Newbie Needs Help, Cat Dragging Hind Legs

Status
Not open for further replies.
L

Lunarstruck

Member Since 2013
I'm re-posting this here because I really need help:
Our 9 yr old neutered male DSH cat that has had diabetes for three years controlled with Lantus insulin is now dragging both legs behind him. He can feel them and sometimes use them but not well at all. We took him to a new vet yesterday who x-rayed him and said its diabetic neuropathy but to keep him on the same dose of insulin which was just reduced by .5 right before this happened. The glucose test showed 104 but my stupid b/f gave him 5 units that morning without my knowledge, its his cat. The glucose level last week was 164 on his blood test but they said he had a normal curve that day. I'm so frustrated and don't know what to do for him and can't find a meter that works. I doubt its a clot because he can and does stand and even walk a bit better sometimes but mostly drags his hind legs behind him but has feeling in them. It started about a week ago, he was walking weird but nothing like the plantar walking from diabetic neuropathy he's had twice before when we had to adjust his insulin and it went right away. This is different - it started out lame on both hind legs and just looking weird, no plantar walking at all. It got worse after we reduced his insulin by .5 but like I said, I can't do anything with that without a really accurate meter and I can't find one, we test them with the Accu-Chek and they were WAY off, both way higher and then way lower than the Accu-Check on the same day's readings. Vet did x-rays two days ago, can't find anything but impaction so I gave him a cat enema and he pooped but not all of it and I don't know if he's peed, we have another cat in with him we can't remove anywhere else. I don't think he pooped today. Took away all dry food and are feeding him Fancy Feast Classics canned with a lot of water in them only about 4-5 times per day including after his BID Lantus insulin shots.

His "off" blood levels are posted below, the rest were all in very normal range:

WBC low at 5.22 K/ul
GLU high at 167 mg/dL
TP high at 9.3 g/dL
GLOB high at 6.3 g/dL
AMYL high at 2294 U/L

BUN is 22 mg/DL
creatinine 1.8 mg/dL
GGT <0 U/L
K 3.7 mmol/L
MCV 42.8 fL
MCH 13.8 pg
NEU 3.22 K/uL
LYM 1.29 K/uL
MONO .30 K/uL

Questions:

I've been given Cobalamin shots by the vet and need Methylcobalamin - is this good for diabetic cats and can you even use the sublingual crushed into their canned food? Does it have too much sugar? http://www.iherb.com/Natural-Factors-B1 ... blets/2521 What dose/mgs. do you need daily and do you have to give it for life?

Do I need to give potassium and what dose for how long? I know you can overdose so I'm a bit afraid to give it.

One reason for this is could be he was on Baytril liquid at the time of the bloodwork for a suspected UTI that I later found out from the new vet had tested neg. at the old vet and they STILL put him on it so we left that office (for good reasons) where he had been treating for 3 years and took him to the vet I normally use. He's been off it for I think 4 days now and had glucose of 104 at the vet two days ago when the hind leg dragging started. I think it was gradual in about a 1-2 week period but this cat has been hiding abnormally for about 2 months now.

Susan/Toney
Riverside
 
I'm glad he's sometimes standing and walking. To me, there is hope there.
Have you thought about acupunture? I've never used it. Maybe others who have can advise.

I give a weekly injection of cyanocobalamin to J.D. for his pancreatitis, so I think the cyano form is for tummy issues.

I know you need the methyl form for neuropathy. I use Zobaline for daily methycobalamin. It's just a small tablet that I give J.D. in a piece of pill pocket with the rest of his pills.

What dose is your cat on?
 
Here is the previous post

I understand you are frustrated. Unfortunately, there are no quick fixes.

Note that regular B12 (cyanocobalamin) may be helpful in pancreatitis, so you might hang onto those pre-filled syringes.

The ReliOn Confirm will never match the vet's meter or lab tests. This is OK. We have reference numbers for use with a human glucometer.

Some glucose reference ranges for decision making using a human glucometer

< 40 mg/dL
- Treat as if HYPO
- At nadir in long term diabetic (more than a year), may earn a reduction

< 50 mg/dL
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50.
- At nadir, often indicates dose reduction is earned

50 - 130 mg/dL
- On insulin - great control when following a tight regulation protocol
- Off insulin - normal numbers

> 150 mg/dL
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol

180 - 280 mg/dL
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine. Test for ketones, glucose is too high.

