? Need Vetsulin Dosing Advice / New Diabetic Cat

Hello.
New here. A member suggested I post here. Here's a quick summary of my situation. I have 1 cat (Exxon inside only 3.5yrs old) and 1 small dog (Bailey inside/outside 4yrs old). About 3 months ago I found a kitten in the woods behind my house (Lola now a inside only cat). About a 3 weeks ago she was having a lot of dirahea and got dehydrated. She was at vet hospital for 3 days. When she came back she was sneezing. About a day or two later Exxon started sneezing. On Friday Sept 25 we took both of them to the vet. Vet said Lola probably caught a bug while she was there at the hospital and then gave it to Exxon. Vet gave Exxon an antibiotic shot & Lola anitbioitcs to take by mouth for 10 days.

Friday the 25th night and Saturday the 26th morning Exxon got way worse. I was scared, called the emergency number and paid the vet the emergency fee to see him. There was a lot of what I would call drool constantly running from his mouth and nose. He kept opening and closing his mouth like he couldn't breath. Wouldn't eat, etc. The vet said it looked to her like he was having an allergic reaction. I said could it be to the antibiotic shot he was given yesterday? She said it was a general antibiotic and they had never seen and allergic reaction from it before. She gave Exxon a steroid shot, said his breathing was fine, and sent us home. He got worse on Sunday night I was afraid he was going to be dead when I woke up Monday morning.

I called off work Monday morning and too him back to the vet. She said, yes he is definitely worse and dehydrated. He needs to stay here and be on an IV. Exxon was in the hospital from Monday Sept 28 to Monday Oct 5. He was on antibiotics the entire time. During that time they told me he has Diabetes. They said his levels were over 400. Of course I started freaking out. He's normal weight (maybe a little under weight at times) and only 3.5 years old.

I picked Exxon up on Monday Oct 5 and the vet sells me Hills dry and canned food. (Which I have discovered since then is garbage! Lol..) The Vet recommended and sold me VETSULIN (procine insulin zinc suspension) U-40 10ml vial. Draw back to 4 and half on the syringe and dispense twice daily. She said when his level was over 400 they gave him a unit every couple of hours and it took that many to get it down. I asked about Home Testing? I told her I did some research and saw the ear thing online and she said that was the first she had heard of that? -frown-. She said I don't have to home test and set up an appointment for Exxon to come back in Thursday morning to get his levels tested. Basically all she told me was to do the shot twice a day, 12 hours apart, and make sure he eats something first. She also showed me how to give the shot of course. Oh and she also said if he acts woosy, lethargic, and unresponsive that means his sugar is low and to rub some syrup on his gums.

So being very scared, I made sure he ate first and gave him a shot Monday night and Tuesday morning of 4.5 Vetsulin. I later discovered from the GREAT people on here that replied to my introduction section post that I should always Test before I give a shot. Because of their Kind Support I ran out last night and purchased the Reli On Confirm Meter.

I tested Exxon last night at 10:48pm and the result from the meter was 76 mg/dl. I was told by the members this too low and not to give Exxon his shot. (My understanding so far is that it needs to be 200 or above on the Reli On Confrim Meter in order to shoot? Is this correct?)

I tested this morning at 7:20am. I used 3 different strips this time with the Reli On Confirm Meter and this is what I got: 1st read: 67mg/dl 2nd read: 84mg/dl 3rd read:61mg/dl. Once again members said this is too low and not to shoot. I went ahead and fed him and came to work.

I will retest tonight to see what I come up with. Could this mean he is not diabetic if I keep getting these kind of number? He is still sick and looks a little rough.

Thank you So Much for taking the time to read this long post. And I would like to publicly thank: Woodsywife, Sharon 14, Bobbie and Bubba, Squalliesmom, Robin&BB, & Nora !!!!!!

 

Love these latest photos of Exxon, Steve! You are so very welcome; we're all just so happy you ran out & got that meter last night!!! (Wish you could see my Happy Dance!)

