first time posting, please help me. I just need an answer

Okay so just to give you background, my 12 year old baby boy was just diagnosed with diabetes, kidney disease, and pancreatitis. He was at the hospital for five days, they said he was eating well and doing just fine on the 4 units of at home insulin they were giving him. When I got him he wouldn't eat and I needed to give him a shot. I ended up hand feeding him two small handfuls of dry food, giving him the shot, and leaving the rest in his bowl so I could go to work. I got home 3.5 hours later and none of the food was gone. About a half hour after that he was laying on me and he went unconscious for about 15 seconds with maybe 5 seconds of very slight muscle twitching. I kind of freaked out and made a little screech that actually woke him up so I immediately attempted to get him to eat. He ate a little more but not enough to make me happy so I gave him some honey on a spoon (which was all I had but he actually liked it so it wasn't a struggle). So the next morning he wouldn't eat again so I didn't give him his insulin. I called the vet who was super busy and couldn't talk so I talked to the girl at the front desk. She told me I reacted appropriately and to try mixing his new food with his old food. So when I got home, I did that and he ate about 2/3 of his wet food and some dry food. So I gave him his shot before work. He's been fine since then. Eating his normal amount and fine on his normal amount of insulin. He just seems to be sleeping so deeply that it concerns me. He's been a very good sleeper his entire life, so it's not the amount he's sleeping that's bothering me, it's the fact that I can pick up a paw and drop it a few times without rousing him. How do I tell if he's sleeping or unconscious? The way he passed out the other day, was he went from sitting up awake to falling over asleep. My biggest fear is that he will already be sleeping and slip into unconsciousness. I'll think he's sleeping but he's really passed out. I don't know if I'm overreacting and if he's always slept like this? But at this point the diagnosis has me riddled with so much anxiety if his tail twitches the wrong way I practically lose it. Please help =(

Edit: he's on 4 units of novalin n twice a day. Vet has him eating 1/2 can of wet food with each dose.

 

Going to tag @Chris & China ....she is awesome and will know ...hang in there

 

@Critter Mom

 

Shannon..go to thread tools and hit 911 icon to draw more attention...I will tag others...help is coming !!! You r doing great so hang on

 

It won't let me do that? It only gives me the option to edit the title

 

Ok, at far left of thread bar. Touch there and a menu will drop down ..that's where 911 icon is

 

Got it, thanks!!!

 

Good... helpers will want to know type of insulin, don't have a home meter to test BGs, what food are u feeding ...all helpful and useful info... I will watch you til they come...back in October my Elmo's life was saved by great peopl here so hang on ...I know it's hard

 

Are you able to home test your boy's glucose levels? Novolin N can hit quite hard and fast then wear off too early - it is possible that he's dropping too low in the early part of the cycle, especially after being started on 4 units which is a very high starting dose for any insulin.

 

Do you have a home meter to test with?

 

@Mum of two felines - was it Novolin N your boys were on? Can you offer any advice?

 

Hi Shannon,

I can fully relate to how scared you are right now.

Urgent Questions:

- What is your kitty doing right now? Sleeping very deeply again or conscious and moving around?

- How long ago did you give the last insulin dose?


Mogs
.

 

The vet sent me home with very little information. I thought 4 units was high too after reading a bunch of threads here. I don't want to change anything without vet approval but he's impossible to get a hold of. I have an appointment in a week where I'm hoping to compile a list of questions I need answers too. We're not monitoring levels because I was never told to (or shown how) I would do it if I knew.

 

If you can get (or have someone else get for you while you stay with him) a glucometer, test strips and lancets (the ReliOn Prime, Confirm or Micro are all good choices and are available at Walmart), then we can certainly help you learn to test him at home.

However, for right now if you don't have anyone who can get that for you, then we need to make sure he's safe through this cycle even if that means giving him carbs (honey is good - my Rosa always loved honey too) and letting him run a little high. If you think he might be unconscious or close to it, please do NOT leave him unattended - we can help you get through this but he will need someone with him all the time.

 

Right now he's sitting at the end of the bed. He's pissy with me because I'm finding it hard to let him sleep longer than 15 minutes without checking to see if he's okay. He was just laying next to me for about 2 hours just sleeping normally. About an hour ago I got a little panicky that it was a deep sleep because I was able to pick up a paw and it dropped straight back down but when I touched under his chin he woke up. His last insulin dose was 4 units at about 4:45, he had eaten a 1/2 of wet food and a 1/4 cup of dry. I did give him another 1/4 cup of dry food a little while ago because I was scared.

