Cat "drunk" while eating

I hope I'm using the 911 tag appropriately--I'm very worried and can't get a hold of a vet again until Monday.

My cat, Jazz, was diagnosed with diabetes on Thursday and sent home with me on Friday. This morning and evening both, he got "drunk" while eating. Laid down to finish eating and staggered/crawled when he tried to walk. Couldn't stand at all at first, but this did not stop his ravenous eating at all. The staggering only seemed to last a few minutes and then he was reasonably ok again. When it happened this morning, I gave him his insulin (1 unit) about 15 minutes after her ate after much frantic calling to see if this was safe to do. This evening, I gave him the insulin as he was eating and the episode didn't seem to last as long. When I came home a few hours later, however, he seemed kind of wobbly again, and I let him have a tiny snack. Didn't seem to make much difference one way or another. I think he'd eat every can of food in the house if I'd let him.

Does anyone know what this might mean, and what, if anything, I should do? It seems like he's having hypoglycemic symptoms, but only while actually eating, which doesn't seem to make sense.

Background:
I took him in Thursday for diahrrea and increasing lethargy. The measured his BG at 6xx and convinced me to leave him there overnight. It spiked to 887 before they got it down to 557 about 4 hours after the original reading. They sent him home with me on Friday with a reading of 396 (I think they said there was a jump over Thursday night, but not sure of the details). This morning, it was 735, but they didn't want to keep him or change his insulin (so why they made me bring him in, I don't know).

I am educating myself as rapidly as possible, but I'm mighty confused! He's far worse since coming home from the vet than he was when I took him in. Any insight would be much appreciated!

 

@Marje and Gracie could you please help?
Thank you!

 

Do you have a meter? Take his BG immediately. This sound like he is going hypo. It is a true emergency. He could die! Rub some honey, Karo syrup or any other syrup on his gums. Call your vet, he should have a answering service or take him to the closest pet ER. Post right back after you test his BG. Someone will stay with you to help as much as we can.

 

Hello and welcome!

What's the name of the insulin?

Your cat may be dropping dangerously low (ravenous appetite), eating may pull his numbers up, and then his blood glucose numbers "bounce" very high.

Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will usually clear kitty's system within 3 days (6 cycles).

The only way to tell what's happening is to learn how to test his BG numbers at home.

Here's some help:

Hometesting Links and Tips

How to treat HYPOS

jojo and bunny's HYPO TOOL BOX

 

Hi,

If you're in any doubt give Jazz a little honey or karo.


Can you let us know the following ASAP.

1. Did the vet make the diagnosis just on a few spot checks of blood glucose levels? Or did they check urine and fructosamine levels?

2. Did the vets say that Jazz has an infection or other inflammatory illness?

3. BEFORE bringing Jazz in to see the vet was he drinking & peeing excessively? Was he losing any weight despite eating enough/more than usual?

4. What insulin are you using?

5. Did the vet test Jazz for ketones?

6. Was Jazz crazy hungry BEFORE the diagnosis or has the excessive hunger only happened since he started insulin treatment?



Mogs
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Sending prayers

 

@Jill & Alex (GA) -

Have you seen situations like this before?

I am worried about the staggering behaviour happening when Jazz eats. I am wondering whether there is any possibility the FD Dx may be unsound and that the pancreas pulsing insulin in response to incoming food may be adding to the effect of the injected insulin and dropping his levels too low. (Speculating here but I've never seen a description of clinical signs like this before - it's really odd.)


Mogs
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Other then the hunger, this sounds exactly what my vet said to watch out for as hypoglycemic. We need that BG test numbers.I sure hope they have a meter.

 

Oh, my goodness, you people are amazing!

I don't, yet, have a BG home test kit. I just brought him home last night.
He's not staggering now, and just jumped up onto my lap!

1. Did the vet make the diagnosis just on a few spot checks of blood glucose levels? Or did they check urine and fructosamine levels?
I'm not certain. They did a full blood draw for older cats (he's 15), and there are itemized lists for "Glucose-Vet Test," Glucometer-Glucose, and Glucose Curve

2. Did the vets say that Jazz has an infection or other inflammatory illness?
They did say so. He has had a recurring sinus infection for the past year.

3. BEFORE bringing Jazz in to see the vet was he drinking & peeing excessively? Was he losing any weight despite eating enough/more than usual?
Yes to both.


