Insulin increase and Diet

Discussion in 'Feline Health - (The Main Forum)' started by Ninja & Baby, Feb 14, 2017.

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  1. Kris & Teasel

    Kris & Teasel Well-Known Member

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    That's my take on it but I'm not a vet, just the mom of a bouncy cat who easily gets stuck in high numbers. That led to his DKA episode in March last year at the end of his first round on Lantus.
     
  2. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Yes that is exactly what we are referring to. I'm guessing the dose of insulin was too high all along and what you ended up with was a cumulative effect. His BG didn't come down so they shot more insulin while he was still hyperglycemic from previous doses and you end up in a vicious circle. This is the problem with cats and vets offices. The stress factor can elevate the BG by 100 points or more in some cases but the vet has no idea how much of the BG reading is "real" and how much is stress induced which leads to them prescribing too much insulin. Something we see around here a lot unfortunately. :(:(:(
     
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  3. Ninja & Baby

    Ninja & Baby Member

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    I need advice. I went to the vet's office to check on Ninja. As far as I could tell, they've done nothing for him. They are still giving him 2 u of vetsulin. His BG was 732. It appeared they weren't even giving him fluid. The vet wasn't there so I was not able to get any information. I was told he would call me later. I've spent nearly $2000 trying to get him straightned out in the last 6 weeks and he's worse now than when he started. Should I switch vets? Am I jumping the gun?
     
  4. Kris & Teasel

    Kris & Teasel Well-Known Member

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    My personal opinion is that horrible high of 732 is a bounce from far too high a dose of insulin. His body can prop it up only so long and then he'll crash to very low numbers. That's the big worry. Unless/until you get really good information from the vet about what's going on and a good treatment plan outlined, I'd get him home as soon as you can (if he's otherwise OK) and start experimenting with lower doses. At the same time, you could call other clinics to ask how many FD cats they treat.
     
  5. Ninja & Baby

    Ninja & Baby Member

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    I need advice. I went to the vet's office to check on Ninja. It appeared that nothing has been done for him. They are still giving him 2 u of vetsulin. His BG was 732. I saw no signs they were giving him fluids. The vet was not there so I could not get any information. I've spent nearly $2,000 and 6 weeks and he is worse now than when I started. Would I be jumping the gun to switch vets? Should I wait?
    I'm going to go get him. How much do you think I should give him tonight?
     
    Last edited: Feb 17, 2017
  6. Kris & Teasel

    Kris & Teasel Well-Known Member

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    In the interest of not burning any bridges you might ask to speak to the vet to see what he/she's thinking, not that it should change your mind. If there was no DKA in the picture I'd say try 1 u. However, it might be better to go with 1.5 u tonight and tomorrow AM to see what happens. You can lower it more if needed.
     
  7. Ninja & Baby

    Ninja & Baby Member

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    Update: I went to pick up Ninja. The vet wanted to talk to me. He said we had two choices: try another insulin in a lower dosage or keep him over the weekend and purge all insulin from his body. At that point, he said sometimes the pancreas kick in. I chose to try ProZinc at the lower dosage and see what happens.
     
  8. Kris & Teasel

    Kris & Teasel Well-Known Member

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    ProZinc is a good insulin. It's an in-and-out insulin like Vetsulin (no slow release depot like Lantus) but is gentler: slower in onset and lasts about 12 hours in most cats. What lower starting dose did the vet suggest?
     
  9. Ninja & Baby

    Ninja & Baby Member

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    He said I should give him one unit every twelve hours.
     
  10. Kris & Teasel

    Kris & Teasel Well-Known Member

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    That's a good starting dose. :) I think trying the ProZinc is a better plan than stopping insulin for the weekend. This is exactly what plunged Teasel into DKA when his insulin was stopped. The plan was 48 hours off Lantus with a restart after he got stuck in high numbers. After 24 hours of no insulin, Teasel started a DKA episode.
     
  11. Ninja & Baby

    Ninja & Baby Member

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    I was afraid to take the insulin fasting route. He said it would be rough on Ninja, and I'm not sure he could endure the ordeal. He's so thin and stressed and frail. I was suppose to watch him after the injection but he has hidden and I can't find him.
     
