Cat in hospital from hypoglycemia and suddenly blind, unregulated glucose

Hi all,
My cat Oero has had diabetes for the past several years. He was regulated, then in remission, and now unregulated for a couple years. We've tried every dose and different insulin, they think something else is happening but not sure what.

Last night, I came home from work and he was paralyzed and barely consieous. I rushed him to the animal hospital and he had hypoglycemia and was on the verge of a seizure (maybe even had one before I got home). He was cold, heart barely beating and couldn't move. I had literally just taken his glucose Wednesday twice and it was very high, 450+. But he threw up his food yesterday, so I guess that threw him into hypo .

Since last night, they got his temperature back to normal and he is now walking and sitting up and even eating a little, although still tired/weak. His glucose was regulated for 20 hours or so on IV sugar at hospital but now they said it's suddenly spiked above 600. The worst part is he is blind. He doesn't react at all when you put something in front of his face, and when I saw him earlier he cried for a very long time knowing I was there but not being able to see me. I held him and he finally calmed down though.

My heart is breaking.They say they don't think he is suffering, so I've asked them to keep trying to get him to a stable place.

Does anyone have experience with this? I'm not sure if he is going to be permanently blind, I'm not sure if they will get his glucose regulated, I'm not sure if he will survive, I'm not sure of anything. I don't know if I'm doing the right thing, I just feel like he went from paralyzed to walking in 12 hours and I want to believe he will continue to improve based on that fast turnaround. But I don't want him to be hurting. So lost!

 

I wish that I could offer something solid in the way of experience with what you're dealing with, but my cat's only recently been diagnosed and I don't personally know what can or will happen now. I have had experience with a non diabetic cat who pulled through a debilitating stroke and lived on with a great quality of life, so I think you're doing the right thing by giving him time right now. He needs time to get better and you need time to see how he recovers through this. I know that's what I would do. I'm so sorry that both of you are going through this. You've come to the right place for support and information. Others with more experience can hopefully address your concerns.

 

I am so sorry! It is such a awful feeling when all you can do is love them and home they get better. I am not a expert but will bump this up for more experienced eyes.
I vaguely remember reading post where there was temporary blindness. Fingers crossed
bump

 

I'm so sorry you're going through this. My cat is the same, was in remission and then out and unregulated for the past two years. This is a huge fear for me. I think many cats in this situation so regain their sight.

If you will set up a spreadsheet for us people can help you with dosing.

 

So sorry to hear you're going through all this, but where there's life, there's hope.

I've heard of a couple of cats here that had serious hypo's that made them blind....it was temporary and they did regain their sight, but I've also heard of one that remained blind.

But blindness doesn't bother our kitties like it bothers us. They live in the moment and don't feel any "loss"....they just adjust.

If he does end up staying blind, just make your home as easy as possible for him to get around and soon you'll never know he can't see.

 

Animals see to adapt very well to a loss of one of their senses. My parents had a dog that became blind. You could not tell that he was blind by the way he acted.

I will pray for his recovery.

 

I'm sorry to hear of your kitteh having the deep hypo. I am also very experienced with diabetes for several years. Leo gave us a surprise deep hypo in January - and I documented it
>>> in this thread here

>>> Here <<< is the most recent update 3/13/2019, with pictures

He had partial blindness for a couple of days. And cognitive issues. It took a week for him to recover. He has other health issues, prior to the hypo.

Now, two months later, Leo's eyesight is mostly back. I would say he has trouble seeing in dim light. And he doesn't seem to focus as well as before. In addition, in medium light, his right pupil is slightly larger than the left one. HOWEVER, he does get around. He goes in the backyard and explores. So there was recovery.

It just plain sucks. He had the hypo while laying on my lap, and I feel horrible. Now, I am back to monitoring Leo like a hawk.

Blindness is not the end. If your kitteh does not recovery, your kitteh will adapt, and so will you. Hugs to you and your kitteh. I hope Oreo recovers some eyesight.

 

Thank you so much for your reply! I think everyone's responses have made me feel much more comfortabke with him being blind, if that ends up permanent. I am so thankful for that!

But I'm not even sure when/if they will let him out of the hospital because they haven't gotten his glucose regulated. If we can't get it under control, there is too much risk of this happening again. Every night he is there is over $1k and it's adding up really fast. I don't know what to do .

 

I'm so sorry to hear your kitty had a severe hypo event. A few things to consider in regards to the high blood sugars right now......

Oreo is in a strange place with different people and lots of smells and sounds he's not used to. Add to that, his loss of vision and it is understandable that your kitty is stressed which can and likely is contributing to his elevated BG.

The low hypo BG would also set off bouncing which is the body's defence system flooding the bloodstream with more glucose than is needed. Again a stress reaction. The bouncing will clear but may take a few days.

Adapting to the loss of vision will take a bit of time but will no doubt be easier for him once he gets home in a familiar environment with familiar people.
Take a piece of worn clothing into the vet to put in the cage with your kitty to give him a little sense of home. It might help to lower his stress level a bit.

Don't give up. You will get his BG under better control. No matter whether he regains his sight or not, your kitty can live a perfectly happy life.

 

If it was me, I would now take Oreo home and get him re-accommodated to your house. As Linda said, he may have high BG due to being in the hospital. If you have time, you could test him every hour or every two hours, depending on how his BG range.

