LOW numbers with Robbie...

OK you are all very good at this - just tested Robbie at 10pm and it was 62 - but not a good blood sample so re-tested and got 55 - tried to get him to eat - wouldn't but seems fine - still gave him some maple syrup - he is awake and moving around will test soon - any help would be great - have left emergency message for vet.

 

Remind us what kind of insulin you are using. How long since the shot?

Looked at your other post. Looks like it is PZI, 8 units right?

55 isn't super low. Depends on how long since you shot.

 

shot was at 7:15pm - he weighs 17.5 lbs - he ate dinner at 5:30 ish and a snack later on - all wet food - high protein/low carb. It went from 62 to 50 to 40 - all in about 35 minutes - just spoke to the ER vet who advised to give more maple syrup (we'd given just a very little) and to watch him carefully - he did eat some tuna and a very little bit of dry - (the dry he's been screaming for he won't eat much of ??) won't eat the wet food - poor thing is all sticky from the maple syrup.
Vet suggests NOT giving him 8units again until he is seen by our regular vet - his next dose wouldn't be till 7am

 

he is on ProZinc 8 units 2x per day 7am 7pm tested 103 before dinner at 5:30 gave him the 8units at 7:15. Vet says this could just be the adjustment but still suggested the maple syrup or honey and to get him to eat if he would.

 

So it is 35 minutes after your shot?

The maple syrup will bring him up but he won't stay there very long. I would give him a few pieces of dry. Do you have a lot of strips? You are going to need to be testing every 15-30 minutes.

 

Here is the hypo info: viewtopic.php?f=14&t=1122

 

no it is 10:44pm here he had his shot at 7:15pm - gave him dry he only ate a tiny bit - ate some fancy feast and a bit of people tuna.

 

You are at 3 hours after the shot right? If he will eat any of the dry food I would go for that.

 

Oh good, 3 hours is a lot better than 30 minutes.

But you will still have 3 hours or so until nadir, so you will need to keep testing.

You are doing a great job - the small bits of food are much better than a large feeding. You want to him to continue to eat for you.

 

Im kind of losing it here - he did eat some but not much and won't eat more - I put some tuna juice on his fave dry food and he's licking the tuna juice off but thats it - 1am is nadir I think (his shot was at 7 - 6 hrs later?) Vet sounded not too crazed - but I am - how worried should I be - I'm seriously scared to test again and see if it's gone down more.

 

Breathe. This happens and you can do this. You need to test again. It's been about 30 minutes since you tested, right? We need another number.

Did you print off the hypo sheet? Does he have any symptoms?

Joanna posted on Community so we should have more eyes in a moment. Don't worry - you will have people helping.

 

If you can test regularly and get small amounts of food in him and syrup if needed (rub it on his gums if you have to) he should be fine. Don't panic, but make a pot of coffee, read the Hypo guide if you haven't, and take some deep breaths. You need to get him safely past nadir time, which with PZI can be anywhere from around +5 - +7.5, those #s are just approximate. He has quite a bit of insulin in his system so it is definitely not something to be taken lightly, but it can be counteracted with enough sugar.

How far are you from the emergency vets? Is that who you talked with? Did they recommend bringing him in? If they are nearby I would consider taking him in, and maybe others will chime in on that front as to what the best route is. If they are far away, I would think you may be better dealing with it at home, IF you can test regularly & get syrup in him if needed.

Deep breaths!! There are lots of great people here who will help you through this.

 

I printed the hypo sheet out today at work - and no other than kind of acting lethargic (but not much normally he'd be sleeping now so...) he's not showing any symptoms - he's drinking water right now - just tested again - it's 72 now - so up some (it was 40 last time I think -gotta check but yes, 62,55,40) he ate about 7 nuggets of dry food and lapped up some tuna fish juice - gave him a bit more syrup (as per vet who said more in 30 minutes) and will test again in about 20 minutes - he is walking around a bit more now as he just went into the kitchen to drink the dogs water.

 

the ER vet is about 40 minutes away - my husband is supposed to be at work at 5am- I'm keeping him up to help me with this - the vet I spoke to is the Vet who will answer emergency calls to my regular Vets office (he used to do it himself and has been to my house in the middle of the night for another cat but now he has 2 other vets who trade off) she doesn't know Robbie but was very specific and asked lots of questions - she is unfortunately in Manhattan (2 hours + away) on an appt. but said to call her again if needed. She did not feel he should be taken in - felt we could handle it at home but said if he showed any other signs to get him there but bring a syringe of the syrup with us and our tester. 72 is a bit better right?

 

This is sounding pretty good - no symptoms and he is willing to eat some variety of food.

The syrup brings the bg level up pretty fast, so that is probably why he is in the 70s. It won't keep the levels up however, so that is why you want to continue to offer food - dry is fine - if his levels drop for the next test.

One thing I always forget to mention is that you can expect to see high numbers tomorrow morning. The sugar and the dry food can mean sky high numbers as his body reacts to all the carbs and glucose. But you will need to reduce the dose tomorrow. Don't let a high number trick you into 8 units again.

 

he just walked over towards me and is visibally a bit shaky on his feet - Vet said to continue giving syrup - thoughts?

 

are you squirting the syrup down his throat or rubbing it on his gums? rub some on his gums with your finger if you've been squirting it down his throat.

does he like ice cream or milk? do you have any? you can mix the syrup into something he will eat, even in the tuna juice if he will eat more of that.

 

squirting down throat - did rub in the beginning - he loves ice cream I will try that I just looked at it in the freezer and thought hummm.... ok will try

 

Ellen,

You should take another reading if he seems shaky. Cindy's idea of ice cream is great - I always forget that one.

