Rising BGL, going to need help

[alex7 & Bigboy feral cat]

Bigboy's severe stomatitis has not resolved using surgery and meds. His quality of life has been deteriorating due to the pain and not eating. I was able to finally get an appointment to see my regular vet of 40 years. He examined him and said his mouth looked liked raw hamburger. We discussed everything that was done so far to control the stomatitis. We also discussed his diabetes, and that he has been well controlled. I have not been giving insulin for the last few weeks because he has been in normal ranges. My main priority has been getting him to eat, staying hydrated and pain free. He is a fiercely feral cat and I can only get bgl checks while he is distracted eating.
I asked my vet to give him a steroid and convenia injection to help his mouth heal, with a plan to go back in and re-do surgery. Within 24 hours he is a new cat. He is eating, grooming, purring, playing and wanting to cuddle! However his BGL is rising rapidly, which I knew would happen.
I need to know what other members have experienced when they had to have intermittent steroids given to their sugarcats. I also need guidance in dosing under these unusual circumstances. Does anyone know of a steroid injection curve, onset, peak, duration, etc? I am assuming he gave a (vetalog) kenalog injection. I need to know when to test, and how often because of the influence of the steroid.
Please review his spreadsheet if you can. Thank you so much.

 

[Bron and Sheba (GA)]

Hi. I’m sorry he is having all this trouble with his mouth. I’m sure it is painful.
My daughters cat had a mouth that looked terrible too. It was decided that she needed most of her teeth out. She has been absolutely fine since then. Her mouth looks normal.. No redness at all. She has no issues eating a raw diet.

I can’t help you with dosing around steroids but I’ll tag @Wendy&Neko. She may be able to help you.
Healing vines to Bigboy

 

[jt and trouble (GA)]

My heart goes out to Bigboy. I'm grateful he has such a good caretaker. I have only prayers and encouragement to offer. Our feral with stomatitis didnt have diabetes(thank God) But he declined to the point, that we had to make "the" decision. He would never come close but never missed a meal. Would disappear for years at a time. In the end we wound up just trying to make him comfortable with metacam. He loved the stuff but it is VERY hard on the kidneys. He was a neat cat looked, walked, acted completely feral but would take the metacam climbing up my leg! Poor ol Tux. I miss that little guy.

Sending healing prayers vines for Bigboy and strength for you!

 

[Sienne and Gabby (GA)]

To the best of my knowledge, there isn't a dosing method when cats are on a steroid. When a cat needs a medication that has an effect on BG levels, the position has always been that you can work the insulin dose around the other medication. I would talk to your vet about the particular steroid. Like many medications, depending on what the drug is, the dose, etc., the duration may vary. Bottom line, the only way for you to truly know how the steroid is effecting BigBoy's numbers is to test. While I realize that is a challenge, would it be at all feasible to feed him several smaller meals so you can get tests while he's eating?

The good news here is that you are using Prozinc. If necessary, you can adjust the dose without not too much of an issue.

 

[Wendy&Neko]

I have seen cats react differently in response to a steroid, so there isn’t a prescribed way to deal with it, other that following what the BG numbers tell you to do.

 

[alex7 & Bigboy feral cat]

Thank you for your responses. I am able to test every few hours, because he is eating now. He went from amps 560 to 161 at +5 with 1 unit prozinc. I think because of the steroid effects and not knowing when the effect will start declining, I will need to be super vigilant on testing. I was micro-dosing 1 drop last month.

 

[Bron and Sheba (GA)]

How is Bigboy today? I hope he is still enjoying feeling better!

 

[alex7 & Bigboy feral cat]

How is Bigboy today? I hope he is still enjoying feeling better!

