Diabetes and Steroids

Edited to add first post
https://felinediabetes.com/FDMB/threads/new-member-newly-diagnosed-ish-02-09.234547/#post-2627503

Hi all! It's been a while.

So further to my first post Bo has been weaned off steroids and her blood glucose has returned to normal. However her liver enzymes (ALT) have been creeping up and on her latest have just creeped above the upper normal range.

So it seems my girl needs steroids to keep her liver in check and naturally I'm worried about her glucose increasing again and developing diabetes. My vet suggested we could go back on steroids but at a lower dose or go back to the specialist hospital and have a liver scan and biopsy. I'm in two minds about the tests because if it doesn't change the treatment plan of going back on steroids then it's a lot to put her through.

Does anyone have experience of having a sugar kitty on steroids. I'm hoping the dose we start on won't raise it too much but I like to be prepared. She's on low carb wet food already and I have everything to home test.
I would welcome any and all advice.

 

How high is the ALT? Max had chronic pancreatitis and his ALT would go up when it flared. My vet said unless it was over twice high normal and other labs or symptoms it didn’t mean anything. He never needed steroids

 

It's been steadily increasing since she came off the steroids. She's had monthly bloods and it's gone up by approximately 100 each time (I'm in the UK and ranges may be different) so as it's a steady increase and because of how poorly she was we can't leave it. No other signs of pancreatitis so it is likely it's related to the damage caused 19 months ago.

I've decided to get the tests done after finding her discharge letter. They couldn't do a biopsy when she was an inpatient as she wasn't stable enough for the anaesthetic and they suggested if she improved and remained stable on the treatment then no need. But as she's now off steroids with her ALT playing up I thought now would be the time to get them and confirm the liver damage. Also the specialists can weigh in on treatments etc and advise on managing her liver and her impending high blood glucose on steroids.

But my vet did feel that either way she'd need the steroids so rock and a hard place. Do nothing and we risk her becoming poorly with her liver. Start steroids and we risk diabetes.

 

You can manage the diabetes with insulin. We will help you.

 

Thank you, just feels like it's going to be an uphill battle already!