Vet Glucose Curve- low readings/wants me to stop insulin??

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WileyWonderCat

WileyWonderCat

Member Since 2013
I have been very busy these past two weeks with work and haven't had time to give an update. Wiley was diagnosed about two weeks ago and has been on 1 unit Lantus BID for these past two weeks and I took him in for his first glucose curve at the vet today. (Note that he ate his normal breakfast about an hour before the injection given at the vet). His readings were as follows:

+1 = 130
+3 = 63
+5 = 62
+7 = 90

The vet staff basically had to force feed him at the third testing time as they were pretty concerned about the low readings. When I came to pick him up the vet recommended that I actually stop the insulin altogether for the next 2-3 weeks and then bring him back for a fructosamine. Just to backtrack, Wiley's diagnosis was a bit strange in that it took the vet about a month to officially give the diagnosis since Wiley's symptoms and blood and urine readings were kind of inconsistent. And his tests may have been influenced by a long-acting steroid shot that he had back in August. Now the vet thinks maybe he wasn't diagnosed correctly - like maybe he doesn't really have diabetes? Or could he have already gone into remission in just two weeks?

He hasn't had any hyperglycemia symptoms since starting the insulin - but I also haven't really noticed any obvious hypogycemia either. Unfortunately, I have not been successful in home testing yet - partially due to the fact that I've had a lot of long workdays, but also in that Wiley is a pretty difficult cat. He is super squirmy and does not like being fussed over. Even with treats, he isn't very cooperative. BUT now I think I really need to start having successful tests (maybe try the cat burrito?) because I'm a bit worried about just stopping insulin altogether.

Any suggestions or thoughts about stopping insulin are appreciated. Maybe I should drop the dosage to .5 unit BID? I know it really is riding on home test results...
 
Re: Vet Glucose Curve- low readings/wants me to stop insulin

Me personally, I would listen to your vet and definitely stop the insulin if you cant home test. A hypo can kill and happen suddenly, you don't want to be giving insulin if he doesn't need it. Those are pretty darn good numbers, actually kinda low especially considering the stress from the vet, which normally increases the BG.

Yes he could go into remission that quickly, especially being steroid induced.
I had a 10 year old cat years ago that had what the vet called " a transient diabetic episode" from a steroid shot. Her sugar was high, she was screaming for food 24/7. The hunger abated but her glucose remained high. My vet was just about ready to prescribe insulin, when like a light switch going off, she was back to normal and her glucose went back down. She lived another 10 years with no sign of diabetes. I never let her have another steroid shot again.

If you stop the insulin, you can always monitor his urine for any sign of glucose with the Ketodiastix urine strips until you go back to the vet in 2-3 weeks. It's not perfect, but if you cant home test, that will at least give you idea if his sugar is going too high while off insulin.
I just use a ladle to catch the urine while she is urinating and then use the strips.
https://docs.google.com/document/d/1qut ... DKZ16A/pub

This is just my opinion, but If it were me, that is what I would do:) Good luck!
 
Re: Vet Glucose Curve- low readings/wants me to stop insulin

The problem is that until you are able to successful test, you don't know if it is safe to give insulin or not.

If you are unable to do blood glucose testing, there are other ways to test - here is a link written by BJM about secondary monitoring tools - please take a look and see if you can do any of these.

https://docs.google.com/document/pub?id ... fQqL3zX_88
 
Re: Vet Glucose Curve- low readings/wants me to stop insulin

You should be able to do these:
Food Consumption
- Measure/weigh the amount of food you put down each meal.
- Measure/weigh how much food is left at the next meal.
The difference is food eaten and some evaporation of moisture from the food.
This will gradually decrease as you get better control.

Urine output
Roughly measure the amount of wet litter produce each day and it’s characteristics
- have you got oceans, lakes, ponds, or cups?
oceans = uncontrolled or possibly some other problem such as renal disease or hyperthyroidism
cups = better controlled or lack of water intake

The 5 Ps
Purring - is the cat exhibiting customary signs of contentment or happiness?
Playing - will the cat play and interact with others?
Preening - is the cat maintaining its fur and cleanliness?
Peeing - occurs, and is a normal volume?
Poohing - fecal material is formed and passable?
Constipation may happen with a food change; adding a tablespoon or so of water may help, plus ensures the cat is hydrated properly.

Weight
Obtain a reliable, digital baby scale (Craigslist is one resource to check)
Weigh weekly, at about the same time and before a meal.
Pre-shot might work well as the time to do this.
Unplanned changes of more than 0.25 pounds (3-4 ounces) should be noted
Unplanned changes of 0.5 pounds may indicate something is happening.
A consistent, unplanned trend over time may suggest a problem; see the vet.
 
Re: Vet Glucose Curve- low readings/wants me to stop insulin

Thanks for the responses! I definitely agree that I should stop the insulin until I can test him at home. Those were really low numbers for testing at the vet. He gets really nervous at the vet typically, and his previous results at the vet (before yesterday) were all really high. His urine results were always high too, though never had ketones.

So its been only 24 hours OTJ and I can't tell much difference in his eating, drinking or mood yet. I appreciate the tips for other types of testing/monitoring. I definitely monitor the food and water levels, but I have another cat so it can be difficult to determine if one or the other is consuming it when I'm not home. I wish I could afford cameras to monitor their activity!
 
Re: Vet Glucose Curve- low readings/wants me to stop insulin

Finally had my first successful home glucose test!!!! Yay!!! I am so excited!! :-D

Wiley has had no insulin injections since Tuesday morning - so that means 7 doses that I haven't given. His result tonight was 58. I am so glad that I haven't been injecting him after he had such low results at the vet and tonight.

Wiley definitely flinched during the ear prick, so I really need to work on my technique with the lancet. I hope I can continue to test him as much as possible.
 
