Discussion in 'Feline Health - (The Main Forum)' started by Squalliesmom, Aug 5, 2015.
Good to know.
Lucy, I have an appointment in a few minutes so I have to log off for awhile.
Others are watching and will help if needed. Although, you have such great intuition and have done such an awesome job! I'm not so sure you need our help any more, but don't worry... there are others who will check in with you.
I'll have to catch up to you later...
Whew! Tested him just now, his BG is 203, and we're getting to the time in the cycle when his BG starts to rise, anyway. Called my vet, she said to skip his dose tonight and call with a BG reading in the A.M. and she will adjust it from there. He has an appointment tomorrow at 4:00, so we'll hash out a new plan of attack then, I'm sure. I'm still monitoring him to make sure he doesn't drop again, but I think he's going to be okay. Wow, scary, scary afternoon! I can't thank all of you enough, you were all a tremendous help, and helped keep me calm, too. Thank you so much, from the bottoms of mine and Squallie's hearts!
Thank you for all your help!
I'm so relieved to hear that the numbers are going up, but I'm sure no one is more relieved than you and of course Squallie.
I need to go as well, did not want to leave you in a lurch. Please keep us up to date on squallie's progress and know your in our harts as well.
Squallie never exhibited the classic signs of hypo that I've been told to look for. The only reason I was testing him today was because his AMPS numbers were low, and I debated whether or not to give him his morning dose. But I looked at his spreadsheet and saw a few other times he had similar low numbers and was okay, so I decided to go ahead, but was concerned enough that I thought I should monitor him throughout the day. Boy, am I glad I did! Based on his behavior alone I never would have suspected his BG was dropping so low. Lol, I have to say, I think Squallie thought this was a GREAT day, except for all the ear pricks; he got to eat all his favorite foods that he's not allowed to have anymore!
Thank you so much for all your help
That's for sure! And thank you for all your help!
Are there any post-hypo dangers I should look for or be aware of?
Hi. I'm just seeing this thread. You did a great job handling this! Squallie is lucky to have you watching out for him,
You could see some very high numbers post hypo. First, because he may "bounce" up high as a reaction to being so low. Second, he ate all that yummy, high-carb stuff! So don't be worried or surprised if he is high tonight or even tomorrow morning. Though I'm not familiar with your insulin, a dose reduction is definitely due, even if he's high tomorrow.
My vet advised not to give him any insulin tonight. Will he be okay if his BG goes way up?
Not a good day for cat crises at my household; just found out that while I was busy dealing with Squallie, my naughty Bengal boy Khoji was busy figuring out how to circumvent the lock on the back door! Fortunately my son spotted him before he got too far afield and we lured him back in with early dinner, lol.
(off topic): Maggie has the prettiest face I've ever seen!
Going way high up isn't nearly as bad as way low, unless it's chronic. A night of bouncing up high will be fine... Luna does it all the time!
Sometimes we've seen kitties be more sensitive to insulin following a hypo, but *usually* after a symptomatic hypo.
If he hasn't been throwing ketones, I wouldn't think there would be any problems skipping a shot. Skipping would allow you... and him... to rest and relax tonight! A little R & R does wonders for the soul.
Wonderful! You don't need another kitty crisis tonight!
You really did a great job today. Squallie is lucky to have you in his corner.
Get some rest...
Thanks! She not only pretty, she was about the sweetest thing ever, too. We still miss her so much…
I bet! I'm sure she lived a very happy life. She was born before I was!
He should be fine.
Okay, now Squallie's BG is really climbing, it was 419 with the Relion and 485 with the Alphatrak. Of course, my vet is closed for the day! Do you think he"ll be okay without insulin with his BG that high?
Probably a mix of a bounce and a mix of all the stuff he got. If the vet says no insulin I say no insulin. If you check my spreadsheet Luna popped over 500 from a bounce the previous day, that was nowhere near as low as Squallie's #'s. Last thing you want is to have this happen again tonight.