  12. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Just catching up now. Didn't get any alerts since yesterday morning for some reason!:mad::(

    I agree with a reduced dose of insulin but the rationale for changing to another insulin right now escapes me. The immediate goal is to get Ninja's BG down. At least with Vetsulin you know how he acts and what his numbers have been so far which gives you some history on which to make dosing decisions. IMHO changing insulin at this point in time just complicates things more because you have no idea how he will react to it. You are going to have to monitor him very closely even if that means closing off other rooms or keeping him in one particular room so you can find him.
     
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  13. Ninja & Baby

    Ninja & Baby Member

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    I think I left out part of the story. The vet said he withdrew insulin for 24 hours and Ninja's numbers didn't drop. I reported earlier that he had been receiving 2 units of vetsulin. That is what the nurse told me because that was what was written on the board. I assume the vet knows what's going on but who knows. That's the reason I agreed to the ProZinc.

    His BG this morning was 541 which was +13 since his last shot. I did notice that his water consumption is down. I don't know if that is from the lowered dosage, the different insulin, or he is just shutting down. I kept trying to get him to eat. I finally gave up and gave him 1u since his BG was 541.

    I have been trying to get a check on ketones but no luck yet. Just not drinking and peeing as much.
     
    Last edited: Feb 18, 2017
  14. Kris & Teasel

    Kris & Teasel Well-Known Member

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    There are so many things going on here that it's hard to know what to do:
    • he needs insulin and you gave him 1 u of ProZinc
    • he needs food so you might have to isolate him like Linda suggested and even try syringe feeding meat/broth baby food and also give water by syringe
    • he needs to have urine ketones checked. A litter box in the room you put him in will help and you'll have to watch him so you can catch him at it.
    • give some serious thought to taking him to another clinic for a second opinion. I'd call around and ask if they're experienced in treating diabetic cats.
    I'm sorry if this list feels like pressure. We're trying to give you some concrete things you can do to help Ninja.
     
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  15. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    That makes a bit more sense except that if this is insulin induced hyperglycemia then it will take longer than 24 hours to clear his system. If he is not eating, then what we'd normally do is withhold or reduce the dose of insulin because there is no food on board for the insulin to work with. If his numbers don't come down more today, I wonder if a further reduction of dose might be in order. Has he eaten yet?

    I'm surprised his water intake is down. Check his scruff to make sure he is not getting dehydrated again and syringe some fluid into him if need be. Please make sure you test him to see what his BG is around +3 or +4 post shot. It's vital to keep tabs on him right now. And I agree with Kris that a second opinion would be a good idea.
     
  16. Ninja & Baby

    Ninja & Baby Member

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    I don't know if you saw my spreadsheet, but Ninja's BG was Hi at +2. It went up after I gave him his insulin. I think you are right, Linda. Maybe even a lower dose is in order. I am syringe feeding him hourly...just a little at a time. ...I would tell you how much but it is a big syringe and I am giving 10??? I don't know enough about syringes to know what it is..I guess ml's??? Does that sound reasonable? I just talked him into peeing--negative for ketones. I think he may be constipated. It appeared he was trying to poop and nothing came out.
     
    Last edited: Feb 18, 2017
  17. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    So glad to hear he peed and has no ketones. Constipation could cause some BG elevation but certainly not that much so keep an eye on him. I guess the big question is when did he last have a bowel movement? Has he gone since he came home? Has he eaten enough to go? If you are syringing food into him, that too will bring his BG up a bit. Mixing some water into the food you are syringe feeding will help some. I don't know whether your measurements in the US on baby syringes would be in ml or oz. Does the syringe have "ml" stamped on it beside the 10? If so that is milliliters.
     
  18. Ninja & Baby

    Ninja & Baby Member

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    I see it now. It is ML. I don't know when he's had a BM.....not since he's been home. I don't think he's eaten enough to have a BM, but he thought he needed to go. Do you think the insulin injection could have raised his BG?s Any ideas on constipation relief?

    I am going to work with Ninja this weekend and if he's no better on Monday, I'm going to get a 2nd opinion....ASAP!
     
  19. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I'm so relieved to learn there are no ketones! I'll check in later - have to go out.
     
  20. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Right now it's hard to tell what's causing the BG to stay up especially when you are using a new insulin for which we have no history. Yes it was a smaller dose but it is a different insulin. Check his BG again around +4 and see where he's at. ProZinc has a slightly later onset than Vetsulin so until you get a few more readings, we are just guessing.
    As for constipation, I'd be reluctant to give any laxative right now but you could try some pumpkin mixed into his food. It has to be plain pumpkin and NOT pumpkin pie filling. It's good for constipation as well as loose stools as it adds bulk.
     
