Semi-Newbie could sure your opinions

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allaboutdean

Member Since 2014
Hello..I'm a Semi-Newbie..I have visited this website many times in the past because I had a diabetic cat. I'm glad to have the opportunity to offer my Thanks and I would like to ask for opinions regarding my current situation.
My 18 (yes, I said 18) year old cat, Dean, was rollin' right along until he started sneezing..2 months ago.
LOOONG story short..it was a Herpes virus flare-up for which he was given Prednisolone....turns out this was a bad choice
Ok, so now he has drug-induced diabetes and he also has a high free T-4 (hperthyroid)
In my opinion he does not show symptoms that I have observed previously in a diabetic or for that matter a hyperthyroid..had both.
He is being prescribed Methimazole for the Hyperthyroidism and 2 units twice a day of Glargine insulin.

BTW..Not thrilled with the new Vet, not very informative.
I'm trying to find out if one can effect the test results of the other.
Can an elevated free T-4 effect blood glucose levels or vice-versa.
I would like to know if anyone has any experience with treating both problems at the same time.
TIA
Dean's Mom
 
Larry and Kitties
Thanks for your interest

The lab results state...Total T-4.... 3.2 ..and.. Free T-4 dialysis ..82

Meanwhile..I am not a fan of Prednisolone..Vet assured me that this was the right drug for Dean, eventhough she was aware that when Dean was about 7ish he was diagnosed with diabetes that remissed with a diet change...I have since found out that you should never give Pred to a diabetic cat. Now, he's in a pickle.
 
Here is what the IDEXX lab says about T4
Interpretive ranges:
<0.8 Subnormal
0.8-4.7 Normal
2.3-4.7 Grey zone in old or symptomatic cats
>4.7 Consistent with hyperthyroidism

Cats with subnormal T4 values are almost exclusively euthyroid sick or
overtreated for their hyperthyroidism. Older cats with consistent
clinical signs and T4 values in the grey zone may have early
hyperthyroidism or a concurrent non-thyroidal illness. Hyperthyroidism
may be confirmed in these cats by adding on a free T4 or by performing
a T3 suppression test. Following treatment with methimazole, T4 values
will generally fall within the lower end of the reference range
(0.8 - 2.3).

To me it is not clear that your cat is hyperthyroid.
 
Larry and Kitties
I agree.. I have since been bing-ing and google-ing
I have learned that diabetes can elevate a free T-4 and since his "total' was normal for his age, I think that the diabetes may be causing a higher than normal free T-4...
Thanks for your reply
Dean's perplexed Mom
 
Wendy & Tiggy
Dean was prescribed 2-10mg tablets every 12 hours for 2 weeks with a 2 week weaning-off (not supposed to just stop Pred.)
In fact, I had only dosed him for a week, when I happened to run in to my former Vet (retirerd). She was stunned that with his history , he should be prescribed Pred and that the dose was very high. She told me to get him off of it ASAP. I weaned him off of it, but the "damage" was already done. He started testing with high blood glucose, which initiallly was not in his urine, but a week later, it did show up in his urine. I have since learned that this is not uncommon and that it could be temporary or permanant. (I picked up my prescription for the Glargine today and I was "thrilled" to find out that it cost $350 a bottle!
Thanks for asking
 
Once the prednisone wears off his blood glucose might come back down again. Lantus lasts six months if you keep it in the fridge and don't roll or shake it.

Are you home testing? It's important especially in this case where you don't know if the effect of the prednisone is temporary and you want to watch for overdose,

Wendy
 
Wendy & Tiggy
He has been off the Pred for about 3 weeks, I don't know if it's still in his system.
Meanwhile, I have not started the Lantus, yet.
His most recent glucose test was yesterday at the Vet..he was 516.
What's strange is his behavior, which is very Dean. No excessive drinking or urinating, appetite normal, etc.
I know that the numbers are what the numbers are, but he is behaving normally...go figure!
I will test him myself tomorrow.
Fortunately, I have been able to chat with my former vet, she wants me to hold off with the insulin until she gets a copy of yesterday's bloodwork.
All this should be sorted out tomorrow morning.
Thanks ..I appreciate your replies
Kiss the kitties for me!
 
You really need to check for ketones with that high of a glucose. There are some tips on that in my signature link Secondary Monitoring Tools.
 
BJM

They checked his urine, yesterday..no ketones. I will pick-up urine test strips tomorrow. Are they reliable?

Thanks for helping.
 
Yes, ketone test strips work fine. They tell you what has been happening since the previous void.
 
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