 

hi, came back to check on you. whatever he gets to eat we should leave a little room in his tummy for later. that 8u can last for a longer time than usual.
let's not get fooled by a syrupy higher #, those don't last.
get out the dry. lasts longer...if he'll eat it.

 

ice cream beautiful too, but not fill him to the top.
agree/disagree group? i'm thinking he could plunge again.

 

he won't eat more dry - he's now hiding from me cause I'm pestering him to eat etc. - he walked in there fine - no shaky - rubbed some syrup on his gums he licked some ice cream with a bit of syrup in it off my fingers but not a lot.

 

You are doing great, Ellen. The object is to keep him eating little amounts of food, with syrup added or syrup on his gums.

How long since the 72?

Don't forget to breathe!

 

stay with us ellen. keep an eye on him, maybe without pestering.
how long since last test. in hours not the actual time. like 15 minutes, 1/2 hour??

 

Can you sit on the floor and hand feed him the dry... My charlie hit 42 one evening.... and had six hours till nadar... I sat and held them one at a time... He looked at me like.... I'm not hungry mom, but for you I'll try... I gave him honey... and syrup, and FF with gravy... he hit 400 something the next morning... but I got him through the night... Let hubby head to bed... you really can handle this.... I know you can.

 

oh yes, definitely, this is gonna be up and down for a few hours if you ask me.

if he is shaky though we do need to zoom him up quickly, then steady him out with higher carb foods, either wet or dry. dry will probably hold him steadier but it will take possibly an hour or so for it to even start to do much. syrup is fastest, followed by higher carb wet foods, then dry if i remember correctly.

eta: ellen, just so you know, we've walked dozens thru this before. i would actually venture to guess i've held hands on about nearly 100 of these situations since i joined this board way back when. you can do this but you have to stay calm. we are not there with you nor know you very well, if there's any doubt about this and you want it over quickly, you can take him to the vet and they'll have him up pretty quick

 

Sorry, my internet is being flaky.

Yes, 72 is very reassuring, but like others said you'll need to keep on top of it for a few more hours as he'll drop back down after the syrup wears off. He has some dry in him though, so that is good news. ER is a bit far away, so if you are doing ok, keep at it. Do you think he'll let you get another test in?

Recap for anyone just arriving:

PMPS 103 8u PZI
+3 62
+3.25 50
+3.5 40 --> gave small amounts maple syrup, LC wet & LC dry (not eating well on his own)
+3.75 72 --> continuing with syrup, ice cream, small amts food when he will allow it

I'm hoping that is close to correct! I think we're currently around +4.25, so 1/2 hour since last test? Shot was 7:15 pm East Coast time.

 

can we address tomorow morning? i'm going off line in about 15 min.
ellen you will likely see a very high am #. do not, repeat do not react to it.
with the 103 you had tonight i vote to not shoot the morning #
peeps?

 

the 103 pmps you had could indicate diet control...

 

cindy you walked me thru it 3 years ago. while i was half gone on ambien! we survived it!

 

Ellen,

I think we are wondering. One of your posts said he seemed shaky; the next one said he wasn't. Shaky is a symptom. So is hiding. So you need to be watching him and telling us if anything seems unusual. As Cindy said, symptoms mean more syrup.

Yes, as already mentioned, expect a high number in the morning and do not give 8 units. I would like Joanna or Cindy to give you an idea of dose when you get things settled tonight.

 

Tested last 25 minutes ago - (the 72) spoke to vet again - she said considering what he's on etc. etc. she thinks he's stabilizing now - he is sitting more perky - he is NOT happy with me - the ear thing is so new he doesn't like it and earlier tonight he flinched and I got him a good one - scraped instead of poked and he was NOT happy and has a small bruise mark now - I'm doing the other ear. I just put a plate with tunafish on it about two feet away from him - normally this would last 5 seconds - he's looking at it but not moving - when I put it near him he moves away from it - I will try hand feeding him - this is not a lap cat - he loves to be held but not on a lap - while standing -and he sleeps with me but on my feet - so holding him isn't easy - plus he's huge - a big maine coon who was 23 lbs we got him down to 21.5 before this all started and he lost 4 lbs in 5 weeks which was what gave us the biggest clue something was wrong. He is sitting with his head up, eyes open. Vet said to give the dry he ate a chance to show up and that can take 30-40 minutes so that should have showed up or show up next test. Wish he'd eat more of it.
thank you for all your support - this is making me nuts - I'm just not sure what to do and am very worried. My husband says he couldn't sleep - so I'm telling him to close his eyes in the recliner and relax.
He looked shaky at one point walking across to me but than walked into the kitchen and didn't seem shaky at all.

 

He'll forgive you. You can hold on to the spot for a few seconds after the test and that will help the bruising. Also neosporin works.

There is no way to tell he is stable yet. You will need several tests, all moving up before you can relax. The syrup is almost certainly what is raising his bg levels.

 

You people are amazing - seriously can I just say you should all go look in a mirror and say "I am amazing" - thank you - typically I am a very in control, take charge, no it all type - but this has me thrown a bit. DO NOT repeat DO NOT want to go to the ER Vet - they are far away, in a not great area and I don't really like them - plus it's so expensive and we have spent quite a bit on this situation already- not that I wouldn't go further into debt but...
OK he just got up, walked over to the small plate of tuna fish I put out when he turned his head up at dry food and ate the plate of it - about 3 tablespoons of tuna - I know not a high carb food but food none the less right? I wish he'd eat his fave dry food - the cat screamed bloody murder at me this am when i wouldn't give him any - now he turns his nose up at it.
He just walked into the bedroom - gonna go see what he is doing - if he is under the bed I'm cooked - he is impossible to get out from there -

 

he peed - and took up his night position on the floor of our bedroom - where he sleeps if he's not on the bed with us. He is wide eyed (in a good way) and flicked his tail a bit at me when I asked him what he was doing.
Hubby is sound asleep - testing without hubby holding him is gonna be tough - going to try in a minute or so.

