? Wheezly breathing in post DKA post Hypo cat

Discussion in 'Lantus / Levemir / Biosimilars' started by Tanya and Ducia, Mar 1, 2017.

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  1. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    My post DKA & fatty liver cat girl Ducia is currently at the clinic under stabilization treatment after Hypo. She was admitted yesterday BG 22, low temperatures, convulsions. Dextrose drop catheter was given and at 2am pacific today her BG was 409, dextrose cancelled, glucose taken out of her food, they monitor. She responds well to the treatment, at about 3am was sitting, interested in her food and reacted at nurses.
    Ducia was on Lantus 1unit. Possible that we accidentally overdosed her giving 10 units instead of one. I have questions as to home recovery and in particular about the dose adjustments.
    Image below is what we are using at home. Hypothetically, if Ducia will require frequent tests and then dose adjustments by 0.25 increment how can one make sure where 0.25 is on the syringe shown below? That is what I don't understand. The 0.50 increment would be easier but again not perfectly precise simple aim at half the measure, it's not precise. But how to measure 0.25 if there is no marks? We went thru horror of Hypo yesterday and I am no longer confident in human TRUEplus lancets. Are there any better products for not very experienced tester to use at home? Her little years were almost shredded after endless testing.
    [​IMG]
     
  2. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Dec 2, 2014
    If you are using Lantus you need to use the syringes with the orange cap which are for U100 insulin which Lantus is. The syringes with the red cap are for U40 insulin such as Vetsulin/Caninsulin. You can get the U100 3/10ml (this holds up to 30 units in total) with the 1/2 unit markings.

    This link shows the BD brand syringes and there are links on the left that show how to do smaller doses.

    http://steverapaport.com/jock/SyringeFineGradations/


    ETA It is VERY important that you use the correct syringe with different types on insulin
     
    Last edited: Mar 1, 2017
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  3. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Ok here is what we use. The smallest mark is one unit, right? But if 0.25 adjustment required, do I measure it with my naked eye for the best of my ability? My vision isn't too good, I may over shoot and if so will it mess up the numbers again?
    upload_2017-3-1_5-20-41.jpeg
     
  4. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    The smallest mark is one unit unless these are syringes with half unit marks. It doesn't seem so from this photo. Many brands of syringe will have U100 printed on the barrel on addition to the orange cap. The box that the syringes came in should say U100 on it. Later on it would be a good idea to buy some U100 syringes with half unit marks. You would have to eyeball 0.25 u on those but you could measure 0.5 u using the marks.

    Have a look here: www.adwdiabetes.com.
     
  5. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Dec 2, 2014
    The orange cap syringes are the correct ones for Lantus. Do your syringes have the 1/2 unit markings on them? There should be marks on the right side and marks in between on the left side if they have 1/2 unit marks. It would look like this:

    http://steverapaport.com/jock/SyringeFineGradations/

    When using the syringes with 1/2 unit markings you can measure a 1/4 unit dose by "eye-balling" between the 1/2 and 1 unit marks. Some people use calipers but I am not familiar with their use, though I am sure someone will be by and explain how to use calipers.


    ETA In the photo I posted the marks on the left (bottom)are 1/2 unit and the ones on the right (top) are 1 unit markings.


    ETA Sorry it won't post directly to the correct photo. If you click on these photos it will give you a larger image
    [​IMG]
    Exactly 1 unit.

    [​IMG]
    Exactly a half-unit


    It will give you a larger image of these
     
    Last edited: Mar 1, 2017
  6. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Thank you! We didn't buy our Lantus nor the syringes. They were kindly shared with us so I don't know yet how it works or what available. I thought that Lantus comes with syringes, it didn't ossure to me that it is two separate items to buy. Will know now. I hope they can stabilize her to the point that we wont be needing adjustments too often. I haven't spoken to the dr as yet so at the moment there is no treatment/maintenance plan.
     
  7. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    No need for larger, THANK YOU!! Got it. My syringe is one unit only marks. When I asked about 0.25 increase I was speculating as to "what if", we do not if Ducia will require any of it but need to restore my confidence after Hypo. Thank you so much.
     
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  8. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    It would be a good idea to try to get some U100 syringes with the 1/2 unit markings. Dose changes are usually done by 1/4 unit increases or decreases and it is much easier to eye-ball "for example a 0.75" unit dose if there are 1/2 unit markings rather than only 1 unit markings.
     
