? Worried and confused about insulin effectiveness and dosing for vetsulin

I took smoky for an ultrasound last Monday, results were inflammation in his pancreas, liver, and bowels. The vet thinks allergies could be causing it in his bowels so started him on his allergy meds again, drops under his tongue. The vet won't give him steroids due to the diabetes bit others have told me some antibiotics can have anti inflammatory properties.

It seems to me that the vetsulin which usually causes big drops by +6 didn't change much from AMPS to PMPS. Am BG @475, +3@ 371, +6.5@348, and Pm BG @392.
His dose has been 1.5 units for the past 4 days now. Smoky has been drinking a lot more water than usual and eating double what he normally does. I am wondering if the insulin dose needs to be increased. He is extremely underweight so I guess eating more is good. I tested his urine about an hour ago and it was negative for ketones but glucose reading was 1000 on ketodiastix. He has been hiding under coffee table in bedroom and sleeping a lot. I don't know what to do, how can his BG improve if he has all that inflammation going on?

 

Oops I forgot I had another thread going today. Sorry about that guys

 

@Carol & Murphy
Has experience in your issues with you kitty.....
I agree no steroids... my 2 cents

 

In short: No steroids. They almost killed our diabetic cat. When he had a liver inflammation at some point, he was treated with antibiotics. He started eating and drinking less than 24h after we had started the treatment, which lasted a few weeks (I can look up the details if you would like to know).

Explanation: Our 9 year old male was diabetic and we didn't know at the time when we took him to the vets because he smelled like acetone and he wouldn't stop scratching his ears. The vet dismissed my acetone claims (!) and without properly examining him he decided to treat the scratching with steroid injection that lasts three weeks. It almost killed our cat. (Now if you wonder WHY I let him do this, why I didn't run for the second opinion... He's been our vet for ages and is usually responsible and caring. And he made me question myself and look a bit ridiculous and over-worried. And in the end I wanted to hear some good news).
Less than 24h later he could barely breathe. We took him to a clinic and they diagnosed him with diabetes which was aggravated by the steroid shot.

Hope this helps.

p.s. I wanted to ask about the insulin type you're using. We started on Canininsulin. Our vet offered to change to Lantus at some point. When she was worried that he may had become insulin intolerant she wanted to put him on ProZinc hoping to get best results. We haven't switched yet since we're hoping that the change in diet will continue to yield good results (normal blood glucose levels).

 

It sounds like your kitty may have triaditis - (inflammation of liver, pancreas, inflammatory bowel disease, sometimes bile duct) - the cat could be intolerant of certain foods and proteins and that could be the "allergy" component Your cat could have inflammatory bowel disease - there's a really good web site for all IBD related information - www.ibdkitties.net -please take a look - it's quite a complicated diagnosis. Here is an overview http://www.ibdkitties.net/about-ibd/
I am not familiar with the insulin you are using - but from the high numbers, were you considering increasing the dose? @JanetNJ - do you have any dosing advice?

 

Smoky hasn't been checked yet for possible IBD so I will talk to his vet about that. I didn't even think about that. It seems counterproductive to give him insulin when all that inflammation is keeping his BG high. Plus I don't know if I shld keep adjusting it daily or not.

 

You definitely want to get his blood sugars in a good range - good glucose is definitely possible for cats with IBD - lots of kitties on this forum have IBD- I don't know anyone else who uses Vetsulin - perhaps adding Vetsulin in the title of your thread and add question on dosing will get some experienced Vetsulin users. I strongly encourage you to start reading the ibdkitties.net website. What allergy medicine are you giving?

 

I want to try and switch to prozinc or maybe Lantus. It is expensive though for Lantus. He went to see a dermatologist and the allergy meds are drops made of saline solution and a mix of the allergens he is allergic to.

 

You might want to post on the Version forum. It's getting busy now. Someone with knowledge of IBD might be able to help. The more forums you post on, the greater your chance of getting informative.

 

I think you could try an increase of 0.25 u. Smokey being unwell and having inflammation will push up the numbers, it's complicated but to do with the effect of stress hormones which are more active, they have many effects but increasing the release of glucose is one of them, so the insulin, which is also a hormone, is in effect fighting the other hormones by trying to push glucose into the cells while they are trying to get it out. Steroids are a powerful anti-inflammatory but should only be used in diabetics when there is no viable alternative due to the effect on blood sugar. I wonder if it might be worth having a look at the food as well, my kitty really improved with a change of food, she did have a big swollen liver to start with but this all resolved when I changed her food. I'm not sure what it was in her previous food that might have been causing the problem.

 

I'm wondering if the vetsulin is just not the right insulin for him. The problem is that he is allergic to chicken and all the Friskies, FF, and a lot of others have chicken or poultry by products in them.
I tried giving him weruva and tiki cat which don't have that in some of their food but he doesn't like most of them.

I just increased his dose 0.25 units from 1.5 to 1.75 in the last day or so. I'm not sure how to copy this thread to the vetsulin forum though.

 

I have complete empathy for you having a cat that cannot tolerate alot of different foods and/or wont' eat them. You could post a new thread of the vetsulin forum - to do that, post a new thread - then in the body of the thread you can post the link to this thread - here is the link to this thread http://www.felinediabetes.com/FDMB/...-and-dosing-for-vetsulin.167199/#post-1809671-- just copy the hyperlink- click on the little chain icon (the 7th icon on the toolbar) - paste this link in that then click insert and you should be all set - again, I strongly urge you to read about feeding IBD cats on the ibdkitties.net website
there is also an ibdkitties Facebook page - they are very active and if you post on there about the ultrasound results and the issues you are having with food, you will be able to get some assistance and advice

 

Thank you everyone for all your help. I will get on my laptop and try to post link in vetsulin forum. I can't seem to get it to work from my phone.

 

It IS coming down over 100 points, so the insulin is working.... But I don't think your dose is enough. I don't have any experience with pancratitis so I can't advise there, but I probably would up the dose to 2 for a few days and see what happens. 2 really is not a large dose. (My cat who didn't have pancratitis was up to 3 for a while which was her "breakthrough dose before starting to bing her numbers down finally).

 

Hi Lisa,

I'm sorry to hear about the findings from Smoky's ultrasound.

Here are useful links for you WRT learning about pancreatitis clinical signs and treatment (recommend you bookmark them for reference):

Nausea and appetite problems - symptoms and treatments

IDEXX pancreatitis treatment guidelines

Pancreatitis is typically diagnosed with SNAP fPL and Spec fPL blood tests plus clinical signs (some of which may be subtle for low-grade, chronic pancreatitis). For general background information, an inflamed pancreas may show abnormalities on ultrasound (e.g. enlargement), ditto with liver. The only way you can get a definitive diagnosis for IBD is through a biopsy. That said, if it is present then an ultrasound may show thickening of the intestinal walls.

SAM-e and milk thistle supplements can help the liver. I see others have already referred you to ibdkitties.net for help with that side of things. My heart goes out to you over the food worries; I have found food issues to be really difficult to resolve - a lot of trial and error may be needed to find a food that agrees with Smoky but it can help matters a great deal once agreeable foods are identified.

A course of B12 injections may help both the IBD and the pancreatitis. Also, pain management with buprenorphine may help the pancreas (details in the IDEXX document).


Mogs
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Hi,
I have to take smoky to be tested for pancreatitis yet. I'm thinking I shld have him tested for IBD but I can't afford to have a biopsy done. I had to borrow money just to get the ultrasound done. I barely have the finances to treat his diabetes w/o treating him for other illnesses. If that would happen I would have no other choice but to put him down.