 

It's been 30 minutes, Ellen. Time to drag him out from under the bed and do another test.

 

he's eatting that good. cat's like humans can tell when their having low blood sugar and are often hungry and shakey.
just keep an eye but let him be.
next test in....how long has it been now?

 

maybe she can give him some time if he just ate a lot.

 

That's awesome that he ate the tuna, go kitty! Have you been able to get another test in? I think we are about +4.5 now? You are doing great!

On dosing for the morning I'll defer to Lori & Cindy! No experience here with post-hypo shooting strategies. I wouldn't think anything more than 1u tops though. And then after chewing out the vet tomorrow :mrgreen: ask for a copy of all the BG tests to date - sounds like there may be a fair amount of data already collected.

 

Ha Ha Ha , joanna, chewing out the vet. :lol: i was literally in shock when he recommended 8 u on the pmps 103...i was -- in---shock!

 

I think the last test was on the hour, so now 1 hour since the 72...? If he's acting ok and ate some that sounds promising, it's the 8u that has me worried. Not sure really when the danger zone has passed on that kind of dose, with only small amounts of food in his system, and tuna won't raise his BGs much. Could be affecting him long past a normal nadir time? If he were eating his dry food I'd be less worried.

Ellen, are you there? Doing ok? Remember the hypo kit comes with a box of kleenex and large quantities of chocolate for the bean. :mrgreen:

 

or a small amount of adult beverage.
i have to go,,,but don't want to leave ellen alone.
someone gonna be on line for a bit longer?

 

11:55 pm est 79
Tested him again - had to get him out of the bedroom - where he hung onto the rug with his claws like I was taking him to the torture chamber. Got hubby up from dead sleep to hold him (17.5 lbs of squirming cat flesh is tough to deal with)
79 up from 72 - not up much but up. Gave more maple syrup (mixed with some honey) and rubbed some on gums giving about 4-5 ml's this is second full dose of that - gave about 1 ml originally than 2 more - than after vet heard his weight she said "give him the full syringe" which I did and now just did again. Will keep at it but testing him alone isn't going to work - I tried and almost took his eye out.

BTW - think Vet was doing a good job - but will not let him convince me to continue on 8units after this. I can't even remember if he knew about the 103 - did I call him - see I'm really losing it here - I'll have to go back and read everything

 

oh, god don't any of you live in Cal. or Europe or something ;-) and can stay up with me without killing yourselves?
I'll be OK - I just don't know for sure what to do at this point. The vet said I can call her at any hour or text her. He is heading under the bed right now according to hubby who is IN bed.

 

i can tell you what i would do in this situation tomorrow morning. no matter what the number, as long as it is a ways over 150, i'd start thinking about either not shooting anything and letting some of this 8 unit buildup clear out of his body or if i considered shooting, i'd shoot 1 unit and that's it. no more.

then i'd pick up some ketostix while i was out tomorrow and test him for ketones tomorrow night and continue on that path for several days, as long as the numbers warrant it.

and in a few days i'd give a good look see to the numbers i get over those days and see what i think. i'd even put a yell out here for "can someone look at my post-hypo numbers and help advise?"

yes, testing a cat in the beginning is a pain in the ass to put it quite frank. i used to have to chase Mousie in circles around my house for no less than 30 minutes, often 45, until she was so worn out she couldn't go any further. that allowed me to get my hands on her at least and then i recruited my fiance to help hang on to her for the actual testing and pilling that she was getting for the first month. she was a street rescue that i had never touched prior to her diagnosis so you can just picture that ordeal.

put simply, their lives depend on us doing what you are doing tonight. if we don't do it, they get sick or they die. in time, they learn that what you are doing makes them feel better and they just live with it. I pop the top on the vial of test strips now and Mousie is running AT me, bright eyed and bushy tailed and voluntarily sits for her tests.

 

I can be on for another 30 minutes or so. What about you, Joanna/Cindy?

I agree that this may be an unusual hypo with 8 units given on a 103...... Glad he hasn't gone down (the 79) but remember a lot of that is the syrup. You will need to stay up a while and plan on some more tests.

BTW, you are doing a fantastic job!

 

i'm in california and definitely will be here for a couple more hours. don't you worry about that

 

oh honey, if you gave him a full syringe of honey/syrup i think you can rest easy for awhile. that's a lot. leave food out for him and the two of you can take a break, check on him visually but i think he's kewl for at least a couple of hours and by that time the insulin should be on it's way out.
i'm still thinking no shot in the am, and that you WILL see a big # in the morning but lets see if he takes it down on his own. it's not a true #, it's the result of all the sugar you've pumped into him as well as the hypo episode. i've seen them come down on their own after that. my tom did, altho' it killed me not to shoot his 400 morning #. by night fall he was 170 all by hizself! no insulin.
it's the 103 that makes me think he's doing well.
did'nt need a shot tomight.

 

Oh, good. Ellen, Cindy has helped many people through a hypo. You are in good hands. Just stay with her - even though 79 seems like an okay number, he has a lot of syrup and honey in his little body. You can't assume he is really heading up and out of this hypo.

Ellen, you have been a trooper. Someday soon you will be helping someone else through a hypo. I'll sign off - good luck. You will be fine.

 

ok, i iz signing off as i have company here...dat's right. i abandoned my friends cuz this is where i needed to be.
ni ni
bless you cindy, doing this while in mourning.

