Spicoli pt 3

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Wesley and Spicoli

Wesley and Spicoli

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So we've done a few more increases, up to 6u. Today after his mid morning snack (didn't eat much for breakfast) he was napping by me. He suddenly woke and started rolling around and meowing as if he was in pain. He jumped off the bed and continued this behavior before just crouching as if he was in pain.

I immediately rushed him into the vet....Got a lecture on insulin and Somogyi effect (not our usual vet). However he thinks that cat had a seizure due to constant higher bgs. Is this possible?

So Spicoli is staying at the vets...again. I'm a little frazzled as i've never seen a cat act like this before. And he's been acting so wonderful lately - like a normal cat. Playing, grooming, eating, everything. Even though he's still been more elevated than I'd like his behavior hasn't been this good in a few months.

Any ideas?
 
W.K. said:
So we've done a few more increases, up to 6u. Today after his mid morning snack (didn't eat much for breakfast) he was napping by me. He suddenly woke and started rolling around and meowing as if he was in pain. He jumped off the bed and continued this behavior before just crouching as if he was in pain.

I immediately rushed him into the vet....Got a lecture on insulin and Somogyi effect (not our usual vet). However he thinks that cat had a seizure due to constant higher bgs. Is this possible?

So Spicoli is staying at the vets...again. I'm a little frazzled as i've never seen a cat act like this before. And he's been acting so wonderful lately - like a normal cat. Playing, grooming, eating, everything. Even though he's still been more elevated than I'd like his behavior hasn't been this good in a few months.

Any ideas?
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No ideas other than I'm skeptical of the idea than elevated BGs caused a seizure. It might be worth considering a trial of Lantus or Levemir though.
 
I've been thinking about changing insulin types... just doesn't seem like prozinc is doing the trick anymore.

Since I know you've used both how much better do you like Lantus vs. Prozinc?
 
W.K. said:
I've been thinking about changing insulin types... just doesn't seem like prozinc is doing the trick anymore.

Since I know you've used both how much better do you like Lantus vs. Prozinc?
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Lantus has been better for Teasel. He's still bouncy but less so and he's a bit more predictable now.
 
I have to wonder about a seizure due to higher numbers as well. Maybe it was a hairball? Just for another 2 cents, I am liking Lantus a little more for my boy too :cat:. Hope Spicoli gets to come home safely soon :bighug:
 
Yong said:
Hope Spicoli gets to come home safely soon :bighug:
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Thanks :) I'm sure he will. I doubt it was a hairball...he hasn't thrown up in...well longer than I can remember. I suppose it could have been one passing through his system though.

Yong said:
I have to wonder about a seizure due to higher numbers as well.
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Yeah, not sure I'm buying that one. I've tried to find something on the topic but there really doesn't seem to be anything...

I guess I just worry that maybe the reason he became diabetic could be a pancreatic tumor...and what if it was rupturing...that's why I went to instant panic mode and rushed him in.
By the time the vet was checking him out, you'd have never thought anything was wrong. He was jumping from the floor to the counter and didn't seem to be in any sort of distress. I'm just a worry wort over him. He's just super special to me, one of those rare bonds unlike any other I've had with the other 12 cats I've had.

Our vet will be back in the office tomorrow and I think I'm going to bring up switching him over to Lantus and see what he thinks. If he won't budge I might be finding a new vet. There's a nice cat only clinic about 45 mins away. And the vet/owner has even written about FD and seems pretty well versed in the topic.
 
High blood glucose can cause seizures in humans, so I think it could be possible.

I would also suggest you read about Levemir. Some people prefer it for the higher dose kitties because they say Lantus can sting in larger doses, and Levemir doesn't. I wonder if it also might be worth getting Spicoli tested for the high dose conditions. It's something to consider once a cat gets to six units.

Those conditions wouldn't explain the seizure, but they might impact your dosing decisions.

Hopefully your regular vet will have some ideas too. Please keep us posted on what happens!
 