  9. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    We will buy. I just hope SO much that they can figure out her dosage in the clinic before discharging her!
     
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  10. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Dec 2, 2014
    Poor Ducia has been through DKA and a hypo so close together. With all the other problems such as the tube feeding it will be difficult to set a good dose. Home monitoring is going to be so important especially in the early days once she is home. But there are lots of very experienced people here, who have dealt with the same issues you are facing that can help you along the way. :bighug: :bighug:
     
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  11. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    That's exactly what worries me so much now. I am not experienced tester with exception for the past week. Can you recommend any brand/size for a novice tested with not very good vision/aim? We currently use human needles between 23-28 gauze but they are too long. We also use TruePlus lancets but they proved a disappointment yesterday during Hypo when I need to test every 20 - 30 minutes. Human needles are ok except their length but are not sold without Rx, I am correct?
     
  12. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    All these have half unit markings and are the correct syringes for U100 insulin and are available from ADW online:
    UtiCare
    Monoject
    Carepoint
    Sure Comfort
    BD Ultra-Fine

    They're also available at WalMart if you have one near you..Their Relion Brand 3/10ml, 3o or 31 gauge, 8mm insulin syringes all come with half unit markings and are only $12.58 for a box of 100 (although it seems a lot of WalMart employees don't realize that they DO come with half unit markings!!)
    relion insulin syringes.PNG
     
  13. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    I will get one later on this week, thank you for the info. I talked to a nurse who looks after Ducia and asked if 1U is too much for her weight and size but she was firm in her opinion to stick to what Dr said. It was expected. Ill try to discuss it with the discharging Dr but she is a witch.
     
  14. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    How much does she weigh? (they should be able to tell you)

    Also, if you were using the U40 syringes with the Lantus and gave 1U, that's 2.5 times as much which is a HUGE overdose.....we do increases in .25 unit increments because it can be the difference between a "good" dose and a bad one....2.5x as much is a BIG difference and could very well explain the hypo
     
  15. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    She was 7.6 over the weekend but ate very little. I will most questions abpout her propose food plan as I have a feeling 5.5 total for the day isn't enough. It was most likely an accidental overdose. She is stable as the the clinic said, was BG 345 at AM. The Dr insists on starting with 1U Lantus. I post below picture of what we have currently but will definitely get the half unit marked syringes from Walmart. At least I should keep them in HYPO TOOL BOX which I wish I had yesterday.
    The biggest hope is that she responds well to 1U. We are picking her up tonight.
     
  16. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    1 unit is a pretty normal "starting dose", but for Ducia, at 7.6lbs, the starting dose would be a little lower

    If she's only getting low carb food, I think I'd start her at .5 instead (the "official" starting dose for Tight Regulation is "weight in kgs x .25", so that would be .86 (which you can't do) so we'd probably suggest starting at .75....but you have to have syringes with half unit markings to do that too
     
  17. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    I wont have syringes at least not until Friday. The home adjustment by 0.25 is scary proposition. I doubt my abilities all together after Hypo. Cannot read symptoms. Not skilled at the testing when fast and frequently needed.
    The shots and adjustments (god forbid we ever need them) are to be done by my husband, human medic who at work all day long.
    How unsafe is it for to be on 1U?
    I'd hate to play with shots after Hypo. If there was an overdose (maybe not) I don't think we should be trusted with it at home, no vet supervision, no car to go to the emergency if trouble during the day. I am still shaky/mind numb.
    Can the food intake be manipulated? All I have at home is low carbs.
    There is some dry food in the freezer Royal Canine adult but that I thought what get her in to trouble. I
    am too new at it to understand the entire picture.
    We'll see a Dr at the clinic. What kind of questions should I be asking about her food? They firmly believe that 1U is good for her.
    please check out Ducia's spreadsheet the number are close.
     
  18. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    There's no way to really know until you try it and get some tests in

    You must have U100 syringes (with orange caps) before you give Lantus.....do you have any of them?
     
  19. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    I have, but they are without half unit marks. No way we can eyeball precisely 0.25 decrease. I will buy half mark from Walmart tonight. They are just $13.
    Do you think we SHOULD give decrease?
     
  20. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Nobody can get exactly .75 unless they're using calipers

    The best ANY of us can do is eyeball it

    The important thing when dosing is to make it as consistent as you can do it, not that it's exactly .75.......just that every time you give that dose, it's as close to the same as the last one as you can get it. A lot of people will use some colored water and pull up a "sample" where they decide .75 is going to be so they have something to compare to when they giving the real thing

    As for what you should do, I wish we had a crystal ball and could see into her future......we're not vets....just people who've been doing this dance every day ....some of us for many years and we've just learned what work and what doesn't.

