My 16 year old cat was recently diagnosed with diabetes, need advice please.

Discussion in 'Feline Health - (The Main Forum)' started by Dan&Heather, Dec 21, 2016.

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  1. Dan&Heather

    Dan&Heather Member

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    Ok, we just gave her .5 at exactly 8:30pm. We don't have an alarm clock because we always just use the phone and I'm going to have the phone at work. Dan has set an alarm on the computer for 2 hours so he can check her sugar. I have to leave for work right now, so we will each be posting here, me from work him from home to let you know how it goes.
     
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  2. Critter Mom

    Critter Mom Well-Known Member

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    Hi Dan,

    - Injection time of 8:30pm is 'time zero'.

    - When you post a test result please tell us the BG reading and how many hours after the dose it was taken. For example: if you were to test at 10:00pm your time and were to get a reading of 321, you'd post:

    +1.5 - 321

    We use +<hours> to keep track of BG levels in relation to how the insulin typically works over time so as to make sure the dose is OK. (It also helps members in different time zones to fully understand how things are going.)

    As a precaution tonight, I suggest getting the first test at +1.5 hours after the injection. (Novolin N may have an early onset.)

    - Post the +1.5 result here when you get it.

    - Do the next test at at +2.

    - Please keep helping Mittens to get food down.

    * * * Did you give her any mirtazapine? * * *


    .
     
    Last edited: Dec 23, 2016
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  3. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Heather and Dan, you have my admiration for how well you are looking after Mittens. She is obviously a very loved and lucky kitty! You are getting great help but I am following too and will help if need be. :bighug::bighug::bighug::bighug:
     
  4. Dan&Heather

    Dan&Heather Member

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    Ok I can check her BG at 10:00 and post back here, and again at +2. We did not give her any mirtazapine yet. Should i try and feed her now before the BG test or wait until after? Thanks again.
     
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  5. Dan&Heather

    Dan&Heather Member

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    Yes, Mittens is definitely part of the family :) This place has been amazing since we found it, thanks alot to everyone!
     
  6. Critter Mom

    Critter Mom Well-Known Member

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    - Feed her now. She needs the calories.

    - I suggest waiting till after the +1.5 test before giving any mirtazapine.

    Will keep an eye out for the +1.5 BG result.


    .
     
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  7. Critter Mom

    Critter Mom Well-Known Member

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    Glad you're here, Linda. :bighug:

    .
     
  8. Dan&Heather

    Dan&Heather Member

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    Ok got her to eat a small amount of the chicken n broth baby food, and tested her BG a few minutes after. Her BG was 237, is that ok?
     
  9. Dan&Heather

    Dan&Heather Member

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    Tested it at +1.5 -237. I think i got that right, that seems like a sharp drop though im not sure.
     
  10. Dyana

    Dyana Well-Known Member

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    Hi Dan. Remind me what she was at PMPS (that means PM pre shot) test, again.
    I like seeing the response to the insulin. Give her some food. If it were me, I would test again in an hour. Would feeding her for 15 minutes and then sleeping for 45 minutes be okay with you for now, or are you afraid if you nap you won't wake up?
     
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  11. Critter Mom

    Critter Mom Well-Known Member

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    It's a substantial drop, Dan, but she's in safe numbers. (On a human meter, 50 is the lower end of the normal reference range.)

    How did the last feed go, Dan? Was it a little bit easier than earlier on?
    .
     
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  12. Dan&Heather

    Dan&Heather Member

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    Her PMPS was 389 about 2 hours before the shot of insulin. Yeah i can feed her some more, will do that right now. Ill be fine, i wont fall asleep. Gonna feed her now.
     
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  13. Dan&Heather

    Dan&Heather Member

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    Thanks, thats good to know. Shes fighting the feeding kind of bad now, but it just takes a little longer.
     
  14. Dyana

    Dyana Well-Known Member

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    Did you watch the video and see how the less restraint the better? I just remember I petted J.D. while he laid next to me, and when I went to give him a ml or so of food, I just held his head a little with my left hand, while my right hand worked the syringe. I would let him swallow and pet him some more, and then do the next ml or so. I also warmed the food if needed by placing any refrigerated (cold) syringes in a tall cup of not hot but very warm water for a few minutes. How are you doing the assist feeding? I know some kitties need more restraint at first.
     
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  15. Dan&Heather

    Dan&Heather Member

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    Hi everyone, this is Heather I am at work now. I just got my first break and I'm glad to see her number is down. Thank you Dan, I'm sorry I had to leave you at home to take care of this alone! Specially cause we're just beginning the insulin and I know your tired.