 

yeah, he didn't need a shot tonight and I'm kicking myself - I will try and test him again - but not for a bit - he needs to chill and I need to let my husband sleep.
thanks all - I'm wiped
I don't see how I'll pee strip test him but I'll see what I can do - his poor one hear looks like I socked him. There is no way I can sleep and I was up with him till 2:30 last night as well cause that 81 kind of freaked me out.
this is a cat who when we had him on inhaler for his asthma was so good with it for like a year than one day - he just put his huge paw on my hand and pushed it away like NO MORE - and after that he wouldn't hold his head still for anything - so we switched to the prednisone pills and here we are...

 

Lori & Cindy & I are in Cali - I think Lori maybe signed off, I can be here probably another hour, maybe longer

79 is good - you are holding steady - I would say you have a formula that works - if you know about how much syrup you have been giving & how often, keep with that plan

as time wears on the insulin will be past peak and then it's not quite as scary, but the dose is still a high enough one you may need to maintain things past then with syrup to keep him from dropping

for now I would keep what you are doing syrup/food wise, repeat at the same intervals & get in another test when you can

do you have any closepins? you can use those to scruff them and then get in a test, supposedly it works really well and doesn't hurt them or anything - if you have some on hand I can get the link that tells you exactly how to use them

 

Sue/Lori thank you and apologize to your family friends for me - I am sorry - but I do know I would help if I had the knowledge you all do so I can only say someday I will try to repay this.
Cindy I am sorry you are in mourning - I had no idea - I have not had a chance to read much of the forum except the basic info and a few posts. Going to go check on Robbie and see if he is really under the bed or just hiding under the sham

 

with him in the 70's i think you can wait a little longer between tests. figure you give the syrup, it kicks in and then for danger to occur it has to poop out and his levels drop a ways so i'm guestimating you could maybe go 45-60 minutes for this next test. you are east coast sooooooo, by my calculations it's been about 5 to 5.5 hours since the shot yes?

theoretically we should be nearing the end of this but yes, with essentially what is an overdose, the insulin can work longer than it normally would so it's possible this could go on for another couple hours. but we'll know with the numbers. if you test him in another hour and he's higher than the 70's with no more syrup given in this next hour, that would be a good indication that the insulin is starting to poop out and you are winning the game.

if that number is about the same or lower, than that would mean the insulin is still working and we'll have to keep going at this for probably at least another hour

 

shot was 5.5 hours ago - he isn't under the bed - his stomach is making all sorts of gurgling noises - must be the very odd diet he's had tonight (regular dinner, snack of wet, small amount of sisters dry, maple syrup, tuna fish, dry, friskies, tuna fish, ice cream, syrup, water, dry, tuna fish...)
I am not giving him anything in the am - vet said to test him but don't shoot - she said to call my regular vet (who is off tomorrow but his partner has seen Robbie once or twice) and discuss. I am not giving him 8 again I can tell you that. The change to diabetic food and cut off (almost out) of dry has obviously had the desired effect - but now we have to figure out the insulin.
Vet told me today he just had a cat go off insulin thanks to changing diet. So he was all happy about that being a possibility for us -
Where in CA are you Cindy? I have friends in Marina Del Ray and another further south (I htink)

 

sounds good. sometimes looking at the cat is darn near as good as getting a number so if he seems ok at the moment, give him a short break.

i'm in southern california. i actually live in xxxx and work in xxxx. which of course doesn't mean much to those who don't live here but basically, close to the disneyland area

ummmm, yeah, i lost one of my civies last night (aka: non-diabetics). he got sick very quickly and we had to make the decision very quickly so it's been a real shock but to be honest, and i know this sounds very wierd probably, having something else to think about is helpful right now.

 

Ellen, don't kick yourself for what you didn't know. Now you know. Rough way to learn, but it happens - unfortunately all too often. You are doing great, and his #s are holding perfectly so far, great job! Hang in there and keep doing what you are doing. Poor tummy though. Hopefully the food will stay down.

((((Cindy)))) So sorry you lost your kitty.

 

OMG Cindy - I am soo sorry - this is very kind of you - thank you thank you -
I actually know about where you live - I have a close friend who grew up in Pico Rivera - and worked at Disneyland as a piano player for years and lived in Santa Monica as well - so she's given me some idea where things are - and I've been around Ca. some - I'm kind of foggy now - glad I'm a distraction but I am truly sorry - Robbie is my 4th cat as an adult- first one lived to be 22 than the second one - is still around - she's 11 - the 3rd developed Cardiomyopathy at about 2.5 and I had to let him go after about 7 months of trying to stabilize him - Robbie was my "replacement" from the breeder - who refunded my money and closed down her cattery because she was afraid the HCM was from her blood line - so she gave me her next male breeding prospect - Robbie - he filled a big hole in my heart and has been my baby from day one. Dealing with the asthma has been hard but this... I just don't know - it's got me spinning. Gonna go check on him again

 

btw he is booooooooooooooooooootiful oh sorry, the boyz prefer haaaaaaaaaaaandsome :mrgreen:

 

thank you Joanna - he really is handsome - just an amazing looking cat - but NEVER again with the pure breds - at least I don't think so - our dog (new to the house 6 months ago ) is a rescue mutt - and all my other cats were too - but fell in love with a friends Maine Coon and have had 3 - one had to be put down when his cardiomyopathy got so bad he had no quality of life at all - the other is 11 and looks and acts like she's 2 and than there's Robbie - asthma, mega colon, diabetes - but the sweetest, cutest, musiest boy around.

 

Just went to see if I could test him on my own - he is curled up cleaning himself on my pillow on the bed - I SO hate to get him all miserable again with the ear pricking... he seems fine - should I chance waiting some more?

 

with him acting fine, you could theoretically wait a little longer. that being said, it's 1 am there right? so the question becomes do you test him, get a nice high number about 130 or so and breathe a sigh of relief and go to bed or do you stay up a bit longer and giving him a little more of a break?

