Leo - Ultrasound revealed a mass on his pancreas

I finally found a new vet and was very happy with him. He listened to everything and looked at my spreadsheet. He think the prior vet had taken him off vetsulin too soon. He says we were getting much better numbers then and he thinks we just didn't go high enough and give it time.

He wanted to do an ultrasound to see what could be making his numbers so unregulated. He found a mass on his pancreas. He said we are unsure if it's an abscess, tumor or cyst. He said we could do exploratory surgery to see but we could also start him on antibiotics to see if it's an abscess. He did have pancreatitis back in July.

He wants me to bring him in the morning and let him spend the day at the vet and he is switching him back to vetsulin. He said our best case is to get him regulated so his has a better quality of life.

Has anyone dealt with this?? Did it end up being an abscess or cyst? If it was a tumor, how far has it progressed. Would love to connect with others that might be going through this.

He said we will do another ultrasound in a month to see what the mass looks like at that point. He hopes that it will be the same size, smaller or gone altogether. He said if it has grown we will know what we are dealing with and at that point it will be just keeping his quality of life until we can no longer do that. He told me it could be months. That makes me very sad but I am still hopeful its just an abscess and next month we will get better news.

 

I had a kitty who had a mass on the pancreas and unfortunately it was a cancer. However Leo’s mass could well be something else.
Maybe ask for a second opinion.
Does Leo have any symptoms at all at the moment?
Is he eating well?
Is he nauseated? Has he covered fully rom the pancreatitis in July.

I don’t think swapping back to vetsulin is a good option at all. You would be far better staying with Lantus.
Vetsulin is an insulin which was made for dogs that have a different metabolism to cats. Cats do not get a long enough duration on vetsulin.
Please reconsider changing back to vetsulin from Lantus. It would be a backward step.

If I were you I would consider trying the tight regulation protocol. At the moment you are not really following the SLGS method properly. If you posted each day, we could help and guide you. Your kitty might just need more insulin.

 

The only symptom he has had is the unregulated diabetes. He eats really well and has actually maintained weight.
When we looked back at my notes from the very beginning we realized he was getting much better #s on the vetsulin in the beginning. When we switched to prozinc the #s actually went up and we've never had the #s we did on vetsulin and that was at a small dose. The vet said he has had good results with vertsulin and thinks we switched too early. He wants to retry vetsulin to see if he responds better. His numbers have been the same or worse on Lantus so I think it's worth trying to see if we can get them down.

He is at the vet today. They wanted to watch him for a bit while switching him today. They are also starting antibiotics in case the mass is an abscess. We are going to do another ultrasound in a month to look at the mass again. He said that would give us more to go on. If it's the same or gone that is GREAT! If it has grown a good bit he will know more what we are dealing with.
I really trust this vet. I had a kitty that started coughing and was told my one vet that she had a hairball that was stuck. Then another vet did X-rays and found 2 masses in her lung. They told me there was nothing to do and she had maybe 6 months. Then I came to this vet and he redid X-rays and told me she had fluid in her lungs and that she had a heart condition. They completely missed it. He said that was her most immediate issue and started her on meds. The fluid cleared up and she started feeling great. She stayed on heart meds and lived another year and a half. She was 16-17 when she passed and it was the heart condition as he said instead of the masses that finally caused her to pass. He had gotten to where he was only in the clinic a couple of days a week so I started seeing another vet in the office and then that vet left and I went to the clinic I had been at until yesterday. I am glad this vet is back in the office more as well as they have 2 new vets that joined the clinic.

I read through some post in the Vetsulin forum and it does seem that some have had success and even remission on vetsulin. It may be the one that he responds to the most. I really am very worried about taking it into my own hands and changing doses without talking with the vet first. I don't want to do anything that is going to make him worse instead of better. I know it's a fine line between enough insulin and too much and I don't want to skew the numbers by moving too fast.

 

If you are following a dosing method, it is quite safe to change the dose with the help of experienced people here until you have more knowledge. We increase in small increments (1/4 unit) whereas most vets increase in 1 unit increments.
It is completely up to you whether you decide to follow what your vet says or if you would like to get some help here.

Please let us know who Leo gets on at the vet and how he is doing.

 

@Susan Shropshire
Hi Susan since you switched back to Vetsulin can you please add that to your spreadsheet and the date. Thanks

 

Susan -

Regardless of which insulin you're using, please do not make dose changes in 1.0u amounts. This is particularly the case with Vetsulin. A change in dose of a full unit is huge -- it's x4 larger than what is recommended here. Vetsulin works fast and can slam numbers down very quickly. You need considerably more testing to be sure that your cat is in safe numbers and you also need to make sure you've fed Leo 20 - 30 min before administering Vetsulin (which you may already know).

As an FYI, I suspect you were not seeing much progress on Lantus (and possibly on Prozinc) since you never increased the dose. If you were following SLGS, you would have been evaluating the dose on a weekly basis, doing a curve, and if numbers were not in the normal range, you would be increasing the dose. It also is necessary to get at least a "before bed" test on a nightly basis. Lantus dosing, much like other insulin, is based on the lowest number in the cycle, not on pre-shot numbers. If you are not testing in the evenings, you're missing half of your data. You have no way of knowing if numbers have dropped much lower at night and the data you're getting during the AM cycle reflects a bounce in to higher ranges.

 

I am working with the new vet (he's new to us, but not new to being a vet). He said with the mass we will need to do things a little differently, so I am staying with what he is telling me. So far we are seeing much steadier numbers. Where we were going up into the 400's and down in the mid 200's now we are steady through the day. We have been doing a unit and then waiting a week. With Leo I see that he normally goes up for the first day or two when we change his dose (that's been even at .5 unit). So I am hoping as we increase his dose we will start to see a steady set of lower numbers. I think he is doing the 1 unit increases now, since he was at 5 units of lantus. We are only at 4 units now of vetsulin so I feel we will need to increase at least to 5 units we want to take it slower and increase gradually. I have been getting overnight numbers and they basically stay the same as the daytime. I feed him before we go to bed @ 10pm, and he eats almost an entire can, and he usually wakes me up around 5am to eat.

He is doing well and eating wonderful. We even took in a kitten, and he has been playing with the kitten. My prayer is that when we did the next ultrasound that mass is much smaller or even gone. That is what the vet has been telling me as well. He has said if it is the same or smaller we will take the watch and see approach. If, however, it has grown, we will talk then. The main thing right now is getting his glucose numbers down under 300 constantly (he said that is the kidney threshold) and then he likes to stay in the 100-200 range for the majority of the day.

 

@Susan Shropshire
Hi Susan can you please add to your signature you have now switched back to Vetsulin and the date , thank you