Worried newby - possible remission? BG still slightly high.

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Helene & Cleo

Member Since 2012
Hello people.

I've been reading the wealth of info on this board on and off since my little Cleo cat was diagnosed last December, keep meaning to post, so here I am.

Cleo is 15 years old now, 14 at diagnosis. She has been VERY difficult to regulate - she was put on caninsulin, and the dose just kept on going up and up and up, based on sporadic test results, obtained as and when the vets were able to get a sample out of her. Her dose peaked at 3 units twice daily about a month or so after diagnosis.

It was only after this point we learnt two things: firstly, the terribly expensive specialist dry catfood the vet was selling us was perhaps not the best thing for her, so we switched to a low carb, fish only wet food diet.

Secondly, after a terrifying experience of a hypoglycaemic seizure, we learnt the benefits of home testing. Unbelievably, our vet hadn't even presented this as an option. After recovering from her initial pre-diagnosis ill health, Cleo would not let the vets near her to take blood - she can be very feisty when she needs to! The vet was scared for herself, and also for the cat, additionally stating that such high stress levels would give an inaccurate glucose reading.

So we managed to coax/ bribe her into letting us do enough ear prick tests at home to discover that her need for insulin had decreased massively (due to diet perhaps?) and we have been steadily decreasing the dosage. Now, Cleo hates being tested at home also, but it's the least worst, compared to the stress the vet visits put her through - at one point the vet was suggesting sedating her just to take blood, which really pissed me off. Far too high a risk to take with an elderly cat, for what should be a routine procedure.

Anyway, so here we are, 10 months post diagnosis. Cleo's insulin dose has been reduced steadily, to 0.25 units twice a day. This still seemed too high - she's been a little 'twitchy', and just hasn't quite seemed herself recently, which is what prompted me to torment the poor creature and try and get some glucose readings out of her - her peak glucose levels have not gone over the 5 mmol/L mark, and the lowest ones frighteningly low, at 3mmol/L.

So, right now, Cleo has not had any insulin at all for the past 48 hours, and her glucose levels have ranged between 5.4 and 7.5 mmol/L (the 7.5 reading is the most recent.) This is a good, normal range, right?

Now, as I said, Cleo gets stressed even when I home test her, and I honestly don't enjoy doing it either. The absolute most I can test her is maybe twice a day, for three days in a row; she's never going to be a cat who has a nice hourly glucose curve plotted!

So, does anyone have any thoughts / advice on this situation? Obviously, I will need to do some further tests, but I do worry about the stress it puts her under, especially at her age.

Any feedback is greatly appreciated!

Thanks, H.
 
Re: Worried newby - advice on possible remission?

Helene said:
Hello people.

So, right now, Cleo has not had any insulin at all for the past 48 hours, and her glucose levels have ranged between 5.4 and 7.5 mmol/L (the 7.5 reading is the most recent.) This is a good, normal range, right?

Thanks, H.
Click to expand...

Hi Helene,

Yes, those are lovely numbers. They are at the high end of the normal range. So definitely NO insulin! This is very exciting news! Cleo may now be able to be diet-controlled!

Feeding Cleo small frequent snack-size meals may help to stimulate her pancreas to work without overwhelming it while it gets stronger.

I read your other post before this one. There are lower carb foods out there like 'Bozita'. Switching to something like that could inch those BG numbers down a smidge further.

You will need to test Cleo's sugar periodically to make sure these numbers are constant. Maybe test once a day for a while to monitor her? 'Remission' can be temporary or permanent. We're keeping fingers and paws crossed for ya! dancing_cat dancing_cat dancing_cat

Edited to add: Are you rewarding Cleo with a treat after each test?
 
Re: Worried newby - advice on possible remission?

Normally, people test at am and pm shot times for 2 weeks, and if no insulin is needed for those 14days, you can consider the cat is off insulin.
After that point, it's good to do some periodic tests, every few days, do a test, then maybe once a week, then once a month, and so on.

I feel that since you did have an issue that required insulin support once, you want to be sure your cat's pancreas stays healthy and not in need for help again in the future. Spot checks and sticking with the low carb wet diet are needed. My cat's been off insulin since January but I still do tests here and there... better safe than sorry.
 
Re: Worried newby - advice on possible remission?

Thanks for your replies.

I've been rewarding Cleo, bribing her, begging her, coaxing her... She is just a fiercely independent little critter, who does everything on her own terms! I have no squeamishness type issues myself with testing, and if I get her whilst she's sleepy, she doesn't notice what I'm doing, and get it first time before she shakes the damned blood drop off her ear and starts growling at me, it's ok. ish. But if she realises somethings going on, or for whatever reason I need to do another pinprick, no chance. Biting, scratching, yowling etc. And I just can't do that to her!

