PMPS of 70 but full dose of Caninsulin injected

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

  1. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Your English is excellent, Sif! (Much better than that of many native speakers I've encountered in my life. ;) )

    A quick question: when the vet gave you insulin for Epi did she advise you to home test BG levels?

    (ETA - Blood? Urine? Both? Neither?)


    Mogs
    .
     
  2. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    Thank you :oops:

    Talk about the testing :
    No she didn't !! I discover the fact that we can test our babies at home because I discovered Dr Lisa Pierson and then this forum !

    Did you see somewhere in the topic that Epi had gingivitis at the moment of the diagnosis ? That's Sophie who made me notice it.
    The gingivitis hasn't been treated with medication but it's probably over because they remove the tartar from the teeth.
     
  3. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    Nothing.

    I also bought the ketones/sugar strips by myself. (By the way still negative yesterday before the night)
     
  4. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Sif, your English does not "suck" at all. You have communicated with all of us very well under stressful conditions. I'm glad that you were able to get all this sorted out with the vet today even if it meant arguing with her. You now have a plan going forward.

    Regarding the weight loss: do you have a scale at home that you can use to weigh your kitty? A complete changeover to low carb wet food given at scheduled times in specific amounts is the way to help with weight loss. Is your other kitty heavy too? Can you train them to eat in separate rooms on the same schedule? Canned low carb food is best for all kitties.

    Teasel's brother was overweight at his last checkup and I switched him to the same low carb food that Teasel gets about 6 months ago and it's worked very well. He's a large cat and has lost almost a kilogram.
     
    MiCo and Sif like this.
  5. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    So no fructosamine assay, a significant starting dose of insulin; no instructions on monitoring for safety at home; and a request to bring your cat back for a check in three weeks. Three weeks!!!.

    Very poor. Very dangerous.

    Thank the gods that you chose to home test BG, Sif: you very likely saved your cat's life.

    ((((((((Sif))))))))


    Mogs
    .
     
    MiCo and Sif like this.
  6. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    Do you know when?
     
  7. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    :)

    I just got a baby scale today (Salter) !
    Ok for the wet food, for both of them.
    The other one is just normal. They are trained to eat at their respective places (otherwise Epi would steal Diego and the first would begin bigger while the other one could starve to death...).

    So nice for your kitty ! Encouraging. Did you do it progressively ? If yes could tell me how you did the transition please ? I know that I must do it slowly, otherwise, big stomach problems. And I heard about "hepatic lipidosis", did you also ?

    Yeeees, now that I learned so much with you, I can say that I agree, totally...
    And yes, in a way, I have been "lucky" :)

    For the results of the blood test (a new worry for us...) she was supposed to send it to me today except for the fructosamine. I had no time to call her today, so I will call her tomorrow if she doesn't send it.

    (Evening BG : 64 mg/dl :cat:)
     
  8. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    All I did was exchange the one can of higher carb wet food per day that he was eating with one can of low carb wet food like I feed Teasel for his diabetes. The cans are the same size, about 5.5 - 6.0 oz. but the low carb food is lower in calories. They all get three meals a day with nothing in between and are fed in separate rooms. I began feeding the diabetes food at the beginning of July 2016 and now 6 months later Teasel's brother is almost a kilogram less in weight (from 7.6 kg to about 6.7 kg). That's all I did for feeding. I have a baby scale for weighing Teasel and his brother every few weeks. Now that his brother's weight is good, I give him a little bit more food at his mid day meal.

    Yes, I know all about hepatic lipidosis. I lost a kitty to that many years ago.
     
  9. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    (((Kris)))

    Same here. I'm so sorry for your loss. :(

    .
     
    Kris & Teasel likes this.
  10. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    Bonjour @Sif ,

    Do you have any news?
     
  11. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Here is a very helpful article for you, Sif:

    http://www.dentistryiq.com/articles...litus-a-review-and-clinical-implications.html

    From the article:

    Current evidence suggests that insulin resistance may be a major shared metabolic abnormality linking the interaction of periodontal disease and type 2 DM. As insulin resistance in type 1 patients is less prominent, this relationship may be most significant for type 2 patients. A model is proposed by which chronic inflammation resulting from periodontal disease may contribute to increased insulin resistance in type 2 DM, thus worsening glycemic control. Subsequently, a reduction in periodontal inflammation through treatment may possibly result in enhanced insulin sensitivity and better glycemic control.​

    [Emphasis mine]

    Could explain a lot.

    A lot of diabetic cats have problems with infection and gingivitis needs to be dealt with. Often BG numbers improve after cats have had dentals.