I'd look into Lev too for those higher doses...works very like Lantus, but it is used more in high dose kitties.

I would have rushed right into the vet too...you did the right thing!
 
Just went and picked him up... they wanted to send him home after they saw how his bgs were doing. We were a little late for his shot tonight. He was at at 464 at about a half hour past his usual time. Vet recommended we back down to 5.5 at least for tonight and see how things go this evening. I plan on staying up pretty late to say the least. I didn't get all his numbers for today but was told he dropped into the 90s around +6.

Going to try to take him in next week sometime and discuss that insulin change.

Djamila said:
I wonder if it also might be worth getting Spicoli tested for the high dose conditions.
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I've already asked his regular vet about this. He said there are a number of different tests we can do (i was interested in growth hormone). Also, since he has suspected IBS it has been recommended that if he doesn't get regulated in the next couple of months to do intestinal biopsies. But I honestly don't know if this will be financially possible and I don't want to do the cheaper endoscopic since it's not as accurate. Any of you guys have any experience with this?
 
Well we're having a strange day...

8/31 pmps 316 reduced to 5
+2 245
+4 114 fed 14% carbs so i could sleep

9/1 Amps 572
+4 365

pmps 151 stall retest 177

any advice? 3 test strips left...more should be here tomorrow but i need 1 for am.
 
It's been an hour since the 151.
He's risen to 248.
Dosing ideas?

From the way he dropped last night I'm thinking 5u is way too much for tonight.
 
Hey Wes, I'm out of town (actually in your state :P) but trying to check in once a day lol. I can't see your SS on my phone but are you thinking of dropping to like 4.5 or just a tiny decrease at a time?

*paws crossed* these are good signs for Spicoli!
 
I ended up going with 2.5u last night.
The last time he was that low for preshot I did 3u and he bounced.
But overall I am thinking of dropping his does as it seems to high now.
We had a fur shot this AM so I'm not testing today :( But i think i may try the 4.5u for a bit and see where that takes us.
 
It's hard to know what to say...I'm terrible at decreases. It does look like the 5.75 was too much as it gave you some long cycles, but 2.5 was too little. I think your idea of trying 4.5 for a few cycles would be good. See what that does...then you can go up or down from there as needed.

You are testing for ketones, right?
 
Last night wasn't actually a bounce. The high number this morning is the result of not enough insulin last night. Same with the cycle after the 3u. A bounce is when the body panics from a low number and throws extra glucose into the blood stream. In both of these instances, there is no evidence of a low enough number to cause that panic - just not enough insulin to hold the BG down through the PS.

You are seeing the insulin get better duration at this dose which is how the PMPS numbers are coming down. Your tests last night showed that he was rising, but hadn't reached the usual high numbers. That's a good thing. It's how the numbers come down in general.

I think if you continued with the current dose, even on those lower PMPS's, you might start to see the AM numbers come down as well. It would require more testing though because I could also be wrong :D. You generally test enough to keep an eye on him if he did go lower, and have been at this long enough to steer if it was needed.

If you think it would be better to lower the dose, please please test for ketones. We've seen way too many kitties go into DKA from lowering the dose on a kitty in high numbers recently.
 
Rachel said:
You are testing for ketones, right?
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I am. It's been 5 days but I'll grab one tomorrow.

Djamila said:
Last night wasn't actually a bounce.
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And then he's high tonight from the fur shot this AM. I only did the 2.5 because I only had 1 test strip left at the time...they got here this morning. I knew that wasn't going to be enough but I don't think anyone was around at the time I was seeking some dose advice and I really didn't want to risk a possible hypo without being able to test. I'm probably wrong, but I figured something was better than nothing or a hypo.

I'm not eager to decrease by any means I just want to find what works for him since things got all out of wack with his 2 ear infections. And I was told by the ER vet Wednesday that he has gingivitis so it looks like a dental is now necessary.
 
That definitely makes sense to be conservative when you won't be able to test. Dental issues are often connected to high BG, so hopefully once that's taken care of you'll see some better numbers.
 
