Very high Fructosamine (?) help please

Discussion in 'Feline Health - (The Main Forum)' started by lovemycat444, Feb 3, 2018.

  1. lovemycat444

    lovemycat444 Member

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    Jul 10, 2017
    Hi, Taco got complete blood work done. I'm so grateful vet said all was normal all but very high fructosamine. Recently Taco's water intake has increased. It seems more so in the last week. How do you deal with this (does he need his insulin amounts adjusted (by the vet, definitively not done by me) Thank you!
     
  2. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    The high fructosamine tells you his average BG over the last few weeks has been high. The extra water intake is consistent with high BG. It seems you're working with your vet on dosing so you'll have to get his/her advice. How often is a curve being done? Are you doing them at home?
     
  3. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    The high fructosamine result tells you his BG is not well regulated. It cannot give you the full picture though since it is an average. Home testing results would give you a clearer picture of what is going on. Could you please add a signature that tells us basic info like when Taco was diagnosed, what insulin he is on, etc. That will keep us from having to ask you all the details every time you post.

    Most of us here adjust the insulin dosing ourselves based on our home testing data which is the most accurate way to keep up with BG levels and impact of dose. Some work closely with their vets on those decisions (providing the vet with their testing data), but many do not. Mia's doctor leaves the daily management of this to me and tells me to reach out if I need him for anything. Really, after living with this for 7 months now, I cannot imagine leaving everything up to a vet. It is all too ever-changing. I would either have to bother the vet frequently or, if I was not home testing and just taking her in every couple week for a BG check, there would have been times when she was in serious danger from unexpected drops.. or when she would have run too high for too long. I think I would also be worried all the time if I did not know her numbers. For me, having the data makes it less stressful and is empowering. :)
     
  4. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    What insulin is he on and how much? Are you willing to learn how to home test? Is the best way to find the most effective dose and to keep your cat safe. We can help you learn and give a shopping list of what you would need.
     
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  5. lovemycat444

    lovemycat444 Member

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    Jul 10, 2017
    Thank you so much! Yes the vet is increasing his Lantus dose. I need to do curves more regularly. I did one the week before we went to the vet. Before he was going in for bloodwork. I remember one reading was approx 480. I did then curves regularly on him this past summer, he seemed less regulated then.
     
  6. lovemycat444

    lovemycat444 Member

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    Jul 10, 2017
    And thank you! I'll write his signature now
     
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  7. lovemycat444

    lovemycat444 Member

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    Jul 10, 2017
    Thank you Janet! He's on Lantus vet just upped his 4 units to 5 units. I do home testing but need to do it weekly. I don't understand the charts people have for BG curves? Can you please explain? It looks Much more detailed than the numbers I get from
    At home curve testing
    Thank you!
     
  8. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    We test daily....ALWAYS before shooting (to make sure they're high enough for insulin at all) and then at least one mid-cycle (like 5-7 hours after the morning shot) and a "before bed" test on the PM cycle. If you can't test mid-cycle during the day due to work, it's even more important to get more tests on the PM cycle and then get daytime tests any time you can.

    Lantus dosing is based on how LOW it takes them, not the Pre-shot numbers, so it's important to get tests in between the shots to see how low the dose is taking them.

    Testing weekly isn't enough. We've seen cats go from 400 to 40 and back to 400 in one cycle....if you only saw the 400's, you might think they needed more insulin, when in fact, they need less!!

    We also don't increase by full units....small dose increases can make big differences, so we do increases in .25 or .5 unit increments. Again, too much insulin can look like not enough....the only way to know is by more thorough home testing.
     
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  9. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    That is a huge increase. Increasing lantus in 0.25 increments is preferred so you don't skip the ideal dose. If you write on the lantus forum they can help yousort out the dosing. At the top of the forum are yellow stickies, some of which describe dosing methods.... Tight Regulation and SLGS protocols. Read through and see which you are most comfortable with.

    So glad you already know how to home test.

    Great job getting your signature on... It's very helpful.
     
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  10. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    Note the fructosamine values and BG values are not directly comparable. What was the specific fructosamine value?

    Cats Fructosamine values
    (micromol/l)

    Normal non-diabetic cat 190-365
    Newly diagnosed diabetic cat 350-730
    Treated diabetic cats:
    Excellent control 350-400
    Good control 400-450
    Fair control 450-500
    Poor control >500

    Above from:
    http://www.caninsulin.co.uk/fructosamine.asp?context=management_cats
     
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  11. lovemycat444

    lovemycat444 Member

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    Jul 10, 2017
    Thank you Larry. I really appreciate ur post
    I'm not sure how to read these records
    Does this make sense to you so I can find the fructosamine level? Thank you!
     
  12. lovemycat444

    lovemycat444 Member

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    IMG_9383.JPG
     

    Attached Files:

  13. lovemycat444

    lovemycat444 Member

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    Attached Files:

  14. Kris & Teasel

    Kris & Teasel Well-Known Member

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    This is confusing but I wonder if the fructosamine number is the 956 way up at the top. Beneath it you see the reference ranges. If that's the case it's very high.
     
