? Senior cat just diagnosed - Concerns!

Discussion in 'Feline Health - (The Main Forum)' started by Bobbi & Angel, Jun 29, 2016.

  1. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    No, it would mean the insulin didn't last a full 12 hours. If the dose is too low, she would likely be higher and flatter. Not lasting long enough would not be unusual with Humulin; it is usually one of the shorter lasting insulins. Raising the dose would also likely lower the nadir number. She does have some room to drop further at nadir, but I would stick with the dose at least a few more days. It does take awhile for their bodies to get used to using the insulin efficiently and to the change in diet. Raising the dose too soon can mean some surprises in terms of lower numbers. Better to give it awhile.

    Make sense?
     
  2. Bobbi & Angel

    Bobbi & Angel Member

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    Yes, it makes perfect sense! Thank you!
     
  3. Bobbi & Angel

    Bobbi & Angel Member

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    I just did Angel's preshot test and it was 182. What should I do for tonight?
     
  4. Sharon14

    Sharon14 Well-Known Member

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    Have you shot or fed?
     
  5. Sharon14

    Sharon14 Well-Known Member

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  6. Bobbi & Angel

    Bobbi & Angel Member

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    I am supposed to do her shot in 30 minutes. I think she is having trouble with constipation right now, not sure if that's normal or not, but she's only just started eating well again the last day or so....hasn't seemed too interested in food for the last few hours or so, and she's been walking back and forth to the litter box for a few minutes now trying to go. Is there something I can do to help her?
     
  7. Sharon14

    Sharon14 Well-Known Member

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    Is she peeing normally? Just hasn't had a bowel movement? To prevent constipation, we often add plain canned pumpkin- not pie filling- to their food. Let me check around to see what to do for now.
     
  8. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Can you get another test to be sure it was a good test? It'd be really unusual for her to drop late
     
  9. Sharon14

    Sharon14 Well-Known Member

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  10. Bobbi & Angel

    Bobbi & Angel Member

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    I will test again now.
     
  11. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Miralax often works. I think it's 1/8 teaspoon. You can dissolve it in water and add it to the food or syringe it
     
  12. Bobbi & Angel

    Bobbi & Angel Member

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    Ok, her test was 214 this time.
     
  13. Bobbi & Angel

    Bobbi & Angel Member

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    She is due for her pm shot now, but I'm not sure what I should do. Is this number ok to shoot?
     
  14. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Change. Forgot you had the high pre shot this am and one unit took her down so far. How about 0.5 units?
     
  15. Bobbi & Angel

    Bobbi & Angel Member

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    Ahh!!! I read your first post and went ahead with the 1 unit like you said. I will stay up to test her tonight. I have k/d dry food that I can probably feed her if that would help...I'm not sure what to do now. :(
     
  16. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Sorry, Bobbi. My fault. She should be fine but yes, I'd monitor. What works best if she'd go down to the 50s is the gravy off higher carb food - Fancy Feast gravy foods are good. Just a teaspoon brings them up. They work better than dry, but you can use it if that is what you have.

    I will be up 5 more hours and will keep an eye on you two.
     
  17. Sharon14

    Sharon14 Well-Known Member

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    I'm sure she'll be fine. She stayed in the blues today so didn't drop too low. It wouldn't hurt to get a test @+1 Do you have honey or syrup, just in case? Has she pooped?
     
  18. Bobbi & Angel

    Bobbi & Angel Member

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    Ok, thanks. I have some syrup her, like maple syrup? I can go get some Karo syrup though.

    She pooped a little bit before I did her shot, but it wasn't a full bowel movement like she usually has. She wasn't eating or pooping much before yesterday.

    Should I go get some Miralax for her? She seems like she isn't feeling so well. When I just petted near her abdomen, she growled at me. I'm assuming constipation in a cat is just like in humans and can be making her feel a little sick to her stomach.
     
  19. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    I think Miralax is a good idea, if you are going out anyway. Since she had a little bm, maybe give a little less than 1/8 teaspoon.
     
  20. Bobbi & Angel

    Bobbi & Angel Member

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    Ok thanks. Will she be able to taste it?
     
