? 14 year old cat, UTI, Lantus & Numbers are going higher

Hi everyone- I joined a while ago but my 14yo cat went into remission from her diabetes from over a year ago. She responded well on Lantus after a week or so.

5 days ago I took her to the vet- she began peeing a lot and drinking water again in large quantities. They did outside urine testing, no ketones at that time, but UTI was present. Began her on antibiotics- have 4 days left of 7. The antibiotics may have gotten her nauseous so yesterday she wasn't eating in the AM. I bought smelly salmon and tuna- she's eating now no problem. Otherwise I always have her on Wellness Turkey and Salmon which is low in carbs and she's done very well on that for a long time.

Vet pushed PZI because my Lantus bottle was over a year old, I agreed it might not be effective. 2 days on PZI at one unit hasn't done much. Yesterday I called vet at noon- her numbers were 623- even higher than 539 before eating in the AM (539) so I ran out and bought Lantus $266 and gave 2 units at night. At noon vet said to give her one unit of the old lantus bottle which I did.

Yesterday:
7:45AM 539
ate very little gave 1 unit PZI
12:30 noon 623
Called vet- he said give 1 unit of old Lantus bottle
2:30pm 576
3:30pm at smelly food I ran out to buy
6:30pm 540
She ate smelly food, no problem and drinking water too
Gave 2 units Lantus NEW BOTTLE @ 8pm

This morning 537
11:30am 573 (its going up??!!)
2pm 598!
Vet is supposedly calling me back in 30 min.
She's eating today and drinking a lot still but not too much water.
She's alert but just kinda tired.

He is out on vacation, but didn't tell me he would be. Sub vet got ahold of her yesterday afternoon, trying to get her input on these numbers.

Question- could this be the UTI needing to play out its course? Maybe I'm not supposed to be so worried about the high numbers. It just seems to me in the 500-600 range is super dangerous for her kidneys, ect.
Maybe my Alpha track is out of whack? I don't have the fluid to check the levels- but up until recently her numbers have all been very low with regular spot checks- in the 120's.

Up the Lantus? Wait out the UTI?
Should I buy strips to test ketones to be safe?
Keep feeding her smelly food just to get her to eat? Maybe that food is not helping her numbers? So many variables here, I feel so helpless.

Thank you for any advice.
Alicia

 

Alicia,
I think that UTI plays a big part in numbers going up.
The numbers are essentially the same so don't assume they going up. It takes time for insulin to work.
You need to get to the bottom of UTI - is it bacterial? Did you have cytocentesis done and culture? If not you need to ask the vet what sort of UTI he diagnosed and what about treatment?
Marlena

 

HI Alicia! I never used Lantus, but I can tell you those numbers are probably somewhat high due to the infection. Lots of our cats run higher when an infection is present and go down some when they feel better.

Yeah those numbers are high but I wouldn't worry too much yet! Insulin takes a little time to work and I know the Lantus depot has to fill so I think it could be a few days before you see the numbers start to come down a lot. I know some Lantus folks will be along to help out more with the insulin questions but to wanted to chime in until then!

 

Hello!
I'm not an expert by any means. But stop and take a deep breath. I think most 911 posts are for emergency situations like hypos where people need instant information because their kitty is in immediate danger.

The infection she has will have pushed her big levels out of whack, so I wouldn't be panicking just yet. (Easy for me to say!). When the UTI has settled then I think you will have a better judgement on what the numbers actually are.

Yes definitely test for those keytones, it won't do any harm and will give you peace of mind.

I don't believe the tuna and salmon should do any harm, and it's better she eats something. Maybe try topping her usual food with it or mixing it through?

Those numbers are high, however short term they shouldn't do any harm.

Stay calm if you can, I know - not easy, I would be the same.

 

Welcome Alicia and kitty! (name?)
First let's take down your 911 (Top right area should be an option for "Thread tools", Click edit title, remove 911 or change to a ?). Second, for you.

The UTI can definitely be the cause for higher numbers. I am also surprised the Vet told to you administer 1.0U of old Lantus when you had already given her 1.0U of PZI 5 hours before . I don't think that helped either. As the others have mentioned, Lantus is a depot insulin and since you were only exposed for about 5 days the first time around, her depot was probably just starting to fill/stabilize and then she went into remission .

If you think your AT2 is acting up, can you change the battery? I wouldn't increase insulin just yet, as stated, it takes a few days to fill the depot to really see what the dose is doing. Usual starting dose is also 1.0U twice a day. I would go ahead and get some ketone test strips just to stay on top of things, to be safe .

I believe the recipe for DKA (diabetic ketoacidosis) is: not enough food, not enough insulin (doesn't mean give a bunch more ), and an infection.

While the following may not be of the same quality as Wellness, you could try picking up some Fancy Feast classics or Friskies pate (non indoor formulas) and see if she'll eat those. Eating some tuna / salmon is OK for a little bit but we don't want to create another problem; tuna junkie.

