Harry - Lantus with blood glucose swings/bowel disease

Discussion in 'Lantus / Levemir / Biosimilars' started by Dee123, Dec 29, 2017.

Thread Status:
Not open for further replies.
  1. Dee123

    Dee123 New Member

    Joined:
    Dec 29, 2017
    Hi there,

    I am posting hoping someone else has encountered the problems poor Harry is having. I will fill out a chart as instructed, but I thought to post something first so you could get to know him and the issues he is having. He is currently at the vets having developed ketones from his diabetes being uncontrolled. He was not eating enough with an upset tummy. His intestinal lining is inflamed (ultrasound) and nutrients are not being absorbed due to that and the blood glucose levels. He was treated the following way: he was given the fast acting insulin to get him under control. First 24 hrs on CRI. Then remained on it for another 48 hours. the following day he went on Lantus. The next day he was transitioned back to CRI within 24 hrs alert but they continued for 72 hrs. Then he was transitioned to lantus again for 2 days and was bright and alert. Then he came home. He exhibited some shakiness of the hind quarters the next day at home. It turns out that this was the beginning of the potassium levels plummeting again. His blood glucose dropped from 16.1 at 10 p.m. to 1.9 at 9 am the next day.

    He is on lantus insulin, and is seeing an internal medicine specialist who also specializes in diabetes. We are exploring all angles and trying to figure out why his blood glucose is experiencing such highs and lows in short periods of time. Is it the lantus? Should he be on another type of insulin?

    History:
    He had diabetes for many years. He had problems regulating it before and they finally stabilized him. He also had pancreatitus. He came to us with limited information from a Humane Society where he had recently been moved as the vet clinic where he lived could not adopt him out after 2 years. They hoped the Humane Society would have more luck as they have a high adoption rate. We recently received more information from that previous vet, that had not been passed along to us by the Human Society. They had diarrhea problems with him that persisted. The diarrhea persisted even when everything else cleared up (pancreatitis, stabilized blood glucose on 2 units for 2 months and then increased to 3 units. He was transferred then and I suspect now that the blood glucose was never resolved. They noted that switching him from DM to WD fixed the diarrhea. I’ve included information from a previous vet as it shows what they did to stabilize him.

    He has had slight diarrhea since we adopted him a year ago. It is not liquid diarrhea, about 3-4 on the fecal scoring chart - formed, somewhat solid, but not truly solid. The weight loss seemed to speed up after he had dental surgery to remove teeth. Post surgery he had a diabetic episode and almost went into a diabetic coma due to low blood glucose. He was then switched from 3 units to 1 unit, but the blood glucose remained very high (15 - 24). It was increased slowly back to 2.5 units. He also refused to eat at times and couldn’t be given insulin. Was eating FancyFeat from Blinkey’s list - the wrong ones that manufacturer changed formulation as we later discovered.

    We sought advice about the weight loss and they discovered he is not absorbing the food nutrients and an ultrasound revealed a severely inflamed intestinal lining. Could be cancer or bowel disease. He is not well enough to be sedated for a test to determine which. We all agreed to treat as bowel disease. Switched to DM. He was not gaining weight and blood glucose was still high. Switched him to a raw food diet - Stella & chewy and also tried some gluten free canned foods. Nothing worked. He liked it for a few days and stool would become normal, then he would stop eating and/or stool would slowly change back. He became tipsy due to ketones in his blood and low potassium and was taken to a specialist in internal cat medicine and diabetes.

    Most recently he has been on 3 units of Lantus every 12 hours after being treated for ketones in his blood, low potassium and uncontrolled diabetes at the vet’s. He was on IV Lantus there attached to some kind of special pump on an IV pole. He did really well as it was monitored hourly and his blood glucose regulated at 8 metric or 144 imperial. He came home on 3 units of Lantus. He has lots of gas and did not like to eat due to discomfort at times. Rubbing his belly released gas and he ate. Stool normal consistency, but dark brown. He seems like he is not pooping as much. Potassium dropped again. Specialist investigating Somogyi effect.


    Let me know if I forgot anything. He is at the vet's now so we can't do much, but it would be good to hear what people think is going on. We are all stumped.
    Thank you,
    Harry & Deea
     
  2. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

    Joined:
    Dec 12, 2016
    Hi There!