I could certainly use some rest! I was up almost all last night with Squallie, and was just about to take a nap today when I decided to check him one more time - glad I did! but no nap for exhausted Mom.
I think you can nap now!
Thanks for the advice and support, I truly appreciate it!
Thank you for the advice and kind words, much needed!
He's my best friend, I'd do anything in the world for him.
First, GOOD JOB! After today, you're officially a 'pro'.
I think what you're seeing with those high numbers now is a combination of the dry food finally getting a good hold and a bounce caused by Mr. Liver dumping extra 'sugars' into his bloodstream to compensate for those low numbers. That's the body's way of 'saving itself'. Those counterregulatory hormones can hang around for up to 3 days....
Wow, reading back over this has made me realize how much I DON'T trust my vet's advice. Guess I either need to work on that or get a new vet. I didn't realize it was that bad!
Aaagghh! Will he be okay? I mean, at what point does too high become potentially deadly?
I've been away from the board this evening. I am so relieved you successfully raised Squallie's numbers.
(((Lucy and Squallie)))
Vaseline can cause an error on an Alphatrak meter if it comes into contact with the test strip. I can't remember the source but I have encountered advice not to clean the test area with alcohol-soaked wipes because it can interfere with glucometer test results.
Lucy, my understanding is that Squallie would have to be HIGH, HIGH for several days if not longer before damage to internal organs occurs. One night, or several days from a bounce, he should be fine.
And you did great today!!!
On the average, you need 2 weeks of insufficient insulin before ketones start forming in the blood (average meaning some may form them sooner, some may form them later). From that point, it is an average of 5 days before the ketones start showing up in the urine. If your cat has ever had ketones, we suggest getting a blood ketone meter, to detect them sooner whenever there is loss of appetite, high glucose, and possible infection.
Hi Lucy - just caught this post. So nicely done for Squallie! I hope you can get some rest tonight.
Thank you, Aine, I am much relieved, too. What a scary day we had! How is Saoirse doing?
Thank you! That helps me breathe a little easier.
To the best of my knowledge he's never had ketones. I tested his urine this AM and it was negative.
Thank you, I think Squallie and I both need a rest! Poor baby got his ears pricked so much today that this afternoon, when I went to test him for the umpteenth time, his poor little ear stared bleeding before I even pricked it. He is such a sweet, tolerant kitty, but even he had had enough, and tried to hide under my bed.
I don't think #'s can really get too high and the biggest danger is long(er) term stuff like organ influences or ketones/DKA. I don't think a night or two of high #'s can be too bad unless we're talking like 700 or 800. I think then the cat would be floating around like a balloon!
I hope that yourself and Squallie are doing OK today and that you managed to get some much-needed rest after all of yesterday's 'excitement'.
I think Squallie may be getting Vetsulin carryover from one cycle into the next (e.g. 20 Aug). You're also getting quite early onset (+2) and late, low nadirs (riskily low for such a harsh insulin IMO). I'd recommend you seek advice from your vet and Vetsulin people here about dosing. I would recommend a very conservative approach giving insulin - especially for the next few days - until you get test data to determine whether Squallie has become super-sensitive to insulin after yesterday's severe hypo.
I'd also suggest considering another gentler, longer-acting insulin going forward.
My two penn'orth.
(Saoirse's muddling along, Lucy. Thank you for asking after her. )
Thanks for the input! Obviously the vet and I are going to have a lot to discuss today. No rest, been up all night again, Khoji made the great escape, little brat, so I've been up all night waiting for him to come home :-(. That little man is too smart by far!
Oh no! Khoji, you're very, very bold!
You must be absolutely banjaxed, Lucy.
I really am. And I have a busy day today so no rest there, either. Good thing I'm used to running on no sleep! Khoji is very naughty to worry his Mom like this, the longer he is out the more I worry.
Fingers and paws crossed he'll be home very soon.
Thanks! I am very concerned, he still has not come home.
Sending kitty homing beacon vibes ....