    The 1U dose may be fine....it may be too much....it may not be enough.....Only testing will answer that question, but as long as you're able to test, you should be able to keep her safe.
     
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  21. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    @Chris & China

    I am wondering if after that severe hypo at 1 unit of Lantus whether that it would be safe to give 1 unit again. Ducia has been through the mill with DKA and then the hypo last night so my concern is it is very hard to say what is a safe dose.
     
  22. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    It depends......I believe she was using U40 syringes instead of U100 when she gave the 1U

    The ER vet is giving the shot before she leaves so we don't have a lot of say in it :(
     
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  23. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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    Thanks Chris . I didn't see where she had used the U40 syringe last night. I thought she had used the U100 that came with the Lantus. If the U40 was used that would definitely have made a big difference. The ER vet would be aware of all the problems and hopefully the 1 unit will be a safe dose.
     
  24. Dyana

    Dyana Well-Known Member

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    I think most vets only think in 1 unit increments for some reason. It's like they have never heard of syringes with 1/2 unit marks on them. It must be part of their training.
    I wonder if the person who sent you syringes to work with the Lantus could verify or confirm that the ones you used were the U100 syringes.
    I am keeping you in my thoughts and prayers. Please test tonight, especially about 4 to 5 or 6 hours after the shot is given. Post here for any concerns. I hope you have lots of test strips. It is recommended to keep an extra box of 50 with your hypo kit, as you never know when you will go through a bunch and the last thing you need is to run out of strips in the middle of the night or during the day when you have no car.
     
  25. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Updated info from PM's to keep it public.....I have asked her to start a new thread in the Lantus forum

    Back home from the clinic
    PMPS BG 368 Lantus 1U
    +1hour BG 308
    not very interested in eating on her own
    going to tube feed if does not whithin one hour

    All they gave was another antibiotic, I had to request that the meds she was Rx on her prior stay ARE RETURNED TO US because Dr thought they were too much for her.
    We are trying to trick her to eat but it does not work. She ate very little at the hospital. Should offer anothertype of meal? Or should I go ahead and tube feed right away. SHe is tiny.
    The DR WANTED TO GIVE HER 2 UNITS!!!

    The Dr at ER said that she needs nothing but Amoxicillin. Even cancelled her potassium( I know she is depleted), Denamarin, vitamin K and the rest. I really do not understand her new treatment plan. It just didn't sound right.
    We gave a little too much of water with the meal. Can we overwater her?
    She sleeps quietly and I am worried that she is lethargic, like just before

    I also do not understand that the Dr cancelled her Potassium. I spoke in the am with another dr and she told me that Ducia needs potassium.
     
  26. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Jul 18, 2011
    Do you have a regular vet?
    Who tested her and said the potassium was low enough to need a supplement to start with?
    Did they do bloodwork at the ER?
    If you don't already have it, request a copy of any labs that were run, both at the ER and at your prior vet visits. There is a tab on your spreadsheet where you can enter the values. We have people here that are very experienced at reading them and interpreting them. If her potassium is indeed low, it is important that she get the supplement. Low potassium can make her feel lethargic and unwell, and she won't eat.

    What food was she eating before she was diagnosed with FD?

    Sorry, a lot of questions, I know, but just trying to get a handle on what is going on and how we can help.
     
  27. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    I will get the copy of her latest blood work later on by email - it wasn't ready wehen we checked out.
    I know some detailed because I spoken to another dr earlier on the phone and she said that potassium and phosphorous are down. Needs supplement. My current is an orally gel - almost impossible to give and not suitable for the etube.She will get some if she eats but it'll take time.
    All my data is from the ER doctors. We have a vet to whom we went to be diagnosed on the 1st place. We'll be back with him to check the blood work and find acceptable potassium supplement.
     
  28. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Ok, the latest is at 12am the BG was 168 (down from 308 at 9pm), then she ate on her own more than 1/4 can of 5.5 Friskie. She is alert, grooming. We need to get her to eat more. If she shows no interest in the food I left in her bowl than it's going to be flushed via etube. 25-30 ml slurry.
     
