Vetsulin adjustment and force feeding advice urgently needed

Hello everybody,

my name is Tanya. I'm a newbie in this forum, and never heard about feline diabetes until now. I have human med background and hope to provide my girl with the best at home care possible.

I need help and advice for my beautiful 8 ½ YO girl named Ducia.

Yesterday Ducia was diagnosed with diabetes, DKA and possible pancreatitis. We give her 1st shut of 1unit Vetsulin earlier today without prior testing. We tested her about an hour after the shot and Relyon red 236. Four hours later tested again and it is up to 253. I just added 2 units shot.

We will monitor her blood sugar again in few hours. Ducia refuses to eat and I am afraid to overdose her. The syringe feeding Friskie diluted with Pediatric electrolyte was a fiasco twice today already. She hasn’t eaten in 2 or 3 days. Since Thu she received about 150 ml Ringer’s solution SC.

She is lethargic, motionless, refuses food and drink completely. She also avoids us petting her and turns her face away from food. Went to hiding in the closet.

Thank you for any advices and thoughts.

 

Did your vet up the dose this evening or did you? It's dangerous to increase by whole units like that... And without eating vetsulin can really hit hard and fast. How long ago did you give the two units? Please recheck her 2 -3 hours past the shot to make sure she isn't dropping too fast. Vetsulin usually hits it's lowest point 4-6 hours post shot.

Other than the sub q's, is she getting any other medications? She needs something to get her eating like cerenia and possibly bupe pain meds.

Getting her to eat ANYTHING is super important to avoid fatty liver. Offer tuna, chicken, anything.

 

@Kris & Teasel

Are you around to comment? I may not be in much longer

 

At what time did you give the first shot of Vetsulin? How many hours before the second shot?

Meters are allowed to have up to 20% variance in readings so these are essentially the same number and not that high either.

This is a very large dose increase and if this second shot was only 5 hours after the first one (from what you described) your kitty might be in a situation of insulin overdose. This can be dangerous.

What treatment was given by the vet? DKA requires intensive care at the vet for a few days and pancreatitis needs to be treated with pain and anti nausea meds.

If she's has/had DKA she must eat. She might need an appetite stimulant along with anti nausea meds. She's at risk of going back into DKA or developing hepatic lipidosis if she doesn't eat.

My opinion is that your kitty is still very ill and needs vet attention. You also need to be very careful in how you dose insulin. Generally a starting dose is 1 unit twice a day 12 hours apart. This dose has to be given for several days to see how your kitty does on it before any changes are made. We recommend increasing in very small amounts of 0.25 u.

 

A cat that is not eating and in DKA really needs immediate vet care-- this is a situation that is life-threatening and very very difficult to treat at home. Once the DKA is resolved and she is eating we can offer lots of advice about dealing with the diabetes, but this is a life-threatening situation right now.

There is a page on syringe feeding here that gives some tips that might be helpful. She needs both food and insulin to deal with the DKA, if you are unable to syringe feed she absolutely cannot be treated successfully at home.

 

Done!

 

I saw.... I was glad to see you on.

 

Thank you all for replies!
I have good news GB is 145 now, and 10 ml of Friskie w/ Pelialyte just went successfully down. I am here to post.

 

How long has it been since the second shot. This is important because if you have a few hours to go until nadir it could go too low.

 

If BG was 253 just before your first post 20 minutes ago and you had just given another 2 u of Vetsulin, a BG of 145 is a huge drop. That 2 u dose will not have its maximum effect until 4+ hours from now. Ducia's BG could very low by then.

 

The 1st shot was at 1pm, reading 236.
I increase the dose myself the vet's office is closed, and we cannot pay for the hospital, not until next week. The vet will see as for assessment on Tues. His recommendation was to hospitalize but, unfortunately, no money.

 

For feeding, a couple of links for you: Suggestions on How to Stimulate Kitties Appetite and this video on assisted feeding. You need to get whatever food you can into her.
Assist Feeding (video)

 

The last shot was at 7 pm. How soon should we test her?
Definetely going to give her food again later on.
I never posted/replied on boards such as that one. Still figuring out how to.

 

Wait.... So you shot 1 u at 1 pm, then 2 more uNits like 7 hours later? That was an hour ago your second shot?

Shots are to be given 12 hours apart... And that is way too much. I think you better get some honey ready. Not to scare you, but You may be in for a hypoglycemic event.

