? Remission Questions

symian277

symian277

Member
Good morning. I am wondering about my Skye girl.

Background to the questions:
She has been in remission since September of 2020. She does not seem to be drinking an excessive amount and her litter box is pretty standard for her. Recently, however, I am noticing that she seems to be more hungry. She has also been vomiting. Some of that is due to how fast she has been eating, but I am not sure if that is all of it.
I checked her blood sugar this morning and it was 153 mg/dL on a ReliOn meter. I am, of course, going to check it again this evening when I get home from work. She had some food left in her dish so I am not entirely sure that she didn't have a morning snack. I also didn't realize that my one tube of strips had expired in April. I am going to be getting a new tube this evening. Random checks have been showing her blood sugar around 90 mg/dL up until now. The only exception was when she was in the emergency vet after vomiting from a new arthritis medication and we had to travel an hour to an emergency vet that would see her.
I realize this may be premature but I want to be prepared.

Questions:
If she comes out of remission is it possible to get her back with a short course of insulin? She is already on low carb food that is also low in phosphorus for her newish onset mild renal failure. (She has been on it for several months).
ProZinc seemed to work well for her last time. Should we stick with it if she goes back on the juice or is there a better option?
Any other advice?

Thank you everyone! I am feeling that same fear as when she was diagnosed in 2020. I REALLY hate giving insulin and all the dangers that involves.
 
So unfortunately second remissions are usually a long shot, but not impossible. And it looks like you probably caught it early, which is good!

There's a few things to rule out first (aside from bad strips/meter battery):
  • Possible infection/inflammation (you did mention arthritis which could qualify - how long has she been on meds, and how long ago was the vomiting issue?)
  • Possible dental issues - this is the #1 cause of relapses
  • Thyroid issues, strongly suggest a T4 test
  • CKD can make BG a little funny, but usually not in the early stages when it's manageable with food and fluids
 
I am getting new strips this evening so I am going to check her blood sugar again with the new strips. I am also planning on tomorrow morning. If I get three in a row we are going to set up a vet appointment. She has one in early November for a rabies vaccine so she is going in regardless, but if this is not resolved it will be sooner rather than later.

She is not really on anything for the arthritis other than joint supplements. I had her on Gabapentin for the pain but all it did was make her wonky. She was still limping around and she moved even less than she has been. We tried her on a course of Adequan but she started vomiting within 15 minutes of her first injection and we had to stop. This fall we are hoping that they will approve a particular set of monoclonal antibodies (the trade name escapes me right now) that is in use in Europe and has shown good promise. I don't really know what else I can do for her. I haven't found any other great ideas and my vet doesn't have any either.

She does have dental issues, but I am hoping that we are not dealing with that again so soon. She had a set of extractions in January when we found her to have the beginning of renal failure. That will definitely be one of the things that I bring up when I take her in.

I will have to look at the latest round of bloodwork for her. I am not sure if they tested her thyroid at her last appointment. Another thing I plan to bring up for sure.

They did a renal panel on her a couple of months ago when she was last seen. The vet was super happy about her numbers. She did have some elevated values but they were within high normal. She is currently eating the lower phosphorus food (or as low as I found for a diabetic diet) and on a renal supplement. We have not progressed to any fluids or medications at this time.

Thank you so much for the ideas and advice! I REALLY hope this was a one off. I was kind of afraid that if she came out of remission that it would not be likely to be corrected. :(
 
Her blood sugar was 99 mg/dL last evening but we are back up to 148 mg/dL this morning. We had food left from last night so I am not sure how long it had been since she ate something. Of course she jerked and I cut her ear. :confused:
We have an appointment coming up soon for a Solensia injection. Yay! Would a frucosamine level be helpful?
 
I would not bother with a fructosamine. She is just barely above the normal limits that a fructosamine would come back normal or borderline. Depending on vet, they might not even want to do anything about it.

I would start with teeth and arthritis and see where that leads. Obviously check ketones here and there as well just to make sure.

At this point I would check her every other day, or 2-3x a week just to make sure it isn't climbing. No need to bother her for more than that lol
 
After this morning she will be super glad to hear that advice. I feel like the meanest cat mama ever after cutting her ear with the lancet. :oops: We are going to give the right ear a little break. Unfortunately that is her best ear (for me) to get a sample from.

She is actually going to see the vet as well as the vet tech on Tuesday when we go for her injection. I will have her look over her teeth while she is there. I am really hoping that this injection will be amazing for her because I know she is in pain. They have had great success in Europe with it. If we can get her feeling better so she wants to move we can work on getting more vigorous play. Dropping her weight a bit will help both her diabetes and her joints.
 
I know a lot of people here have been waiting for Solensia, really hope it works!
 
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