  29. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    The one who diagnosed her, yes. But we seen him only once, he is not specialist. He certifies in trauma/rehabilitation
     
  30. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Jul 18, 2011
    This is great news!!! I know you need to get more calories in her, but these are signs she's feeling much better! Let's take our encouragement where we can.
    I'm a little concerned about a gel - possibly sugar in it? But right now, if her potassium really is low, it's more important that she gets her supplement.
    Great! When you get it, post the numbers on that tab in the SS - then we can get Marje to look at it. She's awesome with labs.
    Sometimes when you are dealing with several vets and they are not communicating, you can get conflicting info/advice and just don't know what to do (we sometimes have that happen here with different members giving input). It will be good when you can see just one vet who will get to know Ducia and work with you consistently. For now we just have to try to make the best out of what you have so far.

    Great job getting today's numbers in the spreadsheet. When things calm down, it would be helpful if you can go back and add lines for all the days for which you have readings, so it's easy to see what's been going on. We can help you with that if you like - I know you said you aren't super tech savvy.

    That is a significant drop from +2 to +5. Not alarming, but it would be a good idea to get a +6.

    You mentioned Ducia's poor ears earlier. Did anyone tell you to get some Neosporin with pain relief gel? If you rub a bunch of it on her ears every night, then wipe it off in the morning, it will help them heal. You can get a generic at Walmart that'll be cheaper, just make sure it's the gel and has pain relief. It also makes it easier for the blood to pool on her ear for testing.

    How are you and DH holding up? This has been an insane couple of days for you - very stressful. You've done a wonderful job.:bighug:

     
  31. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Thank you Tricia Cinco,
    I thought of getting +* but will do +7. I read about neosporin and will get one. But would it make tests contaminated? I had a horrible roller coaster at the hypo - when the honey was all over the placing the readings went from 484 to 43.
    I gave Ducia a little water after she ate >1/4 Friskie, about 4 ml via tube. The tip of her nose is soo dry. I can't overwater a cat, can I? She had >10ml with her meal at 10pm and that's it. The meal was watered too.
    I'd love to see a good vet. I supposed he has to be a D specialist? Or is it an endocrinologist? We have no insurance for her and the costs must be scary. Do you have any idea how much a visit like that may cost?
     
  32. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Jul 18, 2011
    Not if you wipe it off before testing. Lots of people here use it and none has reported an issue. I used it on Harvey's ears all the time.
    Well, you can give her too much via the tube. I had a cat with a tube once and I had to learn the hard way to give small amounts at a time and let him process it before giving more - otherwise he would just throw it up, which made everything worse. That was four years ago and I was still learning a lot about cats and their health. Wish I'd known then what I know now!
    It doesn't necessarily have to be an endocrinologist or even an IM that specializes in FD, although sometimes that is what you need. As long as you find a vet that is open minded and hopefully has some experience with FD. Younger vets tend to be less set in their ways, too. Specialists can be very expensive. I am fortunate to live about 40 minutes away from UC Davis, and their Veterinary Teaching Hospital is rated #1 in the country. We spent a lot of money there from early 2014 to late last year - four cats diagnosed with cancer, two had FD, one went blind, two Hyper Thyroid, etc. We saw oncologists, ophthalmologists, dermatologists, dentists, Internal Medicine Specialists, Integral Medicine specialists and one awesome endocrinologist. But for good basic care, my regular every day vet is just fine. It's too bad UCSD's Vet School doesn't have an Internal Medicine department. A typical visit, with bloodwork, would usually cost several hundred dollars. When we get our next cats, we are definitely going to get insurance!

    You could ask on the Board if anyone in the San Diego area would recommend their vet. I'm pretty sure there are other members there.
     
  33. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    I gave her 10ml water + watered slurry 20 ml at 10pm, then 4 ml water at 1 am, and 6 ml water + 27 ml slurry at 2:30, it's not too much, is it? She went to the litterbox at 2:30.
     
  34. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    I will, just wanted to get an idea how much it could possible be.
     
  35. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    I am soo sorry about it. Very painful experience.
    I am beginning to think we are having an epidemic. The hardest thing to learn was that so much pain and sorrows could have avoided by simply switched to wet low carb/ raw food.
     
  36. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    well, that would be ideal. However last night when I was checking Ducia out I had surreal experience of talking to a vet who wanted to shot my girl with large amount of Lantus while prescribing her to eat anything even dry food high on carbs. As if she was holding a bucket of water - Lantus in one hand and fanning the fuels with another hand - by giving more dry food. I will ask around about good vet. we met one at the ER, creative, attentive, competent all you wish in vet and doctor, but he is critical care, not the long maintenance. Our vet is a good one I know. But he had to consult specialist to read our results.
     
