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End of Remission?

Discussion in 'Feline Health - (The Main Forum)' started by Waheeda, Nov 22, 2019.

  1. Waheeda

    Waheeda Member

    Joined:
    Apr 11, 2017
    Hi! I’m back. My cat jebat was in remission 2 years ago. Two days ago he seemed to be much quieter and moody. Checked his blood glucose n it’s 216. Is he out of remission? Should I start insulin?
     
  2. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Is that the first test you have done and found it higher than normal?
    When did you last test the BG?

    I would get a couple of more tests in first before starting insulin.
    Try feeding him, taking the BG first, the test 3 hours later to see if the BG has gone up or down. If the pancreas is still working, it should go down.

    If he’s quiet and moody, do you think he may be unwell? That can send up the BG.

    How are his teeth? Cats in need of a dental, can drop out of remission.
     
  3. Waheeda

    Waheeda Member

    Joined:
    Apr 11, 2017
    Hi!
    Yes, it’s d first time I tested him cos he’s his usual self all these times.
    I do suspect he has dental issue since tues cos he moved his jaw weirdly after he drank.
    I’m taking him to the vet soon to check on his dental. Do u think the high BG is temporary or he’s really out of remission?
     
  4. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    If it’s a dental issue and you can get it fixed very soon, he may drop back to normal numbers.
    I’d get a vet apt ASAP if there is a chance of getting this sorted and back into normal numbers.
    Please keep us posted.
    Good luck
     
  5. Waheeda

    Waheeda Member

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    Apr 11, 2017
    I do hope so. He was his naughty playful self just 2 days ago. Can’t get appt so have to go as a walk-in. Probably wait 2 hours. Sigh! Pray for us! Thanks.
     
  6. Waheeda

    Waheeda Member

    Joined:
    Apr 11, 2017
    Well he has glucose in his urine and bg was 293 at the vet. He also tested positive for pancreatitis. my question is : is d pancreatitis causing the high bg? Or he’s alrdy out of remission and cause the pancreatitis? Vet couldn’t tell me. Maybe starting Low dose of insulin in few days time. Doing ultrasound tmr.
     
  7. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Did the vet give him subQ fluids, antinausea medication and an injection for pain? That is the normal treatment for pancreatitis. And some antinausea oral meds to bring home and some pain meds as well.

    While Sheba was in Remission she got pancreatitis a few times and each time her BGs went up but came down in a couple of days with treatment for the pancreatitis.

    I would say the pancreatitis caused the high BG, not going out of remission caused the pancreatitis.

    I would give it a couple of days to see if he comes down first. But the vet needs to be treating the pancreatitis...it's painful, causes dehydration, nausea and loss of appetite.
    It will almost always be higher BG at the vet from stress.
    He may not come back down, but he might....but he needs treatment.
     
  8. Waheeda

    Waheeda Member

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    Apr 11, 2017
    Thanks for sharing your experience. He gets daily sub-cut for his kidney disease. He also has heart issue. Vet gave him pain injection at the clinic and I just gave him potassium tablet and appetite stimulant. Another sub-cut tmr noon before we go to scan the pancreas. He ate some boiled chicken meat. Hopefully appetite improves and he eats more. Very stressful when they get sick. Strangely his kidney value improved over 5 days. Creatinine in normal range. You solve one problem and you get a new problem.
     
  9. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    It’s a good idea to make sure they are not nauseated before you give an appetite stimulant. Something like cerenia an hour before the appy stimulant is best.
    Please let us know how he gets on.
     
  10. Waheeda

    Waheeda Member

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    Apr 11, 2017
    He is not nauseated from what I observed. He’s just purring all the time. Is that normal? Cos my other 2 cats don’t.
    Vet seems to think he’s definitely diabetic cos of sugar in urine. From your experience, will this get resolved when he gets better?
     
  11. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Cats can purr to comfort themselves as well.

    In my experience cats in remission... their BG can go up for a few days if they have some sort of infection going on and as long as it is resolved the BGs can go back down.
    Not always but I would wait a couple of days
     
  12. Waheeda

    Waheeda Member

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    Apr 11, 2017
    Thanks for your comforting words.
     
