? BG higher (and appetite ravenous) after IBD treatment?

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Peter Moore, Feb 23, 2019.

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  1. Peter Moore

    Peter Moore Member

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    Jan 26, 2019
    So things have been a little rocky and at times weird the last couple weeks.

    We thought we were on the road to remission. Down to single drops. However, appetite was lower and Zelda was losing weight and vomiting more frequently than she should, and stools were soft and occasionally diarrhea. She would frequently crouch after meals as if she had indigestion. Last week (2/17) she didn't want to eat at all and was extremely lethargic. Bounced back a little after subq fluids but not 100%.

    After an X-ray, ultrasound, and blood panel, vet found thickened intestinal walls and severe B12 deficiency. He thinks it's IBD and/or small cell lymphoma. Seeing an oncologist Tuesday, but we started treating for IBD regardless with a weekly B12 shot and daily metronidazole and pepcid beginning last Wednesday 2/20. Also have been adding a pouch of Fortiflora probiotic each day.

    The transformation has been dramatic. Her appetite is RAVENOUS. She's already gained about 0.5 lbs. Her energy level is almost as high as it was before she was diagnosed as diabetic. No vomiting, and she has gigantic well formed poops. (This morning it was the size of my fist, I kid you not). The vet was very happy (and I think surprised) at how well she's responding just to IBD meds.

    However, the BG is now quite a lot higher and we're seeing glucosuria again. Consequently I've been ramping up her insulin, now at 0.5U glargine BID. Note although there were a couple days earlier this week where I was giving some forbidden dry food just to entice her to eat, for several days now she's been eating nothing but Purina DM pate, Fancy Feast Pate, and plain cooked beef. The actual volume of food is also not much higher than when she was well controlled, certainly not enough to account for the BG difference.

    Have others found that that when IBD treatment begins, BG and insulin requirements go up? I'm speculating whether the "remission" we thought we were seeing was actually just her not getting the energy from the food out of her intestines. Now that she's digesting her food properly again, the energy is getting to her system and thus the insulin requirements have returned to her "normal" diabetic state. Could this be why her low BG incidents were consistently accompanied by vomiting?

    Does this make sense or does anyone have an alternate explanation?

    Thanks!
     
  2. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    Budesonide is also commonly prescribed for IBD. That may increase BG/insulin needs but I found that it had negligible effect. I would say the increased BGs are t to feeling better and eating better.
     
  3. Maggies Mom Debby

    Maggies Mom Debby Well-Known Member

    Joined:
    Dec 28, 2009
    When you have other health problems, you usually treat the problem and adjust the insulin accordingly. The important thing is Zelda is feeling better. A little more insulin is a small price to pay for that!
     
  4. Peter Moore

    Peter Moore Member

    Joined:
    Jan 26, 2019
    She's not receiving that. Just B12, Pepcid, and Metrodinazole.

    Yes agreed thank you. However I would still like to understand the reason for the very significant BG increase as it may bear on her diagnosis and/or prognosis.

    So I take it no one has come across my situation of a "phantom remission" associated with GI issues, followed by high BG and insulin needs once beginning IBD treatment?
     
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