Perlutz's BG is still very high and seems to be getting higher still We've had such high hopes when changing to ProZinc as the numbers were albeit still hight at least somewhat constant but 4 weeks later, we're still seeing a lot of red and more recently black on his SS With the increased numbers, he is now drinking a lot of water and obviously wees a lot but he is in very good spirits for these numbers. He is constantly hungry though and for the first time in his life, he started waking us up in the mornings demanding food We try to avoid cooking or eating at home now as he is always meowing for food He is eating Thrive wet cans, usually 1x can twice a day before insulin and a 3rd can spead throught the morning/evening but now that is not enough, he meows for more and I'm not sure if to give him more? As of yesterday, he weighs 6.4 kg, he was 7.1 when diagnosed mid January (he used to have a combined dry and wet food diet before dx). Any opinions and advice would be greatly appreciated as we are feeling lost and unsure what to do to finally get some yellows and blues on his SS... Thanks!
I think it's time to increase by 0.25 u every 4 cycles until you start seeing a lot of yellow and blue. At that point you can slow the rate of increase. If you hold ineffective doses too long glucose toxicity can build making him less responsive to insulin. The way through that is regular dose increases until you break through the toxicity. It can take a while but at that point the dose level often has to come down. Make a point to get as many tests as you can in the middle part of the cycle on days off as well as a before bed test every evening. You need data to assess the dose especially if you begin regular increases.
Thank you for replying Kris. We did increase the dose but everytime we do so the BG goes up as well! We gave him 2.25U tonight, highest dose he has ever had...We are trying to get some additional measurements but it’s been bit difficult lately with longer commutes to work, overtime and I am stressing a lot sometimes and not managing to have any progresses with Perlutz has had me near a mental breakdown few days ago... Do you have any advice for his constant hunger? Should I give him an extra can a day? Thank you!
How is his weight? If he's underweight or losing weight, then yes, you can and should feed him more. If he's at a good weight, you can increase his food, but you'll need to monitor closely and make sure he doesn't gain weight. If he's overweight, then that can contribute to diabetes, so you'll want to keep some control over the food, making sure that he loses slowly. Rapid weight loss can have negative impact on cats. If you're not sure, you can stand on a scale and weigh yourself, then get off the scale, pick up Perlutz, and get back on the scale. Then subtract the two numbers. Or you can purchase a baby scale to get more accurate weights. I have found several at local thrift stores for less than $10. You might need to check with your vet to determine if the weight is high, low, or good since cats have different builds, and different breeds have different weight ranges.
Hi Djamila, He is overweight at 6.4 kg (14 lbs) and his ideal weight would be around 5-5.5 kg (11-12 lbs). He was on a diet for weight loss way before diabetes and nothing happened. Now I know there was no way of him losing weight on the prescribed Hills Metabolic or other similar foods recommended by the vet... But since the diabetes diagnosis mid January and the diet change, he has lost 800 grams (1.76 lbs), at a faster rate at the beginning when still on Caninsulin and not feeling very well and then slower through diet. We weigh him once a week give or take or anytime we feel there might be a change. So keeping all this is mind, he should still be eating his 3 cans which make up a calorie intake for weight loss but I don’t want him to starve all the time and I don’t know if this hunger could end up affecting the diabetes somehow. And boy he acts like he is starving! Even half an hour after downing a whole can he still meow for food, lick the bowl although he (already cleaned all the crumbs etc
When do you feed him? Sometimes breaking the food up into smaller portions more often can help them be less hungry. What does he eat?
He is eating Thrive, various flavours as a main food. Every now and then, maybe 1-2 meals a week, he will get Miamor/Animoda/Applaws or rarely Purina Pate as a diversification. Normally, he will get 1x can at 6:30 AM, 1/3 of a can 1-2 hours later, depending on what time we leave to work, 1x can at 6:30 PM and the rest 2/3 of a can would be split in smaller portions before bed time. Now he downs all these 3 cans, begs for food from us if we eat, and just spends time scratching the wall next to his feeding area demanding more! Before this hunger started about a week ago, he would sometimes not even finish 3 whole cans during 1 day!
