Returning User, needs some guidance

Status
Not open for further replies.
Ellspeth

Ellspeth

Member Since 2015
I was on this wonderful forum about a year ago when my dear cat was originally diagnosed with diabetes and hypercalcemia. I was one of the lucky ones, and both conditions went into remission once I got him on proper food. I was and still am grateful for the help and support I got here. Thank you all for making this seem less scary and more manageable.

About a week ago I started noticing some new and recurring symptoms. Lack of grooming, increased in water consumption, increased litter box use, and now my poor guys meows like he's upset or in pain. According to his vet visit in Jan and now, he has lost .5 lbs since January.

I bought new testing supplies since all mine had expired, and so for have the following data:
4-27 4:11am 207
4-26 4:43pm 333
4-26 6:00am 283
4-25 10:09pm 358

On 4-26, I changed his Fancy Feast grilled back to the classic pate, and removed his dry Hills w/d food. He was taken to the vet today and he does NOT have any ketones in his urine YAY. We are waiting on a full blood panel to return in the morning, but here are my questions:

My new vet (I just moved from San Diego to San Francisco in January) has indicated that diabetic cats normally have kidney problems too. Has that been anyone else's experience? I believe I have also read that all dry food is worse than wet food, has anyone else experienced remission from switching to an all wet diet for their cat(s)? Do any of you think the limited BG curve above warrants insulin? Are insulin injections normally given daily? twice a day?
 
It's good that you're removing the W/D....it's way too high in carbs for our diabetic cats and is most likely the reason Godric came out of remission. Once a diabetic, always a diabetic, so it's important that he stays on a low carb canned or raw diet the rest of his life.

Diabetes is very hard on the kidneys, so kidney disease is a very common problem. Keeping their blood glucose under renal threshold will help protect those kidneys, as well as getting as much water into their body as possible. A lot of us add water to our canned food just to increase the amount of water our cats get. Depending on the source you look at, renal threshold can be anywhere from about 150 to 250

If he were my cat, I'd get the dry food out of his diet completely and onto a low carb canned food as soon as possible and test over the next several days.....It's possible that getting back to a low carb diet may bring those numbers back down and keep you from having to start on insulin. It's also safer to lower the carbs he's eating now...before you start giving insulin.

If the numbers don't come down in a few days, it's important to go ahead and start on insulin to get him back under control as quickly as possible. A second remission is a lot harder than a first one so you're already fighting a harder battle. You'll want to make sure to get a good insulin for cats too, like Lantus, Levemir or ProZinc.

Cats have a fast metabolism, so all insulin is given twice a day...every 12 hours

Keep asking questions! The people here are great about sharing their experience and wisdom!
 
Sooooo blood test results came back and my vet says my cat has mildly elevated liver enzymes which indicate pancreatitis. She wants to start him on insulin but since we JUST removed dry food and his BG came down, we are waiting for that to settle first. I am also going out of town for a wedding next week, and since I just moved I have 1 acquaintance who can catsit but is not comfy giving injections. I am also not ok leaving and having hi start treatment. The vet is on board with waiting 1.5 weeks before we start insulin. By my next trip I will have either saved up for boarding or found an adequate sitter. I do have a good friend nearby but she is recovering from a surgical procedure and can't help right now.

My vet wants to do 1 unit of glargine to start off with. She thinks since he went into remission before and ALL other test results are normal, it is possible that with this diet change combined with some insulin to let his pancreas rest, he may be able to go into remission again. 1u t start seems like a lot, and I haven't done ANY research (yet) on this brand. Does anyone have any info on it?
 
Glargine is an excellent insulin...it's the same thing as Lantus

As for waiting to start, I think considering the circumstances, it's probably a good idea, especially since you're going to be out of town and nobody around is able and willing to give shots and test

1 unit is a pretty standard starting dose, but it depends on his weight, what kind of food he's eating and which protocol you want to be on. Spend some time reading the "sticky's" at the top of the Lantus Forum....there's lots of great information there (almost too much, so don't get overwhelmed!...we'll be here to help you!)
 
I've been spending a lot of time reading and learning about this. I am still not opposed to insulin, but since removing his dry RX food my cats BG levels are staying around 170. I can't find a conclusive answer on what BG level range is considered in remission, does anyone know?
 
To be considered in remission, the BG needs to be between 50-120 without insulin for at least 2 weeks....with most of those numbers being under 100
 
Excellent notion removing his dry food. I'm still learning this game, but one thing i do know is NO DRY food ever for any cat who has ever had glucose issues. I hope your kittie manages remission again without insulin. That would be great! Hoping by the time you return from your trip, his numbers will be even better.

Insulin is given twice a day. We are on the lantus glargine.
 
Thank you all for your replies, I can't tell you how reassuring it is.

I spent a quiet weekend at home which allowed me to have extensive time to test my cat. I removed all dry food on Tuesday night, April 26 and all weekend my BG tests ranged from 87-140. This includes a test done 1 hr after mealtime. These numbers seem far too low to me to safely give insulin. I've called my vet to inquire, but I was interested in all of your feedback as well. If my cat is in this range, and has not had a spike above 140 for 3 days, is insulin safe?
 
If you're getting numbers under 140 on the AlphaTrak meter, those are pretty darn good numbers!!

You might want to try testing in the morning and then feeding and testing again in 3 hours....if the number comes down, his pancreas is doing something!!
 
My vet gave me 3.9 - 8.3 mmol/L / 70 - 150 mg/dL as the normal BG reference range for a cat as measured on an Alphatrak meter. On that basis all of Godric's numbers would have been in the normal BG range, albeit with some of them on the high side.

The following suggestions are based on the assumption that you're still not giving insulin.

In order to assess how well his pancreas is functioning you could try fasting him for 2 hours, taking a BG measurement, feeding, lifting the remaining food and then testing BG at +1, +2, and +3 hours after the meal to see how Godric's system manages the blood glucose levels. If the numbers go down then it will give you a gauge of how well the pancreas is pulsing insulin. If the response is good then you might consider feeding mini meals every few hours day and night to use the mealtime insulin pulses to help keep Godric's numbers in a lower part of the normal range.

It would also be advisable to test Godric's BG levels after a fairly long fast. If you fast him for, say, 5 or 6 hours (assuming that this is medically safe for him to do so) and the BG levels spike after the fast then that can be a pointer to Godric having impaired fasting blood glucose regulation. Should that be an issue, a spell of insulin therapy might help the pancreas to rest a little and possibly create the foundation for a stronger remission. Provided you can home test and track data it is possible to microdose at lower numbers with one of the longer-acting, 'gentler' insulins (e.g. Lantus, Levemir) to give the pancreas a little more support and healing time. It's an option to consider and discuss with your vet.


Mogs
.
 
Status
Not open for further replies.
Back
Top