Looking for help my cat's really sick

So Nudi is on Adequan every two weeks for arthritis. We just got through the initial dosage of every 4 days and he just got his first dose after the first two weeks. His sugar has been high lately and he has been off insulin since July 2019. I started him on .25 then .5 and now 1 unit of Prozinc. His sugar has consistently been in the mid 300's which is high for him and even went up to 400 once. The insulin doesn't seem to be helping at all except one day it went down to 243 and on 12/26 is was at 277 in the evening. Today it's at 417 at 5:00pm which is extremely high for him! He starts to feel pretty badly as soon as he hits 300. We've been giving him Prozinc at 10pm and 10am but yesterday by boyfriend gave him the insulin at 7:00pm. He threw up horribly tonight a ton and was projectile vomiting and there was a lot of it. He usually doesn't throw up. He's been tested and has had mild pancreatits in the past and possibly IBS but we're not sure. He just seems really, really sick. He's just sleeping and out of it, he's barely moving. I can tell he's really sick. The vet is closed tomorrow (Sunday). The Prozinc says it expires on 01/20 so technically it should still be working? I could try to go to an emergency clinic to see if they can give me some Prozinc to see if their's works? I know I need to be better about putting the numbers in the spread sheet. We started the insulin about a week ago and numbers ranged from mid to high 200's (twice) to 400 (twice) but mostly in the mid 300's.

He's been in remission and off insulin since July 2019

Update: he’s eating and seems really hungry.

 

First, can you update your spreadsheet with the numbers you have seen lately? It’s quite possible the dose is too low. Has the vet seen him lately? Bad teeth are often a cause of a cat going out of remission, though Nudi didn’t really look ready for remission when you first stopped insulin.

 

Have you tested his Blood glucose in the last 30 minutes? If not test now - make sure he’s not having a hypo.

 

Have you tested for ketones in the urine?
If not I would go out and buy a bottle of Ketostix from Walmart or a pharmacy and collect a urine sample and dip the test strip in and read exactly 15 seconds later. Anything above a trace of ketones needs vet attention.

If he is not eating, vomiting and is lethargic I would take him to the ER.

 

We just tested and it went down to 368. He just threw-up again, less this time and then he went right back for the food. He’s looking a bit better but it’s weird for him to be throwing up. We’re debating whether we take him to the hospital tonight or try to wait for the vet tomorrow morning.

 

So he is eating my husband saw him eat twice tonight. Once right after he threw up the second time. But he was definitely lethargic. Looking a little better now then before. We just tested his sugar again and it was down to 368 and we are due to give him the insulin in 30 minutes but I don’t think the insulin is working. We got him tested for keytones the last time we went to the vet and he didn’t have them. We’re debating whether to take him to the ER tonight or wait for the vet tomorrow morning. Ok he’s actually eating again right now. Also he seems quite ravenous. I just gave him a bunch of the Purebites Salmon. He loved those and he’s eating them up. Hopefully that’s the right thing to do.

 

At 368 he needs insulin. Bron gave you good advice - ketones can develop quickly especially if his blood sugars are high. If you at least test for ketones you will know if you are dealing with an emergency or not. He could have something else going on too like an infection which would raise both his bg and increase the risk of ketones.

 

Ok thank you. It’s really hard for me to test for keytones myself. He hates peeing inside and he can usually hold it forever.

 

Well, first off , vomiting is a nonspecific symptom as it could be anything from a metabolic problem such as kidneys, ketones(which should be checked regularly ), hypoglycemia; mechanical issues such as a fur ball, partial foreign body obstruction; gastritis or a gastroenteritis; chicken allergy; parasites; toxin ingestion and the like. You need to start with the obvious so make sure that the ketones are not an issue. You can place Saran Wrap over the cat litter and collect a fresh urine sample that way to test. A lodged furball can cause cats to vomit immediately so a furball remedy should be used on a regular basis especially if your kitty has medium or long fur. Cats hide their issues well and don’t show how sick they are getting until they’re in trouble so if your kitty is laying around and sleeping more than usual, there could be a fever present, pancreatic inflammation, or serious kidney issues to name a few. You may want to have him checked out sooner than later. Please watch him very closely. It’s always better to be proactive than reactive!

 

Some human blood glucose meters can test for ketones as well. My cat refuses to let me get a pee sample so I need test her blood. You use it just like a bg test but using ketone strips - I use the Abbot Freestyle - a bit more expensive than the urine strips but it has been a great investment

 

Give him the insulin he is due if his BG is 368 and he is eating some food. It is really important that you keep the SS up to date for us to be able to help you.
He may be dehydrated.
When you pull up the scruff of his neck, does it drop down quickly or does it slide down slowly?
Feel his gums. Are they slippery or tacky?