  21. Ninja & Baby

    Ninja & Baby Member

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    Still high at AMPS +5. He threw up the syringe feeding. I'm lost.
     
  22. Nan & Amber

    Nan & Amber Well-Known Member

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    Do you mean he is reading "HI", or is there a number?
     
  23. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Is there another vet you can take Ninja to? The HI BG may be making him nauseated. I'm really not sure this is something you can deal with at home. I'd expect him to be coming down at least a bit and he really hasn't moved that much and is up again after the insulin. I really think he needs some intense monitoring right now.
     
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  24. Nan & Amber

    Nan & Amber Well-Known Member

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    Never mind, just checked spreadsheet.

    Constipation can make him feel nauseated and throw up. Hoping that is all that is going on and that it will resolve itself soon.
     
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  25. Nan & Amber

    Nan & Amber Well-Known Member

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    I agree. This is making me worried. Glad the recent ketones test was negative, but there is something going on here.
     
  26. Ninja & Baby

    Ninja & Baby Member

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    I do not want to leave him at a vet. The last overnight visit to the vet was very stressful on him. Even the vet said he had gotten very ornery which is not like him. I'm afraid he will just shut down altogether if I drop him off again.
     
  27. Nan & Amber

    Nan & Amber Well-Known Member

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    I don't know about just dropping him off again, but it would be good for a vet to check him out, ideally a second opinion rather than the first vet [edited for clarity]. If the problem is simple constipation, they may be able to give him something for it to get it resolved, and then there is always the possibility of something more serious, like a blockage that he can't clear on his own. Or maybe he has some kind of infection going (though you'd think the other vet would have caught that), but the point is, there's something causing these ultra-high numbers, and it might need vet care.
     
  28. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Paula, I realize you are concerned about his wellbeing at the vet but the problem is that we don't know exactly what is happening here and with the DKA recently we don't want to decrease the insulin too much but also don't want to perpetuate what looks like hyperglycemia due to the insulin. This is a fine wire to walk and I just don't think it's safe to try to handle this at home. Nor are we equipped to coach you through it because we are not vets and quite frankly this has gone beyond anything I've seen before. If he can't hold down food/water then he's going to be set up for another bout of DKA. Urine doesn't show ketones immediately so I strongly urge you to take him to at least get a second opinion.
     
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  29. Ninja & Baby

    Ninja & Baby Member

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    Headed to another vet for a 2nd opinion. Appointment at 5:30 eastern time.
     
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  30. Yong

    Yong Well-Known Member

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    Fingers and paws crossed!
     
  31. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    We'll be keeping you all in our thoughts and prayers Paula. I really think it's the right thing to do. :bighug::bighug::bighug:
     
  32. Ninja & Baby

    Ninja & Baby Member

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    At the very least, he's going to need fluids before tomorrow. I will keep you guys posted.
     
  33. Ninja & Baby

    Ninja & Baby Member

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    The new vet was very discouraging. She thinks he has a mass in his abdomen. My other vet did x-rays and never mentioned it. She said he is dehydrated. I'm going to ask her to give him some fluids and something for nausea and take him home. I asked her if his numbers could be high because of too much insulin and she had no idea what i was talking about.
     
  34. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    If she is just palpating and he is constipated, that could be what she is feeling so don't despair. If the other vet did xrays and didn't see anything seems unlikely he has a mass. Get him well hydrated at the vet and if blood ketones are clear, I'd skip the insulin tonight to see if that brings him down some. Then you can re-start insulin at a low dose (lower than 1u) and work to get him leveled off. I'm feeling for you Paula and we'll stay with you and help as best we can.
     
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  35. Ninja & Baby

    Ninja & Baby Member

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    She said she felt hard fecal matter. Also, she said he is down to a little over 6 pounds. :'(
     
  36. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Well then did she suggest the possibility of an enema to clean him out. That could be partly responsible for elevated BG as well as his vomiting. He was dehydrated before and is again which certainly explains how he would get constipated.
     
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  37. Ninja & Baby

    Ninja & Baby Member

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    She didn't have any helpful advice!!! All I got out of it was a bag of fluids and a shot for nausea....and that's what I asked for. She did say she could keep him for several days to put him on an insulin drip. . . . . .uhhhhhh, really????????? And I could have gotten that deal for the bargain price of $600!!

    I'm thinking at this point why am I even giving him insulin? It isn't helping and for all I know it is making it worse. Does he need to be weaned or can it be cold turkey or just a lower dose?
     