It's certainly not outside the realm of possibility; has happened before. Here's one possibility: While Exxon was so sick, the infection spiked his BG#s; also could have been raised some, too, due to stress of being in the vet hospital. Could be that all that insulin given at the vet hosp. really kicked his pancreas into high gear ... we will see what happens over the next few days; perhaps he won't be needing any more insulin - time will tell. (All fingers, toes & paws crossed out here!)

This really concerns me: Can you check and find out if the antibiotic shot they gave was Convenia? As there have, indeed, been some serious adverse reactions to that particular antibiotic; but sounds like Exxon is doing better now - just keep an eye on him in that regard, ok? "They had never seen an allergic reaction from it before." Sheesh! Doesn't mean it's never happened just because they hadn't seen one; sounds to me like now they have, huh?

 

It is not uncommon for a steroid, either oral or a shot to cause transient diabetes. That seem to be Exxon's case.
Yes keep testing before normal shot time.
WHen yo say you gave 4,5 units of Vetsulin, did the syringe have a red needle cap?
I ask since Vetsulin is a U40 insulin (40 units per ml) while human syringes are for U100 insulin (10 units per ml).

 

@Larry and Kitties - Excellent point, Larry!

On the "Welcome" thread, I recall Steve said that vet sent him home with instructions for 4.5U, a bottle of Vetsulin & U40 syringes.

 

Yes, my understanding is they are U40 syringes and they do have a red cap.

That would be AWESOME!

Yes, I will call the vet. He was only sneezing when I took him and Lola to the vet that Friday evening. He actually seemed to get worse after the shot but of course that could have just been a progression of his illness. But the drooling and constant opening and closing of the mouth didn't start until after the shot. I will post the name of it as soon as I get it. Thanks!

 

Yes, will be good to know which drug it was, as those symptoms can be a hallmark of anaphylaxis, an acute allergic reaction. So was VERY good that you took Exxon to the ER when you did.

 

My thoughts exactly, @Robin&BB! As I was reading this I positively got a chill when Steve mentioned the antibiotic.

Amen to that!

Steve, there is a long-acting, broad spectrum antibiotic called Convenia that a lot of vets have started using in the past few years. It seems that a lot of cats may have bad reactions to it, some being quite severe. It would be good to find out if this is what she gave him. And just as a heads-up, I would strongly suggest requesting, in the future, that your vet NOT give Convenia. There are many good, safer antibiotics that can be used in it's place! My Squallie got Convenia twice in a row, in about two month's time, and I am very lucky he didn't have any sort of reaction; I learned to always ask what shots they are giving my cats, before they administer them.

 

Just got off the phone with the receptionist at the Vet.

Friday sept 25th Exxon was given a shot of "Ding Ding Ding" Covenia.

Saturday he was given a Steroid shot of: Dexamethazone.

While he was hospitalized he was given via IV antibiotic: Cefazoline

 

You are so very welcome Steve, I am so happy this had a happy ending!

 

Bingo, it was the perfect storm!! And now the sun is shining!!!

 

Whew, that's three times, now! If you hadn't acted quickly in getting him to the emergency vet... Exxon is so much luckier than he will ever know! Wow! Hugs to you for being Exxon's life-saver!

 

Perfect storm, INDEED! Thank God for your fast action in taking Exxon to the ER, Steve! You, sir, saved Exxon's life the very next night.

 

You are batting a home run Steve in saves, once when you rescued him from the gas station, again to get him to the ER when he had the allergic reaction to the convenia and last night by trusting what we were saying to you and getting the meter so you could see that your cat did not need insulin at that time.

 

What appears below I pasted in from Dr. Lisa Pierson's website catinfo.org (interesting that the drug manufacturer only refers to "foreign market experience," isn't it???):

Note what is stated on the Convenia's drug insert. (The bold text is my doing.)

