newly diagnosed with hypo incidents won't eat

Papoose (14 years old) was diagnosed with diabetes approximately 4 weeks ago. He hasn't been truly regulated the entire time. He still has the disheveled look that a diabetic cat has. He has spent 4 days over these weeks with the vet to monitor his blood sugar. Unfortunately, he will rarely eat while he's there. This morning I found him frozen at his water dish, not moving/blinking/waging tail/anything. He had uneaten food at his dish (he loves to eat, so this is unheard of). He was rushed to the vet where they attempted to get him regulated over the course of the day. He froze again while at the vet and they force fed him and checked sugar. Unfortunately, he threw up the food. The vet wanted to keep him overnight, but I brought him home where he is more likely to eat and to monitor him constantly. Should he be given a shot tonight? Anyone had this happen with their cat? Thank you!

 

I don't know if you've given a shot tonight yet, but I'll bump this up for you. It may help to let us know what the vet said- was he hypo there? What did the vet do to "get him regulated," insulin or a glucose drip? Does he have ketones? Do you test his BG at home? What insulin is he on? Did the vet tell you to give insulin tonight? These things affect whether or not you should shoot tonight.

If you're not monitoring his BG at home and he was hypo this morning, that makes giving a shot riskier.

When is your normal shot time? You may want to add a "911" prefix to your title (Thread tools > Edit Title > Click the little down arrow and click "911") It will get some more experienced help here quicker.

 

normal shot time is 7 a.m and p.m.
Vet force fed food since he was not eating. (He threw it up.) If they did anything else to help with the sugar, they did not tell me.
Insulin = Novolin, was 2 units each dose, until last Friday and then Vet had me up to 3 units.
I have not given the insulin tonight since he has not eaten.
I did give him 1/2 pill for nausea just in case that was the problem with him not eating.

 

Has it passed tonight? Did you give insulin? How about the other questions from my first post?

Sorry to bombard you with questions, but the more we know, the more we can help.

 

added more info to last post

 

Are you testing at home? If not, PLEASE PLEASE consider it really quickly - like going to get meter tonight or tomorrow. You'd know immediately if he was in a hypo situation if you were. Hypo's can quickly kill a cat...not good...bg's taken at vets office are falsely elevated due to stress of travel and being at vet's office.

 

Good call on not giving insulin tonight. Many cat parents use Novolin, but I've read from many here it brings down numbers harshly and quickly. I agree with Lyresa that testing at home is imperative, and you'll hear that from most members here.

Did they tell you anything else about his state at the vet? Did they do bloodwork or any BG tests (even if they're elevated, knowing them will help)? If I were you, I'd call and get that information ASAP. They wanted to keep him overnight, so it may be more than him not eating. Did they give you anything so you could try to force feed at home if necessary?

 

Yes, Novolin is fast-acting, harsh and can cause BG to dive sharply. I know from firsthand experience because CJ was on Novolin and went hypo on it. The day I learned to home test was the day I learned she was hypo. I saved myself an ER visit by home testing and getting guidance from members here.

Please rush out and get a glucometer tonight. Many of us use Walmart's Relion Micro or Confirm and strips. You can use any lancet/gauge but starting out, we suggest using a 26 gauge. If you are not near a Walmart, Target, Rite Aid and other places sell human glucometers.

Force feed with a syringe. If your cat is dehydrated, give unflavored pedialyte.

Tips for home testing: http://www.felinediabetes.com/FDMB/threads/testing-and-shooting-tips.85113/

http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

 

upon arrive at vet this morning/about 7:30 a.m., BG was 240; after he had been given pancake syrup twice (due to his severe hypo episode).
Vet didn't tell me all results from today. Vet gave him a shot soon after I got him there (even though they knew he hadn't eaten). One of his test results today was 35..that's when they force fed him. BG when I brought him home today around 4:30 p.m. BG was 119. No mention of force feeding him at home. It is 9;14 p.m. and he still hasn't eaten anything.

 

So you are home testing, right? If so, that is good. You can treat hypo episodes at home with guidance from members here.

Since Papoose has been bouncing, check his BG again. If #'s continue to be under 200, don't give a shot tonight. If he isn't eating, force feed him low carb food. If his BG falls under 50, steer his #'s up with honey, karo syrup or high carb gravy food. You can give the honey or syrup via a syringe.