  38. Kris & Teasel

    Kris & Teasel Well-Known Member

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    If you can get him over this hump and get the constipated issue under control, a low dose of insulin is what to try next.
     
  39. Ninja & Baby

    Ninja & Baby Member

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    In the meantime, do you think I need to keep up the 1u twice a day since it isn't affecting him at all?
     
  40. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Deep breathes Paula. If Ninja got something for nausea then maybe he'll eat on his own. If not, you can give him some food via syringe. I take it she showed you how to give SubQ fluids? Did she check for ketones? If I were you, I'd skip the insulin tonight and see if that doesn't bring his BG down somewhat. Test him once tonight to get a baseline starting point. Even if it's HI you'll know when you get an actual number that it's coming down. Let's play this You could get some Mirolax to help with his bowels but I've never used it myself and I'm not sure I'd want to do that till he's eating on his own again. I think for now I would work on getting his fluids up. Keep in mind that if he's really dehydrated, that would affect his weight quite a bit so don't despair over the 6 pounds. Water is heavy.

    I think you are going to have to take this one cycle at a time right now. I really think the first goal has to be to get him rehydrated and get that BG to come down so he feels better. The dehydration alone will cause some elevation of BG.
     
  41. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I agree with Linda about waiting to give insulin and getting fluids into him first.
     
  42. Ninja & Baby

    Ninja & Baby Member

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    I feel like a cat chasing its tail. They gave him one unit of fluid and said to give him one unit twice daily. He did seem to feel better pretty quickly after that. I'm thinking that some of this could have been avoided if I'd had SubQ fluids all along.

    No, she did not check his blood glucose nor did she check his ketones. She wouldn't look at my spreadsheet either.
     
  43. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Paula, I'm sorry. I've been following this thread and was waiting for you to get back from the vet this evening. I know having a sick kitty is very, very stressful. If the vet felt hard fecal matter, you could try giving Ninja a little coconut oil, olive oil, unsalted butter, or even some hairball gel... something to see if you can get things moving. That and fluids may help. By the way, I don't know why, but some cats will eat a little if you have the food bowl ready to put in front of his face the minute you get done administering fluids.

    I understand the reasoning behind Linda and Chris' suggestion to skip tonight's shot, but I'm not so sure I agree. Skipping shots isn't a good idea with kitties who have had DKA recently.

    Have you tested his BG lately? If he's high enough to shoot, if I were in your shoes, I would get some insulin into him even if it's just a half dose.

    You might find something helpful in these posts:

    I'd definitely talk to your vet tomorrow about having an ultrasound done to determine if there is a mass in his abdomen.
    I'm a little confused by this. How much is one unit of fluids? 100 mLs... to the first mark on the bag?



    Just some thoughts for your consideration...

     
  44. Ninja & Baby

    Ninja & Baby Member

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    100 mLs every 12 hours (1st mark on the bag). Thanks for the suggested reading, and ideas on constipation. I will definitely check it out!

    I haven't checked his BG since 4 p.m.. It was Hi then.

    I have some mirtazapine that I had forgotten about for appetite. There's some good ideas. I never thought of making little meat balls and putting it in his mouth.
     
    Last edited: Feb 18, 2017
  45. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    You're welcome!
    Let's hope he's come down some by his evening shot time.
     
  46. Ninja & Baby

    Ninja & Baby Member

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    Ninja didn't get an evening shot, and I didn't check his BQ. I checked him this morning and it was Hi. I don't know whether to shoot him or not. Like I said earlier, it's not doing any good. He was in much better health before he ever started insulin. He was thin, but he did eat. He drank a sizable amount of water, but that didn't get out of control until he started insulin. I don't know what to do. My gut instinct says to just stop and see what happens. He's about dead as it is. He's dying anyway. I want to keep up the nausea pills and fluids and I will do some syringe feeding.
     
  47. Nan & Amber

    Nan & Amber Well-Known Member

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    Hi Paula--

    Don't give up. Ninja had some great days last week, he's got a lot of fight left in him. I really think that the problem could be something simple that just hasn't been effectively addressed yet-- my guess is still constipation. I have to say, I'm kind of irritated that the vet you saw yesterday didn't even suggest an enema to try to get things moving and see if that would help. Between that and the lack of any interest in even looking at the spreadsheet or considering the role of insulin in Ninja's treatment, I'm not impressed at all with that vet and I'm glad you didn't leave Ninja with them.

