Hi plus an intro

my name is Melissa and my cat is Baby Cat. He is 14 and we have had him since he was five weeks old. He was diagnosed last summer with diabetes and put on insulin. We have done a fantastic job of properly caring for him.

About 2 months ago, we adopted a rescue pup. Circumstances prevented us from being able to slowly acclimate him to our cats. Right about this time, BC got anew bottle of insulin. Not long after, he started crying in the night and asking for the bath tub water to be turned on, so I took him to have a BG check at the vet. It was over 700. Over the course of the next weeks, we could not stabilize him, and his insulin dose went from six to 15. I asked the vet if it could be the insulin and he was adamant that it could not. I asked if it could be the stress of the dog moving in and he said no.

About a week ago, I opened a fresh bottle of insulin. Last night, at two AM, I heard a crash in the kitchen and he started howling. My son made it to him first and he had pooped himself in the bed, his neck was stiff and he was still responsive but acting blind. I grabbed the Karo and drew up about 2 ML and started giving it to him. While I was doing that, my son put some in a dish and added a tsp of water or so to thin it out so we could easily draw it up. I got him wrapped in a towel, cleaned up, etc while still administering the Karo. Soon, he started to be quiet and lightly purr so I kept fussing over him. After about an hour and a half, I curled up in the recliner with him in my arms and we dozed till five, when he got up, used the box, ate and demanded the tub water be turned on. He's been tired and seem exhausted all day today. At six tonight, we will see our vet.

I'm hoping to find what I need here to just start treating him myself. He is really fat and the doc says I should not try to feed him any differently. But from what I know of insulin in humans, the more you take, the more weight you can gain, then the more you need to take. Does it work that way in cats? Is there hope for him? He is such a great kitty.

Special needs are nothing new to me. My son is autistic, our dog has a liver shunt, so I understand the importance of schedules and special diets. I just need some hands to guide me to the right way to manage Baby Cat's diabetes with maybe less involvement from our vet, who saved his life and I adore and respect. There just has to be a better way. This is the first low he has had since diagnosis.

Thanks for listening. I'm about to head out to have his sugars checked and find out what Doc thinks we should do.

 

Just really quickly, in the hope this catches you before you head out to the vet. Please don't rely on any high reading you may find at the vet today - if Baby Cat was truly in hypo badly enough to show symptoms last night, then he is quite likely to be bouncing today (showing a very high reading) in response to an earlier low. If he is bouncing, then it is possible that your vet will want you to raise his insulin dose. Please don't do that without posting back here for some help. More info to follow, but I just wanted to get that said quickly.

 

Thanks. I had actually planned that already. Something has got to change.

I'm sure I gave him way more than a tablespoon of Karo, though.

 

How very scarey for you and your son! I am so glad you had some Karo and a hypo plan, and acted so quickly! What kind of insulin and diet is he on? I'm pretty new here, so can't give you much in the way of advice, but the answers to those questions will get the ball rolling for the more experience members to give you some insight. Great job in acting fast and saving BC last night!

 

No worries - it's just I know not everyone knows about bouncing...I'd have hated to see you raise his dose after last night's scare.

We all overdo it the first time (or two, or three). You got him out of danger and that's what matters - better too high for a day than too low for a minute!

If I can suggest just one thing to change at this point, it would be to start home-testing Baby Cat's BG levels. Once you get a routine with this, it is actually really easy and only takes a few seconds. Not only can you be certain that his level is high enough before you give him a shot, but you can also check to see how low his current dose is taking him. Once you can test at home, you can avoid situations like you had last night because you'll know if he's starting to drop low before he reaches the point of having symptoms and you can guide him back up with some higher carb food or a little karo before you get to the point where it's an emergency. Stress can, absolutely, cause BG to be higher - many cats test higher at the vet than at home because of stress and the stress of having a new pet in the house can definitely have an effect too. So it is quite possible that, although his levels were raised for a while, they've started to stabilize now as he gets used to the new addition...but of course now he's getting much more insulin than he was. The only way of knowing for sure is to be able to track his glucose levels on a daily basis. There is a lot of help available right here on the board for getting started with home testing, so if that is something you think you could do, please let us know and we'll help you figure out a good meter to use and help you with a lot of tips to get you started.