Even though our regular vet not 3 weeks ago said he didn't need a cleaning, I really like our ER vet and trust him even more. I really wish he was available on a regular basis. Anyways, I plan on scheduling one next week. Spicoli hasn't had one since he was dx with FD so I'm not quite sure how we'll deal with it...I know he will have to eat that morning since he needs insulin. But I'm not sure how anesthesia without fasting will work...

He's had dental issues in the past. About 1 1/2 years ago he had 2 bilateral FORLs...but recovered quickly. They didn't pull the molars but I was told, they ground them down to the bone. It's really no surprise he has something else going on... We have 3 cat children and he's our problem child :)
 
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He'll still need to fast before the dental. Most vets say to give half of the regular dose of insulin, and then my vet did Sam first that day and they monitored his BG in case he went too low (or too high from the stress). My vet is great, but he still kept insisting that dentals and FD aren't connected. Funny how Sam's numbers dropped so much after his extractions though...;):p
 
Djamila said:
He'll still need to fast before the dental. Most vets say to give half of the regular dose of insulin, and then my vet did Sam first that day and they monitored his BG in case he went too low (or too high from the stress). My vet is great, but he still kept insisting that dentals and FD aren't connected. Funny how Sam's numbers dropped so much after his extractions though...;):p
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Chloe has never had dental work before, but she eats funny. I asked the vet to check her teeth when she was in the hospital, but he did just a cursary exam and said she looked fine. When we go to see her new vet next week, I will watch as she does the exam. Good wishes to Sam, brave boy, and you.
 
So today's curve hasn't really been a curve.

AMPS (wrong code) 503
+2.5 436
+4 364
+6 284
+8 226
+10 194

I'm interested to see what his PMPS will be. Gonna hold at this lower 4.5u unless you guys have different opinions.
 
Wow!! this is really surprising for me.
pmps 276
+2 306
+3 212

Gonna try and stay awake for a bit longer to get a +4. But I think the 4.5 may still be too much :)
 
W.K. said:
Wow!! this is really surprising for me.
pmps 276
+2 306
+3 212

Gonna try and stay awake for a bit longer to get a +4. But I think the 4.5 may still be too much :)
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Actually, I don't think 4.5 u is too much. I'd stick with it for a couple of cycles. They sure don't make this easy! o_O;)
 
W.K. said:
Just went and picked him up... they wanted to send him home after they saw how his bgs were doing. We were a little late for his shot tonight. He was at at 464 at about a half hour past his usual time. Vet recommended we back down to 5.5 at least for tonight and see how things go this evening. I plan on staying up pretty late to say the least. I didn't get all his numbers for today but was told he dropped into the 90s around +6.

Going to try to take him in next week sometime and discuss that insulin change.


I've already asked his regular vet about this. He said there are a number of different tests we can do (i was interested in growth hormone). Also, since he has suspected IBS it has been recommended that if he doesn't get regulated in the next couple of months to do intestinal biopsies. But I honestly don't know if this will be financially possible and I don't want to do the cheaper endoscopic since it's not as accurate. Any of you guys have any experience with this?
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I don't think I would put him through intestinal biopsies not to mention the financial costs to you. An ultrasound was able to determine that Smoky had IBD and it had morphed into intestinal lymphoma. I'm not trying to scare you, your boy has IBS which can be treated.
It was difficult to diagnose Smoky since I feel the symptoms of his FD masked the underlying symptoms of the lymphoma. Is your kitty losing weight or seem to have trouble digesting his food?
 