>= 280 mg/dL, especially if for most of the cycle between shots
- Uncontrolled diabetes and in danger of DKA and hepatic lipidosis
- Test for ketones; more than a trace, go to vet ASAP.
 
I read cyanocobalamin is toxic to cats. Also, the meters I used were BOTH higher AND lower than the Alpha-Trak on the SAME DAY, they were completely inaccurate all by themselves. They didn't work at all and we returned them.

SUSAN/Toney
Riverside, CA
 
cyanocobalamin is used in cats (and dogs).
http://vetmed.tamu.edu/gilab/research/c ... nformation
Where did you hear it was toxic?
Regarding potassium, what was the measured level? You do not want to supplement potassium without knowing the current level.
As asked in your other post, can you take and provide a link for videos that shows the problem With a BG of 160 or so I would not expect neuropathy.
Did the vet discusses possible saddle thrombosis?
http://www.veterinarypartner.com/Conten ... ID=3001459
http://www.youtube.com/watch?v=Ii_Iv-cpK2o
 
When you compared your meter to the AT meter on those days, were the tests done side by side using the same blood sample?


Larry, the K value was 3.7.
 
Lunarstruck said:
I read cyanocobalamin is toxic to cats. Also, the meters I used were BOTH higher AND lower than the Alpha-Trak on the SAME DAY, they were completely inaccurate all by themselves. They didn't work at all and we returned them.
Click to expand...

No, cyanocobalamin is not toxic; it is a form of Vitamin B-12. It is water soluble, and excess will be excreted through the renal system.

Some info on human and animal glucometers in the US:

1) They are not intended to replace a lab test.
2) They are intended to give an approximate value for home monitoring.
3) The FDA allows meters to be sold which provide values within 20% of what a lab would get. That means for any test you get, the likely lab value is somewhere in the range +/- 20% of that value
- A test result of 50 is actually between 40 and 60, a range of 20.
- A test result of 500 is actually between 400 and 600, a range of 200.
It also means that if you take 2 tests on the same blood drop, you can narrow that range to what overlaps.
4) While pet-specific meters will read closer to what a lab test might provide, there are pet-specific reference numbers for using a human glucometer on a pet. It is like the difference between reading temperature in Celsius vs Fahrenheit. Freezing is 0 degrees Celsius or 32 degrees Fahrenheit.

On the average, you will get readings that are "good enough" to do home monitoring - human diabetics use these glucometers all the time to manage their diabetes and insurance companies often cover the cost of these meters for humans.
 
Susan

Did you see my previous post about comparing meters? How some are plasma calibrated, some are whole blood calibrated and you can't compare those two. Also, you can't compare meters that use different assay methods. If you have an Accu Check, why not just use it? We are going to be able to help you the most if you hometest and let us know what numbers you are getting.

Also, in the previous post, I posted a link for you on potassium. You should not supplement potassium without your vet being on board and involved because you have to test 24-48 hours after the first dose and then you have to test blood every week to two weeks. You cannot just give him potassium on your own because you risk raising the potassium to a level that is too high which is dangerous.
 
I know the difference between blood types on meters. These five meters were all SO far off each time they were NOT useable for anything. I threw the last one out. They were off over 100 each time in DIFFERENT directions than the vet's meter, there is NO WAY we could depend on them for ANY type of reading, they were all WAY too off. I used ear blood, the vet used jugular blood and they were BOTH way off. I'm SO BEYOND frustrated with this, my vet FINALLY called back just now after two whole days and said she doesn't think its diabetic neuropathy and that the other vet had given us cyanocobalamin injections. I told her that doesn't work for diabetic neuropathy, just inflammation and she had no idea. She looked it up online and called me back and said someone named Alice Woolf DVM who is a specialist website they use lists methylcobalamin dose as 250 mcgs, so 1/4 of a 5000 mcg tablet would be okay TWICE A WEEK. I said I thought it had to be given daily and that you can't really overdose them and it should be at a higher level and she really doesn't know. I'm thinking we're switching vets AGAIN after this episode, I already switched four times on a pancreatitis cat we have because three vets treated him totally incorrectly and would have killed him - they refused to give him food while hospitalized, didn't want to give prednisolone and when I finally got to the 4th vet who agreed with me, he got better right away and I saved his life. I'd like to do that again in this case, poor Toney is only 9 years old and is standing on both hind legs right now but not walking well and sitting down quickly. Doesn't seem painful so I don't think its saddle thrombosis or a blood clot. Vet said his potassium isn't low enough to supplement and quite honestly, I'm afraid to if I can't do blood tests right away. PLEASE HELP, what is the recommended dose for methylcobalamin and where can I get some QUICKLY?

