Out of Remission :(

Blu started losing weight and was interested in water - home checked him and glucose was at 290. Brought him to the vet the next day. He had been OTJ for over a year and a half. Glucose during periodic home checks while OTJ were stable in the 80-90 range. Before that, he was diagnosed with glucose in the 500's, and was on Lantus for around 4 months then quickly went into remission. He's been food controlled eating only Fancy Feast Classics. We are back on the Lantus starting today.

Upsetting of course, but less stressful than the first time this happened as I know more of what to expect and do. Is this usual to go out of remission when eating an approved diabetic food? I asked the vet if he could achieve remission again and she mentioned that she had one cat patient who was on insulin 5 times with long remission periods in between and she seemed hopeful that Blu could go into remission again, but I've read elsewhere a 2nd remission is much more difficult to achieve. Thoughts or experiences with 2nd remissions? He does have some oral issues, couple teeth need to be removed but not until his glucose is under control per the vet.

 

Did the vet do any bloodwork on Blu? Any other signs of infection or illness?

I'm asking because typically, the big things that cause a cat to come out of remission are Infection/Illness, Dental issues, Reintroduction of dry or high carb foods into the diet, and steroids. If none of the other three issues are on the table, then you can definitely point to the dental issues as your culprit.

Many vets seem to want to wait to get the cat regulated or under control before doing the dental, but because the dental problems are what is causing the BG to be out of control, you really have to have the dental done ASAP. If your vet wants to wait a few weeks to settle him in on the Lantus, that's fine, but I wouldn't wait much longer than a month or so. You'll likely need a couple weeks of lead time with antibiotics before the dental anyway.

The good news is that once the underlying issue is addressed (most likely his oral problems), he can go right back into remission. Bandit had a relapse due to the dental issues in 2011, we dealt with them (we ended up having to pull all his remaining teeth except his lower canines), and he went off insulin after only about a month. Recently, Bandit relapsed because of several months on oral steroids, and once we stopped the steroids he went right back into remission again.

 

Hi Tanya,

I'm sorry to hear that Blu has dropped out of remission. Same problem here with Saoirse (she has other health issues which may be contributing). I can really relate to your comment about insulin therapy second time around. While it is disappointing to have to start giving injections and worrying about high readings and hypos again, it's definitely not anything like as overwhelming as first time around.

I hope that when Blu has the dental done his numbers will improve again.


Mogs
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Thanks for the info about his dental. I will see if I can get the vet to do it ASAP. They did run a full blood panel, but I haven't received results yet. Geez - I hope nothing else is wrong that is causing his sugars to run high. He's a senior cat. Prior to his numbers rising, he seemed to be less interested in food, but wasn't losing weight, so I didn't worry too much. Hopefully I get his results today. Thanks for the kind words - hopefully it is just the dental pushing his numbers up, as that would be a somewhat easy fix.

 

Got the blood panel results - everything normal except his glucose. Second day of Lantus and his morning pre-shot, pre-meal glucose at 190, so already showing an improvement. Hopefully once the oral issues are addressed, this will be a short insulin stint!

 

Prayers & positive thoughts for short insulin stint!!!

 

All fingers, toes and paws crossed for you - that after Blu's dental problems are resolved, he'll get right back to being an OTJ kitty again!