PMPS of 70 but full dose of Caninsulin injected

Discussion in 'Feline Health - (The Main Forum)' started by Capoo, Dec 26, 2016.

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  1. Sif

    Sif Member

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    No
    2/3 of the meal of the morning.
    He got the third part of the morning meal just after the test (usually he gets it after the shot). Then, usually, he gets the other half of the daily meal later, a little bit of it at the end of the afternoon and the rest after the 2nd shot in the evening.
     
  2. Sif

    Sif Member

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    And NO NO NO, I won't do the shot now. And for the next one I guess that we will have to drop the quantity of insulin. 1IU is probably too high. I wrote an email to the vet with all the BG and time.
    (Do you think now that we should remove the "911"or not yet ?)
     
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  3. StephG

    StephG Well-Known Member

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    Is that mmol/L or 70 mg/dl? Sorry I keep asking but I don't know the conversions.

    So for his morning meal before his last test of 70 how many ounces or grams did he eat?

    I was expecting a reading higher than 70mg/dl.
     
  4. StephG

    StephG Well-Known Member

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    I think it's probably safe to remove the 911.
     
  5. Sif

    Sif Member

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    Yes sorry I begin to zzzzz.
    70 mg/dl
     
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  6. Capoo

    Capoo Member

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    @Sif , do you want me to remove the 911?
     
  7. Sif

    Sif Member

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    He's ate 2/3 of 28 great and then the third one. Dry food, Carnilove, 4400 cal/kg and 20% de carb
     
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  8. StephG

    StephG Well-Known Member

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    @Capoo what's your take on his post meal reading?
    Do you think he's still being influenced by the insulin?
     
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  9. Sif

    Sif Member

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    If it's better for the forum in case of another problem with another cat: yes please :)
     
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  10. Capoo

    Capoo Member

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    That's exactly what I was wondering : I've never seen Caninsulin working for such a long time, and that was also my wondering when I saw the first PMPS of 70 yesterday.

    I know that each cat is different, but mine weights around the same weight as Epi, and even with doses as high as 7 IU, I have never had this type of preshot numbers.

    I was even wondering if this cat is still diabetic at all.

    I can't remember if Sif changed the food just after the diagnosis.

    I need to reread the first emails...
     
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  11. Capoo

    Capoo Member

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    @Sif, can you test the meter on yourself?
     
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  12. Capoo

    Capoo Member

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    I have read the first email : was Epi diagnosed diabetic only with a spot check of his BG at the vet, or was he also showing some clinical signs of diabetes at home (terrible quantity of pees each day, always thirsty...)?
     
  13. StephG

    StephG Well-Known Member

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    I am wondering about the diagnosis too!?

    70 BG after all the kibble treats and his AM meal is a beautiful number. I fully expected it to double after all that but I only have some experience with ProZinc.
    Google says max duration is 12 hours in cats. Every cat is different but this one seems to be quite the exception.
     
  14. Capoo

    Capoo Member

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    That would also be good to retest Epi, but this time, with a big drop of blood, just to be sure that there is enough blood in the meter.
     
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  15. Sif

    Sif Member

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    Me too !!!


    He drank and pee a lot, yes.
    They discover the terrible quantity of sugar during test before anesthesia (to remove the tartar of his teeths). Then to avoid the possibility of a higer sugar because of the stressful situation (going to the vet is nightmare for Epi), they tested it also while he was sleeping. And there were sugar in the pee also. Then they said that he was diabetic and ask to give me Caninsulin blablabla.

    FOR THE FOOD :
    I just slowly drop the quantity of food (was 60 gr, then 57 gr), keeping first the same food (Carnilove, 20% carb, 4400 cal/kg). I wanted to change for low carb wet food but for now I did nothing but drop the quantity of the old food.

    Here is the MAIL I SENT TO THE VET, a recapitulative also for you.

    "Here is what happened yesterday with the blood glucose, in order :

    20:32 : BG = 3.9 mmol/L

    + 40 min after the first BG : usual SHOT 0.05 cc/ml of Caninsulin

    + 1:00 after shot : BG =3.7 mmol/L

    + 3:00 after shot : BG = 2.6 mmol/L !