Here's a handy glucometer guide to help you:https://docs.google.com/document/d/1oI_34_EgqeKdpyttFW0oLoG1mbw16IkATAWHhoQD2JU/pub

If Papoose's #'s dip below 50 again, start a new thread with the Prefix 911 so members can assist you quickly.

 

Not testing at home (will be starting tomorrow)...vet had not mentioned it and I am new to this. I think the Vet gave him 3 units this morning, but I'm not 100% on that. We just raised Novolin last Friday to 3 units, twice a day (from 2 units) as his sugar had been up to 500+ at the vet's office.

 

He did have a hypo incident at the vet's office today...dropped to 35...that's when they force fed him. Vet said she had never seen a cat freeze like he did when going hypo.

 

BG #'s at the vet are likely to be elevated by 100 points or more especially with a stressed cat. Home testing gives a more accurate picture of what Papoose's true BG #'s are and allows for better insulin dosing. Can you get a glucometer tonight? You'll need it to see if Papoose is dropping again or bouncing too high. Members here can assist you with dosing and if he goes hypo again but we need you to be home testing.

 

CJ went to around 35 when she went hypo. I steered her #'s back up with guidance from members here and saved myself and CJ a needless trip to the vet. Plus I saved tons of money.

Novolin is fast acting and very harsh so it can cause a cat to bounce sharply. It is such a harsh-acting insulin and CJ got so sick on it. A better insulin to consider would be Lantus or Prozinc (I believe Prozinc works in a similar way to Novolin in terms of how you administer it but lasts longer).

 

@BJM @julie & punkin (ga) Can you help catmommy7?

 

what did you do for hypo incident? anything different than syrup?

 

Fantastic job on getting Papoose to the vet today when you noticed something was wrong. Even when hometesting, it happens, you did the right thing. Experience and knowledge (and data!) about his reaction to insulin may help you handle some things on your own in the future, but getting a cat showing hypo symptoms to the vet when you don't now what to do is so important.

 

I gave CJ karo syrup with a syringe and kept checking her BG every 30 minutes or so. But her #'s only went below 50 twice. After that, she never bounced back up and went right into remission. Most cats don't do that; she was one of the unusual lucky ones. She was lethargic and "off" for a few days; the hypo incident hit her hard but I forced fed her food and fluids till she was able to eat and drink on her own again. I can't emphasize how important it is to home test. I never had to take her to the vet during her hypo episode. I had wonderful expert members guiding me here.

If you're not familiar with home testing, please see the links I gave above and watch the videos. They will be very helpful. It really will give you peace of mind to test at home and get Papoose back on his feet sooner. Giving insulin without checking glucose levels first is like driving blindly. You'll also be able to do glucose curves at home instead of at the vet.

 

I don't have experience with Novolin, but it sounds like it was a hypo - 35 is dangerously low. You did the right thing by giving him syrup - you can also rub it on his gums if he won't eat it. I haven't heard of freezing up as a hypo symptom, but that must've been related.

Are you saying that you saw him freeze, took him to the vet, and THEN he got his shot? Then after that he was 35? I wonder if the vet tested before they shot him . . . If I'm understanding correctly, he may have been very low before he got his shot. I don't know.

It's good you skipped his dose tonight. Whatever dose he's had that got him to 35 this morning is too large. He needs his dose reduced. Sometimes cats that have had a symptomatic hypo like this can be more sensitive to insulin afterwards.

We are all pro-home-testing. None of us are vets, so all we have to go on are test numbers. I can't encourage you enough to get a glucometer. Human ones (as opposed to Alpha Traks, or pet glucometers) are far cheaper to use than the pet meters.

Here is a link that has a lot of ideas for getting a cat to eat. Especially with a diabetic cat, it's essential you get him eating asap. I wonder if he's lost his appetite because he's having some pancreatitis. Take a look at that link and see if it's describing what you're seeing. Pancreatitis is common in diabetic cats and there are things that can help make it better.

 

thank you...I'm on it. We are staying in the same room tonight where I can keep an eye on him all night.

 

just thinking about that freezing up - do you think it could've been a small stroke? are you seeing any effects on either side of his body?

 

found him frozen first thing this morning...gave him syrup until I got him alert and acting somewhat normal...took him to vet within the next hour....vet gave him a shot about 1.5 or 2 hours after hypo episode (he had not eaten). Not sure at what time during the day he went to 35 (she kept him all day).