Re: Vet Glucose Curve- low readings/wants me to stop insulin

That's great! We don't advise newbies shoot under 200. Also if he can stay in normal levels of 40-130 without insulin for 14 days then we consider him to be in remission! To help him you want to support his pancreas by giving many mini meals through the day instead of a couple of big ones. For this period you also want to test 1-2 times a day to keep an eye on him.

Keep us updated and if he goes two weeks we can give tips to stay OTJ. If he starts to creep up we can look at starting insulin again. And remember no dry food or dry treats,

Wendy

Ps it might help to put a smear of neosporin pain relief ointment on his ear before or after.
 
Re: Vet Glucose Curve- low readings/wants me to stop insulin

WileyWonderCat said:
Finally had my first successful home glucose test!!!! Yay!!! I am so excited!! :-D

Wiley has had no insulin injections since Tuesday morning - so that means 7 doses that I haven't given. His result tonight was 58. I am so glad that I haven't been injecting him after he had such low results at the vet and tonight.
Click to expand...
Yay!!! 58 and no insulin! That is is great!
 
Re: Vet Glucose Curve- low readings/wants me to stop insulin

Wiley is doing pretty great! I have only been able to do a few tests during the past week, but all have been under 100. I still haven't given him any injections, so he's currently on day 9 without insulin. He really hates the testing now though (he got really freaked last time), so I'm back trying to get him to trust me again. I haven't tested in two days...but have just been trying to get him to sit still and I'm rewarding him with new treats. The treats I was using before don't work now, as he's associated them with the ear prick/manhandling.

Anyway, I've been diligent about measuring water intake, as well as monitoring the litterbox. His water intake and urination have been normal. And his energy levels have been great! He's back to playing again, something he wasn't doing at all when he was hyperglycemic. His hunger has been crazy though - he acts like he's never getting enough food. I feed him wet food 4 times a day - breakfast, "frozen food pop" during the day, dinner and before bed. And treats too here and there.

So because my testing has been inconsistent, I think I will still take him to the vet for a fructosamine in a week or 2. Keeping fingers crossed that he is in remission! :smile:
 
Re: Vet Glucose Curve- low readings/wants me to stop insulin

If he can achieve 14 days of 50-130 then we consider him in remission! Meanwhile keep feeding those mini meals. Also here are some tips for keeping him in remission if/when he gets there (anti jinx!)

Tips to stay OTJ

We say a cat is in remission if the cat can maintain BG levels for 14 days between 40-120 with most of that spent under 100. However, please keep in mind that once a diabetic always a diabetic.

1. Never feed dry - not even treats. If you change wet food types, be 100% sure the new food is also low carb and same low carb % as your current food. Some cats are very carb sensitive and an increase from 3-6% to 8-10% can spike the BG’s. Don’t feed if you aren’t sure!
2. Weigh every 2 weeks to 1 month to watch for weight changes. Too much of a weight gain can cause loss of remission.
3. Measure blood once a week, indefinitely. You want to catch a relapse quickly.
4. No steroids or oral meds with sugar - remind your vet whenever giving you any medication. Always double check.
5. Monitor food intake, peeing and drinking. If increasing, a sign of losing remission.
6. Regular vet checks for infection such as dental , ear or UTI. And get them treated quick!

If he does fall out of remission you need to be more aggressive and resolve issues/ back on insulin as soon as possible as the window for a second remission is tight if any.

Wendy
 
Re: Vet Glucose Curve- low readings/wants me to stop insulin

YES!! We are on day 20 of no insulin! But I haven't been very successful with home testing, so I am afraid to celebrate too much until I can take Wiley in for a fructosamine next week. He has had no hyperglycemia symptoms at all and seems to be doing really great. I am carefully measuring water and food intake and output. The last time I had a successful test (a few days ago), it was still under 100.

I am cautiously optimistic, but feel like a weight has been lifted. I consider our situation very lucky and am so thankful for a resource such as this.
 
Re: Vet Glucose Curve- low readings/wants me to stop insulin

:mrgreen: :mrgreen: CONGRATULATIONS!! :mrgreen: :mrgreen: :mrgreen:

Tips to stay OTJ

We say a cat is in remission if the cat can maintain BG levels for 14 days between 40-120 with most of that spent under 100. However, please keep in mind that once a diabetic always a diabetic.

1. Never feed dry - not even treats. If you change wet food types, be 100% sure the new food is also low carb and same low carb % as your current food. Some cats are very carb sensitive and an increase from 3-6% to 8-10% can spike the BG’s. Don’t feed if you aren’t sure!
2. Weigh every 2 weeks to 1 month to watch for weight changes. Too much of a weight gain can cause loss of remission.
3. Measure blood once a week, indefinitely. You want to catch a relapse quickly.
4. No steroids or oral meds with sugar - remind your vet whenever giving you any medication. Always double check.
5. Monitor food intake, peeing and drinking. If increasing, a sign of losing remission.
6. Regular vet checks for infection such as dental , ear or UTI. And get them treated quick!

If he does fall out of remission you need to be more aggressive and resolve issues/ back on insulin as soon as possible as the window for a second remission is tight if any.
 
Re: Vet Glucose Curve- low readings/wants me to stop insulin

Great job!
Lack of all those signs is really encouraging. I'll be interested in what the fructosamine is.
 
Re: Vet Glucose Curve- low readings/wants me to stop insulin

Fructosamine results came back as normal (260)! Wiley is officially in remission according to the vet who has been completely baffled by this whole incident. He agrees that the diabetes was a result of his steroid treatment. I am so grateful. I know that Wiley and I are very lucky. I definitely plan to keep him on his low carb diet and monitor all of his eating and drinking, etc.

Thanks to everyone who contributes to this site - it is such a great resource!
 
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