    + 4:00 after shot : BG = 3.7 mmol/L

    + 5:00 after shot : BG =4.3 mmol/L

    Between every BG test until here, Epi had honey & a little bit of his usual dry food.
    Then just a little bit of wet food (low carb)


    + 6:00 after the shot : BG = 3.3 mmol/L

    Usual dry food + honey

    + 7:00 after the shot : BG = 4.3 mmol/L (stop food until +8:00)

    +8:00 after the shot : BG = 4.6 mmol/L

    +9:00 after the shot : BG = 3.8 mmol/L (dry food until +10:00)

    + 10:00 after the shot (so 7 o'clock) : BG = 4.0 mmol/L (he is supposed to get the next shot in 1 hour)

    + 11:00 after the shot (8 o'clock) : BG = 3.8 mmol/L

    Usual quantity of food gave to him. By the way I kept the same food than before, I just controled more the portion (60 gr per/day > 57 gr now). 28.5 gr of food (20% carb, 4400 cal/kg).

    + 12:00 after the shot (9 o'clock) : BG = 3.9 mmol/L. Is he still under the too big shot of Caninsulin ?

    I didn't do the usual shot.
    No symptoms except very tired and starving +++++ (and maybe something weird to one eye)

    I just wait for your reply for the rest of the day...


    Thank you"

    Ok ! I am at 97.2 @Capoo
     
    Last edited: Dec 27, 2016
  16. StephG

    StephG Well-Known Member

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    Maybe another test for him too. Would be 2 hours after his meal now and +13 from his last shot.
     
  17. Capoo

    Capoo Member

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    That was maybe enough to "remove" the diabetes.

    Can you describe precisely the problem with the eye?

    @Critter Mom , are you there?
     
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  18. Capoo

    Capoo Member

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    Yessssss, with a big big drop of blood.
     
  19. StephG

    StephG Well-Known Member

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    Did he have any infections that were treated or any teeth pulled?
    Capoo could be on to something here.

    Btw, my boy was diagnosed after losing weight, excessive drinking, always "starving" and leaving puddles in the litter box. His bloodwork came back at 560+! Just cutting out dry food dropped him to 350 range so that is one example of how much just cutting dry food out can help lower it. His diabetes was steroid induced.
     
  20. Sif

    Sif Member

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    Yesterday one of the eyes seemed to have a bigger pupil (but I am not sure) and after, it seemed to be more closed than the other one.

    If it is that..................................!!!!!

    Ok, I do it.

    What do you thing about my glucometer (I am at 97 mg/dl)
     
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  21. Capoo

    Capoo Member

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    It's ok, you're not diabetic ;)
     
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  22. Sif

    Sif Member

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    No treatment and no teeth pulled.

    Epi has the same symptoms than your boy.
     
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  23. StephG

    StephG Well-Known Member

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    I think that eye thing could have been a low blood glucose reaction.

    97 mg/dl for you is a normal reading so it seems like your meter is working.
     
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  24. Capoo

    Capoo Member

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    Maybe the removal of the tartar was enough to stop a small gingivitis.
     
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  25. Sif

    Sif Member

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    Do you think that gingivitis could make the blood sugar so high ?

    I always thought that he drank a lot because he loves playing with water (and because of a story of territory with the other cat), and that he felt the need to eat because of a behaviour trouble....

    In France before leaving for Iceland, my vet checked the blood and said "it is a little bit high but probably because of the stress. Now, he must loose weight in case of, to prevent diabetes".
    But last week the level was apparently crazy (the vet talked about 20.7 mml/L so 372 mg/dl !!).

    Last year he had a severe gastritis. We never knew why. Maybe because of an infection to the teeth (red gums, hobo's teeth...)...
     
  26. StephG

    StephG Well-Known Member

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    Chuck (my boy) went from 13 pounds to 10 in about 3 months and lost muscle mass as well. He lost another pound in the 3 weeks we tried diet control approach so that's when I knew it was time for insulin. He was wasting away and is only back up to 10.4 pounds after almost 4 months.
    I wish I caught it sooner... He's still not regulated and is very reactive to any type of food.