 

How do we feel about 110? Got a 107 but didn't really get good blood on the stick - and it kind of stalled before giving number and I know when it does that with me it's often a false reading - he was still bleeding a bit so I milked a bit more out and did a new test strip and got 110. He is bright as a new penny - sitting on my side of the bed and is now purring (which he was NOT doing at all before even when I was petting him). It's 1:06am - I am going to watch Rachael Ray on the Late Late Show and check him again and call it a night I think - let you have some time to yourself Cindy and you too Joanna.
What do you ladies think??

 

awwwww.... I'm going to have to sign off... started a new job today (yay!) and I am pooped out! Cindy knows more than I do anyhow, you are in great hands with her. There are others who sign on later too, so even if she has to go in a while there will be someone here to help you out. You are doing really awesome. Here is the clothespin trick just in case you need it later:

http://www.felinecrf.org/giving_sub-qs_ ... _peg_trick

 

so this is 6 hours since the shot. that's good.

how long has it been since the last round of syrup? an hour? if so, i'd say you're probably good. you could always let him have a bit more food to make sure

if it's been 30 minutes or less since the syrup, this number could still be the syrup and you'll have to test him again.

 

thanks Joanna - love the clothes pin trick - just like holding them by the scruff to calm them down - I don't have any in the house of course - but he did let me test him - he was all lovey and happy and thought I was going to bet him and maybe clean more of the sticky ick off his chest (he's covered in dried syrup) and than i go and prick his ear - he was NOT amused but let me do it and actually stayed on the bed when I was done (normally he'd jump off and run away).
I am seeing double I'm so tired - I don't know that I could read another test number...

 

see, he's learning already that what you are doing helps him.

your seeing double comment made me realize something. you just said something about "when it does that to me i know....." are you diabetic? if so, when was the last time you checked your BG? the stress from this can play a role in human diabetes as much as it does in our animals so before you go to bed you may want to check yours too if you are diabetic

 

LOL yes, I am diabetic and I should probably check my blood - oh, brother - I don't even remember now if I took my pill... I think I did right after our way too late dinner - but thank you - I am crossed eyed right now but I think it's a sleep thing It's been over an hour since syrup- about 1.15 actually - think I am gonna go see if I can fall asleep - my husband will be up in 4 hours or less so i'll get up and check him than too - you think he could crash again now? I know you aren't a psychic but what is your thought? My eyes are closing as I'm typing this - I've had a really loooong week - my company was sold and my job is in major flux so it's been beyond stressful even without this whole thing - but if he's in danger I'll set my alarm for an hour from now. thoughts?

 

HI Ellen:

I'm just coming on here and seeing this (from Oregon) - you're in excellent hands with these gals - you made a great catch and have done a great job. Home testing - is there anything better? It's the only way we can stay on top of their numbers.

It sounds like he's on his way up now - the few times I've had to bring Dude up from a 40 or 50, he decided he really liked all that food and was ready for it next cycle - and upset that he didn't get it.

Hang in there- you're doing great.

Emmy & Dude (& Mittsi too)

 

with it being that long since the last carb load, i think you can safely go to bed (but yes, i'd test myself if i were you. if there's 100 people in my family, 90 of them have diabetes so i know a little bit about it in humans too )

in the morning, either skip completely and give this time to clear out of his body or post here and ask for advice. you'll be up waaaaaaaaaaaaaaaay earlier than me so i doubt i'll be around for your morning test.

 

I just popped on and wanted to tell you that I think that you are doing an amazing job! Amazing.

 

LOL, I have typed several posts and by the time I get it to submit successfully (flaky internet), the news has changed and I have to retype, and then repeat that cycle again, LOL LOL LOL! I'm a bit fuzzy myself so I'll let others answer any questions at this point. Glad he is doing so well, hopefully the worst is over, I just don't know how much level of worry there is at this point with this dose and the possibility the #s might drop, sorry. (((((HUGS)))))

 

thank you all again so very much - well, the real test for me - I just put about 15 pieces of his fave hairball remedy kibble (dry food) in front of him on the bed and he popped up and ate it all. I'm sure I'll regret that when I see his morning number - but it lets me know he is himself pretty much - or feeling much better. I am going to bed and thanking everyone for their help. You are an amazing group and I hope I get to pass it on someday -

I don't think he's getting anything in the am - MAYBE if he's over 300 I'll give him 1 or 2 units but seriously going to consider that carefully. Got to figure out - does his dose need to change completely ? Do I just test and if it's lower than something like 180 not give him that much? If so how much? Going to have to grab the vet again it seems.

of course since I had a big cup of coffee with some sugar in it my blood sugar is 140 - not good but I also don't think I took my pill tonight- I just found one sitting on the dinner table - not good again - plus all this maple syrup is going into my system thru my fingers LOL

god, whatever you conceive that to be - must bless you all....

 

Joanna - I know I keep having to recheck my posts - thanks again and I think we are in the clear for the most part - more to follow in a few hours I'm sure.

 

and that he just ate will help keep him up to so yes, time for bed

and you can read the rest of this tomorrow

in the morning, if he's 180, i wouldn't shoot. if he's only 180 or around there with all these carbs in his system, and you give him insulin too............between the insulin kicking in and the syrup clearing his system, he could easily crash.

if he's around 300 or up, i'd consider 1 unit. no more.

in a human we are accustomed to doses like 40 units or i've even seen 100 units. cats are much smaller than we are and they metabolize that insulin at twice the rate as we humans do so dose variances as small as 1/4 of a unit can make all the difference in the world to our little kitties. there have been cats here who a drop either way can make them go into remission or make them rebound and ride a rollercoaster for days. it is always better to be safe than sorry. you can always add more insulin if the dose isn't working but you can never take the insulin back out of them once you inject.

i know if you see a 400 in the morning it is going to kill you to not shoot or not shoot what a human diabetic would consider pretty much no insulin, cause even 8 units doesn't seem like much compared to doses humans take, but you have to sit on your hands and don't rush this dance. you ever hear the saying "speed kills"? it doesn't always apply to driving a car

and on that note, zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz

 

Hi,

just checking in from Europe-quite a rollercoaster.