 

So by "frozen", do you mean lethargic? That is common with a cat dropping so low.

 

he was sitting in a frozen position...wasn't blinking his eyes/waging his tail/any movement like he would normally have when I walked into the room. They syrup brought him out if it that's why I feel fairly certain it was hypo.

 

Find out in the morning what the vet did and if any blood work was done. Did they check for pancreatitis?

 

i know the vet did bloodwork, but I don't know the results other than a few of the BG readings. I will ask if she has tested for pancreatitis.

 

I can only imagine how scary this day has been for you.

One of the benefits of hometesting is that you no longer have to wonder about what's going on. You'll be able to test and know. It can be intimidating to start with, but you'll get the hang of it in no time. Kitties can and do accept the testing - you'll give a treat with every test so Papoose (what a cute name) will come to associate the testing with a treat. Knowledge is power - and testing answers so many questions and tells you what to do with his dose. It's all good.

The one thing I'd add is to not get discouraged if you have trouble getting blood at first. The ears will be stimulated by poking and they will grow new capillaries. After a couple of weeks you'll get blood every time.

This is a link to the WSAVA below. Take a look at page 156 - the recommended insulins for cats are PZI, Lantus and Levemir. They are longer-lasting and less harsh in their action. You may want to ask for one of these insulins instead.

• 2014 ~ 39th Congress of the World Small Animal Veterinary Association (WSAVA) ~ many thanks to Larry and Kitties and Wendy&Neko for sharing:
  • Which Insulin in Cats - p 156
  • Management and Monitoring of the Diabetic Cat - p 160
  • Feline Diabetes - p 229
  • Diabetes Mellitus and Quality of Life - p 730
  • Acromegaly in Cats – p 733
  • Insulin Resistance – p 737 (description of mechanisms of resistance on p 738 under heading Pet)
  • Medical and Nutritional Management of Diabetes Mellitus – p 739 (description on p 741 of glucose toxicity and lipotoxicity)

 

If you've found him like that after 3 units, then 3 units is too much insulin. Tests at the vet may be from 100-180 mg/dL higher than at home.
Here is our guide on using Novolin NPH (aka N, similar product is Humulin NPH).
N lasts roughly 6-8 hours in most cats and may require dosing every 8 hours for better control.

 

@catmommy7 Let us know how Papoose is doing. And don't forget to take a deep breath.

 

Papoose was to return to the vet this morning, but made it clear he did not want to go. I chose not to take him as I just don't feel I'm getting anywhere (other than a big fat bill). He did eat around 3:45 this morning and again after 7 a.m. I gave him 2 units. Will see where we go today.

 

Did you home test first? If not, please get a human glucometer and strips today. Giving insulin without checking glucose levels is like driving without seeing. You may run the risk of another hypo episode today or in the days ahead even at a lower dose because Novolin is so harsh and fact acting. You cannot always observe a cat based on symptoms alone. Plus, by home testing, you'll spare yourself and Papoose needless, stressful vet visits and expense.

 

Please read this guide: http://www.felinediabetes.com/hypo-emergency.htm Had I kept giving CJ Novolin without testing, she would have been going back and forth to the ER or vet. She wasn't showing symptoms and her BG #'s were as low as Papoose's when she went hypo. As you mentioned in your first post, Papoose has not been truly regulated and this is indeed true with Novolin. It is hard to regulate any cat on Novolin because it isn't long lasting and isn't easy on a cat.

Again, please get the meter and home test. It will make life so much easier for you and Papoose and spare you needless vet visits.

 

@catmommy7 , how is Papoose doing? We are all on pins and needles waiting to know.

 

I've force fed Papoose 3 times today. He may need to go to the vet for iv fluids. I'm giving H2O with a syringe, but I'm afraid it is not enough.
He is still very lethargic (but is walking around some) and has very glassy eyes. I'm hoping this is due to the 2 hypo episodes yesterday. P.S. He has not used the litter box in about 11 hours.

 

have given him 15 ml of water each time I've force fed him today (3 times so far/getting ready for the 4th)

 

Have you checked his BG? If you aren't testing, and he still glassy eyed, I think I would take him back to the vet. When you say he is still lethargic can you tell us what you mean?