    I should be getting breaks every hour and a half or so and I go straight to the message board when I get to the break room. I'm so sad that I'm not there, I have tomorrow off though so I can help with this. I watched some of the syringe feeding video I'm going to finish it in a bit, I hope it gets easier. Or better yet I hope she starts to feel better and starts eating on her own.

    Thank you to everyone on here I really truly don't know how this would have ended up if we hadn't found you. Well, I do know how it would have ended and I can't even think about that right now. I wish we lived closer to you guys, we owe out alot of juicy steak dinners!

    I'm going to keep being hopeful that she responds well to the insulin. I will check back on my next break.
     
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  16. Dyana

    Dyana Well-Known Member

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    Hey, Heather, a nice outdoor barbeque dinner on a nice day celebrating her and your success would be delightful, if only we all lived closer ;)
     
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  17. Chris & China

    Chris & China Well-Known Member

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    As much as I love steak, don't even worry about it!! We're all here for the same reason.....we reached out for answers when we didn't like the ones we got at the vet or we wanted to learn more about what we were up against

    The people here are great and are just "paying forward" the kindness that was shown to them when they were new, scared and confused.

    Soon, you'll be reaching out to a newbie too....if only to say "we were where you are not long ago and we understand. If we can do it, you can too"....those are some of the most beautiful words anyone can share
     
  18. Critter Mom

    Critter Mom Well-Known Member

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    As Dyana says above, lots of gentle and reassuring praise can really help.

    (I also find that if I try to explain to my kitty exactly why I'm doing something helps me calm down a bit. And when we're calmer our little ones feel more reassured.)

    .
     
  19. Dan&Heather

    Dan&Heather Member

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    Ok, Dan here again. When im here alone i just go lay on the floor by her and try to feed her with the syringe, i usually let it sit under some warm running water, i just fed her some beef and broth baby food, she didnt want much but ill try again after i post this message. I have not watched the video yet, but i will before the night is over.

    I just checked her BG again at +2.5(2 and a half hours past the insulin)and it was 266. So i think the write way to phrase it is +2.5 -266? Sorry if i got it wrong but 2.5 hours after the insulin her BG is 266. Gonna try to give her the rest of the syringe of baby food now.

    I cant stop saying Thank You enough, the amount of help here has been huge!
     
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  20. Dyana

    Dyana Well-Known Member

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    You did perfect Dan. Her +2.5 is 266. That's good.
    Have you tried to cut up a pill of mirtazapine yet? Do you have a pill cutter or a clean razor blade?
    How were you planning to give it to her? You only want to give her like 1/8 of the little tiny tablet.
     
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  21. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    U said that just perfectly Dan and we know what you are up against being so tired and worried. That number is fine and good that you got more food into her.
     
  22. Dan&Heather

    Dan&Heather Member

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    I havent tried the pill yet, i can do that now. I dont have a razor blade handy, we got some pretty sharp knifes which is the closest thing we got. Im just hoping she opens up for me, shes been pretty reluctant with the feeding syringe. I was gonna try to set it in the back of her mouth and massage her throat softly? I think we watched a video on it, i honestly cant recall right now tho. It would be easier if i could give it to her in some food but i understand if that wouldnt work. She drank some water on her own after the last BG.

    Thank you, im really glad its come down some from yesterday.
     
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  23. Critter Mom

    Critter Mom Well-Known Member

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    Well done, Mittens!

    It's great that she's taking on some fluids under her own steam. Fluids help to flush ketones out of the system.

    .
     
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  24. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Dan, pilling isn't really that hard if you can get one hand on top of her head and your fingers just behind her canines. Then use your other hand to pull down her lower jaw and put the pill on the back of the tongue. Usually they will open wide if you get the top hand in just the right spot. You may need to kneel on the floor and put Mittens between your legs but I find it easier to sit my cat on my lap because then I can see what I am doing and where I am placing the pill.
     
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  25. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Pill admin - part 2 .....as soon as you get the pill on the back of her tongue, close her mouth so she doesn't spit it out and stroke her throat to get her to swallow. Then grab a syringe with water and give her a bit of water to get her to swallow again. Just keep an eye out for the pill because they can be little devils and spit them out even if you think they've swallowed it.
     
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  26. Critter Mom

    Critter Mom Well-Known Member

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    Repeating the pilling technique from earlier:

    To give the 1/8 tablet try this method:
    • Kneel on the floor with Mittens between your thighs, back towards you and facing away from you.
    • Tilt her head back and ease open her jaws with thumb and forefinger. You need to see the back of her tongue.
    • Gently drop the 1/8 tablet into her mouth so it lands on the back of the tongue.
    • Keep Mittens' mouth closed and very gently rub her throat - it will encourage her to swallow the tablet.
    • Syringe about 3-5ml of water after giving the tablet to wash it down properly.
    • Keep an eye on her for a minute or two to make sure she doesn't spit it out! ;)
    .
     