  37. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    That might not be a bad thing. It indicates he is aware he doesn't know everything. A lot of vets seem to have a "god complex", where they think they know it all, and won't listen to what you say. I have one that is just fascinated by all the studying I have done, and when I ask about something she isn't familiar with, she goes and researches it. That is a really good vet. She told me that when she is talking to me, she forgets I'm not a vet, as I understand everything she tells me. I take that as a compliment to the Board. I've learned so much here.

    I see Ducia is headed back up, so I think it's safe to go to bed. I'm sure you're exhausted. I've had a hectic day, too. Unless there's something else I can do for you? I'm going to turn in.
     
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  38. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Ducia breather with wheezes as someone with a cold would be. I do not like it. Her gums are not blues, purple or gray, pale pink moist. I am worried. She semms to dislike the heater near by.
     
  39. Dyana

    Dyana Well-Known Member

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    Dec 28, 2009
    Did the breathing with wheezing just start?
     
  40. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    no, she had in the hospital.
    When she was admitted with BG 22 and low temps her breathing not wheezy but like drums, bangy, very odd. I asked right away what it was but she just into her cage and they didn't start anything. When I was picking her up I heard it but thought that she tries to purr. The water from feeding thru tube could not get into her lungs , it goes straight in her tummy. What could it be? Maybe tubes? Sounds a lot like bronchitis but without cough.
     
  41. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    the wheezing seems to be only when in upright position.
     
  42. Dyana

    Dyana Well-Known Member

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    Dec 28, 2009
    But, she had it before and then it stopped for a while and now it's back, or has she had it since the hypo?
    I hope the tubes are in place. My cat had a tube down his nose, so I don't know about E Tubes. J.D. is a DKA survivor and came home with a feeding tube because he wouldn't eat the entire 8 and 1/2 days that he was hospitalized.
    Can you get a video of the breathing and post it?
    I need to leave for work, but others should be around to help. I don't see your posts in the Lantus forum, yet. You could try posting there, too.
     
  43. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    after we took her home hospital after the hypo.
    Seems its only when in upright position. Mow is laying down flat, sleeps I hope not lethargic, and the sound is as of a human with severe cold or bronchitis.
     
  44. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Good idea!! I will let rest now but when testing / shooting I can record it. Thank you .
    Thank you for staying so long with me. Have some rest.
     
  45. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Hello,
    my post DKA, who has Pancreatitis and fatty liver/ probably jaundice cat girl Ducia is recovering from Hypo.
    Her breath when is laying down sounds like of someone who had severe cold. But when her upper torso is in upright position or when she interacts with me - head bangs- she makes odd wheeze noises.
    She has been fit with E-tube. She had amoxicillin in her system. She is been fed and given water thru tube today.The tubes goes straight in her tummy, nurse at the clinic assured me that no water could have gotten in to it. I heard the noises in her when I checked her in with Hypo and when was picking her up but not so obviously. The sounds seem to increase when she is in upright position. When she lays down flat, like now, she sounds like someone with severe cold. The breathing rate is normal. Gums neither blue, grey nor purple, pale plight pink moist.
    Does anyone has any idea what it could be?
    She is post DKA, post hypo, possible pancreatitis and possible jaundice. BG at 2 am 235. She receives Lantus 1 U
    There is a human medic in the house, has stetoscope but no experience with feline health.
    We appreciate any thoughts.
    Thank you
     
  46. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    Hi Tanya, I am sorry that I don't have an answer for you I hope that someone who does will weigh in . My best advice would be to call the clinic and tell them your concerns and especially since it has gotten worse since you picked her up from the cinic. I would think that if it were an upper respiratory infection the AB she is on would help.
    What does that mean?
     
  47. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Hi,
    my thought exactly on Ab. Next dose around 6am.
     
  48. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I'd call the clinic. The feeding tube might have shifted its position and is causing some airway irritation.
     
    Bobbie And Bubba likes this.
  49. Squalliesmom

    Squalliesmom Well-Known Member

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    Jun 26, 2015
    If your medic listens to her lungs does he hear any unusual sounds? I would definitely call the clinic; if the sound is loud enough, maybe you can hold the phone near her and they can hear it.
     
