Chyna update; vet/poss. dental for Monday...

Hi everyone. Previous post: Last Condo

Well, I just did Chynas BG and it's up to 272 from 175 yesterday, up every day since the 7th. I don't know what is causing it, and the vet hasn't gotten back to me from when I dropped off the list of all her supplements. I don't know what else to do, or why she is spiking so high in glucose. If there is an infection, I want to treat it- I don't know what it is...but I think she needs to go back on insulin in the meantime? Thoughts on doses? I was thinking microdose to start...I of course have to work the next few days.

I don't have any insulin but for the 11 month old vial in my fridge that I hadn't disposed of yet, the stores are closed now, and I'm down to very little cash in my overdraft but there may be enough for a vial of Lantus. I still have syringes, and not a ton of strips but some. And of course my hypo kit is still in the cuboard...I'm so down about this. Isn't there usually a cause to throw them out of remission like this? I feel like I'm treating the wrong thing with insulin if she has something else wrong but she needs to be in healthy range :cry: I guess I'm babbling on. She seems normal other than the BG...

Re: Chyna back from the falls? Doses/ideas?

Sorry to hear this Rachel :sad:
If it was me I'd be making an appy for the vet to rule out everything else first and when was her last dental?
That's what I did when Hoot came out of remission.
It all just about broke me but at least then I knew it was the diabetes and no underlying health issues.
Good luck and paws crossed that you get it figured out and China gets back to the Falls ASAP!!

Re: Chyna back from the falls? Doses/ideas?

Hi Rachel,
I don't know enough to give advice on something like this. You really need to talk with the vet and have some tests to see if there is an infection or maybe a pancreatitis flare. You say that Chyna is acting normally? Is she drinking more water or peeing more? Those would be the first things I would think of if she needs to go back on insulin. If she does, you are lucky to live in Canada, where insulin is so much cheaper than in the US!

I hope you get some answers soon. Try not to worry.

:YMHUG: :YMHUG:

Ella & Rusty

Re: Chyna back from the falls? Doses/ideas?

Thanks for the hugs. She was at the vet two weeks ago for bloodwork when I noticed her BG going up...they said it didn't show infection there and her kidney values were about the same. They couldn't look at her teeth when she was in with her freaking out and biting...I've been trying to get a picture but it's just me trying to hold her mouth open and take a pic, I'll have to have mom come over :shock: Her last (only ever) dental was in Feb. this year. I'm not sure where I'd even come up with the money for a pancreatitis test...but she doesn't seem to have the symptoms of that that I've read, but I'm no expert on that of course.

She doesn't really drink much since she gets subqs and water mixed into her food and I think her pee volume seems normal for a CKD cat. She's been eating, purring, preening, pooping (although constipated which is again normal for CKD and I give her pumpkin or squash to help). I'm so sad and scared right now, thanks for the support.

Re: Chyna back from the falls? Doses/ideas?

i'm so sorry, rachel. what a disappointment. i think with a 272 i'd probably start back up with the insulin. but i would think 11 month old would be too old, but i don't really know.

:YMHUG:

Re: Chyna back from the falls? Doses/ideas?

Rachel, I'm sorry that Chyna's numbers are creeping up. It would be a good idea for vet to get a look at her mouth, even if it's through pictures.

Your SS says that Chyna is 13 lbs - what is her idea weight? The protocol suggests a starting does based on idea weight. But I'd wait until you have time to watch and enough strips. As for insulin, if it was possible to get a single cartridge, that might be a better way to go, but I don't know who sells it that way. Maybe ask at a pharmacy or one associated with a hospital or retirement home if they'd break up or sell a single cartridge. Lantus is about $100 for a 5 pack of cartridges around here so a singleton would be a reasonable price.

Re: Chyna back from the falls? Doses/ideas?

Rachel I am so sorry to hear Chyna's numbers are creeping. Prayers and hugs that this is just a short blip!

Re: Chyna back from the falls? Doses/ideas?