 

Vetsulin is supposed to be dosed 12 hours apart, and a 2 units starting dose (esp with the reading only in the 200's) is a lot!

 

Then you'll have to do the best you can at home:

1. syringe feeding of plain meat/broth baby food (without seasonings, onion, etc.) or pureed canned cat food
2. syringing of water/pedialyte
3. regular dosing of 1 unit insulin AM and PM 12 hours apart
4. test BG before feeding and giving insulin AM and PM (no food at least 2 hours before)
5. test BG again around 3, 5, 7 hours after AM insulin shot
6. post BG results here for advice.

Until you start a routine, you need to post BG numbers here tonight. Your kitty is in danger of hypoglycemia because of the large amount of insulin given.

 

Tanya please read this.... Get prepared.
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

Please retest soon and let us know If it is still dropping. Do you have honey or Karo or syrup in the house in case she crashes?

 

Hypo symptoms:

The symptoms to be concerned about include but are not limited to:

• staggering, uncoordinated movements, 'drunken' walk, wobbling, balance problems
• ataxia - usually lack of muscular coordination, but maybe changes in head and neck movements
• disorientation (yowling, walking in circles, etc.)
• twitching
• stupor
• convulsions or seizures
• coma

 

Yikes I really wish you didn't give that second shot. This is the info on hypo. Please test right now.http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

 

Thank you for your response . I will check BG in a few hours again I hope she will get better. Her ACT and ALT on blood test over 400. It may look like pancreatitis. Food is really dangerous to buy.

 

Please check her now.... Don't wait a few hours. The insulin had not yet reached its lowest point. If it goes too low she could be in danger. Numbers too low are MUCH MORE dangerous them high numbers.

 

She was most likely behaving the way she was because of the pancratitis, not the elevated bg.

 

You need to check her now and post the BG number here.

 

8 pm BG 114
rubbed a little honey onto her gums

 

G 114
rubbed a little honey

 

the vet did not tell us about pancreatitis- I picked up copy of her tests and got it from there AST 484 ALT 384 norm 15-95, her bellyrubin 1.5 norm is 0.4
What to expect?

 

Going to feed her, and test her at 9 again.

 

If you could get her to eat a bit, food is longer lasting. Just keep the honey on hand just in case. I am glad to hear she's not under 100 yet. I would test again in 20-30 min to see if she's dropping more.

 

another 2 syringes Friskie+pedialyte
will check BG in 30 min

 

Why is your vet not telling you what you need to know?! The ast and alt are saying she's got liver problems. She probably has fatty liver er from not eating. What did the dr say about why she's not eating? it's not the diabeties. Her numbers aren't sky high.... And numbers often go up when a cat is sick out stressed. So they may cone down once her other issues are resolved.

It COULD be pancratitis..... But he should have given you treatments IF. that's what it is.... Cerenia, sub q's, pain killers.

He also didn't give you enough instruction on dosing. What's up with this vet? THANK GOODNESS you are at least testing at home.

Listen, no more insulin before 5 am tomorrow, ok? And test before you shoot. And no more then 1 unit 12 hours apart.

Over the next few days we can help you set up a spreadsheet like the one you see in our signatures below. It will help you to track her progress and help others with dosing advice.

 

You are doing a great job getting blood samples. So many of us struggled with that in the beginning!! Way to go.

 

It would be very helpful if you could make a list of dose times and BG test times like this:

• 1 PM - 1 unit Vetsulin
• 2 PM (1 hour later) - BG: 236
• 6 PM - BG: 253
• 7 PM - 2 units Vetsulin
• __ PM - BG: 145
• 8 PM - BG: 114

 

How much does she weigh? My cat (not the diabetic one, a different cat) who is 16 lbs had pancratitis a few months ago. He is normally a big eater so when he was barely nibbling for three days we brought him in. They did a snap test to diagnose. He was already on sub q's because he has kidney disease, but was still dehydrated so we went from 100 ml twice a week to every day for a few days. He also got cerenia for nausea and a plain killer as pancratitis is very painful. After a day in that he started eating more on his own. We were fortunate that he was basically fully recovered in a week. Some cats do need to be hospitalized.

The fluid bump is going down slower this time because she's not as dehydrated as she was yesterday.

The best thing is to keep getting as much food into her as possible. Really important.

