Still at the vet?

My cat, Lily, was just diagnosed on Monday 3/12 in the afternoon. The vet said her level was at 316 and it should be under 200. Today is Thursday 3/15 and I just spoke with the vet again. He said that she's at 274 and seems to be holding steady and hopes I might be able to bring her home tomorrow, Friday 3/16. I'm new to this and what I've read is that a vet does not typically keep a cat more than a couple of days unless it's critical and that the high normal for cats without diabetes is 200 but with diabetes, the high end is 300. My questions are:

1. Does this sound like a critical case?
2. Is the length of time she's been at the vet typical or does it seem extreme?
3. If it seems extreme, what are some reasons he could be keeping her?
4. Is 316 really high? What is the reasonable level she should be at before I can bring her home?

This vet has really exceptional reviews & he's been great at keeping in touch with me even calling with an update after 8pm. I want her to be in the best possible condition before she comes home so I'm not really complaining. I'm just curious if this seems like an unusual amount of time. I'm only concerned about the costs if this amount of time at the vet is unusual.

I really appreciate any help someone can give.

 

Has the vet said anything about ketones or diabetic ketoacidosis? Is Lily eating, drinking, pooping, and peeing currently? Any other health issues?

The main reason to keep a cat at the vet at initial diagnosis is ketones/DKA (which definitely does require intensive vet treatment). Other than that, I'd think she could come home. You are correct that it's really not realistic to get a cat regulated on insulin in a couple days. Among other reasons, stress due to being at the vet will inflate BG numbers and make it hard to figure out the proper dose. 316 isn't even that high, especially if the vet is using a pet-specific meter.

If no other issues are present and she's eating, I'd ask to take her home as soon as you can.

Are you thinking of learning to home-test Lily's blood glucose? It's a great way to keep her safe, and to make sure she's on the proper insulin dose-- as mentioned, it's really really hard to figure out what that is in the vet environment due to stress. You get much more reliable numbers at home.

Good luck!

 

Hi, welcome to you and Lily,

I am not a vet so I cannot assess his strategies.
What prompted you to the vet on the day she was diagnosed?
Are there any other health complicating issues?

If the stable BG level is the only current concern then your plan of action - how soon to take her home - depends on your ability to provide care at home - to do BG home testing regularly. It is in fact much easier than it is sounds, especially when you just only learnt her Dx.

 

Thanks for the quick responses!!

He hasn't mentioned ketones but I think that might be a concern too because when I cleaned the litter box after I took her in, I noticed that the litter was really dark. Then on the side I saw what looked like syrup. When I wiped it, it was sticky and thick. I'm assuming that was her urine which, I think, would mean her ketone levels were high too but he hasn't mentioned it.

I took her in on Monday because she had dropped a lot of weight very quickly. She had been on diet food for over a year & a half. She never liked it and when my husband & I noticed that she was eating less than usual, we started feeding her the food she was on before (purina one hairball formula). Our other cat, Eddie, is on a special food for urinary tract issues so we had to put them in separate rooms to eat. She was crying and scratching at the door more than usual so I started feeding her the same food as Eddie & left it out for them to eat throughout the day. We noticed that her weight was dropping and she was more playful. I left my job in November so I couldn't tell if she was either drinking more water than usual or if I was just seeing her drinking more since I was at home.

We struggled on whether time take her in or not because our concerns were matched with good things. Our biggest concern was her weight dropping so fast but now she was at the weight she should be at, she was more active, playful & cuddly, and her coat was just as soft & clean as usual. But the weight loss seemed extreme so i decided to take her in just in case.

I will definitely be doing home testing. She's a fairly anxious cat and she likes to be petted while she's eating. She also hates being given pills and we've had complaints from vets who have tried giving her pills. So she's not great at the vets.

I read on this forum about how the stress from being in the kennel can cause her bg levels to be higher than usual so I went to visit her yesterday. I brought her a blanket to lay on & to have something familiar there you help reduce the stress. I stayed with her for awhile & petted her while she was in the cage. She growled at first but I let her sniff my hand & noticed that she was sensitive behind one of her ears where it was obvious that it was where she was given the injections. So I started petting her on the other side & she immediately stood up & came straight for me. She was very responsive & as I was petting her she started eating a lot from the food bowl.

I just don't know what to do. On one hand I don't want to bring her home without the vet's okay just because I think she's been there too long or the stress is making it difficult to stabilize her then she gets worse and I have you take her back. On the other hand I don't want her there if there's a high probability that the stress is making the stabilization take longer and it would be better if she was home.

I hope I answered all the questions.

 

did it look like some blood maybe in there? have you mentioned it to the vet?
My cat had ketones but no change in litter clump's color, nor was her urine ever sticky...but every cat is different.

There are foods that are agreeable with both diabetics and kitties with UTI. If no kidney issues with either of them plain old Friskie classic Pate or Fancy Feast classic with some extra water added might work well for both of them. try it out - maybe you won't have to separate them and your wallet will thank you.

home testing is the best tool to keep a kitty on insulin safe! I am gad to read you are up to it. Most of us here use human meter from Walmart - Relion Micro Confirm or Prime. They also carry lancets, strips, etc - all a diabetic needs at an affordable price. We can help you starting it.

it is really depends on knowing what exactly the issue is. Again, IF it is nothing else at all but the higher BG level and you are willing to start home testing from the day one you may want to take him home. It's best that you have meter and all other supplies at home when he returns so you can monitor the situation. Make sure to ask for a copy of all his papers - the blood work, the meds given, etc. It'll help you a lot in the future with, for instance, food selection.

I am a little worried about darkened litter clumps.. But I think that if she had ketones the vet would have mentioned it.