4. What insulin are you using?
Glargine. 100 u/ml

5. Did the vet test Jazz for ketones?
Yes, and he was clear.

6. Was Jazz crazy hungry BEFORE the diagnosis or has the excessive hunger only happened since he started insulin treatment?
Not this hungry! He's always been a treat freak, but now he's scarfing food down. He was not overweight. He should be 9-10 lbs, he's down to 7.7. He was also on dry food, which I've just learned is terrible.

 

Mogs, there are endless possibilities and it's impossible to diagnose over the internet.
When I hear "drunk, wobbly, unable to walk, ravenous appetite" on a message board for feline diabetes, I naturally think hypo.

 

It sounds like all the BG tests were done at the vets.

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How large was his dose of insulin?

 

@Critter Mom and @Jill & Alex (GA)
He has this response when he starts eating, BEFORE I give him the insulin. This is what has me so confused. It doesn't seem to match with what I've read so far about hypoglycemia. Feeding him seems like it should help with the problem, not cause it?

 

1 unit

 

Thanks for additional info.

Have you changed his food since starting insulin?

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I wonder what his blood glucose is prior to giving his shot... it could be very, very low

OR

there's something else going on and your best bet is to have a vet check him out.

 

Yes, I've changed his food. They started him on that Purina DM, which I figured I'd better stick with during this initial phase.
Half a can in the morning and half a can at night. I wonder if that's too little? Can having too low BG and then eating a ton start the bouncing? That seems a bit backwards. I'd love to give him more food. He's so hungry!

 

That's correct. I have so far given exactly 3 insulin shots. Next thing to learn--BG tests!

 

Try to find a vet. Do you have a friend or relative who is a diabetic? If they could test him with their meter, that would work. Many people here use human meters.

 

That starting dose is a tad bit high for his current weight... especially if he's underweight right now.

0.25u x 3.5 kg = 0.875 unit and that's if the caregiver chose to follow the TR protocol.

Some cats show a marked response to Lantus in the first 3 days (dropping low). Without tests, there's no way of knowing.

Seriously, learning to test blood glucose at home is the way to go.
If I were in your shoes, I would let my vet know what's happening. This may be a problem with low blood glucose, but it's also possible there's something else going on. Further diagnostics may be required.

 

Switching to Purina DM from dry food will very likely be lowering his carb intake significantly and that can cause BG levels to fall significantly and relatively quickly. Your vets should have ensured you were in a position to home test before making the food transition.

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I will definitely be calling my vet Monday morning. I was very frustrated when the on-site vet this morning just did a glucose reading, which was very high—735, and sent me home saying to change nothing and with no comment on the staggering.

Grrr... I feel like the vet clinic has not given me all the information and tools I need!

In your experiences, is 2-3 minutes of staggering likely ok to suffer through for one more day? If it were to go on much longer than that, no question I'd take him to the emergency vet.

I am very encouraged that he jumped up into my lap--he hasn't been able to do that since coming home.

 

I will definitely learn this. And definitely be going back to the vet.

Re: units--the syringes they gave me are marked only in whole numbers. Perhaps I'm not reading it correctly?

 

I don't know anyone who is diabetic, unfortunately. From the bit I've read, it sounds like I could go to Walmart tomorrow and get a meter and strips? I'll read up on those next.

 

from the sticky LANTUS & LEVEMIR - SYRINGE & INSULIN INFO: HANDLING, DRAWING, & FINE DOSES:


USING SYRINGES WITH A PEN, CARTRIDGE, OR VIAL:

• U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus or Levemir from vials, cartridges, and pens. BD Ultra-Fine, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brands available with half unit markings. Needle gauge and length is your preference Syringes come in ½ inch or 5/16 inch needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest)
  • Full and half-unit syringe scales:

You want U-100 3/10cc half unit syringes as shown on the left.

Yes, you can get ReliOn meters, strips, and syringes at Walmart.

 

You don't want to see your cat staggering at all.

Relion Micro and Confirm meters are very popular and the test strips are reasonably priced (get a good supply of strips). You'll need lancets (somewhere in range 26-29 gauge), Vaseline or neosporin ointment (not the cream version), and also some urine ketone test strips. (Jill has already advised on the better syringes you need.)