The lethargy concerns me.
If he is continuing to be lethargic and nauseated/vomiting, and he is not himself, I would take him to be checked at the ER, if you are not able to check for ketones yourself tonight.
Ask the ER to check for ketones.

 

Thank you. This is super helpful. I will definitely get these.

 

So here is an update. I took him to the ER last night they checked for Keytones and he does not have any. They also checked his BG and it went down to 306. After the ER visit we gave him his insulin and checked his BG 30 minutes later and it was the same number (hopefully that was enough time). I think the Prozinc bottle we have is no good. The expiration say 01/20 but the ER nurse said if it’s punctured (used) the insulin should only last 30 days to 3 months. Sometimes 6 months. We’ve had this insulin since beginning of summer, June I think, and it had been used. I’m taking Nudi to our regular vet today to get some fresh Prozinc and we’ll see how his blood sugar does with that. Most likely we will get blood work too, his temperature taken and check for dehydration. He doesn’t seem dehydrated to me though. I did the tests. If there is anything else the vet should check for please let me know. I will get better at updating the spreadsheet.

The vet is also recommending we get this device attached to Nudis arm and I guess it checks the blood sugar hourly and this way you don’t have to poke him. It’s supposed to last for two weeks. I’ll find more about it when I go.

Nudi did not throw up again last night. Thank goodness. Thanks again for everyone’s help. I really appreciate it.

 

The device is called a freestyle libre and it does a great job at getting more accurate readings without stressing your kitty. There is an app that sends all of the readings to your phone which you can then forward to your vet. Here is a link for more info
https://www.freestylelibre.us/

 

Oh wow thank you so much. This sounds amazing! I will check it out and hopefully we can get this for him. Thanks Charlotte’s mom!

 

I’m glad Nudi is feeling better.
If you have had the insulin since June it could well be no good now.
Peeps here have had varying results with the freestyle libre device. Some people found them great. Others found they fell off after a few days or didn’t record properly.
I have only heard of it being attached to the body of the cat, not the arm. I doubt it would last long on an arm.

 

I have also heard that it is attached the nape of the neck. It has to be inaccessible (well as best as that can be!) to the cat.

 

Thanks so much. I’m hoping to finally get him into the vet tomorrow. They were supposed to be open today and they were closed! Uh! Now he had to go another day without insulin (well he had insulin but it’s just not working) Now his sugar is 433 tonight! We’re giving him the insulin dose that’s not working and checking in an hour to see if it goes down at all. If not I may need to take him to the ER again. The one I went to last night doesn’t carry Prozinc! And his sugar went down to 306 last night at the ER so I thought we could wait for today to get him to the vet and get him insulin. If we go tonight I’ll be taking him to a different ER one that carries Prozinc. I’m trying to avoid it as this is ER is super expensive but of course will take him if he needs it. I’m dog sitting so not even home with him right now. My husband says when he picks up his skin on his neck it takes a second but then does go back down flat. It doesn’t stay up. I’m hoping this means he’s not dehydrated. On another note if we get the Freestyle I will let you know how it goes and how they do it. Thank you all! I’m hoping Nudi can hang in there for tonight. It’s 10:45 pm here and I’ll take him to the vet first thing at 8:00am tomorrow morning! Thank you again!

 

Please keep us updated.
best wishes to Nudi

 

Thank you so much! Quick question I just got three days worth of Prozinc insulin from the vet to hold us over until his new bottle comes. My question is he’s been getting 1 unit of the old insulin that’s not really working, do you think I should start him on 1 unit of the new insulin or start slow and give .25 or .5 since the other one wasn’t really working and I didn’t want to give him too much right off the bat? But his sugar is in the mid-300s to 400 so not sure if I should just start him off on the one unit? The vet only gave us syringes with 1 unit in them so it will be a little hard to give him less but I could make it work. Thank you so much!

Update: Nudi’s sugar was 308 this morning and this was after eating (I had a lot of trouble getting his sugar this morning it took like seven tries and he ended up eating) so I gave him .25. Hopefully that was the right decision he seems better today! The vet couldn’t take him today but definitely tomorrow

 

If his numbers have been that high, you can start with the 1.0u for the AM shot. Just get spot-checks so you aren't surprised by low numbers. If it seems like too much insulin, you can lower the PM dose.

 

Ok great. Good to know. Thank you so much.