  21. Sharon14

    Sharon14 Well-Known Member

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    I mix it in Colin's food with lots of water and he eats it up. If she won't, you can syringe it. Just make sure to mix it with plenty water, because that's how it works.
    The maple syrup should be fine, as long as it's not sugar free -that contains artificial sugars.
     
  22. Sharon14

    Sharon14 Well-Known Member

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    If you're going to the store pick up the Fancy Feast gravy lovers as Sue suggested.
     
  23. Bobbi & Angel

    Bobbi & Angel Member

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    Ok, I got her to at least eat a little bit of watery food mixed with the Miralax. I did less than 1/8 tsp, so she didn't even get that much.

    She seems so sick right now, like we just went back to how she was in the beginning, I dont understand what's going on.
     
  24. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Is she lethargic? Did she eat? Is she drinking okay?

    If she is constipated, she probably doesn't feel well.
     
  25. Sharon14

    Sharon14 Well-Known Member

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    Has she been peeing? Was the little poop she had earlier dry?
     
  26. Bobbi & Angel

    Bobbi & Angel Member

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    If she has peed, it hasn't been in a few hours and I don't think she's been drinking in those hours either. Right now she's laying down on a chair and doesn't seem interested in much of anythig at all.

    I'm not sure if her poop was dry, but it definitely wasn't wet or runny at all.
     
  27. Bobbi & Angel

    Bobbi & Angel Member

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    She ate a little bit around when I gave her shot and drank a relatively small amount of water, but I put them both in front of her face to get her to do it. She seems lethargic.
     
  28. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Check for dehydration
    - if you pull up the scruff and release, does it stay pulled up and only slowly go back down?
    - if you press on the gums in her mouth and release, do they stay white or pink right back up? Are the gums tacky?

    You could try a syringe of water if you think she is dehydrated. A small needle less syringe of water slowly in the side of her mouth.
     
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  29. Bobbi & Angel

    Bobbi & Angel Member

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    When I pull up her fur, it goes down slowly so I think she is dehydrated. I will try to give her some water that way. How much should I do?
     
  30. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Just start with a little bit, very small amounts in the corner of her mouth.
     
  31. Bobbi & Angel

    Bobbi & Angel Member

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    Where can I get a syringe without a needle? I don't have anything like that.
     
  32. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    You can buy them at any drug store.
     
  33. Bobbi & Angel

    Bobbi & Angel Member

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    I am really worried, she seems to not be feeling well at all! I'm going to go get a syringe, I was going to go see fireworks tonight but I'm not sure if I should put off getting her water.

    also, I think I should go to the vet tomorrow and get supplies for at home fluids. I have to work tomorrow 830-4 and I don't know how I will be able to do what she needs tomorrow but I definitely cannot afford to let her stay at the vet again so soon.
     
  34. Sharon14

    Sharon14 Well-Known Member

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  35. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    I think getting fluids is a good idea. Maybe you can call the vet and they'd get them ready for you.
     
  36. Bobbi & Angel

    Bobbi & Angel Member

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    I just got her to drink some water by putting it in the cap of a water bottle.

    I'll call for the fluids as soon as the vet opens tomorrow because they only open at 8 and like I said, I have to be at work at 830.
     
  37. Sharon14

    Sharon14 Well-Known Member

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    I put water in teacups in windowsills and other places my cats like to sit. It has increased their intake significantly.
     
  38. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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  39. Bobbi & Angel

    Bobbi & Angel Member

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    She seems to suddenly have realized that she is thirsty and got up for a pretty long drink.

    I tested her blood sugar and got 170. I'm going to put out a little tray of Fancy Feast tuna for her to see if I can entice her.

    Its probably safe for me to leave for a little while right? I am going to have to run to Walmart now because the drugstore near me is closed. I don't understand why she seems to be so all over the place with her eating and drinking habits. It's very concerning and confusing.
     
  40. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Glad she drank. It looks like she is dropping pretty slowly which is a good thing.

    Yes, I definitely think you can run to the store. Did you get some gravy Fancy Feast?
     
  41. Bobbi & Angel

    Bobbi & Angel Member

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    I will look for the fancy feast at Walmart.

    Any idea how often I would need to do fluids to start? I didn't see that on the link you posted, but maybe I missed it.

    Thanks for all your help, sorry I am panicking so much!!! but its so scary when she suddenly gets lethargic and won't get up.
     
