PANCREATITIS and insulin resistance

i wrote here first in april about my cat siujim who has diabetes.
at that time, she can't go into a remission and we were wondering why.

siujim is 17 years old, she has been on lantus for almost 6 months. now on 4.5 unit. weight 2.65kg only.
her kidney and other organs are basically fine, no hypertension as well.
pls note spread sheet for details:
http://spreadsheets.google.com/pub?key= ... utput=html

we all doubt it's something else that causes the insulin resistance. so we did another blood test on TLI and PLI.
results are back today. it shows sign of panceatitis
serum folate -- 11.6 (normal: 8.5-20) this one is normal
TLI 372 (normal is 35-130)
PLI 6.2 (>5.4 is sign of pancreatitis)

i feed her b-12 everyday and i guess it is overloaded. her data is
2000 (normal is 150), i will stop right away at least for 2 weeks
first. let her release the excessive b12 via urine. i realize the k+
supplement she take has b-12 on it, and perhaps ihaev double up. i
didn't pay attention because usual blood test won't do the vit and
also vet always say excessive b-12 can be released via urine.
do u think 2 weeks is enough?

vet mentions, they don't have a treatment for that and only gives me
supplement and liver support
SAME, CoQ10, Vit.E, super digestive enzymes

may i ask for your comments?
other suggestions?
is there anyone here who are caregiver to diabetic cats with
pancreatitis? what is your experience?

thx a lot.

best,
anson

 

Are you testing urine or blood? I'm sorry, I'm just a little confused.

Many of us have pancreatitis cats, mine has Chronic Pancreatitis (CP). His PLI has been as high as 28 at times. The lowest ever was 6. I don't test that anymore, I've learned his symptoms and when he's in a flare he gets pain meds, fluids and injectible pepcid.

Here's a link to some great information written by Jojo, a vet tech and contributor to the Board. You'll need to scroll to the top, it's a link I had bookmarked to the told board but it opens halfway down.
http://www.felinediabetes.com/phorum5/r ... msg-876821

We give Tucker his B12 injection once every two weeks.

 

thx so much for the info.
reading them.
my vet has given me similar supplements:

may i ask, do you find all these supplements useful?

SAME, CoQ10, Vit.E, super digestive enzymes

how's your cat now? she feels better? wish s/he can be recovered soon.

also Sub-Q will help?

thx a lot

 

Tucker's situation is a little different, ECID (every cat is different). He suffers from IBD, Irritable Bowel Disease, and other allergies. He had biopsies done a while back when I first adopted him to try to figure things out.

He also has a brain tumor so he takes steroids for the tumor, it was the only way to stop him from walking in circles constantly.

He takes the B12 injections on an ongoing basis and gets Buprenex when I see he's in pain, like when his BGs are high or he's in the meatloaf position with his head scrunched. During a flare the subq fluids help a lot. The injectible pepcid works wonders for him too.

I don't give the supplements, perhaps I should, but he has the IBD and food allergies, so I try not to over do things with him.

Over the years Tucker's pancreatitis was well controlled. Stress from the heat of summer or from me working overtime brought about flares. Also the allergies would sometimes cause a flare. But mostly, using insulin, his pancreatitis flares don't happen that often.

I think what's important is diet, a low carb canned or even raw food, and hometesting the BGs to find the right dose for your kitty. Are you testing the blood for BGs?

 

thx for your info.

yes, she has been on low carb diet since last dec when she was first diagnosed diabetes. since two weeks ago, i also have started to try quit fish for siujim as it is a major source of allerigies.

she is basically on steam shrimp (as a apperitizer to trigger her), a small dish, then wellness grain free chicken/chicken liver.

yes, i do home tests but sometimes after a week continuous check, it is hard to get the blood in the wounds.
so i will rest her ears fora few days. and will check urine (though it is not instant info, usually i check her urine before food. so if she has sugar in urine plus the food after), it is safe to do the shot. if her urine is negative, then i will do the blood test. but it never happened after jan.

i guess because of the pancreatitis for the insulin resistance.

oh, do u think trying another type of insulin is useful, while taking all those supplements and hopefully her pancreatitis is controlled?

thx

 

Are you still on Lantus, because that's a fantastic insulin. In fact you'll probably get some great advice over on the lantus insulin support group.

viewforum.php?f=9

Many folks there have pancreatitis kitties who use lantus. You should check that out, read the stickies and then introduce yourself.

 

yes, i am using lantus.
i did go there before but i stopped as she has been very unstable and we were waiting for the blood test results from UK (in hong kong, we don't have any lab doing the tests.

will certainly post there again.

this morning, her BS is obviously lower. i am so happy. seems like the supplements are working. will go on monitoring.

may i ask one question?
when do u do the BS test?

i usually feed her first, 1 hr later, do the blood test, right before the shot.
is that the correct way?
this is what i am told. but i want to make sure that it's correct.
because if we feed her right before BS test and the shot, then her sugar level doesn't reflect her condition as the food need time to convert into sugar in her blood.
am i getting the right understanding?

thx.
anson

 

My kitty just had a bad bout of pancreatitis, it was a long process but he is starting to make huge improvements. I made a post about pancreatitis and recieved so much information.

I was going to c/p individually but I think linking would be so much easier.

viewtopic.php?f=28&t=15268

 

The problem with feeding so long before taking the blood sugar reading is that you are getting a food spike number. That number is actually NOT the true reading you are looking for. You want to test before feeding, then give the shot while she is eating or thereabouts. I test, feed, shoot in that order then try to get another blood sugar reading anywhere from 4 hours to 6 hours after the shot to see how the insulin is working. And then if you need more data than get more spot checks obviously.