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  15. Sean & Rufus

    Sean & Rufus Member

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    Jan 10, 2018
    If you click on the attached smaller photo, it says the fruct test is 620
     
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  16. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Thanks! Didn't notice that. :)
     
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  17. lovemycat444

    lovemycat444 Member

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    Jul 10, 2017
    Thank you for taking the time to read the records! Taco has an ultrasound this Friday. It's for his unexplained biting growling at his lower stomach . Do you think there's anything I should ask the vet re: his high fructosamine reading? Thank you so much!
     
  18. lovemycat444

    lovemycat444 Member

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    Jul 10, 2017
    Thank you for taking the time to read this/and interpret it. I'll definitely be giving taco weekly curve tests. Did your cat ever have high Fructosamine? If So is there anything u can please recommend I do? Thank you so much again! Ps Taco has an appt this Friday for an ultrasound for his unexplainable growling and biting at his lower stomach (ultrasound) do you think there's anything I should ask the vet about his high fructosamine while I'm there? Thank you so much again!!
     
  19. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    My cat's fructosamine was high early on in his FD journey when I was following my vet's guidelines for dosing, etc. and getting nowhere. I took matters into my own hands in August 2016 and have learned a lot about why my vet's advice wasn't working. I don't bother getting her input now and my cat hasn't had any further fructosamine testing. I monitor his BG at home and make my own dosing decisions. My vet knows I'm doing this but trusts my judgment. She a great vet but, like many, doesn't have a lot of experience with the finer points of treating a diabetic cat.
     
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  20. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    Mia had a fructosamine level of 513 two weeks after she was diagnosed and started insulin. High fructosamine indicates they have had high blood glucose over the last 2-3 weeks. The solution is to get that under control. Home testing the best tool there is for monitoring glucose and determining dosing changes. So, my recommendation is to set up a spreadsheet and start daily home testing. You want to test prior to each insulin shot (being sure Taco has had no food for two hours before that) and test at various points during mid-cycle as you can. Try to get at least one mid-cycle test each cycle. Over time, you will build up enough data to see what is going on with Taco and to be able to make decisions on dosing. You mentioned doing weekly curves. Curves are a helpful tool, but they do not replace the need for daily testing. Are you doing the curve yourself at home? (Normally, a curve is a test prior to a shot then every two hours after that up until the next pre-shot test.)

    Here is info on the spreadsheet:
    http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
    http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/
     
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  21. Sean & Rufus

    Sean & Rufus Member

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    Jan 10, 2018
    Hi! I wish I could help, but my guy is stuck in high numbers and I have no idea why. Rufus has possible food allergy & intollerance and possible teeth issues. Hope you receive some good answers with the ultrasound. That is probably our next step, too.
     
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  22. lovemycat444

    lovemycat444 Member

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    Jul 10, 2017
    Oh thank you and I'm sorry about Rufus's high numbers and teeth. These much loved sweet creatures! Pls stay in touch feel free
    To ask me any questions re my experience with a possible food allergy. It doesn't seem
    Like Taco has this but I have a decent amount of experience now trying to detect a food
    Allergy. Thanks again!
     
  23. lovemycat444

    lovemycat444 Member

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    Jul 10, 2017
    Thank you so much for your response and all the information! I thought doing curves was what I should be doing I didn't realize there was more that I could can do I so appreciate your time to share the info with me
    For Taco. I do at home curve testing the most was 5 ear prick tests in a day.
    Taco absolutely hates it. I've had to pay a friends to help hold him in a towel kitty burrito.
    Clearly I love him and will and am doing all I can for him. That said the costs of RX foods, so many vet visits, so many expensive medicines... and now a ultrasound on Friday. I'm becoming close to not being able to afford this. To be clear. I'm committed to Taco and love him he's part of my family. So I'm keeping him no matter what. But I'm overwhelmed with costs and after spring time to now his wearing a soft e collar and it must be awful for him and it's beyond frustrating to not know from springtime to now what the cause of his unexplained biting and growling at his stomach is.
    Sorry, I went off on a tangent. It's related to the BG testing .
    Thank you for taking the time to write back and I can't believe what a supportive wonderful community this is thank you for being a huge part of that!
    I've read his BG can go up via stress. He's extremely angry and hard to hold still for this. I'm trying to get his BG down via the vet RX his 4 units of Lantus to 5 units (for the last 3 days)
    I really really appreciate the info for spreadsheet I will do this.
     
