Merry Christmas! Newbie here, your generous advise would be highly appreciated!

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Yuling & Casper, Dec 25, 2020.

  1. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Merry Christmas everyone! Hope you and your furry babies are enjoying some great time together and stay safe! 2020 has been tough, especially when it closes to the holiday season.

    My baby boy- Casper, (16) just being diagnosed with hyperglycemia on 12/20/2020. He had been an extremely healthy and active boy for his entire life until end of September that we noticed he had some gum problem. The vet ended up took out 3 teeth out of him and he has never acts the same from that point. He drinks a lot of water, still being EXTREMELY picky with food and lost weight significantly. We ended up took him in to the vet again on 12/17/202, his glucose read: 538 mg/dl.

    Regardless how upset I was (he was a very heathy baby when we first took him in for the gum/teeth problem, all test and numbers came back great), we had him hospitalized for 2 days and took him home with all the supplies before Christmas. We followed all the protocols, OCD being like on the insulin injection time and feeding (ProPlan DM). I started testing his BG on the 23rd. Quite unexpected, instead of seeing it being regulated, Casper's BG raised from 511 mg/dl (first reading from 23rd) to 683 mg/dl (last reading at 10:02 AM PDT, without any food, after 1 unit of VetSulin at 9:00 AM).

    I really don't know what is going on, Casper was responding to VetSulin at the vet, they got his BG regulated at 149 mg/dl before discharge him. And now, seems with all those injections (my poor baby)... the insulin is obviously doing absolutely NOTHING. If anyone who is experienced in this type of situation, please kindly advise!
     
  2. Pookie

    Pookie Member

    Joined:
    Oct 10, 2020
    Hello Yuling. Welcome to the forum. It's wonderful that you are already able to test Casper's BG.

    I don't have the experience to give you any advice, but I did want to point you to BEGINNER'S GUIDE TO CANINSULIN/VETSULIN in case you hadn't already seen it.

    Unfortunately, because it is the Christmas holiday there are fewer people online than usual, but I will tag some experienced members who might be online and who may be able to help. @JanetNJ @tiffmaxee @Critter Mom @Nan & Amber (GA)

    Enid
     
    Critter Mom and Nan & Amber (GA) like this.
  3. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Hello and welcome!

    I'm so sorry you and Casper are having such a rough time :(.

    First impressions, I'm wondering about this:

    does he ever paw at his mouth as if something is bothering him? When he had the teeth out, did the vet take x-rays before and after the extractions? And what was the date of that work?

    The reason I ask is because sometimes, little shards of tooth break off and are left behind during an extraction. Bit of a shot in the dark as to what might be going on with him now (especially if it's been quite a while since the extractions), but always worth asking.

    Other possibilities to consider: did anything else change around the time of the dental work? Food change? Medication (especially any steroids)?

    Last long shot: is the vetsulin you are using a fresh, unopened pen/vial, or did your vet give you something that had been opened (sometimes they do this to help caregivers out with a "bargain", but it does increase the chances that you got some ineffective insulin).

    All that said, long shots aside, sometimes the answer just is, "your cat is diabetic now", no real explanation. The good news is that you're doing the right things to get him feeling better (congratulations on home testing, by the way!!!!), don't be discouraged that it isn't happening quickly. A few days is actually a very short period of time in these matters, it can take weeks or even months to find the proper dose and get regulated, so it definitely doesn't mean that something must be wrong.
     
    Critter Mom likes this.
  4. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Christmas greetings to you all. :)

    Did you get dental X-rays done after the extraction? If not, then it would be a good idea to get some because sometimes fragments of tooth can get left behind and cause problems.

    When was the most recent blood work done? Worrying about whether there might be any oral infection present because high BG, iffy eating and possible infection are all risk factors for generation of ketones. As a general, wise safety precaution I'd recommend you start monitoring Casper's urine for ketones. Here are some helpful links:

    Ketones and DKA

    Tips for collecting pee samples

    Any test result higher than 'trace' requires veterinary attention (ketosis and DKA are medical emergencies).