 

Unfortunately, it's about 12:45 AM where I am and I don't have access to those things at the moment. Are they just normal human glucometers? My mom is diabetic and I'm sure she has an extra one lying around the house.

 

Shannon, rest assured the advice u will be given here can be trusted and acted on in full confidence. As I said, they saved My kitty's life and are very experienced ...trust them please.

 

How many HOURS ago did you give the insulin dose?


(We're all in different time zones and we need to know how many hours the insulin has been in your kitty's system, not the time of the injection.)

 

That would be about 8 hours ago if I'm calculating it right? He's most likely well past the peak action of that shot at this point, especially if he seems alert. However, as you're not able to test him right now, I would suggest that you keep some dry food out for him tonight. Dry food is generally pretty high in carbs which is what he'll need if he's dropping low.

That's OK, but it would definitely be good if you could pick one up tomorrow. They are just regular human glucometers - a lot of us use the ReliOn ones because the test strips (which are the biggest cost to any of the meters) are more reasonably priced than a lot of brands. If your Mom has a spare one, that would be even easier.

 

My apologies, last dose was 8 hours ago.

 

The human meter will be ideal. Go find it and we can tell you how to test.

.

 

That's OK, Shannon.

.

 

Okay so just for my sanity, when is the prime time for him to be showing hypo symptoms. When is the peak action of a shot? I work two jobs and I'm finding it so stressful to not be home with him. It would be nice to know when that time is to drop by and check in if I can

 

@manxcat419 - April: Novolin N can drop BG hard and fast early in the cycle and duration of peak effect can be up to 8-10 hours.

For reference and an idea of Novolin N effect, here are spreadsheets for some Novolin kitties:

Shaak Ti (managed with a lot of food steering)

Woody (one of MO2F's kitties - vet overprescribed so some v low numbers in this one)

Are you OK to run with this, April? (I'm not feeling well and won't be able to stay the distance.)


Mogs
.

 

Novolin N often peaks quite early, but it can vary from cat to cat so at this point it's really not possible to say for sure. If it was my cat, I would not use 4 units as a starting dose especially with one of the harsher insulins (though I wouldn't use 4 units as a starting dose with any insulin unless I was dealing with a huge cat). I would suggest using the standard starting dose information for this insulin of 0.2 units per kg of the cat's weight. If your boy is overweight, then you would use his ideal weight to calculate the dose. If he's underweight, then you would use his actual weight. However, we do need to know one thing - you said he was hospitalized for 5 days. Did the vet mention if he had ketones when they hospitalized him?

Thanks Mogs - very useful information. Of course, as with other insulins a too high dose especially can lead to a good few hours of low numbers. No problem for me to stick around - it's not late here at all. Get some rest - you need it.

 

Vet said nothing about ketones. Just that his diabetes was very bad and that they needed to essentially shock his system back to normal with what he called the "oh s***" insulin. Then they continued fluids to help the pancreas and kept him for an additional day or two to make sure he transitioned well to the "at home" insulin.

 

Sounds as though they must have used 'R' on him for a few days. Though I've never heard of shocking a cat's system back to normal that way. The problem with them trying to figure out his initial dose while he was at the vet is that a lot of cats run much higher numbers due to stress, so a dose that seems fine while they're hospitalized can actually be much too high once they're home and relaxed. And of course if the pancreatitis is getting better, that would tend to reduce his numbers too. The symptoms you're describing sound very much like hypo to me which would indicate he's on too high a dose of the Novolin now he's home and feeling better. No ketones is good - it makes reducing the dose back to the regular starting level safer to do.

 

Would it be out of line for me to contact the vet in the morning to report that he's been super lethargic lately? Again, I'm not home during the day and I'm out most nights because I work two jobs. It terrifies me to continue doing this because I'm not home to monitor his behavior.

 

Not at all. In fact, I'd recommend it. Either way, I would reduce his dose significantly. But your vet needs to know that he's potentially having hypo symptoms on the dose that he's on. You can work and manage feline diabetes - it is absolutely possible. But you do need to be home testing to do that safely.

