Desperate in Texas

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Evie Corso, Aug 14, 2018.

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  1. Evie Corso

    Evie Corso Member

    Joined:
    Oct 1, 2017
    One of our cats has kidney disease and went through a bout of diabetes last Fall, which incuded jaundice and fatty lipidosis. She was not eating. I brought her home from hospital, got her on a schedule of Humulin N, force fed and gave subQ fluids and mirtazapine. After weeks she started eating again. I switched her food to Nulo, which appeared to have more protein and she started improving. After a couple of months I was able to reduce her insulin every few days until she was weaned off and maintained a normal lood glucose level on her own. I checked her blood glucose every so often and it was always normal. I kept up with the subQ fluids once a week, down from twice a week.

    Flash forward to July 15th. I had been lax about the subQ fluids and checking blood glucose, since she seemed normal and passed inspection at her annual in March. July15th she started acting wobbly, and could not balance, with nystagmus. She had thrown up, trying to cough up a fur ball, I thought. I checked her blood glucose fearing her diabetes had returned and caused neurological damage. The symptoms abated within minutes, but her BG was high. It was Sunday evening and I had no insulin, so we treked to the ER. She didn’t have ketones, thankfully and her kidneys were not worse either. She appeared to have a UTI and was dehydrated. She got a shot of Convenia. They wanted to keep her for at least a week and the estimate was in the thousands. Since it was only a few hours before daybreak, I requested a new bag of fluids to go and an insulin shot, so I could get get her started on fluids and stable to transport her to my regular vet which would be open within a couple of hours. They were very amenable and helpful. She got 6 units of Vetsulin and I took the bottle to go. I got her home and fed her canned food and gave her fluids and then took her to my vet. She spent Monday - Wednesday at the vet. They sent out a urine culture, looked at the bloodwork I’d brought from ER and kept her on an IV. She would not eat for them so they force fed her. They could not get her BG where they wanted. By Wednesday the urine culture came back and she needed a different med than the Convenia. I brought her home Wednesday and she started eating right away. They had me put her on Royal Canin Glycobalance. She would only lick the canned food, since it was not a pate, but she ate the dry food for me. They wanted me feeding her twice a day with injections 12 hours apart. She doesn’t eat enough in one sitting for twice a day feeding. Trying to do it twice a day meant she was never getting down to a normal BG. I started increasing her Vetsulin by 1/2 unit at a time and got up to 5 units and she was still staying too high. Any more insulin and I was afraid she’d dive too low. I tried to find a better cat food, looked for higher protein and lower carbs and not too much fat. Tried going back to Nulo since it was better than the RC Glucobalance and only saw mild improvement, still hi readings 4 times a day. Tried other RX diets. She would only lick at the non-pate canned food, so she got even higher carbs. I had to start giving insulin 4 times a day with meals instead of twice just to stay out of the “hi” reading. Anything over 6 hours and her BG is high. I switched to Novolin N a couple of days ago since Humulin N put her in remission last time. No difference. Saw a formula online of how to calculate carbs and it made Hill’s rx food look low carb, so I ordered it. She won’t touch the canned, but likes the dry ok.

    I am giving subQ fluids once a week. I made up charts on graph paper to record BG, Insulin & food. I check BG throughout the day and into the night, (every hour if close to low), except for 4-6 hours when I sleep through the alarm. I finally went back to insulin several times a day, 3-4 units, to even get between 188-500 most of the day. It still goes up to Hi if I sleep 8 hours. I have tried higher doses twice a day, but it just swings from Hi to 70-150 and back to hi in less than 8 hour, so that leaves her in the hi, (above 600), for lots of hours.

    Something has to change. SOS
     
  2. Evie Corso

    Evie Corso Member

    Joined:
    Oct 1, 2017
    She got 4 units Novolin N at 9 PM with food. In two hours, she was at 271 and dropping. By 4 hours the curve will start rising. By 3 AM her BG will be over 600 again. More food and more insulin?
     
  3. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi.
    For us to be able to help you, you need to set up a spreadsheet so we can see what is happening with the BSLs
    Here is the link. If you could fill our all the BSLs you have in the SS please, that would be very helpful.
    http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

    Also if you could fill out you signature which is the top right of the page under your user name. Click on it and you will see signature. Fill with information such as age, date of diagnosis, type of insulin and meter used, any illnesses..then click save


    I have not used Novolin insulin so am unable to help you, but I would have thought using it 4 times a day is very risky.
    I will tag a couple of people who may be able to help you with Novolin
    @Kris & Teasel @JanetNJ @Rachel

    You should probably consider changing over to a longer acting insulin such as Lantus
     
    Last edited: Aug 14, 2018
    Reason for edit: tagged another person
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  4. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I agree that first you need to set up our spreadsheet and enter all the BG data you have from this recent go around. Indicate on it what insulin you used - Vetsulin, etc. There are a number of things going on at the same time that make it hard to give good advice:
    • recently very ill
    • insulin change
    • frequent dose changes
    • quite possibly too high doses that lead to these huge BG swings
    • seeming lack of duration of the insulin.
    If we can see all your data on our colour coded SS it's easier to see what the patterns are and we can go from there. I do think, though, that a different insulin that's slower, longer lasting and gentler in its action will be in order. Let's see the data first, though. :)
     
  5. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

    Joined:
    Jul 19, 2011
    You're not seeing any difference in the Novolin and Humulin because they're the same type insulin - NPH - just different manufacturers.

