? HELP!! BG not coming up No Insulin since 10:04 pm on 1/1/2021

Yesterday at PMPS my cat was @ 187, which is low for him. I decided to hold off until he came up, in the meantime I decided to force feed him and he started to come up to where I thought I could shoot his insulin. I gave him 4.5 u and most of the time i give 5u to him. I decided to check his BG and he has had a constant decline in BG. I gave him Karo syrup this helped for a while and force feed him some more, then he kept on coming down. This morning he started throwing up so I took him to the vet, his regular vet was not in. She did do blood work and she said he had chronic kidney disease and some of his other numbers are off. They had me to hold his insulin so I could get him in today, but he is at 103 and has no insulin since yesterday. I don't know what to do, he is not eating, but acts like he wants to. What do I do, I am SCARED . What if he is still at low numbers, he needs some insulin.

 

You don’t want to give him insulin if he’s not eating. He might be having a pancreatitis flare. Do you give him anything for nausea ever?

 

Teresa --

We can't be of much help without being able to see your test data.

What other numbers are off? Did the vet test for ketones?

He's not going to become hypoglycemic if you haven't given any insulin so that's one less thing to worry about. If the vet is concerned about kidney disease, what did she recommend regarding treatment? You may want to look at Tanya's site which is an excellent place to learn about chronic kidney disease.

 

The labs might be all off from pancreatitis so it’s hard to assess the kidneys if that’s the main issue right now. I am not saying he doesn’t have CKD though. There aren’t any bg readings for a very long time on your old ss. Do you have any to from the past couple of weeks?

 

I gave him ondansetron at 5 am & 1 pm and. he had a shot of cerenia at the vet. What concerns me is his BG staying so low. He did eat some last night and I force feed him. I can force feed him again, but I am worried about the low BG.

 

I am going to need to give him insulin at some point and his BG keeps going down and not up. I have been up all night so I forgot to ask for copies of his blood work.

 

I do have and all of his numbers are high. I don't know if I can get to my 2020 sheet, I can't see it when I go to the SS. I think I am going to lay down for a few minutes.

 

I don't know if she did or not, but should have. He has not peed since we have been home,

 

Just go up top where you see 2020 and tap on that

 

Any change since your last post?

 

No, I gave him some Karo syrup so I could lay down a little while and he came up to 160 and I got up 2 hrs later and he was at 110. I am right now trying to put in some numbers from the last week of 2020. I don't think it will help anything because he was just running high. I can force feed him some tonight but what about insulin when he is so low, he did not have insulin this morning so he should be running high. I would like to talk to @Bron and Sheba, did I do that right.

 

I'll do the tag for you, Teresa.

@Bron and Sheba (GA)

Hope Buddy feels better soon. I can relate to how scared you're feeling. Remember to stop and breathe deeply now and again. It helps a bit.




Mogs
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I am afraid that what was wrong with Bron's Sheba is what is wrong with my kitty, that makes you have low blood sugar, but he needs insulin in case he has something else wrong with him. I have keep him as high as he has been by giving him Karo syrup, I don't know what to do.

 

I went to check on Buddy and he was eating, his BG raised up from 110 to 136.

 

I want to talk to you too, I am afraid my cat has what Bron's Sheba had. I did enter 1 week's worth of BG on Buddy's 2020 SS.

 

It looks like you've been dosing by preshots, or some way we aren't familiar with here. You've given 3 different doses in the last three days. Which just means I'm not really sure how big the depot thinks it is and it makes it hard to suggest what to do next with dose. He could be riding the blues with a combination of higher depot and lack of food. Glad to see he's eating on his own and up a bit.

Have you managed to get a ketones test in lately? Just a little worried about you dropping the dose and possible infection and inappetance. When Neko wasn't eating as much as I needed her to, I started feeding slightly higher carb LC, so around 8-9%. It gave me a bit of a buffer. As long as she got at least 2/3 of her calories in, I was good to shoot full dose. Some times it involved syringe feeding. Never did end up having to reduce her dose. Neko had CKD and heart disease and small cell lymphoma at that point in time, so lots of complications.

How much food has he had today including what you assist fed so far? Are you giving him something different from his regular food? Cats can develop food aversions to food they are syringe fed. Neko didn't, but I did have a foster who went of chicken when I had to assist feed him. I found a/d or Royal Canin Recovery good foods to syringe. Often Neko would eat the Recovery on her own once I got a syringe or two in, sort of priming the pump.

Remember that insulin does more than just combat carbs from food. It is essential to get nutrients into the cells. Cats undergoing anaesthesia who cannot have food, are usually good to get at least half a dose.

 

First thing that comes to my mind is pancreatitis as a complication. I am not a vet but have a male that is diabetic with pancreatitis at this moment.

 

Buddy has not peed since we came back from the vet @ around 12:00 pm. I was force feeding him I/D last night and he got sick and threw up 2 times. When i took him to the vet today she told me not to force feed him when he was sick, so I have been giving him Karo syrup to keep him up. About 10 minutes ago I went into give him some meds and he was eating Royal Canin GlycoBalance and he came up some, he was in the 130's. He had ate almost a whole can. If he does not eat tonight I can force feed him some, but with BG of 110 to 136 I have no idea what kind of dose to give him and I cannot give him 5 u. Buddy, has never been low like this, so I am scared to death. I was up most all of last night watching him, worried because he was so low. Buddy has chronic pancreatitis and his BG has always been all over the place high, but never low. I might feel alright giving him his regular dose, somewhere around 5 u with force feeding if his numbers were higher, but not when his BG is this low. The vet he saw today was not his regular vet, she was the only vet in today. I have to go feed and give meds to another one of my cats. I will be back.

 

Are his numbers high or low.

 

Are you missing some data in the spreadsheet? I don't see anything below 146. That's not low.