He should be fine with you leaving dry now. Whatever that number is in the morning, please don't give him anything like 8u.
Vet should not have started you at 3u in the first pace. It's quite conceiveable he's been on a rollercoaster since day 1.

I'm 100% with Cindy. When you recover, go get some ketostix and cut him right back on dose. You will need to test though as cutting the dose back by this much is a big thing to do.Normally people go for a half dose, but I think 4u is still too high.With all the dry (syrup works it's way out the system fairly quick) his numbers are likely to be very high. Just ignore them.Can take 72 hours for bg's to return to normal.

I would also seriously consider whether you should be looking for a new vet. Bold statement I know, but it does not sound like they know what they are doing.

You've had a nasty scare, but you've come through it, kudos to you :mrgreen:

And Cindy has posted again since I did this-still agree with her.Scritches and hugs. :mrgreen:

 

thanks again Cindy - I am on pills so I have NO idea what amounts of insulin humans shoot - I have never gotten that bad. I just put a post on the other thread where we were talking about the wisdom of shooting at 103 - just wanted to let you know what I just found out when i checked my now almost fully charged cell phone - let me know what you think of that too when you can.

Again - my heartfelt thanks to you all.

 

LOL! sorry guys but i type at a crazy fast speed people who walk in on me when i'm doing it think i'm faking it until they get close enough to see that there are actually legible words on the screen. LOL!!

yeah Ellen, i just saw the update on the other thread. and just in case others don't see it, Ellen had called her vet earlier and a message was relayed thru a vet tech about the pm number she got. it sounds like there was a glitch in hearing as the vet thought Robbie was at 303, not 103.

Ellen's cell phone, which is the number the vet has, went dead thus she didn't get the message from her vet that came in 2 minutes after she spoke to the tech wherein he wanted to verify the number and said, if 303 shoot, if 103, cut the dose and monitor so the vet doesn't yet need to be crucified

she plugged the phone in half way thru this ordeal and just got the message.

 

thanks again - I think our vet is excellent - I think I've been so preoccupied with work he has not gotten the best info from me or follow up from me (for example my husband left the insulin out for 5 hours and forgot to tell me - I used it for a week - now we are on new bottle and it's working....) lots of F'ups if you'll excuse the language on OUR part - the vet started us on 3 because he was showing 400+ in blood test and 849 and there abouts in fructosimine (sp?) tests - plus he knew we didn't want to move him off the dry food right away - so staying on the same diet he put us on 3 -nothing happened no movement so we went to 4,5,7 and RELUCTANTLY on the Vet's part to 8 (he didn't want to go over 7, I kind of pushed cause I felt it would "kickin" soon) than we pulled most of the dry away over the weekend after reading this forum - without consulting the vet and only just told him today that basically he has had almost NO dry - he told me clearly to be VERY CAREFUL to move slowly and to be in touch. He did not give me a don't shoot number - which I will ask him for - and perhaps he should have - but this man has seen us 2/3 times a day for over a month now - plus he's only charged for the tests not the visits - before he was even my vet and was just a friends vet he talked me thru a very rough night with my cardiomyopathy boy - he's a gem and I just won't let the wrong impression be here esp if someone ever reads this who knows who he is or figures it out - he's a gem. I will however, be more observant, listen more and ask more questions and not let work or personal matters stand between Robbie and his health.

thank you all for the amazing support and input and hand holding - I think Robbie might not be in decent shape if it wasn't for all of you here - seriously -you've saved his life all of you.

 

thanks Cindy I type like a maniac too - was at 110 wpm once in my life - - yes, that is the scoop - AND I could have been talking to my actual vet who probaby would have come over here if we hadn't been phone challenged today - (both cells dead, land line acting up) I think that's why the tech thought I said 303 - the phone is all scratchy and going in and out. Totally messed up situation. So tomorrow - I will post numbers when I get them.

best to all you wonderful beans...

 

hi! 1:40 am california time...your dead asleep i hope. but just ran thru the thread and you asked one question i wanted to answer. 'will i have to change his dose completly?"
and the answer is YES!
Maybe we'll start all over, fresh. the numbers will tell you what to do.
the mid cycle #'s are important so you know how well your dose is working.
about clearing house tomorow. 2u i think would be too much. i personally would go nothing but if you absolutly must...1u. try to ignore the number you see when testing. it will be so far off base it won't be funny.
BUT, if it's not, it you only have like 200-300..well that means you have a working pancreas that took care of all that sugar you pumped into him.
consider 300 a decent #.
ni ni
or for you...good morning.
i'll check on you about 10 my time.

 

Woke up at 5:45am here - Robbie sleeping peacefully next to my side of the bed. At 6:30 he was crying for breakfast so I gave him a small scoop of his wet food mix and tried to see if I could test him but between his uncooperative head thrashing and my 3.5 hours of sleep it was hopeless. Woke up again at 7:15 he had not eaten much at all. Managed to test him by about 7:40 at which point it came up as 315. I'm thinking 315 NOT HORRIBLE considering this guy has over 2 large syringes of syrup, a teaspoon of ice cream and some dry food in him - not to mention the tuna fish and straight fancy feast he also got down last night.
Question: what do your cats weigh who are on the much lower doses of ProZinc? I know for humans and it would seem for cats that insulin dose is partially based on weight not just BG #. Robbie is not only 17.5 lbs (down from 22-23 lbs) but he's a BIG CAT - even next to his Maine Coon sister he looks like a different species. I'm considering giving him 1 unit and should do it shortly to keep on schedule if that matters.
Anyone out there have some thoughts?

