? Yum's BG shot up when I stopped her metronizadole

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by MJW, Dec 15, 2017.

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  1. MJW

    MJW Well-Known Member

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    I just realized Yum stopped having yellows and blues when I stopped her metronizadole (for diarrhea) and switched to S. boulardii. Metronizadole (flagyl) has anti-inflammatory properties. Maybe stopping it was a big mistake.
     
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  2. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    Did your vet advise you to stop the metronidazole?

    Some cats will react with higher number to almost any change. However, it's been long enough since you stopped the medication that it may be a factor. You did note that she's eating and there's no diarrhea. You just increased the dose, so let's see what happens. I'm also tagging @Marje and Gracie to see if she has any thoughts on this.

    Also, just a housekeeping note. We try to encourage people to open one condo per cat per day. You could have included this in your other thread and just changed the subject line.



     
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  3. tiffmaxee

    tiffmaxee Well-Known Member

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    Flagyl can have neurological effects if given too long or too high a dose. Best not to restart it if stool is normal. There are other options for inflammation if tgat turns out to be a problem. Eating and acting normal? Just may be coincidental. See how things go would be my opinion.
     
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  4. MJW

    MJW Well-Known Member

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    Sorry re the 2nd condo. I thought of that after Iposted it. It was such an exciting "Aha!" moment when I noticed the correlation on her chart, I got carried away.

    Yum is still having diarrhea. She had a mostly normal poo yesterday but a mixture of liquid and formed poo today. I think the S. boulardii (started Tuesday) is strongly improving the diarrhea but maybe not the underlying inflammation. I believe metronizadole fights infection and inflammation. Yum had simple pudding poo diarrhea many times in the fall due to her intolerance for beef and lamb, but her insulin dose fell to new lows.

    I finished 13 of 14 metronizadole doses on Monday. My primary vet had said she likes to continue it several days after the diarrhea resolves. I kind of gave up on it and switched to S. boulardii, since I had pretty much finished what she gave me. I know it crosses the blood/brain barrier and poses problems.

    My primary vet is out of town and the junior vet just now gave me a new 14 dose (7 day) supply.
    If the rise in Yum's BG is due to increased inflammation due to my stopping the metronizadole, her current dose may be too large if I start it again.
    Maybe I should "take back" the 4 units I pushed her up to this morning and go back to 3.5 units.
     
  5. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Metronidazole is an antibiotic, so it definitely will fight bacterial infection. It also means it's important to keep on going until the end of the course -- just like when we humans take antibiotics, we often keep on taking them even though the symptoms have stopped. Interrupting too early, if the symptoms are gone but the infection has not totally cleared, can make it harder to get rid of the relapsed (possibly resistant) infection.
     
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  6. MJW

    MJW Well-Known Member

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    She still has some liquid poo. Her rising BG seems really anomalous to me. I could give her omega fatty acids for inflammation. @Sienne and Gabby (GA) posted on one of my other condos (http://www.felinediabetes.com/FDMB/...n-at-3-25-should-i-worry.187968/#post-2087543) that they had to use metronizadole for a month following antibiotic induced diarrhea. She wrote that 7 days is too short. I don't want to give her this medication but I need to get her BG under control more.
     
  7. MJW

    MJW Well-Known Member

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    I finished 13 pills of the 14 pill course. It had not cleared the problem. I gave up on it and turned to probiotics. The probiotics helped but her BG took off.
     
  8. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    When it comes to antibiotics, I tend to err on the side of giving them a little too long rather than too short. If there was a bacterial or parasitic infection that the antibiotics were dealing with, and you stopped early, then the remaining nasty bugs go *party! let's multiply!* and off you go for another round. Sounds like the vets both recommend continuing treatment. #iamnotadoctor
     
  9. MJW

    MJW Well-Known Member

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    @Marje and Gracie @Wendy&Neko

    So, I have to decide in the next hour and a half whether I should:

    1. hold her at this morning's new very aggressive dose of 4 units and restart the metornizadole tonight
    2. drop her back down to yesterday's 3.5 units and restart the metronizadole tonight
    3. hold her at 4 units and contemplate when to restart the metronizadole.