  13. Waheeda

    Waheeda Member

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    Apr 11, 2017
    Just an update:
    He’s eating well on his own since yesterday evening. Guess the pain patch is working. I gave him cerenia too. BG was 170 yesterday and went down to 140 today. Ultrasound scan showed enlarged pancreas, thickened intestinal wall and inflamed lymph nodes. Honestly I feel the scan was really not needed. I shall never see this vet again as initially she even wanted to hospitalise him and start on insulin. I wasn’t very comfortable with that and thanks to @Bron and Sheba (GA) ’s response to my post, I decided to bring him home.
     
  14. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    I would keep up the pain meds and cerenia for a few days and gradually reduce them when you think he is over it.
    That's good the BGs are coming down. I would still take them a couple of times a day until they are back down to normal and the. Monitor closely for a while.
    If they don't come back down to normal, you will have to restart the insulin.
    Can you update the SS with the tests you have done recently please as we always look at the SS when helping ...thanks.

    What did the vet say about the thickened intestinal wall and inflamed lymph nodes......that may need investigating.
     
  15. Waheeda

    Waheeda Member

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    Apr 11, 2017
    He’s had thickened wall since 2 years ago. Can’t do much except monitor cos he has heart condition plus ckd. We do annual heart scan too plus quarterly checks on his renal values.
    His pain patch will last 5 days. I hv cerenia for 4 days. I’ll continue with appetite stimulant for few more days. I’ll update d SS in a while.
     
  16. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Looks like you have it all monitored well.
    Please keep us updated on his progress as we worry about our kitties when they are not well
     
  17. Waheeda

    Waheeda Member

    Joined:
    Apr 11, 2017
    Hi!
    I’ve been monitoring his bg and it’s hovering above 100. U can see my spreadsheet. Should I be worried? How Long do they take before it goes down further? He’s eating well. Acting normal too.
     
  18. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    The numbers are outside of normal range. The big question is whether your cat is still in pain from the pancreatitis and if the pancreatitis is still active. Pain and/or inflammation can cause blood glucose numbers to be elevated. 4 or 5 days is a rather brief time to get the pancreatitis under control.
     
  19. Waheeda

    Waheeda Member

    Joined:
    Apr 11, 2017
    Do I need to bring him to the vet to check his pancreatitis? Or just monitor his bg for another week suffice?
     
  20. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    I would continue to monitor. At least for me, the question is whether he needs anything to help with the pancreatitis. Many cats need pain meds since pancreatitis is very painful and the pain can cause a rise in numbers.

    Have there been any other changes with Jebat? Are you still feeding him FF and YA? When was the last time you had his teeth checked? Dental issues/gingivitis is one of the common problems that throw a cat out of remission.
     
  21. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    @Waheeda
    Sorry I haven't been around. I had no internet service for a week due to storms.
    I see Jebat is still running a bit above normal.
    Are you still using the pain patch? I agree with Sienne that the pain from pancreatitis can be severe and he may need more pain meds.
    You mentioned a possible dental issue earlier in this thread. What did the vet say about that?
     
  22. Waheeda

    Waheeda Member

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    Apr 11, 2017
    Appreciate both your replies.
    Vets not doing anythg with his dental cos of high risk as he has cardiomyopathy and kidney disease. Not sure if he still is in pain as he’s acting perfectly normal, active and vocal. This boy will be very quiet when he’s not well. His pain patch was till last fri.
    I’ll keep monitoring this week. Not too keen to start on insulin honestly. I have forgotten on dosage and even reading the unit on the syringe. Lol!
     
  23. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Keep testing and keeping in touch with us.
    Hopefully he’ll come back down.
     
  24. Waheeda

    Waheeda Member

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    Apr 11, 2017
    Tested today and he’s 136. I’m not having a good feeling on this. At which point should I consider giving him insulin? My vet said he will only give at 200.
    He’s not ravenously hungry or thirsty. I have stopped with cerenia and Remeron. Should I continue? First time dealing with pancreatitis and I really am not sure if he’s totally over it. What are the signs?
     
