Zelda 2/2 - AMPS 218 / +6 147 / PMPS 212

Peter Moore

Peter Moore

Member Since 2019
Not a misprint. (Edit: Oops, it was. 218. Still flat though). Almost the same value as last night's PMPS. Flattest I've ever seen her since this all began.

We're trying a new ear medication, because she still needs it. It was specially compounded without croticosteroid. However it contains glycerin which makes me skeptical. I can't find any research on the use of glycerin in diabetic cats. In any event, I'm only doing pre-shot tests for awhile. The glycerin makes her ears dry and while she was an angel for her test this morning I know it was uncomfortable. I might need to find a safe moisturizer for her.

She ate her initial 1/2 can of Fancy Feast, but not as ravenously as usual. But she jumped on high chairs for beef treats so seems to be feeling fine. If she had virtually no BG swing over the course of the night, she might just be feeling normal. Watching her throughout the day of course.

Wondering how significant these drops really are and if low 200s / high 100s are just about what her pancreas is able to give us right now given no dry food or drugs to screw with it. If, after eventually going to 0, that's where we land at the end of the day, and she has no clinical DM symptoms, would that be considered a success?

Edit: Here's yesterday's conversation.
 
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I've never been a fan of mineral oil due to the smell, but otherwise not sure of the difference compared to vaseline for moisturizing. I like the barrier properties of the vaseline.
You can try both and see what works better?

Eta: my mom used coconut oil on her dog's ears, I have no idea if it's good for cats or not.
 
Sure. Well I have some mineral oil on hand so I'll try that first.
I also heard vasaline is good for helping the blood coagulate during a blood test so probably should get some anyway.
 
Please link to your yesterday's condo in your first post so people can read the history if they wish to.

Did I read that correctly that you do not plan to test in between the PS tests for a while? I highly encourage you to get at least one test in between.
 
Sure thing.

Yes, because the ears are raw from the new medicine (amoxicillin compounded with glycerin). If they get better I'll try a mid-day though.
 
As for your question about high 100s/low 200s, we call that under renal threshold, but we strive to see 50-120 (human meter) or 68-150 (pet meter) for 2 weeks with no insulin before we can say the cat is in remission. The cat will always be a diabetic that is diet-controlled so same food must continue to be given.
 
I guess I'm just wondering if we just wind up not being able to get there completely, are we better off doing insulin therapy for life or living with less than perfect numbers? I know what the vets would say...

Not that I've given up!! :bookworm:
 
WOW. @Chris & China That is dedication. I honestly don't know that we could do that for that long.

My mother had a diabetic cat who was receiving 1U glargine once a day and lived to be 18 or 19. She refused to test or do 12-hour shots. Ruined any chance for remission, but the cat seemed to have a nice life until the very end. You just never know I guess.
 
Peter Moore said:
Yes, because the ears are raw from the new medicine (amoxicillin compounded with glycerin). If they get better I'll try a mid-day though.
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It is possible to take a blood sample for a BG test from their paw. I've never done it myself, but some have found it easier, and it would be an alternative if her ears are too sore. I'll just see if I can find some info on that for you
 
Thank you! I actually tried that with the lancing device but the pad was too thick to be penetrated, so I'd need to do the prick manually. Still not at that point. :) But I certainly will begin trying that again if the ears prove to be unworkable.

Oh they also say it should be the unused pad, basically on the wrist.
 
Peter Moore said:
I actually tried that with the lancing device but the pad was too thick to be penetrated, so I'd need to do the prick manually.
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You might need to adjust the lancing device so it penetrates the pad, but yes the videos I've seen folk seem to be doing it free hand.
 
Here's an interesting website about coconut oil use in cats. https://www.petmd.com/cat/nutrition/coconut-oil-cats-it-good-idea
Good thing it's positive since Luci demands some of my coconut oil daily (I use it on my feet as a moisturizer) and she will NOT leave me alone until she gets some of her own. I put about a 1/4 tsp in the lid to keep her occupied for a few minutes - she licks out every tiny morsel of it and pushes the lid across the carpet - doesn't want to miss out on a drop. She's crazy though...:p
 
AMPS 218 / +6 147 / PMPS 212

Wow. This is a testament to how exact the drop method is. Unfortunately it requires one syringe per drop! I wonder if it's worth wasting syringes and doing 3 drops. I suspect that would be her perfect dose, but then I would have to up the testing frequency. Regardless I don't want to change anything up again until this ear infection is dealt with. I'm sure it's skewing the numbers.

