my diabetic cat registered High on glucometer

Discussion in 'Feline Health - (The Main Forum)' started by Theresatramondo, Jun 5, 2013.

  1. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    Hi, I am new on Feline Diabetes - I pulled a cat off the Euth list and she is diabetic. She just registered High on glucometer. I hit her with the insulin 3 unit, it went thru her, so I rehit with only 2, hoping 1 unit absorbed, and thinking if not, 2 isn't bad. Most of the shoot thru was on her coat, that I could tell. Any suggestions, she just ate about 3/4 a can????? HELP. nailbite_smile
     
  2. LynnLee + Mousie

    LynnLee + Mousie Well-Known Member

    Joined:
    Dec 28, 2009
    no need for panic. being high for a bit is not as bad as being too low so you don't need to do anything more right this moment

    typically we advise not to reshoot if you do a furshot (aka: shooting thru the cat, missing the cat, etc....) as that can result in an overdose but what is done is done and since she's reading high, you'll probably be ok this time.

    can you tell us more about the kitty such as what insulin are you using? how long has kitty been on insulin? is there anything else wrong with kitty? how is kitty acting?
     
  3. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    "Better too high for a day than too low for a minute."

    Since you really do not know how much of that first shot was truly a 'fur shot', Please test again. To see which direction the blood glucose (BG) is heading.
     
  4. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Remain calm and breathe.

    High glucose is not an emergency. It is somewhat urgent, as it you want to start working on it because it slowly damages the body and may generate ketones via fat breakdown for calories if the glucose can't be used.
     
  5. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    Hi, thanks for responding. I feel much better. Tiffy is 8 yrs old. I pulled her off the euth list. She was very sick. She is now doing better, but the insulin is not regulating and her readings are growing higher. The vet has her on Wd. A person with a diabetic cat, who is brilliant, said switch to Evo, I just today put her on 1/2 wd and 1/2 Evo. I use Evo with my other cats. Tiffy is like 6 pounds. Very Skinny!!! Although she might have gained. She didn't eat a lot tonight. Approximatley 1 1/4 can of wet with 1/2 cup of water in it for hydrations. She typically is dehydrated. I've only had her since May 3rd and was at vet from 5-3 (pull date) to 5-15 with a URI. Then she relapsed a week later and was back at vet for another week.
    The vet put her on ProZinc. We have no prior history on Tiffy (my sweetie pie bug). She has neuropathy, her heels touch the ground. We have no idea how long was was on the street without insulin, but I must have been long. She was matted, smelly. And She runs to the garbage pail in my apt so much so that I have to lock it up and anything that she could consume.
    She is lethargic, but she plays with me. She likes sleeping on the marble floor in the bathroom. I'd like to take her temperature, but I don't want to push her as she lets me test her, admin insulin and clip her nails. She's a snuggle bunny. Very sweet. She does growl though at times. We don't know if she is spayed yet and we havent given her shots yet either due to the problems, but she is not FIV.
    She's sleeping right now.
     
  6. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    Hi, thanks for responding. I tested her this morning at 6:44 am and she was 585. She ate like no tomorrow. At 7:15 tonight, she registered Hi. I just tested her again at 8:35 and she registered 628.
     
  7. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    to recap,

    1. Tiffy age 8, female, 6 lb
    2.Prozinc 3U
    3. W/d dry food, switching to 1/2 w/d and 1/2 evo wet

    6/5 am 585
    pm HI
    +1 628

    appetite good, URI prone, advanced neuropathy - walking on hocks, unregulated, ravenous

    What meter are you using for home blood glucose testing?
    What was the starting dose of the Prozinc?
    How often do you give the insulin?
    How many hours apart?
     
  8. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    OMG, you guys are great. I don't know how to thank you!!!
    Alphatrak 2 (brand-new, and control tested. I spoke to Abbott Lab on it already) Just because she is so high.
    ACC had her up to 2 units in am and 2 units in pm.
    Vet lowered her to 1 unit in am and 1 unit in pm. I called Alphatrak (aka Abbott labs). My vet uses their old Alphatrak and it is not suggested. They said they changed the old meter for a reason and the new meter that I have prevails in readings. My vet got lower readings.
    When Tiffy relapsed, they raised her to 2 1/2 units, and this week she just got raised again to 3 due the above 500 level readings.
    I administer at least every 12 hours. I can give you the times if you want???? Approx every 12 hours. So 6:30 to 7 am to 630 to 7 pm (sometime 7:15-ish).
    So I admin her twice daily 3 units (total 6)
     
  9. Hope + (((Baby)))GA

    Hope + (((Baby)))GA Senior Member Moderator

    Joined:
    Dec 28, 2009
    She will be hungry until her body starts utilizing the insulin so you may have to feed her more. W/D is old school food and the dry especially is high in carbs. Also used as a weight reducing diet for fat cats, not much nutrition in it. One of mine, when I first adopted her would suck down 3 cans of Fancy Feast at one sitting. Bless you for saving her from being euthanized.
     
  10. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Hello and welcome to the board!

    I agree with everyone and the main take away here is that the sooner you can stop the dry and feed only wet the better.

    The tests you have got are at the end of every cycle. Its important also to know how low it is taking her before changing the dose. Can you get a few spot checks during the day?

    Wendy
     
  11. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    she just tested at 10 pm at 480
     
  12. Martica and Fred

    Martica and Fred Member

    Joined:
    Jan 15, 2010
    Hi
    Could more of you please weigh in for Teresa here? She is using PZI. I am a Lantus person. However, in speaking with her, I am coming to the conclusion that her cat is doing somogyi rebounds over and over. We are both in NYC and she pulled the kitty, Tiffy, from the kill list at the shelter and he went straight to a NYC vet--who helps rescue a lot, but is not well versed in insulin dosing. If you all recall, back 1.5 years ago, I pulled Shane (now Sebastian) also from the kill shelter while in diabetic ketoacidosis...This vet saved him from DKA but then proceded to overdose him on Lantus--going from 0.5 units to 2.5 units in 3 days for a 6 lbs skinny cat.

    I insisted on bringing him home once I realized that he was not being fed mid shot and also that he was being sent into hypos repeatedly...ONe hour after I brought him home from the vet he was in the 30s....Sebastian is still today, 1 1/2 years later on 0.5 units of Lantus only once a day and he is in the 100-200s He is 12 lbs, not 6.

    This cat, Tiffy, was at this same vet's fro 14 days....she had not posted nubmers yet I don't believe, but she needs PZI advice on dosing. Right now the vet is advising 3 Units BID..for a 6 pound cat and she's getting PS number after PS number that is 500s/600s to HI...And these higher raised doses are not bringing it down at all.

    Please weight in...what is the lowest she should back track with? If it were Lantus, I would advise dropping to 0.5U BID and letting that hold for 5 days and then reevaluating. I don't know with PZI if it's the same.

    Thanks
    Martica
     
  13. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    That's how long after the shot? Two hours? Three? We refer to the time after shot as +the number of hours so.. If its two hours after the shot we all it your +2.. If the test was three hours after the shot, it's a +3..

    Anyway she is dropping. Can you set the alarm to get a +6? Want to see how low maggy is going..

    Wendy
     
  14. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    at 7 she registered hi, at 1 plus she was 628; at 3 plus she was 480.
     
  15. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Ok cool. Tonite if you are up then get a +6... Otherwise you will want to get one in the next day or so to see how low she is dropping before you change dose. Maybe even a few spot checks mid cycle ie +4, +6 and +8...
     
  16. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    to recap once again w/ updated info

    1. Tiffy age 8, female, 6 lb
    1a. kill list pulled 5/3
    1b. 5/3 til 5/15 at vet with URI
    2.Prozinc 3U , BID, shots roughly 12 hours apart
    3. W/d dry food, switching to 1/2 w/d and 1/2 evo wet
    4. Alpahtrak 2 meter
    5. Starting dose of 2 U BID
    6. Dose lowered to 1U BID
    7. Dose raised to 2.5 U BID
    8. Dose raised to 3U BID
    9. Shot times about 6:30 - 7 am and pm. EDT

    6/5 AMPS 585
    PMPS HI
    +1 628
    +3 480

    appetite good, URI prone, advanced neuropathy - walking on hocks, unregulated, ravenous
    In my numbered list above, there are the dose raises, numbered 5-8. Would you please put a date associated with each of these dose changes. Thanks.

