Fin panting, drooling with diarreah

When I woke up this morning I found Fin panting, pupils huge, mouth open, tongue lolling, and laying in a pile of drool with poop coming out his bottom. I quickly checked his blood sugar which was 568 (I think he must have gotten into my dogs food). I gave him his insulin shot and he quickly started to stabalize. His usual numbers are between 200 - 300 (he goes in for a curve next week for insulin adjustment). He must have been like this all night - which is too horrible to even think about.

I have to go into work later - I don't know if I should feed him or not. I don't want to drive him down the other way.

Traumatized me and I just want to make him okay.

 

I think he needs a vet visit. Rule out ketones, get him rehydrated with IV and check potassium. I know that may not be what you want to hear, but I wouldn't feel safe saying anything different. I hope that he gets better quickly.

 

I agree with Jennifer. If you leave him all day, you don't have any idea what is going on or what will happen.

 

ditto what Jennifer said. There is a chance he may be fine after this but if we were to give advice, it would be to err on the side of caution.

I hope he is ok, please let us know later ok?

Jen

 

OK, thanks everyone. I will update later.

 

Will be looking for the update...hope Fin is doing well and that he gets checked out okay.

 

do you have any info for your spreadsheet for June? just wondering 'cause i'd have to wonder if it's possible he hypo'd real bad and rebounded? just a thought. doesn't make a whole lotta sense but i can't seem to get it out of my mind.

prayers he's ok

 

Vet told me to monitor him at home - ???

I called my boss and she was cool about me working from home and was actually very concerned.

So here is where we are:

amps 568 - 3u Prozinc, NO food
+1 502
+2 433
+3 376

I will check his ketones as soon as he pee's again. Is there anything else I should be doing??

nailbite_smile

 

I do not have a spreadsheet for June as I started tracking it offline and had a computer crash. However, he was really stable (for him) the entire month with numbers between 200 - 250 consistently. I will be keeping his numbers online as well now so I don't have that again.

 

Did the vets find ketones? Is he not eating b/c he won't eat, or the vet said not to feed him? If he isn't vomiting, it sounds like food might be in order? (Understanding that I don't know all the details of course to know what is best for him, but typically as I understand it it's important to get food into them, especially if ketones are suspected.)

((((hugs)))) hope he is feeling better soon!

 

No, the vet didn't see him and told me to monitor him at home since his numbers were dropping appropriately.

I didn't feed him this morning because I thought that would drive up his blood glucose when I am trying to bring it down.

Here is the progression again:

amps 568 - 3u Prozinc, NO food
+1 502
+2 433
+3 376
+4 370
+5 367
+6 361

He is scheduled to eat in just over 4 hours.

 

So how is he acting now?

Honestly, those aren't normal symptoms. Have you been able to check his urine for ketones?

 

He hasn't peed yet.

He seems okay, took a nap and is now cleaning himself. His BG seems to leveled off in the mid-300's.

Yeah, the symptoms were not anything that I had remembered reading about hyper or hypo. I was thinking he maybe got into my dog's food, but now I am not so sure. Because when he has done this before it only elevated him about 100 points.

Someone mentioned Symogyi Effect so I am reading on that.

 

symogi effect is rebound, from too much insulin. I doubt that would account for the symptoms you describe; I've not followed what you are doing for dosing and cannot comment on that but if others are concerned then some reading would be good.

 

Food spikes occur but they don't drive the numbers up, feeding actually helps regulate a kitty. I feed my furries 4X per day, this helps Tucker keep his BGs relatively steady during the day.

Plus an unregulated diabetic is going to be very hungry, you're feeding the diabetes, not the cat. I wouldn't skip food at this point.

 

hi there,

pretty scary morning.

I was just wondering - what was the temperature like in your home?
Hot overnite/early morning by any chance?

hope your kitty feels better, but do keep an eye on him - get the ketones check when he pees.

post here when you can for help.

 

Okay...first I am glad he seems to be doing better. I have to ask because I was rereading the symptoms...could Fin have gotten into something? Maybe chewed an electrical wire?
I hope he continues to do better...and ditto what everyone said about him getting some food.

 

The ketones are normal (checked twice). Gave him 1.5 oz of food (1/2 Fancy Feast can) after some of the responses on here.

PMPS 345 3u - Regular food schedule
+2 351

Thanks for all the advice today, it was a tough day. I am afraid to go to sleep....don't ever want to find him like that again. Poor Finny.

 

glad Fin is doing better and recovered so quick

 

Woke up every two hours last night to check on him and Fin woke me up this morning by sitting on my chest and licking my nose until I opened my eyes....then he yelled at me to feed him

His numbers are back to normal and he seems fine. Thank you all so much for helping me through this...