    I hope your boy is in remission.

    Pain, stress, infection... They can all influence BG levels.

    Have you tested him again yet?
     
  27. Capoo

    Capoo Member

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  28. Sif

    Sif Member

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    At +14 : BG = 64 seulement !! Et avec une grosse goutte de sang.
    @Capoo
    @StephG

    OOOPS, sorry I spoke in French........ so 64 mg/dl ONLY, and with a big drop of blood !
     
    Last edited: Dec 27, 2016
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  29. Sif

    Sif Member

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    Not easy.... I wish him and you the best of the best...
     
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  30. StephG

    StephG Well-Known Member

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    If it makes you feel more comfortable you can feed him a little more food but I think he's stable at this point. He's not dropping more than 20% and hasn't really for hours now.

    I would call your vet and discuss this further. I suspect the diagnosis was wrong or he's in remission.
    I really think he was probably high at the vet from stress and maybe his underlying dental issues that were taken care of with the cleaning.
    You can continue to test throughout the day when you can to prove his BG is running normal numbers without insulin. Mainly for evidence to show your vet.
    I would stick with the low carb wet food because it's better for him either way.
     
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  31. StephG

    StephG Well-Known Member

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    I'm not a vet so my advice is just that... Advice.
    If anyone disagrees with me please don't hesitate to post!
     
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  32. Sif

    Sif Member

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    Do you think that I can be at work 4 hours this afternoon ? (My boss needs me). Or not safe ?
     
  33. StephG

    StephG Well-Known Member

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    And if for some reason he does go up I would not give him insulin if his number is under 200 and if it is I would give a tiny amount to start over.
     
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  34. StephG

    StephG Well-Known Member

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    I think he should be fine. It's been 2 hours since he ate and he's not dropping... You could leave a snack out if you feel better that way or give a small snack of his wet food right before you leave.

    Anyone else have advice on this?
     
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  35. StephG

    StephG Well-Known Member

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    @Bobbie And Bubba do you have a minute to give your thoughts?

    I've been stalking the "members online" area for the pros!
     
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  36. StephG

    StephG Well-Known Member

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    I have to take a quick nap. I'm sure you could use one too! If you check him again post his reading and just note how long since his last shot and how long since he ate and how much if you feed him more.

    I'll be back in about 2 hours.

    If the situation changes you can put the 911 tag on a new thread or a ? Tag to get attention.
     
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  37. Sif

    Sif Member

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    Yes he droped : from 70 to 64.8 mg/dl (last shot 40 minutes ago)
     
  38. Capoo

    Capoo Member

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    Last shot 40 min ago?????

    Please tell us that you didn't shot any insulin, please!!!
     
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  39. Capoo

    Capoo Member

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    Otherwise, given that there is a variance of 20% in meter readings, 70 and 65 are the same numbers.
     
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  40. Sif

    Sif Member

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    So, last TEST !!!!!!!!!

    No, NO SHOT !!!
     
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  41. Nan & Amber

    Nan & Amber Well-Known Member

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    Hello--

    Just read through the thread. I agree with the idea that what we are seeing doesn't look like the insulin from last night. I'm not going to state that definitely because I've never used this insulin and I don't have enough overall experience to be able to say for sure, but it has been a looooooong time since that shot, and Caninsulin is an in-and-out insulin, so....

    I do think it would be safe for you to go to work at this point.
     
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  42. Capoo

    Capoo Member

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    Oufffffffff! :woot:
     
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  43. StephG

    StephG Well-Known Member

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    Sorry I didn't explain the drop thing.
     
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  44. Kris & Teasel

    Kris & Teasel Well-Known Member

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    @Sif
    While I was sleeping you had excellent help from Steph and Capoo. You did very well yourself with this baptism of fire (as Capoo said in French)! You have learned a lot in a very short time. :)
     
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  45. Sif

    Sif Member

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    @Kris & Teasel : thank you :)

    So just now, at +16 = BG 72 mg/dl (with a little bit of stress because Epi just wanted to live and tried to a lot).
    And a little bit of high carb before I go.