We took Leo to the hospital during the severe hypo, but I brought him back home that night.

Ultimately he is your cat and you own the decision process of leaving him or taking him. $1,000/day is a lot for anyone.

 

As long as he's no longer dropping into unsafe territory, I too would go get him and bring him home. I totally agree with Jeff - he'll be a lot more comfortable at home and those numbers should come down. Right now he's scared, he can't see, he doesn't understand, he feels like left-over poop and he's not home where 'love' is. I also say don't give up yet - get him home and see if he improves. You need to very quickly learn to test at home so you'll know immediately if you have an issue developing and head it off.

 

Since you take his bg at home, take him home. Set up a spreadsheet. Enter all the readings you have from the past few weeks. Be sure to ALWAYS get a preshot test and try to get at least 1-2 mid cycle tests a day as well. We can help.

 

Thank you so much for the advice! He was discharged and home now. He cried for a while as he felt around the house. After a bit of that, he calmed down and feel asleep. He must be so drained! Hoping for the best, going to that BG soon to check in .

Ok

 

Thank you do much for the advice, especially since you went through this with Leo.

Oero is home now and resting calmly. He will definitely need time to adjust to not being able to see, but he already found his litter box without help. I am beyond proud of him. He is such a tough cookie and I am so, so thankful he's doing so much better now. It's going to be a battle still I'm sure, but he's 100% going in the right direction.

I am going to monitor and test very, very closely. I appreciate everyone's responses, feedback and continued support as we try and get this under control!

Any other advice you all have as he acclimates back and we try to regulate him, please let me know! I'll take all the advice I can get!!

 

Great to hear he's back home!! Love is a most powerful treatment for any problem so I'm sure he'll be getting lots of it!

Get our spreadsheet up and if you have any readings, put them in. That will help us help you going forward.

Also if you click on your name at the top right of the page, there's a drop down menu where you'll find "Signature"....click there and a new box will pop up for you to enter some basic information like;

Your name, Cat's name, age, sex, date of diagnosis, type of insulin, type of meter, type of food, any other health issues? and a general location where you live. (I'd include something like "severe hypo on (date)" with the "other health issues".

Cat's who've had a severe hypo like he has can be very sensitive to insulin afterwards, so you'll need to monitor him very carefully.

 

Glad to hear Oero is back home. (I thought his name was Oreo).

You can do us a HUGE favor. Over the next 1-8 weeks, it would be great to hear Oero's progress. There are not a lot of reports of recovered deep hypos. So it is helpful to us, to hear the recovery and the lasting symptoms.

For blind people and blind kittehs - stable households are helpful. Furniture and other items should not be moved around. That helps the blind kitteh, so they won't bump into things.

 

Care credit has 0% financing if they offer it-the more you spend the more time you get free financing....most vets do especially ER vets

 

Oero is adjusting relatively well after about 30 hours being home. He glues himself to my side and cuddles a lot. He has been walking around crying every so often, I imagine he is still stressed from the whole event. I wish I could help him more or knew why he was crying!

He peed in his litter box twice, pooped 3 times in it and then peed next to the box twice. Pretty good odds for now. No vomiting and good appetite. He's always starving and that hasn't changed, I'd prefer that over no appetite.

I am adjusting his insulin dose based on his BG throughout the day. It's been ranging from mid-100s to mid 300s, so not too shabby.

He's pretty bold in jumping up on the couch, onto the coffee table and back and forth. It seems as if his eyesight is back a bit maybe, but I know not well because his hind legs never make it when he jumps so he's misjudging the jump. And he slides down to the floor or scrambles to pull himself up the rest of the way. Maybe hes making the jump from memory, or maybe he can see a little. I'm putting him down on the floor as much as I can so he doesn't jump and hurt himself, but he seems determined!

I'm so happy to have him home.

 

Great report on Oero. It sounds like he is recovering well. I'm glad to hear he is mobile and active.

I held a treat up and moved it back and forth. Leo was able to track that - better as the "deep hypo" recovery week progressed. I'm hoping Oero can do the same as he progresses.

 

Which insulin are you using and what's the dose?

 

Lantus 2x/day. I take his BG throughout the day to see how low he's getting and then base dosing off that .

Below is what my internist suggested and then we are checking in tomorrow. He was on a VERY high dose before from the other internist I was working with. Had been on 7 units for 6+ months after going down to 1 unit and progressively having to increase over several months. He's been impossible to regulate at any dose and any insulin. But, hopeful so far this round.

BG under 200 : 1 unit
BG 200-350: 2 units
BG 350 & up: 3 units

 

I used to give Leo a variable dose too. With Lantus and Levemir, you have to be much more careful. They are depot insulins - some of the insulin is still in the depot after the 12 hour mark. Variable dosing for depot insulins is not very popular on this forum - just saying it out loud. Doesn't matter to me though! I think there is sound evidence for the consistent dosing protocol. But it does not work well in some situations.

During some periods, Leo is bouncy and all over the map. He had Acro and also then got SRT (radiation) to neutralize the tumor. Acromegaly is diagnosed via blood sample. One of the characteristics is high insulin usage - such as over 5 units. Prior to SRT, Leo was getting 18 units/dose.

 

It would be really useful to see some of the pre-shot and nadir (6 hour) values.