  50. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    the human medic with no feline health knowledge said that if she was human than she might be having an acute bronchitis, and that the sounds or noises are on the"upper level" not from the deep. If it explains anything. The cover around her neck that protects the tube entrance is not too tight.
     
  51. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Yes, the sounds are unusual but isn't familiar with felines, sounds like human acute bronchitis. Very quest.
     
  52. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    it is too quiet for video
     
  53. Squalliesmom

    Squalliesmom Well-Known Member

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    Jun 26, 2015
    I don't know for sure but I would imagine feline lungs sound about the same as human lungs, I mean, lungs are lungs, regardless of the species, and I don't think they should be making noises outside the the usual sounds of breathing. If he's hearing bronchitis-like sounds in the upper part of her lungs, I would definitely pass that information on to the vet.
     
  54. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I keep thinking it's related to the placement of the feeding tube. If their anatomy is anything like ours, the entrance to the esophagus and the trachea for breathing are very close at the top in the neck. We have a flap that closes when we swallow so food doesn't get into the trachea - and it's not fool proof as anyone choking can tell you.
     
  55. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I replied on your other thread. If I had to place a bet it would be on the feeding tube somehow irritating or interfering with the air way.
     
  56. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    We will, he is rather unsure about what he hears. Bronchitis for humans.:confused:
     
  57. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    if sits on her own it is very quiet, as if someone with cold or a stuffy nose breathes. It is only when I pet h the sounds increase.
     
  58. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    I called the clinic twice and was told that due to my refusal of he proposed treatment per owner's request I will no longer receive phone explanations. The proposed treatment was to start her on 2U and I refused. I actually wanted to talk to them to go below 1U which but it never came to it.
     
  59. CassAndGordy(GA)

    CassAndGordy(GA) Well-Known Member

    Joined:
    Sep 23, 2016
    WOW!!!! I don't have any advice regarding the wheezing (I have no experience with tubes and such), but that is super uncool of the Vet office. Can you bring her to your normal vet, or call them? (Unless this is who declined helping you over phone.)
     
  60. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    the stuff over there is amazing! The owner isn't so much.
     
  61. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Did Ducia have anesthesia recently? I have heard of kitties who had too large a tube for intubation get a wheezy sound afterwards cause things were irritated.

    Let us know what you find out.
     
  62. PumpkinsMom

    PumpkinsMom Member

    Joined:
    Oct 5, 2011
    Tanya, call them and ask them what level the feeding tube should be at. It should have markings on it. You want to make sure that it hasn't changed position.
     
  63. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Wendy&Neko,
    Yes, she has been under anesthesia for a short time for E-Tube fitting procedure and actually due to her not been able to rid itself quicj enough she groggy for longer than I would expect. The procedure was success.I cannot any longer communicate with the clinic staff. I had ro refuse their propose increase in Ducia's dose from 1U to 2U. Her weight was 6.5 lbs, and I believed it to be too large of a dose. I thought that her high 300s could be better managed than another Hypo that we went thru the day before yesterday, and refused it. Now, because I did not accept their treatment plan, refused their services, the owner forbade her staff to discuss anything with me over the phone. Even when I asked if that's the possible cause I was told you have to bring her in and that their are the techs and would not know. The owner did came to the phone and asked who it was and after I named my self she hanged up without saying other word. I got her stuff finally email me the lab tests from yesterday and it turned out that for managing her Hypo crisis they didn't do any blood work only the glucose test. I expect it now, but the copy has been sent to my vet, the one who original diagnosed DKA. I am going to call him.
    But I have 2 questions that maybe you can help me with:
    a) Yesterday after the discharge Ducia was in much better condition. Her numbers are in the SS. Not bad.
    this morning 6:45 Bg 342 Lantus 1U 20ml watered slurry, meds and at 8:45 BG is 366. It is going up. I am very anxious and do not know what to think. Why is it up ? Will test again 11:30. She is semi letargic I think, sleeps, reacts to me calling her, but lays down sleeping.
    b) the coat under the Tube protective colar is wet. It must be leaking. Can I do anything about it?I will discuss it with the wet but your thoughts are much appreciated. Thank you all
     
  64. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    Tanya, definitely call your vet. I've never dealt with a feeding tube but it seems reasonable to me to think that it might be leaking and maybe needs to be repositioned. It worries me that it may be interfering with her breathing, somehow. I'm sorry you were treated so shabbily by the clinic that put the tube in, they should never have hung up on you! But please DO call your own vet and let him/her know what's going on!
     