Given the very high numbers, and that the hunger only started about a week ago, I think I might suggest a vet visit. Hunger in these numbers is to be expected as their bodies can't process the nutrients in the food in those numbers. However, since it's a new symptom, that makes me wonder if something else is going on. When was his last blood panel? As Rachel suggested, breaking the food into smaller portions and spreading them out might help as well, although it sounds like that would be diffcult with your work schedule. You could also try getting a timed feeder that could open every couple of hours during the day while you're gone. I've found one to be very helpful with my guy so he doesn't wake me up at 2am!
He hasn't had a blood test since dignostic, he's had a check up nearly every 2 weeks. His vet didn't think additional blood tests were needed. He has had few days here and there with hunger, but not so bad. We do have a vet visit scheduled soon, willl see if we could find an earlier app and I was already thinking of maybe discussing a blood test. We do have an automatic feeder with 6 slots so we could portion his food throughout the day. However, he does not touch the food when we're gone, prefers to sleep all day and "concert" us when we're at home Doesn't wake us up at night, only in the morning 20-30 min before feeding time. Also, last night he was meowing for food but decided he did not want to touch Miamor and just meow some more to get different food
So a quick update - we've had a vet appointment last night... During check up I spotted a bit of red on the gum around 1 tooth and he didn't even mention it, I had to ask The answer was very vague, something on the lines of "it's not very serious yet and I don't think it has to do with the high BG you've been seeing lately". Stupidly, I didn't challenge it and now I'm worried about it as I don't know if it's ok to just leave it untreated? Regarding the high BGs he only said to hold his current dose for the rest of this week, do a curve on Sunday and he'll call on Monday to discuss the curve. I don't think he was impressed with us raising the dose since last check up... We've also asked for a referral to RVC and I think we've offended him a little He said he will do it but nothing more and then the appointment came to a halt. In case we do get a referral, has anyone been to the RVC in Hatfield?
Hi Georgiana, I was hoping you'd post an update from the vet visit. Ref the red area on Perlutz's gum - this could be a sign of infection or inflammation, and infection of any kind can raise bg, so your vet was a tad casual about it IMO. I would keep a close eye on this area and if it gets worse, ask the vet to take a proper look. Vets don't like to be challenged so it's no real surprise that yours didn't like you raising the dose without his say-so. But a good vet would at least respect you educating yourself and trying to understand how best to manage FD. Given the numbers you've been getting, it's not unrealistic to see what a slightly higher dose would do. It's also not unrealistic to ask for a referral to the RVC, given the current numbers. There are one or two people here who have been there, I will try to find their names and tag them here so you can ask some questions. It's certainly something to consider and Hatfield isn't too far for you to travel, so if you get a chance, go for it. ETA the member I'm thinking of who had her cat treated at the RVC is Rebecca Thomas. I don't think she's been on the board for a while so I'm not sure if it's a good idea to contact her or not... you could do a search for her posts. TBH I don't really know how the referral system works, and if your vet can try to get you seen by the RVC when you haven't as yet had a diagnosis of any kind other than FD. In Rebecca's case, her cat had acro - which Perlutz does not have as far as we know.
