? Super High BG Readings. Need Advice.

[tinnyandodd]

Hi Folks.

My almost 9 year old 13 pound big boy Reid was diagnosed around Oct of 2017 and I was able to get him into remission with a diet change (dry to wet) from November of 2017 until August of 2019. He developed an infection in August and had to have 4! teeth removed so his numbers blasted up. Once the surgery was complete, he went back into remission until January of this year when I started to notice his urine smelled sweet so I began testing him again. I have an Alphatrak2 meter. His numbers have been crazy high again since January 22nd when I started testing again. Since he was in remission for so long I never got the proper education on feline diabetes and now I’m stuck ...

I ignorantly wasn’t paying attention and writing down his insulin dosages for tracking purposes because I was assuming his numbers would go down in a couple days. I got one low number on February 2nd and that was it. So, I started tracking his feed time / BG / and insulin properly February 12th and this is what we have so far. I’m at work in the day so I can’t test him until I’m home after 6.

I take his BG before he gets fed at 730am and at 730pm and he gets his shot when he’s eating. He’s been on the same 1 can of 156g Friskies Pate AM and PM since his diagnosis so I can’t imagine it’s his food? I’m thinking it’s an infection? He has an appt. this Friday at a new vet (my last one moved) but in the meantime, does anyone have any advice? I’m worried about his kidneys.

He’s been on Caninsulin since diagnosis but he was only using it sporadically for a month when he first got diagnosed, then about a month again in August, and now. His Caninsulin I’m currently using is from July of 2019 so I also am assuming the batch has gone off. It’s been stored in the box in the fridge. I’m just waiting to see the vet on Friday to get his urine/blood testing done.

Anything I should ask my vet about specifically on Friday?

Also, I live in Canada and these strips are costing me a fortune. I’m hoping his high numbers are temporary again but just in case can anyone recommend a cheaper meter and strips I could buy in Canada?

Cheers

Jack (me) and Reid.

 

[Juls and Billy]

Hi Jack and welcome! I am not the most experienced member here, but I can help a bit until more members chime in. Getting diabetic cat into remission so that he's a diet controlled diabetic is great, but as you know, many things can knock a cat out of remission. What I've learned here, is when a cat comes out of remission, there's no guarantees you can get them back into remission. It seems to be harder the second (and third) time around. That doesn't mean you should fret. Reid could go back into remission, or he could need insulin the rest of his life, but either way he can have a happy and healthy life with proper treatment.

Something you will learn here as you read is that unfortunately, most vets have very little training on feline diabetes. There is a lot on this site that can help you. Even though this is not your first rodeo, I suggest reading all the sticky posts in the Health Links FAQs section of the forum. You'll learn tons and know more than your vet probably does about feline diabetes.

And so, here's the first thing I suggest you ask your vet about. Canninsulin is not the best insulin for cats. As you can probably see from the name, it's a dog insulin. Cats tend to do so much better on Lantus, Levemir, or ProZinc. I strongly suggest asking your vet for one of these. So strongly, that if the vet doesn't want to, I'd look for a different vet. If Reid is going to have a chance of another remission, these are the best insulins to try.

Be careful of the dosage the vet suggests. Members here will recommend you start on 1 unit twice a day, wait 3 days, and then see if the dose needs to be adjusted. If you get a new type of insulin, you may want to post here for recommendations for dosing. Some vets start right off on 2, 3. or 4 units, which is very strong and risks complications and dangerous hypoglycemic events.

The other thing I would suggest is that most cats do better on many small meals throughout the day rather than 2 big ones, yet vets still suggest the two giant meals. Human diabetics use many smaller meals to regulate blood sugar, and cats do well that way too. The only thing necessary is to pull up any uneaten food 2 hours before test and injection time. This makes sure the cat is hungry when they get their insulin, and gets you a more honest BGL which hasn't been pumped up by food.

The food you are feeding is great. If you want more choices for Reid, there's a great food chart here. You want canned food with less than 10% calories from carbs, and most cat owners look for choices lower in phosphorus, as it's healthier.

The other thing I suggest is to get your signature set up and make Reid a spreadsheet. Look at the information in my signature for an example, and click on the link that says Billy's Spreadsheet. It's easy to do and will be invaluable if you need members here to help with dosing advice, etc. There are instructions here: New? How you can help us help you!

And the biggest thing of all, take a deep breath. Get yourself a treat. I'm going to suggest a Coffee Crisp bar, because I love them but we can't get them in the states. You're taking great care of Reid. Like I said, even if he has to stay on insulin, he can have a long healthy life. We'll have all our fingers crossed for remission though. Either way, you and Reid can totally do this.

Edited to add: I'm guessing you are using a pet meter? The strips are expensive. Most members here use a human meter. The numbers are a little different, but human meters work fine. I use a ReliOn Premier meter from WalMart, and the strips are super cheap.

 

[Chris & China (GA)]

He’s been on Caninsulin since diagnosis but he was only using it sporadically for a month when he first got diagnosed, then about a month again in August, and now. His Caninsulin I’m currently using is from July of 2019 so I also am assuming the batch has gone off.

Yeah, it's probably lost it's punch. One nice thing though...while Caninsulin isn't a very good insulin for cats, because you live in Canada, you can get Lantus, Basaglar or Levemir from any human pharmacy without having to get a script from your vet! They are much better choices than Caninsulin and we can help you learn how to use them effectively if your vet isn't familiar with how they work best. (which is a pretty common problem we all share)

can anyone recommend a cheaper meter and strips I could buy in Canada?

What kind of meter are you using? Unfortunately though, while you guys enjoy much cheaper insulin prices than we do here in the states, you can't get the meters we can that are much cheaper to use like the Relion Prime from WalMart. Do you have any family or friends in the US that might be willing to buy them and send them to you?