    When were these 500 level readings taken in relation to the time of the shot? In other words, did your vet increase the dose of insulin based on the pre-shot test numbers or a mid-day cycle reading?

    We express the test times in hours since the last insulin shot. A test 5 hours later is the +5 (5 hours have elapsed since you gave the shot). This gives all of us in different time zones an idea of when the tests are taken.

    Any update today on Tiffy?

    With the change to more low carb wet food, you may need to drop the insulin dose very, very quickly, like drop it in half. A change from that high carb food to a low carb food can drop the BG's 100 points. You do not want to deal with a hypo.
     
  17. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    Hi, at +5 last night she dropped to 281 and me and Martica (in note above) feed her 1/2 can due to rapid drops.
    @ +7 she raised to 448 ( didn't keep food in caged area)
    @ +10 she was 440
    at +12 she was 501. I admin'd 1 1/2 (I dropped her from 3 units to 1 and 1/2), I waited 1/2 hr and fed her.
    at + 1/2 she was 438
    I didn't leave food out for her
    I went to work
    When I got home @ +11 she was 512, I admin'd 1 1/2, and waited 1/2 hr, within in that time she had diarrhea and she threw up bile. Within 15 minutes I feed her 1 can with 1/2 cup of water. (she ate 3/4) .
    I typically add water to the food due to dehydration.
    +2 she was at 470
    +4 she was at 301, and I feed her a half can, she at almost all of it (again 1/2 cup of water)
    I mixed half can of evo and 1/2 can of wd together, but she still got diarrhea. I was trying to avoid that. So I am weening her off wd.
    she is much better. she is purring and grooming herself. she is wide-eyed and spunkier.
    It was advised to take her down to 1 unit tomorrow and completely get her off wd.
    I am worried about the rapid decreased in insulin and also the quick change in food. I kind of like gradual.
     
  18. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    You should look at Wink's SS in my signature. Look how fast he dropped from the higher yellow and pink numbers down into the blue and green numbers. I had just started the food change and his BG numbers headed down really, really fast.

    If I had known better, I would have cut his insulin dose in half instead of the tiny decreases I was doing.

    Yes, the high numbers are scary to most new members, until you know that the high numbers do slow damage over time. The low numbers, under 40 can kill quickly, in hours. That is why we say: "Better too high for a day, than too low for a minute."

    The gradual change over in the food is a good idea, because as you have seen, it can cause diarrhea. go slower on the food changeover if you want to.

    Has Tiffy had DKA? Has she had ketones? Do you test for ketones?

    You dropped the dose from 3 to 1.5 which is what I suggested with the food change. I do not see where you were advised to drop the dose to 1U.
     
  19. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    Hi, I know here personally, so it was over the phone. So anyway, she really advised to change the food right away, and so middle of night feeding, like 2 am ( didn't glucose her), I feed her Evo only with water 1 1/2 cans. This morning she was slightly high. 501 at 7:00 am. I waited an hour before I feed her to let the insulin kick in, at +1 she was 451, and I feed 1 can of Evo with a can of water added. She licked it down and is resting. I feel these numbers are too high. I will see how she defecates today and if all is okay, I will just make the switch.
    So I have her at 1.5 on the insulin down from 3 units. My friend said even drop her to 1 unit. It is just a lot of changing going on. She is much better!!!!!! She is off her Hocks. She is high on her toes. Ha!! I am so scared she went hypo on me from too much insulin. She bounced back, but I really don't want that to happen again.
    She is really skinny, so I am with the feedings midday and midnight. She is gaining more weight with the feedings. Again, I am concerned about these high number. In Nadir she is only at 281 and 333. I would love to see that like 180. I am going to test all day today and into the weekend.
    AND NO, I don't do ketones. Can you assist with that, please? And give input on the numbers and feedings nailbite_smile
     
  20. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    Well, listen, your cat is so much lower than mine. Tiffy is High and would be in the black zone as per ams and pms are always in the 5s
     
  21. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Please, any advice you get like that over the phone, needs to be put in the post. Otherwise, there is no way for us to know what is going on and properly advise you.

    If I talk to someone by PM, any advice I give is put in the post ASAP. I won't give dosing advice in a PM, only talk about food or personal stuff. We want to keep what is going on with your cat as public as much as possible. Whoever is advising you, if they are a member of this board, should post what she said to you here on the forum, a quick synopsis. That way, we know what is being said.

    One of the great things about this board is the peer review. We all have different experiences to share.
     
  22. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Yes, Wink is now much lower than the numbers you are getting. He is now diet controlled and does not need insulin for the time being. We are trying to get your cat Tiffy there too.

    If you look at Wink's spreadsheet, it only gives you a tiny slice of his diabetes journey. He was in a shelter for months in the high 600's, 500's 400's and it took 5 months to get him to where he could stop getting the insulin.

    That is my goal with Tiffy. Let's work together on that.
     
  23. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    The food change and the insulin changes take time to see the effects.

    The food may take a week or more to see any change. It may take two weeks. If you stay with the total changeover as your friend suggested to you over the phone, it will be faster, but there may be intestinal tract issues. It's a balancing act, to get your cat Tiffy eating better food without upsetting her tummy so that she vomits or has diarrhea.

    Prozinc insulin is a an in and out type insulin. Whenever dosing changes are made, it takes time to see the changes helping. We have people keep the same dose for a minimum of 3 days or 6 cycles, each cycle being 12 hours.

    Patience little grasshopper. This journey you have decided to take with Tiffy is a marathon, not a sprint. Take it slow and easy and things will improve. It took more than a month or two for the diabetes to develop. It will take time to improve it. These are hormones we are giving, not medicines that cure in a few days.

    Which EVO food are you feeding her?
     
  24. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Ketone testing is checking the urine with little test strips. You can buy urine ketone testing strips at the drugstore or pharmacy counter, 50 strips for about $10-12. They are checking for the presence of ketones in the body, which are produced when the muscle in the body is being broken down too quickly. You need to get a fresh sample of pee and dip the test strip in there for 15 seconds and then compare to the color chart on the vial.

    Do you think Tiffy would let you get close enough to her while she is in the litter box to either put the test strip directly in the urine stream or put a small clean shallow container under her bum?

    If not, I'll go find the urine catching tips and tricks.

    We suggest ketone testing any time your cat is in the higher numbers, over 300. Ketones can develop at lower numbers with a combination of not enough insulin, not enough food and an infection (could be hidden, think teeth). This combination can lead to ketone production which can then lead to Diabetic Ketoacidosis (DKA), a several day stay at the vets.

    As you test today, would you please post the numbers? I'll be watching out for you. The weather is rainy and yucky so I won't be outside playing in my gardens.
     
  25. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    You might want to add some plain canned pumpkin to Tiiffy's food to help with the diarrhea, about 1 teaspoon. Plain pumpkin, without any spices added to it, not the pie filling one. I freeze this in small portions in tiny ice cube trays, about 1 teaspoon portions. Pop out of the ice cube tray and pop them into a Ziploc. Had to give Wink a bit of pumpkin this morning to help with his diarrhea. The tiny portions thaw quickly, so I take one out of the fridge and let it thaw while I do some other morning chores.

    The pumpkin can help with diarrhea and with constipation in cats. No sugar in the plain pumpkin to raise the BG numbers.
     