 

he's walking and moving around, but definitely not perky and his usual self...he did not fight me when I force fed him food and water. But, he's also a very clam cat who will normally let me get by with anything with him.

 

Do not give him insulin tonight. Novolin is very hard on a cat, very harsh. The 2 units you gave this morning may have very well put him into another hypo episode.

Do you have someone who can buy a glucometer and strips tonight and help you test? If not, I'd get him to the vet/ER ASAP. Without home testing, you don't know how low his numbers are and very low #'s are dangerous. Do not give insulin until Papoose's BG levels are checked and above 200 (home BG #'s). You'll get the best results testing at home.

@BJM, @julie & punkin (ga) can you please help? Papoose went hypo yesterday on 3 units of Novolin. catmommy7 gave 2 units of Novolin this morning and it appears Papoose may be in another hypo crisis. catmommy7 hasn't home tested yet.

 

I hate to sound like a broken record, but you really need to be testing him at home. His behavior doesn't sound good to me.

 

So more members can help you more quickly, please edit your title and add the prefix 911. We care and want to help.

 

From an alternative Hypo Symptom Guide to the one on FAQs:

Symptoms of hypoglycemia: [in order of ascending severity]

• 
  
• abnormal hunger / complete disinterest in food
• restlessness
• weakness, lethargy
• head tilting
• shivering
• staggering, uncoordinated movements
• problems with eyesight
• disorientation (yowling, walking in circles, hiding, etc.)
• convulsions or seizures
• coma

This list is by no means exhaustive; cats have also been known to be very sleepy, drool, vomit, or have glassy eyes. Be aware of behavior from your cat that is uncommon...

(Emphasis mine.)

Source Link: http://www.felinediabetes.com/hypogly.htm

If it was my cat displaying those symptoms and I had no means of home testing I would rub honey or karo on its gums IMMEDIATELY and call my emergency vet with a view to getting the cat under veterinary supervision as soon as possible. For me it would be too risky to wait and see.


Mogs
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@Shiloh & Rhonda, @Cat Ma - Can you keep watch on catmommy7 and Papoose? I'm feeling really rough and I desperately need rest.

 

Shiloh and Rhonda are off to sleep. I will be here for little while longer. Thank you, @Critter Mom

 

just fed him and he squirmed...I told him it must be working to make him feel better;

 

Have you rubbed any honey on his gums yet?

If he is hypo (and there is a distinct possibility that he is) then the food won't raise his levels fast enough.

 

@catmommy7, Do you have any way of getting someone to get a meter for you tonight so you can check his blood glucose #'s? Honey, karo syrup or a high carb gravy food is good.

 

@catmommy7, did the vet tell you to give 2 units of Novolin this morning?

 

no...Papoose didn't visit the vet today

 

Please can you let us know if you've given Papoose some honey. It's really important for your cat's safety.
.

 

@catmommy7, Please don't adjust Novolin doses on your own.

When CJ went hypo, I stopped giving her insulin. I listened to the advice from expert members here.

 

@Cat Ma - I'd actually keep suggesting that @catmommy7 keeps using honey on gums as a precaution and get her cat to the vet (or, at minimum, phone her vet for advice). There are too many unknowns without BG readings and the symptoms don't sound good, especially the glassy eyes.

I can't stay on any longer. I'm really struggling with exhaustion. If you need support try posting a 911 on health and also on L&L. Suggested title: "HELP NEEDED - Possible Novolin Hypo in Progress - NO METER." I hope everything goes OK for Papoose.


Mogs
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If you can get to an ER vet, that would be best.

Can someone else drive while you give high carb gravy or syrup?

If you gave insulin and he's in hypo again, you need to give 1-2 teaspoons of gravy or food with honey/karo/other syrup, every 20-30 minutes. It may not be enough.

 

It's very hard to regulate a cat on Novolin, @catmommy7. Please get Papoose in to the ER or vet. Don't ride out this Novolin roller coaster on your own. Figuring out and cutting back the dose on your own puts Papoose's life at risk.

Often, when a cat goes hypo on Novolin, one has to wait till the #'s go back up above 200 before giving insulin at a reduced dose. Occasionally the #'s never go back up, as they did in CJ's case. You can't know without home monitoring daily.

Giving insulin blindly without testing before shooting (giving insulin) will keep putting Papoose at risk for repeat hypo episodes.

