New to Lantus glucose reading 522

NewHI , Max has been newly diagnosed and I finally yesterday got a glucometer (Onetouch Ultra2), only to find the test strips had expired, and could only get new strips today. Anyway, he is on 1.5 units of Lantus twice a day, eats mostly fancy feast,which he has been wolfing down but he does have some kibble which he does not really like anyway (multicat household). I got home tday to a very miserable cat, could tell straight away something was wrong. I did his first reading and it was 29 mmol, which I believe converts to 522. That's the highest he has ever been, he was lower at the vet, even stressed out. He vomitted and is point blank refusing to eat. I phoned the vet who said I must give the insulin whether he eats or not, and I need to try and get a urine sample (I didn't get the stix...must get tmr), and if he still doesn't eat tmr morning I shouldbring him in. I have tried to get him to eat even his treats but he won't touch a thing. He looks really sick. When should I test again? Any ideas on how to get him to eat?

 

Re: Miserable kitty glucose reading 522

Hi and Welcome to the board.
I know this is a very difficult time for you.
Yes 29 is 522 which is high, Any way of getting those ketostix today and testing Max
for Ketones. DKA is very serious.
Right now the most important thing is getting Max to eat. Are there any specific foods
that he likes?
When you say newly diagnosed, when was that? Were you started at 1.5u?
I will cross post your concerns in the Lantus group for someone with more experience
to come over and check.
Why don't you edit your subject line - 'New to Lantus. Need help BG 522"
You are in the right place to get Max the help he needs.

 

Re: Miserable kitty glucose reading 522

If he threw up and isn't eating - with that high number I am really worried about DKA. If he doesn't eat soon (within the next few hours) he needs to go to a vet to get checked out. Can you run to the store and get the ketostixs now?

 

Re: Miserable kitty glucose reading 522

It's probably the middle of the night in SA right now... I forget how far ahead they are from the US... gonna go check

 

Re: Miserable kitty glucose reading 522

Not sure where in South Africa Max is or how late stores are open but it's 7:35pm in SA

 

Re: Miserable kitty glucose reading 522

I can't help much except say that yes, it would seem that he needs the insulin to bring the sugar down even if he doesn't eat...but I'm not an expert by any means.

I have a Max too...just wanted to help keep you bumped. And posting in the Lantus forum would probably help a lot. There's lots of great people over there that know way more than I do who can help you out. Good luck!

 

Hello everyone, my internet connection is not the best.... what is DKA? I don't know the terminology very well. Yes, it's 7:50pm here, everything is closed. Vet said I must watch him and bring him in tomr first thing if he still doesn't eat, and try and get the urine sample. I tried to even give him milk which is uber treat and nothing, he took one lick and went back to sleep.AAAArgh...I wish I could just kiss it all better :cry:

PS: He was diagnosed two weeks ago, started on 1 unit of Lantus and the increased to 1.5 units after the vet did a curve a week later.

 

DKA is diabetic ketoacidosis and is a very very very serious condition that can only be treated by a vet or animal emergency room. Cats *can* recover from it, but only with treatment.

This condition is a big reason people are urging you to get ketostix tonight. (They are available at the drugstore, without prescription. Humans use them, too.) With the ketostix you do a urine test. If the ketone reading is negative, you can breathe a little easier. If it is positive, it's a much more serious situation.

 

We just don't have late night or 24 hour drugstores here, all of them close by 6pm. Does the condition come on suddenly? They tested ketones last week and it was negative, but then his highest reading was 21. He has been doing so well, and then tonight this!

 

Yes it can come on suddenly and could be serious if untreated.
When was the last tim you checked his BG?
You gave him is insuiin correct?
Would you haooen to have any all natural baby food around.
Chicken or Turkey would be good.
(21=378)

 

Yes, it can come on suddenly.

Is he drinking? Will he accept water (or broth) if you spoon or syringe it into his mouth? Getting liquids into him is important. If he'll take broth, that would have at least a little bit of nutrition in it.

I am NOT a dosing expert by any means, but even so, it does sound to me like you should give him his insulin. Lack of insulin is one of the triggers for DKA. With as high a number as he is getting, it doesn't sound like there would be any danger from the insulin.

Very first thing tomorrow, do take him to the vet!

 

Fluids are extremely inportant to flush out.
Tuna juice and water. But DKA will require hospitalization and intervenous.
BTW how old is Max and what does he weigh. Has he had a lot of weight los?

Is there a vet that is open now that you can go to or an emergncy hospital
if needed?
If you are very wooried and he is looking very sick I would consider bringing him
to the hospital tonight.

 

I gave him his insulin about 3 hours ago now. I have just tested Bg is 22.6 or 406, so it has come down a little. Please tell me this is a good sign! Max is turning 12 and yes he has lost about 2 kg. He is a big boned cat to begin with, but the weight loss is why I took him to the vet in the first place (and the thirst and frequent urination)

 

Poor Max, he must be feeling pretty badly. I don't know enough to be of any real help, but you've got us here with you while you wait. Definitely try to get liquids into him. Is there any sort of store open this late where you might get baby food? I had friends in SA years ago, so I understand that you're pretty limited in what you have access to tonight, but having no idea where you are or what's available. You want to be sure there's no onion or garlic in the baby food and you want one that's pure meat. You'll be able to water it down to soup and syringe or spoon feed Max, if you can get it. Know anyone with a baby?