 

Got it, thanks so much for all your help. At this point he seems to be more alert than he was when I started this thread so I think my anxiety has subsided enough for me to get some sleep (hopefully because I have to be up for work in 4 hours, yikes.) thank you so so much for all your help. I'm sure you'll hear from me again when it comes time for testing and I'll do my best to remember to update you guys with what the vet says tomorrow. Thanks again! Goodnight!

 

Oh, I've been in that situation a few times. I do hope you manage to get some sleep now that he seems to be doing ok.

Please do keep us updated and ask when you start trying to test. There is lots of help available here for that - we've all had to learn, most of us without any tuition from our vets. Just before you go to sleep, I just want to check with you that you can leave some of his dry food out overnight for the carbs in case he does start to drop again. Until you're able to test him, I would recommend not removing the higher carb dry food from his diet at this point.

 

Absolutely not the slightest bit out of line, Shannon.

The vet may say that lethargy is to be expected:

1. because of the pancreatitis.

2. because the body can take time to adjust to insulin treatment.

What you're describing does NOT sound like the sort of lethargy seen due to the above reasons; it sounds like the sort of lethargy one sees as a result of hypo (and possibly of a cat swinging wildly between higher and lower BG levels - it's very hard on their systems). You need to stress that your kitty is unresponsive (tell about the 'paw drop' checks you've been doing) and that a lot of the time you have difficulty rousing your cat.

[ETA: be prepared to stand your ground with the vet if s/he is dismissive of your concerns; you know your cat intimately, you spend far more time with your cat; you are making and recording very significant and valuable observations of how the insulin is affecting him - and all of your concerns have complete validity. Some vets don't fully appreciate that severe lethargy (especially with unresponsiveness) can be a hypo symptom.]

If it were my cat I would talk to the vet about a dose reduction until BG testing can establish your kitty's safety. Also get some urine ketone test strips (e.g. Keto-diastix) to make sure your kitty stays clear of ketones - especially when reducing insulin dose, doubly so when eating is a bit hit 'n' miss.

The sooner you can learn to home test the better, Shannon; it will answer a lot of questions for you, help you check dose safety, and give you some desperately needed peace of mind.


Mogs
.

 

Home testing educational links: -------------------------------------------------------------------

Home testing links and tips​

Testing and injecting tips (inc. helpful diagram of the testing 'sweet spot' on the ear)​

Safety information: -----------------------------------------------------------------------------------

How to treat hypos (Familiarise yourself with this, and keep a printed copy somewhere you can grab it in a hurry should the need arise.)
​

Check this link to make sure you have the supplies it lists in your hypo toolkit: -------------------

​

What to include in your hypo toolkit​

Ketone monitoring info: ------------------------------------------------------------------------------

Are you testing your kitty for ketones? If not, do it!​

Tips for catching and testing urine samples​

Mogs
.

 

Hi Shannon, I'm sorry you had such a scary experience with your baby and glad he seems to be better. You are in the right place for help.

Please be sure to mention the shaking you observed to your vet - sounds like a seizure, which is a sign of a hypo event.

When you see this, could you please remove the 911 from your subject line? The emergency has passed and it scares people when they see that! Thanks.

 

Hi, Shannon! Sorry I wasn't on here last night. Buy, yes both my kitties were on Novolin N. Both were over dosed. Neither one had the same symptoms when they were hypoing. Buzz would start twitching, his pupils would get large, he would casually eat, and he'd lie around. Woody would howl at his food dish, scarff his food down, vomit, but would not show twitching or laying around. YOU know your cat. My vet was dismissive to my concerns, told me not to home test because it wouldn't help me, and basically reversed their order of not free feeding.

I can't stress how important it is to begin home testing. That is the underlying reason why my kitties didn't die. I would not have Woody if it wasn't for home testing then coming to this board any following the members' advice. I left my vet and found on who would entertain my home testing and wet food diet.

Good luck, and if this were my kitty I would not give 4 units again. I would calculate the starting dose based on his weight. I would also leave food out for him until you can monitor during his cycles.

 

Please remember that your vet works for YOU. If he is hard to get a hold of, dismissive of your concerns (and soon you will know his reaction to you home testing), then it might be time to search for a new vet. No one can stop you from home testing, but it would be helpful to have a vet that is on board with it. And it will help save your sanity so that you know exactly what is going on with his blood sugar at times like this when he is acting off.

Best,
Sandi.

P.s. Did I miss kitty's name?

