Hello everyone

Hi my name is Nickie and my 11yr old Frosty was diagnosed with FD in July 2016 started on Lantus 1u 2x day, was doing better then all of sudden in November went down hill, took to vet and they treated for pancreatitis. They took him off insulin for 10days, his numbers then went into 500+ do vet had us increase dosage in increments of .5o units, we are now upto 3u 2x day. Doing better now, but even with all the reading I am doing, I still feel confused on his dosing, feeding, and numbers.

I look forward to learning more.

 

Hello Nickie, welcome to you and Frosty! I think we were all confused in the beginning, and sometimes still are, but it will get easier. One thing that really helps things make sense, is home testing our cats glucose. Its really easy to do and with the data you gather you will know how well your insulin is working. It will also help you to avoid a hypo episode and if one would occur, enable you to treat it quickly. Come to the Main Health Forum to ask any questions you have on feeding, testing and any other feline problems you have.

 

Welcome Nicky and Frosty.
I am really surprised your vet took Frosty off insulin for 10 days when he had pancreatitis. I have never heard of that before. Does your vet know much about diabetes.? He should have stayed on the insulin during the pancreatic episode.
How is Frosty now after the pancreatitis? Is he eating again OK?

A couple of things:
As Sharon 14 said it is really important that you test Frosty's blood sugar levels. It is probably the most important thing you can do for him right now. You don't need your vets permission to test and you can buy human testing kits at Walmart I think you call it in the US. They have a Relion and a Relion micro both of which are good and the test strips are a reasonable price.
Here is a link to testing the blood sugar. It might seem frightening at first but it very soon becomes very easy...I promise you
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
Unless you are testing the blood sugar, you really don't know how low the insulin is taking Frosty. The blood sugar varies day to day so getting it tested at the vet every so often is not giving an accurate picture. Also cats get stressed at the vet and their numbers will be higher than they are at home. We recommend you only go up in 0.25 units increments so as not to miss the best dose and to be safe.

Have you been testing for ketones in the urine? It is a very good idea to have a bottle of ketostix at home to test for ketones. You just need to get a sample of Frosty's urine and dip one of the test strips in the urine. Ketones in the urine can lead to a serious illness. Here is the ketostix...easily picked up at a pharmacy or Walgreens
https://www.walgreens.com/store/c/ketostix-reagent-strips-for-urinalysis/ID=prod19769-product

What are you feeding Frosty? We recommend you feed wet canned food 10% carbohydrates or less. We do not recommend dry food at all. Here is a link to some food charts
http://www.felinediabetes.com/FDMB/threads/links-to-various-food-charts.169055/

Ask lots of questions, we are happy to help
Here is a link to the health page where there are more people to help you
http://www.felinediabetes.com/FDMB/forums/feline-health-the-main-forum.28/

 

Hi, Nickie. Welcome to yourself and Frosty.

I agree with Bron; Frosty should have been kept on insulin during the pancreas flare.

For general information, researchers into pancreatitis at the University of Manchester have identified a protective effect that insulin has on cells in the pancreas during an acute flare. (Research is in the early stages.)

http://www.manchester.ac.uk/discove...hope-for-the-treatment-of-acute-pancreatitis/

From the above article:

Diabetes makes pancreatitis worse and diabetics are at higher risk of developing pancreatitis and multiple organ failure. Moreover the incidence of pancreatitis is reduced in diabetics that receive insulin. Although tenuous, these studies suggested that insulin might have a protective role, however, it remained unclear how insulin was working. What makes the Manchester research unique is that it provides the first evidence that insulin directly protects the acinar cells, which is where the disease is initiated.

Dr Bruce explains: “Insulin works by restoring the energy levels of pancreatic acinar cells, which fuels the calcium pumps on the membrane of these cells. These calcium pumps help to restore cellular calcium and prevent the catastrophic cell death and autodigestion of the pancreas.”​

For future reference, a common reason cats fall out of remission is due to pancreatitis flares. In Saoirse I noted a re-emergence of her chronic pancreatitis symptoms when she stopped insulin treatment after going into diabetic remission. Other members of FDMB have reported similar observations in their kitties. I've attached below a journal article co-authored by vet and respected authority on feline diabetes, Dr. Jacquie Rand. It specifically mentions the importance of insulin treatment for diabetic cats with pancreatitis and hyperthyroidism.

From the attached article:

Frequent causes of relapse are hyperthyroidism and chronic pancreatitis. Very few such cats achieved a second remission because additional glucose toxicity of a further
diabetic episode has destroyed too much beta cell mass for a second remission to be possible.

The more quickly effective treatment with insulin begins and the return to euglycemia is achieved, the more likely a second remission will become. It is advisable that
cats whose blood glucose concentrations increase and are consistently at more than 120 mg/dL be treated with insulin, beginning with small doses that can be ramped
up quickly.​

If Frosty continues to be affected by chronic pancreatitis it can help with management to have a good awareness of the clinical signs of nausea, and also the appropriate treatments tp request from your vet. It also helps to learn tricks to encourage pancreatitis kitties to eat, and also to ward against constipation (the latter can make symptoms worse). Here are some resources that I have found to be extremely helpful.

Nausea symptoms and treatments

IDEXX pancreatitis treatment guidelines

Persuading your cat to eat

Tips for stimulating a kitty's appetite

www.felineconstipation.org

I hope Frosty is fully recovered from his flare; it's tough on both cat and caregiver. (((Frosty and Nickie)))


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