HELP! HELP! HELP!

Maus' number went way high tonight - 338. She won't eat. Should I give her the shot now? Panic mode, please help!!!!

 

Re-test. Could have been a bad strip, though it's worrying that she won't eat. How is she acting otherwise?

 

Tested again a few minutes later - 340. She isn't out of it, but kind of sluggish.

 

When did she stop eating? I know she has some other health issues-- does anything seem to be acting up? This is a rapid change from this afternoon....

 

Just got home from work. She ate before I left.

 

I am really freaking out! Should I give her the shot?

 

OK, so the big worry here, especially given the skipped shots, is ketones. While they can come on really rapidly, I am hoping that that isn't the problem here-- she hasn't been ketone-prone in the past. But it is a worry.

Can you tempt her to eat something, anything? Carbs are fine at this point. I'd like to see her get some insulin tonight, but not on no food with Vetsulin.

 

Just gave her 5 syringes of canned. Should I do more?

 

OK, that should be a decent base of food, enough to be able to give a shot. If it hasn't primed the pump to get her eating on her own, you can do another meal later, but hold off for now, don't want her throwing up what you just got into her.

 

How long until injection?

 

I think I'd wait a half hour, to make sure that meal stays down, and to see if the food has perked her up any.

Any idea what this could be? Lots of things can make them feel yucky and both cause a spike in BG and send them off their appetite, but it's just such a sudden flare-up. Has she ever been diagnosed with pancreatitis? Any chance she got into something she shouldn't have while you were away at work?

 

No pancreas issues that I am aware of, and there is really nothing for her to get into. She has had some vomiting off and on for the past couple weeks, but not in the last two days. She had a UTI when I took her to the vet about the vomiting. Did antibiotics for UTI (went away), but she was still throwing up every couple days. Then they did xrays for kidney stones, but found none. Never did get to the bottom of that with vet. I don't know if that means anything. Vet didn't seem very worried, or say that it had anything to do with her diabetes. Maybe I should have mentioned this earlier, but I didn't think about it being relevant.

 

Hmmm. Have you been testing for ketones? It's a matter of getting a urine sample and dipping a little tester stick (available with other human diabetic supplies). I'd highly recommend getting some testers and testing regularly going forward, just to be safe. The "recipe" for ketones in a diabetic is, lack of food + lack of insulin + infection/inflammation/severe stressor.

 

Don't know anything about that, was never mentioned by vet.

 

She eats pretty regularly, and she was getting regular injections before the last couple days. She has had several UTI's in the past year or so.

 

Hopefully this flare-up of whatever it is (another UTI, maybe?) will pass as quickly as it came on.

 

I gave her 1 unit about ten minutes ago, and just now she got up and stretched and went to the water bowl. Will get a few hours of sleep and check her again. I feel so helpless with her, the poor thing just can't catch a break. Thank you very much for your help, it means a lot to me. Talk to you soon!

 

OK, I have to head off to bed now, so I'm glad to hear that she perked up enough to stretch and get a drink of water! Those are good signs. The food may have helped, or she may just have something fleeting that is already starting to fade (fingers crossed!). Glad you'll be able to get a test in later too, to see where that 1U takes her and make sure she gets a bit more food in her.

I'd definitely get some ketostix tomorrow and try to test for ketones. If nothing else, that is something else you can do to remove at least one worry, even if you still can't fix what's wrong immediately. If only they could talk.

Feel better soon Maus, and goodnight to you Matt!

 

The test from 3 hours after insulin is 153. Seems much better. Will get those test strips ASAP. Thanks again!

 

She ate over 1/16 cup of Dr. Elsey's after the +3 test. Tested again at +7 and it is at 129. She also ate a fair amount of canned on her own after test.

 

So glad to hear that she's feeling better this morning!

 

Thank you! I really hope we can get this figured out soon.

 

Got some ketone test strips, just waiting to catch her going to the litter box. Fingers crossed.