Last night's test worried me slightly - what I usually do is warm her ear up with a pill bottle filled with warm water, then use the light on my iPhone to shine through her ear for a while - this shows up where the vein is and also serves to keep her ear nice and warm whilst I prick it with the lancet. I must have just got the vein perfectly this time, because my god there was a lot of blood! I felt awful about it. It stopped bleeding within a couple of minutes, but when Cleo did her head shaking thing that she does to stop me messing with her, I was splattered with blood, the BG machine was covered in it, the sofa had loads of tiny little spots all over the place...it made me feel terrible. Although, funnily enough, the cat seemed less bothered than she has been previously...

I worry about how much it stresses her out, I really do. I know it's only for a few minutes, and she gets a nice treat afterwards (usually just a tiny bit of chicken or tuna), but it still concerns me.

H
 
Re: Worried newby - advice on possible remission?

Helene said:
Thanks for your replies.

I've been rewarding Cleo, bribing her, begging her, coaxing her... She is just a fiercely independent little critter, who does everything on her own terms! I have no squeamishness type issues myself with testing, and if I get her whilst she's sleepy, she doesn't notice what I'm doing, and get it first time before she shakes the damned blood drop off her ear and starts growling at me, it's ok. ish. But if she realises somethings going on, or for whatever reason I need to do another pinprick, no chance. Biting, scratching, yowling etc. And I just can't do that to her!

Last night's test worried me slightly - what I usually do is warm her ear up with a pill bottle filled with warm water, then use the light on my iPhone to shine through her ear for a while - this shows up where the vein is and also serves to keep her ear nice and warm whilst I prick it with the lancet. I must have just got the vein perfectly this time, because my god there was a lot of blood! I felt awful about it. It stopped bleeding within a couple of minutes, but when Cleo did her head shaking thing that she does to stop me messing with her, I was splattered with blood, the BG machine was covered in it, the sofa had loads of tiny little spots all over the place...it made me feel terrible. Although, funnily enough, the cat seemed less bothered than she has been previously...

I worry about how much it stresses her out, I really do. I know it's only for a few minutes, and she gets a nice treat afterwards (usually just a tiny bit of chicken or tuna), but it still concerns me.

H
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the trick is to hold her head secure so that she can't shake the head and then you lose the blood.
she will settle eventually, and it is for her health, so like taking medicine.... you may not like it, but it's needed.
I never aim for the vein because there is just too much blood. I have never aimed for anything other than just along the edge of the ear; the ears learn to bleed, so aiming for the vein is misleading and can be very messy.

I know you may worry about many things in the beginning, but please remind yourself that it is for her health that you test her and give her insulin. In time, she will associate a test and the shot to her feeling better. My cat always would come to me to remind me that it was time for testing or a shot, much like a cat comes to you for food.
 
Re: Worried newby - advice on possible remission?

Also, you don't want to aim for the vein--you want to aim above the vein where the little capillaries are. Here's a picture: http://felinediabetes.com/images/laur_danny_famoussweetspot.jpg

Cats have very few nerve endings in their ears (less than people have in their fingertips), so it doesn't hurt them to do the pokes. What the cat doesn't like is being restrained, and having something done to them when they can sense their human is nervous or upset or frustrated. It's very important to keep calm and NOT pity the cat. The cat is fine, but they will act upset if you are upset for them. Giving a low carb treat after every test is also very important, as is making the testing as regular and familiar as possible (e.g. testing in the same spot at the same time every day).
 
Re: Worried newby - advice on possible remission?

Thanks so much for your advice and support, it really is a great help - I can't believe I left it so long after Dx to post here!

I've just managed to get another blood glucose sample out of Cleo, with minimal fuss - I'm not injured, she's didn't growl at me, and (unlike yesterday) there isn't blood splattered all over the room! Reading showing 7.5mmol/L again - this is after her last meal of the day. I couldn't get a sample this morning however, she just wasn't having it, my boyfriend (who has been coming to my aid at test times to assist!) was at work so it was just me - it just seemed that I was pissing Cleo off so much, I had to leave her alone. But this most recent 7.5 post-meal reading is not irrelevant, right?

This is now the third full day since her last dose of caninsulin, and 7.5mmol/L is the highest blood glucose test I've taken. In a cat that is no longer being given insulin, but was on a twice daily regime, when would the peak/ highest glucose reading occur? First thing in the morning/ midday/ last thing at night? When should I try and ensure I get a blood test, what's the most important time to test? Also, there's no way such a short acting insulin could still be having an effect now, is there? Could it be that she has skipped regulation altogether, and somehow we've hit upon a diet controlled situation...? Fingers & paws crossed!

Elizabeth mentioned that small regular meals might be advantageous - I do already feed Cleo multiple small meals throughout the day, this seems to be working well for her, so I'll stick with that.