 

Good Morning Ellen,

Can't believe you are up and typing already this morning! So glad Robbie did well and made it through the night. You have had a trial by fire!

To answer your question, cats are not generally dosed by weight. Oliver was a Maine Coon weighing 16 pounds. Our vet started us on 4 units twice a day. Once we changed the diet and started hometesting, we realized that was way too much insulin.

The reason we say to start low (one unit twice a day) is that it is better to add insulin if needed. As you have seen, once in, it is impossible to take it away! So we tend to ask people to start with a low dose, change the food and start getting bg levels. Then you can safely increase the insulin over time as you see patterns and see that you need to.

I understand that your vet planned on your being on dry food (which does counteract the insulin) but in my opinion, you got in trouble because she increased by so much, so fast, based on numbers she got in her office when can be too high because of vet stress. We suggest increases of .25 and to hold that for a week or so before increasing again.

Our protocol is based on keeping the cat safe and getting him into remission if possible.

 

Glad Robbie is doing better this morning. You are in the right place for help as you already know. I know from experience that beginning to test is very hard. I am an RN and I know I had a lot of trouble testing Baby Blue. people are easier. A couple of things i did might help you. Baby blue likes to be loved when she wants to be loved otherwise she bites. so she sounds like Robbie. But we have gotten to the point that when it is time for her testing she just lays there and waits. A couple of things that helped me were: I got a small flashlight and would shine it in her ear to see where the vein was and mark it in my mind on the outer ear. I would also apply a little bit of vaseline on her outer ear and wipe it off with a cotton ball. I would place the cotton ball in her ear and scratch her while the glucometer calibrate itself. Press the lancet hard against her ear in the area of her vein and test. Then I give her a small treat as a reward for being good. The more relaxed I became with the testing the more relaxed she became. Will continue to follow you and robbie. Good luck.

 

I realize everyone here has lots of experience and last night proved to me (not that I doubted it) how valuable that is and I could not be more grateful - but I do feel a bit under attack about my vet and I just want to say - he raised the levels weekly based on what the numbers were - which were HIGH and NOT MOVING - it was a 5.5 week process that got him to 8 units we started at 3 because he was doing very poorly - not eating, dropping weight right before our eyes and numbers climbing. I find it very hard to believe that an 8 lb. cat and an 24 lb cat would get the same results from the same dose of insulin. Obviously I have no experience with this so I say this with full understanding I could be talking out of my ear. However, I know human insulin is based partially on weight (a type II at 380 lbs won't get the same dose as a type II at 180 lbs) but mostly on their numbers - which are the main factor in all of this. Robbie's #'s were high and at 3 units for a week (or actually 9 days) didn't move, at 4 they went UP, at 5 they didn't move, at 7 they didn't move- so we landed at 8.
I have stated already - there were issues along the way. Was the insulin that was left out for 4 hours in an air-conditioned home tainted? Was it working at full capacity? My guess with what has happened since we got the NEW bottle on Friday is NO it was not - it was not working so for 2 weeks he was getting 7 units and they were not acting as they should. So we upped him to 8, got the new juice, took away 75% of his dry food, put him on 30% diabetic wet food and started feeding him smaller portions more often. Seems to have caused the Perfect Storm of BG drops.
The vet should have been more cautious about the new insulin kicking in better than the one that was left out. For that he is remiss. This is a vet who has approx. 25 diabetic cat patients from what his staff tells me - one just went OTJ following his protocol this week and others have throughout his 15 year practice. His motto on this is slow and steady,he has said that over and over. I think I was the one pushing and I paid for it.
I need this forum, you are all amazing, I want the info and the help - I don't want to feel uncomfortable checking in here because I feel that there I'm being judged about my vet choice. I don't live in a metropolitan area, the vet choices here are good but not wonderful and many of them are over 20-45 minutes drive from my house. My vet is one of the most up to date out here - he also delves into research on anything he doesn't know (he found out a bunch of things about asthma when we were dealing with that for example). I just don't want to have the urge to defend that choice here. Slap my hand for pulling Robbie off dry so fast, or for pushing to go to 8 units or for not listening to my gut when it said "dont shoot at 103" but would it be ok to stop second guessing the choices my vet made up to this point? Moving forward the first thing he hears from me each conversation is all the great info I've gotten here and how I want to implement that with Robbie.
So thanks so much - I tired, at work and facing a hurricane tomorrow - so forgive me if I sound short.

 

Hi, moving forward...

You asked what dose other large cats get, so here is what my two diabetics get:

Rusty is a Maine Coon mix ~approx 18.5 lbs. He eats Wellness low carb canned food and his dose in 0.25u BID -- yes -- LESS THAN 1u of Levemir.

Tiggy is a DSH approx 15 lbs. He also eats Wellness low carb canned food and ALSO gets 0.25u BID of Levemir.

Their preshot BGs are usually between 80 and 125, so they are well-regulated on this tiny dose of insulin. They do need the insulin -- if we skip a shot, they are up over 200.