I hope you are able to get your baby's numbers down. It sounds like from reading your spreadsheet that you are working very hard at helping her to do just that. Yes, do post on the Lantus forum when you can so they can keep up with your progress.

Also, have you ever thought about feeding her raw food? You might look at the testimonials in the link in my signature. Not sure if you can get that in Hong Kong but many people make their own.

And the link for pancreatitis treatments that Cornad gave you is a good one.

 

thx so much. will read the info.

really appericate it.

may i ask, how do u know your cat is in pain?
what is the sythom?
as i don't feel that she is, she purrs, eats, walk around.
so we are not taking any pain meds. though i have reservation to that...
just hope to understand how i could observe if she is in pain or not.

thx again.
anson

 

I believe one of the signs is "meatloaf" position, dont know exactly how to describe it, anyone else?

and hiding and growling is another I've heard of.

I hope things work out for you guys, I know you've been through a lot, keep coming back to the board for help when u can.

Take care!

 

Although I believe Spencer was in pain for a long time, some days he would still purr and want to be held. But when I put too much pressure on his ribcage he would flinch. Some days he wouldn't purr at all and a lot of hiding. I feel like he was in pain even when he wasn't exhibiting obvious signs. I truly believe the pain medication made a HUGE difference and it was after Spencer received it that he was doing much better. He started to eat again and stopped flinching.

Even though cats can't talk, we can still gauge whether or not they're in pain because we can sometimes feel something isn't the same. It's almost similar to when I deal with patients who are aphasic/non-verbal/or have severe dementia, or even language barriers! I can't ask if they feel pain and get a response. But I pay attention to their conditions (some conditions are painful), medical history, assessment of their body, grimacing/facial expressions, body language, etc. I'm a student but when I'm assigned to a patient and nurse, I try my best to advocate for pain relief, worst case scenario they aren't in a huge amount of pain but receive medication--instead of letting the pain level elevate until it's 9/10 and it becomes harder to relieve.

I guess what I am trying to say is that ask about pain medication when you go to your vet. It is a lot of better than not giving it.

 

thx again for everything.
i will try my best to take care of siujim...

wish you and your cats all the best of health,
anson

 

Hi there Anson,

I see you are in Hong Kong, and I welcome you and Siujim to the board I see you are truly devoted to her.

I also see that you and your vet think there is no other reason for insulin resistance, however in looking at her numbers, I wonder if there is a way for you to have her tested for acromegaly. In my opinion, it is possible there is a high dose condition in play causing this resistance. Pancreatitis is often a fleeting condition where weeks go by with good numbers and health and then the kitty gets what we call a pancreatitis flare-up, which will sicken kitty for a few days to a week and then the kitty will heal and the return to better diabetic health without bringing more than a temporary resistance.

There is one other thing: How old is your Lantus? Lantus can be fragile and often not last longer than a month. I am unsure what versions of Lantus are available in Hong Kong, but if you can, get the the Solostar Pens, or the refill cartridges, as there are 5 of them in the box and ultimately will last you longer. http://www.lantus.com/solostar/solostar_insulin_pen.aspx

A pleasure to meet you,
..Carolyn

 

dear carolyn,

thxxx so very much for your comments and support.

it's been so very hard. and for 6 months...

yes, these are the things i have thought of too.
back in dec/jan when she was doing do, and suddenly with diarrhea in mid jan... (perhaps it's pancreatits flare when looking back... i should have do the blood test on PIL earlier... but her vet is on leave for the whole april and the other vet in the clinic simply say it is ok as long as her sugar not jumping high and not losing weight a lot)...

anyways, ever since late jan, she is not stable.
and vet just suggested keeping on raising the dose.
i changed to another vet. she is less experienced and more careing.
sometimes, it is hard to make the decision some vets are experienced but they are less avaibale. some vets are less experienced but more caring. i prefer to go for the latter as diabetes and pancreatits always want more imediate help. and for second opinion, i can always come here... you folks are so helpful. really grateful!!!

now i am very careful. as her dose is very high 4.5 unit on a 2.7 kg cat.
i will either test urine (if i test urine, if it is normal, i will do the blood and if it is not normal, i will make sure she eats before the shot. then she is safe. i test urine because it is very hard to get blood sometimes) or blood before the shot.

any stickies on techniques on blood taking here?

and today, her amps is much better, i guess the supplements and the massage (similar to acupuncture but we use hands massage on certain spots of the body) are working. i will keep checking.
she doesn't vomit and no more diarrhea and regaining weight which is really really good news.

today, i have to work. but at least i will try to get a +4 before leaving.
and see how things go, if her pancreas is recovering, she may need to reduce the dose quite soon.

for the lantus pen, i use a new one every month to ensure it's effectiveness.

thx again for everything.
really.

best,
anson

 

i am thinking about your comments lately on the temporary resistance...
and i am thinking she has a rebound on and off...

she is on a high dose (4.5 unit of lantus for her weight 2.7kg only.

and she was better (210-310) last week after starting the supplemenst (sam-e, vit e, coq10...) and suddenly her BG jumps high as before taking the supplements (340-410).
i wonder should i start from 1.5 unit (the dose where she had 10 days in normal) back in jan... all over again and see how she does?

but i worried that she was on high dose for a long time (for 4-5 months) as the vet just said raising the dose (i always wonder why not start the supplements earlier even without the TLI tests as they are supplements only...)...

may i have your comments?

thanks