 

@MrWorfMen's Mom

 

Just tested and it is 182. Going to feed her now, but I don't know if I should give insulin. I haven't been able to test for ketones. Can you or someone else please advise?

 

Can you monitor today, or are you working? She did well on the 1U last night, but I'm sort of thinking of trying a half dose of 0.5U, just because she was doing so well and keeping low-ish numbers for a few days on nothing? I hope Linda (@MrWorfMen's Mom ) or someone else who has used vetsulin will be able to weigh in on this, though.

If she's eating, that's a fantastic sign re: ketones.

The thing about ketones is that they are much easier (and much less $$$) to treat if you catch them early, so regular urine testing is a good idea, even when she isn't showing outward signs. I'm glad you have the strips now!

 

From your other thread:

So the other option is to follow this and do 0.25U.

I just wish we knew why she spiked so high last night....

 

If Linda doesn't respond within 30 minutes (she just ate some canned), would you personally do 1/4 or 1/2? And yes, I will do my best to check for ketones regularly now that I am aware of the issue. Thanks, as always!

 

Linda is away for the day.

 

I guess I will go with Linda's previous advice and give 1/4, and do some re-checks.

 

Since she's currently eating on her own, if she's otherwise 'back to normal' I think I'd go conservative and just do 0.25U. That gives her some insulin on the off-chance that she's on the edge of ketone development, but not so much that you are likely to get into a lot of trouble today if she's feeling better and her numbers are dropping on their own anyway.

Once you have a ketone test under your belt, we'll have some more information to deal with.

Ah, I see you came to the same place on dose! Great!

 

OK, will do a re-check two hours after giving 1/4 unit. (lol)

 

Thank you for letting me know.

 

The +2 number is 144. I gave her some food, as is normal at this time. Will check again in 3 hours.
**edit** - I was just able to get a ketone test, and it appears to be negative to my eyes (tried 3 times). That is good, no?

 

Great news! That means that whatever was causing her inappetance and lethargy last night, at least it wasn't that, which is a huge relief.

So, for right now, it's just back to managing her insulin needs, and figuring out why they spiked so suddenly and why she was feeling yucky last night.

Next time you have to take her to a vet for one of these episodes, one of the things they can test for is pancreatitis (using either the SNAP fPL, which gives an instant yes/no, or the Spec fPL test, which gives a quantitative read on severity of a flare but has to be sent out usually). The symptoms are usually pretty non-specific (like inappetence) but I'm mentioning it as a possibility because it's fairly common in diabetic cats. More info here: A Primer On Pancreatitis

 

One of the biggest problems I have had with her is that she has been a mess for most of the 2 years that I've had her and she was already 7 when I got her, so I have no idea what her "normal" state is. She is not much like what I call "normal", but maybe that is normal for her. Sometimes she shows flashes of what I call "regular cat" behavior, but she usually acts as a paper weight. No matter how many things we have taken care of medically, there still always seems to be something lurking in the background that is holding her back. That page on pancreatitis looks promising though.

"Kitty might seem lethargic, the blood glucose (BG) may have increased, he/she might be sitting in a meatloaf position, hiding, and/or generally does not seem “right”. Perhaps Kitty also vomits."

That largely describes her most of the time she has been here. The vomiting has always been there, but it was much more rare until recently. I will definitely have her checked for that, it is worth a try. I live to see the "regular cat" that lives inside her, or whatever kind of cat she would be. I don't believe I have ever seen much of the "Real" Maus, but I sure hope to. I hope you aren't getting tired of hearing it, but I can't thank you and Linda enough for all the help and support that you have given us in such a short time.

 

6 pm test 145, so it only went up by 1 in 3 hours. Will check again at 9 pm.

 

Nice handling of Maus Matt. You're doing fine. Great that there were no ketones but sorry to hear Maus went off her food. Your decision making on the dosing was spot on. Being conservative with the dose until you determine her reaction and figure out what is going on with her is the best way to proceed.