If you can let us know what diet Baby Cat is currently eating and what insulin you are using, then we can help you a lot more with figuring out what can safely be changed to get him healthier too.

 

Oh, I'm sorry - I didn't take the time to welcome you properly either as I wanted to get that first bit of information across quickly. Welcome Melissa and extra-sweet Baby Cat! I'm sure that with the collective knowledge on the board here we can help you to get Baby Cat into a better and healthier state - even down to helping you get his weight under control.

 

Hello and welcome. I wish you had posted this with more time before going to the vet. A lot to cover.

 

Ok I'm in the parking lot about to head home. His BG was 46, we fed him some wet food with a syringe. He wants me to bring him back tomorrow, and thinks he might be in remission. He said no more insulin till further notice, which I already knew, and he hasn't had any today.

 

I'll read everything when I get home.

 

Whew! Hope things are settling down for you.

There are some useful assessments in my signature link Secondary Monitoring Tools which you can use to evaluate him to see how he's doing.

 

He's been eating cat chow for kibble and fancy feast classic twice a day. I've left the kibble out because doc said it was important to keep plenty of food available to prevent lows.

The insulin is bovine PZI I think it's called. I'm outside now with the dog and will look when I get back in.

 

Fancy Feast classic pate is a good, low carb option for diabetic kitties. The cat chow kibble (in fact any dry food) rather less so in general terms. However, please don't change his food while still giving insulin unless you are also home-testing! Removing the dry food from a cat's diet can reduce their BG by 100+ points.

Unfortunately, I have no direct experience with PZI so I am not able to help you with dosing for that, but I know there are people here who do including, if I remember right, @BJM.

 

He's been eating cat chow for kibble and fancy feast classic twice a day. I've left the kibble out because doc said it was important to keep plenty of food available to prevent lows.

The insulin is bovine PZI I think it's called. I'm outside now with the dog and will look when I get back in.

 

Doc also noted that he has a bad tooth that is likely affecting his desire to eat so he told me after we get him feeling right again, he will pull it.

Also, I give him meowstard and catchup on his fancy feast because he loves the gravy.

As of now, though, he's off insulin. So it's a good time to look at changing his diet up but not before he's more stable. How long does PZI stay in the system? It's been almost 24 hours since his last shot.

 

That much I do know about PZI - it has no depot so it will be out of his system by now and you would be safe to start transitioning him to low carb wet food only. If his numbers can hold stable in the normal range, then he will be in remission...though I will say it would be very unusual for a cat to go from 15 units of any insulin all the way down to zero overnight. With that said, 15 units of any insulin is an incredibly high dose so it is possible that he had been overdosed for a while (too much insulin can actually look like not enough because it can cause the same high, flat numbers as an insufficient dose). Getting any necessary dental work done can, for some cats, also reduce their need for insulin so it might be that it was the issue with his tooth that caused or contributed the loss of regulation you had recently too.

I agree that changing his diet is safest done for now while he's not getting any insulin at all - especially as we can't be sure how close he really was to his ideal dose. I'll have to look up meowstard and catchup - I'm not familiar with either product so I'm not at all sure what the carbs in those are like.

 

re: your vet's advice about kibble - providing any kind of food out during the day may help prevent lows, not just kibble/biscuits.

Home blood glucose testing will help keep your cat safe, allowing you to decide if it safe to give insulin, and if a particular dose takes him too low or not low enough.

Maybe come over the the PZI/ProZinc section to post further, and have a read of our guidelines for using it optimally, here.