  27. Love-Paula aka Woodsywife

    Love-Paula aka Woodsywife Well-Known Member

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    All I can say is well done Dan and Heather. You have accomplished so much today and Mittens is going to feel better soon. Dan, I hope you don't get to sleep deprived. Maybe a pot of coffee with help.
     
  28. Critter Mom

    Critter Mom Well-Known Member

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  29. Dan&Heather

    Dan&Heather Member

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    Thank you, i was just gonna make sure it was 1/8 and not 1/4. I will give it to her in a little bit, just trying to let her rest for a few minutes. She probably thinks im so annoying right now, if only she knew it was for her own good.

    I was gonna do another BG test in about 25 minutes, that would be +4 past the insulin shot, does that sound good? Sorry for keeping everyone up so late :/ I think we were gonna test at 1.5, 2.5, 4 and 8, at least thats what i think Heather told me, does that sound ok to everyone?
     
  30. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Right Dan. That's the plan. We monitor according to the readings though so if any reading is concerning we may ask you to test more. The cycle looks good so far so I hope we won't be testing anymore than planned!
     
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  31. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    And no worries about us. Mittens is the focus right now! :cat:
     
  32. Dan&Heather

    Dan&Heather Member

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    Ok, will report back in about 20 minutes :)
     
  33. Dyana

    Dyana Well-Known Member

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    You're doing great Dan. Talking to her and letting her know that what you are doing is to help her may help her to understand it's all for her own good.
     
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  34. Chris & China

    Chris & China Well-Known Member

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    You're not keeping anyone up...you'll soon learn who's online at what hours and you'll find that we're pretty much a 24/7 board here.....when the west coasters are heading to bed, the UK'ers and Europeans are getting up! We're actually slow right now due to the holidays

    Those would be great test times!

    Another tip on pilling....once the pill is in the back of the throat, if you blow gently on their nose it makes them swallow (it's reflex)

    Next time you're out at a PetSmart or Petco ( or you can order from Amazon) you should look into getting a pill gun....they're worth their weight in gold!!
     
  35. Dan&Heather

    Dan&Heather Member

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    This is a great community you have here, im a member of quite a few different forums and none of them have been like this. Thanks for the tip, and we'll pick one of those pill guns up asap.
     
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  36. Critter Mom

    Critter Mom Well-Known Member

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    Ask for feedback after the +4 test. Novolin N can keep numbers down a little past +4.

    Members helping you at that time will be able to let you know if you need to test earlier than +8.

    If it were me, even if numbers were OK at +4 I would get a +6 and a +8 test. It's standard practice to do this series of readings at regular intervals (a glucose curve) when starting insulin treatment to check the safety and the duration of the dose.

    Dan, Heather: hats off to you both.

    :bighug:

    .
     
  37. Dan&Heather

    Dan&Heather Member

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    Ok, got her BG tested again at +4 -258. So 4 hours after insulin her BG is 258. Gonna work on the 1/8 pill now and follow it with some water and food, the chunk of pill is small enough so im thinking it shouldnt be too bad.

    Ok, i will test at +6 too :) thanks again.
     
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  38. Critter Mom

    Critter Mom Well-Known Member

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    I can't leave it any longer to take my sleep meds so that I'll be able to check back in for the UK leg. (NB: I could be knocked out until about 12:00 noon GMT. Need cover till that time.)

    For members assisting:

    Potassium supplement - Dosing:

    - Rx is for a whole tablet twice a day for two weeks.
    - first dose was administered somewhere between 21:46 and 22:30 GMT. (ETA - These are the UK Zone time stamps on the relevant posts - needs to be adjusted to D & H's time zone.)

    Jill's tips for administration:

    Try crushing the potassium tabs into a fine powder. If Mittens will eat, you can mix it in a little food. It'll go down easier mixed in food. If not, mix the potassium powder and a little water in an oral syringe and give it to him that way. Follow it with a water chaser... about 4 - 5 ml of water.

    .
     
    Last edited: Dec 24, 2016
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  39. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    That reading is basically the same as the last which is good. At least she is not dropping quickly now. Let us know how the pilling goes.
     
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  40. Dyana

    Dyana Well-Known Member

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    Good night Mogs. Thanks for helping. :bighug:
    What she's saying Dan, is Mittens needs to have her potassium dose 12 hours after you gave the 1st dose. You're on EST, so what time would 12 hours after you gave the first dose of potassium be?
     
