02/16 Kabosu 450 AMPS BG only getting higher every day

Discussion in 'Lantus / Levemir / Biosimilars' started by Dasha and Kabosu, Feb 16, 2021.

  1. Dasha and Kabosu

    Dasha and Kabosu Member

    Joined:
    Jan 3, 2021
    Hi everyone,

    I don't know what to do... Kabosu's BG is getting worse and worse. I've only seen red numbers today, and we are getting close to the black ones. It's been a while since the last yellow-range BG number...

    He has had four courses of different antibiotics in the last two month because they suspected an infection may have caused his insulin-resistance.

    He's had a pancreatitis flare on Saturday. According to his bloods, pancreatitis test has always come positive, but that was the first time he felt so bad that he rejected food. According to our vet, the only treatment is IV fluids, anti-nausea and appetite stimulating medicines, as well as pain relief. He is already eating well and has not vomited since Saturday. I'm giving him Gabapentin in the evening sometimes, and SQ fluids. He's already been in the hospital with IV fluids, which did not help much, that's why I'm hesitating leaving him there again.

    I just want to cry, despite all my efforts he's getting worse and worse. What am I doing wrong?

    Previous post: https://www.felinediabetes.com/FDMB...eat-for-10-hours-pm-shot.243076/#post-2741626
     
  2. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I’m sorry he’s having a bad pancreatitis flare. It definitely can elevate the bg for a long time. Is the nausea controlled? Eating? I wonder if more is needed for pain. Only giving gabapentin sometimes at night is more than likely not enough. There were times Max needed all you mentioned for a few months. I used buprenorphine for pain and many need gabapentin and bupe both. It looks like you need to inc ease to 5.0 as well.

    I hope consistent pain relief will make him feel better soon. :bighug:
     
  3. Dasha and Kabosu

    Dasha and Kabosu Member

    Joined:
    Jan 3, 2021
    I believe so.
    He used to have nausea before being diagnosed with diabetes, then he would constantly make these chewing sounds, then I noticed that sometimes they'd intensify and result in vomiting.
    He did not make those since he vomited on Saturday. He is eating very well now, extremely hungry and begging for food all the time.

    For pain, the vet gave me Tralieve to use short-term instead of gabapentin.
    I don't really know whether he is in a lot of pain right now. Do you think I should leave him in the hospital?..
     
  4. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    This is a Primer on Pancreatitis that oe of our members put together. There may be some helpful information.

    How are the antibiotics formulated? Are they pills or liquid? If the latter, can you make sure that they were not compound in a sugar syrup? Many liquid meds are made in a syrup because the medication is bitter. If you don't remind the vet or pharmacy that your kitty is diabetic, it's a problem.

    From your spreadsheet, it sounds like Kabosu has a UTI. Did the vet get a sterile urine sample (i.e., a cystocentesis -- they get urine via a needle into the bladder) and then have a culture and sensitivity run? This is the only way to determine what bacteria is present and to then choose the appropriate antibiotic. It's also possible that there's a kidney infection. If pyelonephritis is the culprit, it takes a much longer course of antibiotics to treat (probably at least a month).

    Generally, antibiotics do not cause insulin resistance. It's the infection/inflammation that's causing numbers to be elevated. Any infection or inflammation is a stress on your cat's system and it causes a subsequent rise in BG.
     
  5. Dasha and Kabosu

    Dasha and Kabosu Member

    Joined:
    Jan 3, 2021
    He's had pills and injections.
    Also, both free catch urine we collected as well as the sample they took directly from his bladder. They found E.Coli there that was sensitive to all possible antibiotics.
     
  6. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    That all sounds good! I would talk to your vet about the possibility of pylonephritis. It may be that your kitty needs a longer course of one antibiotic.
     
    tiffmaxee likes this.
  7. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Since he’s eating and doesn’t seem to be in pain I would not hospitalize him. Max was only hospitalized a couple times overnight in the 7+ years he had pancreatitis. If not eating despite the support meds then it’s needed as IV fluids and stronger pain management would be needed. It did take two months or more of support at home for Max at times. Some cats can’t get off the support meds at all.
     
  8. Dasha and Kabosu

    Dasha and Kabosu Member

    Joined:
    Jan 3, 2021
    I just do not see any nadirs at all, it's like if I wasn't giving him any insulin. Also, his overall BG numbers are on the upper limit of the red range, and getting higher every day.
    I thought maybe they can give him some stronger immediate action insulin at the hospital?
     
  9. Dasha and Kabosu

    Dasha and Kabosu Member

    Joined:
    Jan 3, 2021
    I'm just wondering whether antibiotics may be bad for him? He's been on and off antibiotics for two months now, and is only getting worse. He was not doing that badly when I first brought him to the vet, his only problem was weight loss, now he has a lot of issues!
     
  10. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    My best guess is that the antibiotic isn't "bad". If this is a kidney infection, if you stop the antibiotic too soon, the infection flares up again.

    This is a link to some info on UTIs. There's a section further down on "not so simple infections."
     
    NyCatMom likes this.
  11. NyCatMom

    NyCatMom Member

    Joined:
    Oct 11, 2020
    We are in the same boat as you and I’m interested to hear if the infection has resolved yet. Honey developed a UTI in early February was treated with Clavamox was not restested before starting chemo treatment for small cell lymphoma. She was moved to Orbax while a second culture and sensitivity was done and started peeing blood all over the house. This week we moved to Baytril and a new culture will be run after seven days. I’ve been told to expect her to be on Baytril for a possible extended period. Blood sugar readings are in the 400s and no one seems concerned about it but me. I am hoping you have good news and are seeing improvement.
     
  12. Dasha and Kabosu

    Dasha and Kabosu Member

    Joined:
    Jan 3, 2021
    I am so sorry to hear Honey is peeing blood and is having high BG numbers.
    I see you are not testing in the middle of the day, do you think her numbers may be actually getting lower at some point of the day?

    Kabosu's urine culture came back clean, but his BG is still in 400s (already on 7.5 units of Lantus).
     
  13. NyCatMom

    NyCatMom Member

    Joined:
    Oct 11, 2020


    Oh wow. I thought Honey was on a high dose of Lantus, 4 units twice daily, but poor Kabosu is nearly double her dose. I’m so sorry to hear that he’s still struggling with his blood sugar. We’re heading back to the internal medicine specialist on Monday. He’s the one who prescribed the chemo therapy and steroids. The drugs are working great for the small cell lymphoma but I suspect are causing all her other issues. I test Honey randomly midday but don’t always log it in since I tend to put her numbers in a glucose monitoring app and then transfer to the spreadsheet every few weeks. I’m still looking for an app with a good export to excel function that I can use to merge with the online sheet. Today she was 401 before breakfast and 396 six hours later.

    What is your vet saying about Kabosu’s high numbers? Are they concerned? Sometimes I feel like I’m stressing out more than they are!
     

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