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My 17-year-old cat has diabetes and Lantus was prescribed…

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My 17-year-old cat has diabetes...
My 17-year-old cat has diabetes and Lantus was prescribed for his therapy. At 3 units his glucose levels stay around 400, monitored by a 12 hour glucose curve. He also to has a lot of arthritis in his back. Could his pain, cause stress and effect the difficulty regulating his insulin? And if so would you consider pain medication?
Thank you
Submitted: 6 months ago.Category: Cat Veterinary
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Answered in 13 minutes by:
12/19/2017
Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 6 months ago
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 34,762
Experience: University of California at Davis graduate veterinarian with 45 years of experience.
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Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 6 months ago

While stressors of any kind can elevate blood sugar, the inflammation associated with arthritis (or any disorder) is the prime reason for poor glycemic control. If his glucose levels have stabilized around 400 and aren't seesawing between a blood sugar less than 100 and over 400 (the Somogyi effect which indicates overdosing of insulin), his insulin dose should be increased or the response of his blood sugar to a nonsteroidal antinflammatory drug (NSAID) such a meloxicam or robenacoxib was assessed. Please respond with further questions or concerns if you wish.

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Customer reply replied 6 months ago
I'm sorry but I don't understand the part of your answer where you say, .........."or the response of his blood sugar to a (NSAID) such a meloxicam or robenacoxib was assessed."
Customer reply replied 6 months ago
I'm sorry but I don't understand the part of your answer where you say............"or the response of his blood sugar to a (NSAID) such a meloxicam or robenacoxib was assed."
Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 6 months ago

Before altering the insulin dose, it would be prudent to initiate an NSAID in an attempt to reduce the inflammation likely to be causing insulin resistance. I might check a glucose curve after your cat had been administered the NSAID for a week. If you saw a good response, you wouldn't need to increase the insulin dose. If you didn't see a good response, a search for other causes of insulin resistance should be made, e.g., oral inflammation from dental disease or urinary tract infection. Please continue our conversation if you wish.

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Customer reply replied 6 months ago
Thank you, ***** ***** is a new direction we can try. I'll pass this on to our Vet.
Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 6 months ago

You're quite welcome. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.

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Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 6 months ago
Hi,

I'm just following up on our conversation about your pet. How is everything going?

Dr. Michael Salkin
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