    There is a lot going on. If he was DKA it could take a couple of weeks for him to feel better and it is probably best he is at the vets for the intensive More important though is keytones are the result of not enough insulin + not enough food + inflammation/infection. Inflammation and infection will also drive up his numbers.

    I am suspecting from what you prescribed that he may have IBD. Which Jones has and actually it what started us on our FD journey. Like you, it was suspected that it was either cancer or IBD but he was so thin and weak by then, that I did not opt for the surgical biopsy to confirm. The diagnoses was based upon an ultrasound. The IBD was treated with a steroid (prednisolone - more on that later) to reduce the inflammation, Cerenia for nausea, Metronidazol for diarrhea and an appetite stimulant. As you can see from my signature, he is still on these.

    There are a few different steroids that can work with IBD but it can possibly drive up the numbers. I would say can cause FD as was in my case but your kitty is already diabetic.

    Has chronic pancreatitis been ruled out? That can be painful and a pain med might also be required.

    There is a lot going on with Harry and it almost sounds like a chicken and egg scenario.
     
  3. Dee123

    Dee123 New Member

    Joined:
    Dec 29, 2017
    Yes, it really feels like we are going round and round in a chicken and egg scenario. He had a bout of pancreatitis before he came to us and it was ruled out but perhaps it has reoccured. What food do you use? Harry is also on that metron pill.
     
  4. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

    Joined:
    Dec 12, 2016
    I think their main focus is the keytones, but I have a feeling the IBD is aggravating the situation and may need to be addressed at the same time in order for him to eat and get insulin consistently.

    I use the Rawz Turkey and Chicken as well as Fowl Ball from Weruva and the Tiki Velvet Mouse Chicken. This was after many, many, many different foods and $$$. I found with him the gums is a big issue. As well, I did have an allergy test done and found out he was allergic to tuna. Yeah, so that has cut a lot of cat food out.

    There is a website www.ibdkitties.net that has a lot of information on it. A raw diet which works for both IBD and FD is suggested for an IBD kitty. Jones was not a fan and he free feeds...which means he can't have the sushi hanging out all day so he can nibble. :rolleyes: I did try the homemade cooked food but I don't think the texture was quite right. Was thinking of trying that again but blend it to a pate.

    A good quality probiotic is also a good thing to add to the daily routine. I use the Ultimate Multi Probiotic.

    I am going to tag @Wendy&Neko. She is well versed in the world of IBD and is a great resource.

    Do you happen to have all the blood work test results that have been taken while Harry is the hospital? If so, there is another lady @Marje and Gracie that is very knowledgeable about kitties and blood work. She may also be able to provide some insight with what is happening with Harry right now and help guide you with questions for you vet.
     
  5. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

    Joined:
    Dec 12, 2016
  6. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
  7. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Hello and welcome to you and sweet Harry. Looking forward to seeing some of your home testing data on a spreadsheet. Are you testing at home for ketones as well? It's good to put the results of ketones tests into the SS, on the Remarks column. Also include when you start or stop meds. For example, prednisolone (which may be needed for IBD), can increase blood sugar and hence the need for more insulin. But if a kitty needs a med that raises the blood sugar, we just work the insulin dose around it.

    A more current food list is Dr. Lisa Pierson's list. Where are you located? Maybe someone in your country can help you find low carb brands to feed. With IBD, you may want to try a novel protein.
     
  8. Dee123

    Dee123 New Member

    Joined:
    Dec 29, 2017
    Hi, Posting to let you all know that Harry has passed away. He had a seizure in the early morning (not blood glucose related) and passed at home. I really cannot write more at this point. I am too grief-stricken and wonder what else I could have done or when I should have noticed sooner. Poor sweet Harry.
     
  9. Mandy & Rex (GA)

    Mandy & Rex (GA) Well-Known Member

    Joined:
    Mar 22, 2017
    I'm very sorry to hear the news. :bighug::bighug::bighug::bighug:
     
  10. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    I'm so sorry for your loss. :bighug::bighug::bighug: He had a lot of things going on. Fly free Harry, and land softly at the Bridge. cat_wings>o
     
  11. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

    Joined:
    Feb 14, 2011
    I'm so very sorry....our thoughts and prayers are with you....
     
  12. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

    Joined:
    Dec 12, 2016
    I am so sorry for your loss. Hugs to you and your family.
     
Thread Status:
Not open for further replies.

Share This Page