SUSAN/Toney
RIverside, CA
 
I found some methylcobalamin liquid with no added sugar except raspberry extract at 1000mcgs per 25 drops. I still don't know the dose to give him but am going to go pick it up now, since I can't locate any anywhere else today.

SUSAN/Toney
Riverside, CA
 
You said " They were off over 100 each time in DIFFERENT directions than the vet's meter, there is NO WAY we could depend on them for ANY type of reading, they were all WAY too off. I used ear blood, the vet used jugular blood and they were BOTH way off. " What were the specific blood glucose values? the hand held meter, even the AlphaTrac meter are only accurate to no more than +/- 20%.
The care takers here use hand held meters from various manufactures and then work just fine. You just have to stick with one meter.
 
I'm telling you - ALL the meters were inaccurate, COMPLETELY INACCURATE. We returned ALL the IPet ones since they are proven to be inaccurate by everyone and the other one I threw away it was so far off even on two side-by-side readings - off by more than 100 up once, then down the other when the Alpha-Trak was showing perfect readings that weren't off by more than 20 each reading on his curve. I'm going right now to get a Relion Micro or Confirm and hopefully that one will work. This site in invaluable for info and I appreciate it, but I still have no clue how to read a human meter vs a cat-calibrated one - the link here and the posts were way too confusing to me. I just dont' get it other than:

<40 = HYPO
50 = lowest nadir you want to have in a new diabetic; if seen before nadir, follow directions for handling low numbers
>240 = exceeds renal threshold; glucose spilling from blood into urine

So I'm hoping the above is correct. The meter isn't going to help me much unless I can get a better way to read it for a cat. HELP! THANKS!

SUSAN/Toney
Riverside, CA
 
susan
I have just about every meter about there. I got them all for free for the most part.
I would say 98% of us on this board use a human meter. which one depends on what strips you can afford. You DO NOT need to worry about the difference between a "CAT " meter and a human meter. you just use the meter and take the readings from that. you are never going to get a perfect reading. it is what it is.

you will go crazy trying to get a meter that is going to match the vets. even with the same meter, taking a sample minutes apart, or even the same drop with 2 of the same meters, you are going to get different readings. If you want to be the same as the vet, then buy the same meter he is using.

how do you know the AT was a "perfect" reading. what is that being compared to??

I'm sorry, but I am not sure I understand what you are looking for or are attempting to perfect
no disrespect meant in my questions or post.

ps. I also know a lot of vets use a human meter also. cannot remember which one but many people here have posted such
 
Pick one meter and stick with it. Forget about the differences between the numbers at the vets and the numbers you get at home.

I got my foster cat Wink in remission using a Relion Confirm meter, the larger version of the Relion Micro.

The cat shelter gave me an Alphatrak 2 but the test strips were too expensive. Switched to the Confirm and never looked back.

Once you buy that new Relion meter, we will help you to get your cat regulated. We well help you to learn what the readings mean.

We don't look at specific numbers most of the time. We look at ranges. For example: <100, 100's, 200's, 300's, 400's, 500's. We look at numbers at specific times of that day. Based on the various numbers, we adjust the dose.
 
Susan

You might also be interested to know that the Tight Regulation Protocol that many of us follow is the only scientific-research based and published protocol for management of feline diabetes...and the scientists used human meters including an Accu-Chek Aviva. None of us would be here if our cats weren't our priorities, just as Toney is yours. So I would not risk my baby girl going hypoglycemic using a human meter for her BG if they weren't proven to be safe and acceptable to use.

It's probably good that you switch vets. I would also print off the info I gave you on potassium imbalances. Your vet is wrong on that but you must have a vet assist you with that.
 
<40 = HYPO
50 = lowest nadir you want to have in a new diabetic; if seen before nadir, follow directions for handling low numbers
>240 = exceeds renal threshold; glucose spilling from blood into urine
Click to expand...

Yes, those numbers are good numbers to go by using a human meter. "Normal" for a cat on a human meter is 40-120.
And if you see a number under 50 prior to nadir, you would want to follow the guidelines for handling low numbers. If and when that happens, you can also post either on the Health board or the Lantus TR forum, asking for help handling low numbers. Someone will quickly hop on, and will "walk you through" the steps. It happens. And people will stay up with you all night long if needed. Lots of us have done that.
And somewhere around 240 (some people use 220, some higher) is considered the renal threshold where glucose can spill over into urine.