  26. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    Hi, Deb, I appreciate this so much. Tiffy has had Diarrhea all day due to the food change, so tonight, I did more of the old food and less of the new, and in my experience that helps with the diarrhea. She is debilitated and I need to do the food change slow. The advice was: Change food, go to 1 unit, and feed midday and midnight, meaning in Nadir, which is putting weight on her, which she needs so much, and the nutrition is helping her hair come back. So sad!!!
    So I didn't want to do 1 unit and all the new food, but she insisted and I know she is right, but it is a big step, meaning 3 units to 1, so I did 1 1/2 and half and half on the food, but she insisted, so last night I brought her down to 1 unit, and still gave half and half, and she was okay with the diarrhea this morning, just one bowel movement, but midday, I did all new and she was streaming, so dinner I did half/half, and she hasn't gone yet. Yehhhh. I am uploading the log for you. She is better. Martica knows what she is talking about, but the cat was debilitated and I think was going to die at 3 units, so she helped Tiffy so much. I wish I could show you before and after pics. The food thing I need to take slow. I also admin'd 24 mls of water via syringe for the dehydration. look for the upload. it will be next.
     
  27. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    There are many different ways to manage the diabetes. You know your friend Martica better than us strangers on the internet.

    We are here to give you other options.

    Did you try the pumpkin for the diarrhea?

    I'll keep my eyes out for the upload.

    How are you doing? Stress levels through the roof?

    Remember to take a break to refresh and renew your spirit and energy. Give yourself a treat. I like a piece of Dove chocolate.
     
  28. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    I am having a problem uploading
     
  29. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    well here are the numbers:
    Fri, 6-7:
    ams -(7 am) 501 (1.5units)
    +1 - 451
    +5 - 250
    +6 -236 (feed her 1/2 evo)
    +8 - 441
    +9 - 467
    pms - 415 - 1 unit
    +3 - 405
    +5 - 338
    +8 - 444
    +11 - threw up
    (obviously plus 8 in 6-8, but I keep it with 6-7 because it is part of that shot)
    5:11 am threw up and had a little diarrhea
    6-8 (Saturday)
    ams (6 am) 472 (1/2 evo 1/2 old)
    +4 - 269 - freeze dried treat and all new food
    +6 - 386 (diarrhea - 12 mls of water via syringe)
    +9 - 410 (diarrhea - 12 mls of water via syringe)
    pms - (6 pm) - 433 (half old food/half new food 1unit)
    (no more diarrhea so far!!! :lol: :mrgreen:
     
  30. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    No more diarrhea, but the number at +4 on 6-8 was high due to old food. this is a double-edged sword! I am going to try to give as little of the old food as possible. it is so horrible. I don't how the vets could prescribe it for use in diabetic cats. it is not good.
     
  31. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    With some cats, you have to go at the cat's pace. Anything else causes problems. If that means slower food changes, then so be it.

    You may adjust by laddering - alternately changing food a little while holding insulin stable, then holding food stable while adjusting insulin, going back and forth between those 2 types of adjustment as needed for your cat.
     
  32. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    Hi, I had to put her back on 3/4WD and then a little more than 1/4 Evo, which the store ran out of, due to the diarrhea. I grab BG, until I can find another carrier of EVO, and that didn't help the diarrhea. Also I am not confident that changing the insulin level was the correct thing to do at this point with the diarrhea. The argument to change the units to 1 from 1 and 1/2, which we just dropped her down from 3 units, and she was doing much better, was because Martica felt she dropped too much in two hours, but she drops after her shot no matter what within two hours after her shot like that no matter what, so she drops a lot and then levels, and she feared hypo, but we had no proof of that because we never played out the 1 and 1/2 units. We fed her when she dropped even if the drop was 200 and she never dropped below that because we feed her. Now I think feeding her is great when she drops. It is and will put weight on her, but 200 is still high. And with the food she spikes back up to 400s and higher. Can I get some feedback on this. I like to feed her, she is skinny. Maybe a lesser amount of food. She suck down 2 cans a feeding this little girl. HELP!
    So summary, she is back on WD and Evo, back on 1 1/2 and doing better, not ravenous, and looks better, gets up and plays, not throwing up, and diarrhea ceased. Numbers are still high, but I left her with food after her breakfast because I am scared not to. Maybe less food than a can because she has a can for breakfast or am shot time. And she was high from the last two days on 1 unit, she automatically spiked.
     
  33. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
  34. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    ACTUALLY I HAVE A SPREADSHEET, but I can't upload it. I have tried several times. I contacted the admin to this site but no response. Can you guys help me with that. Tiff is a little high. I rock-n-rolled her too much between the food and the insulin. I did tell you guys she is back on 1 and 1/2 and I am going to hold that stable until she is on all good Evo food. She had a bad fight with my other cat, who is so sweet. she attacked him. I don't know what is going on.
    So if you guys can assist with the upload or let me have an all exclusive email addy to send to, that would help. I really need a little help. Was 680 tonight, but I gave her an afternoon meal, so I assume that spiked her. Her nadir was 310.
     
  35. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    The administrator of this site is quite ill.

    There are other people that can help you with your spreadsheet. Please check your PM (private messages). I'll try to help you with your spreadsheet setup.
     
  36. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    You asked me this offline, so I wanted to include it here so other people could see and comment.

    The Alphatrak 2 test strips are expensive. That is why most of us in the USA use the Relion Confirm/Micro glucometers or the Relion Prime from Walmart. A meter is around $14-16. Test strips for the Confirm/Micro are $0.36 each (0.3 micro liter blood drop). Test strips for the Prime are $0.18 each (larger 0.5micro liter blood drop). Much less expensive than the Alphatrak test strips. The Prime does require a slightly bigger blood drop. The lower cost of the strips may make that ok with you.

    If you put a little pressure on her ears after the poke, this helps to prevent bruising. 20-30 seconds should be enough pressure. Buy some triple antibiotic ointment with pain relief. the gel version, not the cream formula, that causes the blood to soak into the fur. Put a tiny dab on the ear after the poke and wipe off any excess. That will stop the sting of the poke and help to heal the ears. Be sure to wipe off any excess. You don't want her to clean her ears and face with her paw and get it in her eyes.

    If you are concerned with her going too low while you are away, you can leave out a little food. Yes, it may raise the BG's a little bit, especially until you can transition completely over to the lower carb food.

    "Better too high for a day than too low for a minute".
     
  37. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    Hi, thanks for your help, Deb, but I am frantic. She is very high, and the fact that she is throwing up with diarrhea scared me. I had the wrong code in the glucometer. I guess, just start from the 469 reading at +2. So right now her statis is:
    469 at +2, no diarrhea, solid bowel, but starving????? What should I do? She is killing me with the starvation, but she is too high to feed. I gave her a can of food :oops: :roll:
     
  38. Theresatramondo

    Theresatramondo Member

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    May 29, 2013
    Deb, I am going to stick with Alphatrak, too late. I didn't get the ketone strips. Will do tomorrow, any suggestion on the Brand? Please read prior message also
     
  39. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Glad we got your user id and password situation straightened out.

    Would you smell Tiffy's breath for me. Does it smell fruity, sickly sweet, like nail polish remover (acetone)? This is a sign of ketones.

    Has she had ketones before or did she have DKA?

    Any brand of ketone urine test strips are fine.

    The tricky part is catching them in the litter box to get a bit of urine. Here are some tips:https://docs.google.com/document/d/1quta5WLEjdO0Y_t2dAYSwN84h-LNZWxOdtVsJDKZ16A/pub

    When was the last time she vomited?
     
  40. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    If she is starving and losing weight, let her eat. However I would really prefer her to eat the evo instead of the w/d since her BG is pretty high and the w/d has way too many carbs.. But I understand your worry bout the diarrhea so maybe you can slowly transition out the w/d?

    Which evo is it? Innova evo cat and kitten is a low carb dry you could try.

    Wendy
     
  41. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    No, it doesn't smell sweet to me, but she is starving and being difficult. Deb, about a week ago, her urine or bowel movement smelled like chemical??? Is that the same????
     
  42. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    No, sounds like something different.

    The SS in your signature is a read only version. You will need to sign into google to access and update.

    I thought you were too busy to learn how until Monday night.

    You could always list a few numbers here if you want like this:

    6/15 AMPS xxx 1.5U +2 xxx PMPS xxx 1.5U +2 490
     
  43. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    I am busy, but I love her so much, I just want her better.
    I will post here. It is just I feel like I am screwing her up with the stupid things like not putting the right code in. I can't give her only Evo. She gets diarrhea and will continue to dehydrate.
    Tonight, at +3 she is 369, so she went down 100 points, but we don't have a baseline due to my stupidity.
    SHOULD I GIVE HER SOME FOOD?
     