    Theoretically Epi may have been prediabetic and some oral inflammation might have been enough to tip him over the edge. The dental cleaning may have been enough to send him into remission.


    Mogs
    .
     
    Last edited: Dec 30, 2016
  12. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    Yes that's good to have one baby scale: Apparently this is not good for them to loose weight more than 1-2% of their current weight (Dr Lisa Pierson).

    .........................

    Oh, my ! It is possible, yes. Thank you !

    EDIT : I just got them by email, without any explanation... I will send it to you when I will be at home.
     
    Last edited: Dec 30, 2016
  13. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    Here we go.... Please let me know if you understand something, I'm worried about some results...'
    The vet was "to busy" to give me explanations.
     

    Attached Files:

  14. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    The high HCT, RBC and Reticulate are likely due to the cat being dehydrated.
    Did the vet say anything about being dehydrated?
    Also, do you have the value for Total Protein (TP)?
     
  15. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
  16. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    In cats the platelets tend to clump together and that results in low counts when the platelets are machine counted.s
    Since your results say >137 it sounds like they were clumped
     
    Critter Mom and Capoo like this.
  17. CassAndGordy

    CassAndGordy Well-Known Member

    Joined:
    Sep 23, 2016
    Oh Sif, please tell us after you get back from your trip, you'll be able to find a new Vet. I, personally, feel like it would be in your pets best interest regardless of any illness. He doesn't seem to be very concerned with their wellbeing :(
     
    Sif, Red & Rover (GA) and Capoo like this.
  18. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    No and no...

    Could you explain this to me please ?

    The vet called me and mailed me : she said that there is nothing to worry about. "His blood results came out fine, there are small deviations that have no consequence and therefore we shouldn´t be worried about them".

    Yes I will. Yes.
     
  19. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Some more links for you to read:

    http://www.wisegeekhealth.com/what-is-type-3-diabetes.htm

    http://petdiabetes.wikia.com/wiki/Transient_diabetes


    Mogs
    .
     
    Sif likes this.
  20. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    Am I blind or did this vet test nothing linked to renal function?
     
  21. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Do you mean per month? Many cats must lose more than this if they are severely over weight. My cat's total loss works out to be a little under 2% per month since I started him on his reduction diet. He's now on maintenance so I give a little extra food at mid day.
     
    Last edited: Dec 30, 2016
    Sif likes this.
  22. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    By week sorry I forgot.

    Dr Pierson says : Please pay close attention to the a"rea around your cat’s backbone and the back of his head. Establish a baseline ‘feel’ for this top line area before you start his weight loss program. If these areas become excessively prominent, this is a sign of muscle mass loss which can be an indication of protein malnutrition.The key is to go slowly with a goal of no more than 1-2% weight loss per week." in this article : http://catinfo.org/feline-obesity-an-epidemic-of-fat-cats/#Consider_Calories,_Not_Just_Ounces_
     
    Critter Mom and Kris & Teasel like this.
  23. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    What is supposed to be tested for that ?
    She read in a vet book what to test in case of polyurie polydipsie.
     
  24. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    I thought that BUN (urea) and / or creatinine would have been tested.

    But I prefer to let the experts (@Larry and Kitties , @Critter Mom ) express their opinion on the subject.
     
    Sif likes this.
  25. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    @Capoo -

    Larry's the one for lab test interpretation, Sophie. Unfortunately my understanding of them is limited.


    Mogs
    .
     
    Capoo likes this.
  26. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    When checking kidney function, yes.

    There is very good information on lab tests at Tanya's Site:

    What do all those test results mean?


    Mogs
    .
     
    Sif and Capoo like this.
  27. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    I just sent an email to my vet in France to tell him everything, send him the blood test results, and ask for his help.
    I trust him.
     
    Critter Mom likes this.
  28. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    That's a really good idea!
     
    Critter Mom and Sif like this.
  29. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    The results you reported are for a machine count (LaserCyte machine) of the blood constituents (white blood cells, red blood cels and platelets). If there is clumping of platelets, which is not abnormal normal in cats, the platelet count read by machines will be low. If I look at the bottom of your second image attachment there are words "aggregates detected" which could mean platelet clumping

    The attached images are only for the LaserCyte machine. Blood chemistry is determined by a different machine.
     
    Sif and Critter Mom like this.
  30. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    Please keep us posted when you get a feedback!
     
    Critter Mom likes this.
  31. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    Hi :)
    Summary of the reply of my precious vet in France :
    - no diabetes, just the stress
    - maybe drinks more because he is bigger but :
    - Test the creatinine and ALT or GPT in case of (sorry I don't know if it is written like this in all the world), urea testing
    - Food : give proteins, no fiber, no sugar
    - Change our vet (the oldest are less "marketing" also)
    - We pay so we decide what we want

    Same advices as yours !!!

