? 3/19 need your thoughts about starting insulin again or waiting

Since we last left:

He'd been insulin free!
Numbers ranged from 40-170 (Alpha-Trak2)
1-24-2018 7.44 am 49
2-26-2018 10.01pm 170

I'd tapered down to testing every few weeks-
Last week- Wed evening he looked off.....
Sunday I tested him-
393 @ 9.41pm 3/18
284 @ 3.37am 3/19
381 @ 7.37am 3/19
338 @ 9.43am 3/19
312 @ 1.42pm 3/19
edit- 219 pmbg 3/19

Other changes the vet that understands ECID has moved. We have a new vet that isn't committing to reading his file and all the things he went through with the U and his sinus infection/s. I know BG can rise when there is an infection.

We went to the vet today and he got blood work. Unlike before, I didn't get a copy of the tests, only a call saying everything is fine. Do 1u lantus 2xday, you know what to do. I can't agree to do that. I just can't

I'm not doing well with this.

To those of you that went back, did you go right away? Did you try food changes and antibiotics first? It seems like his pancreas may be working by the ups and downs. When you returned to insulin, did your cat's patterns stay much the same, or were the numbers and patterns completely different?

I tried to get the vet to understand we (cat and I) spent months chasing a sinus infection that never showed itself in blood work, only CTs and based on that it's possible he may have a sinus infection again (still).

I'm undecided if I should do antibiotics & just Young Again for food or jump right into insulin? Thoughts, please. I'm overwhelmed.
He's not losing weight.
He's not drinking more than usual.
He's not urinating more than usual.
He's not got the unregulated diabetic hungries.
He looked like he felt awful and his numbers are high.
Alpha Trak @ vet measured bg lower than my reading (although met the range of difference to be 'the same')

He's in pain from going to the vet and his previous vet did, *acupuncture and chiro*- and now he has none of that and is grumpy and in pain. Difference in vets, vet 1 saw him as a living being, vet 2 sees him as an animal.

If he needs to go back on insulin, who can set-up a spreadsheet for me? I've got my email and passwords ready for someone.

He would start on lantus and if he stays on it, we might move to lev.

Thanks in advance

Start insulin tonight or wait for antibiotics to have a moment- thoughts

Note- the info in my signature is not current at this time 3/19/18

 

Hi, I just read your post...

Davidson was diagnosed Nov 2013, and started insulin Jan/14 and was in it for 3 months then OTJ for 4yrs....I tested all the time and then this past Mar 6th saw his numbers rise for no apparent reason to me. After a few days and consulting with others here, I took him to the vet. He had 4 teeth extracted and 3 infections in his mouth, plus gingivitis. That’s what caused the BG levels to go up. He had no symptoms and I now what to look for, but the infections will do that. He was out on AB’s and has 2 more days to go, and I’m giving him probiotics, etc.

On Sat I didn’t see his levels going down, so I put him on .25u insulin and his numbers are nice, but I will icrease to .5 tomorrow to see if I can get him into the green again, and give him the chance to go into remission a second time.

My vet wanted to start him on 2 u and that work have brought his levels to hypo if you look at his SS. Vets are great, but they don’t have hands on experience like we do, some more then others here.

You still need to fight the infection so I wouldn’t take him off the AB’s.......I’m feeding FF pate food and have not changed Davidson’s routine at all, and yes his pancreas is working too, but more then likely the infections and or healing from surgery is still causing numbers that are up and down

Look at his SS and you will see the older one from when he was on insulin,and this new one where I tested from Mar 6 without insulin and then began the other day....he’s now in the blues so needed the boost.

Just my opinion, but I’m sure others will reply too

Good luck

 

Perhaps you could ask around in your location and try to find a different vet. In any event, you are entitled to a copy of the blood work: you paid for it and it belongs to you. Once you get it you can put it on a Labs tab in your spreadsheet so that the knowledgeable people here can evaluate it.
I'm going to tag @Marje and Gracie about fixing your present spreadsheet or incorporating the data into a new spreadsheet.
Did the new vet put him on antibiotics, or are the antibiotics your idea? It's not clear from your post.
Have you begun testing him on a regular basis? If not, that would be a good place to start. Get tests at AMPS and PMPS and at least one test in mid cycle. It's also a good idea to get a before bedtime test.

I'm sorry I can't help you about starting up insulin again. But it is important to note that if your kitty needs insulin, he should get it.

I hope everything will work out for you and that you'll be able to find a vet you like.

 

Antibiotics:
metro
zenequin
clindamycin
may add clavamox
my idea to try and drop the numbers, since my vet has left and I'm on my own, today's vet agreed to meds

Testing- just returned to multiple times per day, yesterday, when I found the surprise bg number

Thanks for the vet well wishes

 

Hi and welcome back! What's your kitty's name?