  44. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Yes, give her some food.

    Until the insulin gets balanced better, she will be starving. Try not to feed past about +5.

    I do think we need to increase her insulin dose.

    ETA: I'm updating your SS for you as you give me numbers. Until you have some more time on Monday to learn about using the SS.

    Did you click on the words "Tiff'ys SS" in your post signature? Try that now and you will be able to read the SS only. No updating.
     
  45. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    oKAY, I JUST FED HER A LITTLE, LIKE 3 TABLESPOONS OF EVO 95 PERCENT PROTEIN AND 1 TEASPOON OF WD, SO AS TO NOT GET DIARRHEA. I ADDED WATER TO IT.
    AND DEB, TO ANSWER YOUR QUESTION ABOUT WHEN SHE HAD DIARRHEA LAST, IT WAS LIKE 3:00 PM TODAY, AND IT STARTED ON AND OFF YESTERDAY. BUT SHE IS SOLID NOW, SHE JUST HAD A BOWL MOVEMENT. nailbite_smile
     
  46. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    Tiffy's ss, using this in browser didn't pull anything up. I feel better, and I feel help is on the way. she just finished eating and is laying on the table next to me. she is happier now. omg, this is hell. all I did was pull her, and I am suffering because she is suffering, I can't imagine if it was one of my other two, darma or abyss.
     
  47. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Did you scroll down further in the spreadsheet? First page has dates only, not much data.

    Are you getting some kind of an access error message?

    p.s. Have you tried adding plain canned pumpkin to her food to help firm up the diarrhea? About 1 teaspoon should help. More if needed.

    Also, I think you want to increase the insulin dose. She's got room to drop and I think 2U might get her out of those blacks more.

    You also need to switch the food. Part of the swings and high numbers are undoubtedly due to the W/d. She probably has higher numbers when on the W/d. Don't know but if that is something you track, we could check the SS. I know you had some notes on the food and I did put those on the SS for you in the remarks column.
     
  48. Deb, I can read the SS but like you said, you have to scroll down to get to the lines with data in them.

    I also agree with your dosing suggestion on upping it to 2u. Until Tiffy can eat lower carb food without diarrhea happening, it's probably going to take more insulin to fight the carbs.

    I hadn't seen it mentioned but may have missed it, but where are the shots getting injected? Maybe a change in location might help? I'm thinking also that with the bouts of diarrhea, there may be some dehydration issues, and the insulin might not be getting absorbed well. Grasping at straws maybe...
     
  49. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    It has been rough, and I feel like an idiot because I can't see the sheet. I also can't upload Tiffy's pic. Oh, My.
    The other girl made me lower her from 3 units. Let me say this: She was up to 800 on 3 units, so I don't think the answer is in raising it. Let's give it another few days and see what happens, since she has been moving all over between the doctor, Martica, and you guys now wanting more insulin. I am mentioning the 800 because it doesn't make sense to be on 3 units and be 6 lbs and be 800. I even called Abbott labs to consult them with the glucometer. I am not even sure if the diarrhea is from the depletion of the WD. Could you guys think of any other reason why she would have diarrhea? I will get the pumpkin tomorrow. I have nothing in this house as I've been working on a case til 11 each night, starting at 9, waking up though at 6:30. So I am bushed. Plus when I get home, she'd break out of cage and get into the other cats' food. THAT MIGHT BE A BIG REASON WHY SHE'S ALL OVER. SHE DID THAT TWICE IN ONE week. I now have her in the bathroom while I am at work. My cats and her are not getting along well, so I had to re-separate them. Let's Give the separate and not getting into their food with 1 and 1/2 another week or at least until Wednesday. It has been rough with Her. She is a rough, tough outside cat that happens to be sweeter than Pecan Pie. :YMSIGH:
     
  50. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    If you PM me the picture I will shrink it for you and you can post it.

    In terms of dose, I would trust Carl and bob, he has a lot of experience as you can tell from his high number of posts and he knows your insulin very very well.

    It does take some tweaking to find the exact right dose on any insulin and the safest thing is to start low and work your way up which is why deb and Martica said to start at a lower dose.. And then the plan was to gradually raise it.. And she needs it raised because these blacks aren't good for her. But she might not need it raised that much for it to work so I would try 2 units and see how that goes.

    The high BG could also be upsetting her system and causing the diarrhea.

    You could try the food change etc for longer but definitely test her pee for ketones, you don't want her to get diabetic ketoacidosis which is very very serious and costly to treat. I would be testing her daily right now since she is so high.

    Wendy
     
  51. You know, I'm thinking some of these high numbers could be due to something as simple as stress. If you put yourself in her place....new home, new kitties, new bean. She's in a much better place and obviously in a loving environment, but she's got to be as confused as heck.

    Please remember, all we try to do is make suggestions. None of us are "experts". We just try to brainstorm ideas based on our own experiences and from the experiences we've witnessed here since we joined the board. This disease can be extremely overwhelming, confusing, and frustrating. All you can do is try to take it all in, but when it comes down to it, you need to do what your gut tells you is right. No matter what, the amazing people here are "here for you".

    Don't let this drive you mad. We all understand that feeling completely.

    Hugs,
    Carl
     
  52. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    okay, tiffy was panting before. I ordered vet solution renal k, which replaces potassium, but I needed a quick fix. I added 1/16 of salt to a syringe with water and gave her half. I ran, and I mean ran to health store and bought in pill form with no sugars, etc, potassium, in pill form, and I ground it up and mixed in with like 2 tablespoons of evo with more water, and I fed her it at plus 6, which she was high, 468. Not good, but she has been suffering
    I AM GOING TO TAKE BOB AND DEB'S ADVICE BY WEDNES WHICH WILL BE 9 DAYS THAT SHE WILL BE ON 1 AND 1/2 OF PROZINC. I TRUST YOU GUYS BUT ALL SHE'S BEEN GOING THRU IS CHANGING OF INSULIN AND SHE WAS DOING GREAT ON 1 AND 1/2 UNTIL THE FOOD CHANGE IN A SUDDEN SWEEP THAT IS WHEN ALL GOT SCREWED UP. SO I AM HOPING THE POTASSIUM WILL HELP HER.
     
  53. I'm trying to catch up....
    You said she was panting. That can indicate she's in pain of some sort. Does she seem to be in some kind of distress pain-wise?
    The potassium pills you bought. Can you tell us more, in terms of "dosage"? How many mg's or whatever was the tablet your crushed up?

    At +6 she was at 468? You gave 1.5u this morning? What was her BG at shot time?
     
  54. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    D*mn board ate my original post during site transfer.

    Lets first check that dehydration exists with 2 common clinical assessments
    - moderate to severe dehydration:
    Gently pull up the scruff and release. Does it snap right back down or remain pulled up ("tented"). If tented, then you have moderate to severe dehydration
    - mild dehydration or more
    Press your finger firmly on the gums and release.
    Do the gums pink right back up or stay pale? If they stay pale, you have mild dehydration or more.

    If neither of these clinical signs are present, let the body handle the electrolyte balance. As Carl noted, providing supplements in the absence of a veterinarian's diagnosis of need risks your cat's life.

    If you see positive signs of dehydration, I strongly encourage you to seek veterinary assistance.

    From the Merck Veterinary Manual Online:
    "Diarrhea

    Diarrhea can result from numerous GI diseases and can also occur secondary to disease outside the GI tract. Primary causes of GI disease are numerous and include adverse reaction to food, infections (bacterial, parasitic, fungal, and viral), inflammatory bowel disease, neoplasia, and toxin- or drug-induced."

    For right now, I would suggest focusing on 1 change at a time, and getting it stabilized before changing anything else. In this case, I would keep the food consistent in a manner that doesn't trigger diarrhea.

    When we have a diabetic cat with other health conditions, we dose the insulin around the health condition.
     