 

@catmommy7 - Please can you let us know how things are with you and Papoose? We are worried about you both.

 

BG was 68 this morning at the vet. No insulin since yesterday morning. Vet gave him medicine for nausea and an antibiotic (states he has fluid at the top of his abdomen and lots of gas in his digestive tract). She checked his mouth for any issues that may be keeping him from eating and found none. Vet says to lower insulin to 1 unit when I do give it. She wants to see him again on Friday. She states if the sugar stays as low as it has been, she will discontinue use of it. He purred the whole way home. He's happy to not be at the vet getting poked more. Will post more this evening.

 

Did you tell the vet about Papoose being lethargic and glassy-eyed last night?

Did your vet use a pet glucometer or lab equipment to measure your kitty's blood glucose today?

.

 

blaming it on lack of sleep...correction to last post...68 this morning at vet AFTER he had 2 units

 

Did the vet say to hold off giving Novolin till you go back to the vet Friday? Papoose could very well be going into remission if her #'s continue to stay so low.

Did the vet say what the fluid in the abdomen is due to? Do you know the name of the antibiotic the vet gave Papoose?

 

@catmommy7 How is Papoose doing?

 

Papoose is still continuing to improve. He is looking better, although his eating and drinking are still a little sluggiesh. He has received one unit of insulin Wednesday, Thursday and Friday mornings only. He returns to the vet today for a check up. He ate a couple of times overnight (setting alarm clock every 2 hours and checking on him/3rd night of doing that). Definitely think we are moving in the right direction.

 

Very relieved to hear that Papoose is feeling better. He is blessed to have you to care so well for him.

I hope the vet check-up goes well. Do let us know later how you got on.



Mogs
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Flagyl is the antibiotic...chewable...he won't take it.

 

Our vet told me it's foul-tasting. Some cats really froth and drool after it. I'd suggest posting a new topic on Feline Health asking for help with administering Flagyl.


Mogs
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@catmommy7 Flagyl can be given as a shot and/or given as a liquid suspension and mixed in food. I believe it also comes in tablet form and can be crushed and mixed in food. I haven't had a cat that likes chewable antibiotics.

Please let us know how Papoose's visit went today.

@Larry and Kitties how do you give your cats flagyl (metronidazole)?

 

I place my metronidizole in a #3 gelcap and pill MurrFee. 1/4 of 1 250 mg tab of metronizole fits nicely.
Googling only shows IV injectable metronidizole.

 

Any pill can be surrounded by Pill Pockets to seal in the taste of the pill. Then you just poke it down the kitty's throat.

Are you having trouble affording a glucometer? Because there are ways to get you one if that's the stumbling block to getting you hometesting. Cats are notoriously hard to regulate their blood sugar and the only way to know with certainty what's going on inside Papoose's body is to test.

How did the appointment today go?

 

Appt was routine/generic, at best. The vet doesn't seem to be helping. Papoose's sugar, of course, is higher when he is there. Plus, he won't eat when he is there, so she is not getting accurate readings. I've decided to fight the battle at home. My sister had a diabetic cat and it advising and helping me along as her cat fought the battle for 3 1/2 years. Papoose is improving slowly. I still must encourage him to eat, but he is eating. Only giving 1 unit each day and that depends on the behaviors I'm seeing out of him. He was high yesterday morning before I gave the shot. Today, for the first time since the madness began, he was asking for his breakfast....great sign!!

 

That is great that your sister has a diabetic cat so she can help guide you through this and help you with home testing. We're here to help, too!

 

It's great that your sister can help. Is she teaching you the home testing? And as @julie & punkin (ga) asked, are you having trouble getting a meter? There are ways to help.

 

Papoose has greatly improved. I think we are getting the hang of all this. We are on 1 unit twice a day and are well regulated. He's back to eating on his own. Thank you sooooooooooo much for all the advice and assistance through this.

 

It sounds like vet was giving insulin without checking BS first. That doesn't sound right to me. I would think any vet would check first knowing the cat is diabetic.

Anyway you have him home, he is better and eating, you will be monitoring him. That's what counts .

It can take time so don't get discouraged. My Smokey is all over the place with his numbers. I'm getting a lot of support here. Have a list of questions and now my chart to discuss with them in a couple of weeks when we go. You will get there.