Also check out this link for other supplies to get hold of:

Hypo Tool Box


Mogs
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Thank you! The syringes they gave me are definitely not that finely marked. I am not feeling very confident in my vet clinic right now.

I think I will feed him a little more tomorrow. I'll go get the BG testing supplies, watch a million videos, and maybe get my EMT neighbor to help me out. Call the vet first thing on Monday. Does that seem a reasonable course of action?

I'm feeling a lot less freaked out since Jazz seems more content right now than he has since Friday night. And you all are awesome! It's such a relief to know that you all exist and are willing to respond. Thank you all so much. I will be writing a proper profile and returning to learn more.

 

It would be a good idea to leave food out for Jazz to nibble on. Many cats will eat if they feel their numbers dropping.
Welcome to the family! See you around!

 

Oh! Can I do that? I thought I had to completely restrict when he ate. Should I leave out some wet food? He would probably just inhale it all. Or would it be ok to leave out just a little dry food for nibbling purposes?

 

@Jill & Alex (GA) -

I'm absolutely hanging (5am here) so will be offline shortly.

Is there any chance you could advise on visual monitoring of clinical signs and feeding for the rest of this cycle and also what Willow should do about giving insulin again? Obviously the ideal situation is to test BG beforehand but I'm not comfortable making suggestions about dosing.


Mogs
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Ah, I guess I should say that my name is Jen. Willow is my other, non-diabetic, cat.

 

Forum etiquette question--should I delete the 911 tag or does that stay for posterity?

 

Go to sleep, Mogs! You've been so kind.

 

Most Lantus and Levemir users feed several small meals throughout the cycle (4 - 6). Some cats are grazers and like to have food left out at all times.

You can remove the 911 tag for now. You can always put it back up if necessary.

Given the circumstances, I would drink a tall glass of water before I went to bed to make sure I'd wake up during the night (if you get my drift). That way I'd be able to check to see if everything appeared to be ok with my cat. I'd also make sure there was plenty of food left out for grazing.
Dose: I hesitate to suggest anything without a medical history. Under normal circumstances I would suggest temporarily lowering the dose to 0.5u to be given every 12 hours, but I have no idea if there's something other diabetes going on with Jazz. Jen, I highly suggest calling your vet in the morning to ask about dosing.

 

Mea culpa, Jen!

You can take down the 911 if Jazz is OK for now. If get worried about him again you can go back and put the 911 up again (and if necessary update the text in the title to reflect the nature of the new emergency).

Signing off now. Keep a close eye on Jazz for the rest of the cycle and if possible call your vet in the morning. The sooner you can pick up the meter and start home testing the better.

ETA - BE SURE to tell the vet about the switch from dry kibbles to DM canned so that s/he will be aware that the carb load in the diet has been drastically reduced.


Mogs
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@Jill & Alex (GA) - Thank you!

 

Only emergency vets are open around here on Sundays, but maybe I can get one of them to talk to me by phone. The syringes I have definitely aren't suited for 0.5 unit measurements.

I will give him the regular amount of food in the morning, but let him have some snack portions of the same food periodically and watch him carefully to see how he responds. And BG test. And ask around locally for a better diabetes vet.

I will go put a little food out for night time grazing and yes, drink a tall glass of water!

It's way past bedtime here, too, so I will sign off as well. I am so, so grateful that this forum exists!

 

We all were/are!
Goodnight...

 

I will be checking in every so often, on Pacific time. I don't want to leave you alone. If anything coms up someone will be around. I hope everything goes well.

 

The syringes I started with are like yours, I would try to dose halfway in between marks.

 

@Jazz & Willow :

Could you please tell us what syringe you're using now? Could you take a picture of them and post it here?

 

Hi Jen,

How are you and Jazz doing today? Did you manage to get dosing advice from your vet?


Mogs
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Hi Jen

I was tagged earlier but just seeing it now so I’m glad Mogs and Jill were around to help. It also sounds to me like symptoms of a hypo and with a number like 735, that could very well be a bounce from a very low number.

I think it is best to get him checked out by your vet immediately but, if it were me, I’d try to get down to Walmart today and grab a meter and some test strips. There are lots of posts here to help you with learning to hometest (click on the bolded “hometest” for links) as well as members who can give you their tips as well.

I hope he is doing better today.