Hi Diana The gum is indeed worrying me a lot and the fact that the vet brushed it off as nothing when even I know it could be related to his high BGs and I’m such a beginner in FD! I will keep an eye on it and if there’s any changes, we’ll go back. I am doing a bit of reading on brushing his teeth as unfortunately I have never done it to him before. Do you think it’s a good idea to brush his teeth with this redness? Or maybe I should only do it on his right side where things looked normal? I think all he has to do is ring them up or do it on their website and it says on the website they’re offering a second opinion so it should be ok even though he “only” has FD. They’re offering some blood test packages for diabetic cats, we are keen on doing the one that tests for pretty much everything, including acromegaly and on top of that, it would be great to see a vet with a lot more experience in diabetes. I guess I’ll just have to wait until he rings me on Monday and bring up the referral again... On a side note, from crying at the sight of syringes, I’ve just managed to do his shot tonight in about a minute! It’s usually the boyfriend doing it 99% of the time and previously it took me an hour before I managed So at least I am making some progress with this Georgiana
Ah ok so the RVC referral would be for a second opinion, as opposed to getting specialist advice for a specifc condition that general practice vets don't know much about. I agree, it would be good to get Perlutz seen by someone else. I'd keep pushing for a referral. I don't know if it would help to email the surgery to put in writing how you feel about how things are going and why you'd like to go to the RVC...? It would be more difficult for the vet to ignore a written request. That's what I'd do, anyway. As for the mouth issue - most cats won't tolerate having their teeth brushed but you could give it a go and avoid that area. Definitely keep an eye on the area though, and report back to the vet next time - it may be something very small but may be contributing to the high bg. Well done for doing the shot so quickly! Sometimes if you just get the things out and get on with it without thinking, it's all over and done with before you realise. Give yourself a treat now!!
I am not 100% sure how the referral works but the way I understood it it's that they have various specialists and you will be seen by a doctor in whatever speciality your pet needs. And I am really hoping it is this way as the blood tests only cost £350 And most importantly, we need someone who really understands FD! I'll bring the referral up on Monday when the vet calls and hopefully he will do it soon. I found some toothpaste recommendations on FDMB and I'll order some, hopefully Perlutz will like it. I know the gums may or may not affect his bg but regardless I'd like to do whatever I can to avoid any more issues for his general well being and quality of life. I looked at his gums and it looks the same. He's not thrilled with me checking his teeth but at least he tolerates it. Thank you Diana and everyone else for replying and answering my questions. I honestly don't know where we'd be if we hadn't found FDMB
Good job! I nearly fainted in the vets office when they handed me a syringe to practice ! lol I've done it twice now though and I think even though it's scarier it's technically easier for me than testing his blood most of the times lol
I’ve just done another shot and although he moved, I didn’t lose my calm and did it PHEW! I completely understand you, I have fainted in the past when going for a blood test and I wasn’t much better at the sight of blood either But after nearly 3 months with Perlutz’s diabetes, I can take his blood glucose and the blood doesn’t bother me in the slightest. If the boyfriend is at home, I’ll let him do the shots as I’m still not entirely comfortable doing them myself, but I promise you it gets much better in time! Always remind yourself it’s much worse in our head, they can’t feel it if done properly and it’s for their own good! I wish you and Jasper good luck!
Update please, Georgiana! How is Perlutz doing now? What happened about the referral and how is that red area on his gum? Hope you will keep us informed, we are all rooting for you, you know!
Hi Diana, Perlutz is doing fine, thank you. He is his normal happy, lively self and eating very well but he is still in high and very high numbers... As an update on what’s been happening lately: His gum is still red, to me it looks the same as when we’ve first spotted it. Will definitely not let it go next time we see his vet We’ve changed the Prozinc vial and got yellows next 2 AMPS but back to reds and blacks after. It made me hope the old one was dodgy but it seems it wasn’t. He had diarrhea 2-3 times, one quite bad others not so much. One was after changing the insulin vial so I’m not sure whether the yellow next morning was due to new vial/diarrhea or something else. Few bum shuffling and poop stains on the carpet later we’re back to normal poops Oh the joy of having to have his daddy hold him while I had to clean some poop off his tail just under his bum More on poop, this morning it was normal but he did half of