 

Yes it is a good sign that his numbers have come done and terrifc that you are hometesting him.
What was his weight before the loss of 2kg (which for the american friends is about 4.5 pounds) and over what period of time?
When there is a quick weight loss and no appetite we then get concerned for hepatic lipidosis, known as fatty liver too. My Max had that twice.
It is very important to get liquids and food into Max.
You did not answer if there in an emergency vet open.

 

I know my vet is not open, but I'm sure there is a emergency hospital. The weight loss was over a period of time, it just became noticable recently, but he has never had an issue eating ever.This is a first. I found a can of salmon in the store cupboard, tried to put some in his mouth and he moaned, and spat it out. Of course the 3 other civvies are in heaven because everything I have tried to give him, I have to give them a bit too....I think they are just waiting for me to crack out the lobster next <sigh> He used weigh about 9kg, like I said a big boned ginger cat, at the vet he weighed 7kg, so hence the 2kg diff. Sorry I don't know the pound equivalent.

I'm going to see if I can organise some baby food. Is the Gerber Purity Baby food okay?

 

I'm not familiar with the baby foods, hoping someone can come answer that for you. The brand is the same as our Gerber baby foods, they added Purity when they started selling it in SA, that much I do know.

 

Do you have any low sodium broth handy that you could try to spoon or syringe into him? That would get some liquids into him while you're waiting for the folks who have more experience.

 

I don't like that he moaned.
I have not had babies in a while. Gerber is good and maybe it is stage 2.
Absolutely no other ingredients besides the meat. No Onion, no garlic....
Try that and it can be watered down to try and get into his mouth.
I have to leave now for a bit. I am sure someone else comes by.
I started a link in the "Lantus Group" for you.
Maybe you can start asking questions there so it will get more noticed.
Max is a big ginger cat?
So is mine as you can see from the picture.
Canada we use kg's too but a lot of board memebers are US so that is why I converted.
Same with the BG reading use your numberX18 so you don't freak anyone out because
a 21 in our scales would be very very low.

 

UPdate, he has just got up and went to the litter, but to poo not pe. His poo is very watery

 

I'll try to stick around for company till someone shows up =)

 

http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=12422

That's the link to the post Randi started in the Lantus forum, it might catch more eyes if we take the discussion over there. That post is linked back to this one so anyone can come over here to catch up on what's going on...

 

I'm hoping that is a good sign, the fact that he got up and went. Not sure what the runniness indicates when everything else is taken into consideration.

If you don't have broth try to get some more water into him, the liquids are important.

You're doing great =) Just keep holding on, someone who knows something will be along shortly.

 

Hi guys, found a emergency room. I'm taking him in now.... will update probably tmr. Thanks for all your support

 

Good luck! Please do let us know!

 

Really good call getting Max to the emergency room.. definitely the right thing to do! Hopefully it turns out unnecessary and everything is ok. Let us know and we'll have you in our thoughts. Come on Max.. get better, you can do it!

 

Any update?

 

Thanks so much for hanging in with me last night. I balled my eyes out all the way to the ER. Vet said his bladder was completely empty and he was dehydrated, couldn't even get a drop out of him to test. He put him on a IV straight awayand admitted him. His BG was 20 (360) when we got there. He did more blood tests to rule out Aids and leukemia and check his blood count. He was running such a high tempreture. He has some sort of infection as well, so started on antibiotics. He stayed there overnight on the IV, and for them to monitor him. I'm going through now to check on him and to give the vet his food. Vet said he wants him home as soon as possible because of the stress of them being there but won't release him until he is happy he is okay again, so I'm quite relieved that they are watching him, but he might be there overnight again today. Might get the ketone answer today if he passed some urine last night. Again, thanks so much for all your help.

Sandra

 

{{{Sandra}}} I'm so glad you were able to find an ER and get your Max seen! I thought about you both a lot last night. I hope you will come back and let us know how he's doing! Come join us in the Lantus forum once you've got your boy home and settled in, lots of great folks there who know loads about Lantus, how it works and how it can help Max and how you can manage your life along with Max's diabetes. We just had a couple of Max kitties go off the juice in there, I think we're a bit Max deprived

 

((Sandra))

I am so happy that you got Max to the vet last night.
I am by no means an expert but I just did not like what I was hearing and better safe
than sorry.
Please keep us updated on Max's status and while you are waiting,
how about going over to the Lantus Group and read all of the "stickies" - the items with gold stars.
It is a fantastic place to be and my Max is one of those that just went off insulin.
We had his party last week. We could not have done it without the help and support
of the board.
Here are some links that are in the tech section to help you get started
so you can join the amazing people in LL (lantus land) when your Max gets home.
viewtopic.php?f=6&t=486
viewtopic.php?f=6&t=531

 

I'm so glad you were able to get Max to a vet last night. Do let us know how things are going, whenever you get a chance. I know you have more important things on your mind than typing messages on the computer!