 

Take a look at this vetsulin info too when you get a chance. http://www.felinediabetes.com/FDMB/threads/vetsulin-caninsulin-user-guide.302/

 

I have to hit the hay now. I'm exhausted after dealing with Teasel's low numbers since late afternoon.

 

9pm - BG 146
10pm - next test
10:30 pm - next syringe
Planning on to give next shot around 5am
Ducia went to litter box to bury poop after 2 days interval and her walk was "drunken" a little on the way there but straight on the way ba
Will keep honey at hand
Thank you all so much!
If you can please stay in I want to post something and hear your feedback

 

Thank for the info, will definitely read thru. Ducia's weight om Thu was 7.2

 

Good

 

10 pm test - 142.
Will check again at 11pm
She is extremely weak.
I am afraid she is dying.

 

Have you gotten any food in her? Check out the assist feeding video I posted. It's essential that she eat. I fostered a fatty liver kitty and got him through it, but I had to keep helping him eat for a couple of weeks.

If you think she had/has pancreatitis, this primer on pancreatitis may help, including meds to help her nausea and get her eating.

142 is a good number.

 

@Tanya and Ducia

You might try contacting Diabetic Cats In Need....they can sometimes help with vet bills

If you have a Facebook account, you can message them HERE

If you don't, you can send an email to amy@dcin.info or jenna@dcin.info

 

WE were just talking about pancreatitis. Thinking to give her another 150 ml SC Ringer's. The water bump from morning iv dissolved just recently late at night. Thank you for the info so much. The 142 BG is good but it i s lower than 146 an hour earlier, so there is downward tendency. I will check BG later on but love to hear your thought as to watering fpor pancreatitis. We do not have any pain killers.

 

She had 2 syringes Friskies+Pedialyte at 8pm

 

Given that meters are allowed a certain variability, the 146 and 142 are really the same number. Her numbers aren't really changing.

How big are the syringes you fed her? When I had the fatty liver kitty, each of his meals were 12 syringes, but that's because I was using the 3 ml syringes at the time. He got 6 meals a day. You want to try to get the equivalent of close to a can of food a day into her.

 

Thank you. We use 10 mp syringe but it hard to say how much exactly went in. She resists aggressively. At list 1 1/4 at 8 pm, and closer to 1 at 7pm.
We just gave another 150 ml SC.
Her condition regardless of BG's level is bad. She lays motionless on the bed, covered with blankets. I watch my girl going maybe in pain and its nothing I can do. Vet never mentioned any complications on top of DKA. We guessed it from the test results and dr. google.
What can we do help her?

 

11 pm BG 156
She lays down motionless, there is unusual smell around her face
Any thoughts? Anyone?

 

does her breath smell like fingernail polish remover? If that's it, that's due to the DKA and she really needs to be at the vets office

 

No, non acetonic smell. Rather unpleasant nor her own usual one. As somebody else dirt. There were also some spills done while feeding diluted Ocean White Fish Friskies which I cleaned but maybe some stuck under her chin

 

@Tanya and Ducia

Please fill out this form for DCIN ......they will help you with getting treatment for Ducia

https://docs.google.com/forms/d/e/1...siQ9GYYVjF4h2g/viewform?c=0&w=1&usp=send_form

They are watching for it

 

Thank you!

 

@Tanya and Ducia where are you located? Do you have an emergency vet clinic you could go to tonight if we could arrange for payment?

Please full out the application for assistance for Diabetic Cats In Need that Chris gave you.

I'm sending you a pm.

 

Form was just filled.
Animal Urgent Care
2430 S Escondido Blvd a, Escondido, CA 92025
is near by.
You arrange payment for me?

 

what is pm that you sending?

 

@Tanya and Ducia I'll go look st your application right now.

A pm is a private message.

I'll be right back.

Oh & while I think of it, you could try syringe feeding some baby food. Just make sure it's the kind that does not have onions or garlic in it. We usually recommend the gerber brands & you can get the meat flavours just check the label to make sure no onions or garlic.

 

@Tanya and Ducia can you please givd me the phone number to the Urgent vet clinic?

I'm going to make some phone calls now.

How long has it been since Ducia has had insulin & a check of her blood sugar & how long ago was the last time she had some food?

 

@Tanya and Ducia our director of Diabetic Cats In Need, Jenna is going to call you right now.

 

JanetNJ,

I am very sorry to hear that one of yours has pancreatitis. I fear that is what Ducia is having.