    I am leaning towards "2". Reduce her insulin and restart the metronizadole tonight.

    Of course the data on the chart may all be a coincidence. It just seems really anomalous to me, though, that she is needing a bigger and bigger dose of insulin when she was responding at 3 and 3.25. I was thinking it meant she had a new infection. The correlation of the rising BG with the cessation of metronizadole gives me a working hypothesis. Metronizadole fights infection and inflammation. Maybe it does different things than the S. boulardii. She still has some diarrhea. I believe she even had blood in her wet stool today, which is an indicator of inflammation.

    I will keep her on S. boulardii too, whether or not I start the metro.
     
  10. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    If you are restarting the antibiotics then it is definitely better to do it sooner rather than later.

    You know, I have my own "is this a coincidence" thing going on: Quintus has never been so low (since I'm testing) than this evening. I'm staying up way past my bedtime because he's in the blues and still going down. AND guess what? I gave him his Convenia (antibiotic) injection yesterday noon. Maybe it's unrelated, but maybe he has an infection (there's been a lot going on with him and I have previously noticed he really improved in the days following the Convenia), and the antibiotic is reducing it, and therefore the BG is going down.

    Who knows...
     
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  11. MJW

    MJW Well-Known Member

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    Sounds logical to me. Yum's numbers finally went down last spring when we gave her the right antibiotic---but I was a newbie and I didn't track everything as closely. I am now very curious about how soon the BG responds to the end of an infection. It sure shoots up with the Strat of an infection. Yum finished Orbax for her UTI (successfully) on 12/3 but her numbers didn't come down. Of course by then she had developed severe antibiotic induced diarrhea. Not sure if antibiotic induced diarrhea means a gut infection or just gut inflammation.

    Good luck with Quintus' numbers tonight. I'm glad Convenia seems to be the right antibiotic for his infection. We started with it for Yum but then had to switch to Orbax.
     
  12. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Antibiotics kill bacteria (generally -- sometimes they also have a go at parasites). The gut is full of bacteria. What sometimes happens when you take antibiotics is that in addition to killing off the bad bacteria responsible for the infection, they also (collateral damage) take out a good chunk of the gut bacteria we rely on for good digestion. That's why probiotics can help, to reconstitute what was lost.

    Did I understand right that Yum was given metronidazole for her digestive issues? Do you know what kind of infection the vet suspected? The wikipedia page introduction for the molecule lists some of the nasties that metronidazole can deal with. Giardiasis for example is a "parasite" that can give nasty diarrhea. https://en.wikipedia.org/wiki/Metronidazole
     
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  13. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    Metronidazole is typically prescribed if they think there's an aerobic bacterial infection. Many women are prescribed this for yeast infections (if you're familiar with Flagyl). Gabby had all of the tests done for parasites, etc. Nothing was positive. She also didn't have a case of antibiotic induced diarrhea (sorry if that was confusing). I had no clue what was going on but the extra long treatment with metronidazole did the trick. I was also using ReNew Ultimate as a probiotic.
     
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  14. MJW

    MJW Well-Known Member

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    Well, since she finally had a yellow on the 4 unit dose (AMPS 687 +3 631 +6 491 +10.5 334 PMPS 286) I decided to shoot another 4 units and hold off on the metronizadole. Maybe the S. boulardii is working enough on the aspects of her diarrhea that are probably causing the insulin resistance. I don't like giving her metronidazole for many reasons. I will have to keep close watch on her tonight. I guess she might bounce from a whopping 400 point drop.
     
  15. MJW

    MJW Well-Known Member

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    They didn't do any cultures. (Sigh.) I think it is just a protocol to prescribe it for diarrhea. I know I read that it has anti-inflammatory properties in addition to targeting specific infections.
     
