? Help needed interpreting Cher's high numbers

Hi Everyone
Just wondering if someone is able to help interpret Cher's SS and offer any suggestions as to how best manage her BG levels.

Basic Medical History 2017:
Pancreatitis and Ureteral Stones (Subcutaneous Ureteral Bypass) 20 Feb
Pancreatic cyst
IBD diagnosed via Endoscopic biopsy 13 Jun
Prednisolone 5mg BID commenced 15 Jun to treat IBD
Diabetes diagnosed 22 Jun
Hills ZD Diet for IBD (high in carbs)

Diabetes managed by IM Vet:
22 Jun - Lantus 1 unit daily - ceased Lantus 24 Jun - possibly in remission
26 Jun - Prednisolone reduced to 7.5mg daily
29 Jun - Lantus 1 unit BID restarted - increased to 2 units BID 30 June
14 Jul - Prednisolone reduced to 5mg daily
24 Jul - Lantus increased to 3 units BID
5 Aug - Lantus increased to 4 units BID
21 Aug - Prednisolone reduced to 2.5mg daily
30 Aug - Lantus reduced to 3 units BID

Our IM vet prefers that BG levels be tested for curves only.
My preference is to test before shots and whenever necessary
I have just read today that when PS levels are low, the shot should not be withhold. Unfortunately I have withheld the shot thinking this was the safest thing to do!

With the reduction of the Prednisolone, the BG levels appeared to be coming down, however when I gave Cher her AM shot on 29 Aug, the area around the shot bruised suddenly and then for the remainder of that day, the levels rose until the PM shot was given. Then the numbers fell dramatically at +3 PMPS, continuing to fall until they reached 61 (3.4). This was when I made the decision not to administer the shot. Then the numbers rose with a vengeance.

After this episode, I took Cher to the specialist centre but as our IM vet is currently in Britain, his colleague examined her. She was uncertain about the bruising and did a ProCyte Haematology test which came back OK.

With regard to the rise in BG levels, it was suggested the Lantus may not have been working as it should have been, due somehow, to the bruising.

It was decided the Lantus should be reduced by 1 unit BID from 4 units to 3 units as the reduction in Prednisolone appeared to be lowering the BG levels. I thought of only dropping the Lantus by .05 units but I felt that when I did the new curve on Monday and sent it through to the relieving vet, that she would not appreciate the fact that I had not done what she requested.

We have also discussed with Cher's regular IM vet, that the ZD food is very high in carbohydrates and that we would like to look at changing her food to perhaps 'Raw' or something lower in carbs but he does not support this. He feels that her IBD is more of a priority than the diabetes and she needs a hydrolyzed protein diet. I do agree in that if the IBD is aggravated by a diet change there will possibly be a major problem with trying to get her to eat.

Hoping that someone can help put our little girl back on the right track as she has been struggling with bad health since February.

Thanks,
Jan

 

I suggest that you repost this on the Lantus forum. It's a large group and there are many experienced members there, including those who have kitties with multiple health issues. Trying to orchestrate a decrease in insulin as a steroid dose is decreased can be complicated. I do think you haven't yet been able to see what the Lantus can do because of the frequent dose changes.

I completely agree!

 

My Tigger is on 2.5 mg Prenisolone every other day for skin allergies, and that is a reduction fro 5mg every other day. My vet pretty much said the opposite...the diabetes was the most important thing and we would deal with the allergy if it pops back up. I'm glad to say it hasn't. I had a cat with IBD and while serious, I believe diabetes is more apt to lead to a dangerous medical emergency.

Also, you are in control. If you want to test pre-shot, do it. You don't have to tell the vet about it. If it eases your mind and keeps your kitty safe, how could it be a bad thing.

Tigger was also on Z/D for the allergies. We switched him to Fancy Feast classic and decreased the pred. and that is when we started to get some control over the diabetes. How about a limited ingredient food that is lower in carbs? There are a few on the list...Natural Balance is one and Instinct is another. To my recollection, they are not below 10% carbs but they are certainly better than z/d!

Good luck and bravo for home testing!