  42. Sharon14

    Sharon14 Well-Known Member

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  43. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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  44. Bobbi & Angel

    Bobbi & Angel Member

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    I will call the vet tomorrow morning and ask if we can maybe do bloodwork sooner or talk about subq fluids sooner. The plan was to wait one week from Angel's vet stay to go back and do another round of bloodwork, so it wouldn't be until Saturday that we go back. I'm not sure what the logic for waiting was but I feel uneasy with waiting so long.
     
  45. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    If you tell the vet you are concerned and nervous about her progress, he/she should be willing to do things on your time table. Just tell he/she your gut tells you she is not feeling well and you don't want to put off helping her.
     
  46. Sharon14

    Sharon14 Well-Known Member

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    If she doesn't have a bowel movement by AM, mention that too.
     
  47. Bobbi & Angel

    Bobbi & Angel Member

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    Ok. I don't think they will give me a problem, since they've been listening every other time I call.

    Ok, Sharon. I will be able to observe her tonight until probably midnight or so (+5).
     
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  48. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Bobbi, is it about +3? Can you get a test?
     
  49. Bobbi & Angel

    Bobbi & Angel Member

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    I just tested and got 94. It's closer to +4. She's drinking some water on her own and isn't just laying around.
     
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  50. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Glad she is drinking. How about giving her a little something to eat? 94 is a good number, but you still have a way to go before her nadir - if it is the same as today's. It would easy for you if she'd surf along and not go a whole lot lower. Food might slow her down. Remember, if she gets to 50, give her some gravy off the food (like a teaspoonful) and test again in 20 minutes.

    I am not going to be around for an hour or so. If you want reassurance or help, start a new thread with her numbers.
     
  51. Bobbi & Angel

    Bobbi & Angel Member

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    She has eaten a little, not much, but hopefully enough. I will test again at +5 before going to bed.

    In the morning, if her preshot number is back up in the 300s, should I do 1 unit again? I am assuming it's going to be lower though. If there are any guidelines you can give me for when to shoot or how much to shoot, that would be great. I won't be home most of the day tomorrow so I want to be careful. I can drop in during lunch, which I may be able to time to be +5 like her nadir was today.

    Is it normal for this to be so complicated in the beginning? I am so stressed out trying to get her stable and I hope I'm not putting her through all this stress for nothing.
     
  52. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Unfortunately it is difficult to gauge the dose in the beginning. Not only do you have to work around the fact that her body is adapting to the insulin and therefore changeable, but you are busy gathering the data that will help you from now on. Eventually you'll have data and be able to predict what a given dose might do for a given number, and she will be more predictable. Some day soon you will be posting on a new member's thread and telling them that it gets easier.

    You are doing great. You are testing and keeping her safe. Her numbers are good - especially for Humulin.

    I'd say in she is in the 200s tomorrow, maybe 0.5 since you won't be around? 300s, maybe one unit minus a few drops?
     
  53. Bobbi & Angel

    Bobbi & Angel Member

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    Okay, thanks a lot for all your help!!

    If she's below 200, should I skip the dose altogether? That's what we the first few days when her dose was too high.
     
  54. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    The other option is to stall, if she is near 200 but still below. So wait 20 minutes without feeding and retest. You want to be sure she is rising, not falling, and above 200. If above 200 then, you could shoot, but I would do an even smaller amount - maybe 0.5 minutes a few drops.

    All this is good news! She is on a tiny bit of insulin and getting nice numbers.
     
  55. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Or you can skip. That is always an option.
     
  56. Bobbi & Angel

    Bobbi & Angel Member

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    Ok, I will see what happens and post her amps in the morning.

    I just tested and got 204! Could this be because I let her eat some higher carb food earlier (k/d)? It's past my bed time bed time now, so I hope this means she'll be safe from dropping too low tonight.
     
  57. Bobbi & Angel

    Bobbi & Angel Member

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    Her morning test was 252. I'm going to do 0.5 units.
     
  58. Sharon14

    Sharon14 Well-Known Member

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    Good idea. How is she feeling? Is she eating?
     
  59. Bobbi & Angel

    Bobbi & Angel Member

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    She ate a little bit, but not much. I gave her the 1/4 Pepcid pill. I haven't seen her drink any water yet this morning.
     
