Question about Pancreatitis and Diabetes and one about proper amount of insulin to give

Discussion in 'Feline Health - (The Main Forum)' started by Kerri2455, May 9, 2019.

  1. Kerri2455

    Kerri2455 Member

    Joined:
    Dec 26, 2017
    Hi everyone
    Oliver was recently diagnosed with Pancreatitis. His ultrasound showed an enlarged or inflamed pancreas but the blood test was not done (YET). I am curious as to how these two affect one another and if its best to have him eat and not worry about low carb food or if its best to keep him on low carb food even if it means he may not eat quiet as well.
    He had a small stroke last Friday which is how we ended up finding out he has pancreatitis and to top it off a tumor on his colon (could be in his colon). We go tomorrow for a cat scan and possible biopsy/aspiration. So we have had a big health scare and he has not been well all week. He is on pain meds and eating just ok but nothing near what he normally would eat. So i am curious if treating one is better than the other or if both go hand in hand?

    Also wondering about dosing his insulin. The ER vet said 3 units was a high dose of insulin for a cat. My vet had told me based on the numbers, mid to high 300's to give the 3 units. He's been between 330-360 the past few evenings- but we didn't want to give 3 units so have done 1 and 1/2. Is there a chart to tell you how many units based on his glucose reading?

    THANK YOU ALL, appreciate any info you can provide on either subject.

    Kerri and Oliver
     
  2. Teresa & Buddy

    Teresa & Buddy Well-Known Member

    Joined:
    Jan 2, 2017
    I am sorry to hear that you and kitty are having so many health scares lately. My cat Buddy has had chronic pancreatitis for several years, 1 of his vets saw an inflamed pancreatitis so he took out part of Buddy's pancreatitis. For me I want to keep Buddy eating because of his insulin, if you feed food that is not low carb kitty will need more insulin. At this time I am not feeding low carb wet, but he is eating low carb dry food. When having a pancreatitis flare Buddy's BG numbers go up.

    When starting insulin you should start on a low dose, please read the sticky's about getting started.

    I hope that Oliver is getting better and his health starts to improve. Please, post on what you find out about Oliver and how he is doing. Take care of your self too.
     
  3. Kerri2455

    Kerri2455 Member

    Joined:
    Dec 26, 2017
    Thank you Teresa. I was supposed to go for a cat scan today to see what kind of tumor we are dealing with but Oliver ended up jumping up on the vanity in the bathroom to help himself to food, which he hadn't done in over a week so I was happy he did that but didn't expect it so didn't put the food away. I was going to test his blood to see if he truly has pancreatitis.
    How do you know when they have a flare up?

    I do feed low carb dry and canned pate style food but this past week to get him to eat I broke out the cans of friskies i use for the ferals. He loved it even though I know its not great food for him to have. He's eating now so i guess my concern isn't him eating and he seems to be ok with the food we have been using.

    We are going to see a vet Monday that does eastern medicine as well as western and i may try some laser treatments to see if that helps his pancreatitis.

    Will keep you posted. I appreciate the response, thanks so much!

    Kerri
     
  4. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    When cats have a flare up of pancreatitis they usually lose their appetite, hunch up, sometimes vomit or have diarrhoea and are dehydrated. Here is a link to pancreatitis and treatments.
    http://www.felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.83108/

    With the insulin dose you should have started on 1 unit and gradually gone up in 1/4 unit increments depending on the nadir or lowest point of the cycle. Are you home testing the blood sugars. If not I would recommmend you think about startimg to do that. That is the biggest thing you can do to help your Kitty at this stage.
    We do not recommend you give a certain amount of insulin if the blood sugar level is in a certain range. Every cat is different and reacts to insulin differently so if you test you will see how your cat reacts to it daily not only everyso often at the vets,where they usually run high anyway.
    If I were you I would go out and buy a human glucose meter and start testing the BSLs.....we can help you And I would setup a spreadsheet.. here is the link. Keep asking questions
    http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

    I hope the scan is clear of any real issues.
    I have never heard of laser treatments helping pancreatitis. He needs pain meds, rehydration, anti nausea meds to support him until the flare subsides..
     
  5. Kerri2455

    Kerri2455 Member

    Joined:
    Dec 26, 2017
    Thanks Bron! I do test at home but don't do it every day. He was pretty consistently between 337-368 for three days straight to which i was giving him 1 1/2 units. There was no really big swing in numbers between AM and PM testing these days. I just wasn't sure if the unit and a half was enough as my vet had told me to give 3 units for numbers this high but the ER vet said 3 units is a really high dose.

    For pancreatitis i did get pain meds which helped immensely. I only gave him twice and he now seems to be so much better. I just wasn't sure what to watch for as far as flareups go so thank you for the link, I will print and keep handy.

    The laser treatment is supposedly to help with inflammation but i don't know if it will help with pancreatitis and in no way will it replace the pain meds/food/water therapy. I just thought in addition to it might offer some relief. I also have Mirtazapine and cerenia that i can use too.

    Appreciate the help!

    Kerri
     
  6. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    I've not heard of using laser before so be careful.
    I am glad he is feeling better.
    Are you testing during the cycle to see how low the insulin is taking the blood sugars?
     
  7. Kerri2455

    Kerri2455 Member

    Joined:
    Dec 26, 2017
    I don't know that the laser will help, i have questions to ask but i read it helps with inflammation so thought it might help his pancreatitis. I know it wont help his diabetes.

    As for the testing, we had been testing before meals and then yesterday we tested before dinner and he was 221. He ate and we went to dinner. We didn't give him insulin as our ER vet said at that number he doesn't need any. I decided to test when we got back home from dinner a few hours later and he was at 397 and so he got a unit and a half of insulin. I did not test after that.