 

Thanks for the tip! Still getting the hang of this forum. I'll be sure to mention that again when I call today.

 

Kitty's name is Cosmo! He's the beautiful 12 year old in my avatar. I LOVE my vet. He's a friend who cuts me a great deal when it comes to treatments and he is so good with Cosmo. I don't find him dismissive so much as busy and hard to get a hold of. Unfortunately, he's the owner of a very small animal hospital in the area and my personal opinion is that he is overbooked and overworked. It's just him and his wife that run the practice (along with several techs) and they come highly recommended and they're very popular in the area for the level of compassion they show. He is personally hard to get a hold of because he's always with patients and I feel the vet techs don't have the answers I'm looking for. This has all happened so quickly (I got him home a week ago today), I've only tried calling once and I couldn't talk directly with him which was frustrating after that first scary episode. I actually ended up turning to a friend who's a vet tech who was able to give me some answers to my questions. Since then, he was seemingly fine until my anxiety took over last night and I started thinking maybe he is sleeping more than usual and deeper than he should be. I'm positive the vet would be on board with at home testing, I just need to get a hold of him!! I'm going to try calling again today, specifically asking for him or at least someone who can spend a few minutes with me to answer questions. If not, I do have an appointment scheduled for next Tuesday so I'll be sure to go in with my ever growing list of questions.

 

Good morning, Shannon....great job done by you and sweet Cosmo. Be sure to get the glucometer and strips today so u can start collecting data which tells helpers so much. Glad you like ur vet and glad u have connected with us here. Cosmo is in good hands

 

Oh, and lancets. Many of us "free hand" the lancets...I personally found that easier and gave me best success getting a blood sample.

 

Thank you so much. This thread has been such as blessing. I'll be sure to get that today!

 

Totally agree about home testing...it's important for Cosmo as well as important and peace of mind for you .

 

.....it truly is a blessing

 

Oh, Shannon, one more thing (someone needs more).... I'd encourage you to pick up a spiral notebook to keep a daily log/BGs/questions in....I use two pages per day, the left hand side for notes of what eaten, behavior and any litter box activity noticed...the right side for recording BGs taken ...not how it has to be done but has worked for me

 

Hi Shannon,

Here is one of the more comprehensive lists I've come across for symptoms of hypoglycaemia:

An abnormally low level of sugar (glucose) in the blood. This is a life threatening situation as the brain is critically dependent on a constant supply of fuel. Symptoms can include the following, but your cat may exhibit only some or even different symptoms:

• lethargy, lack of energy, sleepiness, difficulty in waking, sleeping or hiding in unusual places
• tilting or swaying, head or body, glassy eyes
• weakness, appearing drunk, staggering, falling over
• hunger
• restlessness, pacing, abnormal crying or howling
• shivering, cold
• disoriented, non responsive, convulsions or seizures
• coma, unconsciousness
• vomiting

[Emphasis mine]​

Source: http://sugarpet.net/complications.html​

I would add a recommendation about checking BG or visually monitoring more closely if one observes any unusual or uncharacteristic behaviours in a cat receiving insulin.

For general information, it is worth noting that some vets believe that when a cat becomes hypoglycaemic it will always automatically look for food. This is NOT TRUE, hence the need for home BG monitoring and close observation of a cat's clinical signs.

With such a caring vet I can understand how he would be so busy. I hope the information you're getting here will help you to better get across to the staff and the vet techs at the practice that something requires your vet's urgent attention; your own observations and concerns are spot-on.


Mogs
.

 

If he is (understandably) too busy at the moment to talk to you, you can request that he give you a call-back at his earliest convenience.

 

Hey guys! The vet got back to me. He agrees and is afraid of a hypo episode. I have an appointment on Thursday and until then we've decreased to 3 units twice a day instead of 4. At the appointment I'll ask about a glucometer. Thanks again for all your help!

 

I would actually cut that down to 2 units at MOST. 3 is still a higher than average dose, and a very high starting dose. MOST cats start at 1 unit and then adjust as needed. Without testing that's still a high dose.

 

Thanks for the update, Shannonmarie! I'm glad you got to speak with your vet today.

Needless to say, keep a close eye on your little one: sometimes after hypos cats become more sensitive to insulin and a reduction to 3IU BID isn't a big one. I hope it won't be the case but should you see similar worrying clinical signs act to raise BG levels with carbs and also let your vet know immediately to discuss dose before giving insulin again (and make sure the reception staff know it's an urgent matter).