Thanks guys. Wendy, she's at her ideal weight. They said that a few months ago that they didn't want her to lose but not to gain either ;-) I'm kind of scared to start up that high if her pancreas is working... nailbite_smile I've asked a few pharmacies so far this week (I was thinking ahead :cry: ) and so far no splitting Lantus pens. I may have to just get a vial.

I'm wondering if it's her teeth as well, she does scratch around her face...I asked last appointment (3 months ago) why she likes her gums rubbed and suggested her teeth and the locum vet was like "oh that's part of allergies". And the reason I took her in two weeks ago was to get checked over. I'm a little frustrated with that, I wish I'd been more aggressive in this but I kept getting locum or new vet who was nice but timid at exams instead of the one I wanted who was not in, and Chyna was so scared. I'm not sure how to pay for a dental...wrong season for a garage sale :!: I'll try to get pics, again and call the vet when they open. Although all they will say is bring her in...

Of course, right now we're having a snow storm and getting 10-15cm every day for four days and it says for the next three we're expecting 20cm more. I'm not even sure if my car will get out of my street this morning for work :shock:

Re: Chyna back from the falls? Doses/ideas?

most of the time when a cat comes back after being OTJ, they need more insulin to go off again than they did before, ie, they end up at a higher dose before starting back down again.

The weight-based start would be 1.25u, so if you're thinking that's on the high side you could start at 1.0u and see what it does. You can go up if you're not seeing good numbers.

I can imagine what's going on with the vet - you always think of what you should've done after you get home! ohmygod_smile i do not think scratching around her face is "normal" behavior, but more likely you are right that there's something bothering her, especially if this is a relatively new behavior for her. If she's been doing it for a couple of years, then allergies might be an explanation (maybe.) Dental issues do bring cats out of remission sometimes.

Re: Chyna back from the falls? Doses/ideas?

You said she likes her gums rubbed and that makes me suspicious.
And it sure would be a cause for her numbers to be climbing.

If you scratch her lower jaw line or in her whisker area, basically scritching where the teeth are underneath her skin ( cheeks, lips), does she chatter with her mouth? Chatter like she's shivering/shuddering or when there is a bird out the window.
If she does.... then feline absorptive lesions may be the reason. It's very common in cats. And the vet needs xrays to see all the hairline cracks/fissures
in her teeth.

http://www.avds-online.org/info/felinelesions.html

Re: Chyna back from the falls? Doses/ideas?

Thanks Julie, I was hoping to not have to...sigh. I do always think of something I should have said or done when I get home :roll: She has always had itchy ears (the vet called it chronic ear infections) but I've noticed her scratching under the chin lately, it seems to be the main place. Not a lot, but some. When we first discovered food allergies, she was scratching everywhere on her face and it came along with pooping issues.

Thanks Rhiannon, I'm suspicious of it being teeth too since she actually takes my fingers and rubs them along her gums. She does like to have her ears, chin and cheeks rubbed (always has, I think) but I've never noticed a chattering. I'll have to try it tonight and try get those pictures...I need four or five hands :lol: .

I made it to work, but may not make it home again, in all the snow. I called the vet office this morning and they said they suspected falling out of remission. When I mentioned why, like teeth or infection, and how her ears both feel warm now, or trying antibiotics (since she jumped 5 points in a day for BG (sorry, US 90)) they said they'd read over her chart and get back to me. AND I'm still waiting, at work. Last time they finally called at end of day. How long does it take to read her chart?? Yes, I'm impatient and worried nailbite_smile

I know ECID, but if it's a dental, should I hold off on insulin till after, assuming it can be done soon, and if I can borrow money or figure out some way to pay? Do antibiotics help bring BG down if it's just an infection and she could still manage to stay in greens alone? Or is it always the needs more insulin to get them back into remission? I know anesthesia brings BG down...and I don't know if they'd do it with CKD issues? I may just go get Lantus on the way home. Sorry if these are stupid and unanswerable...worried bean

Re: Chyna back from the falls? Doses/ideas?

we all understand worrying about your baby!

if it were me, i wouldn't hesitate to restart and then adjust for the dental when it happens. unless it gets scheduled within a few days, then maybe wait.

yes, if there is an infection sometimes BGs will drop when the antibiotic kicks in.

not sure, but my guess would be that once she's come out of remission, she would be likely to need insulin to get back in. but i have no personal experience with it, i'm just thinking out loud.

