Newbie Needs Help, Cat Dragging Hind Legs

I'm re-posting this here because I really need help:
Our 9 yr old neutered male DSH cat that has had diabetes for three years controlled with Lantus insulin is now dragging both legs behind him. He can feel them and sometimes use them but not well at all. We took him to a new vet yesterday who x-rayed him and said its diabetic neuropathy but to keep him on the same dose of insulin which was just reduced by .5 right before this happened. The glucose test showed 104 but my stupid b/f gave him 5 units that morning without my knowledge, its his cat. The glucose level last week was 164 on his blood test but they said he had a normal curve that day. I'm so frustrated and don't know what to do for him and can't find a meter that works. I doubt its a clot because he can and does stand and even walk a bit better sometimes but mostly drags his hind legs behind him but has feeling in them. It started about a week ago, he was walking weird but nothing like the plantar walking from diabetic neuropathy he's had twice before when we had to adjust his insulin and it went right away. This is different - it started out lame on both hind legs and just looking weird, no plantar walking at all. It got worse after we reduced his insulin by .5 but like I said, I can't do anything with that without a really accurate meter and I can't find one, we test them with the Accu-Chek and they were WAY off, both way higher and then way lower than the Accu-Check on the same day's readings. Vet did x-rays two days ago, can't find anything but impaction so I gave him a cat enema and he pooped but not all of it and I don't know if he's peed, we have another cat in with him we can't remove anywhere else. I don't think he pooped today. Took away all dry food and are feeding him Fancy Feast Classics canned with a lot of water in them only about 4-5 times per day including after his BID Lantus insulin shots.

His "off" blood levels are posted below, the rest were all in very normal range:

WBC low at 5.22 K/ul
GLU high at 167 mg/dL
TP high at 9.3 g/dL
GLOB high at 6.3 g/dL
AMYL high at 2294 U/L

BUN is 22 mg/DL
creatinine 1.8 mg/dL
GGT <0 U/L
K 3.7 mmol/L
MCV 42.8 fL
MCH 13.8 pg
NEU 3.22 K/uL
LYM 1.29 K/uL
MONO .30 K/uL

Questions:

I've been given Cobalamin shots by the vet and need Methylcobalamin - is this good for diabetic cats and can you even use the sublingual crushed into their canned food? Does it have too much sugar? http://www.iherb.com/Natural-Factors-B1 ... blets/2521 What dose/mgs. do you need daily and do you have to give it for life?

Do I need to give potassium and what dose for how long? I know you can overdose so I'm a bit afraid to give it.

One reason for this is could be he was on Baytril liquid at the time of the bloodwork for a suspected UTI that I later found out from the new vet had tested neg. at the old vet and they STILL put him on it so we left that office (for good reasons) where he had been treating for 3 years and took him to the vet I normally use. He's been off it for I think 4 days now and had glucose of 104 at the vet two days ago when the hind leg dragging started. I think it was gradual in about a 1-2 week period but this cat has been hiding abnormally for about 2 months now.

Susan/Toney
Riverside

 

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I'm glad he's sometimes standing and walking. To me, there is hope there.
Have you thought about acupunture? I've never used it. Maybe others who have can advise.

I give a weekly injection of cyanocobalamin to J.D. for his pancreatitis, so I think the cyano form is for tummy issues.

I know you need the methyl form for neuropathy. I use Zobaline for daily methycobalamin. It's just a small tablet that I give J.D. in a piece of pill pocket with the rest of his pills.

What dose is your cat on?

 

Here is the previous post

I understand you are frustrated. Unfortunately, there are no quick fixes.

Note that regular B12 (cyanocobalamin) may be helpful in pancreatitis, so you might hang onto those pre-filled syringes.

The ReliOn Confirm will never match the vet's meter or lab tests. This is OK. We have reference numbers for use with a human glucometer.

Some glucose reference ranges for decision making using a human glucometer

< 40 mg/dL
- Treat as if HYPO
- At nadir in long term diabetic (more than a year), may earn a reduction

< 50 mg/dL
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50.
- At nadir, often indicates dose reduction is earned

50 - 130 mg/dL
- On insulin - great control when following a tight regulation protocol
- Off insulin - normal numbers

> 150 mg/dL
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol

180 - 280 mg/dL
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine. Test for ketones, glucose is too high.

>= 280 mg/dL, especially if for most of the cycle between shots
- Uncontrolled diabetes and in danger of DKA and hepatic lipidosis
- Test for ketones; more than a trace, go to vet ASAP.

 

I read cyanocobalamin is toxic to cats. Also, the meters I used were BOTH higher AND lower than the Alpha-Trak on the SAME DAY, they were completely inaccurate all by themselves. They didn't work at all and we returned them.

SUSAN/Toney
Riverside, CA

 

cyanocobalamin is used in cats (and dogs).
http://vetmed.tamu.edu/gilab/research/c ... nformation
Where did you hear it was toxic?
Regarding potassium, what was the measured level? You do not want to supplement potassium without knowing the current level.
As asked in your other post, can you take and provide a link for videos that shows the problem With a BG of 160 or so I would not expect neuropathy.
Did the vet discusses possible saddle thrombosis?
http://www.veterinarypartner.com/Conten ... ID=3001459
http://www.youtube.com/watch?v=Ii_Iv-cpK2o

 

When you compared your meter to the AT meter on those days, were the tests done side by side using the same blood sample?


Larry, the K value was 3.7.

 

No, cyanocobalamin is not toxic; it is a form of Vitamin B-12. It is water soluble, and excess will be excreted through the renal system.

Some info on human and animal glucometers in the US:

1) They are not intended to replace a lab test.
2) They are intended to give an approximate value for home monitoring.
3) The FDA allows meters to be sold which provide values within 20% of what a lab would get. That means for any test you get, the likely lab value is somewhere in the range +/- 20% of that value
- A test result of 50 is actually between 40 and 60, a range of 20.
- A test result of 500 is actually between 400 and 600, a range of 200.
It also means that if you take 2 tests on the same blood drop, you can narrow that range to what overlaps.
4) While pet-specific meters will read closer to what a lab test might provide, there are pet-specific reference numbers for using a human glucometer on a pet. It is like the difference between reading temperature in Celsius vs Fahrenheit. Freezing is 0 degrees Celsius or 32 degrees Fahrenheit.

On the average, you will get readings that are "good enough" to do home monitoring - human diabetics use these glucometers all the time to manage their diabetes and insurance companies often cover the cost of these meters for humans.

 

Susan

Did you see my previous post about comparing meters? How some are plasma calibrated, some are whole blood calibrated and you can't compare those two. Also, you can't compare meters that use different assay methods. If you have an Accu Check, why not just use it? We are going to be able to help you the most if you hometest and let us know what numbers you are getting.

Also, in the previous post, I posted a link for you on potassium. You should not supplement potassium without your vet being on board and involved because you have to test 24-48 hours after the first dose and then you have to test blood every week to two weeks. You cannot just give him potassium on your own because you risk raising the potassium to a level that is too high which is dangerous.

