2/14 | Jude: AMPS 242; +4 143; +8 145; PMPS 165; +2 105; +4 85; +6 99; 2 questions about FD

Recently, Jude's numbers have been in the blues and mostly greens; as a matter of fact, we've been struggling to get the correct dose for him because he keeps nose-diving (or, what Bhooma calls, racing down the dosing ladder). So, he's sort of suddenly had low numbers that I've had to prop up with carbs. With that in mind, here is the strangeness I'm trying to understand. I took Jude to the vet the other day bc his appetite hasn't been very strong. We discovered that he has a mild UTI and his teeth are, as the vet put it, "not good." It is WEIRD to me that, while Jude is suffering from a UTI and from a likely dental issue (we don't know for sure what all is happening in that little mouth, but likely some infection), he is also having the lowest numbers ever. I would think that either of these issues would send his bg soaring, as it has in the past when he was initially diagnosed with FD (he had a UTI) and then when he came out of remission (he had a UTI). I would love to hear some thoughts on this.

Also, I'm curious if someone can explain to me (or point me to a sticky that explains) what actually happens to cats who go into remission. Is their pancreas actually restoring/healing?
 
Marielle said:
Recently, Jude's numbers have been in the blues and mostly greens; as a matter of fact, we've been struggling to get the correct dose for him because he keeps nose-diving (or, what Bhooma calls, racing down the dosing ladder). So, he's sort of suddenly had low numbers that I've had to prop up with carbs. With that in mind, here is the strangeness I'm trying to understand. I took Jude to the vet the other day bc his appetite hasn't been very strong. We discovered that he has a mild UTI and his teeth are, as the vet put it, "not good." It is WEIRD to me that, while Jude is suffering from a UTI and from a likely dental issue (we don't know for sure what all is happening in that little mouth, but likely some infection), he is also having the lowest numbers ever. I would think that either of these issues would send his bg soaring, as it has in the past when he was initially diagnosed with FD (he had a UTI) and then when he came out of remission (he had a UTI). I would love to hear some thoughts on this.

Also, I'm curious if someone can explain to me (or point me to a sticky that explains) what actually happens to cats who go into remission. Is their pancreas actually restoring/healing?
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@Bron and Sheba (GA)
@Bandit's Mom
 
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Marielle said:
With that in mind, here is the strangeness I'm trying to understand. I took Jude to the vet the other day bc his appetite hasn't been very strong. We discovered that he has a mild UTI and his teeth are, as the vet put it, "not good." It is WEIRD to me that, while Jude is suffering from a UTI and from a likely dental issue (we don't know for sure what all is happening in that little mouth, but likely some infection), he is also having the lowest numbers ever. I would think that either of these issues would send his bg soaring, as it has in the past when he was initially diagnosed with FD (he had a UTI) and then when he came out of remission (he had a UTI). I would love to hear some thoughts on this.
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Yes, normally, any sort of infection/inflammation/pain will affect their BG - make it hard to regulate and even knock them out of remission. For whatever reason he has flipped a switch at 3U. Maybe he was seeing some glucose toxicity (despite the occasional green) from October to January and hit a breakthrough dose at 3U. Maybe all the time he spent in lower numbers helped his pancreas heal and produce some insulin.

Marielle said:
Also, I'm curious if someone can explain to me (or point me to a sticky that explains) what actually happens to cats who go into remission. Is their pancreas actually restoring/healing?
Click to expand...
Yes, when cats go into remission, their pancreas have healed and are producing insulin and they don't need insulin.
 
Thanks, @Bandit's Mom, for weighing-in on my question. 3U was definitely the "switch" number for Jude. Those of you who have watched so many diabetic cats on this forum have an incredible wealth of knowledge. If I have learned anything from this experience of coming out of remission, it is this: I probably should have started him at a larger dose than I originally did when Jude came out of remission. I was fixated on the terminology of SLGS, so I thought starting lower was the best approach. I read today that, while slightly overdosing with Lantus at the onset of FD can increase the risk of hypoglycemia, it usually results in achieving early glycemic control that often leads to remission. It's fascinating to me how the insulin works on their system and how it can ultimately rehabilitate their pancreas.
 
Marielle said:
I was fixated on the terminology of SLGS, so I thought starting lower was the best approach. I read today that, while slightly overdosing with Lantus at the onset of FD can increase the risk of hypoglycemia, it usually results in achieving early glycemic control that often leads to remission. It's fascinating to me how the insulin works on their system and how it can ultimately rehabilitate their pancreas.
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Yes, a lot of people with newly diagnosed cats are very overwhelmed (and worried about hypos) and the thought of "starting low and going slow" really appeals. While there have been cats that have gone into remission with SLGS, some cats tend to experience glucose toxicity and would benefit from TR (faster dose changes) to reach a breakthrough dose. With newly diagnosed cats, as well as cats that have fallen out of remission, the sooner you get them to good numbers/a good dose, the greater the chances of getting regulated/going into remission. Therefore, for cats on a lower carb diet, where the CG is able to test as much as is required by TR, the more aggressive approach afforded by TR makes sense.

We have also seen cats that have been started on too high a dose by a vet or where dose changes are taken in whole units (and often without home testing) "benefit" from the shock of hypoglycemia by getting regulated/going into remission, we would not suggest such overdosing - the risks far outweigh any potential benefits.
 
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