Now, obviously there is still an issue with testing - the advice given by both Blue and Julia has certainly helped me to gain confidence in myself, and confidence in the knowledge that I'm really not hurting Cleo - you're absolutely correct, it's the stress and fight that she puts up against being restrained that causes what I interpret as distress. Which probably leads to the fact that up to now I've been rather opportunistic in my approach to blood glucose testing, namely catching Cleo off guard, wherever she happens to be, as long as she is chilled out and sleepy - basically just getting it over with as quickly as possible, with minimal fuss, then giving her a treat afterwards. This obviously doesn't fit with the advice given regarding regularity and consistency of testing. Is it better to make more of an actual 'event' out of it all? Cleo just is not the sort of kitty that you can pick up and plonk on your lap, and she'll stay there. Don't get me wrong, she's a soft little lapcat when she wants to be (she's curled up under the quilt with me at the moment, warming her paws on my stomach!) but it's always on her terms. If I pick her up and put her somewhere, she leaves! And as for restraining her whilst she mooching about doing her thing, I'd just get scratched to shreds...

Any further thoughts?

Many thanks once again.

H
 
Re: Worried newby - advice on possible remission?

Hang in there, Helene! This is a task you can master! I'm not sure how you're positioning the kitty, but I'll just tell you what I do. I do testing in the same place most times except when Buster is napping. Then his ears are usually good and warm :-D He comes when I call, but basically I get him to a quiet room with no droolers or crazy tv's or anything going on. I have him sit in front of me and then I kneel behind him so he's basically between my thighs with his back to me. In the beginning, he was squirmy and he also tried the full reverse maneuver so I had to use my legs to hold him and cross my feet to prevent escape. Thankfully, he calmed down after a few rodeos. I use treats along the way - freeze dried chicken - Om nom nom!

Some people make a little kitty burrito using a towel or blanket to keep from getting jabbed until kitty submits.

I think a lot of it is also the energy you bring to the event. I know when I'm all stressed out for one reason or another Buster doesn't behave quite as nicely.

You're doing great! Stick with it! (pun intended) Hopefully Cleo's little pancreas can kick into gear and keep her off the juice! :mrgreen:
 
Re: Worried newby - advice on possible remission?

I'm getting there...

Another two successful tests today - one in the morning at 7.4mmol/L, and one just now at 6.0mmol/L - so still no need for insulin!

I have tried to turn testing into some sort of a routine, but the clever little kitty has got wise to it far too quickly - as soon as I try and put her somewhere to test her the growling starts, and the claws come out. I'm just gonna have to carry on with my opportunistic approach, i.e. sneaking up on Cleo when she's not paying attention, making a fuss of her and then surreptitiously pricking her with the lancet. It doesn't feel great, but before she's worked out what's going on she's being fed a post-test treat, so hopefully that takes her mind off the perceived indignity!

Re. kitty burritos - nice idea, I can see how it'd work with most cats, but our Cleo reacts worse to any kind of restriction of her movement than she does to a sneaky prick on the ear - she bites, she scratches, she hisses and growls as soon as I try and hold her still. I end up bleeding more than she does...

I did ask before, but maybe no-one was certain enough to give me an answer: when is the most important time to test a possibly no longer insulin dependant kitty? I'm trying to test her in the morning and the evening, at the times when I would have been giving her insulin. This should correspond with the peak glucose levels, right? Or does that change when no longer dosing with insulin? When is a cat likely to have the highest (and lowest) glucose levels? Early in the morning, late at night? After eating?

Thanks again!

H
 
Re: Worried newby - advice on possible remission?

Helene & Cleo said:
I'm getting there...

I did ask before, but maybe no-one was certain enough to give me an answer: when is the most important time to test a possibly no longer insulin dependant kitty? I'm trying to test her in the morning and the evening, at the times when I would have been giving her insulin. This should correspond with the peak glucose levels, right? Or does that change when no longer dosing with insulin? When is a cat likely to have the highest (and lowest) glucose levels? Early in the morning, late at night? After eating?

Thanks again!

H
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Hi Helene,

For a cat in 'normal numbers' - as with humans in 'normal numbers' there will be an increase in blood glucose after meals (which should settle down again when the pancreas produces sufficient insulin to process the energy from the food.)

I very occasionally test my own blood glucose (well, I have the test kit so why wouln't I? :lol: ) in the mornings when I get up, and this gives me a 'fasting' blood glucose level (a sort of baseline). Then, when I eat - if I test again, I can see a distinct rise in my blood glucose. But that settles down again within an hour or so. For a diet controlled cat I think you'd see a similar pattern.

Eliz
 
Re: Worried newby - advice on possible remission?

I'll take a try at how I understand this. No food for 2 hours - should be low blood sugar and no need for insulin - pancreas snoozing. Cat eats, blood sugar goes up within 20 or so mins. Pancreas responds and produces insulin and thus blood sugar begins to drop. About 2 hours later, should be at lowest point and remain until next meal and cycle begins again. I might have the times a little short, but I think that this is the basic cycle.
 
Re: Worried newby - advice on possible remission?

Helene & Cleo said:
Re. kitty burritos - nice idea, I can see how it'd work with most cats, but our Cleo reacts worse to any kind of restriction of her movement than she does to a sneaky prick on the ear - she bites, she scratches, she hisses and growls as soon as I try and hold her still. I end up bleeding more than she does...
Click to expand...