  55. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I saved some of the posts in this thread before the site transfer wiped them out. Here they are:

    Theresa said
    Reply

    Deb & Wink said
    Theresa said
    Deb & Wink said
    Theresa said
    I had cut and pasted the comment from her friend martica asked for the link and wanted to know if the 31 gauge syringes were ok. Deleted the rest. Up to Martica to post here if she wants.

    Deb & Wink said
    Theresa said
    Sorry, that was all I backed up for this post before the server change.
     
  56. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    This is difficult. I just posted a whole update and it kicked me off.
    Listen, I didn't get your update at that time. This is delayed.
    At PMshot time +12 420. So I gave her another potassium with 1/2 WD and a little more than 1/2 Evo with water.
    NOw, can you tell me if you got my update? The potassium is the same as Vet K. I just ordered Vet K off Amazon, but it won't be here for 5 days or so. A little background on Tiffy.
    Tiffy was abandoned and has been dehydrated since the day I got her. She was on IV for approx. 5 weeks. She had an URI and relapsed into it a week after I got her home. Her hair was matted and gross, now coming back to life.
    I did test her for dehydration. Her Scruff stuck together and and stood up. 3 hours after the salt and Potass pill, it subsided. Her Scruff is down flat now, and nicely flat, better than I've seen it in a long time. This might be something good. She even played stringy with me like a nut.
    What I will do is see how she is tomorrow morning dehydration wise, if she is good, I won't give the Potassium pill.
    I did boost her to 2 units via Bob/carl and Deb. I won't hurt her. She is basically high.
    She had a bowel movement and it was hard. So let's hope she gets on a better track now.
    I am segregating her for another 3-4 weeks and then will reintroduce her back to Darma and Abyss (my two utterly sweeter than sweet abbys.
    I hope you get this update. I don't see my prev updates her. Blek
     
  57. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    fyi, Carl/Bob, I use the red cap syringe and I admin'd 2 units tonight.
     
  58. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Yes, Theresa, I see this latest update.

    Sorry, but the server is being moved today. Still ongoing and posts after 2 PM CDT will be lost. Don't know how long they will continue to be lost. Will keep my eyes on Announcements forum.

    Expect to randomly get kicked off, posts to fail, posts to go missing, etc. until the move to the new server is complete. No announcement yet on when that will be complete.

    Sounds like the dehydration is better. Try to get more fluids in her. A lot of us add extra water to the food, 1-2 tablespoons.
     
  59. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    Yes, I do add water. Thanks for the update on server. I was wondering what was going on. I sent you sheets via email. I don't know if initially you got them all.
     
  60. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    update on Tiffy: she was 420 at +12, so her pm shot, at +4, she is 316, so she only dropped about 100 pts in 4 hours. I did just up her insulin to 2 units. Let's give it a couple of days. :?
    Deb is working with me to learn the spreadsheet you guys use and that will help, but I am sorry, I have worked all weekend, and then with what happened todoay, I freaked out and lost some hours, like 4 hours and it is delaying me learning the spreadsheet input.
     
  61. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    It is OK to free feed her and that may keep her glucose from having a severe food related spike after eating discrete meals.

    She cannot use all her food because she is not close to being regulated and needs as much as 50% more food, too.
     
  62. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    Hi, Does anybody have any feedback on Her growling and hissing all of a sudden when injecting her. I inject at base of neck, scruff. I am thinking neuralgia due to diabetes. Now, since I admin'd the potassium last night 2 doses, her scruff is tighter and laid down on the neck whereas before, you can lift and it would stand. Do you think that is why?
    I think I am going to inject while she is eating to avoid a conflict. She actually walked away when I had the needle in her. This cat lets me inject her without a problem. confused_cat
     
  63. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Deb will be keeping Tiffy's SS updated for now. I've offered to do this from the handwritten notes that Theresa scans and sends me in an email. I Told her I would do this because I want to see what is going on with Tiffy.

    BJM, do you think that free feeding is a good idea with the Prozinc, even after the mid-point of the cycle has been passed? I know with other people, we have advised the food be pulled up after mid-cycle so the cat does not continue to spike up after the insulin has been used up.

    So free feed, but pull up the food after mid-cycle was my thought.

    Growling and hissing may be because she is feeling better and is more feisty. You can inject the insulin in other areas of her body, along the sides, belly, etc.
     

    Attached Files:

  64. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Theresa, I got your handwritten notes via email last night. Exhausted and had to crash early. They are for 6/7 through 6/14.

    Even though the numbers may be off for those days when you did not have the correct code in the meter for the test strip change, they are still useful so have entered them and will put a note in the remarks saying they may be off and why.
     
  65. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    I don't think it Is that many days, Deb, I think I was off Friday morning, so June 14th or Thursday, the 13th, so, but anyway I messed up with forgetting to give her insulin with the feeding first - then admin insulin advice from Abbott, when she was vomiting. So she was way off.
    So pls just note it at the 13th on thru Saturday the 15th in the am I discovered it.
     
  66. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    And with regard to free feeding, I won't do after Nadir, or midpoint. But she spike today even with it being at +4. I don't like her the 400s so long. Will give you the numbers after pms.
     
  67. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Prozinc is a little more forgiving of the shot times. Ideally, it is best dosed on a 12/12 schedule. But there is flexibility in the shot time. I know you have to work long days sometimes.

    I've made the notes on the SS. If you see anything wrong, that needs correction, let me know.

    We put the actual shot time as the PMPS or AMPS test. That is why you will see some of those numbers that you took in the AM in the +11 column of the night before. Because you did not shoot until an hour or more later.

    I know that Tiffy has been vomiting, and that is why you have delayed the shot sometimes. You want to make sure she is going to keep the food down.

    If you are going to shoot more than about 30 minutes later than your pre-shot test, or forgot to give the shot, it is best to test again. Especially with the shot where you forgot and did not give the insulin until 2 hours later. There can be big changes in the BG numbers in 2 hours.
     
  68. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    Re: super high reading for +4 Tiffy

    hi deb, I did increase her dose as you suggested to 2 units. she is right now at 432 and I feel that is high and she has been high, but I think that is why I am getting panting. I can't get a ketone test, but will continue to try. she doesn't has that smell on her breath, and she has been actually fine, although I feel she is higher than usual. I made sure I got her insulin in her too.
    this is what I just sent to you, deb.
    Can anyone suggest something. it is going to be a long night. nailbite_smile
     
  69. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    Hi, Tiffy's BG is 432 at +3.5. I admin'd 12 mls of water via syringe hoping it would bring down BG. I will do another 12 mls at 10:45. any suggestions nailbite_smile nailbite_smile
     
  70. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Theresa, you just have to hold fast on those high BG numbers for now. Yes the high numbers are scary but they are not as dangerous as the low numbers.

    I get worried when the numbers drop below 50.

    For now, be patient and we need to give this new dose of 2U Prozinc time to see how well it works.

    Giving water will not lower the BG's. Only time will do that. What giving water will do is keep her hydrated. She is prone to dehydration so we want to make sure she does not get dehydrated again.

    Check for ketones in the urine if you can and smell her breath for that nail polish remover smell. You said she did not have a funny smell to her breath earlier.

    We have a saying here. "Better too high for a day than too low for a minute'.

    How is she doing with the diarrhea today? The notes you sent me did not indicate any diarrhea today.
     
  71. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    Tiffadilliac is 320 at 11:00 pm, +4.5. She dropped approx. 100 points with the admin of approx. 9 mls of water via syringe at 9:30 (my feeling is that water dilutes the glucose in the blood. At 11:00 I admin'd another 10 mls of water via syringe in an effort to drop her below 300 so she can be at rest and peaceful through the night. I will attempt to do another 9 mls after 11 news. I didn't pull Tiffadilliac so she can die in my hands. I pulled her so I can give her a better life and place to live in. Please know I love Tiffadilliac with all my heart. I believe she loves me so much, as much as a cat can love. She eye kisses me every night. Good night and peace to this board. you are helping me save this cat.
     
  72. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    She dropped about 100 points after the passage of 1 hour.

    What I am seeing is the insulin taking effect and bringing her numbers down. I do not think the water has anything to do with the lower BG numbers. It will not hurt to give her water as that will keep her hydrated.

