? 1/7 Luci AMPS 275 - WITHOLD INSULIN? ADVICE PLEASE

Yesterday's Condo

Update: Just learned from the Radio-Cat Hospital that they want to give her insulin at 8 a.m. and 6 p.m. during her upcoming three day hospitalization beginning Monday, January 11. The nurse just called and left voice mail that their tech will not be there to give the pm dose at 8 p.m. nor will there be anyone there to check on her overnight. She even went so far as to call my vet to check to see if that would be ok, of course he said, no problem with giving insulin 10 hours after the a.m. dose and then the a.m. dose would be 14 hours later.

My inclination is not to send any insulin at all for Luci during her three day hospitalization - she will be there Monday night, Tuesday night, Wednesday night and back home on Thursday morning.

I am very uncomfortable with them giving an early dose in the evening and then having no monitoring whatsoever overnight.

@Wendy&Neko @Sienne and Gabby (GA) - any opinions on whether to risk hypo vs. no insulin for Luci's hospitalization for I-131 treatment? Anyone else have any experience with going without insulin or risking hypo overnight? I'd appreciate anyone else weighing in with thoughts/advice! Thank you!


Good Morning everyone!

Happy to report the COVID-19 vaccination process, although there was a line waiting, it was very orderly and smooth. We arrived just before 9 a.m. for our 10:30 a.m. 'appointment' - and it appeared by the line of cars that everyone had an appointment for the same time...There were to be 500 doses administered between 9 a.m. and 2 p.m. and I think everyone with an appointment (which was required) was arriving in the morning.

But there were plenty of law enforcement and volunteers all along the route to direct people and keep things calm and orderly. Every once in a while someone would drive the wrong way ??? Not sure what the issue was and they were kindly asked to go back to the end of the line (at least from what I observed).

Getting the vaccination itself was completely painless and effortless - we didn't even have to get out of the car! We went to lunch afterward and ran a couple of errands. We noticed in the late afternoon that we were feeling exceptionally tired so decided it was time for a nap/rest...got up from that feeling cold and a little achy...like I was coming down with a cold. Overnight I felt like I had a sore throat??? And this morning I feel like I've caught a cold, but otherwise I feel ok! Yeah! Luci is sitting here beside me now waiting for her 6 a.m. routine! I swear she can tell time! I think she's pretty much recovered from her day at the vet and is feeling back to her curious self.

I hope you all have a lovely day and that your kitties surf safely!

 

Very interesting to read about your experience. Hopefully the side effects subside soon.
Glad that Luci is back to herself. Have a good day.

 

Glad you got the vaccine and so glad Luci seems to be back to her old self (and hope she stays out of any contraband ). Have a wonderful day, Sue

 

I'm glad Luci is back to normal. I hope she surfs safely today. I hope you get over your reaction to the vaccine soon. Sending prayers.

 

Thanks for telling us about what you were feeling after getting the vaccine.
Hope everything wears off soon. I'm glad Luci is back to feeling like herself.
Have a good day Sue

 

So nice to hear good news!

 

Glad Luci is feeling better, hope you feel better soon as well. Have a great day

 

glad luci is feeling better.
hope your jab drag passes quickly.

 

Update? Anyone?

 

Hi Sue,

Sorry, but Why do you think you should withold insulin?

 

Ah, I see... because she is going into hospital. Hope this bumps to other people attention. No experience!

 

Would asking them to give a much lower dose be a compromise?

 

An old saying around here - a day too high is better than an hour too low.

They want to give her insulin in the evenings 10 hours after her morning injection. There also will not be anyone there to watch for hypoglycemia overnight - in fact, there is no supervision at all in the overnight hours.

I'm not going to allow them to give her insulin that could potentially set her up for a hypoglycemic episode with absolutely no supervision - for me it's a recipe for disaster.

 

That's ok! I appreciate you asking And yes, it does bump it up...

 

I know it's covid, but is there an option for you to administer the dose when the tech isn't there? Just run in, test, shoot, and leave. And then with no monitoring, I'd do some sort of vacation dose if it were me. I do agree that I would not give the evening dose 2 hours early...who knows what would happen with the overlap. You'll figure this out Sue

 

They won't let me in the building. Not just because of COVID, but once she has the treatment she's radioactive - and needs the post-procedure time to 'cool off'...we have plenty of instructions for when she gets home - like not holding her on our laps for more than 45 minutes a day (as more exposure could cause sterility)...like I care at this point...and I have to scoop her litter into the toilet - since it too will be radioactive - and must be flushed and not disposed of in the trash...lord...lots of instructions...basically as if you've just gotten a little Atomic Bomb back into your home...it's small, but it's there...radioactivity has to be handled with care.

Thanks though...I'm leaning toward withholding the insulin altogether...I'm just too worried about the lack of supervision overnight after they give her a dose two hours too early

 

I have no experience with this, but the lack of supervision and giving the doses at weird times would make me uneasy too. If it were me, I would wouldn't give them the insulin either.

I'm keen to see the opinions on this!

 

I think you have your answer!

 

I cannot bear the thought of that 'phone call'...you know the one where they call you in the morning and apologize profusely but say she's gone...and then I'm left with the thought of why did I do this???

I just cannot justify allowing them to administer insulin 1)Early and 2)With no supervision whatsoever all night long...

The nurse said, we'll make sure she's eating...

Right...I'm sure that's enough - NOT! I'm quite annoyed with them...she told me the last time we discussed that every 12 hours would not be a problem - now we're just a few days away and it's a problem...

I'm just going to update the paperwork, no insulin...at least not under those circumstances.