Did she receive 2.0U of Lantus at 07:45 this morning too?

Let's try to get some information in your Signature too about your kitty: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/
And since you are home testing, it will be helpful to setup your Spreadsheet: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

We're a support group for your kitty and YOU! Feel free to keep asking questions / second, third, fourth opinions . We live and breathe FD (feline diabetes)

 

Oh wow! Thank you all so much for the responses. The first time I posted last year I was AMAZED at how caring everyone on this thread is- really it brings so much comfort in a time like this. I am detailed oriented so given she went into remission last year after not eating and needing fluids, I am all over it this time.

Yong- to answer you! (first thank you- I took down the 911.. sorry... and will add in the signature/ start the spreadsheet) I did give her 2 units of the Lantus this morning.

The cover vet just rang- she seems very knowledgable and said the same as many of you beautiful souls here- the UTI is clearly the culprit. I am going to do another test in and 1 1/2 and call her back with that number- she may adjust the Lantus a little or just keep it at 2 units. She didn't recommend I needed the sticks to test her urine, but I may go out and buy them anyway. Gigi is my sweet cat's name- she was abused so I try to take extra good care of her.

BECAUSE YOU ALL WROTE ME SO FAST...! I was able to ask the vet if the urine testing was sufficient and if a culture is needed at this point. She said given there are 4 days left of the clovamax she won't know until after that course if we need to continue her on more or if I need to take her in to do the full culture. She mentioned in 99% of cases she's seen the antibiotic works fine. So, I guess I was freaked out given her numbers are 550-650 that she might start seizing or whatnot. She is walking around and just nibbled on more food, and drank water out of the tub drip that she loves to do. As long as she's eating I guess I don't need to freak out.

I will go get more smelly friskies and fancy feast- yes, I agree, don't want any addicted fish head old lady cat on my hands. lol. I also like the idea of mixing with her regular food to see if it will take.

Above all, I have friends and family that are telling me I may need to consider putting her down at some point. I cannot afford taking her to emergency care so am trying my best to help her get better...I am wondering at this point if it might be she is just simply getting old...and that this might be part of the natural course of things. I've never dealt with putting an animal down- but at what point do you know it's the best option? I am worried about being able to be here 2x a day to give insulin if needed- I PRAY that it goes into remission very soon...my work hours will be very long soon again and I don't know how I will manage (it's just me to give her shots). Makes me feel so nervous and overwhelmed that idea.

Thank you again from my heart.

Alicia & Gigi

 

No need to apologize, you didn't know. Even for emergencies, once members start replying someone will suggest taking it down after like an hour tops. It tends to send us into worry too

I don't understand how people can abuse animals , so very glad she found you! Or vice versus. I think we're talking about ketone test strips, not glucose test strips for urine .

As long as she doesn't develop ketones, the higher numbers for a little bit shouldn't do anything to her by themselves. Was that confusing? lol I might be a little confused re-reading it

If it comes to that, you'll know but for right now, remove that idea from your head . My friend recently asked me if I considered euthanizing my boy because I'm starting a full time job in a couple weeks. He's lucky he didn't ask me that face to face. It's just me for caring for my boy too but this can still be done with a full time job. What kind of hours will you be working? While Lantus is one of the better insulins for cats, there is another that has more flexibility, called Prozinc. Let's think about all the things you'll be able to do and not dwell on what you might not be able to do. Boy I sound positive! lol. It's a new thing for me but I mean every word

 

It was for this reason (flexibility) that I insisted on proZinc, it's really really good if you work full time. (I don't but have health issues that mean I needed a bit of leeway).

 

Alicia, you are so wonderful, such a good hearted person!
Don't worry about Gigi high numbers, I hope she just have an infection but make sure that she has long enough course of antibiotics (2 weeks at least). And 2 weeks after the antibiotics are finished the vet could run another test to see if infection is gone.
Keeping my fingers crossed for Gigi, hopefully she will recover and you will not need to give her insulin.
I would advice you to remove all kibble from her diet, we always suggest here that you feed proper low carb wet food. The transition has to be gradual though but we can go into more detail for that after you tell us what you feed your kitty.

With your work commitment I'm a bit worried about you not being able to manage with Lantus, I think in your situation a different choice of insulin (PZI maybe) would have been a better choice.
It needs careful consideration and maybe discussion with other members.

When it comes to saying goodbye to kitty it is always very difficult but I think your vet would be able to give you an idea how your kitty is affected by an illness and together you might need to establish when there is a time to let the kitty go in order to stop suffering when there is no hope for recovery.