    I'm going to leave for 4 hours soon.

    Too bad that we cannot tag everybody but : THANK YOU A LOT FOR YOUR PRECIOUS HELP :kiss:

    And probably see you after work, to tell you about the decision of the vet etc :D
     
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  46. Critter Mom

    Critter Mom Well-Known Member

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    Just read back through thread. This was not a good situation and thank you to all who helped see Sif and kitty through this dangerous situation. :bighug:

    Steph and Sophie - very sorry I wasn't able to answer earlier tags (was trying to get a few hours sleep).

    * Very relieved to hear that dose was skipped - I recommend testing again and if @Sif has to leave the house to leave some high carb food out for grazing.

    Although Caninsulin is an in-out there can (depending on the cat) be a carryover BG lowering effect LONG into the next cycle - and possibly some residual effect into the cycle after that; an effect only made visible when doses are skipped. (Numbers may hover around in a lower range than normal without any insulin for anywhere from 12-24 hours before starting to drift upwards again.

    @Sif - IMPORTANT QUESTIONS

    - did the vet run a fructosamine test as part of the diagnostics in order to give your kitty the diabeties diagnosis?

    - has your kitty ever tested positive for ketones?

    - did you switch your kitty from a high carb to a low carb diet AFTER diagnosis and start of insulin treatment?

    - if you did change to a low carb diet, WHEN did you do the change?

    - Is this the first dose of insulin you have given? Could you have mismeasured the dose?

    If you must leave the house I suggest you leave plenty of high carb food out for free grazing. (Situation is uncertain and HC food is safest option.

    ****** SIF: Please buy some urine ketone test strips when you are out (pharmacies have them).


    Mogs
    .
     
    Last edited: Dec 27, 2016
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  47. CassAndGordy

    CassAndGordy Well-Known Member

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    Sif, I've been following this but not cutting in because you were in super helpful hands (and I'm a newbie).
    But it is seeming like Epi is indeed heading toward (or in) remission. (Or he was never diabetic to start with.)
    Good luck with the vet!!!
     
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  48. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Sorry I am just getting this as I went back to bed after I test/fed/ shot Bubba this AM Glad that @Critter Mom weighed in.
     
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  49. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Hi Sif, I skimmed all the post today and wanted to say, good job and so glad that you did not shoot insulin with a number that low.

    When trying to steer numbers up it is best to give wet food as dry food takes to long. You can add a few drops to the wet food if kitty is eating.
     
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  50. Sif

    Sif Member

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    Hi @Critter Mom ! Yes I did it before leaving, let food. And I will do it again, the testing.

    I don't really understand (maybe because my brain looks like jam just now... could please explain it to me ?

    No ! That's why I asked to do it the next check up... next appointment on thursday (it was supposed to be on the 6th of january but with the events...): Any recommendation about what to ask or do on thursday ?

    Yes and until yesterdaym nothing ! I have the Bayer Keto-diastrix strips: I will test him again tonight.

    I just drop the quantity of food (dry food, Carnilove, 60gr to 57 gr so 3gr less than before, 20% of carb, 4440 cal/kg) in progressively, in one week because the quantity was too high. I did after the diagnosis and the insulin, right.

    The second of the day. I think no mismeasured, we both check with my husband.
     
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  51. Capoo

    Capoo Member

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    @Sif , what was the reading when you came back home?
     
  52. Sif

    Sif Member

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    I was still at work when I replied to Critter Mom.

    I just came back home, gave him food and 5 minutes after : at +21 : BG = 75 mg/dl
    5 hours before he ate high carb dry food (but he didn't touch to the food that I put "in case of" for after my departure, he probably didn't notice that it was here).
     
  53. Capoo

    Capoo Member

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    Super!

    Great!:bighug:
     
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  54. Sif

    Sif Member

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    So I guess that I don't have to do a shot now ? :)
     
  55. Capoo

    Capoo Member

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    :cool: I appreciate the joke! :D:D:D

    But just in case a newcomer see only this post : we don't shoot under 200 mg/dL.