It just takes a little time and conditioning. When I started testing Bandit, I was in tears because he fought me tooth and claw, and he was hissing and biting at me the first two weeks. What I did was got a basket a little bigger than he was, lined it with fleece blankets, and gave him every test wrapped in another blanket with just his head poking out so he couldn't scratch me. He would growl at me and try to bite me, but he wasn't able to with me holding his ear pretty firmly. He got a treat after every test. After about two weeks of this, several times a day, he realized test=treat or dinner time, and he stopped growling at me when I put him in the basket. It also helped that MY attitude changed--instead of thinking "Poor kitty, I'm so sorry," while I was testing, I starting thinking, "You know what cat? We are doing this whether you like it or not because it's saving your life, so you're just going to have to deal with it. I poked myself and it doesn't hurt me, so quit being such a wimp." and I stopped feeling bad for him. After about a month, I didn't need to use the blanket anymore--he would sit pretty still in the basket as long as I kept one hand on him. Then he started napping in his basket, and hanging out there when I wasn't testing him. Fast forward 3 years later, and when he hears the glucose meter beep on he comes running, hops in his basket, lies down and starts purring. If you had told me that first week that my cat would do this, I would have told you you were insane! So I understand the feeling that while all these other cats here might be ok with testing, your cat is different. But the thing is, I bet she's not! There have been some really difficult cats here (worse than Bandit even) and some have taken longer to come around and accept it than others, but nearly all of them do. :smile:

However, if the poke and run approach seems to be working pretty well for you for the time being, I then do it that way. As long as you can get tests consistently as you need them, that's fine. If she really is in remission, after 2 weeks of daily testing, you'll only need to test once every few weeks after that. Just make sure you're testing at least once a month--a diabetic cat in remission is still diabetic, just diet controlled. Many things can knock a diabetic out of remission--reintroducing high carb or dry food, infection, dental issues, or even stress. The sooner you catch a relapse and start insulin therapy again, the sooner your chances of getting her into remission again.
 
Re: Worried newby - advice on possible remission?

Thanks guys.

Julia, your post has been especially helpful, moreso in helping me change my attitude than anything else - you're right, this is for the cat's best interests, so she just needs to grin and bear it! And you make a good point, I've pricked my own finger, it doesn't hurt. In fact, I've had countless holes pierced in my ears, nose, tongue even at one point or another across my (misspent?!) youth, and they didn't really hurt either - despite being pierced with a MUCH bigger needle than the little lancets we're using. So time to stop making such a fuss, kittycat. Besides, she wouldn't be getting all these lovely little tuna & chicken treats otherwise, and honestly I do believe she enjoys those more than she hates the blood tests.

Isn't it strange that Cleo never really minded about the insulin injections though? I guess it just comes back to restriction of movement again - I was always able to jab her with the insulin syringe wherever she was, whatever she was doing; I didn't need her to keep still for it.

I think this is typical of the Burmese and Siamese attitudes - fiesty, fiercely independent, yet intensely loyal when it comes down to it. Wouldn't swap her for anything!

H
 
Re: Worried newby - advice on possible remission?

Just a quick update - most recent BG test reading was 7.0mmol/L. This was an hour after Cleo stuffed her face on not only her own dinner, but a few sneaky mouthfuls of my steak pie also! So we're now into day 6 without insulin.

She's on oral antibiotic & antimucosal meds at the moment for her sinuses, so this should perk her up a bit more, as she's been a little sneezy & snuffly recently, but other than that, things are going well for us.

Also, the last BG test I took provoked no growling or scratching whatsoever, not even a headshake from Cleo. It's like she's slowly learning that a treat is to follow, and if she sits still and lets me do what I need to do, there's less chance I'll end up losing that blood sample and having to re-test. We're getting there!

All this is due in no small part to the help and advice of everyone here; thanks again from both myself and Cleo.

And here's a photo of the little lady herself:
8126300914_bf2909b342.jpg


H
 
Re: Worried newby - possible remission? High BG Test - HELP

Hello all.

Rather than posting a new thread, I've edited the title to this one - I hope people will notice and give some advice.

It has been 9 days since Cleo had any insulin. Her tests for Saturday evening, yesterday morning and yesterday night were 7.0, 6.2 and 7.0mmol/L respectively. I didn't test her this morning (naughty human), but the test I did just now came back at 10mmol/L (which is 180mg/dL).

Cleo is currently on Clindamycin antibiotics and bisolvon antimucosal meds for a blocked sinus flare-up, which was beginning to make her a bit off-colour. Cleo has been on these this Friday, and is feeling much, much better - more active, less sneezing & snuffliness, just generally back to her usual, cheeky, active, mischievous self.

But Cleo has been eating loads today, she's been really hungry today, and has eaten quite a bit more than usual throughout today and last night. In fact, she woke me up asking for food in the middle of the night, which she doesn't usually do. Could antibiotics cause an increase in appetite? I usually just feed her small amounts throughout the day, maybe 5 or 6 very small meals, totalling around 220g-250g of wet food a day. She probably had nearer 300g over the past 24 hours.

