Steroid Induced Diabetes - LiLi

[Sandy & LiLi]

Hello. My LiLi was just diagnosed with diabetes (fructosamine 400). She has lymphoma and part of her protocol is prednisolone - she has been on it for over a year. When her oncologist saw her bg creeping up, he started decreasing her prednisolone. Unfortunately, we are now at the point where she will be starting insulin. I would imagine we need to reduce her pred even more - this concerns me because of the lymphoma, but the oncologist said the chemotherapeutic is more important. But I believe the pred helps keep her feeling better and eating well, so not sure what the right balance will be.

I am trying to see if she will take to the Purina DM - she's nibbling it, but prefers the other dry food that she has been eating so well. On chemo, it's been tricky to keep her eating well, so I need to make sure she has something she likes. My vet is planning on starting her on Lantus twice a day at a very low dose combined with the Purina DM (hopefully!) and reduced pred.

I was just wondering if anyone has had a similar situation with steroid induced diabetes - I read it's difficult to treat the diabetes while the cat is still on steroids, but I'm not sure if not steroids is an option for LiLi because of the lymphoma.

Any thoughts would be appreciated.

Sandy

 

[BJM]

Welcome to the message board, the best place you never wanted to be.

There are 4 things you'll need to manage your kitty's diabetes:
- You - without your commitment, the following won't work.
- Home blood glucose monitoring with an inexpensive human glucometer such as the WalMart Relion Confirm or Target Up and Up (the pet ones will break your budget!). This saves you the cost of going to the vet for curves and done regularly, removes the need for a fructosamine test. All of our insulin guidelines use human glucometer numbers for reference.
- Low carb over the counter canned or raw diet, such as many Friskies pates. See Cat Info for more info. If already on insulin, you must be home testing before changing the diet. Food changes should be gradual to avoid GI upsets - 20-25% different food each day until switched. There are 2 low carb, dry, over the counter foods in the US - Evo Cat and Kitten dry found at pet specialty stores and Young Again 0 Carb found online.
- A long-lasting insulin such as ProZinc, Lantus, BCP PZI, or Levemir. No insulin lasts 24 hours in the cat, so giving it every 12 hours is optimal for control.

Note that when there is another condition requiring medication which elevates the glucose, you adjust the insulin around that, so if she needs the pred for the lymphoma, then that is what you do.

 

[Anitafrnhamer]

Ditto what BJM said about adjusting insulin around the roids.

Squeaker had steroid induced diabetes as well.

Just a couple of tips, I haven't seen many cats who will eat the DM. That being the case pretty much any low carb wet cat food (or the dry options mentioned by BJM) may be something to look into.

Have you joined the lymphoma group? Here is the link for that https://groups.yahoo.com/neo/groups/Feline-CRF-Support/search/messages?query=feline lymphoma

 

[Sandy & LiLi]

Thank you both for your responses! I do belong to a wonderful lymphoma group - they have been a huge help with LiLi. Her oncologist is recommending tapering off the pred because it's really the chlorambucil that is the most important drug in the treatment protocol. We'll see how she does as far as eating, etc. after she is off the pred. If it impacts her appetite, she will need to go back on it. She is a dry food eater - she is offered canned and eats some, but she will eat her dry food. Good suggestion on the EVO - I'll see if she likes that. She is eating the DM - at least for now.

I am going to get a glucometer and will home test. Unfortunately, not new to diabetes in cats . . . but it's been a few years, so I need a refresher

Thanks again!

Sandyh