There are also "bookmark numbers" for reducing or increasing dosage. But all of the numbers we typically use are "numbers on a human meter". When people use vet meters like the Alpha Track, we adjust our thinking to that as needed. Because 90+ % of people use human meters here, we typically think that way by default.

I said I thought it had to be given daily and that you can't really overdose them and it should be at a higher level and she really doesn't know.
Click to expand...

I think part of her confusion might be due to the method of "delivery". My understanding is that if you give the B-12 orally, a cat will only absorb up to a certain amount, and the rest will be "voided" by way of urinating out the excess. I am not sure that the same applies when it is given by injection, but someone else might be able to clear that up.
 
The difference is that what is injected is typically cyanocobalamin which doesn't have the same benefits as methylcobalamin.

Since we all live and breathe this 24/7, we often have more updated information and methods than many vets.
 
Thanks, SO MUCH everyone, I picked up a Relion meter today, it is either a Confirm or a Micro, I looked at both and they are about the same, they even use the same strips. I can't remember which one I got but will see what it says and post it. I'm exhausted from all this, I also got methylcobalamin liquid but it has things in it which may be sugars and I wont' be able to tell until Monday, so I really hope this meter works. I'd rather give him a few sugars and deal with the insulin than wait another two days to give it to him.

SUSAN/Toney
Riverside, CA
 
Okay, I got the ReliOn Micro but will have to try it tomorrow as the b/f went to sleep early and I need help. I also got Clark's Nutrition's B-12 Sublingual Liquid, which is Methylcobalamin 1000mcg per 25 drops and has only other ingredients listed as: Vegetable Glycerin, deionized water, Raspberry and Berry Natural Flavors, Citric Acid. I have no idea how much sugar is in this as it doesn't state and they didn't have any tablets or any other kinds without toxic Xylitol or sugars. Do you think this is okay to use now or should I wait until Monday to find out the sugar content? Thank you guys all SO MUCH for being here, I don't know what I'd do without you!

SUSAN/Toney
RIverside, CA
 
Okay, I got the ReliOn Micro but will have to try it tomorrow as the b/f went to sleep early and I need help. I also got Clark's Nutrition's B-12 Sublingual Liquid, which is Methylcobalamin 1000mcg per 25 drops and has only other ingredients listed as: Vegetable Glycerin, deionized water, Raspberry and Berry Natural Flavors, Citric Acid. I have no idea how much sugar is in this as it doesn't state and they didn't have any tablets or any other kinds without toxic Xylitol or sugars. Do you think this is okay to use now or should I wait until Monday to find out the sugar content? Thank you guys all SO MUCH for being here, I don't know what I'd do without you!

SUSAN/Toney
RIverside, CA
 
Okay, I got the ReliOn Micro but will have to try it tomorrow as the b/f went to sleep early and I need help. I also got Clark's Nutrition's B-12 Sublingual Liquid, which is Methylcobalamin 1000mcg per 25 drops and has only other ingredients listed as: Vegetable Glycerin, deionized water, Raspberry and Berry Natural Flavors, Citric Acid. I have no idea how much sugar is in this as it doesn't state and they didn't have any tablets or any other kinds without toxic Xylitol or sugars. Do you think this is okay to use now or should I wait until Monday to find out the sugar content? Thank you guys all SO MUCH for being here, I don't know what I'd do without you!

SUSAN/Toney
RIverside, CA
 
Okay, I got the ReliOn Micro but will have to try it tomorrow as the b/f went to sleep early and I need help. I also got Clark's Nutrition's B-12 Sublingual Liquid, which is Methylcobalamin 1000mcg per 25 drops and has only other ingredients listed as: Vegetable Glycerin, deionized water, Raspberry and Berry Natural Flavors, Citric Acid. I have no idea how much sugar is in this as it doesn't state and they didn't have any tablets or any other kinds without toxic Xylitol or sugars. Do you think this is okay to use now or should I wait until Monday to find out the sugar content? Thank you guys all SO MUCH for being here, I don't know what I'd do without you!

SUSAN/Toney
RIverside, CA
 
I'm not familiar with that product, Susan, or whether any of the other ingredients would be unsafe to give.

Forgive me if I misunderstood, but did you say previously that he had had neuropathy which resolved but this looked different? What did you give him before? And again, apologies if I misunderstood.