  25. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Mostly signs pancreatitis are not eating, nauseated, dehydrated, hunched up in pain, lethargic, sometimes diarrhoea.
    If he’s eating well there would be no need for the cerenia.
    It could be his teeth.
    Did they check for a UTI?
    Normal numbers are 50. - 120 so I think if you have checked everything out that we have suggested and he is still above the normal range by mid week I would post and ask for advice on restarting insulin.

    I would also look at getting one of the better insulins such as Lantus, levemir or Prozinc. They are much better for cats than Vetsulin
     
  26. Waheeda

    Waheeda Member

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    Apr 11, 2017
    Yes I think they tested for uti last week.
    I’ll make appointment with the vet end of the week then cos can only get insulin from them.
    In the meantime, I pray he has better numbers.
    Just when I said he’s eating well, today he seems quieter. Could it be he hasn’t fully recovered? Appetite this evening lesser than 2 days ago.
     
  27. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Did you give another cerenia?
     
  28. Waheeda

    Waheeda Member

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    Apr 11, 2017
    I gave him appetite stimulant. Appetite better today. Now my other 2 senior cats not eating much. Sigh! They can be well one day and unwell in a matter of hours.
    check with you - if I start insulin again, what’s the likelihood bg will go back to normal and stay in remission? Cos I read that 2nd time is really hard.
     
  29. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    It can be true that getting a cat into remission a second time is hard. I couldn’t get Sheba back into remission a second time after a very easy time the first time.
    But I know of cats here that do go back into remission. There is one cat here that has been in and out of several times. So don’t lose heart.

    I would definitely change the insulin over to Lantus or levemir though and start with a very small dose. Jebats BGs are not all that high and I think Vetsulin would drop it too much.

    If you do decide to restart insulin, I would post and ask for assistance with dose. At the moment his BGs are not very high.
     
  30. Waheeda

    Waheeda Member

    Joined:
    Apr 11, 2017
    I’ve made appointment to see the internal med specialist tmr. Will ask her for advice. Today’s bg is 148. Seems to be creeping up. I’m feeling all the stress again. And he’s really not happy getting his ears pierced.
    I still have some 2 1/2 yr old vetsulin in d fridge. But if lantus is a better insulin, I’ll ask for that. I hope there’s a lantus expert on board who can guide me. Janet helped me with vetsulin back then. She and Yong were very helpful but I don’t see them here anymore.
     
  31. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Yes there are people who use Lantus who can help you
     
  32. Waheeda

    Waheeda Member

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    Apr 11, 2017
    Thank u so much! Will look for u again.
     
  33. Waheeda

    Waheeda Member

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    Apr 11, 2017
    Hi Bron,
    I cancelled my appt cos his bg was 120. But I hv asked the vet if I can buy lantus without seeing her. I’m trying to save money from unnecessary tests which they will do if I bring him in. Caring for 3 senior cats with multiple illnesses is not cheap.
    I’ll be monitoring till maybe fri, and if it doesn’t come down, I’ll start lantus on Sunday. I’ll look for you on the dose to start. I’m going to do this with this forum’s help again.
    Thanks in advance. Appreciate all your advice.
     
  34. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    You can get cheaper Lantus shipped from Canada if you have a script. I will tag @Chris & China (GA) to give you details.

    120 is the upper end of normal BGs.
    I would wait a bit longer before looking at insulin with numbers like that.
    Try testing him, then feed him, then test 3 hours later. If the BG goes down, that means the pancreas is working, at least a bit.
     
  35. Waheeda

    Waheeda Member

    Joined:
    Apr 11, 2017
    Hi bron,
    So I took a few readings today.
    1st - 9am : 2 hrs after food - 122
    2nd - 11.30: 2.5 hrs after food - 115
    3rd - 6pm : 3 hrs after food - 158

    looks like we need to start? I can get lantus tmr. At what dose shld I start?
     
  36. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Did you take a BG level each time a couple of hours before you fed. It is the drop inBG we are looking for after he eats.

    I am going to tag @Marje and Gracie about the dose as I don’t think you will need much insulin as he is above normal range but not by a lot.
    So it is now 12 days since you noticed he was not himself. He tested positive to pancreatitis but is now eating well again. He has CRD and cardiomyopathy and vet will not do any dental work in him because he is high risk.
     