    I wouldn't stop the insulin, especially after a skip last night-- I don't think insulin the root of his problems and as @Jill & Alex (GA) says, he needs the insulin to fend off another DKA. Even a reduced dose would be better than nothing.

    Please try the coconut oil/unsalted butter/olive oil, and/or add a bit of pumpkin to Ninja's syringed food, to see if you can get things moving. I'd also strongly consider taking him back to the vet today, and asking for a more thorough assessment of the mass-- an ultrasound can help to determine if it is just hard fecal matter, and to see if there is some kind of obstruction in there.
     
  48. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Paula, I don't know what to say except Ninja needs insulin according to that test and the others on your spreadsheet... tests over the last several days. He's been HI for days now. It sounds like Ninja is very sick and there's undoubtedly more going on than we know. I can't tell you what to do, but one thing we do know from his BG tests is he does need insulin.

    Just sharing from my experiences with Alex...
    When Alex was very sick and wasn't expected to live (acute renal failure and severe liver disease), the only thing I could control was her blood glucose. I do think it made her more comfortable while she was fighting for her life. Against all odds, she rallied and lived another four years after that. Over the next four years she had several serious health issues, but it was extremely obvious she felt better when her blood sugar was controlled through it all. Unfortunately, cancer ended up getting her in the end. :(

    If you truly think Ninja is dying, please read through this post:

    Making "The Decision": Help to know when and how
    .

    It has helped me and many others assess our kitty's condition and quality of life. Maybe there's something there that will help you decide how to proceed.

    Please, let us know how we can help...
     
  49. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Paula, I'm with Nan....extremely disappointed in the vet you took Ninja to last night. I also don't think you should give up on him. He got through the DKA and is a fighter.

    In looking over the SS again, I still think he is hyperglycemic because of too much insulin. Granted we don't have a number of pre-shot readings early on but it looks like Ninja may have gone very low on the night cycle of the 8th leading to the low AMPS of 139 on the 9th. I think this is when the hyperglycemia started and was continually being perpetuated with the 1u doses.

    Since withholding insulin last night made no difference I think the next logical step is to give him insulin to see if that will bring his numbers down but I also think the 1u may be too much. I'd be inclined to try 0.5u to see if that helps get the numbers down at all. Keeping him well hydrated is going to be key here too as that will help bring his numbers down so get as much water/fluid into him as you can orally as well as giving the SubQ fluids as directed.

    You know Ninja better than anyone else but I really think it's worth trying a smaller dose of insulin to see if that helps before you give up. :bighug::bighug::bighug:
     
  50. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Paula, thinking about you and Ninja...
    How are things going?
     
  51. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Paula, we are all thinking about you and Ninja! :bighug::bighug::bighug:
     
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  52. Yong

    Yong Well-Known Member

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    Still no update on Paula and Ninja?:bighug: In our thoughts :bighug:
     
  53. Ninja & Baby

    Ninja & Baby Member

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    Sorry, I had to step away for a while and do what I thought was right for Ninja. I was so stressed, and I didn't want to start reading and second guessing myself. I just reached the end of my rope, and I said, "God, he's in your hands. I don't know what to do." I think I had to give up on the idea that the vet was going to fix Ninja. If you look at his spreadsheet, you will see his BG is starting to come into range. I think divine intervention brought me to a solution in the form of a bag of fluid and Liver Shakes!!! I think the spirulina in the shake moved him out of insulin resistance. I got to wondering about spirulina and it is actually very good for insulin sensitivity problems and helps to lower the blood sugar. Long story, but the point is he is better. He still has a ways to go but you would be shocked at how much progress he has made in 24 hours!!! He has gone from being syringe fed every couple hours to eating on his own!!!! :bighug: :) :cat: :p :D :joyful: :smuggrin: :woot:
     
    Last edited: Feb 20, 2017
  54. Nan & Amber

    Nan & Amber Well-Known Member

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    So happy to hear this!!!!!!!

    Please do keep us posted when you can, we're all keeping you guys in our thoughts. Go Ninja! :):):):):)
     
  55. Ninja & Baby

    Ninja & Baby Member

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    :bighug:I'm so happy and grateful to all of you because without you guys I wouldn't have even had any idea where to start going out on my own or even knowing I need to home test. If I hadn't done that, I would have never known what was causing his problem. How many others are losing their pets because of vets that don't know or just want to keep their hands in your pockets???
     