Mogs
.

 

You don't need your vets permission or blessing to get a meter and start testing.....a lot of vets will even actively discourage it telling people that their cat will hate them, run from them and testing them will ruin their quality of life.

Testing is the only way to know what's going on in your cats body! And you don't need a fancy (expensive to use) "pet meter" either (although again, a lot of vets will say you MUST use a pet meter).....the strips for those meters are about $1 each.....and not many people can afford at least $120/month for test strips!!

The vast majority of us here us human meters.....the favorites here are the WalMart Confirm or Micro (about $15....strips are $35.88/100)......and the protocols we use here were all developed using human meters too!!

Please consider going ahead and starting to learn how to test....Not only will it let you know how Cosmo is responding, it could very well save his life!!

 

The sooner you can get a glucometer and start testing, the better! Three units is still a lot of insulin; if you are testing you'll KNOW whether or not your beautiful Cosmo is safe!

 

Hey everyone! I'm not sure if you'll all receive a notification that I posted but I hope this message finds you well. I just wanted to let y'all know that Cosmo is doing great on the 3 units twice a day. He is much more alert, way less sleepy, and just as active as before. Although I was told by the vet that I could at home test, I've decided against it as of right now. I feel he's under control and happy and I don't need to stress him out any more than necessary. Of course, I do have a glucometer and in an emergency situation or if I felt something was off I could test but as of right now I think he's fine without it.

I did want to ask though, is his poor little arm fur ever going to grow back? Or am I going to have a poodle looking kitten forever lol.

 

His fur will definitely grow back but it can take a while. Feel free to come here and ask anything you want any time.

 

Have you tested him on your own at home yet at all? I am sorry if I missed that in this thread. If not, please at least consider this -- an emergency situation is not really the time for you, AND him, to figure it out. Ive seen it happen here during 911s, and while we USUALLY can walk someone through learning to test, it is so unnecessarily stressful. Your goal should be focusing on treatment of your baby at that time, not learning to test just to diagnose.

Could I convince you to at least test once a week to start so that you both get absolutely comfortable with it? And then, you might just find out that it is no big deal at all, and work yourself up to testing before each shot.

I am really not trying to preach. I can just promise you that the peace of mind that testing before every shot and before bed gives to me is IMMEASURABLE. And I swear that my boy looks forward to it. You might not believe it, but it is true. It is our time when he has me all to himself. I don't even give Whispy any treats at test time. He just gets chin skritches and hugs.

Please consider it.

Best,
Sandi.

 

I understand your decision not to home test but I feel compelled to impress upon you that it is really the ONLY way to make sure it's safe to give your beloved Cosmo his shot. We all love our kitties like they were our children, I know; imagine it this way - would you give a child a shot of insulin without knowing for sure it was safe for them? I hope you will reconsider!

 

Uncle's fur is taking a long time to grow back since he was in the ER in Sept. but I assume it's just a matter of time before it looks normal.

I wanted to let you know that since Uncle has been on insulin, it seems his pancreas has started to kick in. He started on 1 unit of Lantus twice a day and now he is getting only .1 unit (about 3 drops!) twice a day. Not to be dramatic but if I hadn't been testing him along the way, I wouldn't have known to reduce the dose and he could have gone hypo on me. Testing is the only way you'll know if at some point the 3 units is too much. I'm not trying to scare you, you've already seen what a little too much insulin can do, and I know you want to keep Cosmo safe!

 

I'm glad that others chimed in about the testing. I totally agree with what they've said. I just had a sense that last night when you posted you weren't ready to hear this. It really is much easier than you think and the peace of mind you get from it is immeasurable.

 

I agree with the others please reconsider the home testing! It is extremely important. Especially since getting in to see your vet or a phone call has proven difficult due to his high demand. How will you know when your cat is experiencing hypo without knowing what his numbers are? Without consistent BG testing I dont believe Cali would be doing as well as she is and I would never have been able to lower her dose and would have been over dosing her for weeks. I am new here myself and have taken every bit of advice given by all these wonderful angels and know they helped Cali and myself in so many ways. I hope you will do the same for the safety of your kitty and your own sanity. Knowing is better than not knowing and thinking the worst is happening. Testing takes the worry out of it. I hope everything goes well for you and your furbaby!