Cleo is a fairly small Burmese, she weighs about 4.3kg (9.4lb), and doesn't have a tendancy to overeat - she's usually fed small amounts whenever she's hungry, which luckily works out as fairly regularly throughout the day.

So...why the sudden high BG result? Just due to eating more than usual? And what action (if any) should I take? Obviously I will get another BG test done tomorrow morning, and see what that shows, but in the meantime has anybody got any thoughts on why this could have happened?

Thanks!

H
 
Re: Worried newby - possible remission? EDIT: High BG Test-

Her numbers are creeping up. I think it could be the infection, even though the symptoms seem to be improving. Some medications can also raise bg levels - did the vet think the two she is on might possible increase the levels?

Assume you haven't changed foods to a higher carb level or are giving higher carb treats?
 
Re: Worried newby - possible remission? EDIT: High BG Test-

First, Cleo is gorgeous!!!

I believe some meds can cause an increase in hunger and illness or infection can raise the blood glucose numbers. Could it just be the extra food she's eating? 180 is above normal, but we usually recommend that newbies not give insulin unless the bg is over 200. I suspect that when the infection is gone, the numbers will drop again. Keep testing!
 
Re: Worried newby - possible remission? EDIT: High BG Test-

So it's now 4.30am and I've just been woken up by a little Cleo cat licking my face and re-styling my hair...then she did her tightrope walker act along the headboard, and sure enough ended up landing on my head. She's now talking to me, really doing her best attempt at convincing me she is a poor, neglected, starving kitty, in need of feeding!

A tiny portion of food for her, and then she can wait for breakfast in the morning. Midnight snacks aren't entirely disapproved of in this house, but they need to be the exception rather than the rule...

Thanks to Sue and Debbie for your replies; yes, she is a gorgeous little lady isn't she? The problem is she knows it, and has worked out exactly how to turn on the charm in order to get what she wants!

Her food has not been changed, no, she is eating a 1.8% carb Whiskas Fisherman's Choice wet food at the moment, as she has been for quite a few months. Although she did pinch a piece of cheese out of a sandwich I was making yesterday morning - it fell off the chopping board and she was on it in a flash, it was gone before it hit the ground.

The vet stated he was not aware of any impact on BG numbers for each of these meds when I asked; however that doesn't really mean much, does it?

The question is, do I feed Cleo more when she has a higher appetite, or just give her the same every day, regardless of how much she begs? She's never been a cat to overeat, so freefeeding has never been called into question before. Perhaps it is just these meds and/or slight infection. Hmm...

Better go give this little critter some food, she's chewing on my iPhone now as I'm typing this!

We'll see what tomorrow's numbers show.

H
 
Re: Worried newby - possible remission? EDIT: High BG Test-

I would feed her a little more- with the antibiotics and the cooler weather change she might need the food to stay warm- my girl has increased her intake and I am pretty sure that is a reason why.

Also- check for ketones. Even though she is eating she did have an infection and you aren't giving her extra insulin so just to be on the safe side I would slide a ketostix in her direction when she uses the LB.
 
Re: Worried newby - possible remission? EDIT: High BG Test-

hmjohnston said:
I would feed her a little more- with the antibiotics and the cooler weather change she might need the food to stay warm- my girl has increased her intake and I am pretty sure that is a reason why.

Also- check for ketones. Even though she is eating she did have an infection and you aren't giving her extra insulin so just to be on the safe side I would slide a ketostix in her direction when she uses the LB.
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She's not getting any insulin at present - that's what I really am unsure about, whether or not to recommence the shots. Morning attempt at BG test was unsuccessful, going to try again in an hour or so. I'll post the results when I have them.

Is there really a risk of ketones being present with a BG of 10mmol/L (180mg/dL)?

H
 
Re: Worried newby - possible remission? EDIT: High BG Test-

Cleo's after dinner BG was 8mmol/L (144mg/dL).

Still no insulin.

I'm tempted to continue with no insulin until she's finished her course of antibiotics (Friday), unless we see a pattern of high numbers developing, i.e. over 10mmol/L. See if her numbers settle back down to the pre-antibiotic levels we were getting at the start of this insulin free trial (all were under 7.5mmol/L). Anyone think this is a really bad idea?

Also, the ketones thing - that's not really a risk at this sort of BG level, is it? That comment made yesterday by Hmjohnston concerned me slightly. I'm not doing her any harm by continuing without insulin over this period... am I?

Anyway Cleo seems great, better than she's been for ages.

Here's another photo...just because!

8139740634_74de3e4875.jpg

One of her multitude of bizarre sleeping positions...what is that leg doing?!

H
 
Re: Worried newby - possible remission? EDIT: High BG Test-

If the antibiotic isn't controlling the infection, the infection can increase the glucose numbers above what the pancreas can handle. This oculd explain the hunger - she can't use the calories she is digesting, so she tries to eat more. This also could increase the risk of ketones - breaking down fat for energy may result in ketones.

