? Remission Questions

Hi All,

First off - this site is great. It's been a wealth of info during a hard and confusing time for us. Thanks for all you do.

A little background - My cat, Matilda, was hospitalized on 11/24 with DKA and pancreatitis. Once she was stabilized we were sent home with 1u twice daily of Lantus and a switch to all wet food - Fancy Feast pate. She has actually done very well since coming home despite her very scary and expensive initial situation. The vet suspects the oral steroid she was put on for her asthma in October is what caused the diabetes, and because the steroid masked the signs of the diabetes I didn't notice it until she was in crisis, unfortunately. She's on inhaled steroids for asthma now.

Cut to 2 weeks later, I took Matilda to the vet for a glucose curve on 12/12 and the vet said her numbers stayed under 120 the entire time and recommended taking her off the insulin as she suspected she was in remission. The whole thing - not checking her bg at all before I started, pulling all insulin at once - is probably something I wouldn't do again after reading these forums, but she seems to have done ok.

After doing more research I decided I wanted to monitor her bg at home. I picked up a cheap Walgreens monitor (True Metrix I think?) which I have just replaced with a Relion one after reading that the True Metrix was unreliable. On the True Metrix her numbers were in the 50-60 range which I was happy with, but on the Relion I just tested it was 80. She had already eaten some that morning. I know it's hard to tell from that small set of numbers, but does it seem like she's creeping back up and out of remission or would you be you be happy with that number OTJ and ignore the True Metrix readings? I'm also worried that I might be seeing a slight increase in thirst and urination, but I could very well just be paranoid. It's definitely not as bad as before she was hospitalized if there is an increase. My vet really stressed this as a sign to be worried about but maybe just because I wasn't testing bg at home.

My other question is basically where do we go from here? If she does stay in remission, how often should I be testing her bg? Especially if the diabetes was steroid induced to begin with? I'm feeling a bit overwhelmed and I want to make sure I'm doing my best for Matilda as well as taking care of myself and not over worrying myself.

Thanks so much!

 

The BG values from both meters indicate that no insulinis required. The allowable errorin the hand-help metermis +/- % so the difference does not really indicate anything, that is not not indicate any creeping.

 

Great news she is in remission. It is possible that that the change in food and the short stint on Lantus helped to bring her into normal numbers quickly, especially if the steroids caused the diabetes, then sounds like she may have only been diabetic for a month or so before diagnosis?

Hoping some people with remission experience will offer you some advice on how often to test based on her history.

Just my 2 cents, FWIW. Would think initially once or twice a week testing would be smart especially since she is still on steroids, albeit inhaled. Testing after not eating for several hours will give the most accurate number. Use the same meter as long as you know it is accurate. Absolutely keep her on the low carb food as long as other health problems permit, this will help keep her numbers in a good range. Watching how much water intake and urination is also smart. I noticed a difference in my cats urination amount and started keeping track by cleaning litter box every day at the same time and counting the number of clumps in each 24 hour period. It used to be consistently 5-6 large clumps in 24 hours, when her sugar improved some on low carb diet, it was consistently 3-4 smaller size clumps in 24 hour period. After tracking this for a week or so, could definitely see a pattern. Each cat is different of course, but just looking for a change in what is normal for your cat will help you quickly take action if things start to head in the wrong direction.

Hoping this remission lasts and she is doing well for a long time

 

Good news! You might find some useful discussion threads on this forum: http://www.felinediabetes.com/FDMB/forums/honeymooners-otj.13/
(OTJ = off the juice, ie., in remission)

 

When Truffles went in to remission I was too scared to stop testing! Lol. I just gradually reduced the testing. So once a day for a few weeks then once every other day etc etc.

 

Similar thing happened with my Scout - she was fat and likely T2 diabetic, then she had steroids and her BG went into the black. Once I got her regulated and onto low carb wet food, she quickly returned to normal levels. Her BG never went high again, in 7 years!

I'd gradually decrease the frequency of the tests as long as the numbers stay low.

I'd suggest you also get in the habit now of checking for increased thirst and urination, because eventually you'll run out of test strips or they'll expire and you might not keep up with the occasional tests.

Easy way to do this: if you scoop litter at the same time each day, or at a regular interval, it's pretty easy to see how much urine was produced. I think the BG has to get about 270 before increased urination will be noticeable. But if you know what is normal output for her, then, even if you've not tested for a while, you can have peace of mind that its not crept up high enough to cause clinical signs.

If you notice she's not feeling well, or any other symptoms of pancreatitis, get testing. If she has another pancreatitis attack, then her BG could go up quickly.

I'd also keep her on diabetic friendly food (wet, low carb food) unless your vet recommends otherwise.

Lor

 

Hope she's in remission. All you can do is make sure she's on low carb food for life, watch her weight, her thirst and any infections like teeth or other things. Dusty has been in remission since 2013 and I went from testing every other day to weekly to every two weeks to monthly to just keeping an eye on him for strange behavior. I caught some teeth issues early last year and although his BG went up a little, he recovered quickly with no issues.

 

That's great to hear! Yep, Matilda was also fat (lost 1.5 lbs while at her sickest though) and I'm sure that didn't help. I don't even think her BG was ever really that high, even when she was hospitalized I think it stuck around the 300s max, but the pancreatitis made her stop eating and ketones started developing and that caused all kinds of problems. Luckily she bounced back more quickly than even the vet expected, but it's hard not to be paranoid that every little thing she does now in a sign she's getting sick again.


Thanks for the advice everyone! I'll keep testing fairly regularly for now, if only for my own peace of mind. Her numbers have all been normal so keeping all my fingers and toes crossed that we can stay this way.