Glad you got the meter. Let us know when you are able to get readings. I would start with preshot tests. It's not safe to shoot insulin blind (without knowing the preshot BG).

Good job!
 
Thanks, all. His plantar-walking neuropathy changed before when we INCREASED his insulin. I just used the ReliOn Micro for the first time and not sure I got the blood in time b/c I had a hard time getting any but it read 37, which scares me. I don't trust it at all since none of the other meters worked at all and I can't repeat the test since I already stuck him so many times I cannot do that to him again. So I gave him some of my pancreatitis cat's canned Blue Buffalo Basics Senstive turkey and potato food and left a note for the sleeping, cranky b/f to NOT give him insulin in the am but to get him immediately to the vet for another glucose test first. I doubt he will, he will most likely go to the gym and leave me with this and I am SO frustrated. If his glucose is still that low on this meter and the vet's meter reads normal tomorrow, I just give up on home meters ever again. This is the 6th one now.
 
Hungry, ate like a pig again but still can't walk normally. A bit better than 2 days ago but WAY abnormal. Can sit but not stand normally and can't walk. No pain it seems but cats are good pain hiders. I can't take much more of this.

SUSAN/Toney
Riverside, CA
 
Ok first things first - deep breaths. Its a steep learning curve but once you get past this it becomes very routine and it will be worth it when you see your kitty all happy and playful again. And we can help you get through this - which is why you came here

So now for the current issue.

Last night you got a 37 - great job on getting this test but that number is very low and in hypo territory see your other post http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=100355. A hypo could make him weak and stagger. I am hoping he is ok this morning.

This morning, before you shoot, please get a measurement. We dont want you shooting if he is under 200 as that could cause another low.

let me know what the number is!

Also lets just post in this thread right? two going at the same time is confusing. I will ask people in the other thread to post here instead.

Wendy
 
Getting one low reading is no reason to give up on a meter and stop testing. Toney needs your help. Yes, he's your BF's cat, but your BF does not seem to want to take care of him.

It takes time to get the testing down. We can help you with lots of information.

1. warm the ear with a rice sock, heated in the microwave. Put 2 tablespoons of rice or dried beans or dried lentils in the toe of a cotton sock, tie the top closed and heat in microwave til warm but not hot.
2. place something firm behind the ear, like a pill bottle lid to poke against.
3. Use a flashlight to see the area you need to poke.

More ear testing tips here: top ear testing tips

That BG of 37 yesterday earned your cat Toney an automatic dose reduction. 0.25U less than he is getting now.

Please don't give up on Toney.
 
From your other post. So we have all the information here.

Deb & Wink said:
That BG of 37 earned your cat an automatic 0.25U dose reduction.

You might want to keep a notebook and write down information in it. Like what times you gave the shot, how many units, what foods you fed and when, how his appetite is, how the 5 P's are (peeing, pooping, purring, preening, playing).

It would save you having to wake up the BF and you would both know what is going on and what had been done for your cat.

There is also a spreadsheet we have that really helps us to help you better.

For those people home testing, we have a wonderful way to keep track of the test data and shots. There is a google spreadsheet template you can use so you don’t have to start from scratch and figure out what you want it to look like.

We have instructions on how to set one up. how to setup a SS and link to your signatureThe color coding is helpful to see trends over time in how the insulin is working. We even help set them up for people that may be technology challenged. Please ask if you need help.

Having a SS set up and linked to your signature is a great way to get some suggestions from the experienced people on FDMB. You can even share the spreadsheet with your vet, by email. It's totally optional but it can get you some great advice on how to manage your cat with his BG numbers.

What do you think? You can look at Wink's SS in my signature to see what one looks like. I found it invaluable.
Click to expand...
Click to expand...
 
also be aware that sometimes (and this goes for ALL meters), too much blood or not enough can also give you a false reading.. when a reading looks suspicious as in a lot different # than you are usually getting, then retest to make sure
 
A bit more about meters and home glucose tests:

The FDA says that retail hand held glucometers only have to be within 20% of what a lab test (not a hand held glucometer) would find. Each test you get is actually somewhere within a 20% range of numbers, higher or lower.
A result of 100 mg/dLrepresents a range of 80 - 120 mg/dL, a span of 40 mg/dL
A result of 200 mg/dLrepresents a range of 160 - 240 mg/dL, a span of 80 mg/dL
A result of 300 mg/dLrepresents a range of 240 - 360 mg/dL, a span of 160 mg/dL
A result of 400 mg/dLrepresents a range of 320 - 480 mg/dL, a span of 160 mg/dL
A result of 500 mg/dLrepresents a range of 400 - 600 mg/dL, a span of 200 mg/dL
Notice how as the number gets higher, the range in which the lab value would fall gets wider. That may be why your tests and the vet's test were so different; none of the hand held meters are very precise at high numbers.