Hugs to Max and to you!

 

I am so glad that you took him to the ER!

Do you need information on ketones?

Basically, ketones can be produced in the body if the cat has insufficient food/insufficient insulin/infection - usually a combination of factors but not always.

If ketone levels build, the cat can develop diabetic ketoacidosis, which is a life threatening condition.

In the early days of treatment, ketones are a big risk because the cat has likely gone some time undiagnosed (insufficient insulin), may be inappetant due to high blood glucose levels, and may or may not have an infection. Trying to balance everything while learning is difficult!

You need to buy some ketostix from your pharmacy so that you can start testing his urine once he's at home. You'll need to ensure that he gets his insulin even when he doesn't eat, and that you syringe feed food if he doesn't eat. He may need something like pepcid ac (not the pepcid complete version) to soothe his tummy. It will be a balancing act but it DOES get better!

Oh, and ensure that he is on antibiotics for at least 10 days, and ask the vet about whether the antibiotics he is on are specific to his infection

Jen

 

Max is home, thank goodness. A purr has never sounded so sweet. He is back to eating and drinking and being his usual self. He is on antibiotics for the next 8 days, but he had already started on them at the vet. The source of the infection seemed to be his mouth, which they cleaned up and took care of. I have read that this is quiet common in diabetic cats. But it should all be okay from now on. He is ketone negative yay. Vet said to lay off doing curves until the antibiotics are finished as it's common that their glucose reading can be inaccurate when they are getting over an infection. This is not a picnic!!

 

Hi Sandra
I am so glad to hear that Max is home and doing better.
I was thinking about you and hoping you would come back and post the news.
Are you still giving the insulin? If so, you still should be testing his Bg at a minimum
of before his 2 shots and a few spot checks in between.
Sometimes antibiotics will affect the BG so you do need to watch him.
Which antibiotic is he one?
You should also still pick up that box of Ketostix we talked about the other day as you will have to mointor them.

 

Oh I agree, do not stop testing while on the antibiotics. A lot of vets think testing is unnecessary or causes pain to the cat... it is necessary and it is not mean to the cat. It provides you with valuable information.

You could need to adjust his dose up or down while he's on the ab's and you need to know if he drops really low (sometimes when the ab's kick in and the infection is gone, the numbers will go down fast) or if he's riding really high numbers so you can watch for ketones. Ketones can come on quick and are a big deal, so it's best to watch for them and catch it quick so you can get it treated immediately (the longer you wait, the harder it is to treat I think and the more expensive it will be.)

You'll be seeing a whole new kitty once he's feeling better from his dental work I bet =)

 

I also agree. Don't stop testing. When the infection starts to clear, the BG could go down quite suddenly, making the usual insulin amount an overdose. If you're testing, you'll realize that the number has dropped before you give a shot that you can't take back.

When you say the problem in his mouth was taken care of, do you mean they did a real dental cleaning or just that they cleaned up the worst that they could see right now? If they didn't do a full dental (with anesthesia and x-rays), ask your vet about doing one fairly soon. I don't mean tomorrow, but pretty soon, after Max is strong again.

 

Hello everyone..he is on Baytril (don't know if that is a universal name?). They did a full dental workup under anesthesia, removed 2 molars and another tooth, and cleaned everything up. Got the stix, will start testing urine today and will resume BG testing as well, unfortunatley I'm not home during the day, so I test morning and evening shot, but can't test in between, good thing it's the weekend though, and next week I have taken some time off work yay. He is so much better, and to the members that gave me tips on how to inject, Thank you thank you. The injection is no longer an issue, he actually falls at my feet now so I can inject and then jumps up when I'm finished looking for his bonito flakes.

 

This is so great! My Tugger does this too =) He learned very quickly that shot=food so he tries to hurry the process along by flopping over at my feet... before I'm ready! Sometimes, when he's hungry between meals, he'll catch me walking through the kitchen and flop over and yell at me. "Mom, starving here, do that thing you do that means I get food."

Very nice that they got the full dental done. Baytril seems to be pretty commonly given for infections, I've seen a number of kitties on it. You may see some number drops now as the infection clears up. Try to get any extra tests in that you can besides the pre-shot tests. If you can manage. We all understand how hard it is. I'd leave out a bit of extra food for him on the days you can't spot check, just in case he goes low, a lot of cats will feed themselves if there's food available. Probably wouldn't work if he's the type to gobble it all when you put it out (you could freeze some and leave it out to thaw over the day) but I thought I'd mention it, seems like that's what most of the people do who have to work long hours.

If you can, you should set up a spreadsheet with all of Max's BG readings. If you go to the Tech Forum you can find a link that will walk you through how to set it up. It's quite simple =) I did it, I think pretty much anyone can if I did it :lol: Then come hang out with us on the Lantus forum. We're a pretty fun group, come check us out!

You'll find tons more little tips and tricks to make life easier for you too =) I'm so happy Max is feeling better!