Re: Chyna back from the falls? Doses/ideas?

Well, I finally got to talk to the vet after worrying all day. She'd been researching infections, remission, and glucose this afternoon after I'd asked about it and she wanted to rule out dental and UTIs before we worry about insulin. I was on the phone with her for a good 15 minutes. I'll ask about URIs too, she has wheezed here and there (usually puking a hairball after but I have no idea what an asthma attack looks like; yesterday she did 3 wheezes and nothing and I gave her some vaseline. Today she puked a hairball though...)

Anyhoo. So we're going in Monday to IV/sedate her (assuming she turns into a raging tiger like usual) so they can take a good look at her mouth and take a urine sample, and if they see anything that needs to be done in her mouth she'd like to do it while she's already there under. I'm not sure how I'm coming up with the money, but I'm hoping this is a good plan. I forgot to ask if I should have her fast in case...I'll have to phone back tomorrow to confirm. She said to keep doing glucose tests the next few days so they have a pattern? Like I wouldn't :lol: . I don't like the glucose being high like this though, I wish they'd had room tomorrow! I hope this is the right thing to do. Time to go do fluids, will try pop onto some condos later. I have to go shovel AGAIN too. Last night, this morning, and again tonight, ack. Hugs to you all

Rachel

I know you have to work with your vet and you hold the syringe, but with a kitty coming back from the falls and suddenly well above normal numbers, I'd get the insulin started. You don't want her to become insulin resistant which might require that you go up even higher in dose to get a breakthrough. I would not want to leave her in yellow numbers all weekend.

I was really hoping she'd stay around 120 and then settle back down....

Oh Marje I wish I had gone with my gut and gotten lantus on the way home. I was thinking of it...I was hoping she'd go back down too. it will be tomorrow night before I can start it now...is 1 unit good? My syringe skills are rusty....

If you use the old insulin, it may be weaker, yet may have some effect.
Maybe try 0.5 and monitor what happens.

Thanks, I'll try the 0.5 tonight. I didn't get a chance to try the old insulin this morning, couldn't sleep, then finally did and slept in and then had to race for work in the snowstorm that is never ending :shock: I almost got stuck...not sure if I'll make it home since the sidestreets won't be plowed anytime soon. Anyways, I will go to the drugstore near work at lunch for Lantus and test strips and start her tonight...should be safe driving on the main road.

Should I be worrying about antibiotics if they are doing a mouth exam/possible dental?

I guess I'll be starting a new condo tonight with BG and my back on Lantus status...sort of bittersweet :cry: but I want her to be safe and healthy!

Rachel, I wish you were closer so I could split a pack of Lantus pens with you . . . sorry you're having to start up the insulin again, but it's so good that you already know what you're doing this time around! Hopefully it will be temporary until dental or some other issue gets sorted out. Stay safe and warm!

Thanks Amy, me too :lol: If it were nicer weather, I'd try to get a split somewhere but I'm just going with the closest London Drugs on the main road! It's $70 a vial so not too bad...but they don't split pens, I asked them and a few other pharmacies. Ah well :?

I just wish the accu-chek strips I had ordered on ebay would have shipped faster! I have a bayer contour meter and 50 strips on order too for a backup as I don't have one. Neither is due to show till just before Christmas :roll: Maybe that's overkill...I went a little shopping happy when her numbers started creeping up...and I had money from some stuff I'd sold on ebay in paypal to spend ;-) Should have saved it for the vet since I have to go buy strips now as I only have 30 or so!