Oh, MY!!! Just now saw what you & Squallie have been going through - how scary for you! So I told Bat-Bat to cross her paws just like my fingers are crossed --- & we're wishing you & your dear kitty a MUCH better day today!
Thank you. I am just beside myself; he's still not home and I know he would be by now, if he was able to. Something must have happened to him, he would never miss two meals and be out this long. I am so terribly upset. And the vet said to give Squallie 7 units this morning and now he seems to me like he's dropping too low too fast. Sorry, don't mean to pule; I'm sure lack of sleep isn't helping. Well, at least my son is here today if I need to rush to the vet before Squll's appointment.
Thank you, we need all the good wishes we can get today.
Interesting. I've never read this before. Is this anecdotal or is there a source to these figures?
Here we go again, at +3.5 he's dropped from AMPS419 to 86.
Did you do 7 units again today? When's your vet appointment?
Yes, I called the vet this morning with his numbers and she said to give him 7 units. That was at 10:00. my appt is at 4:00 but if he goes much lower I'm taking him in early.
First up, please can you confirm immediately to us here on this thread that you gave Squallie 7 units of Vetsulin this morning.
IGNORE - thread created
(THEN - Start a new thread on Feline Health IMMEDIATELY - Use the 911 Icon and the title - 08/16: Squallie Low Again - AMPS 419, +3.5 86
You need support with this and I can't stay with you. The 911 should get members here to keep an eye on you and Squallie.
Your vet needs a good slap upside her head. HOWLING ERROR.
Eek. They should have told you to give less.
If you go in early be sure to bring some honey or something just in case, if he's super low they might need to give him a glucose drip while you're there I'm assuming.
Couple things I think you should do:
1) Do what Crittermom said.
2a) Discuss the dosage. 7 units is too much. Discuss changing to a longer lasting insulin or at least lowering the dose of your current insulin (mandatory I think).
2b) Find a new vet.
3) Pick up some gravy lover food for these low BG events. The gravy is super concentrated carbs and cats love it typically.
If you have gravy lovers I think I'd be giving my own cat some now before he drops more. A spoonful mixed with a little honey has helped my little guy when he was dropping like a rock on Vetsulin.
I can stay... needing to stay with my own fur child
I'M SETTING UP THE NEW THREAD.
Squallie's mom please monitor the thread Crittermom sets up -
Yes, I'd give some food now as well.
LINK TO NEW THREAD IN FELINE HEALTH:
Lucy and everyone who's staying to support, please move over to the new thread now.
Yes I have sources.
This article by Dr Rand in "Feline Diabetes, An Issue of Veterinary Clinics: Small Animal Practice"
"It is important to recognize the time course for development of ketosis and acidosis. Once insulin concentrations are suppressed to fasting levels (despite the presence of hyperglycemia) ketonemia and ketoacidosis can occur within approximately 12 and 16 days, respecively, if uncomplicated by precipating conditions. Ketoacidosis can occur as early as 4 days after ketonemia is first detected."
Clinical Endocrinology of Companion Animals edited by Jacquie Rand, Ellen Behrend, Danielle Gunn-Moore, Michele Campbell-Vard
"b. Ketonemia detected by laboratory measurement of beta-hydroxybutyrate occurs with about 2 weeks of marked hyperglycemia.
C. Ketonuria detectable with a urine dipstick occurs approximately 5 days after plasma betahydroxybutyrate exceeds the renal threshold and is measurable in urine."
Thanks. Doesn't really apply here as "insufficient insulin" is definitely not an issue.
The other qualifier I think is "if uncomplicated by precipating conditions". I haven't seen a case of ketones on the board that didn't include at least one of:
Infection of some sort present
I have however watched a cat (on insulin) earlier this summer go from no ketones in the original DX blood work, to moderate/high ketones in his urine, to dead within a period of 10 days.
Dr. Rand, I am sure, is correct. But I don't imagine too many cats fit her conditions.
Separate names with a comma.