    I will do everything as said above.

    Do you know how long I can keep the pee, the conditions etc before bringing it to a lab ?
    And can I do it without a vet (just to spare time before I leave for France) ?
    EDIT : about the blood test already done, apparently I made a mistake : we will get more results later (as understood my husband, but he is not sure) so maybe the biochemistry (ALT, GPT, urea etc)...I will call her on monday.

    Thank you and all my greetings and wishes of hapiness (and health) for you and your cat(s) :bighug:
     
    Last edited: Dec 31, 2016
    Capoo, Kris & Teasel and Critter Mom like this.
  32. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    Hi,

    As far as I know (I hope that @Larry and Kitties will correct me if I'm wrong), creatinine, and ALT or GPT are tested from a blood sample, not from an urine sample, so you cannot do it yourself.
    For the test of urine : last time, my vet sold me a special litter made to collect urine (brand Catrine). He told me to bring him the urine sample less than one hour after having it collected.

    Your French vet seems to be very nice, and continues to care for you even if you live now in another country : congratulations!
     
    Last edited: Jan 1, 2017
    Kris & Teasel and Sif like this.
  33. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    This!

    .
     
    Kris & Teasel, Sif and Capoo like this.
  34. CassAndGordy

    CassAndGordy Well-Known Member

    Joined:
    Sep 23, 2016
    I've been told 12-24 hours (by different vets), but it'll need to be refrigerated. Obviously, the quickest you drop it off the better.

    Your vet in France sounds very nice!
     
    Kris & Teasel, Sif and Critter Mom like this.
  35. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    It depends upon the tests/attributes being measured.
    Not over two days and less than 24 hours is desired. The sample should be refrigerated.
     
    Critter Mom and Sif like this.
  36. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    Hi @Sif ,

    Any news from your vet?
     
  37. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    @Capoo
    Hi :)
    We are waiting for the results of sodium, potassium, total protein, albumin, globulin, A:G ratio, urea, creatinine, glucose, ALP, ALT, bile acids, cholesterol, triglycerides and fructosamine.
    It takes time because they sent it abroad.
     
    Critter Mom and Capoo like this.
  38. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    @Capoo @Critter Mom @Larry and Kitties @Kris & Teasel
    Hi,
    Here is the reply of the vet regarding the blood test : (Epi hadn't ate since 11:30 pm the day before and the blood test was in the morning after)

    Her comment =
    "All the values analysed in this test are within normal limits except cholesterol and triglycerides. which could be a postprandial effect. It is recommended that patients fast for 12 hours before these 2 values are measured.

    Do you remember when was the last time he ate before the blood sample was taken at the hospital?

    If he had been fasting, there is a reason to once again analyse his diet. If he had had breakfast that morning, the results are of no consequence.


    I think the course of action now should be the one that we discussed the last time we met, measure his glucose once in a while (every 2 to 3 weeks seems reasonable) to check whether his values are within normal limits.

    Please find attached Epi´s results in this e-mail along with a file with information about obesity in cats and some recommended management strategies."

    Lab report =
    "
    FINN Pathologists
    www.finnpathologists.co.uk FINN Pathologists
    One Eyed Lane, Weybread, Diss, Norfolk IP21 5TT.
    Tel: +44 (0)1379 854180
    Fax: +44 (0)1379 852424
    E-mail: email@finnpathologists.com

    START OF REPORT
    Patient: GERBORE Epi
    Access Number: 17010761049 Dyraspitalinn i Vididal (ICL)
    ID: . Vatnsveituvegur 4
    ASG: 7 Years | Cat (Feline - Domestic) (Domestic Short Hair) | MaleNeutered 110
    REYKJAVIK
    Report Date: 07/01/2017 ICELAND
    Date Sample Received: 07/01/2017 .
    Test Results

    (POLYFE) Polydipsia Profile
    Sodium 151 mmol/l 140 - 157
    Potassium 4.4 mmol/L 3.4 - 5.6
    Chloride 120 mmol/L 111 - 129
    Sodium : Potassium 34.32 26.00 - 40.00
    T Protein 74 g/l 56 - 81
    Albumin 35 g/l 26 - 42
    Globulin 39 g/L 15 - 57
    A:G Ratio 0.9 0.6 - 1.4
    Urea 9.5 mmol/l 6.1 - 12.5
    Creatinine 127 umol/L 45 - 170
    Calcium 2.5 mmol/l 1.6 - 3.0
    Cholesterol H 10.9 mmol/L 0.9 - 6.5
    ALT 33 u/l@37C 18 - 77
    ALP 37 u/l@37C 11 - 67
    Bile Acids 3 umol/L 0 - 15
    Triglycerides H 1.44 mmol/L 0.20 - 1.30
    Glucose 7.1 mmol/L 3.8 - 7.6
    Fructosamine 283 umol/L