  37. Waheeda

    Waheeda Member

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    Apr 11, 2017
    He ate at around 6am and I tested at 830am. I thought we usually test 2 hours or more after food? I went out and came back at 1130am and I took another reading before giving him food. He ate again at 230pm. And 3rd reading I took at about 6pm before giving him food. 2-3hrs after food should be lowest point of bg?
     
  38. Waheeda

    Waheeda Member

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    Apr 11, 2017
    Yes he tested positive for pancreatitis 12 days ago. He has heart and kidney issues plus dental which we can’t do anythg about.
     
  39. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    To see if the pancreas is kicking in and working at all.....if you test the BG level, feed some food, then test the BG level 2 or 3 hours later, that can tell you if the pancreas is working at all.....that is, if the BG taken 2 or 3 hours after the food is eaten, is lower than the BG taken beforehand the food was given, then the pancreas is working, or at least kicking in.
     
  40. Waheeda

    Waheeda Member

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    Apr 11, 2017
    Ok the 2nd reading was after 2-3 hrs and there was a slight drop. From 122 to 115. This means pancreas is working ? but 3rd reading was after 3.5 hrs of food and it went up. Could it be pancreas slows down in the afternoon? Cos I recall when he first had diabetes, his afternoon readings tend to be higher than morning. Just my Guess.
     
  41. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Even if the pancreas is working a bit (which would be good) I think he needs a small amount of insulin.
     
  42. Waheeda

    Waheeda Member

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    Apr 11, 2017
    Yes, I agree and I want to start tmr. I can only get d insulin tmr so I Guess I’ll start the pm shot. So it’s 2 hrs no food, take bg reading, jab n then feed rite? And should I take reading every 3 hours? When is d nadir? At +6?
     
  43. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Take the reading, feed then give the insulin. Feed before giving the shot. Then offer small snacks during first half of cycle. Nadir can be around +6 but not always. Can be anywhere from +4 to +12.
    First day if you can take several reading would be good. Hopefully Marje will answer soon for the dose.

    Do you have some higher carb food if needed. ?
     
  44. Waheeda

    Waheeda Member

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    Apr 11, 2017
    Hi,
    Yes I do have Fancy Feast gravy food and also honey. Wow, nadir can be so late in cycle? If I’m home, he usually ask for food every 2-3 hrs. I will leave Young Again dry food for him when I’m working. I see you are in Sydney. I’m in Singapore. I was looking at the lantus section and I noticed members are still giving shots even tho the amps/pmps is less than 120. Why is this so? I thot 50-120 is normal range? I hope marjie will reply soon.
     
  45. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    the nadir is mostly between +4 and +7 but as we know, every cat is different (ECID) and it can be outside these times. It can also change from day to day so you just have to test and see how he goes.
    Lantus is a depot insulin so you need to hold the dose initially for 7 days to let the depot fill. EDIT unless the BG drops under 50 then you would reducethe dose.
    Once you are experienced with using Lantus you can dose the lower numbers but you need to gather lots of data first.
    If they are giving the insulin when the number is under 120, that is because the cat still needs the insulin to stay in those numbers.
    Read the yellow stickies at the top of the Lantus page for lots of information.
    Don't give any insulin until someone posts and tells you how much.
    I'm speaking to some other experienced people about it. Because he is in numbers that are just higher than normal, we need to be careful with the dose.
     
    Last edited: Dec 5, 2019 at 4:30 PM
    Reason for edit: added edit.
  46. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Just wanted to check what type of syringes you have for the Lantus?
     
  47. Waheeda

    Waheeda Member

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    Apr 11, 2017
    This is what I used before.
     

    Attached Files:

  48. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Yes. Those are the correct syringes!
     
  49. Waheeda

    Waheeda Member

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    Apr 11, 2017
    Is lantus a u-100 insulin? So 1 line on syringe is 1 unit? I don’t thk I shld start at 1 unit? But pulling even 1/2 unit will b tough.
     
  50. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    Yes and yes. It appears that your syringes are only marked in 1 unit increments. BD and other make insulin syringes marked in 1/2 unit increments.
     
  51. Waheeda

    Waheeda Member

    Joined:
    Apr 11, 2017
    I’ll go and check with a supplier if they carry 1/2 markings here. Will make dosing easier.
     

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