 

I know the difference between blood types on meters. These five meters were all SO far off each time they were NOT useable for anything. I threw the last one out. They were off over 100 each time in DIFFERENT directions than the vet's meter, there is NO WAY we could depend on them for ANY type of reading, they were all WAY too off. I used ear blood, the vet used jugular blood and they were BOTH way off. I'm SO BEYOND frustrated with this, my vet FINALLY called back just now after two whole days and said she doesn't think its diabetic neuropathy and that the other vet had given us cyanocobalamin injections. I told her that doesn't work for diabetic neuropathy, just inflammation and she had no idea. She looked it up online and called me back and said someone named Alice Woolf DVM who is a specialist website they use lists methylcobalamin dose as 250 mcgs, so 1/4 of a 5000 mcg tablet would be okay TWICE A WEEK. I said I thought it had to be given daily and that you can't really overdose them and it should be at a higher level and she really doesn't know. I'm thinking we're switching vets AGAIN after this episode, I already switched four times on a pancreatitis cat we have because three vets treated him totally incorrectly and would have killed him - they refused to give him food while hospitalized, didn't want to give prednisolone and when I finally got to the 4th vet who agreed with me, he got better right away and I saved his life. I'd like to do that again in this case, poor Toney is only 9 years old and is standing on both hind legs right now but not walking well and sitting down quickly. Doesn't seem painful so I don't think its saddle thrombosis or a blood clot. Vet said his potassium isn't low enough to supplement and quite honestly, I'm afraid to if I can't do blood tests right away. PLEASE HELP, what is the recommended dose for methylcobalamin and where can I get some QUICKLY?

SUSAN/Toney
RIverside, CA

 

I found some methylcobalamin liquid with no added sugar except raspberry extract at 1000mcgs per 25 drops. I still don't know the dose to give him but am going to go pick it up now, since I can't locate any anywhere else today.

SUSAN/Toney
Riverside, CA

 

You said " They were off over 100 each time in DIFFERENT directions than the vet's meter, there is NO WAY we could depend on them for ANY type of reading, they were all WAY too off. I used ear blood, the vet used jugular blood and they were BOTH way off. " What were the specific blood glucose values? the hand held meter, even the AlphaTrac meter are only accurate to no more than +/- 20%.
The care takers here use hand held meters from various manufactures and then work just fine. You just have to stick with one meter.

 

I'm telling you - ALL the meters were inaccurate, COMPLETELY INACCURATE. We returned ALL the IPet ones since they are proven to be inaccurate by everyone and the other one I threw away it was so far off even on two side-by-side readings - off by more than 100 up once, then down the other when the Alpha-Trak was showing perfect readings that weren't off by more than 20 each reading on his curve. I'm going right now to get a Relion Micro or Confirm and hopefully that one will work. This site in invaluable for info and I appreciate it, but I still have no clue how to read a human meter vs a cat-calibrated one - the link here and the posts were way too confusing to me. I just dont' get it other than:

<40 = HYPO
50 = lowest nadir you want to have in a new diabetic; if seen before nadir, follow directions for handling low numbers
>240 = exceeds renal threshold; glucose spilling from blood into urine

So I'm hoping the above is correct. The meter isn't going to help me much unless I can get a better way to read it for a cat. HELP! THANKS!

SUSAN/Toney
Riverside, CA

 

susan
I have just about every meter about there. I got them all for free for the most part.
I would say 98% of us on this board use a human meter. which one depends on what strips you can afford. You DO NOT need to worry about the difference between a "CAT " meter and a human meter. you just use the meter and take the readings from that. you are never going to get a perfect reading. it is what it is.

you will go crazy trying to get a meter that is going to match the vets. even with the same meter, taking a sample minutes apart, or even the same drop with 2 of the same meters, you are going to get different readings. If you want to be the same as the vet, then buy the same meter he is using.

how do you know the AT was a "perfect" reading. what is that being compared to??

I'm sorry, but I am not sure I understand what you are looking for or are attempting to perfect
no disrespect meant in my questions or post.

ps. I also know a lot of vets use a human meter also. cannot remember which one but many people here have posted such

 

Pick one meter and stick with it. Forget about the differences between the numbers at the vets and the numbers you get at home.

I got my foster cat Wink in remission using a Relion Confirm meter, the larger version of the Relion Micro.

The cat shelter gave me an Alphatrak 2 but the test strips were too expensive. Switched to the Confirm and never looked back.

Once you buy that new Relion meter, we will help you to get your cat regulated. We well help you to learn what the readings mean.

We don't look at specific numbers most of the time. We look at ranges. For example: <100, 100's, 200's, 300's, 400's, 500's. We look at numbers at specific times of that day. Based on the various numbers, we adjust the dose.

 

Susan

You might also be interested to know that the Tight Regulation Protocol that many of us follow is the only scientific-research based and published protocol for management of feline diabetes...and the scientists used human meters including an Accu-Chek Aviva. None of us would be here if our cats weren't our priorities, just as Toney is yours. So I would not risk my baby girl going hypoglycemic using a human meter for her BG if they weren't proven to be safe and acceptable to use.

It's probably good that you switch vets. I would also print off the info I gave you on potassium imbalances. Your vet is wrong on that but you must have a vet assist you with that.

 

Yes, those numbers are good numbers to go by using a human meter. "Normal" for a cat on a human meter is 40-120.
And if you see a number under 50 prior to nadir, you would want to follow the guidelines for handling low numbers. If and when that happens, you can also post either on the Health board or the Lantus TR forum, asking for help handling low numbers. Someone will quickly hop on, and will "walk you through" the steps. It happens. And people will stay up with you all night long if needed. Lots of us have done that.
And somewhere around 240 (some people use 220, some higher) is considered the renal threshold where glucose can spill over into urine.

There are also "bookmark numbers" for reducing or increasing dosage. But all of the numbers we typically use are "numbers on a human meter". When people use vet meters like the Alpha Track, we adjust our thinking to that as needed. Because 90+ % of people use human meters here, we typically think that way by default.

I think part of her confusion might be due to the method of "delivery". My understanding is that if you give the B-12 orally, a cat will only absorb up to a certain amount, and the rest will be "voided" by way of urinating out the excess. I am not sure that the same applies when it is given by injection, but someone else might be able to clear that up.

 

The difference is that what is injected is typically cyanocobalamin which doesn't have the same benefits as methylcobalamin.

Since we all live and breathe this 24/7, we often have more updated information and methods than many vets.

 

Thanks, SO MUCH everyone, I picked up a Relion meter today, it is either a Confirm or a Micro, I looked at both and they are about the same, they even use the same strips. I can't remember which one I got but will see what it says and post it. I'm exhausted from all this, I also got methylcobalamin liquid but it has things in it which may be sugars and I wont' be able to tell until Monday, so I really hope this meter works. I'd rather give him a few sugars and deal with the insulin than wait another two days to give it to him.

SUSAN/Toney
Riverside, CA

 

Okay, I got the ReliOn Micro but will have to try it tomorrow as the b/f went to sleep early and I need help. I also got Clark's Nutrition's B-12 Sublingual Liquid, which is Methylcobalamin 1000mcg per 25 drops and has only other ingredients listed as: Vegetable Glycerin, deionized water, Raspberry and Berry Natural Flavors, Citric Acid. I have no idea how much sugar is in this as it doesn't state and they didn't have any tablets or any other kinds without toxic Xylitol or sugars. Do you think this is okay to use now or should I wait until Monday to find out the sugar content? Thank you guys all SO MUCH for being here, I don't know what I'd do without you!