    On the blood glucose (BG) side of things, there's not enough info yet to be able to make any solid comments. Levels do vary depending on which point in the 12-hour dose cycle the reading is taken, and from day to day. 149 at nadir is quite good for a starting point on Vetsulin.

    Please can you confirm that you fed Casper BEFORE giving the dose of Vetsulin.

    The standard routine for each 12-hour cycle is:

    * Withhold food for 2 hours prior to preshot test (needs to be a fasting BG).
    * Take preshot BG reading.
    * Feed substantial meal.
    * Wait 30 minutes (Vetsulin hits hard and fast so digestion needs to be well under way before administration).
    * Assuming BG is high enough (>200 on human meter when starting out and very little data available) and cat is eating enough, administer Vetsulin dose.

    More info:

    FDMB Vetsulin Guide

    Assuming that you did feed Casper before that dose, the rise in BG could be influenced by food (Vetsulin onset is usually between +1 to +1.5 hours after dose admin), and also sometimes the body can react to BG levels that are too low - or safe but unfamiliarly low - by triggering release of extra glucose from the liver (can affect up to 6 12-hour cycles). When you have more data you'll be better able to understand what's happening. We recommend the use of a standard shareable spreadsheet for recording BG results (so that members replying to your posts can help you interpret what's happening). Here's the info you need to get started:

    FDMB spreadsheet instructions

    Understanding the spreadsheet grid

    For the time being, I recommend testing at AM and PM preshot times and, based on the action profile of Vetsulin, you are more likely to catch the nadir BG (lowest point between doses) between +3 and +6 hours after dose administration. Ideally you'd grab the mid-cycle tests both AM and PM each day. Even if you go to bed soon after giving insulin in the evening a test at +2 hours after dose admin often gives you a warning of whether closer monitoring is going to be needed in the coming hours.


    Mogs
    .
     
  5. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Welcome to FDMB!!

    Since I'm assuming the vet's office isn't open, you might check on your bill to see if. you were charged for X-rays. I had the same thought as Nan and Mogs.

    Are you feeding Casper canned or dry Pro Plan? The canned is lower in carbs. The dry, however, is a high carb food and could be contributing to the numbers in the 500s.

    One other thought. Vetsulin is not recommended by the American Animal Hospital Assn. It has a short duration and can cause a hard, fast drop in numbers. The two insulins that are currently recommended are Prozinc and Lantus. It may be worth discussing this with your vet especially if Casper isn't responding.
     
  6. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Thank you so much for your promoted response Pookie! I didn't really expect anyone to read my post today but I am so grateful to have so much useful information.
    I am slowly reading the post and understand things one by one in between of prep the Christmas dinner. Thank you again for the Vetsulin 101.
     
    Critter Mom likes this.
  7. Lisa and Witn (GA)

    Lisa and Witn (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Welcome to FDMB. In addition to the x-rays, your vet should also do blood work. It is possible Casper may have an infection. That will also increase glucose levels.
     
    Teresa & Buddy likes this.
  8. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Hi Nan & Amber,
    Hope you are enjoying your Christmas! Thank you so much for your promoted response.

    Casper doesn't paw at his mouth, he was taking a small amount of dry food (ACANA and Royal Canin) a week after his procedure. Casper had his tooth extraction done on November 6th, 2020. There is no X-ray done before or after the procedure. We went home with Onsior (pain relief), anitibiotic Amoxi w/Clavalanate and Gabapentin (anticonvulsant and Nerve pain medication). But your suspicion maybe just right, I am going to ask the vet for the X-ray when we go back (tomorrow at 9 AM).

    The only change to his life after his teeth pulled out is that we stopped dry food but offer him Fancy Feast Savory Center and Gourmet Natural, all in pate, no chunks.

    The vetsulin, syringe everything we got is brand new. Although I store the vetsulin in the fridge at 7 degrees Celcius (highest setting). AlphaTrack meter and primed per instruction.

    We really think it could be an insufficient vetsulin. I didn't think like that until this morning, since his BG was so high, I gave him his AM shot at 9AM without giving him any food (very risky I know). One hour later, we tested him again, only came down 34 mg/dl. Either way, I understand this will be a roller coaster journey, but I will do whatever I can in my abilities to get him better.