And it doesn't matter at higher numbers. Too high is too high and you take action to address the elevated glucose, following the rules for the insulin you are using.

Where you want to be careful is at lower numbers, where there is a risk of hypoglycemia. And at lower numbers, that +/- 20% range gets narrower. We use 50 mg/dL as a value we want our cats to stay above. Even if the true value was really a 40 (20% lower), that can be a safe number for cats, as it is in the range of normal glucose values for cats. And, we have guidelines for managing low numbers, to protect the cat.

If you have results from 2 different hand held glucometers, you can check the following:
A) For the low glucometer test, calculate 1.2 * the reading obtained
B) For the high glucometer test, calculate 0.8 * the reading obtained.
If the result from A is greater than the result from B, the readings may be considered the same.
 
Lunarstruck said:
If his glucose is still that low on this meter and the vet's meter reads normal tomorrow, I just give up on home meters ever again. This is the 6th one now.
Click to expand...

there is your problem with home meters. glucose levels can change drastically in just an hour or two depending on where you are in the cycle. of course the number obtained today at the vets is going to be substantially different than the 37 you got last night simply because of the time involved. kitty has eaten not to mention the fact that the insulin has worn off overnight

unless you've used a meter with "tru" in it's name, in all honesty, there was probably nothing wrong with the other 5 meters you've tried. you just haven't given them a chance or yourself a chance to learn enough about all this just yet.

i know it can be frustrating, especially when your partner isn't jumping for joy to help, but it's not a race and in no time you'll be telling someone else the same thing believe me. let me know if i can help ok. i live near the 15/91 interchange and am willing to help as much as i can. i work in orange county thru the week so don't know how much i can do thru the week unless you tend to stay up late but i am pretty free on the weekends and will gladly practice testing with you or sit and answer any questions you have, etc.....
 
THANK you all so much for your help. Thank GOD I didn't give up and
trusted my gut feeling (that his insulin is off and that his paralyzed hind end
(that gets better enough to sit and try and walk, then goes back to
dragging it) is neuropathy of some type - or cancer) and at the advice of you all
bought the only meter that has EVER worked for us on him, the ReliOn Micro.
It worked! I got a reading last night that was really low
(30-something), so gave zero insulin and gave him some higher-calorie food and my b/f
took Toney in to the same vet this morning and their Alpha Trak meter read 52
and ours read 25, so it works! Vet said no insulin unless we test first
from now on. He was stable on insulin before this and this reduction in
glucose is low only b/c we moved him into the bedroom/library room and took him
off the dry food and put him on canned food only (Fancy Feast classics)
b/c of an intestinal blockage. We feed him the canned mixed with water 3-4
times a day and 1/8-1/4 tsp. Miralax once a day. I gave him an enema and he
pooped, so left him on the canned mixed with water and thank GOD for you
guys and this new meter because if we had given his insulin it would have
killed him.

So here are his only tests using this new meter:

7/22/13 10:45am (1.5 hours after eating canned Fancy Feast): ReliOn
Micro 25 (Alpha Trak 52)
5:45pm (before feeding, ate last about 1:30pm): ReliOn
Micro 80

QUESTIONS:

1. I have no idea how much insulin to give him OR when to test, before
meals or after meals and how long before or after? I would think that with
an 80 I would give zero insulin but we took this BEFORE he ate, so I don't
know what I'm doing or when to test. I don't know the scale on these human
meters of how much insulin to give or when.

2. I bought methylcobalamin liquid, 25 drops = 1000mcg. I don't know how
much or if I can even give it to him because the only other ingredients
are: vegetable glycerin, deionized water, Raspberry and Berry Natural
Flavors and Citric Acid. Doesn't say how much sugar it has and I didn't have
time today to call the mfg so I didn't give it. It tastes sweet though. I
don't have access to any other type of it right now but the vet gave him a
shot of cyanocarbolomin and gave us weekly shots of that so don't know how
much or even if the wrong type will convert to methylcarbolomin. She had no
idea it was even the wrong kind or what dose to give of the
methylcarbolomin. Isn't this something every vet should know? I learned this years ago
working for a vet.

