I heard from Dr. B. today regarding Missy's fructosamine test result. He said it was higher than he would like but that it is better than it was. He advised staying at our present insulin dose and we're to have another test in December. Missy's geriatric system may not be able to achieve the same high level of control as a younger cat's. We also need to be careful not to send her into a diabetic seizure by using too much insulin! So there's no change for Missy right now.
fructosamine
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To the vet with Missy this afternoon. It was time to see how well her blood sugar level was being controlled. It turns out she's doing very well indeed. Her weight is 9.1 lbs., up a bit from last visit when it was up to 8.9 lbs., and a good, healthy weight for a cat her size. Her blood glucose was 68.7 — tested twice because Dr. B. couldn't believe it. That puts her blood glucose at a "low-normal" level, way down from the last visit when it was 387. The fructosamine test will be back tomorrow (Wednesday) and will be a better indicator of just how well she is doing — glucose can rise and fall rapidly depending upon a number of factors. She was cringing, yowling, and growling during the exam and blood taking and was, as usual, ever so happy to get back into her carrier. In the waiting room after the exam she got feline treats which she ate enthusiastically — a trick she repeated at the food bowl when she got home. Good ol' cat.
UPDATE: The fructosamine result was 483 (normal is 172-370) which indicates, on average, that Missy's blood sugar level is running high. Her insulin regimen will likely need some tweaking and, I'm guessing, it will involve twice-a-day injections to smooth out the ebb and flow of blood glucose. We're to speak with Dr. B. next week.
Missy paid a routine visit to Dr. B. today. We only arrived back home a few minutes ago after a visit to check her blood glucose level. Missy's been doing fine though still doesn't groom herself much, if at all. She does have a good appetite, is awake and alert for a decent amount of time, and can move around just fine (though there's a hint of stiffness in her hips). In-clinic testing indicates blood glucose seems to be under control though a little higher right now than we would like (it's 387). Her weight is up just a bit at 8.9 pounds; she feels "solid." Following the blood collecting and exam we cooled our paws in the waiting room for a few minutes and Miss sampled some Hill's "dental treats." {Actually, I seem to recall this is Hill's "Oral Care Adult" formula but the vet likes to use them more as treats than staple food.} She crunched happily on five of those things in the safety of her carry case. They're high fat and all but I suppose the fat just makes them all the tastier and suitble as comfort food following a stressful experience. Office staff kindly gave us two small sample bags to take home. Tasha got a couple crunchies that way too and loves 'em. Dr. B. says to continue the once-a-day insulin at the same dosage while we await a "new" blood test for fructosamine (glycated serum protein) which is a good indicator of long-term blood sugar levels and control. If the fructosamine test is "out of range" then the insulin dosage can be adjusted. All-in-all a good report for an old cat. For Tasha the advice is to keep her on her cortisone indefinitely at half a tablet once every third day; hardly any medication at all but hopefully enough to keep her bowel inflammation at bay.
Addendum: The test results came back and Missy's fructosamine level was 584. Normal level for that substance in a cat is 370 – 400. That means that over the previous week Missy's blood glucose level was too high, too. Dr. B. increased her insulin dose from 6 to 7 units per day. We're to recheck fructosamine again in two weeks.
PhotonStopper 