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  41. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Dan, if you don't remember the exact time you gave the potassium, then figure on 10:00 am as your next dose. We know roughly when you gave it and a half hour one way or the other is not a problem.

    Summary of BG so far for reference
    PMPS - 389 (2 hours pre-shot with no food for 90 minutes prior) - given 0.5u Novolin N (NPH)
    +1.5 -237
    +2.5 - 266
    +4 - 258
     
    Last edited: Dec 24, 2016
    Reason for edit: corrected summary times
  42. Dan&Heather

    Dan&Heather Member

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    We gave her the first dose of potassium almost 8 hours ago, so I will wait another 4 hours for that correct? I tried with the mirtazapine pill, i had it in her mouth and it popped out, ill try again after posting.
     
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  43. Dyana

    Dyana Well-Known Member

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    Wasn't there a 237 at +1 too? I may not remember right.

    I think GMT is 5 hours different than EST.
    Maybe pick a time that would be convenient for you to dose his potassium at regular 12 hour intervals. Be sure to wait the 12 hours after his initial dose though, you don't want him to have too much potassium either.
     
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  44. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Ok so you gave it around 5pm? I thought it was later but no matter...Looks like it was a time zone issue.

    Yes you give it twice daily so every 12 hours. so next dose would be at 5am but that is not very convenient under normal circumstances so pick a time early morning and then in the evening that will work for your schedules going forward. I would however try to give it pretty early in the morning right now (may be 6am) to keep the dosing somewhat consistent and then shift the time ahead gradually perhaps a half hour daily until you get to the time you prefer. Getting her potassium up right now is going to help her feel better and should help with any nausea.
     
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  45. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    You're right Dyana. Correcting last post. :)
     
  46. Dan&Heather

    Dan&Heather Member

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    I believe right now were at
    PMPS - 389

    +1.5 -237
    +2.5 -266
    +4 -258

    I'll test again at +6 too.

    Ok, maybe ill wait till tomorrow around noon for the potassium, noon and midnight i think would be easy times to give her potassium on regular 12 hr intervals.

    Edit: Gonna give the potassium at 6am and start 12hr intervals after that :)
     
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  47. Dan&Heather

    Dan&Heather Member

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    Ok I can give her the potassium at 6am that works for us, we keep pretty odd hours here so theres always one of us up at those times.
     
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  48. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Whoa! Right now you need to get potassium into Mittens. I know the early morning is a pain but I think it's important to give it as close to 12 hours as possible right now and gradually move it to the preferred noon/midnight timing.
     
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  49. Dan&Heather

    Dan&Heather Member

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    Ok, the last time i gave her the potassium was only around 8 hours ago. Not sure if i misunderstood, do i need to give her more? Sorry for the confusion.
     
  50. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    If you gave it about 8 hours ago (maybe 8.5 now?) then that would have been about 5pm. So the next dose would be due at 5am. I'm suggesting you give the next dose at 6am/6pm today. Then next day move it ahead to 6:30am/6:30pm and so on just so you keep doses fairly close to every 12 hours until you get to your preferred time (noon/Midnight)

    Thank you for the corrected summary. It gets tough going back through the thread when they get this long! Tomorrow I think you should start a new thread and link this one to it.
     
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  51. Dan&Heather

    Dan&Heather Member

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    Ok, then her next dose of potassium will be at 6am and then 12hrs after that, and so on. 6am/6pm works for us.

    I was thinking the same thing when i was trying to go back in the thread and read some stuff lol, I'll have Heather start a new one tomorrow.
     
  52. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Dan, I take it you got the mirtazapine into Mittens? Have you tried to get more food/fluids into her?
     
  53. Dan&Heather

    Dan&Heather Member

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    Finally got her to take 1/8 of the mirtazapine, and a little bit of food afterwards. Gonna try to give her more
    Yes i got the mirtazapine in her about a hour ago after a few failed attempts.

    Just gave her the +6 -234. 6 hours after the insulin her BG is 234

    Yes i just fed her again about 30 minutes ago, she is really fighting the baby food though and its all i got here for her for another hour. Heather is stopping at the store on her way home for some more fancy feast, maybe Mittens is over the baby food for the night i dont know. Im gonna feed her again as soon as Heather gets home though. She drank a few times on her own but not very much.
     
  54. Dan&Heather

    Dan&Heather Member

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    PMPS - 389

    +1.5 -237
    +2.5 -266
    +4 -258
    +6 -234

    is where im at right now. Gonna give her some more potassium at 6am(approx 3 hours).
     
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  55. Chris & China

    Chris & China Well-Known Member

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    Don't give her more....mirtz lasts for 3 days....give it a chance to work first
     
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  56. Dan&Heather

    Dan&Heather Member

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    Sorry, i meant give her more food.
     