THANK YOU GUYS SO MUCH, YOU SAVED TONEY'S LIFE LAST NIGHT. Another yahoo
group pancreatitis site saved my favorite cat Kobe's life and I am SO
GRATEFUL to these sites that know so much more than the vets. Our vet didn't
even know that the human meters always test 20-30 units different than the
pet ones. Now she does, so your help saved a LOT of cats today. THANK YOU

Susan/Toney
Riverside, CA
 
As a newbie you don't want to shoot under 200. Measure him in a couple of hours and see how his blood sugar behaves without the shot. If he is over 200 tomorrow then you can shoot.

How much insulin have you been giving? You may want to reduce dose even when he is over 200.

Wendy
 
The dosage for the methylcolbamin is 3 -5 mg or 3000mcg -5000mcg .
The link for buying one without sugar was in your other post.
You might want to go back and read thru both of your posts and see if you missed some information. Sometimes things get posted at the same time and get missed.


The colbamin will not help with the neuropathy. So it looks like you'll be teaching your vet another new bit of information.
 
when to test, before meals or after meals and how long before or after?
Click to expand...
Always test before a shot. Always.

You want to test before you would normally give a shot, 12 hours apart. So test in the morning at say 7 am. That is your AMPS or morning pre-shot test. You want to test in the evening at 7pm. That is your PMPS or evening pre-shot test. Those are 2 tests numbers 1 and 2 for the day.

Take up the food 2 hours before these two tests. We want to see a number that is not food influenced.

Other tests that you get throughout the cycle, a cycle being 12 hours, can be food influenced.
So the next good tests to get are a morning mid-cycle test, somewhere in the +5 to +7 hour timeframe (shoot time or PS time = 0, 2 hours later = +2). This is test number 3 for the day.

Then a "last test before you head off to bed" test is a good one to get. This is test number 4 for the day.

Adjust the AMPS and PMPS test and shoot times to work with your work and life schedule. If 8 am and 8 pm work better for you, test then. Try to pick times, 12 hours apart, that will work best for you on a regular basis.
 
THANK you all so much for your help. Thank GOD I didn't give up and
trusted my gut feeling (that his insulin is off and that his paralyzed hind end
(that gets better enough to sit and try and walk, then goes back to
dragging it) is neuropathy of some type - or cancer) and at the advice of you all
bought the only meter that has EVER worked for us on him, the ReliOn Micro.
It worked! I got a reading last night that was really low
Click to expand...

Hi Susan,
You have no idea exactly how happy it makes me feel to read that. I am beyond thrilled that you A) found a meter you can trust, and B) got to see for yourself how it compared to the vet meter. That 37 last night was a scary number from where I am sitting, which is why I said last night that you have no choice BUT to trust a number that low. When I signed off last night, I did so praying that you realized how low he was, and how dangerous going any lower could be.

1. I have no idea how much insulin to give him OR when to test, before
meals or after meals and how long before or after? I would think that with
an 80 I would give zero insulin but we took this BEFORE he ate, so I don't
know what I'm doing or when to test. I don't know the scale on these human
meters of how much insulin to give or when.
Click to expand...

Always, always, test before shot time, before Toney eats. You want the AMPS and PMPS tests to be "fasting" numbers. And for now, no shot if you see anything lower than 200. Once you have collected data that shows you what a given dose will do, you will be able to safely and confidently give her a shot on a lower number.
Assuming you eventually see a number above 200, you can feed and give the shot. A good time to test after that, at the beginning, is at +3 or so. That number can reveal whether the numbers are likely to drop later in the cycle. Do not ever hesitate, before shooting, to "ask for advice". That's what we're here for! For that matter, and time you test, if you need input on what a number might mean, please ask.

Ultimately, the number that is going to tell you if a dose is too high, too low, or just right, is the "nadir" number. That's the low point of the BG 12 hour cycle. It typically happens around +6, but not like clockwork. It can change some from day to day at times. But generally, the low point should happen around 6 hours after a shot.

For now, I'd continue to get a test at the AM and PM times you would plan on giving a shot. But if you see something under 200, ask, or skip the shot. Whenever you aren't sure, err on the side of caution. Our top priority is the safety of the kitties. A day of high numbers is so much better than an hour of numbers that are too low.
 
