? I've printed out the very helpful info on hypoglycemia.
Click to expand...
You can try doing something we call "Stalling". Let's say you get a lower Preshot reading (less than 230). Do not feed anything besides 1 after test treat, wait 20 minutes and retest. Sometimes the extra 20 minutes can show if his BG is rising on it's own and if it goes over 230 you can feed and give insulin. If his BG goes lower, you can 1. Stall another 20 minutes without feeding or 2. Feed meal and skip insulin shot.
As you become more experienced, the No Shot number of 225 can be lowered some :). You'll probably see other posts telling new members not to shoot below 200 but this is for human meters. Since you're using the AT2 pet meter, will bump it up a little more for safety ;)
oslo said:
I feel so bad for our buddy and also feel frustrated with his not being regulated, but it make me feel less like I'm failing him to hear that there are some kitties who just don't get regulated, but that they're still better off with some insulin. But I'm determined!
Thanks again! :)
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None of us like seeing our fur baby's not feel good :bighug:. You would only have failed him if you decided to do nothing, which you have not! :bighug:. My boy is one of those non-regulated kitty's but we've made a lot of progress in 8 months and now he's just a little bouncy in nice numbers. So he is a controlled kitty but not regulated :cat:
 
@Chris & China and @Larry and Kitties - oh, ok....that makes sense. If he doesn't improve after this round of antibiotics, I'll consider another culture after he has been off of them for at least 2 weeks.

@Yong - wow, this is really helpful. So good to know that a lower number is 230...the vet told us that his numbers on a good, regulated curve should be between 90-200...did I misunderstand? I have so much to learn!

I'm so grateful for this resource...thank you all!
 
oslo said:
the vet told us that his numbers on a good, regulated curve should be between 90-200...did I misunderstand?
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No, you didn't misunderstand exactly.....we consider normal numbers on the AT to be between 68-about 150......but until you have enough test data to understand how Oslo reacts to both insulin and food, we err on the side of safety...so at first, if you get a test under 230, you'd want to stall, don't feed and post for help so someone with experience can be watching out for you during that cycle
 
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