    Do you have any feedback from your vet?
     
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  56. Sif

    Sif Member

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    Just an appointment on thursday for the check-up instead of the 6th of january......................................
     
  57. Capoo

    Capoo Member

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    Ok.

    I guess that you're exhausted so : Bonne Nuit (have a good night in English)!
     
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  58. Sif

    Sif Member

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    @Capoo : thank you, you too :)
     
  59. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Surf is on! This is great!!!!
     
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  60. StephG

    StephG Well-Known Member

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    Wonderful surf indeed!
    Glad you got him in quicker for checkup. I suggest continuing the spot checks. The after meal tests (1-2 hours after his meal) will tell a lot about how his body is reacting to food. Take the info with you to the vet.

    Critter Mom's response is why I STILL look for advice from the pros! Their knowledge and advice is priceless!
     
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  61. StephG

    StephG Well-Known Member

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    How has he been today? Still staying around 70? Or did he eventually go up?
     
  62. Sif

    Sif Member

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    I don't' know it was the night here :) . I will test him soon. But for now he seems to be OK. Yes I would like also to know if it did go up.
     
    Last edited: Dec 28, 2016
  63. Sif

    Sif Member

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    Oh I forgot, my husband tested him yesterday :

    At +26 : BG = 75 mg/dl (so exactly the same than at + 21 and after most of his meal (just difficult to say how long after the meal because I gave him in several times so I don't remember).
     
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  64. StephG

    StephG Well-Known Member

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    That is great! Over 24 hours with no insulin and still normal numbers!
    Please update us after his appointment! I'm very curious about what the vet will have to say.
     
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  65. Capoo

    Capoo Member

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    All the family is testing addict now :cat:
     
  66. Sif

    Sif Member

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    @Capoo :joyful::joyful:

    At + 36 : 66 mg/dl.
    He just ate 6 kibbles from his usual food 3 hours before.

    I couldn't test the ketones yesterday so I must succeed today.

    Appointment tomorrow with aaaall the results.

    One advice before I leave for work ?

    Thank you again :rb_icon:

    Edit : I would like to change for a mix of dry and wet food. I will wait for Friday after the appointment.
     
    Last edited: Dec 28, 2016
  67. Critter Mom

    Critter Mom Well-Known Member

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    Hi Sif,

    I am pleased and relieved that your kitty is OK and I'm sorry the two of you had to go through such a scary experience. You did wonderfully well to keep him safe; that wasn't an easy time at all. (((Sif)))

    I'm very tired at the moment and I need to get rest so I might not be able to answer all of your questions today (sorry!).

    Just to make sure I've got this right, my understanding is that your kitty has been tested for ketones and that the results of the tests have always been negative.

    Is this correct?


    Mogs
    .
     
  68. Sif

    Sif Member

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    Thank you so much !

    No problem, have some rest :)

    Yes, correct !
     
  69. Critter Mom

    Critter Mom Well-Known Member

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    Hi Sif,

    That's very good news about the ketones. Thanks for letting me know. :)


    Mogs
    .
     
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  70. Sif

    Sif Member

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    Dec 23, 2016
    At + 49 :p : BG = 72 mg/dl (3 hours after almost all the evening meal).

    Tomorrow, vet hospital, with all the BG, from the BG before the shot to now.
    I will tell you.
     
  71. Sif

    Sif Member

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    @Capoo @StephG @Kris & Teasel : question : I am seriously wondering if I will go to the vet tomorrow.

    Now, after all these events (they let me shot my cat with 2 IU twice a day without testing him during 3 weeks,without telling me what is a good BG for him, and without warning me about hypoglycemia except "if he has hypo, put honey on his mouth") I don't trust them anymore...

    For the check up, what are they going to do ? When they said that he had diabetes (because he is big, he drinks a lot, and he had 372.6 mg/dl of sugar in the blood), they said that for this check up, I will have to bring his food and his insulin. Now, I'm afraid of the fact that he could have a big BG with the stress (my cat is so stressed when he goes to the vet that he pees on himself). And then they would give him insulin. On the contrary, still at home, he will probably keep his normal BG.