  65. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    The leaking around the tube is a worry. If water or food slurry gets inhaled she could develop pneumonia. This needs attention by your own vet ASAP.
     
  66. Tanya and Ducia

    Tanya and Ducia Well-Known Member

    Joined:
    Feb 25, 2017
    The clinic won't discuss anything with me over the phone at the owner's request. I am not even sure I am welcome to brinh her in.
    My vet hasn't called yet.
    But hold on everybody, cross your fingers. Ducia just got up and eats on her own warmed yammy WhiteOceanFish pate, phosphorus high, very good for her.
     
  67. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    I cannot call ny more. But she is up, ate some. It's her meal time but I am not sure I want to use the tube now. My vet hasn't called yet. Dialing him up right now.
     
  68. Tanya and Ducia

    Tanya and Ducia Well-Known Member

    Joined:
    Feb 25, 2017
    Ducia woke up and ate about 1/4 of Friskie 5.5 can, not much but is good, visited her box, groomed, reacts when called. No longer lethargic.Alert. She should get some water in to her but I am not sure I should use her etube without talking to the vet. He is swamped, but the office received the paperwork from the clinic. I hope he will soon.
     
  69. Tanya and Ducia

    Tanya and Ducia Well-Known Member

    Joined:
    Feb 25, 2017
    wet coat rather, it was not leaking as in faulty leaking/dripping faucet. No. It is visible wet. And she licks front of her body often, like right now. But the over all demeanor is better than before.

    Her number was up, and now that she has eaten when should I test her?
    Does it make any sense to test now?
     
  70. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Did you give insulin this morning? The units column on the spreadsheet is blank. It helps us help you if the spreadsheet is kept up to date. When was the last test and how long since her shot?
     
  71. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    I think this could still be a cause for concern. Please do discuss this with your vet as soon as possible.

    Glad she seems to be improving so nicely! :bighug: :cat:
     
  72. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    she may be attempting to purr but it sounds different due to the tube being in place.....just an idea

    We should probably try to keep all this in one thread....Here's the most current thread on the Lantus Forum
     
  73. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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  74. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    last test at 9am BG 366 +2. I corrected the SS. Still learning.
     
  75. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    that's what I thought
     
  76. Glennie

    Glennie Member

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    Nov 18, 2016
    No idea what amount can cause it with a cat, but you can overdose on water. Water poisoning. I know this because I accidentally overdosed our foster baby on water. She had a feeding tube. It messes up electrolyte balance. She did survive my stupidity, but the whole ordeal was horrible. So maybe you can check for a safe amount of water for Ducia. I am so sorry things are such a mess for you and Ducia right now.
     
  77. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Can you recall "water overdose" signs and symptoms?
     
  78. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    I think you can wait until a mid cycle test now. Maybe somewhere from +5 to +7.
     
  79. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    When Squallie was first dx-ed w/potassium deficiency he was given a gel by Vetoquinol called Renal K and it had no effect on his bg. They also make a powder that you can add to food, which is what we use now; it's a lot cheaper than the gel. You can check with your vet and see if this would be appropriate for Ducia.
     
  80. Squalliesmom

    Squalliesmom Well-Known Member

    Joined:
    Jun 26, 2015
    The following is from Dr. Karen Becker, describing water intoxication in dogs. I would imagine the symptoms would be similar in cats, as well.

    "Symptoms of water intoxication include staggering/loss of coordination, lethargy, nausea, bloating, vomiting, dilated pupils, glazed eyes, light gum color, and excessive salivation. In severe cases, there can also be difficulty breathing, collapse, loss of consciousness, seizures, coma, and death."

    There is also THIS detailing a cat being given too much water by e-tube.
     
  81. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    thank you, I certainly will if he calls, ever.
     
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  82. Squalliesmom

    Squalliesmom Well-Known Member

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    Jun 26, 2015
    If you don't hear from him before the end of the business day I would call back before they close and ask again that he call you at his convenience, stressing that it is a matter of importance to the health and well-being of your sick kitty!
     
  83. Glennie

    Glennie Member

    Joined:
    Nov 18, 2016
    Thanks, Squalliesmom. Much better info than I could give, Tanya. Hope the wheezing gets figured out.
     