It may be prudent to consider a token dose of insulin - maybe just a drop to take the edge off, based on the most recent data you have about how she handled insulin. If you know how low you were able to safely shoot, you might take the midpoint between that number and 200 and use that as your 'no shoot' number. Anything above that number might get a token dose to help out her pancreas during the infection.
 
Re: Worried newby - possible remission? EDIT: High BG Test-

BJM said:
If the antibiotic isn't controlling the infection, the infection can increase the glucose numbers above what the pancreas can handle. This oculd explain the hunger - she can't use the calories she is digesting, so she tries to eat more. This also could increase the risk of ketones - breaking down fat for energy may result in ketones.
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Cleo's sinus infection has cleared up completely it seems, no more sneezing or snuffling at all, much perkier, so I doubt that the infection itself is the cause of any raised BGs. One of my BG meters tests for ketones as well, so I did a quick check whilst doing her last BG test - we're all clear in that department.

Cleo's after dinner BG today was 7.7mmol/L, so it's coming back down nicely. Just gonna keep an eye on it, see what happens after the antibiotic course ends.

It may be prudent to consider a token dose of insulin - maybe just a drop to take the edge off, based on the most recent data you have about how she handled insulin.
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Yep, I'll keep this in mind if her BGs rise again. 11 days without insulin now, Cleo has done damn well; if she needs the odd shot due to an infection she's fighting off, that doesn't negate the progress she's made so far.

Thanks.

H
 
Re: Worried newby - possible remission?

So...today is day 14, 14 days since Cleo had any insulin. I've been testing her randomly at least once every day, and except for a single high reading of 10mmol/L, all have been under 8mmol/L.

Very early this morning her BG was 7.0mmol/L, but she just will not let me get another blood test from her now! I want one last, final, conclusive test to mark the end of this 14 day trial period, just to determine where we are. But Cleo is pouncing on my hands whenever I go near her, and chewing on the BG machine; thinks it's all a big game.

So what do people think about these numbers? They're kind of towards the high end of normal, aren't they? But not high enough to warrant an insulin shot...right?

I'll post back with tonight's BG result once I manage to get one, but in the meantime it'd be good to hear what people think about Cleo's numbers. I know I haven't set up a spreadsheet, but my posts above in this thread give the results as they've been coming in over the past 14 days.

Thanks all.

H
 
Re: Worried newby - possible remission? Update: Day 14 OTJ t

Yes, they are on the high end of a cat in remission. I took my Scooter off insulin with similar readings between 80 and 140 and he was back on insulin within a month. Keep an eye on her :) Congrats!
 
Re: Worried newby - possible remission? Update: Day 14 OTJ t

Ry & Scooter said:
Yes, they are on the high end of a cat in remission. I took my Scooter off insulin with similar readings between 80 and 140 and he was back on insulin within a month. Keep an eye on her :) Congrats!
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Hmmm I'm conflicted re. what to do.

If Cleo was an easier cat to BG test I'd be so much happier. But it really is very tricky to get tests out of her, unless she's ultra-relaxed.

On a longterm basis, what would you say the no-shoot threshold is, realistically? I know the safeguard advice is not to dose if BG is under 200 (or 11.11mmol/L), but that's as a one off test reading, isn't it? You wouldn't want to leave a cat without insulin for any length of time if those sorts of numbers were consistently appearing. But say for instance my Cleo stays within the sort of range she has been, generally maxing at 144 (8mmol/L), is that going to be doing her any longterm harm, being at the high end of normal?

I think with the BG testing difficulties we have, it's just too close to call, too big a risk of not being able to test, risk of a hypo, if I was to give Cleo any insulin at all when she's in the higher end of normal range.

Also, what more can I do to bring her BG down? I'm currently switching her over to a higher quality low-carb food, Bozita, but it's only slightly lower in carbs than what I've been feeding her - 1.2% vs 1.8%. Although, from what I've read the more commercial feeds, such as the Whiskas range I've been feeding Cleo, can be somewhat 'creative' in their analytic constituent info. Could this change be what Cleo needs to bring her down those extra few BG points? And is there anything else I can do to bring these numbers down just that little bit more?

H
 
Re: Worried newby - possible remission? Update: Day 14 OTJ t

I agree with Ry. Her numbers are close, but higher than remission. And lower than I would want to dose with Canninsulin. I would continue to get tests in - anytime you can, mid cycle and pre/post food. I hope she would continue to go lower.

Have you ever considered raw? Some cats get lower levels with raw than the lowest carb OTC foods. We can get raw from the markets here - Feline's Pride and Natures variety - ready to eat, but I'm not sure about Europe. You could also make your own raw food. Dr. Lisa explains how on her website: www.catinfo.org
 
Re: Worried newby - possible remission? Update: Day 14 OTJ t

Hi Helene,

As to giving different food, that really may depend on your budget....