SUSAN/Toney
RIverside, CA

 

Okay, I got the ReliOn Micro but will have to try it tomorrow as the b/f went to sleep early and I need help. I also got Clark's Nutrition's B-12 Sublingual Liquid, which is Methylcobalamin 1000mcg per 25 drops and has only other ingredients listed as: Vegetable Glycerin, deionized water, Raspberry and Berry Natural Flavors, Citric Acid. I have no idea how much sugar is in this as it doesn't state and they didn't have any tablets or any other kinds without toxic Xylitol or sugars. Do you think this is okay to use now or should I wait until Monday to find out the sugar content? Thank you guys all SO MUCH for being here, I don't know what I'd do without you!

SUSAN/Toney
RIverside, CA

 

Okay, I got the ReliOn Micro but will have to try it tomorrow as the b/f went to sleep early and I need help. I also got Clark's Nutrition's B-12 Sublingual Liquid, which is Methylcobalamin 1000mcg per 25 drops and has only other ingredients listed as: Vegetable Glycerin, deionized water, Raspberry and Berry Natural Flavors, Citric Acid. I have no idea how much sugar is in this as it doesn't state and they didn't have any tablets or any other kinds without toxic Xylitol or sugars. Do you think this is okay to use now or should I wait until Monday to find out the sugar content? Thank you guys all SO MUCH for being here, I don't know what I'd do without you!

SUSAN/Toney
RIverside, CA

 

Okay, I got the ReliOn Micro but will have to try it tomorrow as the b/f went to sleep early and I need help. I also got Clark's Nutrition's B-12 Sublingual Liquid, which is Methylcobalamin 1000mcg per 25 drops and has only other ingredients listed as: Vegetable Glycerin, deionized water, Raspberry and Berry Natural Flavors, Citric Acid. I have no idea how much sugar is in this as it doesn't state and they didn't have any tablets or any other kinds without toxic Xylitol or sugars. Do you think this is okay to use now or should I wait until Monday to find out the sugar content? Thank you guys all SO MUCH for being here, I don't know what I'd do without you!

SUSAN/Toney
RIverside, CA

 

Great!

here are some testing tips in case you need them https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

You will want to track your readings in a spreadsheet - that way we all can see whats going on - with Toney - and the meter : http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Doesnt sound like it has sugar in it so you should be fine.

Wendy

 

I'm not familiar with that product, Susan, or whether any of the other ingredients would be unsafe to give.

Forgive me if I misunderstood, but did you say previously that he had had neuropathy which resolved but this looked different? What did you give him before? And again, apologies if I misunderstood.

Glad you got the meter. Let us know when you are able to get readings. I would start with preshot tests. It's not safe to shoot insulin blind (without knowing the preshot BG).

Good job!

 

Thanks, all. His plantar-walking neuropathy changed before when we INCREASED his insulin. I just used the ReliOn Micro for the first time and not sure I got the blood in time b/c I had a hard time getting any but it read 37, which scares me. I don't trust it at all since none of the other meters worked at all and I can't repeat the test since I already stuck him so many times I cannot do that to him again. So I gave him some of my pancreatitis cat's canned Blue Buffalo Basics Senstive turkey and potato food and left a note for the sleeping, cranky b/f to NOT give him insulin in the am but to get him immediately to the vet for another glucose test first. I doubt he will, he will most likely go to the gym and leave me with this and I am SO frustrated. If his glucose is still that low on this meter and the vet's meter reads normal tomorrow, I just give up on home meters ever again. This is the 6th one now.

 

P.S. What does NADIR mean? THANKS!

SUSAN/Toney
Riverside, CA

 

nadir is the lowest bg number of each cycle. ( a cycle is every 12 hours)

see your other post.

How is the cat acting now?

 

Hungry, ate like a pig again but still can't walk normally. A bit better than 2 days ago but WAY abnormal. Can sit but not stand normally and can't walk. No pain it seems but cats are good pain hiders. I can't take much more of this.

SUSAN/Toney
Riverside, CA

 

Ok first things first - deep breaths. Its a steep learning curve but once you get past this it becomes very routine and it will be worth it when you see your kitty all happy and playful again. And we can help you get through this - which is why you came here

So now for the current issue.

Last night you got a 37 - great job on getting this test but that number is very low and in hypo territory see your other post http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=100355. A hypo could make him weak and stagger. I am hoping he is ok this morning.

This morning, before you shoot, please get a measurement. We dont want you shooting if he is under 200 as that could cause another low.

let me know what the number is!

Also lets just post in this thread right? two going at the same time is confusing. I will ask people in the other thread to post here instead.

Wendy

 

Getting one low reading is no reason to give up on a meter and stop testing. Toney needs your help. Yes, he's your BF's cat, but your BF does not seem to want to take care of him.

It takes time to get the testing down. We can help you with lots of information.

1. warm the ear with a rice sock, heated in the microwave. Put 2 tablespoons of rice or dried beans or dried lentils in the toe of a cotton sock, tie the top closed and heat in microwave til warm but not hot.
2. place something firm behind the ear, like a pill bottle lid to poke against.
3. Use a flashlight to see the area you need to poke.

More ear testing tips here: top ear testing tips

That BG of 37 yesterday earned your cat Toney an automatic dose reduction. 0.25U less than he is getting now.

Please don't give up on Toney.

 

From your other post. So we have all the information here.

 

also be aware that sometimes (and this goes for ALL meters), too much blood or not enough can also give you a false reading.. when a reading looks suspicious as in a lot different # than you are usually getting, then retest to make sure

 

A bit more about meters and home glucose tests:

The FDA says that retail hand held glucometers only have to be within 20% of what a lab test (not a hand held glucometer) would find. Each test you get is actually somewhere within a 20% range of numbers, higher or lower.
A result of 100 mg/dLrepresents a range of 80 - 120 mg/dL, a span of 40 mg/dL
A result of 200 mg/dLrepresents a range of 160 - 240 mg/dL, a span of 80 mg/dL
A result of 300 mg/dLrepresents a range of 240 - 360 mg/dL, a span of 160 mg/dL
A result of 400 mg/dLrepresents a range of 320 - 480 mg/dL, a span of 160 mg/dL
A result of 500 mg/dLrepresents a range of 400 - 600 mg/dL, a span of 200 mg/dL
Notice how as the number gets higher, the range in which the lab value would fall gets wider. That may be why your tests and the vet's test were so different; none of the hand held meters are very precise at high numbers.

And it doesn't matter at higher numbers. Too high is too high and you take action to address the elevated glucose, following the rules for the insulin you are using.

Where you want to be careful is at lower numbers, where there is a risk of hypoglycemia. And at lower numbers, that +/- 20% range gets narrower. We use 50 mg/dL as a value we want our cats to stay above. Even if the true value was really a 40 (20% lower), that can be a safe number for cats, as it is in the range of normal glucose values for cats. And, we have guidelines for managing low numbers, to protect the cat.

If you have results from 2 different hand held glucometers, you can check the following:
A) For the low glucometer test, calculate 1.2 * the reading obtained
B) For the high glucometer test, calculate 0.8 * the reading obtained.
If the result from A is greater than the result from B, the readings may be considered the same.