Incidentally AAHA would say to maintain this dose since we had a nadir under 150 (and virtually guaranteed it was over 80). I know both my vets would be thrilled at these kinds of numbers - safe and asymptomatic.
 
Just a housekeeping thing to add on, in case you didn't know- if you'd like to, you can edit your title to show your tests through the day. Not sure if you knew that already or not :)
Your Princess is looking good despite that infection!
 
Mandy & Rex said:
As for your question about high 100s/low 200s, we call that under renal threshold, but we strive to see 50-120 (human meter) or 68-150 (pet meter) for 2 weeks with no insulin before we can say the cat is in remission. The cat will always be a diabetic that is diet-controlled so same food must continue to be given.
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Let me see if I understand correctly then. Please correct me if/where I'm wrong:

If she's below the renal threshold, then that's good news for the kidneys because they don't have to process excess sugar.

However, even if she's below renal threshold, but still above what's considered "normal", the pancreas is still doing more work than we want it to, and the beta cells are not getting the rest they need to be able to maintain her at normal levels long term.

Do I have that right? And what's the long term prognosis for a cat that IS in the high 100s, low 200s indefinitely? Will those levels eventually rise and return to full blown diabetes? Or could she live a normal asymptomatic life thereafter?
 
Your summarization is correct. The cat needs to be in dark green numbers, ie healing numbers, so the new fragile beta cells can build and start working well once you withhold insulin. That's why we do the 2 week trial so those cells can become established.

I'm not sure of the answer to your questions in the last paragraph. Let me tag some people who could better answer that.
@Jill & Alex (GA)
@Wendy&Neko
@Marje and Gracie
 
Mandy & Rex said:
As for your question about high 100s/low 200s, we call that under renal threshold,
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Under renal threshold is the point at which the kidneys do not have to remove excess sugar from the blood. It is detected by testing the urine for glucose. This is done as part of a urinalysis or using ketodiastix. It's ECID on where the renal threshold number is per cat. For some cats it's mid to upper 100's, for others lower 200's.

If your goal is remission, then you want is get as much green on the spreadsheet as possible. That is when the beta cells get their healing time. Of course that's not a guarantee of remission, but regulation is a prerequisite to remission.

The purpose of the two week trial is to ensure that the beta cells are healed and that kitty is in remission. For more info, you might want to read this paper: Glycemic Status and Predictors of Relapse for Diabetic Cats in Remission

Note that not everyone will have the same goals as you. My kitty had two secondary endoncrine disorders that contributed to her being diabetic. Sort of a type 3 diabetes. She had a working pancreas but her pituitary was sending out excess growth hormone, which caused her diabetes. So for her, I didn't really need to focus on "healing" green, cause her beta cells were doing fine. Other people aren't able to test as much and are just as happy with a regulated and happy cat. We've had some kitties here diabetic for 9 years.
 
I’m not sure if you are asking the prognosis for a cat in the high 100s/low 200s if they are not getting insulin or if they are.

If they are not, you potentially risk her getting diabetic ketoacidosis if she ever gets an infection of any kind. That is also a risk with cats on neuron but less so. In addition, it’s likely that her beta cells would become more and more compromised and the BG would rise. Hyperglycemia over a period of time can result in organ damage.

In both cases, if their renal threshold is exceeded, the constant dumping of sugar into the bladder can cause urinary tract infections and damage to kidneys. However, I’ve seen cats stay fairly healthy who were bouncy over a long period of time, receiving insulin.

Bottom line: for her health, she should stay on insulin until she no longer needs it by having numbers mostly between 50-99 for a week or by earning a reduction from 0.1u and making it successfully through an OTJ trial.
 
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