  60. Sharon14

    Sharon14 Well-Known Member

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    Be sure to leave some food for her. Will you be able to get home at lunch to test?
     
  61. Bobbi & Angel

    Bobbi & Angel Member

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    Yes I should be able to come home around +5.

    She drank some water when I put it in front of her, and then did the same with a few bites of food. I'm going to leave out the k/d dry food, I know it's too high carb, but she doesn't seem to eat the wet food once it's dried out and my other cat keeps trying to go eat all her wet food (even though he already had some!!)
     
  62. Sharon14

    Sharon14 Well-Known Member

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    The dry is fine. Right now eating is #1
     
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  63. Bobbi & Angel

    Bobbi & Angel Member

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    Just called the vet. I wish they would just give me the supplies for sub-q fluids. I tried to explain on the phone that I already know how to do it, and I don't need the vet to tell me that Angel is dehydrated. It's pretty easy to tell. But anyways, they are making me bring Angel in again. I have to bring her in after work. I hope doing these fluids will help stabilize her and get her appetite and energy back. I don't know what else to do and this is getting very expensive.

    Do you think I should have them run bloodwork today instead of waiting until Saturday? To get the values for her kidneys? I can't afford to do it again so soon if I do it today.
     
  64. Bobbi & Angel

    Bobbi & Angel Member

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    Are there ways to get financial help for this stuff? I am a college student and next semester (September), I can't work at all because I will be student teaching and it's full-time. I'm so worried that I'm not going to be able to pay for all of the things that Angel needs.
     
  65. Sharon14

    Sharon14 Well-Known Member

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  66. Sharon14

    Sharon14 Well-Known Member

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  67. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    That's a nice amps!

    So you learned several things yesterday. She has a later nadir than usual on Humulin (hurray!) Dry food brings up her numbers fairly fast (good to know if you get a low number and need it to rise. It may be that gravy off high carb does the same). One unit is a pretty good dose for the 300s. We'll see today how 0.5 does for the 200s.

    I would be blunt with the vet. You are on a limited income; you have to figure out a way to care for her at home with his guidance. You know how to do fluids and would like him to keep you supplied with materials if needed. You are testing at home and have a spreadsheet of levels that you can share with him as often as he likes.

    I wonder if it makes more sense to do the bloodwork after you work at getting the numbers stabilized. Lots of kitties have higher kidney values when first diagnosed with diabetes. It's logical since diabetes impacts the kidneys. Angel may have more kidney issues than a usual diabetic cat, but maybe fluids and getting her levels down will help. Maybe ask him what he would do if she does have kidney disease. Can you be doing some of that already, like finding the best possible food for kidney/diabetes. Maybe review Tanya's CRF site and come armed with questions?

    Sharon gave up you some possibilities for financial help so try those. Ask your vet if he can save you money in any way.

    You are doing great, Bobbi. Things are already improving with Angel. You will be her advocate in this - no one loves her more than you or cares more about her health and quality of life. Just remember - every decision you make for her is the right one because it is made out of love.

    Please start a new thread with your next post. This one is getting too long and we get lost. (at least I do - I'm old. :p)
     
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  68. Sharon14

    Sharon14 Well-Known Member

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    Bobbi, how's Angel?
     
  69. Bobbi & Angel

    Bobbi & Angel Member

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    I was just making a new thread.

    She's been eating mostly only the k/d dry and her blood sugar is very high. I think we need to adjust the dose considering the food? Her number today just came back as "HI" which I looked up for my meter and it means over 600! Again, I will be home today only for lunch and then not until 4:30. It was high last night too, but I thought it might have had to do with the fact we just got back from the vet.

    What would be a good dose? Her original prescription when her numbers were this high was 2 units.
     
  70. Sharon14

    Sharon14 Well-Known Member

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    Do go ahead and make the new thread. I don't give dosing advice, but it sounds like she needs an increase. Maybe try 1.5 for this AM, with a check at lunch, then when @Sue and Oliver (GA) comes by she can give you better advice! Are you offering the wet and she just doesn't like it?
     
  71. Bobbi & Angel

    Bobbi & Angel Member

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    She won't eat enough wet food in a day. She seems to like them for a few minutes when I first give them to her, but she never eats much of it at a time, so it gets dried out and then she doesn't like it.
     

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