good time for Cleopatra

Discussion in 'Feline Health - (The Main Forum)' started by nkuzmick, Nov 19, 2017.

  1. nkuzmick

    nkuzmick Member

    Joined:
    Sep 15, 2017
    Hello all, we are new here this week and posted some background on Cleopatra in the Vetsulin forum. Sharon14 answered most of our initial questions and suggested that we ask additional questions on this forum since it gets more traffic. To briefly summarize what we posted in the Vetsulin forum, Cleo was diagnosed mid September with BG of 483, a high BUN of 54 and some breathing issues. Vet kept her and got her BG down to around 100, but IV caused fluid build up and we nearly lost her. Additional testing and visit to cardio specialist confirmed that she has hypertrophic cardiomyopathy - Cardio Vet prognosis 1-2 year life expectancy. She is 12 yrs and 18 pounds. Started her on 2 units Vetsulin twice a day and several cardio meds mentioned in the other forum. Glad to see a post for another cat with same heart issues still doing well after 4 years.

    Cleo is doing much better now and PS BG is usually mid 200's and drops 50 - 80 points to low point in about 4 to 5 hours (we home test with AlphaTRAK 2 meter) and she is currently getting 1 unit of Vetsulin every 12 hours. She has not had any readings above yellow range at any time in the last several weeks and spends most time in the low 200s or upper 100s. She gets 1/2 can FF classic and 1/4 cup of Hills DM twice a day (we have ordered Young Again Mature Zero) - she is eating well, using her litter, and grooming again. BUN is now down to around 40 - her breathing is easy and has improved to a normal rate of around 30 BPM. With all her other issues, we try to minimize dosages and our objective is to help her obtain the best quality of life for what ever time she has.

    First question - She seems to get sleepy and somewhat lethargic after her Vetsulin injection especially on the higher 2 unit dosage - Is this a common thing? anything to be concerned about? She never goes below 100 BG.

    Second question - the last 3 times we have given her FF beef, she has done fine in the AM feeding but has vomited a small amount of clear yellow liquid (no food) several hours after her PM feeding -could she a digestive issue with red meat? Stools normal, urine clumps normal too.

    This site has been most informative - thanks and Best Regards, Bob & Nancy
     
  2. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    Things are a little slow this weekend, so I’ll bump your post up and tag @JanetNJ as she’s more familiar with vetsulin.
     
  3. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Generally they vomit bile from having an empty belly too long. Does she eat anything between the am and pm shot? If not try giving a small meal mid day but at least two hours prior to the preshot test. If she does then it may be a case of acid reflux. She could take an antacid and see if it helps.


    The dm food is too high in carbs for a diabetic cat, so I'm glad you are trying the young again. A full days serving of ya is only 1/3 cup, so keep this in mind.

    You mentioned the bun being high. Was that from dehydration or kidney issues? If it's kidney issues the fancy feast may be a bit too high in phosphorus. Can you post her most recent lab results?
     
  4. nkuzmick

    nkuzmick Member

    Joined:
    Sep 15, 2017
    Thanks - attached is recent blood work for Cleo - Originally when first diagnosed as diabetic (it was actually mid August on 8/21) her BUN was 36 and her GLU was 483 - vet said ketones OK. Cleo gets very stressed during vet visits and did not do well when they kept her on 8/21, 8/22. Vet said she would not survive the night and we should consider putting her down. Turns out she had a breathing crisis brought on by too much IV fluid on top of her then unknown heart issues. She got a Lasix shot and we brought her home (had to sign against medical advice) to get her into a loving, a low stress place. She made it through the night but was still working hard to breath. Back to the vet on 8/24 when she started mouth breathing and X-rays showed more fluid build up so they sent us to the Cardio specialist who did an echo which confirmed her heart issues. BUN by 8/24 was up to 54 and we suspect the heavy Lasix dosage to purge fluid was the cause of the elevated BUN. Fluid build up around heart/lungs was causing rapid breathing (almost 60 BPM) - Cardio vet put her on 10 Mg Lasix 3 times a day, and reduced to twice a day after breathing improved to about 40 BPM. She also prescribed an Ace inhibitor (2.5 Mg Benazepril) and Plavix which she would not take, so she was switched to 20Mg of aspirin 2 times a week due to clotting risk from her heart issues. With 2 units of Vetsulin every 12 hours her BG was coming down - PMPS was 238 and her breathing was much improved - Retested blood on 9/19 and BUN was down to 36 . Cardio vet wanted her retested again of 9/26 and her BUN was up to 46 so she cut her Lasix back to 15 Mg per day. More blood work on 10/12 and her GLU was 44 so since her breathing was very good 28- 30 BPM) we reduced the Lasix to 10 Mg per day and since her BG was staying around low 200s/high 100s, reduced her Vetsulin dosage to 1 unit. We know Lasix is hard on kidney function, but don't know about the other med.