There are some lower carb foods out there. Are you feeding the bozita cans and not the tetra packs?

If your budget will stretch to it you could try Grau 'grain free'. Although this looks like it has an average carb content of 1.7 - according to the UK pet food carb calculator - I suspect the carb content is actually lower than this because I've just started feeding this to Bertie and his BG numbers have dropped... Or it may be that the quality of the food is sufficiently good that he needs to eat less of it, hence less calorie intake, etc... I'm sufficiently encouraged by the change in his BG numbers to try other premium foods and have just ordered some Lily's Kitchen cat food (Haven't told my OH the price of it.... :shock: ) to experiment with. There is also Thrive cat chicken cat food but I think that is even pricier :shock: :shock: ; something like an 85g tin for a quid a throw.... However, in your situation it may be worth the extra cost at this stage of the game, just to try to get Cleo's numbers down a smidge. But it would be an experiment, just like I'm doing with Bertie... (Though Bertie isn't going into remission, he's just getting much lower numbers lately and seems SO much better than previously, hence our experiment...)
And yes, of course, there is the option of raw food. The main commercially available one in the UK is 'Natural Instinct'. I've been toying with the idea of trying that too... And of course, if Cleo likes it, you could always make your own....if you have a mincer.... You can find recipes on the 'Petsforum' website in the UK but the recipes make quite a bit of stuff....

I've noticed too with Bertie that encouraging him to drink more can help to bring down or 'hold' his numbers. I make chicken broth and often he'll drink a saucer of that instead of having a solid food snack. Some cats like the water that fish has been poached in.

Do remember too that the weather is getting chillier in the UK. Is Cleo an indoor/outdoor cat? If so her body may be telling her to put on a little weight for the winter. Most of my cats are eating a little more at the moment...

As to giving shots below a BG of 11 (200), those are the general guidelines for people whose cats are new to insulin. And it continues to be the rule for some cats. Until recently I couldn't give my cat a shot below 11 even after nearly six years! But now I'm starting to give shots at a BG of around 8.5 as long as I'm satisfied that the previous shot has run it's course and the BG is definitely rising. But I give a teensy amount. And I have a lot of data about how my cat responds to insulin. (And I agree with another poster that it's not so easy with Caninsulin (I use PZI)).

My best bet would be to experiment with some other foods, to feed little and often (I know you're doing that), and to encourage Cleo to drink more. But if Cleo's numbers are not going higher than 8 then giving any Caninsulin - to a cat who ain't easy to test- sounds tricky.

Ah, one more thought... What meter are you using? Some meters (can't recall which ones at the moment) read on the slightly high side...
 
Re: Worried newby - possible remission? Update: Day 14 OTJ t

Thanks all.

Regarding food, I cannot realistically afford to switch to a more expensive food. Cleo seems extremely pleased with the Bozita range, I've just purchased about £40 worth of it in a nice variety of flavours (they have a fantastic selection - crayfish? reindeer?! Thanks to Elizabeth for informing me about this range.) I'm feeding the Bozita Tetra packs, they were cheaper than the cans per kg, and seemed more convenient. But yes, this is about the maximum my budget can stretch in the food department, the others varieties mentioned are just too expensive. As is the pre-prepared raw food, and I just wouldn't have the time to do it myself. Also, money... The Bozita food is around £2.30 per kg, free shipping; the Natural Instincts raw food works out at £11.70 per kg, when shipping is taken into account. Huge difference. But Bozita is good quality, right? 1.2% carbs is very low also. I'm hoping this might just be enough...

I will try and get Cleo to drink more, she does like her food to be quite sloppy and won't eat food if the pack has been in the fridge, so I sometimes add some warm water to it. I'll try and do this more often, increase her liquid intake.

As to the weather, yes, it's changed a lot over the past two or three weeks, hasn't it? Cleo is an indoor cat, but she comes out into the enclosed garden whenever somebody is out there. If I go out to hang the washing up, she follows me. And she comes out on a lead in the summer for picnics, when the weather is good. Also I don't go overboard with the central heating; there's always a warm spot in the apartment somewhere, but I don't put the heating on in all the rooms. So Cleo definitely will be noticing the change in the seasons. Her coat is becoming more fluffy and wintery as it does each year. As you point out, this will of course increase appetite as well.

Caninsulin isn't ideal; if it does come down to restarting Cleo on insulin, I would try and change vets and change insulins. She is obviously very borderline at the moment, and I'm unsure restarting with caninsulin would be helpful in the long run - it just seems like we're almost there, and just need to get those final puzzle pieces in place, you know?

The no-shoot number I've had in my mind is anything over 8.5mmol/L, save for exacerbating circumstances such as infections etc. What do you think about this?

I wonder, if we went to a vet right now, presenting a healthy cat, with normal thirst & appetite, but showing these blood glucose numbers, would she be diagnosed as diabetic? I know this is somewhat academic as obviously Cleo has the Dx and Hx of diabetes, but it's just so nearly there, so very borderline. Frustrating!

