Always low blood sugar

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Rianne

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I took my cat in for a toothache and drool and the vet did blood work and said she had diabetes (glucose at 240), sent us home with insulin prescription etc and rechecked her 4 days later, infection in mouth was horrible by this point, gave her an antibiolitc shot, and checked glucose and levels were low.

She finally feels better after anitbiotics and we have the libre on her now but 90% of the time she is low, even when eating, I stopped her insulin yesterday, she is still low but no changes in behavior at all. She isn't lethargic, eats fine, drinks fine, pees fine. Is there any chance or anyone know of a misdiagnosis? Was her suger just high once due to stress and infection? The vet said put sugar in her mouth if under 50 but she is always at 50 since libre and running around fine.

I'm so confused and I think they are tired of me calling, 3 meals now without insulin tho and levels never over 80. Just wondering if someone has seen something similar or of the libre just isn't very accurate (tho 2 rechecks at vet also low sugar).
 
There are a few explanations that come to mind. But first, what are your kitty's blood glucose numbers when they are "low?"

Most cats are stressed when having to go for a vet visit. The ride to the vet, being in what is usually a noisy waiting room, strange smells (especially if there are dogs there), strange people, someone other than you handling your cat, etc. all contribute to the stress. Stress raises blood glucose levels.

Another source of stress is any form of inflammation or infection. From what you've described, it sounds like your cat had a major dental issue. Even for diabetic cats in remission, dental issues are a big reason for a cat to come out of remission. So it's likely that the infection was contributing to the high numbers.

Now that the infection is under control, it sounds like numbers have come back down to what is normal.

One way to determine if your cat was, in fact, diabetic would be to get a fructosamine test. This is a blood test that's similar to a hemoglobin A1c that's used to diagnose diabetes in humans. The results give you a snapshot of blood glucose numbers over a period of 2 to 3 weeks.

The Libre tends to be less accurate at the lower end of the range. Again, it would be helpful for us to see what the numbers look like.
 
I took a screenshot but couldn't figure out how to post it, her average is 66, only 29% "in range," if that helps. Lowest ever was 51, highest ever 99, since Thurs afternoon, last insulin given Thurs night I will ask my vet about this other test, thank you.
 
Those are non-diabetic cat numbers. The normal range is 50-120 on a human meter which the libre is. I agree with Sienne. Your vet should have done a fructosamine test, which is the 3-week average. That’s how diabetes is diagnosed and based on a spot check. Many reasons why she couldn’t have had a higher bg at that moment. Your instincts are correct in stopping the insulin. As she pointed out, the libre can be glitchy and inaccurate on the low numbers. Any chance you live near a Walmart and can get a meter to double check?
 
Thank you both, I'm just going to feed her the 3 meals and no insulin as long as they stay low through the weekend then ask vet Monday about that test. I hate to drag her back in a dump money again but I need a definite for sure. This process is already at $1100 and she still hasn't had the dental work.
 
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