    It is very likely that Tiffy is bouncing higher off that 257 low she had this morning at +4.5. We have to be patient and give the bounce time to clear.

    Her body is not used to those lower numbers and panics, Mr Liver panics and pumps out glycogen and counter regulatory hormones to bring the BG numbers higher to what her body has been accustomed to.

    It is going to take time to stop her liver from panicking and get used to those lower numbers.

    What is your favorite color?
     
  73. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    It takes a while to get the diabetes under control. You have to be patient. I think Deb may have some patience pants for you - what color would you like?

    You are working gradually towards an insulin dose that you can give safely every 12 hours, that does not go lower than 50 mg/dL at any time, and as much as possible, keeps the glucose level under the renal threshold. Dpending on the cat, and the data source cited, the renal thresholdis anywhere from 180 mg/dL to 280 mg/dL, and may affected by any underlying medical conditions such as renal disease.

    If she is actually dehydrated, please talk with your vet about subcutaneous fluids. Oral syringing of water may be unable to keepup with what she needs. Please do not administer salts as that may make dehydration worse.

    Lets check your shot technique:
    Are you gently pulling up a tent of fur?
    Is she eating when you shoot? That helps distract from the injection.
    Are you sliding the needle into the triangular area that has been pulled up, with the needle bevel upwards?
    Are you holding the syringe almost parallel with her body when you slide it in? If you point the syringe downward, you may inject into muscle which is more painful.
     
  74. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    Hey, Deb, BJM. I am sure I hit muscle a few times. I am shooting her while she eats and I am picking up a tent and hold the needle on a angle though parrell with her body, in other words, not straight up and I am getting it in.
    Now This Morning at about 5 she vomited just about a the diameter of a peach of clear fluid. I feel she does that when she is high or low. Now high, she throws up everything, poor baby, and gets diarrhea, I think that is what all the throwing up is, Deb. Diarrhea could be both that and the quick change. However she is almost weened off WD.
    Now at 6:15 (+12) 243 (lowest I've seen her in all my time with her) Thanks Deb. I fed her 1 1/4 can of food 1/4 wd, 1 can evo with water
    I gave her 2 units.
    Now at 9:20 (+3) (before I left for work), she was 221. Okay. I feared hypo. Should I? I didn't want to leave her all day. So I left a half can of food, a sliver of wd and mostly Evo.
    I got home early - 3:30 (+9) - 465 (not what I wanted to see). Should I not give her that afternoon food? I didn't feed her last night, and look at the figures. But I think she may have gone low, and that is what the throw up was about at 5:00? Any feedback on this? The food midday, the hypo?
    6:30 (+12) 444, I fed her 1 1/2 can with water and fresh grilled chix, no oil just on forman's grill, just a little treat. Goobled it up. :lol:
    Doing much better though. Deb, let me know if you want to do the learning thing this weekend. I sent you a note. My jobs cancelled and I can do it.
     
  75. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Low? She really hasn't been low. We want to see some blues and greens. Nice not to have seen black for a few days.
     
  76. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    parallel, but you know what I mean, sorry about the spelling. I hate typing, I do it all day long. I hate writing, I write all day long. So bear with my style.
     
  77. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    Maybe I shouldn't feed her midday. I was afraid of hypo, but I guess, it won't happen at those numbers, right?
     
  78. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    You are feeding low carb so you can feed as often you like. I free feed my cats and they graze all day to keep the blood stable. Sme people feed mini meals. It's up to you. Over time we might discover a better feeding pattern for you but for now I would feed at least twice a day... After each shot.
     
  79. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    Tiffy, is not dropping tonight much after the pm shot
    +12 - 444
    +3.5 - 395
    +5.5 = 390
    Is there anything I can do cat ohmygod_smile
     
  80. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    She doesn't seem dehydrated, her scruff isn't bad at all. The potassium helped. Maybe I will bring her to vet tomorrow just for a peace of mind check up. I think she has allergies, number 1. She sneezes consecutively. I think there is slight anxiety being in a new household with the other cats, even though they are good cats. Tiffy seems like she struggled out there and at times I see a scared cat. Oh, boy, I saw that tonight when she was in her cage and frantic trying to get out. I usually don't let her sleep out because she ninja attacks the other cats. but I just Bg'd her and let her out. She is resting, and she was panting again. Maybe anxiety. Look at the above note and please tell me what to do, if anything,
    and I like Blue. the color blue, or purple. :sad:
     
  81. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    I think a vet check is a good idea. If she has allergies or a respiratory infection, she may need treatment to help her breathing.

    Note: if said treatment involves steroids, you adjust the insulin around that, even if it means taking the insulin dose higher.
     
  82. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    She has been really High from midday yesterday. Not midday feeding her. Maybe Just water. The potassium brought her down.
    6-18 +5.5 -390, that is high
    6-19 - 3 am. threw up (I think I am right, when she is high, she throws up)
    +12 630 admin 1 and 1/2 cans of food 1/4 wd and the rest evo with water - admin'd 2 units
    +4.5 - 354, down 300 points.
    I don't like these numbers. Why is my ninja so High.
    I am not going to midday feed. Do you guys agree?
     
  83. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Would you PLEASE take your cat to the vet?

    She may be vomiting due to any number of things and the more you delay, the worse she can get.
     
  84. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    she was thoroughly check out. She was at the vet from 5-3 thru 5-15 and then 5-21 thru 5-28. He knows she throws up. It happened more recently with the sudden change in the food. I really think it is because she is high, and I am not an idiot. I have to other cats. It is the regulating the insulin that is the problem. I will bring her in for her monthly checkup, and I will do it earlier rather than later. Her insulin has been all over the place. That can do it. She started at 1 and then a week later 1 and 1/2 and then 2 and 2 and 1/2 and then 3. Then Martica said no, do 1 and I said I am not doing from 3 to 1. So I did 1 1/2. Now you guys said raise it. This all in 2 weeks. That can make me throw up and have diarrhea. Not to mention the spikes. If I bring her in, he is going to call you people amateur. And he is going to yell at me for taking her down from 3 to 1 1/2. Now while I think 3 is too much, I think there is a tweaking. So since she has been thoroughly checked out I am not fearing too much, but keeping in mind anything is possible because she was categorized as a "stray."
    Please help with the dosing. I monitor her better than most.
     
  85. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    another thing, all diabetic cats suffer dehydration, a fact. they need 10-20 mls per kg of body weight. Tiffy is well over that. I syringe her. And hit with potassium tabs which will prevent kidney failure or kidney diseasing from the diabetes. I will ask the vet about that. I will be seeing him by Monday. I want her to settle into the 2 units and get some days under her belt with 2 units My feeling is she needs at least 2 1/2, but time will tell. She does not have diarrhea and is adjusting to the Evo. However...
     
  86. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Theresa,

    I got your new email with the latest SS numbers for Tiffy.

    I do not have time to update her SS tonight. Will try for Thursday morning. I'm fried and need some sleep before my gang start their 5am wakeup calls. Then it proceeds to walking all over me and trampling on top of me.

    I do think the dose for Tiffy could go up a bit. You have some room to drop from those 200's you are getting.. Need to look more at the SS and do the updates.

    Let's stay at the 2U for tomorrow am, Maybe increase to 2.25U for pm dose. Not sure yet.
     
  87. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Hi Theresa,

    Got Tiffy's SS updated for you this morning. I'm ready for your training session on Sunday at 6PM. Time to teach you how to update the SS yourself.

    There are a couple of notes on the SS that concern me.

    1. On 6/19 PM. You thought you did a fur shot. You guessed how much went into Tiffy and then gave an additional 1U. Please, Please, Please never do that again. There is no good way to tell how much insulin actually got into Tiffy with a suspected fur shot. Giving additional insulin when that happens, is not recommended because the 'guesstimate' can be way off and the BG's can drop too low, resulting in a hypo. Hypos can kill quickly if not managed with food and simple sugar. What if you had done this in the morning and then gone off to work? People have come home to find their cats dazed and confused, like the cat had seizures while they were away. We want to keep Tiffy safe because we know how much you love her.