    So i don't know if that answers the question about how the low insulin is taking the blood sugars but its the most recent numbers I have. He's been pretty consistently in the mid to high 300's to which we give a unit and a half. I don't know if that's enough or not but worry he may be getting too much insulin and if we are gone all day working I don't want him to crash and us not be there.
     
  8. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Kerri,
    Would it be possible for you to set up our spreadsheet and add the BSLs you already have? We really can't help much with dosing unless we can see numbers in the SS. And it will help you tremendously as well to ,see how things are going. Here is the link. If you have any trouble let me know and we can help you set it up.
    http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

    Your ER vet is incorrect. Cats need insulin if their numbers are over 120 on a human meter and 150 on an Alphatrak meter. Can you put what type of meter you are using in your signature please as it makes a difference us when we are helping you.? Thanks.

    There are a couple of things......
    Lantus needs consistent dosing and at the same time 12 hours apart. If you are finding you can't give the dose because the BSL is too low than you may need to reduce the dose by 1/4 unit and give that dose consistently.
    We recommmend newbies don't dose under 200 in the beginning, but start collecting data, so we can see how your kitty enacts to the insulin. Then gradually you can start to reduce the 'no dose' number. If you find the BSl under 200, stall, don't feed and ask for help
    Areyou getting tests in during the cycle? Because it is important to see how low the insulin is taking kitty. BSLs can start off in the 400s and drop into the 50s then back up to the 400s by the time of the next dose of insulin,and unless you are testing you will not know. We change the dose on the nadir (lowest point) in the cycle, not the preshot. And we only go up and down by 1/4 unit each time.
    Areyou able to get any mid cycle tests in during the day or night? We also recommend getting a before bed test in to see kitty is safe as cats often drop lower at night.

    How often are you feeding during the cycles. Kitty needs a good feed before the insulin, but manyof us also give some food a few hours later maybe at +2 and +4. If you work,you might like to think about an autofeeder.
    Keep asking questions. It is hard in the beginning but you will soon have it all sorted out and it will become routine.
    It is great you are testing the BSLs
     
  9. Kerri2455

    Kerri2455 Member

    Joined:
    Dec 26, 2017
    Hi
    Wow, i do appreciate all the good info. Oliver has been diabetic a year and a half in December and I had kept a journal of his insulin levels when we started off with him being diabetic. Its just the past week we tested regularly due to his pancreatitis attack or could be his stroke I am not sure which happened but he exhibited signs of a stroke but then i read his panting and walking in circles could be the pancreatitis. So much to learn!

    I do work every day but Sat and Sun 8-5 so its near impossible to get a good read during the work day but we could play with the numbers on a weekend with more time.

    Good to know that i need to give insulin even if 150 as we do use the Alphatrak meter. We try to get him 12 hrs apart but sometimes based on our schedule its an hour before or after and at times two but i try to never give sooner and opt to give later if we have that option.
    He is a good eater and has wet food AM and PM and we leave low carb dry out for him during the day. I have 5 other cats too so everyone eats wet in the AM but two and so i do have to have dry for them. Its kind of crazy to meet everyone's needs but I am trying. Oliver is my concern now.

    Ill test him before we feed tonight to see where he's at. he got his insulin at 7 today, 1 1/2 units so ill see what his level is before feeding and after tonight and see what happens.

    THANKS for the guidance! Appreciate it greatly!

    Kerri
     
  10. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    On the Alphatrak 68 to 150 are normal numbers. When you have time pop the Alphatrak info in your signature.
    Don't change the dose of insulin until you have got some midcycle tests in over the weekend unless Oliver drops low.
    Seeing you are using alphatrack meter don't dose under 230 in the beginning until you get more data.
    Looking forward to seeing the SS when you have time to set it up.:)
    Bron
     
    Teresa & Buddy likes this.
  11. Teresa & Buddy

    Teresa & Buddy Well-Known Member

    Joined:
    Jan 2, 2017
    Glad to see you are getting a lot of useful information. Sorry, I have not been on line for several days and I am just now reading past your first post. My cat Buddy has chronic pancreatitis and this has been seen with an open surgery, plus many PSL (can't remember if this is the whole name. Most of the time when Buddy has a flare (which seems to be most of the time anymore) I will notice his bowels getting loose and he doesn't have much of any appetite. He does not have a drastic appearance of being sick, but if he does not receive his medicine he will get worse. I have seen cats with acute pancreatitis that look as though they will not make it through the night. If a vet is testing for pancreatitis, they should use a test specifically for a cat.

    Hope your kitty is doing well and does not have pancreatitis or any other health issues.
     
  12. Kerri2455

    Kerri2455 Member

    Joined:
    Dec 26, 2017
    Hi there
    So today we were at the vet and did the blood work to test with the PSL so i will have results soon. I did give him a unit and a half after dinner earlier this week and tested and his BG was 165 so i do think the 1.5 units is working. He seems happy and eats and uses his box so I think we are doing well now. I just pray that continues!

    Eagerly awaiting his test results and will monitor his appetite and outputs!

    Thank you for all the guidance! I hope your kitty continues to do well with the meds and no more flare ups!
     
    CandyH and Catcat likes this.
  13. Teresa & Buddy

    Teresa & Buddy Well-Known Member

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    Jan 2, 2017
    Glad your kitty is doing well, hope you get good results from the PSL.
     
  14. Kerri2455

    Kerri2455 Member

    Joined:
    Dec 26, 2017
    Thank you! I am going to call the vet shortly to find out if results are in.
     

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