Anaphylaxis has been reported with the use of this product in foreign market experience. If an allergic reaction or anaphylaxis occurs, CONVENIA should not be administered again and appropriate therapy should be instituted. Anaphylaxis may require treatment with epinephrine and other emergency measures, including oxygen, intravenous fluids, intravenous antihistamine, corticosteroids, and airway management, as clinically indicated.

Adverse reactions may require prolonged treatment due to the prolonged systemic drug clearance (65 days).

FOREIGN MARKET EXPERIENCE: The following adverse events were reported voluntarily during post-approval use of the product in dogs and cats in foreign markets: death, tremors/ataxia, seizures, anaphylaxis, acute pulmonary edema, facial edema, injection site reactions (alopecia, scabs, necrosis, and erythema), hemolytic anemia, salivation, pruritus, lethargy, vomiting, diarrhea, and inappetance.

 

Yikes!

I'm starting to think the $800 dollar vet bill and the week exxon spent in the hospital is due to that shot. That's very disappointing.

 

It's an awful drug, I don't know why it hasn't been withdrawn or banned. Squallie got two shots of it, only about 45 days apart; I am so LUCKY and THANKFUL that he did not have a bad reaction to it!!!

 

I have no doubt that is exactly the case, but don't expect the vet to verify that.

 

What a journey... my vet makes these quick and sort of harsh decisions with my pets too, and doesn't explain the possible consequences at all. It's really bothering me that they just say "well, you pet needs this and they need it now" when they don't know for sure and haven't given you the potential downsides.

 

That's the thing about allergic reactions; they don't happen in everyone. Just like how some people (my sister is one) have full-blown anaphylactic reactions to bee venom - yet I don't (at least not now; that's the other thing: allergenic responses that didn't occur previously can start occurring later in life). So when a doctor or vet administers a drug - unless it is already a known allergen for that human or pet and noted in the patient file (such as penicillin, one of the more common allergens to humans), that doc or vet is off the hook if an allergic reaction occurs.

 

I now tell any vet I go to, right up front, that I do not want my cat to be given Convenia, and request that I be told all medication to be administered, and why, before they are given!

 

Steve, I don't want to alarm you, and I doubt you will have any more problems from it, but just to be safe keep a watchful eye on Exxon for the next couple of months; if you notice any change in health or behavior take him to the vet and, if necessary, remind him that Exxon had a shot of Convenia on September 25 and has already had a reaction to it. Since Convenia stays in the system for so long it is possible to have issues with it until it is completely out of the system.

 

My cat got it on Sept 2 as a preventive 14 days prior to a dental procedure. He was lucky and I was frantic for a bit after I realized what they gave him. Yikes!! And now he is having GI issues and it makes me wonder if it is a delayed side effect from the convenia. Like Lucy said, just keep an eye on him which we all know you will because obvious Exon and Lola mean a lot to you as you are a good Kittie-Daddy.

 

Will do!
I'm hoping his bg levels will be good tonight too. I will post them as soon as I take them.

I plan on talking to the vet tomorrow morning about what I have learned when I arrive for my 9am appointment.
I can understand not knowing if a cat will have an allergic reaction or not but if I was told that he may, I would opted for something else or no antibiotics, because he really wasn't that bad when I took him there. Exxon was just sneezing occasionally. My thinking was I would take both in and try to nip this thing in the bud.

 

The thing about Convenia is this: It continues to work in the cat's system. If they have an allergic reaction, you can't stop it you can only assist in supportive measures like they did for Exon at the hospital. I told my vet to put in BIG letters across my cat's chart NEVER give him that again. When I explained to him what I just said to you about not being able to stop it, his response was that most of his patients like it because it is convenient, no shot, no dosing for the human. Yeah, convenient if your cat doesn't have an allergic reaction to it like Exon did. It just seems like a no -brainer to me that it's just not a good idea to every administer a drug that can't be retrieved.