    I know you thought you were doing the right thing by giving more insulin but it could have resulted in a hypo. Yes, those high numbers are scary, but remember one of our sayings "Better too high for a day, than too low for a minute". High numbers do damage over the long term. They are not immediately as concerning as the low numbers which can kill quickly.

    2. Giving water does not dilute the blood enough to bring down the BG numbers. Let me explain how the insulin works so you can understand why I say the lower BG's you are seeing and the water you are syringing are a coincidence.

    You inject the insulin under the skin. The blood vessels in that area slowly absorb the insulin. You feed and the body starts to process the food, so you see a rise in the BG numbers, what we call a food spike in about 30 minutes to an hour. The insulin takes an hour or two to start taking affect to moderate the food intake and help to process the food and bring down the BG numbers. A little more time passes and the insulin has more of an effect. You see the BG numbers dropping. Maximum affect of the insulin is usually somewhere around the middle of the cycle, sometimes earlier, sometimes later. Cats on Prozinc often have an earlier nadir (low point, peak) for the first month or two and the insulin does not seem to last the full 12 hour cycle. After, the low point or nadir, the BG number starts to rise again as the insulin has been used up trying to process all that food. The numbers keep getting higher, and a bit higher still after the nadir is passed, at the end of the cycle.

    Tiffy's body has also become used to those higher numbers as being the new normal. It takes time for the cells in the pancreas to heal and regenerate. It takes time for her body to become adjusted to those lower BG numbers and not panic. When her body 'sees' those low numbers in the 200's, it panics. Mr. Liver as we call him, panics and pumps out sugars and counter regulatory hormones to bring those BG's back into line with what the body has become adjusted to.

    We call this steep rise a "bounce". She will bounce until she doesn't anymore. Cats can take up to 72 hours to clear the bounce. You have to be patient here and let things settle a bit.

    Here is a definition of a "Bounce" written by someone else.

    Feeding a large quantity of food after the insulin has been all used up will simply cause the BG's to rise higher.

    I'd like to see you trying to spread out the food intake. Feeding all that food at one time can cause the BG numbers to be higher and more uneven. Spreading out the food into more mini-meals would help Tiffy.

    What is Tiffy's weight right now and how much should she weigh? Do you have a bathroom scale you could step on, holding Tiffy then let her down and weigh only you. Subtract to get Tiffy's weight.

    We may want to rethink how much food you are feeding her.

    By the way, Are you syringing the water by mouth? or sub-Q?
     
  88. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    As non-vets, we have to be careful about doing things at home which might actually aggravate or initiate problems. When repeated efforts to deal with something like diarrhea or dehydration don't seem to be resolving, consulting with a vet is the responsible thing to do. The dehydration had me particularly concerned as it could lead to other problems which might result in the cat's death. Yes, I'm a bit paranoid about things - I've lost cats because I didn't go to the vet soon enough.
     
  89. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    THIS SITE IS KILLING ME, I JUST POSTED AND IT ATE IT.
    HERE I go again. this is important so read on.
    I JUST GOT BACK FROM THE VET. She gained 2 and 1/2 pounds since I've had her in two weeks. That is good. She was severely underweight. I have also read your posts and will respond back to them in with the update.
    The food was the biggest problem with the diarrhea and the vomiting. He suggested just keeping her on Wd and Evo until she can fully ween off. Now the further vomiting was -- he believes -- due to the raw medallions I was feeding her and raw kibble. Some cats don't do well with raw. Martica thought it would be a good afternoon meal because it is all protein, and she is right, but not for Tiffy. He wanted her pulled off of the raw. In fact, I gave her a medallion this morning and by 1 she was vomiting, and when I give her the kibble, she somehow vomits that up too. So No raw for Tiffy. He agrees with Deb, I can feed, but was before +5. Deb, I love you. YOu are right on. I think she is getting way too much food in the breakfast meal. And I believe that adds to her vomiting. She is like sucking down 2 cans all at once including the medallion. So I am going to do one can, and a very small midafternoon snack. Think about it when you eat too much. Now, she has gained a significant amount of weight in 2 weeks, so we are right on track and I can scale back safely. Now, I did just feed her, but she did throw up this morning, and it is late, but I will focus on that the rest of the time forward. Tiffy and I have had it rough with all the changes.
    Hydrations: she is still mildly dehydrated, but most diabetics are. I am giving her enough water, and time will tell, but since she was throwing up so much and with the diarrhea, all the water I've been giving her is coming out.
    POTASSIUM - Potassium in pill form is right on spot, and will save them from getting further dehydrated. YOu can never overdose them on oral potassium. It can only help. The fluid potassium is what needs monitoring. :D
    so that can help you with advice to others who have issues.

    THE PANTING - CARL - IS NOT GOOD. HE DID SEVERAL TESTS. URINALYSIS, BLOODS. Thanks for the push, and BKJ (I think those are initials) Thanks for the Push. diabetic cats can develop heart issues and I need to monitor her tonight and tomorrow, and bring her back if it continues. He didn't like it. Neither did I.
    Okay, so where are we? I'd appreciate your help in raising her insulin if need be.
    let's see where we are next week.
    Deb, thanks a trillion over.
    Thanks BKJ??????
    Thanks Carl.
    She is getting better with the insulin, but the numbers are high, so please keep check and giving me feedback.
     
  90. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Glad you took her to the vet.

    You'll see if the raw food was the culprit in a couple of days not giving it; let's hope its that easy!!!!

    If some of the vomiting was scarf 'n' barf behavior, it can help to spread the food thinly across a large platter, freeze part of it to be nibbled as it thaws, or to use a timed feeder.

    Glad to know the oral meds won't be absorbed if not needed; I needed a vet to confirm that, because messing up the electrolytes in the body can cause all kinds of potentially lethal problems.

    We'll pray that the panting is nothing major, but if necessary, there are heart and blood pressure meds that may be given to help reduce the load on the heart. If the panting turns out to be allergy/asthma related, there are some specific meds for that too. You may wind up adjusting the insulin around treatments for other conditions. Thats OK.

    (Its BJM)
     
  91. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    So glad to hear you got to the vet with Tiffy and got some feedback from the vet. We know a lot of stuff but it's hard to know what is going on from a distance without seeing her. Glad you were able to take her in and get some questions answered.

    Sounds like a plan in place to change the food up a bit. No more raw for now. Only the little bit of W/d and the EVO. :smile:

    I wanted to clarify what your vet said about the +5. Was that no feeding food after +5? Is that correct? :?:

    Yeah on the weight gain. She is up to what now, about 8 - 8.5 pounds? :?: Much better than that undernourished poor condition 6 pounds she was earlier when you first got her.

    All good news so far.

    What I was thinking on feeding Tiffy, was to split that morning meal into two portions also. :idea: Give one right after you have given her the AMPS test. Give her the insulin. Wait an hour or so, and then feed her some more, before you go to work. Would that work with your schedule? :?:

    There is a balance we need to achieve between giving her enough food so she does not loose more weight, but not so much that she does not have enough insulin to process all that food.

    Please tell me specifically which EVO Tiffy is eating :?: , I'll go find out the calorie content on that and try to come up with a food plan as to how much she should be eating. Did the vet say what her ideal weight was? :?:

    The first couple of weeks with a diabetic cat are the absolute hardest. It gets a little easier as time goes on and you learn more. You have been doing fantastic struggling with all her issues. Hang in there. We will get you and Tiffy to where you need to be.

    Do you mix any water directly in with the food? :?: I do this with my cats, until it is like thick applesauce or a bit thinner. About 1-2 tablespoons mixed in with the wet food, say 1 T for each 2 ounces of food.

    Good to know the oral potassium is ok. I know BJM ,our resident epidemiologist, was worried.

    I think Tiffy is bouncing right now. I want to hold the dose but would love Carl and BJM to chime in here too. Maybe they see something I don't.

    Still don't like that panting either. Keep an eye on her.
     
