Worried and scared

I posted in the main forum but it was as suggested I post here.

Silver has lost so much weight and the more I feed him he’s still not gaining. I increased his dose to 1u bid last week and his numbers came down a bit bit still in the 300’s. Tonight I tested him and he just vomited up the treat he got after test. His coat is also losing its good condition. What else can I do?

I planned to do a curve today but I gave him a fur shot this morning so will do it tomorrow. His numbers aren’t horrible - I’ve seen worse. Should I be increasing dose again?

I don’t understand how he was getting blues and yellows sometimes a green on 0.25 but now at 1u I’m mostly seeing pink and occasionally yellow.

Can someone help? I am so scared I’m making him sicker by wrong dosing.

He’s not himself tonight.

 

Do you test for keytones?

I think the coat condition is a general reflection of their overall health, could be diabetes related, could be something else.

Sorry I don't have any advice regarding dosing, know nothing about SLGS, but I would definitely check for keytones so you can at least rule that in/out, and if he keeps acting not right, get him to the vet.

 

I can’t test for keystones as I have two cats and neither of them ever use the litter tray when I am in the room. The vet once asked for stool sample but again, impossible to know which one. Also the litter I use is so absorbent there’s never any wetness to test. I did try once but got no reading.

 

There are ways around that, if you want to use the ketostix. I've heard of things you can sprinkle in the litter that read for keytones, putting some plastic wrap on top of the litter, etc. they also make meters that measure both BG and keytones (they use different strips to measure keytones), so that's always an option if the urine route won't work for you.

 

I wrapped the inside of the box in aluminum foil when I used Keto-Diastix earlier this week and that worked. But you'd still have to figure out how to keep both cats from going in there. I'm so sorry that Silver is having a rough night

 

All the bad signs (the fur, the weight loss, etc.) are probably signs of high BG.
After 7 days on a dose, check the results and follow the protocol as below (SLGS):

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit

• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose

• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

You are doing great, keep it simple and follow these rules, you have no reason to panic.
Cheers.

 

Thanks Mel...he is down a bit now - stayed up to midnight to get a +6. I think I am just being a worried mommy. As I live alone with the cats I am aware of every little change in behaviour.

 

Thank you for the encouragement. I am doing the SLGS. Its hard to be patient and wait a whole week with high numbers. I just put him up to 1.25 and I will wait a week again. I got a +6 tonight (his nadir is at +6) and he was 13.9. So much harder this time around. Last time he was in good numbers with just 0.5u.

 

Here is your previous post http://www.felinediabetes.com/FDMB/threads/should-i-increase-again-anyone-help.187261/#post-2078409

Sometimes insulin needs change, I can understand your frustration.

Since you are following SLGS method, you need to hold the 1u dose for at least a week. You only increased 4days ago. There were previous comments provided to you about getting more data as you currently don't know how low the dose is taking Silver. The curve will help, but numbers will be affected because of the FS.

In what way is Silver not himself? It may not be BG related, a vet visit may be needed if he is exhibiting symptoms that are concerning you.

 

Same here. All I do is worry!

 

I’m increasing him tomorrow I can’t possibly leave him running high and he whole week when it’s obvious he’s not getting enough insulin. His weight loss, bad fur and high numbers indicate he needs more.

 

Ok, that's entirely up to you. From the SLGS sticky..."It is not recommended to rush the process, if you follow SLGS, no matter how high your cat's BG is. Rushing to regulation will cost you time in the long run, because you may shoot past the right dose".

Weight loss and bad (unkempt) fur can also be symptoms of hyperthyroidism or kidney issues, among other things. If these are recent changes with Silver, you might consider a vet check to rule out other potential causes for this, as I said before, it may not be due to his BG values that you are seeing.

 

Have you had him tested for hyperthyroidism? Christie is also correct that it could be a kidney issue but I wa thinking perhaps hyperT since it is also an endocrine condition and might explain why he came out of remission and is losing weight so fast.

I think a vet visit is in order.

 

He just had a vet visit and it was the vet wrongly prescribing antibiotics and steroids for a non existent IBD that took him out of remission in the first place. All tests came back normal even the blood glucose at the time. Vet was wrong and I don’t trust vets anymore. My previous vet ask nearly killed him by his treatment of the diabetes. Vet is last resort for me now.

 

I will do a curve before increasing. If nadir is above 5 then it’s still following SLGS to increase right? I was advised to increase a few days ago.

 

Do you know for sure he tested for Hyper T? It's not part of the regular senior panel, so usually they don't do it unless it's requested or they suspect Hyper T.

I love the extra tests that you're getting. It really is helpful. Are you positive you gave a fur shot this morning? Some insulin most likely went in, as Silver was lower at PMPS than at AMPS.

Regarding ketones, there is a meter that tests for both glucose and ketones in the blood - it's called a Nova Max. The strips are a little pricey, but you won't be using as many as you do for your regular meter, and if you really feel you can't get a urine test, it's a wise investment.

Go back and read Ovi's post above. If nadirs are between 5 and 8.3, you hold the dose. I suspect the person that encouraged you to increase a couple of days ago didn't realize you were following SLGS.

 

I smelled insulin on him so I presumed I gave him a fur shot. I was concerned I had maybe shot passed the ideal dose as I had seen blues and a green or two at just 0.25 but that was some time ago. I really don’t trust the vet to take him back. I’m on such a very tight budget I can barely afford the strips for my current meter. Right now it’s groceries or strips. I couldn’t afford a new meter. I’m doing the best I can and hoping I am not failing him. If I’ve shot passed the ideal dose how would I know? Should I start again and bring him back to 0.5?

 

Ok, I just gave him his AM dose and kept it the same - just 1u. His AMPS was the lowest I've seen in a few days - just 15.1.

I'll do curve today and see where he is at.

He seems back to his normal self today.

Thanks for the advice to wait and see. SLGS takes more patience than I usually have. I just want to see him well.

 

No, that almost never works. Just put on your patience pants and hang in there!



I'm glad Silver is feeling better. Sometimes cats get out of sorts for no apparent reason at all. Hopefully that is the case with Silver.

 

Here are some ways to test for ketones:

• put the end of the test strip right in his urine stream as he's peeing
• slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
• put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.

Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.

I use the spoon method with Teasel. I know when he's likely to use the litter box so I can catch him at it. I have three cats who share a large box and this method works well for me.

 

I mentioned before that I can’t test for keytones. I have two cats and none of them ever in all the 11 years I’ve had them EVER use the litter tray when I am around. Only when I’m in bed or out. I can never tell which cat is doing what. And if there’s anything weird about the tray, they’ll use the floor. If I put plastic wrap in it they’ll go nowhere near.

 

You might want to get a blood ketone meter then. The strips are expensive but you won't be using them as often as BG strips.

 

I can barely afford the strips for my current meter. Right now it’s groceries or strips. I can’t afford extras.

 

DCIN (diabetic cats in need) might be able to help you. @Chris & China is the forum member contact person.