I think checking Maus for pancreatitis would be a good idea. It's one of those underlying conditions that quite often occurs in diabetic cats and will rear it's head every so often. If Maus was perhaps a bit nauseated it could explain that suddenly higher BG.

Glad to see numbers coming down again and anxious to see where she's at today.

 

Her pre-shot number is today 140. I don't know if you will respond in time, but I'm not sure if I should shoot or not. Her numbers have been going up in the afternoon, so that has me a bit worried. I am feeding her now, so if I give insulin it would be around 12:00 (45 minutes from now.)

 

What is your availability to monitor today? Is it a work day? Could you monitor to +6 post shot? If you can monitor her, then I'd suggest trying a 0.25u dose and see where that takes her. She didn't drop a lot yesterday on the quarter unit dose but pre-shot is lower today and we're not sure what's been going on with those suddenly elevated numbers of late.

 

Yes, I am off work today and can keep an eye on things. I will do 1/4 and monitor her. (+6 or every 2 hours until +6?) As always, thank you!

 

I'd check Maus at +2 and see what she's doing. If she's dropping a lot, you can steer her with food. Wouldn't wait till +6 as Vetsulin starts working early and some cats hit lowest point by +3.

 

The +2 number was 93! That is our first green number so far, yeah! I am giving her some food this hour, as it it the normal hour before I leave for work. (I try to keep her on the same schedule on the weekend.) Will check again at +5.

 

Yeah for green. Check again anytime now just to be sure she isn't dropping much more. Please don't wait till +5. You need to monitor closely right now to be sure she stays in safe numbers.

 

Oh, OK. I thought I was supposed to wait 2 hours after food.

 

You only need to wait the 2 hours after food for the pre-shot tests. Those are the ones that you don't want food influenced. Other testing can be done at any time regardless of when kitty ate. If you are on the same meal schedule daily, you'll know. It would however be helpful to make a note in the remarks column on the spreadsheet for anyone helping to reference.

 

If you get the chance to peek at my chart to see if this is what you mean? I did another check and it is up to 109.

 

That's fine but you can type "109 @ +3.5" into the +3 cell on the SS but you 'll have to manually colour it blue. I'd retest her again about +5 and if she is still in the greens or blues then maybe around +8 as there is another little hit from the Vetsulin which may or not be evident for Maus. Might as well gather some data while you have the opportunity. If BG is up considerably (I hope not!), then don't bother with the +8.

Looks like she might be a very early nadir kitty but that could just be an fluke given the past few days of ups and downs. All considered though it's good. She is maintaining decent numbers well below renal threshold again now which is great.

You don't want Maus going much below 90 at this point so when you get a reading like 93, best to give her some low carb food as you did and retest in no more than 30 minutes to an hour depending on how far below 90 she is. If BG happens to drop to the 60s or 70s higher carb food like Fancy Feast gravy lovers or a bit of honey or karo added to low carb can be used to bring numbers up but a little more testing needs to be done to make sure she stays in safe numbers.

 

At +5 it is 132, so it is still climbing. This is what is scaring me, because the numbers have been going up the past couple days during the time when I would be at work during the week. I wouldn't be able to monitor her and do anything about it. Should I try to begin moving her towards a later injection time? Also what are your thoughts on the shelf life of Vetsulin? It says stop after 42 days from 1st use. I asked my vet about this, and she said it was good for a couple months after that. Is my vial getting old? I am at 91 days right now. Lastly, I figured out how to fix the chart.

 

Don't panic over individual numbers. Maus isn't regulated but her BG has not been that high aside from the one pink reading the other night and goodness knows what caused that. Even those yellows weren't that high. There are a lot of folks who would be very jealous of Maus' SS. Maus will be fine.