 

That is low when I gave Buddy around 10 or 11 t of I/D during the night and he had ate a little of his Royal Canin earlier in the evening. I gave him no insulin today and he was around 110 and that is low for Buddy, most of the time he would be really high, especially with no insulin. i am going to see about my Mother and my other cat, but I will be back.

 

OK, it's low compared to what Buddy and you are used to, but not low in general. The larger depot can still influence 4-6 cycles so that's likely what took him down to 110.

 

Hi Theresa. I am so sorry Buddy is not well at the moment.
I can’t see any data on his SS after 12/31/ 20 so can’t really see any low numbers except for a run of blue numbers on the 12/31.
Sheba had been in mostly blue and green numbers for the month or 6 weeks before she got the diagnosis of pancreatic cancer, and before that she often had blue or green BGs, so didn’t suddenly drop low. but it’s true she did need less insulin in the last couple of weeks.

If you look at Sheba’s remarks column you will see that I managed the drops in BG with food and honey if needed. Sheba was a diver and bouncer all the way til the end, God bless her.
It would be helpful if you added information into the remarks column as it will help you when looking back on it as to how you managed things. I would not give Karo if Buddy has not had insulin.

 

I gave Buddy karo because the doctor he saw today told me not to force feed him and I had to lay down for a while, I was afraid he would go hypo while I was laying down.
Buddy's vet had told me in the past that When they saw a cat with pancreatic cancer that their numbers would be low and they would lose a good bit of weight. Buddy, has lost weight, he went from eating I/D to Royal Canin GlycoBalance so I thought that was why, but when his numbers dropped so much it scared me to death. What were Sheba's symptons.

 

I hope so, any suggestions. Buddy's BG has always been all over the place, but worse in the last 2 years because of his pancreatitis. I know my dosing is not always the best but I also take care of my 99 year old Mother and sometimes I need some sleep.

 

Buddy, has no ketones, he peed and I tested. What would have made his depot off, it was off last night and I gave insulin. The no insulin was this morning when the vet said to bring him in because they leave @ noon. We were there so long the vet said to hold his insulin until tonight. i just checked Buddy and "Thank The Lord", it was 277. I may not give him 5 units tonight because I do not want him to start running lower tonight and I don't know if he will eat or i must ff.

 

Hi Bron Teresa does have some numbers filled in for 2021

 

Hi Wendy just trying to understand and learn it does look like she is dosing going by pre shots. It says her cat is on Lantus so shouldn't she be going by how low the nadir is taking him?
@Wendy&Neko

 

Thanks @Diane Tyler's Mom i can see the 2021 BG now.

I don’t know what you mean by his depot being “off”. Wendy meant that the depot can influence up to the following 6 cycles.
I would give him some insulin tonight. Not giving insulin is very risky. I know he has no ketones now....that’s great.....but if you continue to skip, ketones could form. And as Wendy said insulin is also needed to get nutrients into the cells.
You could give him some higher carb foods during the cycle if he’s not eating much.
I’m sorry you have such a heavy work load. I’m sure you must be tired with also looking after your elderly mother

 

You are welcome @Bron and Sheba (GA)

 

The only reason he missed this mornings dose was i called the vet for Buddy to be seen, they said come right now, I said he has not had insulin yet and they said we are only open until noon. so come right now. after all of his testing was done and we were leaving the vet said since it is noon wait until this evening to give insulin. This is the 1st dose he has ever missed since he had a fur shot. I have gave him insulin tonight, last night i gave Buddy a higher carb food trying to bring his BG up, but for some reason it did not work. I keep Hill's I/d at all times and it is a high carb wet food. It's not that I have such a heavy work load, but sometimes I need to get some sleep, last night i got around 2 hrs., because I was worried about Buddy and the same today, I got around 2 hrs sleep because of wanting to know what was going on with Buddy. Sometimes, when I think Buddy is running lower I will back off his insulin dose a little bit, but not skip it. Most of the time Buddy runs high, but he has been known to take a dive.

 

Yes, I should, but his nadir is never the same.

 

What I said was I gave Buddy insulin last night, even though he was low, so his Depot should not have been off. I know what Wendy said, maybe it was off last night, but he had his insulin. There was .50units off on his dosing a couple of times, but he was either not eating or running lower than normal. Buddy, has chronic pancreatitis, so he is up and down.

 

If the depot took him down, I am glad that is what it was, not something else.

 

I'm glad he came up enough for you to feel comfortable giving insulin. Paws crossed he keeps eating.

Ours are not the only dosing methods for Lantus. Some groups dose by nadir, some don't. And Teresa's signature says she isn't following any one dosing method we use here. Hence the reluctance to give dosing suggestions on my part. In this post here, Libby gives a good explanation why we don't pick and chose bits from multiple dosing methods.

 

I

The only thing Buddy does that is not done in TR is he eats a small amount of dry food and he eats Dr.Esley dry chicken which has a small amount of carbs but the biggest part of his food is wet canned. I have always done a lot of testing every day.

 

That's fine to not follow TR if feeding dry. But even SLGS doses by nadirs.

 

Hi Teresa. Max had chronic pancreatitis for a couple years before becoming diabetic but I was able to get him tightly controlled. I think I mentioned that before. We all want to help in any way we can but at least for me the only methods of dosing I know are the ones we use here.

 

Thank you very much @Wendy&Neko

 

Buddy, did come up yesterday finally, which is what I was concerned with. Maybe it was the depot and maybe it wasn't, I do not know. I never said that you should not dose by nadir, which seems to be the point of contention here. Buddy, had chronic pancreatitis for years before becoming diabetic and has had for years after becoming diabetic. Hopefully, this does not happen again, because I will not know what to do. Now, he has CKD on top of his pancreatitis.