6 Months Post SRT Sudden Drops in Sugar

pablo'smom

pablo'smom

Member
Hi everyone,

Sorry it has been a while since I've been active but life has been busy and crazy. I know I need to update Pablo's spreadsheet as it has been months but I do check his sugar everyday still, I just need to log the readings and I promise I will update it soon.

The reason I am posting is because Pablo has been doing what I hope is considered good? He was diagnosed with stage I CKD and is on telmisartan (an ARB) and a phosphate binder, his last labs at the end of July showed great improvement in his proteinuria and levels and he will get labs done again in a few weeks. Hopefully we see the same (or better) numbers. However, his sugar has been dropping like crazy lately and out of nowhere. Forever it felt like he sat in the upper 200s-300s and a good day was when we hit 250, but now he keeps getting down to 50s and so I have been reducing his insulin like crazy and within 2 weeks we have gone from 18 units of Lantus to 12 units because he is consistently in the 50s to low 100s. I have been giving him treats like crazy because everyday is scary with the drops and it seems like even high carb treats are doing nothing to raise his sugar. I expected the drastic insulin changes to make his sugar spike one of these days but nope, he is almost always low. I do have karo syrup on hand and I am going to go buy super high carb food just in case. Also I have noticed his appetite is decreasing and sometimes he takes almost an hour to finish a meal whereas before he inhaled his food. I hope and assume this is because the acro and diabetes is finally under control. He also gained a ton weight back with his calorie surplus and now he has to go on a diet which means I need to slowly decrease his food and therefore carbs which makes this all the more stressful. Are these all good signs? He looks very healthy compared to a few months ago.
 
A reduced dose need and not "starving" means the SRT is probably killing off some of those pituitary tumour cells meaning less growth hormone output. Yes, that is a good thing. :). If you could publish the last couple weeks of sugar readings/doses, I might be able to give you some tips to make it less stressful for you. Although he probably loves the treats, they won't help his weight. I never needed super high carb food - each cat is different in how they respond to carbs. For Neko, 17% was good for HC and a drop of syrup when she dropped under 40. Some cats do need carbs over 20% and lots of it. Keep track of how much, what carbs, and when you feed HC on the Remarks section of the spreadsheet. Then you'll be able to spot the patterns and fine tune the HC. I was giving 22% HC at one point, and it was bumping her way too high.
 
I just put in a bunch of numbers. Sorry it is not perfect. My schedule has been so busy that I was gone almost all day for a while and my mom had to help out but now I am going to be mostly remote and thankfully home to keep an eye on him better. I will keep up with the sheet so we can figure this out and keep him safe.

Do you have any food recommendations for times I need higher carbs? His regular diet right now is Weruva BFF play pate plus purina proplan hydracare packets because it is low carb, low protein, and low phosphorous. He was eating 543 calories for a while per the vets instructions since he was nothing but bones due to the diabetes. However he currently is 16.7 lbs when he is suppose to be 14.5-15lbs (he is a big cat naturally). I cut him down to 458 calories over the last few weeks and I am about to cut him down even more but its been a slow process especially with his sugar dropping. I know he is eating way too much but diabetes and cutting food is a delicate balance and not to mention adding post SRT into the mix.

I also noticed he is much more himself lately. Before all of this he used to roll around on the ground and love belly rubs but then quit once he was skinny and frail. Now he demands belly rubs all the time again which makes me happy. 🥰
 
Weruva Grandma's Chicken Soup is low P and something like 22% carbs. I used it for Neko before I found it gave her too much of a boost. I ended up using some of the Cats in the Kitchen pouches for a low P barely HC food.

Rule of thumb when I was seeing SRT action, I reduced the dose if Neko went below 70. Instead of using the 50 per TR. It gave me a little margin. The folks at CSU suggested it, and it seemed to work.

Might want to read these two sections on the catinfo page: Implementing a safe weight-loss program and How fast should my cat lose weight?
 
Looks like he needs another reduction because he’s been dropping lower than we like to see in a post-SRT cat. I would cut the dose by a minimum of 1 unit. If he still drops below 70 and you are having difficulty bringing him up with carbs as you mentioned, I would consider drop it another unit.
 
Wendy&Neko said:
I didn't want to suggest a reduction amount, cause there isn't enough dose data the last week on the spreadsheet. So I don't know how much depot is in play
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I just saw all the recent drops (50s and 60s) over the last six days and thought that since he’s dropped well below 70 over that time, a reduction would be a good idea.
 
Having said that, are those ReliOn numbers (all the recent greens you put into the spreadsheet)? Your signature and spreadsheet say ReliOn, but at some time earlier you were using the Libre. If they’re Libre numbers then the BG might not be so low.

It’s really nice to see Pablo’s numbers and dose going down! I hope he’s feeling so much better!
 
Hi sorry guys! I'm using ReliOn. We have tried Libre a few times but he rips them off each time. I'll make a note of that on the sheet.

Also, I gave him 9 units this morning because he keeps dropping. I'm not going to change his amount of food yet because I want to have his sugar and insulin stable before I do so. I'm okay with him being a little chunky rather than accidently giving him a hypoglycemic episode. I feel like I'm just trying to keep up with the SRT effects at this point as usually a one unit reduction in insulin would have thrown him into the 300s, but his sugar is not going up at all. Do the effects usually happen this fast? His IM vet said that for some cats, it can happen very suddenly so to be on the lookout for drastic changes.
 
Good instincts….. and he already needs less than the 9 you shot this morning.

This is exciting….. and very stressful for you. Hopefully he will be at zero units soon (knock wood.)
 
I also have another question. I noticed over the last few months Pablo has two little skin tags on the upper neck area. His regular vet didn't seem concerned but is this normal with an acromegaly cat? they are small and don't seem to bother him and you can only find them when he moves a certain way or if you pet him a certain way. I'll ask his specialist at his follow up but I just was curious if anyone else had this experience.
 
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