    Here's a wonderful food list by brand with 'as fed' carb count by Dr. Lisa Pierson DVM. Under 10% is best for diabetic cats....

    Food Chart 2017 - CatFoodProteinFatCarbPhosphorusChart.pdf

    I think you may have too many things changing too quickly to get a good handle on this. The foods you're feeding aren't very low carb - be careful and watch closely when you change to lower carb food. That can drop the glucose quickly all by itself.

    Your ssheet will help us see what you're seeing and help us help you...

    HUGS!
     
  6. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    A little confusing sine Humulin (EI Lilly(and Novolin (Novo Nordisk) are manufactures trade name for a FAMILY of insulin. Those include straight R and N(NPH) and mixtures of R and N(NPH)
     
  7. Evie Corso

    Evie Corso Member

    Joined:
    Oct 1, 2017
    Let me clarify. I am not seeing a difference changing from Vetsulin to Novolin N. I confused the issue in my post because Rusty was on Humulin N last Fall when she was first diagnosed, but went into remission while on Humulin N. This time around, July 2018, She was started on Vetsulin, because that is what the ER clinic had, so I started her on it and took her to her regular vet. Her regular vet kept her on Vetsulin because ER had given that to her and sent the bottle with me. Regular vet did not have Humulin N on hand and said they were trying to get it for me but never managed to, so she stayed on Vetsulin until I foun Novolin N available without prescription and thought it was longer acting and more like the Humulin N that worked back in the Fall and sent her into remission. Neither the Vetsulin, or the Novolin N are lasting 12 hours. They, (Vetsulin & Novokin N), seem to be acting the same as each other.
     
  8. Evie Corso

    Evie Corso Member

    Joined:
    Oct 1, 2017
    Thank you for the food chart link. I found it yesterday, but did not recognize any of the ones with low carbs and protein higher than fat, so I will have to research where to order them. Plenty if low carb ones, but they have high fat. . I had calculated the carbs from a formula found online and came out with totally different percentages. Apparently that formula is wrong, so I started trying to contact manufacturers to get actual dry carbs and fat and protein. I have so many types of cat food here it looks like a store, but none seem right. Not sure whether to try to figure out spreadsheets first or go searching through the cat food list and then find where to order.
     
  9. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

    Joined:
    Jul 19, 2011
    You're right Larry but people using one of those brands is almost always using NPH rather than 'R' or '70/30'.

    Vetsulin and NPH do indeed work a lot the same. The carb calculators online use 'dry matter basis' for calculation which is misleading. Note that all those percentages says 'Min' and 'Max'. That just means that's the most or least they include, it does NOT tell you the actual recipe. If they actually use 75% moisture but label says 'Max' 78%, that 3 'calculation points' off right there. That's why carbs should always come from the manufacturer and why some say that is 'proprietary' as it gives their actual recipe used.

    Figure out spreadsheet as that is what will help us help you then find food. The ssheet isn't hard to set up, doesn't take much time and will end up being one of the best tools in your toolbox!

    HUGS!
     
  10. Bama Kitty Mom (GA)

    Bama Kitty Mom (GA) Well-Known Member

    Joined:
    Jul 16, 2018
    @Evie Corso

    Hi Evie and Rusty. Feel free to check out mine and others' spreadsheets to help get a handle on reading them. Lots of helpful info in users' signature lines as well. As you'll see in mine, my kitty is on Novolin N [and has been for nearly 4 years]. When he was diagnosed in 2014, my vet sent me home with Hill's Prescription W/D dry and prescribed 4 units of insulin to start. No curves. No suggestion to self test. Just to come back every few weeks for them to test and adjust dosage. It's a wonder Bama Kitty didn't hypo and die on me. I recently switched him over to all wet food, feeding Publix Gourmet pates which seem to be very similar to Fancy Feast but a little cheaper. Is there a Publix located near you?
     
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  11. Evie Corso

    Evie Corso Member

    Joined:
    Oct 1, 2017
    Thank you. Yes, it seems like a miracle that you did not have a disaster with so few tools to start! No, we don’t have any Publix stores in Texas yet. I have found many other options at Chewy.com and Petsmart.com that are on the list. Rusty and her toothless sister did seem to like the Nature’s Variety Instinct that I found at Petsmart. It’s an expensive option, but it’s a start. She will also drink water added to canned food, several times a day and I give her subQ fluids as well, so if she eats part canned and part dry we are at least moving in the right direction and decreasing the carbs. I finally got the apps installed and am trying to figure out the SS. (It took me a while to figure out that was spreadsheet, not a medical term lol). I will look at your sheet as an example. I have graphs and charts I made up, so I should be able to get the data keyed in.
     
  12. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    If your cats have kidney disease and the one is diabetic, what you need to look for is a food under 10 percent carb and under 250 phosphorus. Tiki cat is a good brand. Bff cans as well.
     
  13. Evie Corso

    Evie Corso Member

    Joined:
    Oct 1, 2017
    Yes, I saw that and have irdered skne Tiki cat canned food.
     
  14. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    My cat likes some seafood flavors but loves their after dark chicken line. Chewy has nice variety packs.
     
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  15. Rardito

    Rardito Member

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    Jul 20, 2018
    Good to know about the publix brand pates!
     
  16. Evie Corso

    Evie Corso Member

    Joined:
    Oct 1, 2017
    I thought we were supposed to stay away from seafood, due to Mercury.

    I didn’t see the Tiki cat “After Dark” on the catinfo.org canned food page that shows what the protein, fat, carbs & phosphorus numbers are, so I was afraid to order a variety pack.
     
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