Possible Remission?

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Morpheus

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Hello to everyone. I was sent/pointed to this site by a very friendly member of another board. I was surprised to see and remember I already had an account here, literally set up the day my cat was first diagnosed!

My nearly 15 year old cat was diagnosed with diabetes in June of 2022. He has been on insulin since, starting with one unit, then increasing to two units, before finally settling in at 2-1/2 units, where he has been for about the last 9 months.

Last Friday, he went in for his bi-annual glucose screening. He was also having a gastro-intestinal panel done, in which he needed to fast, (because of vomiting issues) so it worked out well, as he can't eat when he is getting his screening.

I get a call about half way through his screening. They needed to feed him because his glucose levels dropped below 80 (this was about 7 hours after his injection). The highest he registered the 8 hours he was there was 144 and that was at 4:30pm when I was picking him up. (For comparison, when he was diagnosed, his levels were immeasurable, as the test they used only measured to 500, and he topped that out.)

So my question. For those who have had a diabetic cat go into remission, does it sound like this could be what is happening? The vet didn't want to call it for sure yet, but she did decrease his insulin down to 1.5 units, and he goes back for another screening in 2 months (usually every 6 months due to his age.)

Also, could too much insulin be causing his vomiting issues? he will go a week and be just fine, then vomit for a day pretty much non stop. Then he's fine again for 10 days, then is sick again.

Thanks for any insight!
 
Morpheus said:
Hello to everyone. I was sent/pointed to this site by a very friendly member of another board. I was surprised to see and remember I already had an account here, literally set up the day my cat was first diagnosed!

My nearly 15 year old cat was diagnosed with diabetes in June of 2022. He has been on insulin since, starting with one unit, then increasing to two units, before finally settling in at 2-1/2 units, where he has been for about the last 9 months.

Last Friday, he went in for his bi-annual glucose screening. He was also having a gastro-intestinal panel done, in which he needed to fast, (because of vomiting issues) so it worked out well, as he can't eat when he is getting his screening.

I get a call about half way through his screening. They needed to feed him because his glucose levels dropped below 80 (this was about 7 hours after his injection). The highest he registered the 8 hours he was there was 144 and that was at 4:30pm when I was picking him up. (For comparison, when he was diagnosed, his levels were immeasurable, as the test they used only measured to 500, and he topped that out.)

So my question. For those who have had a diabetic cat go into remission, does it sound like this could be what is happening? The vet didn't want to call it for sure yet, but she did decrease his insulin down to 1.5 units, and he goes back for another screening in 2 months (usually every 6 months due to his age.)

Also, could too much insulin be causing his vomiting issues? he will go a week and be just fine, then vomit for a day pretty much non stop. Then he's fine again for 10 days, then is sick again.

Thanks for any insight!
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@Suzanne & Darcy
@tiffmaxee
@Wendy&Neko

Thanks ladies
 
Insulin doesn't generally cause vomiting. If your cat is becoming hypoglycemic due to too high of a dose, vomiting is possible.

I'm wondering if I'm reading your post correctly. Do you have your cat's blood glucose checked only twice a year? Are you testing at home?

There's no way other than home testing that you can be sure that your cat is in safe blood glucose numbers. All of the members here home test their cat.
 
80 is not a dangerous level for a kitty on insulin, if their caregiver is home testing. Depending on what type of insulin kitty is on, and dosing method followed, the below 80 would mean a dose reduction is in order. But we wouldn't reduce it by a full unit. It's likely he went lower than normal without having any food.

The high numbers you saw later are what we call bouncing. Definition of a bounce is: Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

Basically it means your kitty is not used to seeing numbers that low. It's an annoying but very common phenomenon with diabetic cats.

As far as remission goes, I wouldn't say that at this point. A cat's insulin needs can change over time, one of the reasons we suggest home testing to keep them safe. My cat was an unusual case, but she got up as high as 8.75 units, down to 0.75 units, then back up to 7 units, then back down to 0.25 units over the period of 5 years. She never did go into remission, but her dose needs changed a lot.
 
Sienne and Gabby (GA) said:
Insulin doesn't generally cause vomiting. If your cat is becoming hypoglycemic due to too high of a dose, vomiting is possible.

I'm wondering if I'm reading your post correctly. Do you have your cat's blood glucose checked only twice a year? Are you testing at home?

There's no way other than home testing that you can be sure that your cat is in safe blood glucose numbers. All of the members here home test their cat.
Click to expand...

In the two years my cat has had diabetes, I have never once tested at home. My vet has never even mentioned it.
 
Wendy&Neko said:
80 is not a dangerous level for a kitty on insulin, if their caregiver is home testing. Depending on what type of insulin kitty is on, and dosing method followed, the below 80 would mean a dose reduction is in order. But we wouldn't reduce it by a full unit. It's likely he went lower than normal without having any food.
Click to expand...

What do you mean, "we would never reduce by a full unit". I didn't do that on my own. That is what I was instructed to do by my vet.
 
By that I meant, the dosing methods we follow on FDMB would not suggest reducing the dose by a full unit. Cats need just small changes in dose. However, it's not surprising a vet would suggest a 1 unit change.
 
Many vets don't mention home testing for a variety of reasons. Some vets think your cat will hate you for poking their ear. Trust me, my cat didn't hate me and if you look at Gabby's spreadsheet, I tested a lot! The other reason is financial. You don't need your vet to run tests to assess your cat's blood glucose level if you're doing this at home. The huge advantage of home testing is you know exactly what the effect of the insulin dose is on your cat's blood glucose level. You know if it's not enough or more importantly, too much insulin. You can keep your cat safe.
 
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