Warmest,

Barbi, Fin, CC and MiAmor

 

That is awesome he is all recovered. I hope your vets or someone can give you some insight into what might have happened... you need your sleep!!! Hopefully whatever it was can be prevented, or can be identified so at least you know what you are dealing with and what to expect. It sounds so scary! I wonder if maybe it was a seizure or something? Just a random guess. I know there are some articles around about how DKA feels and maybe it was something like that, but then I don't know they can recover so fast and go right to no ketones the next day?

Anyhow, at least he is better & no ketones, that is great news. Thanks for the happy update.

 

It happened again tonight. Same thing: panting, tongue lolling, massive drooling, loss of bowels, huge pupils. This was right before his pm shot and dinner. I took his blood sugar and it was 498, gave him a shot and he immediately started recovering. Called the emergency vet and they met me at the clinic. They think he is having seizures (excellent guess Joanna) but they don't know why. They did a full blood panel and will call with results on Thursday. They did find an infected tooth that was loose so they pulled that and gave him a two-week, slow release antibiotic shot.

She went through his chart because he has been going there his whole life so at least we have a complete medical history. He has never been regulated (always very high) and has only been on ProZinc. She wants to switch him to Lantus.

On a good note, he lost one pound since I adopted him.

I will be happy when we have a better idea of what is going on with him.

 

I hate to tell you this, but there are some instances of side effects with the covenia shot...please search the forum for posts on the topic. I'm not saying anything will happen, but you guys don't need any extra complications.

It would seem that higher numbers cause seizures with him, but they aren't obscenely high??? I hope you guys can get some good help

Jen

 

Oh my gosh! I'm glad you got him in after it happened a 2nd time. Cuddles actually started having seizures after she had a hypo one night.. but also had a URI (why she hypo'd.. I wasn't testing, and she wasn't eating enough). Apparently a rare side effect of the amoxi antibiotic I gave her, is seizures. I stopped the amoxi, and the seizures stopped! VERY weird, but along with the severe hypo.. you never know what it could do. I hope the bloodwork shows something you guys can actually FIX.. but I know lots of times seizures are from 'unknown origins' and some people never find out what caused them.

Sending prayers Fin will be just fine!

 

Sending prayers from here, too. How scary, and I'm so glad you've gotten a blood panel pulled. Lantus is a good insulin; make the switch. It may help a whole lot.

Best-
Michele

 

So sorry this happened again.

Although I use PZI & like it a lot, I would say there are a lot more people on the Lantus board, and you will likely get more consistent advice & guidance there (no slam on any PZIers, I think most in PZI Ville would agree with me on that, we just don't have as many people around), and also they have a clear protocol to follow for dosing, which I think is a big help. I for one would certainly be hesitant to give you much PZI advice on dosing with a complicated medical problem in the mix. I can't say Lantus would necessarily be better for him than PZI - both are good insulins IMO - but I think you might find the Lantus route easier to get daily support, especially if that's what your vet wants you to do too. The only minus I know of is that as I understand it you have to stick pretty tightly to a 12/12 schedule, so it isn't a good choice for people who need a more flexible shooting schedule.

 

Just took a quick look at his SS. Am I right in understanding he's only been on insulin for a couple weeks? At a quick glance, what concerns me is that the dose never came down with a change to LC food. I'm wondering if maybe he is in a hypo/rebound pattern (though I don't exactly see it in the #s, but still you never know what is happening between tests). I would be scared to shoot 3u on LC canned unless I had tried lower doses first. When Bix switched to canned food, I was slow in lowering the dose enough, and I had him in hypo #s on anything over 2u.

If I were you I'd probably start a new thread here and/or in the PZI forum and ask for eyes on his SS, as well explaining the overall situation. For some reason I had it in my head that he has been on insulin for a few years and now this started, but if it's only been a couple weeks, then yeah, there could be something weird happening if the dose is too high and he is rebounding. It might not be that at all, it's just what comes to mind to me.

 

Sorry for all the posts, took a look at the SS again. Given that both times you have found him like this he had a decent PS on the last shot and then a much higher one at the time of having weird problems, it seems like a hypo/rebound scenario could be possible. If it were me, here's what I would do:

1) Cut the dose in half.
2) Try to get more spot tests in the 1st half of the cycle to see what is going on. Especially maybe around +3 or +4 might give you an idea if he is headed low, vs. if he is not really hitting good #s.
3) Post in PZI for daily help.
4) Post in Lantus for general help, advice on switching, etc.