Those numbers seem pretty high to me, I would want to start my cat back on insulin before all the symptoms come on and see if you can rein it in quickly. I agree with Ella, call and ask for them to send you a copy of the labwork for your own records. This is a situation where fructosamine might actually be helpful and tell you if this has been going on for a few weeks or if it's a sudden issue.

Have you changed his diet from what is reflected in your signature? If you think he needs antibiotics, you can try that and see if it brings his numbers down, if it were me though, I'd do antibiotics and insulin and see about getting things under control quickly to see if he pancreas wants to get back to work.

 

Also, did they do a urinalysis? Was their glucose in the urine?

 

His bladder was empty. No urine tests.

 

Signature is not current. It took me a couple of hours to try and get my account here, up and running, finding all the info and getting re-aquainted with the boards. I'm worried about giving insulin and not being home during the day tomorrow.

 

Understandable, update it when you have the time. So what is he eating right now? And for how long has he been on that diet? He's on all of those antibiotics right now? For how long? You don't need to start insulin tonight, I thought you were just asking in general to start soon vs wait and see if numbers go back to normal. You'd want to start on a day where you could monitor for sure.

 

pain can also cause bg numbers to rise. Has he had x-rays ever to see if he has arthritis?

I too would want another vet.
That being said, remission is just remission. There will be times or events that will knock him out of remission.
The sooner you re-start insulin, the better his chances to return to remission.
Once a diabetic, always a diabetic.

Do try to get more frequent tests so you have a little data to work with. That will help you to make your decision of when to start. If all numbers are staying above 200, it's definitely time to give his pancreas some support.

 

Sorry, I don’t know your name but I forgot to add that the vet gave Davidson a full blood panel including fructosamine and geriatric test. I collected his urine at home and tested it with a ketone kit I had, however the vet also tested his urine when I brought in the staple. Yo can easily put Saran Wrap in the litter box and the pee will collect there, just use a syringe or pour it into a container and th vet will analyze it.

Spiked BG levels can result from many things that you want to check out, incl any kidney, liver or urinary track infections.....I know it’s costly, but it gives you peace of mind and I know Davidson is clean and I only had to deal with his dental issues, which subsequently caused his infections.

 

@rhiannon and shadow (GA)
Just checked right now and he was PMBG 219- I've forgotten the rule- don't shoot if your new and around 200? Is he considered new since it's new numbers? or are we old?

If someone offers to create a new spreadsheet, I'll upload all our new data.

X-rays- none of late

last medical appts- he had acupuncture for TMJ/ and chiropractic adjustment for spine
bloodwork- before my vet left, we did the works and everything was in the normal ranges

Edit to add: pain, yes, he is in pain. His current pain comes from the man-handling he had at the vet to get blood. His spine hurts, tail is down, and he's limping on one hip. When I touch him to pick-up, hold or move him, he grrrrrrrs.

I don't know how to fix that without his acupuncture and chiropractic vet.

 

Thanks to all who have read through this post. After reading it back myself, it seems I need to go take a deep breath- sorry for the rambles. As I'm starting to remember the things I've forgotten about diabetic cats, FDMB, meds, I got (am) overwhelmed and my anxiety is taking charge.

Shorter version:
1. trying to decide if he needs to return to lantus
2. new vet (old vet moved)
3. new vet is old school- keep #s 250 or less; 1u 2xday
4. found out of normal #s yesterday
5. feline started to not look/ feel like himself last week wed; was fine when I left for national pie day- clearly off when I got home
6. I chose to start antibiotics as an effort to drop the #s knowing he's sinus infection prone and old vet has moved
7. foods- assist feeding A/D slurry; self feed- for now, anything he wants-

 

It's late here + his last reading was 219 + giving 1u would mean I'd not sleep; no insulin tonight.

I'll see everyone back here tomorrow- hugs and vines to all that need them.
Thanks for all your care, input and wisdom! It's always very much appreciated.

 

I’ll send you a PM with the info I’ll need to set up your SS.

If he were mine, I’d restart insulin so I’m glad you did. But you aren’t new so you wouldn’t have a no shot number of 200. If you are wanting to get used to things again, you can always post for help any time he’s 150 or below.

 

To clarify- I didn't not give insulin. I'd wouldn't sleep if I did. I couldn't remember the rule for no shoot & I'm realizing how much I have forgotten. Sending you a pm.

 

let me come back and clarify.....

I wasn't referring to a rule .... I just picked that number arbitrarily to make the point that his numbers are above that.....
and you do need to re-start insulin as soon as you can....
at the same time while you are exploring the pain management, and the possibility of infection.
You want to stay on top of it all.

My own experience with Shadow was her pain would keep her a bit higher even though she was in remission... but when her numbers were up, I gave her the shot.

Sorry, didn't mean to add to the confusion....

and post for help when you need it regardless of the numbers.....
we'll support you....