 

And your thinking was on the money, there's no way you could have known he/she would give Exxon Convenia, and that it had the potential for terrible side effects. As Bobbie said, the problem with Convenia is that it stays in your cat's system for about 60-62 days; if your cat has a bad reaction to it, it can't be flushed out of his system the way shorter-acting antibiotics can, so the only treatment is to treat the symptoms as they arise. In some cases this has been fatal. Thank heavens you took Exxon to the vet when you did, and they were able to treat him! However, again, just to be safe, I'd keep a closer eye on him for the next couple of months - much better to err on the side of caution!

I really hate to sound so negative about vets, (by and large I really like most of them!), but I doubt very seriously that your vet is going to tell you that Exxon's reaction/illness is most likely from a bad reaction to Convenia. It seems that most vets want to try to downplay the problems with it, and most don't tell you that's what they are giving you cat; I guess they don't want to be held liable for it, I don't know. Hopefully your vet is different! Good luck tomorrow!

Hugs for you, for all you've been through, and coming out the other side of it a hero, and chin scritches for Exxon, possibly the world's luckiest kitty!

 

Hey Steve, how were Exon's number's tonight. I am thinking no news, good news.

 

Hello everyone. I got home at 8:30 an Exxon was eating! lol
So I'm going to wait two hours and test at 10:30pm
Will post number then. Fingers crossed.
Thanks for the Support!

 

Hey Everyone!

I just tested twice.
1st reading was: 86 mg/dl
2nd reading was: 83 mg/dl

Does this mean I have a non diabetic cat? His numbers have been around this area the last 3 testings.
Quick question what is the difference between the readings on a human meter and a animal meter?
I made need to know this tomorrow morning while I'm at the vet. She said she didn't know about the ear prick so I am thinking she may not know this either. lol

 

It would be my guess, Steve, that you probably have a non-diabetic cat - who spiked a BG# in the 400s at the vet clinic due to:
1) Anaphylatic reaction to the Convenia;
2) Administration of measures to mitigate for this allergic reaction;
3) Stress.

Is darned lucky you are on the ball and take positive action when needed! Exxon is alive today because of YOU!!!

 

Thank you so much everyone! And I mean that from the Bottom of my Heart!

I couldn't have done it without you!

I can't believe I gave him a shot Monday night and Tuesday morning and it didn't kill him?

Exxon. Right now!!!! Looking much better! He says Thank you too!

 

one gorgeous kitty you got there. Would like to hear the vets remark when they see he is not diabetic.

 

Hi Everyone.

Just got back from the vet. I shared the info I had with her. I also had paperwork from the drug website on Convenia. She said in all her years of using it she had never seen a reaction from it before. I told her I was almost 100% sure that is hwta it wasd and to write in my chart never to use it again.

I showed her my chart of my BG readings. She was like you did the ear thing? I said yes. She said you must have one really good cat. (Actually I don't. lol. He is very squimish). I think she was implying that it must have been painful. I told her there were many videos online on how to do it.

They took blood from a vein in Exxon's leg. She used a meter (Looks similar to mine) but she said it was made specifically for cats. Exxon's reading was 135. Which is good, plus keep in my mind there were screaming dogs (3 of them) in the waiting room. They wer driving me crazy (lol) so I am sure they were freaking Exxon out. I miss my old vet. He had a waiting room for dogs and one for cats. He retired.

She said not to give him insulin and come back in tomorrow for another test.

I asked her about his allergic reaction, and the steroid shot throwing him into transient diabetes. Once again she said she had never seen a cat go into diabetes from that particular steriod shot she gave. I even shared with her that I juts found out my uncle has a cat who, when he gets allergy shots, goes into diabetes for about a month so the vet said no more allergy shots for him. Her response, Oh that is a different kind of steroid shot.

I'm going to post this separately to get more feedback but I took back the cans of Hills food that I ddin't use. (They won't take back the dry after it has bee opened). I told her I read online that it is high in carbs and a diabetic cat needs to eat food that has under 10% carbs. She shook her head. She said Hills does have carbs but it is high in protein and I have seen plenty of animals get "regulated" and be able to come off of insulin by eating this food. Then she said you can't believe everything you read online. Aggghhh...