    Thank you again for your kind advice, will post more updates later. Merry Christmas!
     
    Teresa & Buddy likes this.
  9. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Diabetes doesn't take the day off! :D


    Mogs
    .
     
  10. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Hi Critter Mom,

    Thank you for your promoted response! Quite informative. I do have a lot to learn to do this. I didn't discover this forum and all of you wonderful people until later today. I was doing my own recording but updated the FDMB spreadsheet to my signature as I start learning more on this site.

    He did not get any X-ray before or after the extraction. I am learning on the Ketones test and will get the supplies tomorrow when the stores resume normal business hours. I will post more updates after his follow up with the vet tomorrow and start on +3 and +6 monitoring.

    Thank you again for your kind advice, Merry Christmas!
     
  11. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Hi Sienne and Gabby,

    Thank you for your warmly welcome! My 2020 Christmas couldn't be any better than I feel so supportive with so many nice people like you, Pookie, Nan, Mogs, Critter's mom, and Lisa, despite of Casper's condition.

    I am giving Casper ProPlan DM can food, no dry at all. Of course, he is a BIG shrimp lover, we gave him 2 baked shrimp last night. I will talk to the vet tomorrow about Prozinc and Lantus. Obviously, the vetsulin was doing something, then to absolutely nothing.

    He had his blood work done on 12/19/2020, the day before he came home. Because I saw some antibiotics on the bills, I asked vet if Casper has any infection that I should be aware of (as he didn't mention any infection when we were there). He told me Casper was doing well, BG was brought under control. There is no infection, the antibiotics (6 of Unasyn in two nights) is solely for pre-caution purposes. I doubt Casper can develop a serious infection in less than 3 days at home.
     
    Teresa & Buddy likes this.
  12. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Great job getting Casper's spreadsheet going, Yuling! :cat:


    Mogs
    .
     
  13. Aleluia Grugru & Minnie

    Aleluia Grugru & Minnie Well-Known Member

    Joined:
    Dec 21, 2019
    Welcome and I just want to say that Vetsulin, also called caninsulin because it was made for canines not cats who have higher metabolism. It could just be that Vetsulin is not the best insulin for him, but as it’s been said already it takes a while to get your cat regulated. As we like to say here, feline diabetes is a marathon not a sprint. I know you’re getting high numbers now, but Vetsulin is a harsh fast acting insulin and it hits hard and fast. Please do not continue to shoot before giving food. With Vetsulin you need to test and feed at least 30 minutes before shooting so your cat has food onboard.

    happy holidays!!
     
    Teresa & Buddy and Critter Mom like this.
  14. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Hi there, just wanted to give you all a quick update on Casper.
    We went in yesterday at 9 for his follow up check up, asked the vet to do the blood work just in case there was any infection developed within 2-night after he was discharged from the vet. There is no infection, and his kidneys are doing well too. His BG was 509 in the morning, the morning insulin dose was missed yesterday as we were at the vet and I just don't think it makes any sense to poke my poor baby when I know indeed the medicine is no good.
    Unfortunately, the vet doesn't carry Prozinc or Lantus. So, to prove the vet that we were given an defective bottle of insulin at the first place, I purchased another one and we are going to do the curve for 2 days just to make sure the dose is sufficient for Casper.
    BG before this morning shot, it was 611 mg/dl; 2 hours later after morning 1-unit dose, we tested again at 11:00 AM, it comes down at 229 mg/dl.
     
  15. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    That is really interesting! So maybe it was bad insulin after all (pretty rare, but it does happen).

    One caution: the other possibility is that he's dipped down like this before when you haven't caught it, and then spent a couple of days "bouncing" in consistently high numbers afterwards. That's a pretty common reaction in the early days. Right now, that 229 probably looks alarmingly low to his body (it isn't, but if he's been in high numbers for a while, that's what he's used to).

    Time will tell what's really going on here, but in the meantime, it's nice to see him down to yellow numbers at least!

    Vetsulin typically works pretty fast and hard in the first half of the cycle, so after that speedy drop I might test at +3 rather than waiting another two hours to +4. You want to keep him above 100 on an AlphaTrak with Vetsulin, I think (vetsulin users, please correct me on the cutoff), just to keep a safety buffer. The "take action with high carb food" number is 68.
     
