Saturday, August 9, 2008

The Mystery Deepens

After a wonderful couple of weeks with no insulin injections, and Hamlet looking so much better, it was quite a surprise to find that he had a high fructosamine again, when tested. This was very unexpected. His fructosamine was 563, and when his apex was tested it came in at 27.7 without insulin. We are now working our way back up to a suitable dose for him, and sincerely hope we haven't thrown him out by six months again as we did last year when dropping insulin for one day.

At this point there seem to be a number of options as he is developing slight dehydration issues, while feeling as though he may have fluid buildup on the inside that has been just slightly there for a couple of months, now, where we have noticed. There is a possibility of pancreatitis, or other internal disease, and we are likely to need an ultrasound for further choices to be made. The option of using glargine has been put forward, although I am not sure that regression back to needing insulin after such a short hiatus will categorize Hamlet as "newly diagnosed", so no decision has yet been made.

February 9, 2009
The past couple of months have been a roller coaster of emotion for us as Hamlet started exhibiting signs of seizures in mid December, (2008). Right before Christmas they turned into tonic-clonic seizures. After a number of trips with consultation with a variety of veterinarians, there has been no explanation for these seizures. We suspect it is possible Hamlet's glucose readings are going lower at night, (I have observed this in action), to the point that he may have gone into hypoglycemic episodes. A progression of these may have triggered the seizure activity.
However, we also found an explanation for the unstable glucose readings as Hamlet has a benign growth on his pancreas that will probably be changing size, and possibly becoming inflamed at times, thereby changing the pressures on the pancreas and influencing glucose levels. It would explain the erratic readings, and we are just relieved that the growth is, so far, benign, as our poor dear fellow is aging enough without major surgery again.

To control his seizures, Hamlet is being given phenobarbital which, of course, has turned him into a very mellow fellow. We are being far more cautious about the amount of insulin he is receiving, and the latest fructosamine has come in at a low enough number, (518), that we have decided to leave him there for the time being. The nadir of Hamlet's curve can vary from 27.7, (very odd time), to 6.1 as the lowest I have captured lately. I find the high numbers, (27.7) unnerving as it appears to indicate the insulin is having no effect. We have changed bottles of insulin and I am hoping it is just a problem with the last bottle not mixing properly.*

*Just a note here that changing bottles did not make a difference. The eventual explanation is that the lump on Hamlet's pancreas was acting up, as he eventually settled down with time. I was so glad the ultrasound was done to confirm information and make choices so much easier.