I am going back in tomorrow to get checked again this time I am taking my Reli On Confirm Meter so we can compare the two results. It's a sad day when you feel like you know more than your vet does.

 

Yep, a lot of us here share those sentiments. The vets just don't take the time to learn all the current research and treatments for feline diabetes as they are too busy seeing patients. Keep up the good work, Steve. We have to be our fur babies advocates just like we have to be our own advocates when it comes to medicine. Unfortunately, too many docs are more about big business. It's sad.

 

Good for you for standing your ground!!! (shamefully, I caved to my former vet, I was a little bit afraid of her; I just got a new vet because I knew nothing I said was going to change her mind)

As for the expensive food, your vet might like to check out the Hill's website: http://www.hillspet.com/faq-generic.html

"Are Hill's® pet foods guaranteed?
All Hill's pet foods are marked with our guarantee. If you are not satisfied with Prescription Diet®, Science Diet®, Ideal Balance™ orHealthy Advantage® pet food products for any reason, simply return the unused portion to the place of purchase for a refund or replacement."

Note that it says "...unused portion..."

Remember when you go in for your BG test that your human glucometer will read lower than your vet's pet meter.

Get used to it, lol, sometimes I think we educate our vets, not the other way 'round!

Good luck at the vet's tomorrow. I am so happy for you and Exxon that he's doing well and things are looking up for him again!

 

If your vet wont take the unused portion of the food back for a refund contact Hills directly and complain, I'm sure they will look into it and get you a refund. Glad to hear that Exxon is doing so good!

 

The steroid she gave (dexamethasone) can most certainly cause transient diabetes: https://en.wikipedia.org/wiki/Steroid_diabetes. It's one of the top two that causes it.

I am very, very glad you're hometesting. It could be that on the right diet (low carb, canned), Exxon won't need insulin once the illness resolves and the steriod is out of his system. Bandit is just being weaned off a steroid after taking it for several months, and it caused his BG to rise out of control. He went from needing 1 unit of insulin a the beginning of September to .1 units of insulin in just a few weeks, and will likely not need insulin at all anymore in a week or two. I certainly would keep a close eye and err on the side of caution when selecting an appropriate dose for him. Frequent testing and adjusting his insulin dose down as needed is your best bet.

 

What were the results of the vet follow up, Steve?

 

Hey!
Sorry I haven't posted in a while. I didn't want to bother anyone.
I took Exxon back last Friday. This time I fed him before I took him. Friskies Classic Wet Food.
The vet meter tested 111 my ReliOn Meter tested 81. So there was about an 30 point differnce.

I am looking for a new vet but had been taking him to the animal hospital. There are about 4 different vets that work there.
The lady I had been dealing with must have had the day off because I saw another lady, whom I had never seen before.

*Interesting note: She said: Why does it say No Convenia on his chart. I explained to her that he had a Serious allergic reaction to it when they gave it to him over a week ago. She said really? I've never heard of that. Aggghhhh...

She angered me as well. I told her I believed the steroid shot they gave him caused the Transient Diabetes. Of course she didn't agree with me either.
She said my cat was a poster child for diabetes. I said what does that mean??? She said he is male and overweight.
I disagreed to the overweight thing. My mom has a cat "Jake" who weighs 30 pounds! lol. Now that is over weight and he doesn't have diabetes.

The vet weighed Exxon and was like see, when Exxon first came in he weighed 13 pounds, now he weighs 11 pounds that's much better.
I didn't say but I was thinking "You're an idiot!!!!" Exxon has a decent size skeleton frame and is not overweight but whatever.

I haven't tested Exxon since then. To be honest, I'm not very good at the ear prick thing! Lol. But I won't hesitate to if he shows any signs or symptoms. Such as drinking a lot of water, a lot of urination, ravenous appetite.
I am still transitioning him from dry and wet to completely wet food. Can anybody recommend any dry food besides EVO (I saw where it has been recalled twice) and on Amazon a lady has a picture of what it did to her cat! Yikes.....