If you do switch I'm not sure what the timeframe is - unless you are already switching right now, I would definitely consider lowering the PZI dose in the meantime, now that I've looked at the #s. Although those are the only 2 times that look reboundy to me, I don't think there's enough data to rule out the possibility that he's hitting low #s in general. It looks like some days he got into someone else's food, and that could be what kept the #s higher those days. 3u is pretty high for being on LC food, though of course some cats do need that much.

 

I agree with Joanna here. 3u is a whopper of a dose to start off with - even with dry food. Seizures could definitely be a symptom of hypo and the uber high numbers that coincide with the episodes could very well suggest protective rebound. Is there any way you could get some mid day or mid evening tests? Try cutting the dose in half like Joanna said, or even starting again at 1u, and stick with that for 2-3 days and see what that gives you. If numbers start soaring - then you know hypo was not the cause.

 

Of course there's some risk too if his problems are being caused by high #s in and of themselves. I'd still try cutting the dose, but I'd definitely monitor to make sure that's not causing problems. It's a scary situation, sorry. I'm definitely not an expert on any of it, just sharing what comes to mind...

 

Fin has been on the PZI since he was diagnosed three years ago and has never regulated. I just adopted Fin and his sister C.C. a little over a month ago (see other posts for background). The vet we met with yesterday didn't feel that 3u BID for a cat of his size was a lot because I asked her that specifically. I am reluctant to modify his insulin before the test results come back tomorrow. I think I will post the results and get some guidance from the group with a little more data for us to work from. You guys are so great to talk me through this stuff, it is so horrible to see him in this state. I'll update as soon as I hear tomorrow.

Thank you all so much :smile:

 

Ok, that makes sense.

As far as I know PZI isn't dosed by weight, and the 3u wouldn't be a lot on dry food, but is a lot from what I have seen for LC canned, so when you talk to the vet I would ask about that. My vet wanted to dose the same regardless of food, which from what I have learned here, is really off target unfortunately.

If you can get some mid-cycle spot tests in on this dose, that might also help you have a better picture, to know whether the #s might be actually going low or not.

I'll be thinking of you & hoping things are going well! I definitely agree with you to post a new thread with the results, and try to get eyes on it. The extra health problems are out of my league, hopefully the test results and continuing BG data will give you some insight.

 

Next time you are at the vet, bring your meter and compare it with the vets. Yours may be way off. Reading too high.
Just a thought. :smile:

 

I did bring it to the vet and it is within 3 points of their two meters from the same manufacturer.

Thanks for all the prayers and support....anxiously awaiting the results.

 

Just got off the phone with the vet and she said outside of Fin's blood glucose being so high, and his white blood cell count being slightly elevated (because of infected tooth) that his numbers were really good. There is nothing obvious causing the seizures. She is thinking that if he hit the tooth with his tongue or something that the pain could have caused all the symptoms. We are going to watch him for the next week to see if it happens again (hopefully not). So as of right now....he is Fin, international cat of mystery. :?:

We discussed the fact that in all the years that he has been on PZI while there were dosing changes, he was never regulated and consistently maintained blood glucose levels in the 400's. However, none of his caretakers changed his insulin.

So on July 15 (two weeks to make sure he doesn't seize again and that his infection clears up) we are going to change his insulin to Lantus 2.5u per day to start and work up from there.

Time to start reading the Lantus board....

Barbi, Fin, C.C. and MiAmor (drooler)

 

Good news!!! I'm still confused about the food though - he was on dry food in the past, and just switched to LC canned recently? Especially if he was unregulated and didn't have weird symptoms in the past, and now is having strange symptoms just after the food change, unless I'm misunderstanding something, it seems like a lower dose trial would be in order, whether it's a lower PZI dose, or starting Lantus at a lower dose. I'm just worried it's too much insulin for LC food, and that his symptoms could be signs of hypo/rebound, which can get worse if it becomes a repeated pattern. Sorry if I sound like a broken record.

I remember reading about one cat who didn't see much BG change with a food change, but in almost all cases that I've seen the change is pretty dramatic, and the dose needed is very different from dry food compared to LC canned, even when they weren't regulated on the dry. Bix for instance was unregulated on 4u when he was on dry, and on LC canned he has only needed like 1.5u to get regulated. I put him in a pretty scary place when I made the food change b/c I didn't reduce his dose fast enough, and sometimes I'm amazed I didn't hypo him - thankfully he ate a LOT and balanced the insulin despite my mis-steps.

Anyhow, I'm sure the Lantus folks can help you get started & get him on the right Lantus dose, hope things go great with the switch!!!

 

Thank Joanna. I think you may be right, because while he hasn't seized again, he has been getting aggressive. I am going to lower his PZI tomorrow. We are switching over to Lantus next weekend so I am going to see if someone on that board has some more advice on switching. I really do appreciate your consistent mention of the rebound because it stuck in my head, and that is a good thing.