    She is a happy girl for the last month, and so we have not had her blood tested again - she hates vet trips - is well behaved, but very stressed. She really likes the fancy feast classics - was on dry only before diabetes diagnosis and FF made the introduction of that wet food and the switch easy - We had tried 2 different prescription wet foods which she would not eat. She refuses to be pilled even with a pill gun and she gets her meds ground up in her wet food so we try to give her food she will readily eat. She eats her 1/2 can of FF in a 5 - 10 minutes and grazes on the dry all day/night -seldom finishes the 1/4 cup dry serving (Hills MD) but still has not lost much weight . As soon as we have her on Young Again dry for a few days, we will run a complete BG profile - and will pre-test (and +4) every day for a while after the switch - food should arrive today.

    Will call cardio vet today to get her opinion on med dosages, but we are sure she will want more blood work first. Are there any clinical signs we can watch for regarding her kidney health?

    Thank You again - we truly appreciate your help. Very Best Regards, Bob & Nancy

    Best Regards, B img015.jpg img016.jpg img017.jpg img018.jpg
     
  5. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    How is her anemia being addressed?
     
  6. nkuzmick

    nkuzmick Member

    Joined:
    Sep 15, 2017
    Besides RBC are there other blood readings we need to be tracking for anemia? The local vet said that her anemia which was pretty bad in her 9/19 test had improved by her 9/26 test and was back in the normal range - vet has not tested RBC after that. We thought the anemia might have been caused by all the trauma associated with her heart condition and fluid buildup crisis. She is not getting any special treatment for anemia now - guess we are going to have to put her through another vet visit/blood test to confirm but was hoping to put that off for a few more weeks as long as she seems to continue improving. A good sign is her breathing which has continued to slow down and now is consistently 30 BPM or lower - also the last month she has been more alert and more active. Her breathing seems to be back to normal chest breathing no longer labored and in the lower abdomen.

    We thought her increased alertness/activity might have something to do with the lower Vetsulin dose, but looking at anemia symptoms it might be an indication of improved RBC/anemia. We count her BPM several times a day since that is what the cardio vet told us would tell if more Lasix was needed - BPM holding at good levels - She was tested years ago for feline leukemia (negative) as have our other 2 cats and they never go outside so we have not been worried about that. We do feed a some local neighborhood cats outside, but try to use/keep separate dishes for them.

    Should we schedule another comprehensive blood test at the vet to get a better handle on current kidney function and RBC or just monitor her breathing and energy level for the next few weeks? She does not see well/at all so no running around, but she does come out across the room with her tail up high to greet us when we enter the bedroom and is grooming better.


    We appreciate the time and effort you are taking to help us - been reading like crazy on diabetes - now with kidney and anemia concerns the volume of information on line is overwhelming.

    Thanks Again and Best Regards, Bob & Nancy
     
  7. nkuzmick

    nkuzmick Member

    Joined:
    Sep 15, 2017
    Cleo really likes the Young Again mature zero - will have no problem getting her off the Hills MD - started last night and so far no digestive issues - will post BG tests starting tomorrow. Spent several hours trying to learn what the various blood tests mean - so much info on line.

    Looked at the thread on this forum concerning loss of leg function and watched linked video. Cloe is a little stiff with her back legs and not jumping up on things, but no where near as bad as the video cat - saw recommendations regarding Zobaline - any downside or adverse side effects from trying this? Might it help with her activity level? We are always concerned about adding meds.

    Thanks and Best Regards
     
  8. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Zobaline is not a medication, it's b12 methylcobalamin and folic acid. Very safe to use.
     
  9. nkuzmick

    nkuzmick Member

    Joined:
    Sep 15, 2017
    Thanks Janet - will order it
     
  10. Sandi & Whisper

    Sandi & Whisper Member

    Joined:
    Oct 2, 2015
    Totally unrelated suggestion for all - when posting paperwork/results you should blur/cut out your full name and address. Unfortunately we live in a time where you could some day post regarding wanting dosing advice for an upcoming vacation...and now everyone (EVERYONE on the www, not just everyone in this group) also knows where you live and that you won't be home.

    It's a sad reality, but it is our new reality :-(
     
  11. nkuzmick

    nkuzmick Member

    Joined:
    Sep 15, 2017
    Thanks Sandi, yes we should have removed our personal info. on the blood work (vet ID also). We thought about that after we posted and decided we were not real sensitive about name and address. We realize that lots of people on the WWW already know who we are and where we live - now they know we are cat lovers. Good advice about not posting any indications of being away from home - and especially anything that might compromise financial records - Also be careful about what you put on Ancestry and similar sites - agree with you and sorry to say that not everyone has good intentions. If we knew how to copy over text, we would repost blood work and delete original post.