  92. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    Oh, forgot to tell you, the triple and quadruple sneezing, which I thought was an allergy, is a relapse into the URI. He said she had a really serious shelter URI. So we had a 104 temperature too, and that may be why she is throwing up too, coupled with stress of the other cats, and all, poor little girly, We are back on antibiotics, now Erythro 1 ml in am for 6 days and then 1 ml every other day for 8 more days. that may be the panting, she can't breathe well. They released her without an URI. She came home with pills, and they finished, but she continued the 3 and 4 sneezes thru the whole course of antibiotics, and my other cats aren't sick. Wow. may I say that this is the four series of meds. let's hope the breathing is URI AND LETS hope they find the right antibiotic fast. She was in the shelter on Baytril, released to vet on iv antibiotics, home on antibiotics, back to vet 5 days on anti, home for 5 days on anti, now 2 weeks later again. This URL SUCKS. :shock:

    deb, tiffy is 8 and 1/2 lbs. she is on evo 95 percent protein. the best one out there. let me know what you guys come up with. let me know if I forgot something, just hit me back, I am shot, going to feed them and take a jog which I need between all the puke and running to vet, pet stores, etc. pet burnout syndrome
     
  93. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    I've heard from a rescue friend that some infections are becoming resistant and it is taking month long courses of antibiotics like azithromycin to clear them!

    Keep in mind shelter animals are stressed, so the immune system is less effective then.
     
  94. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    I know, plus the stress of my cats probably isn't helping either. My other cat may be coming down with it. I can't tell if she is just irritated or becoming ill.
     
  95. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    They've all been exposed, so if you get the current weights for them, maybe your vet will not require you to bring in each one for a visit if sick.
     
  96. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    8.5 pounds * 15 calories per pound = 127.5 calories + 70 calories = 197.5 Roughly 200 calories a day to maintain her weight.

    Up to 50% extra for uncontrolled diabetes = 300 calories per day.

    EVO 95% foods are all around 200 -218 calories a can

    So roughly 1.5 cans per day of EVO to meet the 300 calories she needs.

    Proposed feeding guide
    1. AMPS 1/2 can
    2. before you go to work 1/4 can
    3. PMPS 1/2 can
    4. before you go to bed 1/4 can
    For a total of 1.5 cans, 8.25 ounces of food a day.

    She probably won't like the reduction in food. Especially since she is getting anywhere from 2 to 4 cans of food a day now. Too much food can cause the numbers to be high also, because there is simply not enough insulin to process all that food.

    Push back if you do not think this food plan will work and give me your ideas. Does she need to gain more weight? Did the vet say anything about that?
     
  97. I don't see bouncing, Deb. To me, the last cycle that looks like it could possibly be a bounce is 6/17 AM. In my personal experience with Bob, he did bounce, but it took very little time to clear them. Like less than 2 cycles. But I didn't dose like most people either. I changed his dose nearly every shot. He was on a sliding scale the whole time he was on insulin.

    Tiffy has all sorts of things going on that could be contributing to the high numbers. The infection for sure could be. Stress too. I'm not saying the dose needs to be increased however. Not sure on that.

    There are a couple of things I am not sure of. If the vet said that oral potassium can't cause potassium levels to go too high, I'll have to accept that I suppose. I just don't understand "why". I gave potassium via sub-q fluids, and Bob had to be closely monitored to make sure his levels didn't go too high.

    I also have not heard that "all diabetic cats are dehydrated" before either. And I can't say that I think that's right. Bob was at first, but he was also DKA at the time. Cats who eat canned food shouldn't be dehydrated unless there's something else going on besides just diabetes. Dry food I can understand, and that's why so many cats that eat dry also drink a lot out of the waterbowl. Bob is no longer "diabetic" (although he will always be one) in terms of numbers, and eats only canned food. He never drinks water. If I see him drinking out of the water bowl, it freaks me out actually. I might see that once a month maybe?

    One word of caution. If you're going to cut back on food, you will most likely need to cut back on insulin at some point, so it will mean closely watching the numbers to see what sort of impact less food has.
     
  98. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Infection often raises glucose levels, so maybe the next round of antibiotics will help bring here down.

    I note on your spreadsheet you believe you shot through the skin, so you gave another unit. We call this a fur shot. We advise you not shoot more insulin as there is no way to measure how much might have gone in and this could result in an overdose. She's been running high enough that you were OK; however if you were in more controlled numbers, that could be disastrous. Just keep that in mind for future reference.
     
  99. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    Something happened weird with the glucometer tonight. I had to do 3 readings. I am going to send the sheets to Deb to update. But let me sum up.
    pmps 6:30 +12 742, I felt that was really high, so I tested again and guess what I got
    6:32 - 519, thought that was strange, so I tested with test substance and it was in range.
    Now at the first test I started feeding her, it is all within 5 minutes bear in mind.
    6:35 (third test) - 654? Any feedback on that one. When I called Abbott they said can be 70 to 80 points higher. He said take the last test. Freaky. I am uncomfortable with that.

    Deb, She will freak out if I feed her half a can. And yes, she does need to put on like 2 more pounds. Tonight I gave a can and a quarter. I didn't feed midday though. I am emailing you the sheets in a few, check out these numbers. Hard to gauge due to the URI.

    CARL: Oral Potassium is what you cant overdose on. Subcut you need to carefully monitor as you can easily overdose.

    BJK (I hate initials;hard to remember) My vet feels Tiffy should be on at least 3 units, and thus if I hit her with 3 units it won't her (by reshooting her). How do you like that one? Although the tech doesn't like reshoots. I won't do it. It is just I am careful with her and can gauge. He thinks she is under insulin. His numbers were lower than mine too by the way, when she is in the hospital, but then again, she is on antibiotics and subcut there. She is in the 200 at the hospital on 2 and 1/2, but she started out at 1 and then I have to say somewhere it was off for it to go up.

    Can you guys tell me the glucometer you use, I hear it is like 25 dollars? Can I order it online? I just want to see it.

    Also, what do you guys do with the needles? do you throw them away. I have been saving them. Help

    Tiffadil is doing better today with the URI. she still wants to attack my cats, so I keep her caged. I hate to do it, but no choice. I can't have that. She is really just territorial and is a street cat. Sweet, but nonetheless. She doesn't like them near me either. :cry:
     
  100. Theresatramondo

    Theresatramondo Member

    Joined:
    May 29, 2013
    Something happened weird with the glucometer tonight. I had to do 3 readings. I am going to send the sheets to Deb to update. But let me sum up.
    pmps 6:30 +12 742, I felt that was really high, so I tested again and guess what I got
    6:32 - 519, thought that was strange, so I tested with test substance and it was in range.
    Now at the first test I started feeding her, it is all within 5 minutes bear in mind.
    6:35 (third test) - 654? Any feedback on that one. When I called Abbott they said can be 70 to 80 points higher. He said take the last test. Freaky. I am uncomfortable with that.

    Deb, She will freak out if I feed her half a can. And yes, she does need to put on like 2 more pounds. Tonight I gave a can and a quarter. I didn't feed midday though. I am emailing you the sheets in a few, check out these numbers. Hard to gauge due to the URI.

    CARL: Oral Potassium is what you cant overdose on. Subcut you need to carefully monitor as you can easily overdose.

    BJK (I hate initials;hard to remember) My vet feels Tiffy should be on at least 3 units, and thus if I hit her with 3 units it won't hurt her (by reshooting her). How do you like that one? Although the tech doesn't like reshoots. I won't do it anymore. It is just I am careful with her and can gauge. He thinks she is under insulin. His numbers were lower than mine too by the way, when she is in the hospital, but then again, she is on antibiotics and subcut there. She is in the 200 at the hospital on 2 and 1/2, but she started out at 1 and then I have to say somewhere it was off for it to go up.

    Can you guys tell me the glucometer you use, I hear it is like 25 dollars? Can I order it online? I just want to see it.

    Also, what do you guys do with the needles? do you throw them away. I have been saving them. Help

    Tiffadil is doing better today with the URI. she still wants to attack my cats, so I keep her caged. I hate to do it, but no choice. I can't have that. She is really just territorial and is a street cat. Sweet, but nonetheless. She doesn't like them near me either. :cry:
     

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