 

there is your problem with home meters. glucose levels can change drastically in just an hour or two depending on where you are in the cycle. of course the number obtained today at the vets is going to be substantially different than the 37 you got last night simply because of the time involved. kitty has eaten not to mention the fact that the insulin has worn off overnight

unless you've used a meter with "tru" in it's name, in all honesty, there was probably nothing wrong with the other 5 meters you've tried. you just haven't given them a chance or yourself a chance to learn enough about all this just yet.

i know it can be frustrating, especially when your partner isn't jumping for joy to help, but it's not a race and in no time you'll be telling someone else the same thing believe me. let me know if i can help ok. i live near the 15/91 interchange and am willing to help as much as i can. i work in orange county thru the week so don't know how much i can do thru the week unless you tend to stay up late but i am pretty free on the weekends and will gladly practice testing with you or sit and answer any questions you have, etc.....

 

THANK you all so much for your help. Thank GOD I didn't give up and
trusted my gut feeling (that his insulin is off and that his paralyzed hind end
(that gets better enough to sit and try and walk, then goes back to
dragging it) is neuropathy of some type - or cancer) and at the advice of you all
bought the only meter that has EVER worked for us on him, the ReliOn Micro.
It worked! I got a reading last night that was really low
(30-something), so gave zero insulin and gave him some higher-calorie food and my b/f
took Toney in to the same vet this morning and their Alpha Trak meter read 52
and ours read 25, so it works! Vet said no insulin unless we test first
from now on. He was stable on insulin before this and this reduction in
glucose is low only b/c we moved him into the bedroom/library room and took him
off the dry food and put him on canned food only (Fancy Feast classics)
b/c of an intestinal blockage. We feed him the canned mixed with water 3-4
times a day and 1/8-1/4 tsp. Miralax once a day. I gave him an enema and he
pooped, so left him on the canned mixed with water and thank GOD for you
guys and this new meter because if we had given his insulin it would have
killed him.

So here are his only tests using this new meter:

7/22/13 10:45am (1.5 hours after eating canned Fancy Feast): ReliOn
Micro 25 (Alpha Trak 52)
5:45pm (before feeding, ate last about 1:30pm): ReliOn
Micro 80

QUESTIONS:

1. I have no idea how much insulin to give him OR when to test, before
meals or after meals and how long before or after? I would think that with
an 80 I would give zero insulin but we took this BEFORE he ate, so I don't
know what I'm doing or when to test. I don't know the scale on these human
meters of how much insulin to give or when.

2. I bought methylcobalamin liquid, 25 drops = 1000mcg. I don't know how
much or if I can even give it to him because the only other ingredients
are: vegetable glycerin, deionized water, Raspberry and Berry Natural
Flavors and Citric Acid. Doesn't say how much sugar it has and I didn't have
time today to call the mfg so I didn't give it. It tastes sweet though. I
don't have access to any other type of it right now but the vet gave him a
shot of cyanocarbolomin and gave us weekly shots of that so don't know how
much or even if the wrong type will convert to methylcarbolomin. She had no
idea it was even the wrong kind or what dose to give of the
methylcarbolomin. Isn't this something every vet should know? I learned this years ago
working for a vet.

THANK YOU GUYS SO MUCH, YOU SAVED TONEY'S LIFE LAST NIGHT. Another yahoo
group pancreatitis site saved my favorite cat Kobe's life and I am SO
GRATEFUL to these sites that know so much more than the vets. Our vet didn't
even know that the human meters always test 20-30 units different than the
pet ones. Now she does, so your help saved a LOT of cats today. THANK YOU

Susan/Toney
Riverside, CA

 

As a newbie you don't want to shoot under 200. Measure him in a couple of hours and see how his blood sugar behaves without the shot. If he is over 200 tomorrow then you can shoot.

How much insulin have you been giving? You may want to reduce dose even when he is over 200.

Wendy

 

The dosage for the methylcolbamin is 3 -5 mg or 3000mcg -5000mcg .
The link for buying one without sugar was in your other post.
You might want to go back and read thru both of your posts and see if you missed some information. Sometimes things get posted at the same time and get missed.


The colbamin will not help with the neuropathy. So it looks like you'll be teaching your vet another new bit of information.

 

Always test before a shot. Always.

You want to test before you would normally give a shot, 12 hours apart. So test in the morning at say 7 am. That is your AMPS or morning pre-shot test. You want to test in the evening at 7pm. That is your PMPS or evening pre-shot test. Those are 2 tests numbers 1 and 2 for the day.

Take up the food 2 hours before these two tests. We want to see a number that is not food influenced.

Other tests that you get throughout the cycle, a cycle being 12 hours, can be food influenced.
So the next good tests to get are a morning mid-cycle test, somewhere in the +5 to +7 hour timeframe (shoot time or PS time = 0, 2 hours later = +2). This is test number 3 for the day.

Then a "last test before you head off to bed" test is a good one to get. This is test number 4 for the day.

Adjust the AMPS and PMPS test and shoot times to work with your work and life schedule. If 8 am and 8 pm work better for you, test then. Try to pick times, 12 hours apart, that will work best for you on a regular basis.

 

Hi Susan,
You have no idea exactly how happy it makes me feel to read that. I am beyond thrilled that you A) found a meter you can trust, and B) got to see for yourself how it compared to the vet meter. That 37 last night was a scary number from where I am sitting, which is why I said last night that you have no choice BUT to trust a number that low. When I signed off last night, I did so praying that you realized how low he was, and how dangerous going any lower could be.

Always, always, test before shot time, before Toney eats. You want the AMPS and PMPS tests to be "fasting" numbers. And for now, no shot if you see anything lower than 200. Once you have collected data that shows you what a given dose will do, you will be able to safely and confidently give her a shot on a lower number.
Assuming you eventually see a number above 200, you can feed and give the shot. A good time to test after that, at the beginning, is at +3 or so. That number can reveal whether the numbers are likely to drop later in the cycle. Do not ever hesitate, before shooting, to "ask for advice". That's what we're here for! For that matter, and time you test, if you need input on what a number might mean, please ask.

Ultimately, the number that is going to tell you if a dose is too high, too low, or just right, is the "nadir" number. That's the low point of the BG 12 hour cycle. It typically happens around +6, but not like clockwork. It can change some from day to day at times. But generally, the low point should happen around 6 hours after a shot.

For now, I'd continue to get a test at the AM and PM times you would plan on giving a shot. But if you see something under 200, ask, or skip the shot. Whenever you aren't sure, err on the side of caution. Our top priority is the safety of the kitties. A day of high numbers is so much better than an hour of numbers that are too low.

 

GREAT. David gave him 2 units of Lantus when he tested 115 at 4 hours post-eating. I told him NOT TO GIVE ANY WITHOUT CHECKING FIRST and to go test him again right now. He just now tested at 90. So I had David feed him 1/2 can of my pancreatitis cat's food which is Blue Buffalo Basics Sensitive Solutions Grain-Free Turkey and Potato AND I put in 500 units of the methylcobalamin that I don't even know if it has sugar or not yet. OMG, I'm so freaked now. At least David stepped up and learned how to test and I really hope he keeps it up. I gave him the link to this site and told him to sign up himself. I am horrified but what can I do now? I told him DON'T DO THAT AGAIN, YOU ARE GOING TO KILL HIM!