    After ending the Hills MD dry and starting Cleo on Young Again Mature Zero night before last her AMPS was 176 today - 50 to 75 lower than she had been (she has been one unit Vetsulin every 12 hours). This is the lowest AMPS we have tested. She was getting 1/2 can of FF with her meds mixed in and when she finished that, 1/4 cup of HIlls MD twice a day which she would graze on between wet feedings. Now on 1/2 can FF and 3/8 cup of Young Again every 12 hours. Only gave her 1/2 unit of Vetsulin this morning - will watch her closely and test BG if she acts odd - will test/record at +4 to see how she is doing with this food and the 1/2 unit insulin dosage.


    Thanks all and Best Regards, Bob & Nancy
     
  12. nkuzmick

    nkuzmick Member

    Joined:
    Sep 15, 2017
    Cleo has been on one unit of Vetsulin for the last week - her numbers are up a little - PS around 220 and at +4 she is 170 -185 - She has been very stable in this range - her PS numbers may be influenced by the fact that she grazes on her Young Again all night/day right up to shot time - she is not finishing the 3/8 cup we give her twice a day. She has always been a slow/little at a time eater especially with dry food.

    With all her other issues we try to minimize all her dosages but are wondering if we should be satisfied with her BG staying between 220 & 160 as good enough or if we should up her insulin dose? Maybe another 1/4 to 1/2 unit?

    What do you think?

    Thanks, Bob & Nancy
     
  13. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Are you using a human meter or pet meter?
     
  14. nkuzmick

    nkuzmick Member

    Joined:
    Sep 15, 2017
    We use Alpha Track pet meter - Thanks
     
  15. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Ok well normal on AlphaTRAK is 68-150.... i would give a tiny bit more with the goal of getting Nadir to around 90-100. So id up it just a smidge to see if that gets you where you want to be.
     
  16. nkuzmick

    nkuzmick Member

    Joined:
    Sep 15, 2017
    Thanks Janet - we will bump her up to 1 1/4 units and track her Nadir daily for a week or so. Is it typical for Vetsulin dose of 1 unit to only drop her BG 40 to 60 points? Guess we should consider ourselves fortunate that her readings are so consistent and she is doing so well on such a small dose with low carb food.

    Thanks again and Best Regards, Bob & Nancy
     
  17. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Some cats 1 unit will barely make a difference....other cats 1 unit will plummet the numbers. You don't know until you track it. Food and amount of activity level makes a difference too.

    My cat is about where yours is with numbers generally under 240. Recently she became more sensitive to the insulin and I've had to drop her dose in the daytime. She runs lower in the day verses the night for some reason. So today for example she had almost the same am and pm preshot 194, 195.... This morning I have her 1.25, which got her to 97... This evening I am giving her 1.5 because it takes just a little more in the evening to get her in that 85-110 range.
     
  18. nkuzmick

    nkuzmick Member

    Joined:
    Sep 15, 2017
    Cleo has been doing pretty well - BG staying between 140 and 190 with 1 1/4 units of Vetsulin. Now a new issue - with no changes in anything she is not quite finishing her food (wet FF and dry young again) and no poop for 2 days - she is using litterbox for pee and acted like she was trying to poop a time or two with no results - We are reluctant to try a little Ready Whip (lots of sugar) or sardines (too much salt) - any suggestions -

    Other than that she is acting normal.

    Thanks Bob & Nancy
     
  19. nmveasey

    nmveasey Member

    Joined:
    Nov 15, 2017
    She may be constipated. I am giving 1/8 teaspoon of Miralax twice a day mixed in with the canned food. Add some water to the canned food too.
     
  20. nkuzmick

    nkuzmick Member

    Joined:
    Sep 15, 2017
    Thank you - Started giving her Miralax this AM. Also cutting back on the Lasix dose she is on to prevent fluid build up from her heart issue - She has dropped about 1 pound (from 19 t0 18 ) in the last month, and her breathing is much improved (from about 50 BPM to now under 30 BPM) so maybe she has gotten rid of any excess fluid and is now getting a little dehydrated. She still drinks lots of water and pees 4 - 6 times a day. She is still eating , but not as quickly/much as a she did a week ago - Finishing most of her daily can of FF, and about 1/2 of her 1/3 cup of Young Again dry. No other obvious changes in her behavior.

    Nancy corrected me and pointed out that today starts day 4 with no poop - How long before this becomes a serious concern that requires a vet intervention? Also how long does it take before Miralax should start to work?

    Thanks, Bob & Nancy
     

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