Lisa and Smoky said:
I don't think I would put him through intestinal biopsies not to mention the financial costs to you. An ultrasound was able to determine that Smoky had IBD and it had morphed into intestinal lymphoma. I'm not trying to scare you, your boy has IBS which can be treated.
It was difficult to diagnose Smoky since I feel the symptoms of his FD masked the underlying symptoms of the lymphoma. Is your kitty losing weight or seem to have trouble digesting his food?
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His weight fluctuates depending on how well regulated his FD is, usually between 12.5 and 13.5 lbs. He does do better on probiotics and proteins like duck, quail, etc... anything that isn't chicken/turkey. I've just had trouble finding ones that he will eat regularly. And venison is a no go - I swear I've tried every brand that's within carb content. The main problems have been diarrhea and small amounts of blood in the stool, no vomiting in about 8 weeks, not even a hairball. We haven't had an ultrasound done as my vets office doesn't have a specialist regarding ultrasounds. However, I'm up for seeing an internist at this point. We have had an x-ray which showed thickening of the small intestines and had the crap scared out of me that night by the ER vet, who I trust almost more so than "our" vet. He has had some acid reflux which we treat with pepcid and if he does throw up I usually give metoclopramide. Overall, he seems to be doing well. And actually reduced his insulin in the last 2 days, and he seems to be responding to it better. He's ALWAYS been a gassy kitty and pretty much always had bouts with diarrhea, no one ever seemed to think anything about it till we moved and got a new vet.

And no worries :) We all have lives outside here. I'm sorry to see you lost your boy (((hugs)))
 
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Thanks Kris,
I'm on vacation this week at ocean city in Maryland. I love the beach here and my mom and I go every year. I'm actually feeling guilty about going with Smoky being gone now and all. I'm doing a little better than I was.
 
W.K. said:
His weight fluctuates depending on how well regulated his FD is, usually between 12.5 and 13.5 lbs. He does do better on probiotics and proteins like duck, quail, etc... anything that isn't chicken/turkey. I've just had trouble finding ones that he will eat regularly. And venison is a no go - I swear I've tried every brand that's within carb content. The main problems have been diarrhea and small amounts of blood in the stool, no vomiting in about 8 weeks, not even a hairball. We haven't had an ultrasound done as my vets office doesn't have a specialist regarding ultrasounds. However, I'm up for seeing an internist at this point. We have had an x-ray which showed thickening of the small intestines and had the crap scared out of me that night by the ER vet, who I trust almost more so than "our" vet. He has had some acid reflux which we treat with pepcid and if he does throw up I usually give metoclopramide. Overall, he seems to be doing well. And actually reduced his insulin in the last 2 days, and he seems to be responding to it better. He's ALWAYS been a gassy kitty and pretty much always had bouts with diarrhea, no one ever seemed to think anything about it till we moved and got a new vet.

And no worries :) We all have lives outside here. I'm sorry to see you lost your boy (((hugs)))
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Thank you for the hugs.I'm glad he is doing better with the FD. Smoky also had to be fed novel proteins. My old vet didn't have a specialist either, had to find one on my own. I had the ultrasound done as it was less invasive and Smoky was 11 at the time. His results also showed thickening of the intestinal walls and he was diagnosed with IBD. I would suggest keeping a close eye on him. IBS might lead to IBD which could then turn into intestinal cancer. The vet thinks this is what happened to Smoky. Please keep us updated on Spicoli.:)
 
He's been dropping FAST tonight.

PMPS 349
+2 220
+3 108 - fed 15% food after this. started hacking after this so gave pepcid and anti-nausea meds.
+4 116

Gonna be up for a while!! Excited he's doing so much better at this reduced dose.
 
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Bouncy boy has been bouncy. His AMPS are still usually in the 500s. His PMPS numbers are lower. I'm toying with the idea of lowering his PM dose a little to try and keep him from bouncing as much. Thoughts?
 
W.K. said:
Bouncy boy has been bouncy. His AMPS are still usually in the 500s. His PMPS numbers are lower. I'm toying with the idea of lowering his PM dose a little to try and keep him from bouncing as much. Thoughts?
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Yes, I think it's worth a try. You can always go back up in a couple of days.
 
I can do that. just retested again at 50 mins after normal pmps at 161 so he is rising just VERY slowly. going to feed and give 1u. since i was going to reduce tonight anyways, it'll only be 1/4 of the dose he was going to get....

Guess I'm going to be up a while :) But at least this is a great step forward.
 
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