As for shot time, that is really up to you. Best to schedule shot times to allow yourself as much time to test at critical times which could mean as an example, getting up an hour earlier and leaving enough time to test before heading out the door. Being able to get a +2 test post shot will give you a better idea where she is headed and you can leave out some higher carb food for her to eat in your absence if she is dropping faster than usual. I have to admit that with Vetsulin, it's a bit harder to deal with the lower pre-shots you've been getting but it can be done. The longer lasting insulins like Lantus are better at holding low numbers than pulling BG down so a little easier to work with in lower BG range.

The insulin should be fine for at least 3 if not 4 months or a little more if stored properly. The 42 days is simply the amount of time the manufacturer tested the insulin to comply with FDA regulations. Usually if the insulin has gone off it will look cloudy or have little particles in it even after the customary rolling before withdrawing insulin.

 

Thanks for putting up with me and my overreaction. I'm new to this. I am trying to learn, but I am prone to letting my emotions get the best of me. As I told you previously, she's been through a lot and she needs to experience some of the "good life". Getting a +2 before work is something I can do every day. By the way, her 11 pm test was down from the previous +7, so I am glad it stopped climbing. I will keep trying to learn about this stuff from you guys (and be more calm, lol). I also plan on switching to Lantus soon. Thank you for everything!

 

Matt, you are a pleasure to help and are not over reacting at all. You are simply showing that you are a very concerned kitty parent who wants the best for his little girl and are making every effort to get her health improved. You're learning just like we all did and the way you love that furry kid, you fit in this group perfectly.

So happy to see that BG down some at PMPS. I'd stick to the 0.25u for a few more cycles if pre-shots indicate it's safe to give insulin and then re-evaluate.

 

The pre-shot was 140 again today. Since .25 was OK yesterday, I made a judgement call and gave her the same again. Will do the +2 before work. As a side note, giving .25 is a bit of a pain because you have to kind of guess where the line should be. Are there syringes that measure .25? Mine only have .5 increments. Thank you & the group, I am SO glad I found you.

 

Sorry but alas there are no syringes with quarter unit markings and all you can do is eyeball it. One suggestion is to take a used syringe and draw up coloured water to what you perceive to be 0.25u to use as a comparison. Being absolutely precise in dose is not as important as being consistent.

Since you shot today, make sure to leave food out for Maus to eat in your absence. If her BG is down from pre-shot, a little higher carb food would be good or more of the low carb than usual just to be sure she has something to eat should she need it.

 

BG was down to 80 at +2. I let her lick the gravy from a can of Friskies extra gravy and will give her some of her regular food. I am a bit worried because I have to leave soon, but I hope it will be OK because so far the problem has been that the numbers have been going up later in the day, not down.

 

Maus appears to be an early nadir kitty from what we've seen so far, so just leave her some food to eat while you are gone and she will be fine. You've likely raised her BG from the gravy which is fine and will keep her safe along with the food left for her.

 

I am not sure what it means, but it looks like the numbers form the past two days are pretty similar. Also, I am not sure what you mean by early nadir kitty.

 

Nadir is the lowest point (peak action of the insulin) in the 12 hour cycle. Maus seems to hit the lowest point in her cycle pretty early on Vetsulin. If you look at your pre-shot readings and +2 tests the last couple of days, Maus drops a lot early on around +2 so her nadir is happening very early and then she starts rising again. This suggests she's not getting much duration out of the Vetsulin and it's not lasting long enough through the cycle to keep her BG down. Another good reason to consider a switch to Lantus.

 

She is at 139 now, and I'm not sure if I should shoot. Not sure if you will see this before 12:00, but perhaps you will and can help me decide. I am going to feed her now.

 

Are you able to monitor at all after shooting today? It's not really different from the 140 you shot the past couple days...

 

I think you are Ok to shoot, retest her before you leave at +2 and if she is dropping fast again, give her some gravy food and leave food out for her to eat while you are away. If you are worried about her, you could reduce the dose a bit by lining the plunger to just below the zero line on the syringe for a dose of 0.10u.

 

I can only do the +2 before I have to go to work.

 

I will try to get some Lantus locally if I can by the weekend. I need to ask my vet for a written prescription, correct?