I know it sounds horrible, but I honestly cannot deal with this without his help right now, I have a pretty bad medical issue (9 months of intestinal dumping and severe weight loss from being unable to digest food after reflux surgery) of my own that I need to deal with every minute of the day until I find a doctor who will treat for it. If I'm not here, I shiver to think what would happen to these animals. All our cats are former ferals or unadoptable rescues, so a few of them have medical issues I have to treat. And my old dog, a horse and 1 of our alpacas too. Poor Toney.

QUESTION: We don't give Toney any food all night long because I'm afraid to give him dry food - should I? What kinds are recommended? Its the same Blue Buffalo dry as the above-described canned he just got. We don't have a dry food to give him right now - what is recommended? Plus, there is another cat in with him, so I put his dry food up on a shelf only he can get to. We have been giving Toney canned Fancy Feast Classics mixed with water 4-5 times per day and 1/8-1/4 tsp. Miralax once a day. I don't even know how much canned food he is supposed to get, he's been eating about 2 small cans per day which isn't enough, but we have to worry about his intestinal blockage. He seems to be peeing and pooping okay now but not totally sure its his and not the other cats. I know he peed in the litter box, what a good boy, don't know how he managed that but I saw him.

SUSAN/Toney
Riverside, CA

 

How long after the shot was the 90?
The 90 was at 10 pm your time?

 

Also, as far as how much food Toney needs... What is his current weight? (Sorry if you already told us that and I missed it)

 

I think it was 12.5 lbs. he lost about 3/4 lb. in the past week. He's a big boy and used to be fat, which is how he got this. Plus, he's a brown tabby and I swear they are prone to it, so I watched him closely for diabetes and the minute I saw him drink extra water, he got diagnosed right away. He's had it 3 years and never went into remission until all of a sudden right now.

SUSAN/Toney
RIverside, CA

 

Okay a good general formula is 15-20 calories per pound, per day. So at his current weight, he'd need between 180-250 calories a day. A can of Fancy Feast classics, low carb, averages 80-90 calories. So maybe two and a half cans would be a good starting place. The more active he becomes once he is moving around better, the more calories he would burn.

 

The 90 I think was about 1/2 hour before I posted that, sorry I have no idea. I've been freaking out ever since. Told David to test him again before bed but he didn't tell me he was going to sleep or if he tested him. I'm SO frustrated. Should I give him some dry food tonight or let him go all night without food? He ate 1/2 small can after the 90. OMG. I hate this so much. It was SO much easier when he needed the insulin! We even have a great petsitter who gives it, she's a vet tech. All his curves over the past 3 years, he never went into remission or low like this, I don't know what is going on.

SUSAN/Toney
Riverside, CA

 

Thanks a TON, Carl, so he's getting about what he needs daily now then. I just don't know whether or not to leave him all night or put down dry food now. ?

 

I really do love Toney, I haven't even eaten today yet since 10am and have been researching this instead and trying to find a doctor who will treat my own condition. I've lost weight myself so rapidly that I figure I only have a month or two before I get too thin to surgically treat it. What a mess.

SUSAN/Toney
RIverside, CA

 

You said David gave him 2u tonight, right? If so, then I would leave food out. I have no idea how much two units will do on a 115.

 

No, it was 90 when he gave him the 2 units. That's why I'm freaking. It went up after we fed him. Have another question, about Zobaline, which I need to get since my liquid methylcarbolomine is only 1000mcgs per ml and not enough if the dose is 3000-5000mcgs per day. How many mcgs is in one Zobaline tablet? Thanks SO MUCH, you are a LIFESAVER, Carl. I swear you guys saved Toney's life and please, please please just keep us from killing him. David promised not to give any more Lantus without checking with me first. GEEZ.

SUSAN/Toney
Riverside, CA

 

No, it was 90 when he gave him the 2 units. That's why I'm freaking. It went up after we fed him. Have another question, about Zobaline, which I need to get since my liquid methylcarbolomine is only 1000mcgs per ml and not enough if the dose is 3000-5000mcgs per day. How many mcgs is in one Zobaline tablet? Thanks SO MUCH, you are a LIFESAVER, Carl. I swear you guys saved Toney's life and please, please please just keep us from killing him. David promised not to give any more Lantus without checking with me first. GEEZ.

SUSAN/Toney
Riverside, CA

 

OK, thanks for clarifying.
BG was 90. He got 2 units. And that was about two hours ago, give or take.

And he ate half a can of food then.

Yo have low carb canned food available. And dry food available.
But no high carb canned, right?


I can't offer any help on the zobaline, I never used it. But I don't think you can overdose it if I remember right. What ever Toney can't use, he'll pee out. Someone else who is familiar with it can help more, I'm sure.

My concern is that Toney can go low from this shot. Can you test again in thirty minutes or so? That should be about "+3" I think.

 

If I have the timeline wrong, please correct me

 

I just put down about 1/3 cup dry Blue Buffalo for him. The other cat might eat it but at least he has something to munch on all night. Just checked him and he looks good, didn't test though. Will in AM before feeding canned or giving insulin. THANKS ALL.

SUSAN/Toney
Riverside, CA

 

In the morning, this is just my opinion but if you see anything under 150, skip the shot. If you're more comfortable with a "no-shoot" of under 200, that's fine too.
If you wake up in the middle of the night, check to make sure there's still food available.

 

And before you go to bed, (not to sound like your mother or anything), make sure YOU eat something.

 

Thanks, I will.

Yeah, I know, I already told her right when I called them and got the info that it was cyanocarbolamin and I was pissed. She had no idea they were different in treating neuropathy. Then she looked it up and later told me I was right. I learned that so many years ago and aren't vets supposed to know? Vets are scary now that I have one cat with pancreatitis and one with diabetes. This is my 6th vet after all the other ones tried to kill my now 15 yr old pancreatitis cat and he (Kobe) is my best friend. He's doing GREAT now a year and a half later on minimal meds (2.5 mgs. prednisolone SID, pepcid and ondansetron BID). The yahoo groups panc site is to be applauded for saving HIS life and informing me. I worked as a vet tech years ago but never saw pancreatitis except on autopsy - no test for it or treatment protocol back then. Same with Lantus. Three years now and had to increase the Lantus .5 every time we did a curve. Now we lower it ONE TIME by .5 after a curve and he goes into remission? Makes zero sense to me.

SUSAN/Toney
Riverside, CA

 

Zobaline is 3mg per tablet, it dissolves very easily in just a tiny bit of water, so you can mix it into food... Probably would need to give a couple a day if your kitty has the neuropathy bad... Carl is correct, it is a water soluble vitamin that is not stored in the body, so they pee out anything over what is needed. I was giving it to Frog daily at first, but as he got better, I started giving it less... I now only give it maybe every 3-4 days.

Frog's neuropathy was only minimal, but it has been less than two months and he no longer shows any signs of neuropathy (that I can see) or weakness that he had previously. I've just ordered the vitacost methyl-b12 myself, simply because of the cost..(buy one-get one sale right now). I really do like the Zobaline, but I have too many kitties and the bottle of 60 Zobaline just empties too fast, lol.

 

How is Toney doing now?

