Royal Canin and Antibiotics

[JGeorge0890]

Hey everyone!

I am new here but I wanted some advice. My cat Mister was diagnosed about a month ago with diabetes (450 aprx). At the Vet's recomendation we immediately switched his food to Royal Canin and began insulin injections of Lantus.

Mister was doing alright for the first two weeks and we had a follow up visit that his BG reflected about 340 but he had gotten fleas in between visits. We treated for fleas and the doctor gave him antibiotics for the bites he had. That night his BG spiked so high he was lathadgic, vomitting, and refused to eat!!

We took him the the emergency pet hospital where they admitted him. He was in an emergency state and they started testing. They put him on an insulin IV and started antibiotics. They didn't find any infections, kidney problems or cancers.

His sugar since then has been up and down by huge amounts. He's home now but we are still giving him antibiotics. Could the antibiotics have caused this problem as he was in a safer state before we gave it to him?

Also the only other large change was the food. Is it possible he'd do better on different food? We were feeding him Special Kitty Dry (Walmart) and switched to Royal Canin Dry. We are checking his sugar twice a day but wondered if anyone else had similar issues.

Thanks in advance,
Jen

 

[Larry and Kitties]

he was lathadgic, vomitting, and refused to eat

Many cats experience those symptoms after given oral antibiotics.
Also some times an abrupt change in food can cause some of those symptoms. Yo really want to feed a low-carb food and those ore really canned food. The following is a listing of canned food with the carb content listed.
http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
You want a canned that has 10% or less calories from carbs.
With switching to low-carb food the insulin dose may have to be reduced.

What insulin and dose?
Good insulins are the human Lantus and Levemir and the pet insulins ProZinc and BCP PZI. For those two human insulin it is best to get the 5 pack of 3 ml disposable pens via a 10 ml vial. Although per ml the vial is less expensive most cats will not use up a 10 ml vial before the insulin goes bad/becomes ineffective. The human insulin N/NPH is sometimes prescribed but only lasts 8-10 hours. Same for the pet insulin Vetsulin/Caninisulin.
Most of us here test our cat's blood glucose at home using a human meter. We test before each shot and periodically between shots. We record our reading and other info in a spreadsheet. See:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
Here is a link to home testing blood sugar
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

 

[JGeorge0890]

Before he was diagnosed we were feeding Special Kitty Dry food, now we are using Royal Canin Glycobalance also Dry food but it is very expensive.

His insulin is Lantus and right now we are doing 4units. His last reading said 626

We have a pet meter from the vet we are using to monitor.

 

[Tracey&Jones (GA)]

His insulin is Lantus and right now we are doing 4units

Was that your starting dose on Lantus? Did they happen to mention DKA at all while he was at the emergency?

Kudos on the home testing. Big first step and the best tool we have for regulation and keeping kitty safe.

There can be a couple of things going on here:

• Like Larry & Kitties said - it can be the food change and/or the antibiotic giving him stomach upset.
• The de-flea medication = maybe?
• The dose may be too high and if you are only testing before giving the shot vs testing between shots he may be going too low and then bouncing back up and you are only catching the highs.

When are you doing the testing?

 

[JGeorge0890]

When are you doing the testing?

We started with 1 unit of lantus and it had gone down from 450 to 340 so the doctor had said to go up to 2 units but we never got a chance because that was the day Mister went into the hospital. Also the same day he got the antibiotics shot and started the antibiotics orally the next day.

We changed his food when he was first diagnosed so he went 2 weeks without a disaster on the new food.

We do the testing before we feed him and then give the insulin after he eats. This is usually like 6:40 reading and 7:00 insulin.

While he was in the hospital they tested for a lot and he had keytones (not sure how that's spelled) but it was taken care of by the time he came home.

 

[Tracey&Jones (GA)]

Ok, so the 4 units is 2 units twice a day then?