Thanks again everyone. You really saved the day for me and Exxon with your excellent advice and quick responses! You guys Rock!!!!!!!!!
Attached is a picture of Exxon when I found him at the Exxon gas station.

 

Ah, such a cute pic! Glad things are still going well. I know you hate to test but it would be good if you could grab one at least everyday until he hits the 14 day mark. Then there are some guidelines we can give you for the rest of the time. You are doing such a great job keeping him healthy and safe. The 30 point difference from the vet animal meter to the human ones is about right.

As far as the dry, Young Again, you can get it online youngagainpetfood.com It's a little pricey but they eat lot less than other dry food because it is so protein dense. They claim it is zero carbs, but BJM here on the boards says it's more like 5% and that is still low. I transitioned my cats off of dry with it and I don't have to buy it anymore ( we went through 1 1/2 bags, so not a big investment, it's about 30 bucks a bag)

Thanks for dropping in and giving us an update. It was still one of the highlights of the time I have been on the boards for success stories and great saves and I know @Robin&BB feels the same. Don't be a stranger! And Exon is not overweight and he is the poster child for Keeping Feline Diabetics Safe!!

 

OMG, Steve - that picture of baby Exxon is so precious that I darn near cried when I saw it! Look at those great big hair-tufted ears - he looks like he's part Maine Coon. Did you mention that to us before? Please forgive me if you did: Gah, my memory is shot. (Are there tufts of fur sticking out between his toes, too?)

My cat is big skeletal frame (vet pointed this out to me when they x-rayed her whole body) and is long, too - she weighs in now at about 11 lbs. (Fluctuates between that and about 10.7, but she's a girl, too. Used to weight 18 lbs+!) Slender is especially good for a kitty who has been dx'd with diabetes (not emaciated, like the way Bat-Bat looked by the time when was dx'd - yikes). If you stand right above Exxon while he's standing up, and you see a little "cut-in" above his hips, indicating a waistline of sorts, that's usually just about right. So once you feel Exxon's at his optimum weight, just maintain portion control every day & he should be just fine!

@Bobbie And Bubba is so right about these things, including the difference in BG reading from the pet-calibrated meter the vet was using. And by the way: YOU rock, too, Steve! You have no idea how proud we all are of the way you jumped right on that steep learning curve. You're what I would call a "dream newbie!" Thanks so much for the photo - you just made my day with your post! Give your both of kitties an extra scritch for me ... and your little dog an extra pat-pat! - Robin

 

Hi Steve. Glad Exxon is doing well now. I posted some additional information about Convenia on your other thread, http://www.felinediabetes.com/FDMB/threads/hills-prescription-cat-food.145620/#post-1515506. Among other things, it has information about how to report a dangerous reaction!

 

Hey guys. I've been kind of paranoid about Exxon so I decided to test him tonight. Tested twice: 76 and 80.

May I please have those guidelines?

Thanks!

Yes hair sticks out between his toes too. I don't know if he's part Maine Coon- I don't know what that is? lol...

 

Hi Steve! Here are the Off The Juice (OTJ) guidelines:


Start the trial on the next green pre shot. (The color reference is to our Spread Sheet which you never had to set up

If he is green ( 50-99) at your normal test times, no need to test further until the next "PS" time; just feed small meals and go about your day. If he is blue at your normal "PS" (100-199) , feed a small meal and test again after about 3 or 4 hours. If his/her number is lower 3-4 hours after a meal, then the pancreas is working!

Occasionaly you might get a number in the blue, if you do post so we can help you decide if a dose is needed. But it would NOT be the dose your vet instructed, LOL

After 14 days of no insulin, we have a party!!

Sometimes the trial doesn't work the first time and we have to give a little more support in the form of resuming insulin. It's not the end of the world if that happens; we just give him/her the support needed. Our goal is a strong remission and it's better to take our time to get that than to rush into remission just to have it fail later on.

Good luck with the trial!!!

Better to be safe that sorry. You are a GREAT Daddy!