    But on the other hand, it could be good to get the fructosamine test ? (I don't know if it's worth it after everything happened). And test something else to know if something else is wrong ?
     
    Last edited: Dec 28, 2016
  72. Kris & Teasel

    Kris & Teasel Well-Known Member

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    They want to keep him there for the day to test BG at intervals. That's why they want you to take the food and insulin with you. There's no need for this and it's an unnecessary expense. I'd also delay the fructosamine test.

    If it was my cat, here's what I would do:
    • cancel the appointment tomorrow and maybe rebook a week from now to discuss your findings
    • test his BG each day at AM and PM before eating and one other time either midday or late evening
    • after a week you'll have more data to talk to the vet about, including proof that your cat probably isn't diabetic
    • keep feeding low carb canned food because it's good for weight loss if he needs that.
     
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  73. Sif

    Sif Member

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    @Kris & Teasel thank you so much. I agree with everything.

    We leave the country for 10 days in one week and a half.
    Our neighbour (cat lover) is going to take care of our kitties but she won't be able to test the BG etc during these 10 days. It means that we have 1 week and a half to keep going on testing him at home. I hope it will be OK.

    With my cat ?

    For the wet food I will begin a slow transition tomorrow :)
     
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  74. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I think you're asking whether you should take your cat to the appointment, correct? Maybe you could just call the vet in a week to talk over the phone about the BG results you have. Your decision.
     
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  75. StephG

    StephG Well-Known Member

    Joined:
    Sep 8, 2016
    I agree with Kris & Teasel!
    The trip to the vet is probably going to spike his blood glucose either way. You can do the curve at home yourself... your spot checks look fantastic so far.
    As long as you get him switched over to a low carb wet food (best for any cat really) I don't think you'll have anything to worry about when you go on your trip. Keep the spot checks going until then and you'll get a good idea of what his usual levels are.
     
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  76. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    I fully agree with @Kris & Teasel !

    At this time, there is really no need to spent money and to stress your cat.

    Usually, a cat is considered to be in remission when his BG are in the normal range for 14 consecutive days (with a human meter, it's between 50 and 80, with some spot checks less than 120).

    Given that you're going to transition him to LC wet food, his BG will continue to decrease (anti jinx).

    I would continue to test until your departure, and if all the BG continue to be in the normal range, just give a call to the vet before leaving. I suppose that all the clinical signs of diabetes have vanished too, right?
     
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  77. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    @
    That's the point : I think that he drinks and pee a lot (and maybe more than when he got insulin ?). At least more than Diego. That's the only thing.

    He still wants to eat a lot but for me that could be a behavior problem. The same for water : maybe the fact to fill himself as I don't give him food. I don't know how to explain...

    Ketones still negative yesterday evening.

    @Kris & Teasel : I corrected the BG that they found at the hospital a week
    and a half ago.
     
  78. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    That can be due to something else than diabetes, and that need to be checked.

    Is it possible that you keep your vet appointment, and just do a complete blood work, but without the BG curve at the vet, just to see what can cause these symptoms?
     
  79. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    I don'the know and I don't know if they are going to understand me...

    Do you have an idea about the other explanations possible ?
     
  80. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    That can be due to renal problems, and a lot of other things. That's why it would be better to check with a complete blood work.
     
  81. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    By the way he didn't loose weight... the vet thought that he lost weight because of the diabetes but it was because we put him on the diet...
     
  82. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    And if you don't trust the diagnosis of your vet, you can post the results here : there are some people experienced in the reading and interpretation of blood work.
     
  83. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    :)
    For that I will have to ask them the blood analysis. Here we don't have the patient's file. Everything is on a computer under our identity number.
     
  84. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
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  85. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    And that would also be interesting to have a urine analysis. Would it be possible for you to collect a urine sample?
     
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  86. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    I'm not sure that my cat drinks more than 300 ml per day. He just drinks more than the other one... that's difficult to say as they are two drinking in the same bowl.
     