 

Sue, will she have food available? Two hours early with Lev may act like an increase, and will give you a little more overlap than usual, if she is having a late nadir cycle before that next dose, but that doesn't seem to be Luci's gig. How often have you found that she reacts immediately after a dose increase? I see more often than not early nadirs, except for December 28th where she looks like she mixed it up a little (bounce break?)

If it were me, I might consider either: dropping the dose down the day before to 0.75u, but 1u is nice and easy to see, hoping the vet tech has good vision or strong prescription glasses . Or, have higher carb food for her to keep things maybe a little higher, but safe. Or a combo of the two. Just my thoughts, hope it helps. Good luck with the procedure

ETA: is Luci under anesthesia for the procedure?

 

Are they willing to monitor during the hours that they are there? And will Luci be ok with that?

I saw on Jax’s thread, that Luci can be...unladylike

I don’t have experience with overnight vet stays and insulin to offer.

 

cant advise on the dose question.
when our civvie had this treatment, we missed the fact in the documentation that any stuff you bring in with her, they will destroy "on your behalf" bc it is considered "hot."
for us that included food, a blanket and some toys.

 

If you choose not to give. Make sure there is a big sign on her cage that day DO NOT GIVE INSULIN. And hope the fonts do it not give R because you aren't bringing hers in.

 

I was told they would 'make sure she's eating'...they did not agree to monitor...and yes, she can be rather unladylike - mostly growling, hissing...snapping...just a few of her displays of displeasure. I think they'll be relieved they don't have to handle her! She would have to be restrained to test or even give insulin...

I think it's just better that they only have to feed her...and leave her be the rest of the time.

 

Yes, they told me the same - but did say that if I sent in insulin or meds they could be returned - otherwise everything that goes in with her will not come back out, toys, liners for the cage, everything...nothing would be returned.

 

They won't give her any medication that I don't send in with her... but I will add a sign to the carrier saying that she is not to be given any medications! That should be clear enough. NO MEDICATION... Let's hope.

 

Do you have a shirt you are willing to part with? I know many places have people bring in a T-shirt they have worn with their scent on it. Obviously you can’t get it back, but possibly comforting for her.

 

They'd have to give it to her 10 hours apart, and no monitoring. That doesn't sound so good to me. I guess you could set a "vacation dose", but then you have to trust them to measure out a very small dose, and two hours early for insulin isn't a good idea. Maybe giving her some once a day in the morning when they can make sure she eats is better than nothing? Otherwise I don't blame you for just telling them not to give it to her at all. I'd do the same. Such a tough spot to be in.

 

I hope the treatment goes well!!!!



(I wonder what superpower Luci will get? )

 

This is my concern—-some cats lose appetite with the treatment & they can’t be in the room too long or too many times so if she’s given insulin and then doesn’t eat, that’s a problem

 

Yes, we've got that part covered! We're 'rich' with old clothes here

 

It would be funny if you took a large hamper full of clothes.....one way to get rid of some stuff—radiate it away !!

 

Yes, Luci gets pretty upset about all of that and most likely won't eat a thing...once she gets her dander up...I just don't trust that anything will go well.

The nurse told me they are used to 'crabby' cats...Luci is a Queen of crabbiness when she's at the vet.

Once when I took her in for spaying, she was hissing and growling so much that they tech asked me to come back to get her out of her cage to put her into the carrier - she wouldn't let anyone else come near or touch her...they were probably happy to see her leave.

 

Let's hope she just gets rid of that extra thyroid tumor! And maybe by becoming radioactive she'll become less grumpy? I just dread this whole thing... Wish I didn't have to put her through that...but am so hopeful it'll help her get back to her good numbers...her blood glucose seems adversely affected by all of this upset...she's out of whack for certain.

 

I will be thinking about you guys and sending positive thoughts her way that all goes better than you think it may go. Hope to hear all good news. I would just call the clinic every day and remind them (like a broken record) about the meds or you can take to standing outside a clinic window with a BIG sign that reads “No insulin for Luci” ....LOL!!

I always like a cat with attitude & fight vs sweet & sensitive when it comes to hospitalizations. They seem to fair better .

Stay positive & tell the Queen to remind them who rules Vet Crabby Catland !!

 

I agree with you and would be concerned; either once a day or no insulin at all during her stay. Monitoring and food are important. You'll be able to deal with her numbers when she's back home!!
Hope everything goes well!

 

hugs to you and Luci

I’m sorry she has to go through that. I would be a nervous wreck I pray that the treatment goes well and it helps her get back to feeling good I’ll be thinking about you guys.

 

Yes, Luci will be sedated for the I-131 injection. In fact Luci requires sedation for everything these days. She doesn't tolerate even having the labs drawn without putting up such a fuss.

They said they would provide food for her as far as 'wet' vs 'dry' - but couldn't be more specific about gravy vs pate' types...apparently they have brands of food available but who knows after that - at first they said 'bring whatever food she will be eating with her' and now they've reversed that - don't bring any food, just tell us what she eats and we'll feed her. They did not say there would be food 'available' of it they just put it in and then removed - but she did emphasize the late day routine includes feeding, cleaning litter boxes and then tech leaves until 8 a.m. the following day.

I've decided not to send any insulin at all with her. I don't trust them as far as fine dosing - the lines on my syringes certainly aren't correct and I used calipers - I highly doubt they're going to use calipers to measure - more like 'eyeball' and hope for the best. She'll just have high BG's for three days and then I'll work with her when she gets home to get her numbers back into some better looking places. Luci isn't exactly a well behaved princess and personally probably the less they handle her, or attempt to handle her, the better. She's not going to be tolerating much from them in the way of testing, etc.

 

LOL!