As to what BG meter I am using - it's a One Touch Verio IQ, but I also have an Abbott Freestyle Optimum. I've been using the One Touch up til now, but have just run out of the 50 strips that came with the meter (and blimey they're expensive!), so am going to be moving onto the Freestyle from now on. I did a comparison test with my own blood to check the difference between the two, and the One Touch read 0.4mmol/L higher than the Freestyle. Is this clinically significant? I suppose it probably is.

Cleo seems really well today, very active and mischievous. She's just been jumping in and out of the big cardboard box the Bozita cat food arrived in, thinking I can't see her when she's inside it, then jumping up to surprise me, playing hide & seek; she was snuggled up under the duvet with me until really late this morning, lazily playing with my hair, until she decided it was time for breakfast, at which point she started to lick my face. She's happy, and I really do love her to bits.

H
 
Re: Worried newby - possible remission? Update: Day 14 OTJ t

Helene, if she is happy and her usual self and peeing and pooping and playing, I think you should rejoice! I am thinking if she went to the vet with these numbers, he would say borderline diabetic and have you monitor her. I don't know what your shoot number should be - personally, I would be uncomfortable shooting under 180 or so and then a token dose. You have so little data and she has responded well to the insulin and diet. I would just watch and be ready to start insulin again if needed.
 
Re: Worried newby - possible remission? Update: Day 14 OTJ t

My Sophia was diet controlled after several months on insulin. I have read that every 8th cat gets diet controlled.... You are so lucky... but you still need to test from time to time to see if it stays that way. I am very happy for you.
 
Re: Worried newby - possible remission? Update: Day 14 OTJ t

Hi Helene,

Yes, I guess a vet would classify Cleo as "borderline diabetic". But the reality is that you have a beautiful happy and healthy cat who just happens to have slightly elevated blood glucose. I think what you've achieved with Cleo is a tremendous success. Yes, theoretically her numbers could be lower. But please don't stress yourself about that. Maybe her numbers will get a little lower and maybe they won't. We just don't know. And maybe they will rise a little and Cleo will need insulin again. But for now, celebrate each day that Cleo's BG is too low for her to need insulin!
 
Re: Worried newby - possible remission? Advice please!

How irritating - just got a BG test off Cleo of 8.6mmol/L. She ate about an hour and a half ago.

I tested her yesterday evening before she ate and she was at 7.2mmol/L.

8.5 was my self-imposed limit, I told myself that if I got another test above 8.5 I was going to start reconsidering things, as I mentioned in an earlier post.

It's just that Cleo is doing so well at the moment, she seems much healthier than she was when on the insulin. It's so frustrating, I really do not know what to do.

I don't want to risk even giving her a tiny dose of caninsulin, as I know how quickly it hits her, and how quickly her numbers drop with even a 0.25 unit dose; the risk of a hypo on caninsulin would be very high.

Her numbers aren't really rising significantly, they're just averaging out slightly too high. Are numbers like this causing her harm? 8.6 seems to be about the highest she's reading at over the past week or so, and 6.5 is the lowest.

Is it worth going to a new vet, seeing if I can convince them to the idea of starting from scratch with another insulin, lantus for example? I'd have to go to a new vet, as my current vets will not prescribe anything other than caninsulin.

Or do I just carry on with the spot checks, carry on testing for ketones, continue observing Cleo's condition, thirst, hunger etc, and be very cautious of any signs of deterioration?

Help!

H
 
Re: Worried newby - possible remission? BG still slightly hi

Hi Helene, hope you're doing OK.

I think if it were me, I'd hold fire on the insulin. 8.6 is still within the 'safe' zone and in all likelihood, the numbers will come down later (typical contrary cats!!). I'd just keep an eye on her and test again later.

Our Monty is in a similar position to your Cleo - he was on Caninsulin for 6 weeks and then came off the squash about 3 weeks ago. He's usually around 5.5 ish but we have had the occasional 7.1/7.2 but then it drops back down. And there doesn't seem to be any rhyme nor reason to it!!

Keep us posted.

xx
 
Re: Worried newby - possible remission? BG still slightly hi

It's the same with cats who are on insulin. I've had brilliant numbers from Bertie for the last month and then yesterday and today his numbers have been rubbish. No obvious rhyme or reason. Cats, eh? :roll:

Helene, I'd suggest you just continue to observe, and try not to worry (easier said than done, I know). The numbers you are getting are still good numbers.

If it is the case that Cleo's numbers continue to rise, and she needs insulin again, then maybe you could consider Lantus which has a much gentler action. Or you could consider Hypurin PZI. But at the moment, just monitor....

Eliz
 
Re: Worried newby - possible remission? BG still slightly hi

Thank you.

Helene is going to stop worrying, relax, and enjoy spending time with her furry feline.

Said feline is keen to demonstrate how much better her back legs are...a small piece of minced beef seems to cure all residual signs of neuropathy, albeit on a temporary basis!

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Thanks all!

H x
 
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