So -- cats should not be dosed by weight -- just by what they need

Most cats need less than 3 units, so it is very possible that Robbie has been in Rebound from day one. Starting over at 1 unit BID would be a good idea

((((((((Ellen))))))))

phoebe

 

Phoebe
Were your big guys in the 400's when it all started and did they respond to the low dose within a month? more or less? Did they have dangerous symptoms or did you catch them before that kicked in? Where a cat lands eventually and what needs to be done to get them there are starting to sound like a least 2 different things to me. I'm curious to try and figure it out - obviously we need to cut his dose - by how much I don't know - going home at 1pm to test him and see where 1 unit when he was at 315 this morning put him. I'd love to know more about everyones journey and will be reading the forums as soon as time allows.
I know someone (my cousin) who left her cat in the high 300's waiting for the dose to "kick in" for about 8 weeks she says - the cat eventually regulated at a slightly higher dose but now is having kidney issues - if those are related to being at those high numbers for over 2 months I don't know but my cousin thinks so - I have urged her to check out this forum - she has kind of given up on her kitty and it's very sad. My sister has about 18 cats- she has a large farm and takes in strays and now has people dropping "sick" animals at her gate - she has a kitty with lots of issues (diabetes being the least of her problems) and to keep her kitty in a normal range her vet has him on 12 units twice a day - I THINK of humalin - my vet said that was "outrageous" and I agree but the poor guy is hanging in - it's acomplicated situation but ECID.

 

Fortunately or unfortunately - they were both pretty well regulated when we adopted them.

Tiggy - adopted Feb. 2009 - 11yo - diabetic for approx 5 years - eating Science Diet Hairball and getting 5u PZI SID for 6 months before we adopted him. (his owner's work visa expired and she had to leave the country - so he was at a vet clinic for 6 months)
We switched his diet to low carb canned food and changed his dosing to BID (2.5u BID) Gradually reduced as needed to the tiny dose of 0.25u BID.

Rusty - fostered by Claudia for ~15 months "cjleo" is her userid here on FDMB - she got him regulated on Lantus after he was found as a stray on the streets of Plymouth, Mass.
we adopted him in March 2010 and switched him to Levemir. He had been getting 1.5u BID Lantus on mixed canned food ~8-10% carbs. We changed his diet to lower carb ~0-5% and went to 1u BID Levemir. In the past 5 months, his dose has been reduced to 0.25u BID.

Norton was our first diabetic cat. We started him on Humulin N in June 2006. We started at 1u BID, and once per week went to the vet for a blood sugar test at +6 hrs after injection. We gradually increased over several months to 13u BID.
He did respond to the insulin - but we gradually increased no faster than 1u per week -- targeting a blood sugar ~100 at nadir (+6 hrs after injection)
We were feeding Science Diet Indoor dry food with FF snacks. After a year of treatment with mediocre results, we found FDMB and learned about home testing, low carb canned food, rebound and causes for insulin resistance.
We did a rebound test which confirmed that Norton needed the high amount of insulin that we were giving him.
We started home testing.
We changed diet to low carb canned food -- slowly transitioning. His dose reduced from 13u BID to 8u BID from diet change.
We were lucky that Norton never had any trouble with Ketones (a risk with high blood sugar)
We discovered that Norton had Acromegaly - a brain tumor on his pituitary caused his diabetes and caused him to need a high dose of insulin.
We switched him from Humulin N to PZI, and started injecting TID instead of BID (3x ~8 hrs instead of 12hrs)
Shortly after this, we discovered that he had inoperable cancer that was causing him pain - we helped him cross the bridge.

After grieving for ~8 months, we adopted Tiggy through this board...

 

Have you read about the High Dose conditions? Check out the sticky posts at the top of the Acromegaly, IAA & Cushings cats forum.

Personally, I suspect that Robbie was started at too high a dose and may have been in rebound all this time.

It is possible that he has one of the high dose conditions, but the dose was increased too fast to really tell.

Depending on how fast the dose was increased for your sister's cat - he may have one of these conditions.

Anyway - when you have time -- check out the high dose conditions and about Rebound

 

Ellen check your pm's on upper left corner of screen. sent you one (just to avoid a possible long discussion about vets on this thread) pm's are messages private, in red.

 

Checked Robbie at 2:15 today (only time I could get home) and he was at 227 after 1 unit this am and he ate some dry food that was out from the night before and his regular low carb wet mix.
Spoke to Vet - check him at 5 again - give him dinner - check him at 7pm - if he is lower than 250 but higher than 190 give him one unit - if he is higher than 250 give him 2 units. I have to go out tonight till about 10pm - my gut is telling me no matter what he shows to only give him one unit.
Vet is hoping that the change in food etc. will put him at under 3 units once we see where he is after this episode - advised to NEVER give him 8 units again. No kidding...

 

your plan sounds good to me.

 

Agree - sounds like a good plan

 

got stuck at work didn't get home till 6 - checked him at 6:30 - it's 277 - so 2 units? I'm thinking yes, but nervous - so thoughts from the experienced hands here?

 

to be completely honest, i'd probably stick with the 1. for a couple reasons. mainly so you can get some sleep tonight

two might be too much and make for another long night and there's no way to know without testing later and at that point, you won't have a choice if the number is too low again but to pull another all nighter

so how do you feel about that?

 

agree, one unit. let's see what he does with it. you'll be home for a +5 check.

 

did a smidge over 1 at about 7pm - had to deal with work issues - got home at 11:30 and he seems fine but when we tried to prick his ear he got into a bad asthma attack (brought on by being stressed out) he would NOT let me near his ear - David held him etc. etc. - now he'd on the floor doing his air gasping, gurggling thing- I have to wait till this passes to try again - looks like I'll be up late again - when we shone the light on his ears there were these big red blobs on the spots where I've pricked him repetedly - I've tried massaging them, put some neosporin on them this morning - but still - they look like clots almost - am I doing something wrong?
He finally coughed out his congestion and is resting now- going to give him some time - so if anyone reads this - hints on the ear pricking?

 

wish i could actually talk to you...that does'nt sound right. are you doing it freehand or with the lancet device?

 

check your pm's..available until 9:50. i know...sounds exact, but gotta test shoot feed and want to watch 'big brother at 10.

 

Free hand - wasn't sure the lancet wouldn't hurt him (it hurts me) so I'm doing it free hand - maybe that's part of the problem? I'll check PM's - he's running around with our girl Roxie so he can't feel too bad right now.