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  87. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    @Capoo I don't trust them about the fact that they won't do BG tests. I'might afraid that they could give him insulin because of a high BG due to the stress... and I'm afraid that my cat start again a kind of diabetes because of the huge stress.

    Edit : which quantity of water drinks a cat of 7-8 kg ?
     
  88. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    Are there other vets around you?

    Anyway, you can stay with your cat at the vet (a complete blood work doesn't require a lot of time), and say NO if you see them doing something that you don't want: you're their client.
     
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  89. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    So you were thinking to just do blood tests and not let him all the day at the vet like it was planned ?

    OK I just saw the rest of your reply !
     
  90. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    Yes, exactly.
     
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  91. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    Do you know which quantity of water a cat of 7-8 kg is supposed to drink ?
     
  92. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    If I remember well, a cat eating dry food should drink around 40 ml per kg, that means in your case around 280 ml per day.
    How many times per day does he pee?
     
  93. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    Ok thanks.
    I would say 2 times per day.
     
  94. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    2 times per day is perfectly normal!

    What makes you feel that your cat is peeing / drinking more than usual?
     
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  95. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    Compared to the other one. But maybe that's more than 2
    And now that I'm thinking of it, it is maybe more because I find more than 2 balls of pee in the litter. I don't know. He started to do that when he got bigger.

    Aurélien called the vet : we can come this morning just for a blood test. I will ask for a complete one.
     
  96. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    Perfect, that's always better to know.

    Keep us posted!
     
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  97. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    *** LONG POST ALERT ***

    Hi Sif,

    I've only skimmed through the latest posts but my current understanding is this:

    * Epi is overweight and his food portions need to be controlled or he will eat more. Current vet recommended high carb dry food for weight loss.

    * Current vet diagnosed feline diabetes after Epi was presented with symptoms of excessive drinking and peeing. (Polydipsa/polyuria, aka PU/PD)

    * Current vet did not do a urine test to check for presence of glucose at time of diagnosis.

    * Current vet did a spot check of blood glucose at time of diagnosis.

    * Current vet did not order a fructosamine test and thus diabetes diagnosis was based on blood glucose spot check and possible PU/PD.

    The following comments are based on the assumption that the information above is a correct picture of events up to and including the time of initial feline diabetes diagnosis.

    The vet SHOULD have immediately checked for presence of urine in glucose (a crude diagnostic measure indicative of existence of significant hyperglycaemia - over the renal threshold - in the home setting and therefore not influenced by vet/travel stress.) As a standard diagnostic measure the vet should have performed a fructosamine test to determine whether BG had been at diabetic levels over the previous fortnight.

    A single BG spot check is NOT sufficient information upon which to base a diagnosis of FD. Without urine and fructosamine testing at time of diagnosis if your vet then went on to prescribe insulin then the vet made a serious, potentially life-threatening treatment recommendation.

    Blood glucose levels may be influenced by a non-FD disease process in the body (e.g. infection).

    PU/PD can be a symptom of several conditions, so your vet was wrong not to order further tests upon which to base a differential diagnosis including comprehensive blood and urine testing, and possibly advanced diagnostic procedures, e.g. ultrasound. The blood and urine tests would also have given an indication of whether any other problems existed, e.g. inflammation or infection. (I cannot see any mention of your vet having ordered any blood tests so I am assuming that none were carried out.)

    The vet should also have assessed your cat's behaviours and carried out a comprehensive physical examination to identify other clinical signs to aid differential diagnosis (e.g: pot-bellied appearance; unexplained and unexpected weight loss; poor coat condition, etc.).

    Here is an article by a world-leading feline endocrinologist, Dr. Mark Peterson, listing conditions in felines commonly associated with PU/PD:

    http://www.endocrinevet.info/2011/01/diagnostic-approach-to-pupd-urine.html

    From the above article:

    Cats
    • Chronic renal failure
    • Diabetes mellitus
    • Hyperthyroidism
    • Hypercalcaemia
    • Pyelonephritis
    • Hypokalaemia
    • Acromegaly
    • Postobstructive diuresis
    • Hyperadrenocorticism
    • Hypoadrenocorticism
    • Diabetes insipidus

    This second article provides a good overview of what you should expect in terms of assessment and diagnostic best practice from a competent vet:

    https://petdoctormom.wordpress.com/2011/03/01/polyuria-and-polydipsia/


    Yes. I recommend doing this at another - more competent - vets. Also urine testing.

