911 Repost..now I may have a problem?.

Sorry to repost this, but it appears so far down I'm not sure anyone will see it.

Earlier today I asked a pretty mild question. But now I may have another issue..and I need some suggestions? The post started as:

"Right now Dottie is fasting..and her BG is slowly, ever so slowly, going down. Does that mean that her pancreas still has a few working cells? Would BG stay more level if it weren't?"

Update: Perhaps I shouldn't have said she is fasting. I might have gotten a response. As it is, this post seems to have fallen to the bottom so quickly it disappeared.

Dottie was really fighting me today about eating. Haven't been able to check her keytones because I haven't seen her urinate. She fought me so hard about eating, with her mouth being sore, that I've decided to call an alternate vet tomorrow, to get an appointment to have someone else take a look in her mouth. I'm worried that there might be a spot of necrotizing bone somewhere, as she can eat, until suddenly YOW! She jumps up, claws at her face, and runs around.

So I decided to take an easy feeding path, and give her whatever she wanted. I got her to drink a little tuna water, and after that, to eat some tuna (1oz.)..and later on, I 'insisted' she eat an ounce of Friskies pureed chicken&tuna. We made a mess as usual but I got most of it into her.

But I haven't been able to give her her shot. Just before her injection time, I fell asleep and she slipped below her threshold that I've set, at 190..and since then, in spite of what I've fed her, there has been a slow march down in BG levels. She's been listless all evening. Can't get keytones from her because she hasn't urinated yet, that I know of...I suspect she went just before I woke.

I started having trouble getting blood out of her ears, so I suspected she might be a bit dehydrated, and so I've given her some fluid. And I also gave her a wee bit of FF gravy to boost her energy until the fluid takes hold. She was so apathetic it was alarming..lay down to get her fluids like she didn't have the energy to stand.

It's been almost 14 hours since her last shot, and her BG is at 99..and I'm still asking: Could her pancrease actually be working, or is it something else dropping these numbers?

For the past day she's been on less insulin, because her nadir kept dropping too low for comfort...so following protocol for PZI, she has only recieved a reduced dose of 1 unit of Protamine Zinc at each injection. I'm torn between wanting to watch to see if she'll stop dropping her numbers and level off, and giving her some more food.

Any suggestions? I will test in a few minutes, and insist she eat some more. OH and Darnit...As I posted this, Dottie just peed in her box, and I wasn't prepared. Rats. Why does everything happen on a weekend night?

 

Can you post the pre shots and nadirs for the last few cycles? It is so hard to advise you when we don't have any data.

 

Whew...nevermind. She was dehydrated. I was having trouble getting drops of blood to test..probably not enough on the test strips, and I'm blind as a bat and wasn't wearing my glasses. I might have missed the crummy amounts on the test strips.

All perky now. I wonder how I missed her not getting enough to drink? I have been feeding wet food in spite of her mouth issues. At any rate, we're calling the vet in the morning. Nebbermind!

 

Did you give subq fluids? That's what Diego had at the vet today and he had a miraculous turnaround. I almost want to do it at home when he needs it but that's a dang 18 gauge needle. If you do give fluids at home, I was going to ask how she takes to it usually.

Also, about the mouth. I am a dental assistant and all of my patients have been human but usually when they jump out of their seat like that when the tooth comes in contact with something hot or cold, it's due to an abscessed tooth or an exposed bone/root.

 

SQ fluids have done really amazing thing for my own cats and my rescues-it is crazy what water will do-
pain in the mouth is terrible--it makes everything hurt

 

You don't have to use a 18 gauge needle--
it is true the bigger the needle the faster it is done but I have 2 that get them at home-
1 could care less about the size of the needle-the other prefers to sit longer and a smaller poke-we also freeze the needle to lessen the sting going in.
They get used to it--
1 has been getting for 6 years and the other since DX with FD in October-

 

Oh thank god. He used a blood-donation sized needle on him today, and then kept removing the needle and re-inserting in four or five different areas on his little body. He got 125cc in him in about 2 minutes but the whole time I kept thinking to myself that I could never bear to do that do him. With a smaller needle, yes. Wondering if mixing water in with his meals would prevent the need for fluids in the future.

 

Yup, that's what I did. It's always amazing the way they perk up. I'm just sore that I missed the fact that she was getting dehydrated, in the first place. The lack of blood on her ear pokes should have been a dead givaway. Note: I've been needing reading glasses for a long time. Was going to get them as a Christmas present. But when Dottie started going downhill, I didn't order those new glasses because I knew Dottie would need mouth surgery, and so I've been almost working blind, depending on good odds to fill those test strips. If I heard the beep I just assumed my strip picked up enough blood, and assumed an error reading would let me know otherwise. Reading a newspaper has been Hades, too.

Dottie takes to the subcutaneous fluids very gracefully. Most cats will. If you put the needle in right, (yes I know it's a whopper), with the beveled edge of the needle on the top, you won't put so much pressure down on the skin when the needle slides in. Don't be afraid of it. Cats' skin is not attached to their body in the same way ours is..there's a thin layer of skin and then lots of space, because the skin is attached to the body by thin membranes rather like tiny threads going from skin to the muscles underneath..there are spaces in between them. That's why you can scruff cats, but not people. We store our fat differently, firmly attached to our skin, unlike most mammals. Usually only sea mammals have this 'sticky fat/skin feature, so it's actually led to the postulation of a theory: somewhere in our background, we had aquatic ancestors!

Back to that size 18 needle: There's not much skin to slide that needle through, and when you put the fluid in, it's going in between the skin and inner body surface, so you aren't pressing that needle into muscle. It's a quick, tiny ouch, much like when you give an insulin injection.

Thank you for the dental info! I am suspecting there's a portion of bone exposed back near the joint of the mandible, or a tiny piece of plaque that has gotten under the skin in that same location. My vet won't even look, which makes me mad, so I'm going to get a second opinion. And if I'm right, and he's wrong.... Time to change vets.

 

Yikes, five times for 125 ccs? You will need to change Diego's name to Pincushion, and check him for leaks when he drinks! And yes, adding water to meals will help.

 

Yeah I have worked with my vet and it is all about doing it fast-
Many people add water to the food-my cats have no interest in that
It has been my experience that if your cat has any early stage of CRF that really no amount of oral water intake will slow the process.... it is still good to drink more but if you are trying to slow the disease SQ is pretty amazing.
My non diabetic was diagnosed at 11 years old--remember that it doesn't even show up until a pretty good portion of the kidneys are not functioning. We began SQ (he is about 10#) 1x a week-
He is almost 16 now and we have increased over time -- he is up to every 2 days and he gets about 150 (average ) each time. He also gets a shot of cerenia (right in the fluid sack as it stings if not in the fluids to disperse it) He could give a darn about the size of the needle but my big guy (19#) who has FD prefers the little needle and sits patiently
FYI we do not move the needle all over the place....1 poke thats it --the skin is stretchy

 

freezing the needle really does help too-

 

Thanks for the info. He's had 2 full lab workups run in the last two weeks, mainly because I'm a neurotic you-know-what, and his levels are all fine except for his glucose being high (KNOCK ON WOOD). I thought it didn't seem right that he was sticking my cat 5 times with a massive needle. Horrific.

 

I have to say that was odd -
if giving over 200 to a small cat sometimes they will use 2 sites but I am a bit perplexed by all the pokes for a relatively small amount of fluids

 

I have no experience with veterinary medicine and even I felt like something was awry with that