    GENERAL COMMENT FOR CATS NOT UNDER TREATMENT FOR DIABETES MELLITUS
    221 - 341 : Within the quoted reference range. Very recent development of diabetes mellitus should not be ruled out however.
    Greater than 341 : Consistent with continuing hyperglycaemia and with diabetes mellitus if in agreement with clinical signs.
    GENERAL COMMENT FOR CATS UNDER TREATMENT FOR DIABETES MELLITUS
    Less than 350 : care that the cat is not experiencing periods of hypoglycaemia, a glucose curve may be advisable.
    350 - 450 : Consistent with good recent hyperglycaemia control.
    451 - 600 : Consistent with fair recent hyperglycaemia control.
    Greater than 600 : Consistent with poor recent hyperglycaemia control.
    Fructosamine is the common name for glycated-protein complexes which produces in the blood when hyperglycaemia is present. The amount of fructosamine present is proportional to the blood glucose concentration over the life span of the protein (1 to 2 weeks). Values are dependant on levels of albumin and rates of protein turnover. Cats with severely depressed albumin levels and hyperthyroidism may have artefactually depressed fructosamine levels. Following the diagnosis of diabetes, samples should be taken initially every 2 to 3 weeks to confirm the establishment of good control. Stable diabetics should be checked 3 times per year.

    Comment
    Glucose comments
    Occasionally serum left in contact with red cells may artefactually alter the glucose measurement.
    Spun gel/serum separation should be performed within half an hour of taking the sample.

    Laboratory List Price #42.15
    END OF REPORT"






    ___________________________________________________________________________
    Epi Gerbore Page 1 of 2 Reference Number: 17010761049
     
  39. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    Hi @Sif ,

    I hope that you're doing well.

    Unfortunately, I'm not able to judge the results of this last analysis.

    It would maybe be good to ask to your previous vet in France what he thinks about these results.
     
    Critter Mom and Sif like this.
  40. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    I find nothing revealing int the reported test results.
     
    Sif likes this.
  41. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    Except triglycerides and cholesterol (high) ?
     
  42. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    I am not concerned at all about those two values being high. They are high for most of my cats. Part of it may be due to feeding a high-carb diet since that means the food has higher fat and or protein content
     
  43. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Low carb diet? (Just checking to make I've got it right myself, Larry! :confused:)


    Mogs
    .
     
  44. Sif

    Sif Member

    Joined:
    Dec 23, 2016
    @Capoo @Critter Mom @Larry and Kitties @Kris & Teasel
    @StephG

    Here is the diagnosis from my fabulous vet in France :

    - The high cholesterol and triglycerides are just a consequence of the obesity. They will be lower with a diet (I will ask again for blood tests when he will have lost weight) : that's what we began to do : diet.

    - Food has to be high in proteins : again, a cat doesn't need to eat cereals (which provide sugar...). (By the way, never trust all the big brands from the majority of the vets like RC, Virbac or Hill's).

    - The loss of weight must happen very very very slowly to avoid troubles like hepatic lipidos.

    - Epi is (very) probably NOT diabetic, but I should test the BG sometimes (and for now everything is ok) :)

    What do you think of that ?

    Again, huge thanks for your precious help. Especially in that terrible night of hypoglycemia... if you wouldn't have been there..........

    I will give you some news of Epi when I will be sure at 100% that everything is ok. I am making a file with all the informations and what happened for the next Icelandic vet.
     

    Attached Files:

    Last edited: Jan 20, 2017
  45. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    What a cute kitty you have! Good news that Epi might not be diabetic. :)
     
    Sif likes this.
  46. StephG

    StephG Well-Known Member

    Joined:
    Sep 8, 2016
    Oh my gosh! He's so handsome! That is great news that he might not be diabetic. I'm a bit jealous I must say! Your vet sounds great! I wish you the best and hope he remains in control of his own body! I too have a fat cat (not diabetic)-- much fatter than your baby! He's on his way back to a healthy weight and it is a very slow journey.
     
    Kris & Teasel and Sif like this.
  47. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Those are great results. No renal disease and not diabetic! Congrats!
     
    Sif likes this.
  48. Capoo

    Capoo Member

    Joined:
    Jan 15, 2016
    Fantastic news!:bighug::bighug::bighug:
     
    Sif likes this.

Share This Page