 

This is so hard. I put out the corn syrup last night for David just in case and told him what to do. We left some dry Blue Buffalo food out last night for him, just a little, about 1/4 cup or less because he was hypo yesterday, no symptoms. Then today, Toney had a 239 this morning pre-shot so David gave him 2 unit of Lantus which only 1/2 his normal dose. 3 hours later he had a 178 and 13 hours later, a 159. Just now he tested 109, no insulin since this morning. He ate his normal 1/2 small can this morning, then only 1/4 can this afternoon and now he won't eat. No insulin since this morning. He looks about the same, I think he's constipated again though but he did poop a little, not a normal amount. So I think I have to leave dry food out again soaked in water this time. I don't have a good feeling about this and am wondering if it could be FIP?

SUSAN/Toney
Riverside, CA

 

I'm going to give him 2000mcgs of the methylcarbolomin liquid right into his mouth right now. I don't know what else to do for him. He doesn't look in pain but won't eat now. I'm hoping David can get him to at least eat a few bites.

SUSAN/Toney

 

This is so hard. I put out the corn syrup last night for David just in case and told him what to do. We left some dry BB food out last night for him, just a little, about 1/4 cup or less because he was hypo yesterday, no symptoms. Then today, Toney had a 239 this morning pre-shot so David gave him only 1/2 his normal dose (2 units) of Lantus. 3 hours later he had a 178 and 13 hours later, a 159. He ate his normal 1/2 small can this morning, then only 1/4 can this afternoon and now he won't eat. No insulin since this morning, we will test him again before bed. He looks about the same, I think he's constipated again though but he did poop a little, not a normal amount. I'm putting out dry food tonight with water in it and giving him 2000mcgs of methylcobalamin right in his mouth. I don't feel good about this, I wonder if its FIP?

SUSAN/Toney
Riverside, CA

 

More than you ever wanted to know about Feline Constipation
Many folks here use 1/4 teaspoon of Miralax, 1-2 times a day to help with constipation. It is possible that diabetic neuropathy may be contributing to that.

What makes you think it is FIP?

 

Susan, I sent you a pm the other day and you might have not seen it....


This is hard....
but it does get easier....


I've seen where the vet can feel when the cat is constipated. If he doesn't poo some more, you might need to take him in for an enema.

 

Thanks all of you SO MUCH for your help with Toney and for making me feel so much better about choosing and using another home meter after 5 meters didn't work properly. This ReliOn Micro meter works great and I'm THRILLED! We tested it against our vet's Alpha-Trak meter and our ReliOn Micro came up reading about 25 units less, perfect for a human meter used on cats. I feel so much better about giving Toney insulin now that I can test at home, not have to rely solely on vet-run curves and not have to keep running him to the vet every time he looks a tiny bit "off" or I think I see him drinking more. We'll still of course continue vet treatment, especially with this new hind end neuropathy problem but testing at home makes it MUCH better for Toney. I finally got some sleep too so can update you a lot more coherently on Toney now.

Most of today Toney looked a little bit better and used his left hind leg more, kind of hopping on his left foot under him with both haunches all the way down, dragging his right leg but not dragging both hind legs out to one side like he has been since 7-18-13. He has stood and sat daily on occasion and has even walked a few steps and it seems to me like the hind end neuropathy gets worse as his glucose gets lower. I just started the methylcobalamin so way too soon to even see improvement from that. Earlier tonight he managed to quickly somehow get himself from right next to me across two and a half large rooms under a nightstand table in only about 10 seconds without me even seeing him do it while I was preparing his test. I have to assume he was feeling better because he hasn't moved anywhere near that fast since the neuropathy happened or even in his entire life. I hate to think he was that afraid of getting tested, he then purred right after while I scratched him during testing and seemed okay with it. He's always really good about being lanced in the eartip, David and I both average getting blood now on the 2nd try and I know his ears will bleed easier the more we test. He really takes the testing and the insulin shots very well and I truly don't think he's in pain, I'm VERY good at reading pain in cats - no eye squinting, purrs a lot when petted, seems happy and even hangs out on the bed with David at night and can even get down all by himself safely (but not back up, David lifts him if he wants up).


7-24-13

158 at 11:20am before food. Toney may have eaten up to 1/8 cup Blue Buffalo Basics Sensitive Solutions Grain-Free Turkey and Potato dry adult cat food w/water added last night but unsure if he ate it all or the other cat housed with him did. Gave no insulin. Gave 3000mcgs methylcobalamin liquid (has no sugar) mixed into 3/4 small can of Fancy Feast Classics w/added water (for extra hydration) and he was hungry and ate all of it. Not dehydrated (according to skin elasticity and gums aren't sticky, which I check 3x daily) so I know he's drinking and David has seen him drink a few times. (There are three bowls of water in the two rooms he is in now so he never has to go far to get water. The other cat has dry food free-fed up on a shelf Toney cannot get to.)

184 6+ Ate well, 1/2 can Fancy Feast with added water and 1/4 tsp. Miralax. Two cats in there, 3 pees today and 2 BM's that look like they are from two different cats, one normal BM, one half the normal amount but normal size/moisture.

227 at 11:10pm after no insulin all day today so I gave 2 units Lantus insulin and another 1000mcgs methylcobalamin liquid in 1/2 can Fancy Feast Classics which he ate very well. I gave a total of 4000mcgs just for today, still haven't decided on a daily dose, from what I've learned with this bad of neuropathy, some give 3000mcgs and some give 5000mcgs, so I went in the middle at least for the first day of it.

90 at 4+ 3:20am Dragging both hind legs again, alert, purred when scratched, ate about 1/8 can Fancy Feast Classics w/water added. Left 1/8th cup Blue Buffalo Basics Sensitive Solutions Grain-Free Turkey and Potato dry food in water again overnight but didn't see him eat any and there is another cat with him we can't remove.


Questions:

1. Is 90 too low for 4+? I can't test him again tonight, he'll have to wait until tomorrow. If so, it looks like we can't even give half his Lantus dose now, prior to the 7-18-13 hind-leg dragging neuropathy, he was getting 4.5 units Lantus, we took him down to 4 and he went hypo, now even 2 units takes him way too low?

2. So next time he goes over 200 should I just give 1 or 1.5 units of Lantus?

3. Can anyone else who hasn't already chime in on how much methylcobalamin B12 will work IF this is diabetic neuropathy? I figure if not, it can't hurt and if so, it will help. Also, should I give the cyanocobalamin weekly shot the vet mistakenly gave me in case this is something else that might be helped by its anti-inflammatory properties? He is due tomorrow for that and he did seem to get better after the last one. Or should I just switch to the methycobalamin instead?

4. Does it make sense for a cat that was totally dependent and well-controlled on 4.5 units of insulin for almost 3 years with no sign of remission to all of a sudden go hypo?

I think Toney did a little better today, had more energy (probably from the M B-12), we are both doing the insulin and tests better, he didn't go hypo today (like the last two days of low 25 and 37 readings) and these figures look more normal. We switched his food on 7-18-13 from dry food only to Fancy Feast Classics canned food). We are using the new ReliOn Micro glucose meter 4x per day and have been keeping a daily testing/meds chart I will copy and fax to his vet tomorrow. I'm not giving up while he's not in pain, still using the litterbox and not giving up himself and while we still don't really know what is causing the hind end dragging neuropathy. I don't think an ultrasound will show the cause and don't think a specialty hospital will be able to do anything more for him and is cost-prohibitive after I spent $700 there on an upper gi scope for my pancreatitis cat that they didn't even complete because they couldn't get it past his pylorus. I worked for small animal vets in the past and I know this bill was WAY too high for an incomplete and inconclusive scope without any biopsies and that really didn't make me want to use them again (CVS Ontario, CA).

