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Managing Diabetes in Cat on Prednisolone (kitty has cancer)

Discussion in 'Feline Health - (The Main Forum)' started by KittyCatJake, Jul 12, 2019.

  1. KittyCatJake

    KittyCatJake Member

    Joined:
    May 3, 2019
    Hi, sorry haven't posted in a while, but I've been on a cancer roller coaster with poor kitty Jake. Though he did go into partial remission after about week 3 of chemo, he took a terrible downturn 2 weeks later, but happy to report that he is now doing much much better, but that is because they have him on prednisolone. Though they initially tried to treat Jake's nasal lymphoma without prednisolone due to his diabetes, it became obvious we were losing the cancer battle last week, so the vet suggested we risk making his diabetes worse to give him some steroids, which are known to work very well on this type of cancer (it is now in his brain). The steroids have caused a dramatic improvement - he went from barely able to lift his head at times, to jumping on to the kitchen counter again. BUT.....as expected, his blood glucose numbers are soaring. Last week, he was getting 1 unit twice a day and I was having to skip shots at times because he was still too low. Now I'm giving him a generous 1 unit and testing before injection yesterday had him at over 30, which is the highest I've seen him. Testing a couple hours ago had him at 23, and that was about 8 hours post injection. He has another 8 days on full prednisolone, then they start to taper it down. Apparently numbers generally improve as they are weaned off it. But, how do I manage it in the meantime? Should I give him 1.5mls tonight and see how he goes on that? It's clear the 1ml won't do it anymore. I know this is really bad for his diabetes, but prior to being on this he had gone completely blind, was getting stuck in corners, couldn't get on or off the bed etc, so it is absolutely essential that he have it, cause the other option is almost certain death sadly. Any ideas/suggestions/advice would be great. BTW, I'm trying not to test him too much as he really hates it and is getting it on top of numerous meds and eye drops all day! Should add, I also started him on cbd oil this week....haven't had time to research it's effect on diabetes, but I do know it's a chance of helping with his cancer symptoms/side effects.
     
  2. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    I'm glad the steroids are helping Jake and his quality of life. The CBD should help too. All you can do is monitor his blood glucose and dose accordingly. If you can set up our spreadsheet, we can help you with the dosing. If you need help setting it up or understanding it, let us know and we’ll be glad to help.
    http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
     
  3. KittyCatJake

    KittyCatJake Member

    Joined:
    May 3, 2019
    Thank u so much! Setting up spreadsheet now! Some dumb questions I'm hoping you can answer....what goes in the AMPS column? And the U column? I'm assuming units dosed in U column? And PMPS? I increased his dose this morning, but he was still over 20 3 hours after I gave him his dose this morning. I so hope I can safely bring the numbers down quickly for him.
     
  4. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    Yes U is units dosed. AMPS is the morning Preshot number, taken before food and shot. PMPS is the PM Preshot, also taken before feeding. Be sure it has been at least two hours since Jake has eaten when you take these readings, so as to get an accurate number that isn’t food influenced.
    Here’s a post to explain the spreadsheet better. If you still have questions, please ask
    http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/
     
  5. KittyCatJake

    KittyCatJake Member

    Joined:
    May 3, 2019
  6. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    Yes I can see the spreadsheet. When you get a chance, fix the AMPS on the US sheet. It’s in mmol so looks like a hypo! What insulin are you using? If you can, set up your signature so anyone answering you can see all his pertinent info at a glance. Include what meter you’re using, what insulin, what food, and any other health problems, like the cancer and pred, as well as what country you’re in (for more specific advice as well as time zone). Then your best bet for dosing advice is to post in the insulin specific forum, although if you’re more comfortable posting in this forum, that’s fine too. Has Jake ever had any ketones? If not, then holding the dose for a few cycles is usually good protocol.
     
    JeffJ likes this.
  7. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    Leo had small cell lymphoma. He was on prednisolone and leukeran (chlorambucil) chemo from June 2017 - December 2019.

    I stopped the chemo in January 2019 when his eating went down drastically, and we suspected his time was coming.

    Pred affected his BG significantly in the A.M. I deviated from the FDMB protocols, and gave Leo extra insulin in the A.M. cycle since that is when he got the pred pill. You can see this in various years including his "2017 Jun-Nov" sheet.

    Pred may have also induced diabetes. We know the radiation treatment for his Acro was successful, as Leo went from 18.0 units/dose to 1.5 units/dose over 2 years. At the end, maybe he only had diabetes from the pred. We do think the pred was successful with the cancer, and did not seem to cause any other issues. (Leo's eulogy)
     
    Figaro's Liz and Sharon14 like this.
  8. KittyCatJake

    KittyCatJake Member

    Joined:
    May 3, 2019
    Thanks so much! I have updated the spreadsheet and saved it to my signature with the other info. His numbers are still high but lower than yesterday. Wondering if I should increase the dose even more?
     
  9. KittyCatJake

    KittyCatJake Member

    Joined:
    May 3, 2019
    Leo sounds like he was an amazing kitty....I'm so sorry. I'm not sure if Jake's is small cell, but do know it's nasal lymphoma. I so hope he lives as long as Leo lived post-diagnosis, but it's hard for me to be too optimistic as he was on death's door just 2 weeks ago (prior to starting the predmix). Thank you for that info re the differences between morning and night....I will watch Jake's numbers closely to see if the same is happening to him.
     
    JeffJ likes this.
  10. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    I recall the predisolone helped turn Leo around dramatically. Above, I gave the summary. But he also had a feeding tube in his esophagus before the SCL diagnosis. The pred and the chemo helped keep the cancer in check for about 2 years.

    I hope you can get Jake turned around and give him some extra lease on life.:bighug::bighug::bighug:

    Thanks for the condolences. We knew Leo was going. He was the very best and we miss him terribly.:(
     
  11. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    JeffJ and KittyCatJake like this.

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