Sputtering Pancreas Signs

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kdakus

Member Since 2013
I would really appreciate some feedback on how to recognize if my cat has a "Sputtering Pancreas" and how to handle it going forward if that is the case.

Dot is 13 yr old male cat diagnosed 3 weeks ago with an initial BG of 28 (504). Fed dry food for 13 years (8 years of salty urinary care Royal Canin SO). Transitioned to wet food 1 week after diagnosis. Weighs 13 lbs (usually 14-16 lbs)
Have fed only low carb wet food for the last week and insulin dose of 3 units of Humulin bid. (Note: Will be switching to Lantus or Levemir shortly, trying to make only one change at a time)

AMPS this morning was the lowest ever at 15.1 (272) and a BIG DROP from 27.1(488) the previous three mornings (see test numbers below). There was one other lower reading of 19.5 (351) shortly after increasing dose to 3 units from 2. There have been no changes to insulin, dose or food type/portion for over a week.

The drop made me nervous and prompted me to reduce his dose to 2.5 units from 3 since no one was going to be home during the day and I didn't know how low he would go if his pancreas was also trying to help him out. I also wondered if this was just a delayed drop from the switch to the low carb wet food now that his body is getting used to it.

Being a newbie any dramatic shifts in his numbers make me get a bit freaky!

Thanks for any light you can shed on this for me! Karen

DOTs BG Readings
AMPS
28.6 (515)
28.0 (504)
19.5 (351)
27.1 (488)
27.1 (488)
27.1 (488)
15.1 (272) this morning

PMPS Range
22.2-25.7 (400-463)

Daytime +6 readings have been averaging 14 (252) and one overnight +6 reading taken was 12.7 (229).
 
I think it's still too early to tell. There is also the factor of the liver's response. Many cats' BGs often drop lower within the first couple of months of treatment simply because their body is unused to lower BGs at first and "panics" at what it thinks might be too low (even it if it's not). Once the body because more used to healthy numbers, the panicking and bouncing slows down. And even with a "sputtering pancreas," you'll still test and treat the diabetes the same.

272 is still a fairly high number. The general rule of thumb is that anything over 200, you respond the same: give the full dose of insulin. I don't think you'll be seeing much better results with the Humulin since it wears off too quickly in cats (works better with TID, three times a day dosing), so the sooner you can get Dot switched to Lantus or Levemir, the faster you'll see more consistent results. In the meantime, check out the Humulin Primer and see if there might be some helpful tricks in there for you two.
 
Thanks KPassa for your reply. I appreciate your wisdom.

Since I am new to all this, the AMPS drop from 488 to 272 threw me for a loop, despite knowing that 272 was still a high number. I will check out the Humulin Primer as you suggested and will probably be switching Insulin by the weekend.

Dot actually is my adult son's cat and he is paying the freight for treatment even though I do the majority of feeding, testing and shooting because of our work schedules. My son is a bit behind me on the learning curve about FD but he is catching up fast!

Karen
 
What an awesome mom! :-D

Lantus does work quite a bit differently than Humulin, so make sure you read up on it if you haven't already. I would also recommend you start with just 1u of Lantus since it has a depot and you need to hold the starting dose at least 5 days before seeing the full impact. And when you're planning on switching over to Lantus this weekend, I would suggest you create a new post here with the subject line something like "Switching from Humulin to Lantus - advice needed."

We have lots of tips and tricks here from ear-testing to cheaper OTC foods to giving shots, so feel free to ask away about anything you might have questions on.
 
Hello and welcome to the board from another Canadian!

Can I ask what kind of wet you are feeding? Some are lower carbs than others.

Also what meter are you using? Some of the butterfly strips ones (Freestyle) are inaccurate for cats -plus expensive.

Lastly I would strongly recommend you move to Lantus - it gives a better chance of remission, is better for cats generally.. and you can get a pack of 5 pens which last over 6 months from Costco for $100.

Wendy
 
Thanks Wendy! I am feeding my cat Dot Fancy Feast classics (mostly chicken, liver and turkey combos) and watching the carb content of what we buy closely. My meter is an Accu-chek Aviva and doesn't use butterfly strips.

We are planning to change him to Lantus or Levemir very soon. With only $20 separating a pack of 5x3mL we're leaning towards Levemir since it's not supposed to sting on injection and appears to have a smoother curve.

Yesterday Dot may have had another sputter with his lowest ever AMPS of 12.7 (229), +6 of 7.3 (131) and a PMPS of 23.8 (430) with no changes in diet or dosage. This morning's AMPS was 15.4 (277) so will see if there is any pattern over the weekend and may do a +6 overnight to make sure his nadir is ok based on his PMPS number.

I don't have a Costco membership and don't live very close either so we're pricing Lantus & Levemir at Walmart, Shoppers and Zehrs pharmacy locally.

Karen
 
Sounds like you have done your research! Thats good on the food choices.. and meter is good too ( I use a bayer contour meter as I can get the strips 100 for $40 incl shipping on ebay.)

I haven't been able to find anywhere that will let me split a pack of pens around here but let me know if you do. By the way Lantus doesn't usually sting unless you are on large doses - which most cats don't need.

Can you set up a spreadsheet? It would help you and your vet track trends but also we can advise better and see whats going on - if its the insulins normal action, sputtering pancreas and/or a bounce. Heres how :http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207


Wendy
 
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