She lays on the bed motionless, looks as if taking a nap, sometimes moves to hiding places, refuses food and drink, resists force feeding, seems to be wanting to be left alone. She is extremely weak. Her gait is shaky. The water bump’s weight on her side almost tilts her to that side. Does it sound to you as a cat w/pancreatic pain? We have no experience with cat in pain and do not know what to look for. I have no meds, and vet’s office is closed until Monday. Any advice as to what we can do to help her?

We gave her another 150 ml of Rigers SC at about 11:30 pm. Will that help?

I also wanted to ask if anyone on the board heard of Diabetic Cats in Need organization? They just offered their help, very generously.

 

@Tanya and Ducia i can assure you Diabetic Cats In Need is a legitimate organization that has been around since 2009.

If you would like to read up about DCIN here is a link to some info. http://fdmb-cin.blogspot.ca/p/our-missionactivitiespeople.html?m=1

 

Ok don't give any more fluids now... It does sound like pancratitis but you can also over hydrate more is not always better. Stick with dosages prescribed. Can you post a copy of the lab work you had done?

 

The DCIN is amazing. If they can help let them. I would bring her to am emergency vet honestly. She sounds to be in poor shape. Do a quick blood test.

 

Hello again everyone and thank you for all your support. The links you sent are tremendous help, as I never dealt before with feline illnesses. Just over a month ago my precious Ducia was a happy cat. I apologize for posting hectically, it was our 1st day with diabetes +DKA+possibly pancreatitis and may be a fatty liver disease. And I never used board before.


I know now how wrong it was to take huge risk of giving her another shot – increased to 2 units instead of 1- after only 4 hours from the initial shot. Here is how her day went on:


12pm 1st shot – 1 unit Vetsulin

1:18 pm – BG 236

5pm – BG 253

5:12 pm – 2nd shot 2 units

7pm – BG 145 Two 10ml syringes friskie w/Pedialyte

8pm – BG 114 honey on the gums, two more 10 ml syringes with food

9pm – BG 146

10pm- BG 142

11pm- BG 156


Before the 2nd shot she was in hiding, lethargic, no food/water, no socializing. The BG was up.

After – she came out of hiding, used her litterbox. Later on she went to the box again for bigger business this time and that seemed an improvement because the last time she did it was 2 days ago. The BG kept at good numbers for the rest of the day.


That makes us think that we should give her 2 units – an increased dosage by us, not the vet – after 12 hours. It’s right after 5 am today. If any of you are early risers will see this post and think that 2 units is wrong please reply. We are in California so my shot due in at 5am is 8 am on the East coast.


Ducia’s condition is very bad regardless of BG is stable for the past 6 hours. She hides and avoids company. She resists the feeding violently although she is extremely weak. And keeps getting away from her bowl of food if we place it near her. This resistance makes her exhausted but we need to get food down into her. I am beginning to think that we are torturing her instead of helping. No appetite, no desire to eat or drink despite the BG improvement. And we have NO syringe feeding skills. We'll improve with practice but right now it feels as if we adding to her misery. She ate about 20 ml in the entire day. She looks devastated after each meal. It is very difficult.


I cannot talk to the vet until Monday. Does any of these signs familiar to you? What can we do if she is in pain?

 

We already gave her another 150 SC water. She seems very dehydrated, her nose is almost brittle. I will post tests next thing.

 

It was 156 at 11:33 pm. I don't feel like waking her up and giving another test.

 

Ok. Please skip the insulin dose this morning since she isn't eating properly.

How much does she weigh?

Does her breath sound labored?

Do you have an emergency clinic by you?

 

Even if the BG is up? About 20 posters told how important to stick to the 12 hours schedule. I don't understand

 

You can tell dehydration by if the gums are wet, or if they feel sticky. Also pull the scruff and see how long it snaps back. If it only takes 2-3 seconds she's hydrated, if it takes a while then dehydrated.


Please remember you can give too many. If she weighs 10 lbs you don't want to give more than 100 ml.

 

She was 7.2on Thu, hasn't eaten
Breath is not labored.
Should we really skip the shot?

