? Tabby's possible diabetes relapse

[Jingwen]

Hi guys, unfortunately, I'm back here posting about Tabby 1 year+ after her OTJ.

I have been testing her BG every month after her OTJ and they are in the normal range. However, when tested this month (22 July), her BG was 268 (no change in diet and her weight is the same). She started drinking a bit more water 3 days before the test. I brought her to the vet and it shot up to 322 & 421 when tested in the clinic. I did a 12 hours curve for her the next day as advised by the vet and it ranges from 132 - 268 (recorded in the spreadsheet). I highly suspect that her diabetes has relapsed and will like to start her on insulin again.

Her fructosamine & urine test results as shown below:

I will like to get advice from you guys again on how to restart the insulin regime.

Thank you in advance.

Her OTJ post here:
https://felinediabetes.com/FDMB/threads/otj-party-for-tabby-today.265144/

Her latest photo for attention.

 

[tiffmaxee]

The good news is the fructosamine is still at the end of normal and you caught this early. I’d be inclined to start insulin on a low dose with the bg you see and symptoms but tagging others for their opinions. How much does Tabby weigh now?
@Marje and Gracie @Wendy&Neko @Bron and Sheba (GA)

 

[Jingwen]

How much does Tabby weigh now?

She weighs 4.5kg (9.9 lbs) now.

 

[Wendy&Neko]

The starting dose for Lantus, if following TR, is 0.25 units per kg, or approximately 1 unit for Tabby.

Did the vet have any suggestions why Tabby has fallen out of remission? Did the vet take a close look in her mouth? Needing a dental is the #1 reason cats need to go back on insulin. I hope it's a short stay. We have a few other kitties here now who have recently started back on insulin. The sooner you can get her back regulated, the greater the chances of remission again.

 

[Jingwen]

The starting dose for Lantus, if following TR, is 0.25 units per kg, or approximately 1 unit for Tabby.

So I start her off with 1 unit?

Did the vet have any suggestions why Tabby has fallen out of remission?

Nope, the vet didn't think that she has fallen out of remission as her fructosamine is still in the normal range and her BG from the 12 hours curve is stable according to her. I'm the one who insisted that she most probably has fallen out of remission by comparing her BG numbers from previously and that I wanted to start her on insulin. They do not advise the owner to inject insulin if it's less than 180 as they are worried about hyperglycemia. I have to ensure the vet that I injected her with insulin back then when she was at an even lower number and I know what should be done, then she's willing to dispense insulin for her.

Did the vet take a close look in her mouth? Needing a dental is the #1 reason cats need to go back on insulin.

Nope, but she did a dental almost a year ago after she went into OTJ and she's not left with many teeth.

 

[Wendy&Neko]

Teeth, what are left, could have gone bad in a year's time. Best to get the vet to take a look next time Tabby is in.

As for dose, you could start lower as her numbers have gotten a lot better on their own.

 

[Jingwen]

Best to get the vet to take a look next time Tabby is in.

Sure, will get the vet to check on them when she goes in again. Are there any other possible reasons that will have caused a relapse so that I could get the vet to check all of them out when I bring her in?
Am thinking if I should also get a Chem15 blood test done for her.

As for dose, you could start lower as her numbers have gotten a lot better on their own.

I most probably be starting off with 0.5 units tonight first to see how she reacts to it then increase when needed.

Thanks for the advice!

 

[Jingwen]

I most probably be starting off with 0.5 units tonight first to see how she reacts to it then increase when needed.

Decided not to give her any insulin tonight as her BG has gone down again to 153 by itself at PMPS. Will take her BG for the next couple of hours and see what are the numbers to have more data.