    Last edited: Feb 20, 2017
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  56. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Oh Paula I am so very happy to hear Ninja is improving. :D Your TLC and persistence is paying off. Testing is a big part of this dance and yet there are so many vets that don't suggest it and far too many who try to discourage it. Please do keep us posted and tell Ninja he looks great in pink! :cat::bighug::bighug::bighug:
     
  57. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I'm SO relieved to see this great report! :bighug::D
     
  58. Ninja & Baby

    Ninja & Baby Member

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    Thank you so much, Linda and Kris and all of you!!!!!
     
  59. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Wonderful news! I hope Ninja continues to improve!
     
  60. Kris & Teasel

    Kris & Teasel Well-Known Member

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    How are you and Ninja doing?
     
  61. Ninja & Baby

    Ninja & Baby Member

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    Well, I've been too depressed to post. Ninja went back to his high numbers. However, I put him on a zero carb diet and having success. I noticed he got a little better on the liver shakes, but his numbers were still through the roof. I decided maybe low carbs weren't low enough so I started him on NO carbs. His numbers are quickly getting better. Check out his spreadsheet. He is still very lethargic and has terrible neuropathy. Very sad to see, but I'm hoping that will resolve. Anyone else notice this kind of behavior? It's like he's in a fog. He's that way this morning and his BG was 123 AMPS.
     
  62. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    Paula, I was wondering why I had not seen any posts from you lately. I'm glad to see the diet change is helping though :). I recently (yesterday) discovered how much the DM dry was keeping Maury's #'s up. Fun times (sarcasm) yesterday with our first double digit #'s. When Maury's numbers were staying high, he did seem like he was in a fog. I hope Ninja has some good days coming with new diet, we'll call it "Catkins" :):bighug:
     
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  63. Ninja & Baby

    Ninja & Baby Member

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    Feb 2, 2017
    This morning his BG was 123 and he seemed almost worse. Almost like a rag doll! Maybe glucose dropping from numbers too high to register on a monitor to almost normal may be causing it???????? Depression from the almost inability to walk???

    I'm thinking diabetic cats need no dry food at all--not even Young Again. They are so sensitive to every little thing. I have some of the Young Again, but neither of mine liked it at all!!!

    Yong, congratulations on the double digits!!!!!!!!!!!!!!!! :joyful: :D :smuggrin: :cat:
     
    Last edited: Feb 24, 2017
  64. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    I have seen a few people who agree with the no dry food for diabetic cats but ECID :cat:. As I have learned quite fast :). I just sent for my free sample of Young Again because Maury looooves his crunchy dry food and he needs to gain weight.

    I am still very inexperienced compared to others here but maybe since his BG was low for the first time in a while he feels weird at a lower BG? It is possible he is feeling a bit down with the moving restrictions. Maury was definitely sad when he realized he struggled to get to his usual places. I'm hoping to see him progress more as I get his BG under better control:).

    Hang in there though! Ninja is a strong spirited boy! He has shown us he still has fight and knows you are doing all you can to help him. :bighug::bighug::bighug:
     
  65. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    I think human diabetics report that big swings in blood glucose make them feel just as yucky as high numbers alone, and I think our kitties are no different. Ninja's body has gotten very used to those high numbers, so the 123 must feel very very weird.

    Is he still eating and drinking well on his own? Any recent ketone tests?

    If the neuropathy is the typical diabetic neuropathy, many caregivers have seen dramatic improvements (over the course of weeks-months) using B12 supplementation. The one most people use is called "Zobaline" (NOT "Xobaline"-- it's for humans, and has a cat-toxic ingredient).

    I'm still worried there's "something else" that's the root cause of Ninja's high numbers and feeling so unwell, but for now, yay on the lower BG number!
     
  66. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    Just saw this lol! Thank youuuu :) It was scary :nailbiting:
     
  67. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    Paula, I just saw the note on your spreadsheet about doing furshots and shooting again yesterday. Two important thoughts about that:

    1. We don't recommend shooting again after a furshot, because there's no way to know just how much insulin actually went in the first time, so you could end up over-dosing your cat.

    2. That said, it's only after doing that yesterday that you finally started to see some movement off of the "HI" readings (I'm assuming that when you say you did the furshot-reshoot "both times" that means the same thing happened for morning and evening shots?). This makes me think that possibly he did get higher doses yesterday and the resulting lower numbers indicate that, possibly, increasing the dose is just what Ninja needs.