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  57. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Ok, sound like things are going pretty well. Her BG is holding steady so no concern there right now and I doubt she will drop significantly at this point. Retest at +8. Keep trying to get food and fluids into her. I am about to fall asleep on my keyboard and I hate to leave you on your own but I have to be at least semi-coherent tomorrow.

    IF and that's a HUGE IF, the BG test at +8 has dropped significantly (any drop of more than 100 points), change the title on your thread by adding a "911" prefix to it. You can do this by clicking the little tab up in the right upper screen that labelled "Thread Tools". Then when you get the title box, select "911" from the selection list on left. This will get you attention and by then there should be some UK/Europe folks online.

    If you have to put the 911 on the post, try to get more food into her right away and restest her in 20 minutes. If there is any delay of a response, and she is dropping, rub some karo syrup or honey on her gums and keep testing and trying to get her to take some food.

    I'm setting an alarm to check in but I wanted to give you this info just in case I snooze through it. Any questions?
     
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  58. Dan&Heather

    Dan&Heather Member

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    Ok thank you, i think we should be good for the night now. Im gonna feed her again when Heather gets home(shes on her way now), and ill retest at +8 and post it here, and get her some more potassium when 12 hours rolls around.

    Thanks for the tips just incase. Have a good night everyone and thanks a ton! :) Im not exaggerating at all when i say we wouldnt have been able to do this without all the awesome people here.
     
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  59. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Good night and I hope you'll have a chance to get some much needed sleep very soon! I can't imagine how exhausted you must be. You are indeed very dedicated pet parents. My kind of people! :bighug:

    Oh I really am getting punchy.

    IMPORTANT
    50 is the BG reading that normally warns us to start intervening with food but it's prudent to raise that number for Mittens tonight to around 130 just because getting food into her is not an easy task and too much honey or karo could cause more nausea. You need a bigger cushion to keep her safe! Don't let anyone tell you she is safe below 130. While it's a safe reading, you need to keep her there or higher right now.

    Signing off! :D.
     
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  60. Larry and Kitties

    Larry and Kitties Well-Known Member

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    What is the mg of the mirtazapine? I have seen it in 7 1/2 mg and 15 mg.
    The standard dose of was 3.75 mg (1/4 of 15 mg) every three days. But now the reduced dose is have that but every two days
    http://veterinarymedicine.dvm360.com/mirtazapine-cats-how-much-too-much
    It usually works in one half to one hour.
     
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  61. Dan&Heather

    Dan&Heather Member

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    The Mirtazapine we have is 7.5mg
     
  62. Larry and Kitties

    Larry and Kitties Well-Known Member

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    You can give 1/8 to 1/4 of a 7 1/2 mg tab every other day
     
  63. Dan&Heather

    Dan&Heather Member

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    We just tested her BG again a few minutes ago it was 290 so it's +8 -290. We fed her about an hour ago, it was 7.5 ml from the oral syringe
     
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  64. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    Good Morning!

    Just caught up on the overnight progress-- well done! She held pretty steady and stayed safe all night on the 0.5U, which is fantastic (I hope that let you get at least a little sleep between +4 and +8, what a time you guys have had the last few days!). The dose experts should be weighing in before the next shot, I just wanted to pop in to say hello and congratulate you guys for all the fantastic care you are taking of Mittens (even if she's not exactly appreciating the syringe feeding at the moment, poor thing). Mittens is so lucky to have two such tenacious and devoted pet parents!

    This morning, when you start a new thread for the day, it'd be great if you could put a short summary of where Mittens is-- the dose and BG numbers from last night, what meds she's taken, etc. plus a link to this previous thread for people who want to peruse the details.

    Go Team Mittens!!!!
     
  65. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Nan!

    I'm doing a summary now (insulin, food, meds, ketone status, etc.).

    I'll post it very shortly. :bighug: ETA - Summary available in new thread (link below).


    Mogs
    .
     
    Last edited: Dec 24, 2016
  66. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    @Dan&Heather -

    I've set up a new thread for today on Feline Health. Click this link to take you straight there:

    12/24: MITTENS - Novolin N - Small Ketones



    NB:

    - Please post all updates and questions to your new thread. Members helping you will automatically follow you over there.

    - I have posted a summary of insulin, meds and food info at the beginning of the new thread so you'll have the story so far available at a glance.

    Great work overnight, Dan. Glad that Heather will be back to you soon.:bighug:


    Mogs
    .
     
    Last edited: Dec 24, 2016
    Barbara & Uncle likes this.
  67. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
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