 

the scruff goes back quickly
there is an emergency clinic but I cannot afford it

 

gums are wet, pale

 

Let's see what the number is. If it's over 300 give a unit of its over 200 but under 300 I wouldn't give more than half a unit being that she isn't eating!! Yes you have to stick with a 12 hour schedule.... They were telling you that because you double dosed yesterday. But with vetsulin you want to make sure there's food on board. It's OK if her bg goes up a bit.... Better it too high for a while than too low. Her numbers have not been bad. Most newly diagnosed diabetic cats are in the 400- 600 range. The thing to focus on at the moment is getting her to eat. You need to get pain meds and an appetite stimulant for her, and possibly an antibiotic Today.

 

Take a reading before the shot.

 

Do you have any labs you can post?


Did you contact the DCIN?

Is she anemic?

 

She's tiny. As long as she's not dehydrated, slow down on the fluids. Her size cat shouldn't really get more than 75 ml at a time.

 

No. But I am going to call them the anim urgent care now. Noone ever offered for me before

 

what's animic exactly/

 

DCIN is an amazing organization. If anyone can help in this situation, they can. Very worried about Ducia.

 

Low red blood cells. Makes then weak and one thing to look for is pale gums. If you have lab reports you would look to see that the hct (hemocrit) isn't low. The treatment would be b12 methylcobalamin supplements or b12 injections.

 

Heading to the anim urgent care

 

So relieved to hear that. I hope they can give Ducia the help she needs.

 

I'm relieved to hear that. I'll check in later to see the update.

 

Ducia is checked in at the vet's office and I have paid the deposit for 24 hours of care to start.

You all know how happy it makes me to be able to help in times of crisis. DCIN is a donation-funded organization and your continued support is sincerely appreciated.

-Jenna

 

You're an angel Hopefully Ducia can get through this.

 

OMG I'm so relieved. I spent a few sleepless hours last night worrying about this kitty. This is really an amazing gift for her and Tanya.

 

Do you take donations from Canadians?

 

Any update on Ducia?

 

Waiting on an update. Hope things are going well.

 

Kris, DCIN accepts donations from everyone!

Here is a link to more info. http://fdmb-cin.blogspot.ca/p/donate.html?m=1

And just in case that link doesn't work I'll ask Amy to touch base with you, she's the expert.

 

We take donations from Canadians and we help Canadian cats! Our Paypal email is donate@dcin.info

Thank you so much!!

 

Excellent!

 

Hello,

I just wanted to post on update for Ducia. She is the hospital for 24 hours stabilization. She was admitted around 4 am and by 7 am the admitting doctor commented that she seemed better a bit. There are good news:

4am test BG 313

8 am test BG 307

12pm test BG 89

She is currently under short-acting insulin.

Her urine ketones at the time of check in at 4 am test was 2000units but at 12 pm test was down to 500units.

Bad news: refuses food, unwilling to swallow, was syringe fed at noon, no appetite regardless of antinausea injection, lethargic, very weak. Not much difference from what it was like at home. There is a big concern with her liver damage, most likely it is lipidosis , or fatty liver, so it is crucial to make her eat. She got antibiotic for liver as well.

They gave her pain killer for pancreatitis.

Thank you all so very much for your advice and support. This message board and the DCIN are the God sent. We all here were so exhausted last night that I even began having bad thoughts. I feel that we may have a hope again. We would not be here without you. Thank you!

 

Thank you for the update. Praying for her liver to get better. I'm glad her ketones are coming down. Sending eating vines and healing vines.

 

thank you for updating. we are all relieved she's getting the care she needs. as I said, I was more concerned with the liver and not eating than the bg. I'm glad she's got the pain killer and hopefully will start eating on her own soon.

 

So glad she's seeing some positive movement on BG and ketones, and that she's got some pain meds on board for the pancreatitis. Hopefully that will help her start to feel better enough to start eating again.

Will they let you bring her something, like an old shirt with your scent on it? Sometimes that also helps-- a vet hospital is a scary place with unfamiliar smells, it might help her relax a little bit. Poor Ducia-- feel better soon, sweet kitty!

 

Thank you!

 

She has her favorite blanket with her, the admitting nurse said to wrap her up with it. The staff was amazing.

 

Thank you JanetNJ, so far she's been refusing/unwilling to swallow. A possibility of fitting her feeding tubes that would send food down esophagus directly is under consideration now. Fingers crossed.

 

Most cats seem to do well with feeding tubes. Ducia and you are in my prayers.

 

I am disgusted that the vet didn't even mention liver side of the issue, and unless I came across FDMB we still would be in the dark. Cannot express my gratitude enough for all of you here.