    If I were you, I'd maybe get a test or two today just to see how he does without insulin (and definitely keep an eye on ketones, too, after the skipped shot this morning), and depending on how the day goes I'd strongly consider upping the dose again tonight, to 2.25U or maybe even 2.5U if you are able to monitor this evening. Again, depending on his numbers today and tonight, so keep posting to get people (esp. the Vetsulin-experienced people) thinking about the issues.

    I'm going to go ahead and tag @Jill & Alex (GA) right now, because she has tons of experience in general, and has already given some thought to Ninja's situation. She may have some insights into what is going on with this sudden (welcome!) movement in numbers and what to do next.
     
  68. Ninja & Baby

    Ninja & Baby Member

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    Feb 2, 2017
    Thanks for all of your input. I have just updated my spreadsheet with more information. Make sure you check that out.

    Yes, Linda, I checked for ketones and not even a trace....but sometimes I look so hard I can't figure out if it's negative or trace.
     
  69. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    It can be very hard to distinguish between negative and trace even under a bright light. Do the best you can.
     
  70. Ninja & Baby

    Ninja & Baby Member

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    Feb 2, 2017
    Nan, I thought about the fur shot maybe being just the extra insulin he needed. At the very least, he had to have gotten at least a little extra when I pulled the needle back out. I increased Ninja's insulin this morning to 2.3. The doctor advised 3u, but I was a little nervous about that.
     
  71. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    Ah, OK, I saw a 0.0U in the dose column this morning and assumed you'd skipped.

    Can you clarify what it is saying-- is it saying that you shot after you got the reading of 561, at what would have normally been around +5 for you? That will make a difference in interpreting the +2 and +4 numbers, if they are not actually +2 and +4, as well as any future numbers. It's tough to get a clear record of a case like this, I might be inclined to start a second row for 2/24 where you can start counting as usual at +1, +2, etc.

    As an aside, no matter what we'd expect to see high numbers today, just because we'd expect Ninja's body to react to the low numbers by increasing BG. This can happen in response to low numbers until a cat gets used to them again. We call it a "bounce".
     
  72. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Dec 28, 2009
    I agree with both of Nan & Amber's points. I think you'll probably have to take Ninja's dose higher than 2u BID to pull his numbers down into a better range. However, my experience with insulins used for feline diabetes is limited to Lantus, Levemir, and N. I'd like to see those experienced with vetsulin or prozinc dosing with a ketone prone cat guide you with dosing. Have you continued with vetsulin or prozinc? I can't be sure by looking at his spreadsheet.
    Ninja simply needed insulin. IMHO, we're seeing movement now that he's getting insulin on a regular basis and because the dose is being increased commensurate with need.
    I see you stalled his AM shot and administered 2.3 units insulin. Just a suggestion... it would be helpful if you made a notation somewhere on his spreadsheet noting at what +hour the shot was given because we're all in different time zones and we don't know the usual clock time of his shots.
    Sometimes it is hard to tell the difference. I found it helpful to view ketone test strips in natural light, but if it's not sunny enough, try looking under the brightest light you have in the house.
    I'm following your logic, but please be careful about shooting again after a fur shot. The fact that Ninja needed a dose increase definitely worked in your favor this time, but it could turn out to be a mistake under a different set of circumstances.


    Edited to add: I'm sooooooooo happy he's not throwing ketones!
     
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  73. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Dec 28, 2009
    Probably, but let's see what happens today. Ninja's dose has been increased and we don't have any data yet to know what 2.3u is capable of doing.
     
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  74. Ninja & Baby

    Ninja & Baby Member

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    Feb 2, 2017
    Look at my updated spreadsheet. Ninja is Hi again. What now?
     
  75. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    Still a little confused about the times of those two tests (350 and 561) and the shot itself relative to the usual shot time (and last night's shot)-- you can add those in as notes somewhere without having to do a lot more re-formatting if you like.

    I don't think there's anything to do but sit tight, keep him eating/drinking, keep an eye on ketone status, and monitor BG as usual. We'll see if the 2.3 can bring that down some!
     
  76. Ninja & Baby

    Ninja & Baby Member

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    Feb 2, 2017
    I'm confused how to note it. What happened was I checked his BG first thing (5:10 a.m.) this morning and it was 123. At that point, I chose not to inject. I fed him a small meal and checked again at 7:59 a.m. It was 350. I fed him a larger meal and checked in about an hour and a half (9:40 a.m.) and it was 561. At that point, I injected him with 2.3u. I checked BG again at 12:08 and it was Hi. Shouldn't it have already brought it down by then? I just checked his ketones and he is clear.
     