Much better, thank you. His quality of life has improved 100%. He is eating like a horse, grooming, purring. I have been able to take him off all the other meds. Since he is on insulin again, I am going to slowly switch him to a limited ingredient diet of venison. He did well on it before. The lowest carb l.i.d. venison I could find locally is natural balance venison. According to Dr. Lisa's food list it is 13% carb. I will need to adjust his insulin accordingly. I will need some help. I started him on 1 unit prozinc, but reduced him to 0.75 because of the huge drop from 561mg/dl to 161 md/dl in five hours. I think I needed to start lower. Last night I gave him a fur shot, so I expect his bgl to be high today. Using prozinc , I need to make adjustments based on preshots and nadir information together, but I am not sure what the ratio's are. Do I try to get a nadir that is 1/2 of preshot number?

 

[Wendy&Neko]

Great report on Bigboy.

Both Nature's Variety and Ziwipeak venison products are 3% carbs.

Have you read the recently updated version of the Prozinc Dosing Guidelines sticky note?

 

[alex7 & Bigboy feral cat]

My heart goes out to Bigboy. I'm grateful he has such a good caretaker. I have only prayers and encouragement to offer. Our feral with stomatitis didnt have diabetes(thank God) But he declined to the point, that we had to make "the" decision. He would never come close but never missed a meal. Would disappear for years at a time. In the end we wound up just trying to make him comfortable with metacam. He loved the stuff but it is VERY hard on the kidneys. He was a neat cat looked, walked, acted completely feral but would take the metacam climbing up my leg! Poor ol Tux. I miss that little guy.

Sending healing prayers vines for Bigboy and strength for you!

Thank you Jt. I know how you feel. It is hard not to get attached to the ferals. I love studying their behavior in colonies. It's amazing how they each deal with conflict, how some of them buddy up with each other or how they try to join the ranch cat group. I always feed canned at night so I can do a head count and make sure everyone is okay.
So many cats are dumped out here. We adopt out anything tame and disease free. We only keep the ones that are not adoptable.

 

[jt and trouble (GA)]

Thank you Jt. I know how you feel. It is hard not to get attached to the ferals. I love studying their behavior in colonies. It's amazing how they each deal with conflict, how some of them buddy up with each other or how they try to join the ranch cat group. I always feed canned at night so I can do a head count and make sure everyone is okay.
So many cats are dumped out here. We adopt out anything tame and disease free. We only keep the ones that are not adoptable.

God bless you!
We did a very aggressive TNR up here a few years back. The only one I couldnt trap, was ol Tux Kitty. Most of the
release'es took off and I never saw them again. Tux would come and go weeks at a time. sigh His endurance just amazed me. It was very difficult catching him that one last day. He would do ANYTHING for that metacam and thats what I used to lure him in. I felt like I betrayed a trust. Brings tears just remembering it again.

 

[jt and trouble (GA)]

I hope you and Bigboy endure.

 

[alex7 & Bigboy feral cat]

Great report on Bigboy.

Both Nature's Variety and Ziwipeak venison products are 3% carbs.

Have you read the recently updated version of the Prozinc Dosing Guidelines sticky note?

No one local sells the venison versions of those brands, small town. I will try to find them online. Our neighbors are letting us borrow an old computer, while everything is closed down, and everyone in the pnw is staying in. I will also read the revised prozinc guidelines, thank you.

 

[alex7 & Bigboy feral cat]

God bless you!
We did a very aggressive TNR up here a few years back. The only one I couldnt trap, was ol Tux Kitty. Most of the
release'es took off and I never saw them again. Tux would come and go weeks at a time. sigh His endurance just amazed me. It was very difficult catching him that one last day. He would do ANYTHING for that metacam and thats what I used to lure him in. I felt like I betrayed a trust. Brings tears just remembering it again.

I am so sorry, I know how that must hurt. We try so hard to keep them comfortable. The best that we can do is spay/ neuter, test, vaccinate and feed them. Vet them when you can. I feed all the outdoor cats in a trap. That way if one is sick or hurt, I can set the trap to catch them. Some are so smart, they will slide the food tray out of the trap before they'll eat. I have been outsmarted many times.