 

Ok, I'm heading to bed. I just stuck his ear and got a reading of 207 with my son's meter. I feel safe leaving him like that for now. He's laying in the dog's bed, with three types of food set in front of him. He ate almost an entire can of Hills urgent care tonight, the vet gave it to me on my way out the door. I'm pretty sure it's the same stuff we did in the exam room while he demonstrated syringe feeding.

Thanks for all the help, you guys. I really appreciate it. I've been checking out other forums etc

 

He should be safe for tonight with no insulin and a reading of 207. That is a little high to call remission, but that's something we can all help you work on tomorrow after you've had (hopefully) a better night's sleep.

 

I did sleep well. I woke up at five with BC sleeping on my feet then head butting the arm that was out of the blanket so I snuggle him up close and we go back to sleep.

I wish I had realized how easy sticking his ear was going to be before. It was easy enough to line up the lancing device with the vein and just push the button, and he didn't even notice.

 

I have a couple questions. Did you give an injection of insulin in the morning before you went to the vet and how many hours went by before the vet did his blood test? If the reading came up 46 I am thinking that was the insulin working because then you said his number was 207. Remission numbers I thought stayed lower and didnt raise up but maybe someone else can explain that better. @Chris & China

 

Nope. He had a shot on Saturday night at 8, seized at 2 AM, then no more insulin. At 6 PM Sunday, he was 46. He ate all day, some kibble, some treats, some FF, and some Hills urgent care at and after the vet visit.

I've got to do a couple of hours of work from home but this afternoon, I'm taking him back in.

 

It's possible (not probable) that when he went way too low at 2am that he could be in remission

We've seen it several times where a cat had a symptomatic hypo and it somehow "shocked" the pancreas into working again.

I strongly encourage you to dump the dry food, continue home testing and let the people here (who've been dealing with diabetic cats for many years) guide you going forward

Under no circumstances would I give 15 units of insulin again unless and until it's proven he needed that much....and unless he's been specifically tested for acromegaly or IAA and is positive, there's really no way he could need that much insulin.....most of our cats here that haven't been proven to have acromegaly or IAA are on less than 2 units

 

Fwiw, he was already on six twice daily when he started acting high and I took him in and he was over 700. The fifteen was a gradual process, and Doc didn't like doing it, over the course of about three weeks of taking him in and raising is in small bits. He stayed level till I opened the new bottle of insulin.
Doc kept saying he felt like I was messing up the shots, but I wasn't, and I know that. You don't go for almost a year of perfect control and suddenly start doing shots wrong.

 

And I do intend to learn here. I respect and adore my vet, but we'd like to give BC the best we can.

I'm also getting things in place to start all of our cats to home cooked food.

I tested him again this afternoon and he was back to being high at 324

 

How did he get to the original 6 units Melissa? Even that is a high dose for most cats.

 

When he was first diagnosed, he was really sick. He spent five days in the hospital. When he got out, we started him on two units twice daily and I took him in every Tuesday and Thursday to be checked. We slowly moved him up until six was keeping him between 95 and 170 on his days. He stayed there for months.

 

So maybe the PZI isn't working as well for him as a different insulin would. I have two diabetics in the house and we have levemir on hand.

 

He tested 574 tonight, and Doc wants me to start him back on 10 units tonight. I'm scared of doing it, scared of not doing it...

 

10 units is really high, since you're using PZI insulin, why don't you post on the ProZinc forum to get some dosing advice. Try that and if things don't improve, maybe a switch to Levemir would be good. Link this thread to your ProZinc post so you won't have to repeat everything.

 

Before you dose any amount lets find someone experienced who can guide you with what to do.

 

Sue or Rachel are really experienced in the Prozinc form hopefully they are online and if not should soon

 

I agree that jumping back in with 10 units might well be too much! @Sue and Oliver (GA) - do you have any information you can offer to help with dosing at all? I know the query needs to go over to the ProZinc forum, but I'd like to get eyes on it from people who know the insulin!

 

I am responding to her on the PZI forum.