    It appears that now your cat is running in normal BG ranges. If a glucose curve is needed you can do this at home with your own home BG testing kit. Apart from sparing yourself unnecessary vet bills the data you gather at home will not be influenced by vet/travel stress and will therefore give a more accurate picture of Epi's day-to-day blood glucose levels in his normal unstressed home environment.

    I would not take my cat back to this current vet for diagnostics, and most certainly not for any advice on diabetes. Knowledge of FD appears to be extremely limited, and response to a possible serious hypo event was pitifully inadequate to the point of putting the cat's life at risk. Food advice appears to be based on promotional literature from major pet food companies and not on scientific principles.

    ---------------------------------------------------------------------------------------------------
    Has there been any change in water consumption and pee volume:

    - While Epi was receiving insulin.

    - Since you have stopped giving insulin.

    I recommend you monitor water consumption for the next while to help you assess whether there is actually any excessive water consumption. (Measure the amount you put out for both cats each day, then measure how much is left after 24 hours. It's easier to do this if you use ONE big bowl which can contain enough water for both cats for 24 hours. It may be necessary to confine both cats to the house during the monitoring period so you can exclude access to alternate water sources outside the home. You will also need to record how much wet food is given to the cats so that you can add the moisture from this into your calculations.)

    Also if your cat runs in normal BG numbers for 14 days (as Sophie advises above) then Epi is either a diabetic in remission - or he may not be diabetic at all (further diagnostics recommended).


    Mogs
    .
     
    Last edited: Dec 29, 2016
  98. Marlena

    Marlena Well-Known Member

    Joined:
    Nov 25, 2015
    Sif, my advice to you is to be really CLEAR with whoever will look after your cat that they don't overfeed him and really make that transition to wet LOW carb food as soon as possible. Otherwise you risk getting your beloved puss into diabetic state again with all stress it brings.
    Good luck.
    Marlena
     
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  99. MiCo

    MiCo Member

    Joined:
    Oct 29, 2016
    YOU are paying for the bloodwork, they should give you a copy. I used to be afraid to ask for this, but it was simple-and the vet just emailed me the file/results from the lab. I entered the #s into my cats spreadsheet, and will track.
     
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  100. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    Hi again everybody ! And thank you.

    @Critter Mom : the picture is correct except that they did test the urine at the time of the diagnosis, so it had sugar in the urine. What does that mean for you ?

    This morning I had to show my precious BG. From the one before the shot (first that I succeeded) to the one this morning. With also all the details about the conditions (food or not, honey etc) and the name of the glucometer (they have the same).

    She took the time to look at it alone. Then she came and said . "It was a type 3, temporary diabetes. He doesn't need insulin anymore, the BG is good. Keep going on the diabetic food (hum... she doesn't know that I kept the old one with less carb than hers, and just dropped the quantity of 3 gr) and test him once a week".

    Then I talked about the polyura-polydispsia, and I asked for a complete blood test to check if it could be from somewhere else. She agreed. I also asl for the fructosamine even if it could be skewed by the last week... but I wanted to it while my cat endured the stress to come here (he was in the car at this moment). She asked for all the tests matching with the symptoms of polyura-polydispsia.

    She will send me the results by mail. For the fructosamin, it takes 3 weeks, goes abroad etc,

    NOW : monitoring + transition to wet low carb food. Check the water, ok.
    Then we will see for another vet, yes.
    That's the problem here, there is no school to become a vet, they have to go abroad to study. Now, imagine the docs that we have here... that's terrible.

    Yes, I was afraid of that... that's also why I didn't want to let him all the day in this hell. And I had to argue to avoid it this morning :mad: Thank you to my glucometer and all the BG that I collected.....

    Again thank you for helping me, this is precious.
    Please ask me if I'm not clear, my English sucks.
     
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