  16. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    If you get rid of infections, you reduce inflammation... I don't see anything anywhere about it being directly an anti-inflammatory.
    From the sources of the wikipedia article: http://veterinarynews.dvm360.com/advances-managing-inflammatory-bowel-disease -- discusses the use of metronidazole for IBD.
     
  17. MJW

    MJW Well-Known Member

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    I don't really understand what antibiotic induced diarrhea means. She developed diarrhea after maybe 2 doses of Zeniquin last spring. I stopped it then, whereas this time I continued the Orbax. Zeniquin is related to Orbax. I think it is a bad reaction not necessarily an overgrowth of bad bacteria. As I wrote to Stephanie, I think they just prescribe it for diarrhea.
     
  18. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    It means that the antibiotic accidentally (collateral damage) killed off an important part of the bacteria that live in your gut. If your gut bacteria balance is out of whack, you get to spend a lot of uncomfortable time sitting on the toilet.
    Never had that happen to you?
     
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  19. MJW

    MJW Well-Known Member

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    I don't know where I first read about metronidazole being anti-inflammatory. I texted a friend at the time "it can reduce inflammation by suppressing the immune system", after she texted me her mother in law was getting an "antibiotic for an autoimmune disease".
    With a quick google now I see:
    "Metronidazole has antibacterial and anti-inflammatory effects and is useful in treatment of IBD in dogs as well as in cats." in
    Advances in managing inflammatory bowel disease - Veterinary News
    veterinarynews.dvm360.com/advances-managing-inflammatory-bowel-disease

    I have no medical training. I might not be interpreting google correctly.
     
  20. MJW

    MJW Well-Known Member

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    Okay. But as I wrote to someone else here, Yum seems to not tolerate Orbax or Zeniquin. So I killed off her good bacteria but I think something else happened as well.
     
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  21. MJW

    MJW Well-Known Member

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    Ha. Looks like I quoted the same article as you but pulled out a specific line.
     
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  22. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Well spotted! this does indeed say what you think it does. Still curious. What seems certain is that it is primarily an antibiotic and used as such. I'm not sure how the anti-inflammatory effect would come about (there are various classes of anti-inflammatories which rely upon different mechanisms to reduce inflammation).
    So... mystery!
     
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  23. MJW

    MJW Well-Known Member

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    Well, if you missed it above, I wrote that I texted someone it suppresses the immune system. It was news to me antibiotics could do that. Don't remember where I read it but I did read it online.
     
  24. Stephanie & Quintus

    Stephanie & Quintus Well-Known Member

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    Sounds very weird to me. That's not what antibiotics do, they target specific types of bacteria. Anti-histamines/steroids are the ones that tend to suppress the immune system. I'll dig into that tomorrow when it's not 2am, my curiosity is aroused!
     
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  25. tiffmaxee

    tiffmaxee Well-Known Member

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    Since she still has liquid poo I would try another round of metronazodole. I thought it was normal. .
     
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  26. Marje and Gracie

    Marje and Gracie Well-Known Member

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    Antibiotics can alter the gut flora. Metronidazole can also cause diarrhea in some cats as a side effect.

    Here is my philosophy on antibiotics: don’t give them unless you know there is an infection and an antibiotic is needed. For that, you need to have a discussion with your vet. I, personally, would not be starting and stopping antibiotics without my vet instructing me to do so.

    Since you increased the dose, I’d hold it. Try not to dose hop. If she does need 4u and you decrease her based on a PS or any other reason (other than an earned reduction), you could cause her to spend more time in high numbers. If the dose is too high, she’ll drop.
     
    Last edited: Dec 15, 2017
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  27. Wendy&Neko

    Wendy&Neko Well-Known Member

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    What Marje said. ;)

    My civie was on low dose metronazodile for quite a few months to help what at the time we thought was IBD. No side effects, but it's wasn't the perfect solution. His issue was vomiting.
     
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