his usual and then the other half about 30 min later. Could be because I was in the shower during the first and he sure likes his privacy when using the loo I now exchange pictures of Perlutz’s poop with the boyfriend He has lost bit of weight but gained back (he’s at 6.3 KG now) No ketones Still drinks a lot and pees a lot (and I mean A LOT) He wants to eat A LOT. He does not want to accept 2 main meals a day and 2 snacks AM/ PM so he has 2 snacks AM and 2 snacks PM most times. As for the RVC referral, we did get it last week. We have made an appointment on May 14th but we are having second thoughts about going. A friend’s acquaintance is an RVC student where we are due to go and she has kindly offered an insight into how these appointments usually go. Unlike what I thought and hoped for, Perlutz would be seen by a student and if they consider necessary they might discuss his case with a vet (a “normal” vet, not necessarily one of the guys specialised in DM). The specialists only see very complicated cases. Also, it is very likely they would request to keep him over night “to better assess his situation” as stated on the paperwork received from them already. Now why I am not sure whether I want to go ahead or not is due to the fact that he will not be seen by a specialist which is why we’ve got this referral in the first place. Also, the price of the consultation only is a staggering £275! For us that is a lot of money at the moment and we (stupidly) don’t have insurance and we’re paying for everything. There’s also the question of leaving him overnight and I know he won’t take that well, he stresses easily, does not like strangers, hates most men (God forbid he sees a bald man ) and definitely does not like being handled by anyone else but mommy. And he hisses a lot. Which might get him the towel treatment and a vet or nurse might lose a finger or an eye The blood tests would cost an additional £350 If he would be seen by one of the doctors specialised in diabetes, I’d go there with my wallet open without giving it a second thought. A student... not so much! As I’ve had a terrible day today, I’m gonna give myself a little praise too and mention that I’ve made some good progress in giving him his shots I can now do it on my own quite confidently (most times). And I’ve even managed to get him to come to me for the blood sugar testing whereas before it was a little chase I’ll attach a picture of how we do the testing nowadays. I’ll also attach a pic of his teeth and gums taken tonight. Any insight/opinion/advice will be greatly appreciated! Georgiana
Awww he's such a beauty, Georgiana! Sorry you've had a bad day but I'm glad you're doing ok with the shots, well done! Thanks for the update (lots of poopy news, don't we all just love it!!!) I can see your point about the referral (actually it seems a bit cheeky to be asked to pay that sort of money to see a student vet). I don't think I'd go ahead, in those circumstances, it doesn't sound as if you'd be getting much for your money really, does it. I'd definitely get that sore area in his mouth properly looked at next time you're at the vet's though, it might be infected and could be contributing to those pesky high numbers. It would be very interesting to see what the Prozinc experts here have to say about all this, and about the numbers on your spreadsheet. @Djamila @Rachel any ideas?
Ah yes, the poopy stories! And your comment about exchanging poop pictures with the BF cracked me up! I agree with Diana about that tooth - it does not look okay to me and is quite likely a contributing factor. (lovely red nails by the way!) I also agree about the vet consult. Those prices seem criminal. I think your money would be better spent paying for x-ray and dental to deal with the tooth (it may need to be extracted as feline dentistry is not as refined as human dentistry). As for the insulin, it's really important to get those before-bed tests in to help monitor that nighttime cycle (which can be quite different than the daytime cycle). I would also start doing regular dose increases - go up 0.25 every third or fourth cycle until you start to see more variation in the numbers. We must get him out of those numbers for as many hours of the day as possible. His PS numbers will likely stay high, but let's see if we can't start to get something better in the middle of the cycle and help with the peeing, drinking, and hunger.
No poopy stories today, I promise! Perlutz has never had any dental issues before so I don’t know much about what it would involve. If his vet still doesn’t think it’s a reason of concern, what should I say? Should I ask for xray? Would that be the best to see what’s going on there? Would he need to be under anesthesia? I think if I know a bit more, I should be able to persuade him to do it. I’ve said before that we’ll try to get more testing, at least before bed but it’s been a hectic month for us humans and we’ve been back from work, did the insulin routine and then out on the door again some evenings... The thing is he will have his main mean 6:30ish PM and then a couple more snacks before bed and his BG will be elevated from the food... Will increase to 3u tonight too.