As for your questions about ticks or fleas - Toney and all our indoor cats are strictly indoor-only with no screens even left open. We do have ticks outside our 3-acre property perimeter and while I have never seen one inside or even on our outside dogs, alpacas or horses, it could happen. I check and can't find anything on Toney. We have had occasional fleas so I don't treat the cats but spray the carpet, floors and bedding (not all at once, I do 1-2 rooms per day just to be safer b/c one of our cats has damaged turbinates and one has pancreatitis/IBD, both are doing VERY well) and I just sprayed in the rest of the house yesterday but won't do Toney's two rooms and no fleas in there so far. I haven't sprayed since early May so its not the spray and the stuff I use is pretty safe. The only thing I have noticed recently on Toney is a small red swelling on the gumline right under his two bottom front teeth. The vet and I both think it could be the start of oral cancer or it could just be him rubbing his face on the carrier like usual - he somehow scratches his nose itching his face on the plastic carrier holes every single time he's in it, too and our other cats never do that when in it. I'm keeping a close eye on it and getting a new soft carrier that he hopefully can't hurt himself on.

SUSAN/Toney
Riverside, CA

 

I like seeing all the little improvements.


His lower numbers indicate that he doesn't need as much insulin as before.
If we could get you a spreadsheet started, you (and we) can see patterns better as to where his dose should be.
how to set up a spreadsheet



Look up at the top of this page...where it says...

Board index ‹ FELINE HEALTH: The Main FDMB Forum
User Control Panel (0 new messages) • View your posts

You should have (1 new message) in the brackets....

 

Sounds like the insulin is making him feel better - too early for the methylcobalamin to be making a difference. The spreadsheet will give us a much better view of whats going on.

To answer your questions..

90 at +4 is ok - really it depends on how low he continued to go for that cycle - Lantus hits max action around +5 to +7. Also remember Lantus is a depot insulin so it will take a few days of the same dose to see what effect the 2 units has. You are probably still seeing carryover effects of the 4 units at this point.

No -as above - I would continue the 2 units for 3-5 days unless he drops under 50.. And at that point re-evaluate. The key to lantus is consistent dosing and you have been all over the place so we really cant tell whats going on.

Check this site for dosing - http://www.laurieulrich.com/jasper/

Did you change the food? Do you know how many carbs are in that dry food?


Wendy

 

You said you put the other cat's food up out of reach of Toney. Just wait until the methylcobalamin and the lower BG's start to have more of a full effect. ohmygod_smile When I first started to foster Wink, he had very severe neuropathy. Couldn't walk more than 3-4 steps without stopping to rest. Couldn't jump or climb up more than about a foot. Walking entirely on his hocks. Couldn't play or run. Now, with his BG's under control, Wink is a jumping maniac, chases the other cats all over my home, and can get at any food within his reach in minutes now that his neuropathy is greatly improved. :shock:

Dry food often has a high mold content. I realize you are trying to get more moisture into your cat's diet by adding water to the dry food. My recommendation is to be conservative and take the moistened dry food up after an hour or 2. For safety's sake. We don't want your cat to become ill from eating the moistened dry food. :!:

You mentioned some redness and swelling on his gums that you and your vet thought could be oral cancer. These types of cancers can be very aggressive and fast moving. Keep your eye on the mouth and gums for further signs of progression. Oral cancer killed one of my cats recently. Cancers have also been known to 'eat the blood glucose' as someone else expressed it. I'm not saying this is what has caused your cat to suddenly need less insulin, but did feel you should be aware of the possibility. :sad:

 

I signed up for Google and went to the spreadsheet, but its too confusing for me to use and getting the insulin right is hard enough without that. Do you know of a more user-friendly spreadsheet? The booklet that came with the meter isn't working out at all.

I did change his food from dry to canned and he did go below 50 - to 25 and 37 on the 2.0 Lantus. His last Lantus level 5-6 days ago was 4.0 which made him hypo and even when giving 2 units of Lantus even once a day now, his glucose drops too low. I doubt he'll go over 250. If 1 unit Lantus is too low, I'd rather have him be high glucose right now than in a seizure or dead. We check glucose 3 and 6 hours after the morning insulin shot and then another 1-2 times after the last shot or even if none given. Below are the instructions I copied from yours and changed for our food, how does this look?

SUSAN/Toney

above 280: 1.5 units Lantus, go straight to vet
250-280: 1.5 units Lantus, feed Fancy Feast Classic canned food
200-250: give 1 unit Lantus, feed as above
Under 200: no Lantus, feed as above
Under 50: no Lantus, feed 1/4 small can Blue Buffalo and 1/4 small can Fancy Feast Classic
Under 40: no Lantus, feed 1/2 small can Blue Buffalo with 1 tsp corn syrup, pancake syrup or honey mixed in. If he won't eat, see below.
Under 30: no Lantus and not seizuring, feed the above. If he won't eat, syringe 1 ml. corn syrup, pancake syrup or honey into his mouth.
If seizuring or coma: no Lantus, syringe 1 ml. corn syrup, pancake syrup or honey anally, wrap loosely in blanket or towel, put on floor of car and GET TO VET ASAP.

 

What does AMPS mean on the template?

SUSAN/Toney
Riverside, CA

 

AM Pre Shot test.

 

Susan, We can get you started with the spreadsheet setup and link it too your signature if you like. Send me a PM if you are interested. Once you see a few numbers in there, you'll find it easier to use.

Here are what some of the columns mean:

AMPS = morning pre-shot test
PMPS = evening pre-shot test
U= number of units insulin given
+1 = 1 hour after the shot
+2 = 2 hours after the shot
+3 = 3 hours after the shot
+x = x hours after the shot

Remarks column for what you want to keep track of. Like how much food fed or how your cat is feeling.

 

A glucose over 280 does not require a trip to the vet, EXCEPT if sick, showing ketones, or not eating (and any combination of these).
- a vet visit is warranted if the cat is sick as diabetes may complicate management.
- ketones may suggest diabetic ketoacidosis which can be fatal and cannot be managed at home
- if the cat has not eaten in 2 or more days, there is an increased risk of hepatic lipidosis, which can be fatal

Also, we do not use a sliding scale with Lantus here; we give the same dose every 12 hours.
Adjustments to the dose are based mainly on the lowest between shot number - the nadir.
If the pre-shot numbers are exceptionally low, and you frequently cannot give insulin, that may also result in a reduction.

 

Where did you get that dosing instructions from?

 

Thanks, but I still just do not understand that spreadsheet. None of the top numbers make any sense and my numbers don't match the top colored number sections AND the section stating +1, +2, etc., there is no place to enter some of them. It is way too confusing, I have zero clue where to enter things. Isn't there an easier spreadsheet out there, preferably one that I can print out and keep near the testing unit and write in? David is testing too and he already screwed up the booklet the meter came with and I can't interpret his tests. We really need an easier way to write them down if I have to make one myself and I'm too exhausted right now.