The cheapest option I know of in Canada is the Bravo meter, but it's only available online so you have to make sure you order strips early enough that you get them before you run out. It's a human meter, not a pet meter, but all our dosing methods were developed with human meters so we're very comfortable using them.

Do make sure that if the vet suspects a UTI that they do a cystocentesis and send out a urine sample for a culture and sensitivity. By doing a C&S, they know for sure which antibiotic will kill the bacteria causing the infection. The C&S needs to be done before starting any antibiotic or it will make the test worthless. Of course as long as they get the sample first, they can go ahead and start Reid on a broad spectrum antibiotic until they get the results and if necessary, change it then.

Keep asking questions! Hopefully if it's just a UTI and some antibiotics and time will bring him back down (and maybe even into remission again!)

 

[tinnyandodd]

Hello Juls and Billy!

Thank you so much for your reply. When he was seen in August by his vet, he was started at 2 units. I did notice it made a small difference, but he did better on 2.5 before he went back into remission for the second time. Because his numbers have been consistently high since January, I have tried to slowly increase his dosage 2 to 2.5 then to 3, but it hasn’t made a dent it seems. When he gets his bloodwork and urine analysis done this Friday I’ll know more about what’s going on with him. I’m just worried his numbers have been so high for almost a month now and I worry about his tiny body (even though he’s a big boy.) Thankfully I have a friend who had a diabetic pet whose vet she recommended (the one I’m seeing friday) and she has been talking it out with me since his BG spiked. Even she’s confused (and shocked) by his high numbers. I didn’t want to switch his food because I didn’t want to surprise his system with more change and it’s worked well for him thus far so I’m going to stick with it for now. The thing about Reid is that he’s very good at masking when he’s sick. He’s eating normally, drinking normally (not excessive), he’s not lethargic (still playing with his toys) or showing any changes other than his sweet urine smell which tipped me off to something being wrong. I’ll know more when I bring him in, but in the meantime thank you again. I came to this forum when he was first diagnosed and everyone was super lovely.

 

[Wendy&Neko]

Hi Jack and Reid. I too am in Canada, west coast. You must be too, or you're a night owl. My vet started us on Caninsulin - not a great insulin for us. Lantus, then Levemir worked much better. You can get both of those over the counter in pharmacies in Canada. You will need to switch to U-100 syringes though (also available at the pharmacy).

As for meter, as Juls said, the AT strips are pretty pricey so most of us use human meters. I live close to the border, so I just got a post box on the other side and had ADW ship meters and strips there. Another tip for those not as close to the border, check out strip pricing on eBay. There are some reliable, and cheaper, vendors there. You just need to stock a bit in advance to account for shipping delays.

Is Reid still on low carb wet food?

 

[Chris & China (GA)]

Even she’s confused (and shocked) by his high numbers.

I can't see all your numbers that clearly, but they don't look all that unusually high to me. We have cats here that started in the 32-39 range. Yes, they're too high, but pretty much in the ballpark for what we usually see.

 

[Wendy&Neko]

AT meters also read higher at the high end than human meters. My girl registered in the 30's on a human meters at points in the beginning, and sometimes so high the meter only said "Hi", which was above 33 (600).

 

[tinnyandodd]

Hi everyone.

Sorry it took me so long to respond. Reid went into the vet yesterday afternoon and as it turns out he has something called "Feline Odontoclastic Resorptive Lesion" or "resorptive lesions" throughout almost all of his mouth/teeth. The vet believes this is likely the cause for the sudden spike in BG. His vet bill on Friday was $548 but that was with the exam consultation, geriatric panel c/ Urinalysis, blood collection, Cystocentesis, supply/disposal fee, Alphatrak2 strips, and a new 10mls bottle of Caninsulin. Step one complete

His test results came back mostly positive. She said his heart and kidneys are okay, and apart from his high BG, he does have small amounts of protein in his urine, though not enough that the vet was immediately concerned. I did start him on the new insulin as well, so I'm going to continue with that until he sees a specialist we have been referred to. The next step is to see this specialist for the consultation, and the vet believes we will more than likely need to remove all of Reid's teeth. He did have 3 or 4 removed last Summer, but apparently it's only gotten worse. The vet said there's a possibly we may be able to save two of his incisors, but the specialist will have more information when they see him.

So, that's where we are now. Poor little dude. He's only 9. Has anyone gone through this process before with removing all of the teeth? He recovered well from his last surgery removal (though he did need 2 rounds of antibiotics.) His BG stabilized and he was off insulin for almost 5 months up until now. I'm mostly worried about the risk of jaw fracture since he won't have anything to protect his gummy little mouth. Plus we all know (especially with uncontrolled diabetes) there's a much higher risk. I'm trying to get an idea of cost as well. The vet tried to give a guess of around $1000-$2000 at her clinic, but this is a specialist, and I'm going to assume it'll probably cost more. I always tend to aim higher than anticipated.

Thanks again for everyone's support!

 

[Wendy&Neko]

We have had cats here need all their teeth removed, or all but a couple. FORLs are quite common in cats. You will need to stock up on really soft blended foods. I have seen the Tiki cat Velvet Mousse in Canada, that might be one option for you. We cannot get all meat baby food here that is pure meat and low carb, and which a lot of people here recommend. Another thing you will need is pain relief, Buprenorphine is a good one.

I am glad you have a recommendation for a dental specialist. I really liked the folks at West Coast dental Vet, if that is where you are going. Specialists are used to complicated cases. My girl had to have a walnut sized bony growth taken off her jaw, and came threw it with flying colours.