Please just do what you can and we will be here for you.
Sending hugs to you and Gigi,
Marlena and Rocky

 

Hi Tara,
how are you?
I haven't seen you here for some time, hope everything is well.
Marlena xxx

 

Hey Marlena,
I'm ok, been a bit of a rough year for me healthwise amongst other things. I'm starting to get back on my feet with a new treatment- my brain is working better and I have a little more mental energy now which is nice.
Tempest is fine still on good numbers! Although that may change when she has her dental - I've put it off since January and can't stall any longer... just terrified she will come out of remission.

Hope all is well with you and Rocky! Xx

 

Oh darling, sorry to hear about your difficult time, hope that new treatment will make you better.
Don't worry about dental ruining the remission, she might get higher numbers for a bit due to stress and pain but it will settle down, I'm sure.

Rocky and I are not too bad but could have been better, battling UTI or CKD, I don't know.
I'm enjoying summer as I'm not working at the moment as my health is not brilliant but hopefully I will get better eventually!
Sending love and healing vines for both of you,
Marlena and Rocky

 

While I agree that the UTI is likely causing some elevation of the BG generally, I really think a good bit of the high numbers you are seeing today is likely a result of the dosing yesterday. Using 2 different insulins and giving 2 shots of Lantus 6 hours apart would have caused 3 nadirs yesterday and this would no doubt cause significant bouncing. Boggles my mind why your vet would suggest dosing with two different insulins!

It may take a few cycles for the bouncing to clear and once that happens your furkid should start feeling better. PZI would be a better option if your work schedule doesn't allow for consistent 12 hour cycles with Lantus.

Mini Hijack...sorry! @TempestsMum Great to hear you little one is doing well! Hope you are too! I'm sure she will do well with her dental!

 

Right? That's what I was thought too . I wrote it somewhere above

 

Hi all, thank you for helping me with this thread. So wanted to update and ask for further guidance....thank you!! Gigi has stabilized and I did a full 2 day curve last week and it was good news. I'm keeping her on 2 units of Lantus, her numbers the last few days before eating AM & PM are in the 88-232 range. The few days prior they were a bit higher in the 143-400 range with 2.5 units of lentos. She's been on a new antibiotic shot since Mon 7/17. It's supposed to run the cycle for 2 weeks. The vet is telling me I can retest her urine this coming Monday 7/31. Today I will go by the vet and buy the granules to collect her urine.
My question is this- over a year ago she went into remission. I don't want to keep giving her insulin if I don't have to. If the urine is negative for infection next week and her numbers stay low with insulin at what point should I wean her off the insulin or stop all together? I know different vets say different things so want to be fully prepared in talking with the vet again.
I need to have full dental work done very soon, she has decay and may need to have teeth pulled despite my getting her teeth cleaned a few years ago. It's super expensive to do this- in the $700 range but mostly I'm concerned with putting her under anesthesia and have her diabetes stable at the same time. My prayer is she will go into remission again.....!!!!! How will I know for sure? Thank you...

 

Normal BG for a cat using a pet meter would be 70 to 150 so if you are still getting readings of 200+, she is still running a bit high and still needs some insulin support. Until she has been in normal range numbers for a period of 14 consecutive days (excluding any obvious stress elevated BG), we would not consider it remission. The diabetes should not preclude her getting the dental work done and getting it done might serve to bring her numbers down even more. It's quite possible that the teeth and UTI, are the very things that took her out of remission and are keeping her from regaining it.

 

Thank you all for the responses. I have been monitoring and I think she may be going into remission but am not sure how to tell exactly.
Her numbers have been 114-134 in the morning and she's been eating, I give her 1 unit of Lantus. Keeping her on very low carb wet food. At night the numbers are in the same range, so I also give her 1 unit of lantus.
She had the dental work done, a cracked tooth was pulled but other than that all went well. She no longer has sign of infection in her urine, a few weeks ago another test came back negative. One day I did give her insulin late and so only gave .5 does and the following morning her number was at 162. How to proceed to see if she is on her way/or already going into remission? I don't trust the vet at this point.

Thank you....Alicia

 

Alicia, your girl's numbers sound encouraging and we'd love to help you out navigating the path to good regulation or better yet the possibility of remission. It's great that you are home testing and are, I assume keeping a record of the tests you do. For us to be able to help you in the best way possible, it would be really helpful if you would set up one of our spreadsheets and log your test data there. It is automatically colour coded making it easier to see patterns (and this dance is all about seeing patterns) and we all use it to formulate opinions and offer advice. It's one of the best tools we have to keep our furkids safe and get them under the best control possible.

It's very simple to use....all you do is type in your readings. You can provide a link to the spreadsheet here and then anytime you need some assistance or advice, the data you have collected is readily available to members here.

The instructions for setting up the spreadsheet are HERE. And THIS document explains how to use the spreadsheet. We don't deal in times here because we have members from all over the world so we log our readings as AMPS (am pre-shot), PMPS (pm pre-shot) and then according to how many hours post shot any other readings are taken.

If you have any problem setting up the spreadsheet, just holler as we can have someone set it up for you very easily.