GREAT. David gave him 2 units of Lantus when he tested 115 at 4 hours post-eating. I told him NOT TO GIVE ANY WITHOUT CHECKING FIRST and to go test him again right now. He just now tested at 90. So I had David feed him 1/2 can of my pancreatitis cat's food which is Blue Buffalo Basics Sensitive Solutions Grain-Free Turkey and Potato AND I put in 500 units of the methylcobalamin that I don't even know if it has sugar or not yet. OMG, I'm so freaked now. At least David stepped up and learned how to test and I really hope he keeps it up. I gave him the link to this site and told him to sign up himself. I am horrified but what can I do now? I told him DON'T DO THAT AGAIN, YOU ARE GOING TO KILL HIM!

I know it sounds horrible, but I honestly cannot deal with this without his help right now, I have a pretty bad medical issue (9 months of intestinal dumping and severe weight loss from being unable to digest food after reflux surgery) of my own that I need to deal with every minute of the day until I find a doctor who will treat for it. If I'm not here, I shiver to think what would happen to these animals. All our cats are former ferals or unadoptable rescues, so a few of them have medical issues I have to treat. And my old dog, a horse and 1 of our alpacas too. Poor Toney.

QUESTION: We don't give Toney any food all night long because I'm afraid to give him dry food - should I? What kinds are recommended? Its the same Blue Buffalo dry as the above-described canned he just got. We don't have a dry food to give him right now - what is recommended? Plus, there is another cat in with him, so I put his dry food up on a shelf only he can get to. We have been giving Toney canned Fancy Feast Classics mixed with water 4-5 times per day and 1/8-1/4 tsp. Miralax once a day. I don't even know how much canned food he is supposed to get, he's been eating about 2 small cans per day which isn't enough, but we have to worry about his intestinal blockage. He seems to be peeing and pooping okay now but not totally sure its his and not the other cats. I know he peed in the litter box, what a good boy, don't know how he managed that but I saw him.

SUSAN/Toney
Riverside, CA
 
How long after the shot was the 90?
The 90 was at 10 pm your time?
 
Also, as far as how much food Toney needs... What is his current weight? (Sorry if you already told us that and I missed it)
 
I think it was 12.5 lbs. he lost about 3/4 lb. in the past week. He's a big boy and used to be fat, which is how he got this. Plus, he's a brown tabby and I swear they are prone to it, so I watched him closely for diabetes and the minute I saw him drink extra water, he got diagnosed right away. He's had it 3 years and never went into remission until all of a sudden right now.

SUSAN/Toney
RIverside, CA
 
Okay a good general formula is 15-20 calories per pound, per day. So at his current weight, he'd need between 180-250 calories a day. A can of Fancy Feast classics, low carb, averages 80-90 calories. So maybe two and a half cans would be a good starting place. The more active he becomes once he is moving around better, the more calories he would burn.
 
The 90 I think was about 1/2 hour before I posted that, sorry I have no idea. I've been freaking out ever since. Told David to test him again before bed but he didn't tell me he was going to sleep or if he tested him. I'm SO frustrated. Should I give him some dry food tonight or let him go all night without food? He ate 1/2 small can after the 90. OMG. I hate this so much. It was SO much easier when he needed the insulin! We even have a great petsitter who gives it, she's a vet tech. All his curves over the past 3 years, he never went into remission or low like this, I don't know what is going on.

SUSAN/Toney
Riverside, CA
 
Thanks a TON, Carl, so he's getting about what he needs daily now then. I just don't know whether or not to leave him all night or put down dry food now. ?
 
I really do love Toney, I haven't even eaten today yet since 10am and have been researching this instead and trying to find a doctor who will treat my own condition. I've lost weight myself so rapidly that I figure I only have a month or two before I get too thin to surgically treat it. What a mess.

SUSAN/Toney
RIverside, CA
 
You said David gave him 2u tonight, right? If so, then I would leave food out. I have no idea how much two units will do on a 115.
 
No, it was 90 when he gave him the 2 units. That's why I'm freaking. It went up after we fed him. Have another question, about Zobaline, which I need to get since my liquid methylcarbolomine is only 1000mcgs per ml and not enough if the dose is 3000-5000mcgs per day. How many mcgs is in one Zobaline tablet? Thanks SO MUCH, you are a LIFESAVER, Carl. I swear you guys saved Toney's life and please, please please just keep us from killing him. David promised not to give any more Lantus without checking with me first. GEEZ.

SUSAN/Toney
Riverside, CA
 
Status
Not open for further replies.
Back
Top