 

If you plan to purchase the Lantus at a pharmacy, then yes you need a script from the vet. If I was you, I'd check out the supply closet. Even if it means a couple of days delay for delivery it would be a lot easier and far less costly and Maus will be fine till it arrives.

 

OK, I will do that. I was thinking get it done fast.

 

The lantus pens are very expensive, don't know where you live but look in the supply closet under forums, members sell them after their kitties
I found this one for you in the supply closet, see if she has any left
I copied it for you

megmonger tap on her name and start a conversation with her and see if she has any left, I see that she has syringes that you would need to use lantus and other items

Our dear furbaby Abby went to the rainbow bridge in November and I have 4 unopened never-used pens (3 ml each) of Lantus left in my fridge that are good until 08/2021. Purchased from Marks Marine Pharmacy. I can’t fathom throwing them away but our vet is unable to take them because the box itself was opened (we used 1 of the 5 pens).

Might there be anyone here near the PA/MD/DE border that could use them? I don’t feel entirely comfortable shipping them due to fluctuating temperatures so if possible would want to just meet/deliver directly. We live near Elkton, MD. I paid $165 plus $25 shipping for the box of 5 originally, so would reasonably ask $25 per pen.

If desired, I also have about 30 syringes left for the Lantus, plus several meters and possibly some extra test strips. No cost for those with the purchase of the insulin

 

I am in Illinois and she doesn't want to ship. I saw that one too.

 

How about this one

Julia Rae
Joined:
Jun 11, 2015
I have 4 lantus pens and I am asking 30.00 + the cost of shipping ifinterested pm me

 

I saw that one. Maybe I am just stupid, but I can't figure out how to pm, and that is what she asked for. I just asked on this thread about availability.
http://www.felinediabetes.com/FDMB/threads/lantus-solstar-pens.222861/

 

If you can't find any than you are better off getting them from Marks Marine Pharmacy in Canada, most members buy from there because they areca lot cheaper, go check out their site

 

Another option would be checking with Alan Hamman. He's reliable and a lot of folks have got insulin from him. He's got some Levemir pens which is a very similar insulin to Lantus and could also work well for Maus. Another option to keep costs down if purchasing locally is only option is to ask about Basaglar. Same as Lantus but generic and a bit less expensive.

To PM anyone simply click on the picture area of the avatar then choose "start conversation".

 

I will look into that if I can't find something else. Thank you!

 

I saw that, but I wasn't sure if that was the same thing. Thanks for the info, I will keep learning!

 

Matt go to the supply closet and look for her name to the right Julia Rae and then reply to her

 

Just so you know, while we can buy insulin OTC here in Canada, you will still need a script to order from Marks Marine because a script is required in the US.

 

I was wondering about that.

 

Can you give me an estimate on how long 1 pen lasts? 1 would be best to buy 1 right now because cash is a bit tight.

 

One pen contains 300 units of insulin so at a dose of 1u twice daily (which is likely more than Maus needs) one pen would last 150 days or roughly 5 months.

 

Wow, that would definitely last longer than I need due to money. I think I want to try Mark's Pharmacy. I don't see much on the Supply Closet, especially that doesn't need to be shipped long-distance. For this reason, I think I would feel more comfortable with a reputable pharmacy handling the packaging and shipping. It isn't that I think any of the members would do something knowingly bad or wrong, but insulin is nothing to fool around with. I am very (probably overly) picky when it comes to things like this.

 

Here is a pic for you
You want the Lantus SoloStar pens. They are pre-filled with 3 ml of Lantus. Here is a picture:



You don't need the pen needles. Just stick the insulin syringe needle into the rubber stopper.

 

That is what I was planning on getting.

 

If you go on the marks marine site on the top where is says FAQ it will give you answers to most all of your questions such as shipping rates , how long it will take to receive it, etc I see one pen is 49.99 not bad, you will also need the U-100 syringes for lantus with half unit markings. I just recently switched to Lantus myself and I love it