  24. Sean & Rufus

    Sean & Rufus Member

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    Jan 10, 2018
    Thanks! I'm pretty sure turkey is his #1 allergy, but not sure if anything else. We've being dealing with it for a while, and actually think his diabetes were caused by all of it. So now it's difficult to get him to want to eat what we need him to eat. His current fave is Fancy Feast, which I'm sure has some turkey in it. I have rabbit food waiting for when he's ready to switch :)
     
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  25. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    I hope the ultrasound uncovers the issue causing the biting and growling and that it can be treated so he can have some relief from that. I know it would be a relief for you, too. It must be so scary and frustrating and sad to watch your baby go through that for so long without even knowing why. :(

    Have you tried some of the testing tips people give here to see if the testing would get any easier? It was hard when I first started testing Mia, but it got easier pretty quickly. I followed the suggestions of always doing it in the same spot and always giving her a treat and lots of praise and attention. I think part of it was also me getting more comfortable doing it. Now, she comes running and gets in her testing spot and holds her little ear out for me to poke it. I'm in and out quick, and she is on to eating her treat. Testing can save you on vet costs. You do not have to pay to go in for glucose tests or fructosamine tests.
     
  26. lovemycat444

    lovemycat444 Member

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    Jul 10, 2017
    Thank you SO much. I truly appreciate ur compassion for Taco and for me. You're right everything you mentioned it is so scary to not know what's causing him such severe distress and I'm scared and try not to think of the worst case scenario and for me I get frightened and overwhelmed when I think I'm not being as good as a cat mom to not of figured this out by now via medical tests cat dermatologist, etc etc It's great to hear about all the info here thank you! And I am so glad for you and Mia that's so wonderful that Mia comes to the spot to sit for ear prick and I think for a cat that is Amazing!! I'm not being disparaging towards sweet cats at all I only say bc for me in my experience with much loved cats. They really decide things for themselves when they want food etc I respect cats for all of this and I know how sensitive they are. Thank you I didn't know that at home testing would enable one to not have the expensive fructosamine panel! ($118) and ultrasound on Friday ($450) I love Taco's vet. She has been unfailingly dedicated to him. But this forum it's also so unbelievably hopeful, supportive and kind as are you and this community it (all of you!) and you, Mia's mom give me hope whereas often I've felt alone and helpless regardless of how much I've tried to alleviate his pain. I know I'm not helpless it's a state of mind I get when The next new medicine doesn't work (this week 50 mg of Gabapenten RX 3 times a day and chloride I forget the full name (it's in my notes) and the many times Taco has had to try diet changes and the number of different Medications he was on since spring, so thank you for helping me to feel less hopeless and helpless to help my beloved family member, Taco. (Ive never and I won't give up hope for Taco, the situation can feel hopeless). Thank you Mia's Mom!
     
  27. lovemycat444

    lovemycat444 Member

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    Jul 10, 2017
    Ps Sean and Rufus a vet told me with potential food allergies I should not give taco any food any treats anything to eat outside of the very specific food chosen to see if there's a food allergy. Just passing that info on. I hope he's better than ok!
     
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  28. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    Just to clarify, the home testing would not replace an ultrasound, but it can replace fructosamine tests.

    You may want to review the AAHA guidelines: https://www.aaha.org/professional/resources/diabetes_management.aspx They mention that at home glucose curves are the best way to go and really only mention fructosamine being tested at diagnosis and in cases where home testing is not being done. Also, I saw your other post about Taco being hungry, the guidelines say feeding four times a day is ideal, using an auto-feeder if needed. They also say that free-feeding is okay if your cat is underweight. (You would still want to make sure all food was taken up two hours before your pre-shot glucose test.)
     
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  29. Sean & Rufus

    Sean & Rufus Member

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    Jan 10, 2018
    Yeah, both cats were eating tempation treats, not a whole lot, but they do have a bunch of garbage in them. Of course I have 4 bags of hydrolyzed treats that Rufus won't touch now :( I guess that's ok because he shouldn't be eating treats anyways. Just feel bad because he doesn't like any treat besides tempations and it would be nice to have something to reward him with. He will not eat freeze dried anything.
     
  30. lovemycat444

    lovemycat444 Member

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    Oh! I hope you don't feel badly . I think you're doing a wonderful job for both kitties. This is the hardest long term situation I've ever dealt with. I commend you and everyone on here! And I'm going to get some of those cat treats bc I've been reading worst worst case scenario Taco goes hypoglycemic one think to have handy is treats but!!!! Of. Course more extensive info besides treats as i.m quite sure you know already - how scary a hypoglycemic situation would be
    Thanks again for responding and I hope the best for you and your two kitties!
     
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  31. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    Have you ever tried Orijen Wild Boar treats? China wouldn't eat the freeze dried anything either (and I have a ton of opened bags to prove it) but she loves these!

    They're very soft and crumbly. You can crush them easily between your fingers

    The dogs ones are a better value than the cat ones and they're the exact same thing, only a little bigger
     
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  32. Sean & Rufus

    Sean & Rufus Member

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    Jan 10, 2018
    Thank you! This is hard, but totally worth it. Love my rufus to pieces! Best of luck to you too, we'll all get through this :)
     
  33. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I second this. Teasel loves these. :)
     

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