    Squalliesmom likes this.
  84. Tanya and Ducia

    Tanya and Ducia Well-Known Member

    Joined:
    Feb 25, 2017
    that has already been done.
    He did the same thing when we were expecting his call about Ducia's blood work. Called much much laer than then agreed. And all I could get from his staff was "he is with the patient" or he is in the room. He has very busy practice.
     
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  85. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    That's totally normal.....remember, her levels are all out of whack due to the hypo

    There's something we call "bouncing" going on too....when they 1. drop too low, 2. drop too quickly or 3. drop lower than their body is used to (or any combination of all 3), the liver releases stored sugars and hormones to bring them back up fast

    It can take up to 3 days for those sugars and hormones to clear the body before you start to see "real" numbers again
     
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  86. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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  87. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Ducia Bg 305 +7
    I expected lower on 1U
    she at 10:50 but not much watered food and peed at this time
    The vet hasn't called; Ducia didn't drink 7 am but ate watered meal
    7 am water was about 6+ml
    she seems to avoid over heating, sneaking from under the blanket, lays almost lethargic. There is trouble with tube but should I give some water anyway?
     
  88. Squalliesmom

    Squalliesmom Well-Known Member

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    Jun 26, 2015
    I would hold off on giving her more water until somebody more familiar with e-tubes and hydration can weigh in. How long ago (in hours) and how much water have you given her?
     
  89. Meya14

    Meya14 Well-Known Member

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    Jan 2, 2015
    As a general guide, cats need about 350ml total oral water a day. A 5.5oz can has about 250ml give or take, so free oral water intake should be about 100ml. Too little water and too much water can be a bad thing. Too much can overload the kidneys and heart if there are issues with these organs. It can also cause electrolyte issues. Keep track of how much extra water you are adding to food and giving her otherwise.

    I'm not sure if hydration is the current source of breathing issues. I do know that after one of my cat's dental, she grunted and coughed for a few days because the breathing tube irritated her trachea.
     
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  90. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Mine didn't know you could get them with 1/2 unit markings. I had to show her.
     
  91. Meya14

    Meya14 Well-Known Member

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    Jan 2, 2015
    Also, ---Are you testing for ketones??-- Please try to get a test, as lethargy can mean she's sliding back into DKA.
     
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  92. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    She sent me the info she posted above by PM too since I set her spreadsheet up for her

    I've asked her to stick to one thread for now because it can get pretty confusing to try to keep track of two separate threads on two different forums

    This is her latest thread on the Lantus Forum
     
  93. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

    Joined:
    Jan 11, 2010
    I'm not familiar with problems that an e Tube might cause, but I know that one of our members (no longer active) highly recommended the Yahoo Feline Assisted Feeding Group. https://groups.yahoo.com/neo/groups/Feline-Assisted-Feeding/info
    The people there are very knowedgeable and helpful. You would have to join the group and then they send you 4 informative files. They would be the best positioned to help you, and I have heard that they are terrific and caring.

    Sending vines for Ducia, hugs for you,
     
  94. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    The water up until now is about 21-22 ml, 47 ml slurry and about 1/2 canned 5.5 ounces food. Her nose was dry to the touch and went to litter box twice. Is it too much of water?
     
  95. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    The water up until now is about 21-22 ml, 47 ml slurry and about 1/2 canned 5.5 ounces food. Her nose was dry to the touch and went to litter box twice. It's too much. The last water she had was 4 ml via tube at 1pm. The last time she ate was about 3:15pm.
     
  96. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Tanya....please only post in one thread....it's just too confusing for everyone to try to keep track of what's being said in two separate forums

    I have asked one of the mods to merge the threads but I don't know how long that might be
     
  97. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    The vet will see us tomorrow afternoon about breathing and tube leak.
     
  98. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    If she's peeing, I think she's probably getting enough water

    Do you know how to check for dehydration?
     
  99. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Dec 28, 2009
    Today's threads have been merged per request.
     
  100. Squalliesmom

    Squalliesmom Well-Known Member

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    Jun 26, 2015
    26 ml is less than one ounce, so I definitely don't think that is too much water. How much water was in the slurry? Do you mean 47 ml water to 1/2 can food? If so, that's still less than 3 ounces of water, all together. If she's only had 1/2 of a 5.5 oz can of food, she will need more, I'm pretty sure. Did the vet give you any information on how much to feed her, and how much water she would need? If not, make sure to ask your vet tomorrow when you go in. She needs enough food to make sure she doesn't slip back into DKA. I'm really glad you have the appointment with your own vet tomorrow!
     
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