Below are Toney's latest numbers and I don't care if it is Lantus or not, there is NO WAY I'm giving another 2.0 if he goes over 200 again, it just keeps taking him way too low and then I'll be up all night AGAIN. 6 days ago he was on a 4.0 Lantus dose and got hypo and now even 2.0 is too high a dose, last night it took him from 227 to 90 at +4 last night and I'm sure went even lower and I didn't sleep all night again. I can't do that even one more night. I'd rather have him a bit hyper than at a 25 or 37 again. I just hope these numbers I'm getting on this meter are right, I know they must be close from the Lantus response.

QUESTION:
1. How do you know how much blood is enough or too little? The meter is supposed to tell me if there isn't enough blood but it never has and twice now I didn't think I had enough, don't remember which times but it never said that. I already have to go buy more strips and lancets, you go through these like crazy testing 4-5 times a day like this but with these numbers, I have to.

TONEY'S GLUCOSE TEST/MEDS/FOOD CHART

All tests were done before feeding canned food and taken on a ReliOn Micro unless stated.
It will state if dry food was left out all night (because glucose was too low).
BB = Blue Buffalo Basics Sensitive Solutions Grain-Free Turkey and Potato (canned food or dry food is stated)
FF = Fancy Feast Classics Chicken Feast canned food

DATE GLUC. TIME FOOD and MEDS GIVEN VITAL SIGNS

insulin dose reduced from 4.5 to 4.0 resulting from curve at old vet's office (don't have)
7-18-13 104 11:00am 104 (on vet's Alpha-Trak meter) Weight 16.3, Temp. 99.7, Pulse 220, Resp. 30
(David gave wrong dose of 5.0, should have given 4.5)
7-20-13 Dr. Sanders returned my call. I asked Dr. Sanders what type of Cobalamin Dr. Dillman gave us
on 7-18-13 in the pre-drawn syringes labelled just "Cobalamin". She said it is Cyanocobalamin and
that it converts to Methylcobalamin in cats. I said no, only Methylcobalamin works for diabetic
neuropathy. She looked it up online and said I am right. I asked her for the M-B12 dose and
she said 250mgs. 2-3 d. or 1/4 5000mcgs twice a week. I said I thought it was higher, 3,000mcgs
to 5,000mcgs and she said no. She said she still doesn't think the bilateral hind-leg dragging is
diabetic neuropathy but the methylcobalamin can't hurt. I asked if low his 7-8-13 K of 3.7 is low
enough to cause it and Dr. Sanders said no, its not low enough to cause this and normal K is 3.5-5.8.

7-21-13 37 10:46pm (no Lantus given, gave BB canned food)

7-22-13 25 10:45am (no Lantus given, gave higher calorie canned food)
52 10:45am Using Alpha-Trak meter at vet's office, Dr. Sanders calibrated our ReliOn meter at 25,
Alpha-Trak at 52. Dr. Sanders told me over the phone to reduce Lantus to 4.0 and that this meter doesn't work, I explained that human meters
run about 20-30 lower than Alpha-Trak so this does work like a human meter should on cats.
80 5:30pm (no Lantus given, gave Fancy Feast canned food)
115 8:22pm (2.0 Lantus mistakenly given)
90 9:51pm (gave higher calorie canned food and left dry down all night)

7-23-13 239 at 8:00am (2.0 Lantus given)
178 at 10:00am (no Lantus given
105 at 10:30am
159 at 8m (no Lantus given)

7-24-13 169 at 8:30am (no Lantus given, Fancy Feast Classic fed, ate 1/2 can,
may have eaten up to 1/8 cup BB dry food left out last night)
158 at 11:20am (no Lantus given, 3000mcgs MB12 mixed into Fancy Feast Classic canned food, only
227 at 11:10pm (gave 2.0 Lantus)
90 at 3:20am 4+, fed Fancy Feast Classic Chicken and put down dry food

7-25-13 188 at 8:40am (before meal, but left out dry food again because last night he was only 90 at 4+, didn't look like hardly any is gone and there is another cat in with him I can't remove.)

Just talked to our vet, she said its okay to go ahead and try the 1.0 or 1.5 Lantus dose even once a day while testing every 3 hours at first. She made an interesting comment that this is why vets' offices don't test at all during the first week of any food change in diabetic animals. I told her I could never do that, but I do understand it now. Hopefully this will work and I can finally get some sleep, will keep you all posted. Thank you SO MUCH for all your help!

SUSAN/Toney
Riverside, CA

 

Hi!

I put a SS together for you and will share it with you so you can edit it, if you PM me your email address

Take a look at it and see if it looks right to you? https://docs.google.com/spreadsheet/pub?key=0AmWmpHZ2Pu8QdDRBTWZoczNnd3B3RV80MHJ6UEJmQ1E&output=html

Wendy

 

Re: spreadsheet

First column is date.
Column labeled AMPS is for the morning (AM) pre-shot.
Column labeled PMPS is for the evening (PM) pre-shot.
Units is dose of insulin given
AMBG = morning blood glucose if not on insulin
PMBG = evening blood glucose if not on insulin

Columns labelled +# represent the hours since the shot was given; you enter any mid-cycle, in-between shot tests in the column which represents how many hours it has been since the prior shot. Members are in different time zones, so rather than trying to convert for that, we reference how long it has been since the shot was given.

 

Thanks, but I still don't understand the colored sections at the top, they don't make any sense.

 

Just had to post to all - Toney hasn't needed any insulin for two days now, his glucose levels are normal AND LAST NIGHT HE STARTED WALKING. Its the methylcobalamin. I'm SO glad I knew the shots the vet gave me looked like the cyanocobalamin and asked them and then didn't listen to them and gave the M-B-12 anyway. They told me to give 250mcgs and I said NO, its 250mgs. They insisted but didn't even know, had to look it up online. So I gave 4000mcgs for 2 days and the third day, he started WALKING. I'm lowering to 3000mcgs once he gets better and then when do I stop giving it? I was so tired from being up for 4 nights with him hypo, I slept 20 hours so only now could post this. THANKS ALL

SUSAN/Toney
Riverside, CA

 

The neurapathy is a side effect of uncontrolled diabetes, so once he's walking normally, you probably can taper off to nothing. It is water soluble, so if he doesn't need it, it will be excreted through the renal system.

Just keep an eagle eye out for signs of infection - dental (look at the mouth weekly for redness & tartar), bladder (frequent, small volume pee spots), and respiratory (goop in eyes, nose, coughing sneezing).Those elevate glucose and may bring a return of the neurapathy.

 

I am still pretty sure its not the methylcobalamin - it takes 4-6 weeks. Could be just that his blood sugar is way better and so not damaging his nerves.

What do you mean "normal" for his blood sugar? Can you give us some numbers? (Normal cats levels by the way are 40-130.)

Wendy

PS coloured row at the top (above the horizontal blue row) is just a key to remind you what the colours mean ie black is when blood sugar is over 500, red is when blood sugar is 400-500 etc.

 

I don't know, I've never seen neuropathy reverse itself this quickly and I worked as a vet tech. This is amazing. He didn't reverse like this when his glucose went down before giving him the M-B-12.

SUSAN/Toney
Riverside, CA

 

Whats his blood sugar levels like?