The vet should be able to form an initial idea of whether there's some work needed in Pertlutz's mouth by taking a good look as opposed to a cursory glance... he can't deny that there is something amiss there. If he thinks it's nfection, a course of antibiotics might clear it up (and hopefully improve bg!) but an x-ray would clarify things and if it's a bad tooth it might need to come out (and again, hopefully lower bg). X-rays may well involve sedation as the cat wouldn't stay still otherwise. Dental work may be expensive but as Djamila says, it would be a better use of money than a visit to a student vet. When's your next scheduled vet appointment? If it's a question of "persuading" your vet to take x-rays, you may need to gather your courage! Usually it's the other way round - medical peeps like doing tests to rule things out, and us patients aren't so keen. I would give it some serious thought and maybe say that you've heard from other pet-owners who have found that bg improves after dental problems are diagnosed and treated (sounds better than saying you've been reading on the internet?) Try to get the vet on your side but of course, don't let him talk you into unnecessary treatment... we here are guessing that there's a mouth issue, but we can't be sure. It's his job to diagnose and treat, it's our job to suggest and support! Yes, increase to 3u tonight as Djamila says, and maybe keep a little diary to remind yourself when to carry on increasing if necessary. Good luck and keep posting with any updates, good or not so good!
I agree with Diana and Djamila. That tooth looks troublesome, and I think if you push some, the vet should be willing to examine it more. I've got a pretty good relationship with my vet where I can explain my concerns and they're willing to do what tests are necessary. Maybe even just say that you're just really concerned about the tooth and ask if they can do some tests to be rule it out and help calm your worries? That often works with vets who know that we are worried about our babies!
We're actually seeing his vet this Sunday afternoon. When we've first seen Perlutz's red gum, he said he doesn't consider it an infection that would affect bg's so at least he is aware that it could happen. I will ask him to check it properly and maybe request antibiotics for starters? That, of course, if he doesn't say straight away that x-rays are needed. Even if maybe it's not a full blown infection, there's something there. I just hope we can get Perlutz to take antibiotics of that's the case Also, I did mention FDMB to him and all the useful info I find here and he's always listening with interest and doesn't dimiss it as "just that thing you read on the internet" so it's all good in that regard. It was actually funny when during our 1st-2nd appointment I brought up Somogyi effect and he was like whoaaa someone's done their research
Haha I get that! When I walked into my vet's office and started talking about everything I knew, he asked if I was a nurse! I told him no...just someone who researches. The good news is that made him trust me and I basically just have to call up and say I need something and why and he'll get it for me...and when I go to see them, they just accept that I already know what's up and am managing my cats well!
I feel so bad now for not pushing about the tooth earlier I looked pictures of dental issues in cats, everything seemed 10x worse than Perlutz's so I just thought it's fine... I'm sure he will be on board if I say I really want it looked at properly and treated. He thinks I'm a bit crazy sometimes, I'm sure, but he seems to understand that we want the best for our babies and he'll go ahead with it.
Don't feel bad, Georgiana, it's obviously not bothering Perlutz too much himself - if he wasn't eating due to dental discomfort it would be worse for him. It may not be a major thing but by getting it checked out at least you'll know. Let us know how the vet visit goes.
As Diana said, we can't diagnose - we can just look at it and go, "Hmm...that doesn't look good." So it really will be up to the vet to take a good look and decide. If an x-ray is needed to be sure, my vet does them at the same time as the dental. So once we've decided there is sufficient redness to need a dental, he puts Sam under anesthesia, takes the x-ray, and then does any work/cleaning right then. Unfortunately bad teeth and feline diabetes often go together. And fixing a tooth doesn't mean the BG goes back to normal, but it does usually improve following a cleaning/work.
We’re back from the vet and Perlutz is booked in for a dental and some blood tests on the 22nd of May. We’ve discovered some more redness on the other side of the mouth, more than in the picture I posted above I’m going to collect a urine sample tomorrow and take it to the vet on Tuesday as he wants to run a urine test before the dental. As Perlutz is not the happiest chappy at the vet, they’d rather take the blood samples when he will be sedated for the dental. I wish we’d go a bit sooner but our vet is away for few days and didn’t want to be seen by someone else...
That's good progress, Georgiana. A dental is always a useful procedure to get done. I've replied in more detail on your thread on Health.
Hope the dental work will help Perlutz feel better! Such a smiley face . Don't be too hard on yourself, you're doing something about it We wouldn't be here doing what we do if we didn't care about our fur babies .
