Diabetic Remission

Hi everyone....here is some background on my cat

18yr
Previously diagnosed with small cell lymphoma july 2016
Been on transdermal (ear) prednisolone since july 2016 stopped oct 2018
chlorambucil pill chemo every other week
underlying CKD had a BUN creatinine spike in july 2018 otherwise normal blood work
no major problems related to lymphoma/ckd
her coat was beginning to get matted and unkempt in august 2018
developed steroid related diabetes july 2018. Tested fructosamine value 530
1 unit Vetsulin twice a day since July 2018
New fructosamine value is now 208
Her coat is shining and well groomed.
Does this look like remission?

Waiting to hear from my vet...should I discontinue the insulin now? I was not doing daily testing.
Thanks for any advice.

 

Hi, that fructosamine level is on the low side of the normal range. It 'might' indeed indicate remission. But because the fructosamine test gives an average of the blood glucose levels over the previous couple of weeks, it could also indicate that your kitty has had hypoglycemic levels at times. (With the fructosamine test there is no way of differentiating...)

The best way to check whether she's in remission would be to check her blood glucose levels at home.
If you test, before feeding and giving insulin, and see a number in normal range (approximately 50 to 120 on a human meter, or 65 to 150 on a pet meter) it may be that remission is on the cards. Here, we say that a cat is in remission if they can hold normal numbers, without insulin, for 14 days.

I would encourage you to test her blood glucose at home. But if that really isn't possible for you, you could still get some information by testing her urine glucose. It's not the same as a 'real time' blood glucose test, but will tell you how much glucose is being excreted in the urine. If there is no glucose, that would mean that her blood glucose is below the 'renal threshold'. That may not mean remission but would mean that the glucose isn't high enough to show up in the urine (could be anywhere between low end of the normal range up to the renal threshold).

Given the low fructosamine result I'm 'guessing' that your vet may suggest stopping insulin and restesting the fructosamine, maybe in another few weeks, to see if it remains in normal range without insulin. Well, that would make sense to me, anyway....

Eliz

 

Thank you Elizabeth and Bertie (what a beauty). The vet is having me give herself 1unit of Insulin in the morning for 2 weeks and then we are going to do a glucose test in office. I really need to learn how to do this at home. I mean I give daily shots, IV fluids, etc...this shouldn't be that hard. SHe fits all the criteria for remission of diabetes so I'm hoping that is what is happening here. She's such a strong willed cat and loves her life so of course I will do everything and anything for her. Thanks again for the reply.
Steve and Craver