 

I am, too. Definitely, please tell your vet about this. He should know about it regardless of the cause. Any changes in urine should always be discussed with your vet.

 

I would love some advice on home testing and a supply list. Today I asked the vet for a list of supplies I should get before I pick her up & he said that he'll give me a prescription and some syringes were I won't need to run out to get any but he didn't mention a testing meter or anything else. He's a very busy vet & whenever he calls he sounds very hurried & I have this thing where if someone sounds busy I have an overwhelming response to not bother them so I end up not asking questions. I just called, again, and gave a tech a list of my questions to give to him for when he calls be later tonight. I put on the list my concern about the stress thing.

I'm not too sure about the dark litter. I didn't see any blood and since she's been at the vet for so long that they would probably have noticed it. I'll keep an eye on it though.

Thanks for the advice on the food situation! Our cat, Eddie, has had multiple uti's so he's on hillside science diet c/d which is not cheap so I'd love to get him on some less expensive food.

 

One of our members @JanetNJ made the best home testing tutorial video - the link is in her signature block - it is the best online.
The shopping list for Wamart is like that:
Relion Meter & box of 100 strips (I use Relion Micro and cannot complain).
Relion Lancets 1 box of 100 gauge 26 or 28.
Pack of cosmetic rounds/ cotton balls to hold behind the ear when you getting blood sample from the ear.
Neosporin Ointment (better than cream) with Pain Relief.
Honey or Karo syrup.
Fancy Feast Grilled - Chicken or Tuna Feast in gravy - 3-4- cans 2.8 oz ea + Fancy Feast Gravy Lovers - Chicken or Beef x 2 ea. These two are not for every day feeding but to help the glucose numbers up in case he is going too low. Keep it separately s won't accidentally feed it. I mark mine with its carbs content - FF Gravy Lovers 15 - 20%, and the FF Grilled just below 15%.

Dr. Pierson Blog - fantastic info about UTI and its prevention and the food can be found there.

If there is no issues with Eddie 's kidneys but he is prone to UTI try Friskies Classic Pate - I fed Ducia Turkey and Giblets and Mixed Grill flavors. I hope that both your babies will eat it well. Also available at Walmart. Transitioning to a new food is best if done slowly/ gradually. Check out the UTI section and the Transitioning to wet section in Dr. Pierson blog - the subject tabs are on the right of the screen.

I'll post some more a bit later.

 

Wow! Thanks! I didn't think I'd get so many responses so quickly! You guys are awesome!

 

Here is the food chart for wet foods - aim at anything with the carbs content below 10%.
Frisky Pate, Fancy Feast Pate are very popular here.

 

Walmart also sells insulin syringes - I use Relion brand for Lantus (Glargine) insulin.
You may need different type - depends on the insulin your vet is going to Rx.

 

Have you tried giving Eddie D-mannose? It works by preventing certain kinds of bacteria from sticking to the walls of the urinary tract and causing infection. Squallie was having idiopathic UTIs repeatedly, on and off ABs all the time (which really won't treat idiopathic UTIs anyway) so I figured, why not? I started him on it over a year ago and he has not had a single UTI ever since. I get the NOW brand powder from Amazon, and it only takes a tiny amount added to his meals twice a day. For him, it has worked like a charm!

 

Home testing Instructions are HERE
How to teat Hypo - HERE. I had it printed out.

 

Welcome. I have a video in my signature showing how I test my cat CC at home.

 

She's home!! The vet said she was at 240 & he was wanting to get her levels to under 200 but agreed that the stress she may be under could cause a 40 to 50 point increase. He showed me where & how to do the injection and gave me 3 pre-filled syringes. This way I can wait until tomorrow I get the prescription. He's given her Relion insulin & at 3 units, 2x's s day at meal time.

I just fed her Blue Healthy Gourmet Pate Ocean Fish & Tuna which I just bought at the store using the food chart. It has 34% protein, 58% fat, & 8% carbs. I gave her the injection right as I put the food down. She doesn't handle needles or pills very well (even vets have complained). I grabbed her by the scruff, put the needle in the excess skin at 45° angle, and as I was putting the insulin in she moved a bit. I finished but when I pulled the syringe away, I noticed that the needle was bent at a 90° angle. I checked and the needle is intact and I felt around the area where I injected her & there's no wetness & she's not reacting as if the area is sensitive. So I think it's ok but I need to figure out a better way to do it.

She's so happy right now. She's sitting next to me and just purring away while I pet her. Thank you all SOOO much for your help! I'll be getting a home tester tomorrow when I get her prescription.

 

I'm glad you'll be testing because 3 units is a huge starting dose. The recommended starting dose is 1 unit twice a day.

 

I thought I had read that somewhere. Since it took the vet so long to get her levels down I figured it was a pretty critical situation. I told him about the dark & sticky urine and he said that was the sugar in her system. I also took that as a sign that this might be a critical situation.

He said that her body isn't producing any insulin. I don't know if that changes anything. She seems to be doing really well, though. She hasn't been drinking or urinating effectively or not enough. She's about to fall asleep which she hasn't done since I got her home about 4 hours ago.

 

What signs do I look for if it's too much?

 

Here's a list of symptoms and how to treat hypos:

How to treat HYPOS - THEY CAN KILL! Print this Out!!

If you're worried about the 3U dose, you can leave some food out. Many cats will eat when they start to go low, helping to bring the blood glucose up.

I'm not sure what you mean by "relion insulin". Are there any other names on the bottle/vial/pen? Lantus (glargine), ProZinc, Vetsulin/Caninsulin, Novalin N, Humulin?

 

I had the same question. It's probably Novalin or Humulin, I think Walmart sells one or both of them.

 

She is such a beautiful girl!