That is spelt right. Did they tell you if it was a DKA episode (Diabetic ketoacidosis)? I ask because DKA usually happens when there is an infection, high BG's with not enough insulin and not eating enough food. And once a kitty has a DKA episode they are more prone to having another. And it can be a life threatening situation if not caught early. So, you may want to pick up some keytone testing strips from your local pharmacy to have handy. Then it is just a matter of "catching" him peeing. I have a stainless steel soup ladle and I watch when he goes and I slip it under him to get some urine. You only need a drop. Some have put some crinkled up saran wrap in the box to catch some urine.

So I am sure you have done some reading, if not check out the yellow sticky notes on the Lantus forum.

 

[Tracey&Jones (GA)]

We do the testing before we feed him and then give the insulin after he eats.

Has anyone talked to you about setting up a spreadsheet like the ones we use here? It will help you track his numbers and dosage and it helps the people here if you have a dose question.

Here is how to set one up and if you need help - give a shout.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

And this is how to read the spreadsheet - which will help you see the patterns.
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

And this is how to set up that information you see at the bottom of everyone's post. So we don't ask the same questions over and over and over.
http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

 

[JGeorge0890]

Has anyone talked to you about setting up a spreadsheet like the ones we use here?

No one has talked to me about it but today is the first day I've been on this site. I have been logging how much he eats, his insulin, his BG and the antibiotics we are giving him.

 

[JGeorge0890]

Ok, so the 4 units is 2 units twice a day then?

4 units twice a day. But his sugar is still pretty up and down. One reading could be 350 and the next is 550. That's why I was wondering if the antibiotics could be effecting how he takes the insulin. His BG was not too bad until he got the first set of antibiotics.. that's when it started going up and down so drastically.

It was DKA so we are keeping a close eye but we have 5 other healthy cats so it would probably be really difficult to test him for that.

 

[Tracey&Jones (GA)]

No one has talked to me about it but today is the first day I've been on this site. I have been logging how much he eats, his insulin, his BG and the antibiotics we are giving him.

I would set up a spreadsheet. Take a look at Jones in my signature. I have extra tabs for tracking calorie intake, food that he will eat and should eat with carb% and there is a comment section to put notes in. You will notice I put lots in some days. That way if anyone looks they can kind of see what is happening.

I would get at least 4 tests in each day if you can. The AM pre-shot number - to see if it is safe to give the insulin, a mid cycle one - anywhere about +4 to +8 from injection and then repeat at night PM pre-shot number and another test before you go to bed. The key here isn't how high he is when you give the shot but how low is it taken him? And then how is he reacting to that. Insulin being a hormone is not a give X dose and get Y outcome. It is more of a dance but we need Mister to tell us his story through testing.

I can't give dose advice but I am wondering if the flea bites and infections caused his BG to rise - then the antibiotics started to kick in which could lower the BG's as the infection subsides. Then his dose was increased quite significantly and quite rapidly at the same time - which means you could of just shot right past a good dose from him.

Eventually you may want to change his food once you are routinely testing. That food is actually high in carb especially the dry. You should be using a wet food that is less than 10% carb. Here is a list of a lot of commercial foods and the carb %. http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
I wouldn't do this though until you have his DKA episode behind you (Mister may not feel good for a few days).

 

[Tracey&Jones (GA)]

Once you have your spreadsheet up and linked to your signature. You may want to post your results and ask for dosing advice in the Lantus forum. Lots of experienced eyes over there. We can help you with anything - home testing techniques, getting keytone testing in, help with adjusting the dose in a systematic way that will help Mister and so much more! Ask us anything.

I am concerned the dose is too high for Mister (proof will be in the testing). Which is sending him lower than he is used to and then he is bouncing. Bouncing can occur whenever Mister's body thinks that his blood sugars are too low and the liver will dump glucose in response. It doesn't mean he is low or in a hypoglycemic state - just that his body perceives that way. And this can occur when the dose is too high as well. If you look at Jones sheet in the beginning you can see when I was adjust the dose up and then down then all over without enough testing. Then you can see where the testing started and the changes to dose were calculated, based on the protocols here and with the help of the people here.