    Last edited: Feb 24, 2017
  77. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    Great news on ketones!

    On the spreadsheet: sorry if I'm making this more confusing! The main thing is just to stick with the "+" time notations, so maybe just go back to the way you had it but change the 9:45am to +whatever it would be relative to your usual shot time. I think if you do that it should be pretty clear to other users, especially if you also write a little note in the "notes" column.

    Where it might become important is tonight when you go to shoot, anyone offering advice will need to be aware of the shift in times. Vetsulin is largely short-acting so there isn't likely to be a huge problem with shot overlap if you shoot closer to your usual time (which would be less than 12hrs from this morning's shot), but the possibility is something people should be taking into account when giving advice.
     
  78. Ninja & Baby

    Ninja & Baby Member

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    Feb 2, 2017
    Is that better?
     
  79. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    Ideally, I think it'd be good to see the numbers in the note on the SS lines. Is 09:40 his regular shot time?
     
  80. Ninja & Baby

    Ninja & Baby Member

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    Feb 2, 2017
    No, 9:40 is not his regular shot time. At his regular shot time, his BG was 123.
     
  81. Ninja & Baby

    Ninja & Baby Member

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    Feb 2, 2017
    You guys think 2.? is in order???
     
  82. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    What time is his shot time? Instead of me guessing lol
     
  83. Ninja & Baby

    Ninja & Baby Member

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    Feb 2, 2017
    Well since I gave him his shot at 9:53 this morning, I thought maybe 9 p.m. I'm so tired and so burnt out, and so broken hearted I can't even think to share all the necessary information.
     
  84. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    I think I agree that I'd like to see the numbers in the note entered into colored boxes on the spreadsheet (they are easy to miss if they are only in the note). Probably best the way you had it originally-- 123 for AMPS, blank for the shot, then the 350 and 561 in +3 and +4.5, then the shot noted in +5.

    I totally hear you on the fatigue-- when we care so much for these little guys, it's heartbreaking to see them feeling lousy. :bighug::bighug::bighug:
     
  85. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    Ok don't worry about it then :bighug:. We can read the notes. I know we worry about our kitty's but you have to take care of YOU too!:bighug:
     
  86. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    Just checked the spreadsheet, and it has a dose of 3.0U for tonight I think? Would be good to monitor on this one-- I do think he needs more than 2.0U, but that's a big jump.

    Really wish some of the Vetsulin people would weigh in with opinions. Paula, would it be possible to start a new thread with a "?", and asking for specific Vetsulin dosing guidance? It might get some fresh eyes on Ninja's situation.
     
  87. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    I unfortunately am going to have to sign off now-- Paula, please do start another thread, especially if you start getting some low numbers. We do want the low numbers, but we also want to keep Ninja safe, and we don't know yet what the dose jump from 2.0 to 3.0 is going to do-- please get a few numbers tonight, and post if you need guidance! :bighug::bighug::bighug::bighug::bighug::bighug:
     
  88. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Dec 28, 2009
    Paula, just checking to see how things are going. How are you doing? Have you been able to get any rest? How's Ninja? Have you had a chance to test for ketones lately? Sorry, one more question... would you clarify for us... are you still administering prozinc or did you go back to vetsulin?
     
  89. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Just catching up and wondering how things are going with you and Ninja. We are all concerned about both of you! :bighug::bighug::bighug:
     
  90. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    Still no update since Friday. Hope they are okay.:bighug:
     
  91. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Hoping they are OK here too! :bighug:
     
  92. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    Paula and Ninja,

    Thinking of you both :bighug:
     
  93. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    Have a bad feeling :( Ninja's SS file is in the trash. I was trying to look to see if at least that had been updated.:(
     
  94. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    @Yong I had a bad feeling when Ninja started reading high and wasn't dropping at all despite getting insulin. I've never seen anything like that and wonder if there was something else going on. And now with the silence and the SS, I fear the worst. This can be such a complicated disease to deal with and sometimes it's a guessing game. I still have a feeling the insulin dose was too high rather than too low but with the history of DKA, deciding what to do was a gamble at best. It's times like this that I wish with all my heart that vet's were far better educated and cautious about dealing with our sweet fur kids. Far too many don't seem to know enough to deal with situations like this.:(
     
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  95. Yong

    Yong Well-Known Member

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