    Last edited: Dec 27, 2020
    Critter Mom likes this.
  16. Aleluia Grugru & Minnie

    Aleluia Grugru & Minnie Well-Known Member

    Joined:
    Dec 21, 2019
    Critter Mom likes this.
  17. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Oh my!

    Just peeked at Casper's spreadsheet, and saw that 61 at +4!!!!!

    Please give him a little high-carb snack, and test again soon-- ideally 30mins after that 61, if it's already been longer then please test immediately. That's too low on an Alphatrak, so we want to bring him up asap.
     
    Critter Mom likes this.
  18. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Also dose needs to be reduced to 0.75IU immediately, in line with the FDMB guidelines for this insulin.


    Mogs
    .
     
    Nan & Amber (GA) likes this.
  19. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    Hi , you said your vet doesn't carry prozinc or lantus
    You can buy Lantus from Canada , most of us do
     
  20. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    • when you get a chance ,It would be helpful if you can set up your signature so we don't have to ask you the same questions over again. Members will look at this first .
    • It appears after each post in gray, look at mine,



    • On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
      • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
      • Add any other text, such as
      • Caregiver & kitty's name (optional)
      • DX: Date
      • Name of Insulin
      • Name of your meter
      • Diet: "LC wet" or "dry food" or "combo"
      • Dosing: TR or SLGS or Custom (if applicable)
      • DKA or other recent health issue (if applicable)
      • Acro, IAA, or Cushings (if applicable)
      • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
      • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
    Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.


    tap on your avatar where it says your name ,then hit profile page ,tap on that ,then go up to the very top, upper right hand side and tap on your name ,it will bring down a drop box, tap on signature, the signature will be under settings, tap on the signature then and you can start to add what I posted above, make sure you hit save ,
    Welcome to the best place you could ever be and an awesome group of people
    You can also add where you live in your profile, not your signature
     
  21. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Hi everyone, so sorry I haven't been keeping up with the posts, as a newbie, I have to admit that I am truly overwhelmed with the situation.
    As you might noticed, his BG is all over the place. I only skipped 1-dose on the night of 12/27/2020 as his BG was 126. I also stopped test him so frequently after building his 2-day curve, just wanted to have his paws, ears to have a chance to heal. Unfortunately, I still don't hear anything from his vet yet as he supposed to provide a plan for Casper's treatment. I might just need to walk in tomorrow for a solution.
    Something new happened today: Casper threw up twice, once in the lunch time, once in the night, both happened within 30 mins of feeding- Proplan DM wet for lunch and Tiki Velvet Mousse for dinner.
    We also noticed he barely eat by himself anymore with insulin and he absolutely hates Proplan DM . We usually syringe feed him and leave a small amount of food (1/3 can) in the night, since we have multiple cats, I can't really pinpoint if the food was finished by Casper or not.
    On the positive side, so far, his ketones test came back negative (tested twice) and I will keep monitoring his urine while he battles this disease.
     
  22. Shelley & Jess

    Shelley & Jess Member

    Joined:
    Jan 23, 2020
    Hi Yuling & Casper
    I don't use Vetsulin but this post will bump you back to the top.

    @Critter Mom
    @Nan & Amber (GA)
    @JanetNJ

    We've got another recent lime green - 42 on an Alphatrak along with vomiting and not eating.
     
    Nan & Amber (GA) and Critter Mom like this.
  23. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Hi---

    Yuling, you must reduce the dose-- that 42 is Casper telling you that 1U is much too high.

    OK, the Proplan DM is off the menu! For now, just find something he wants to eat-- even if it is high carb, that is much better than not eating. Let's get him through this rough patch.

    Has he ever been tested for pancreatitis?
     
    Critter Mom and Shelley & Jess like this.
  24. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I agree 100% with Nan. The 1IU dose is too high and needs to be reduced immediately by 0.25IU, according to the FDMB Vetsulin guide (see below for link). See also the important note about BG testing below.

    The reason you've been seeing blacks in the spreadsheet is because the 1IU dose has been taking Casper too low and the body is trying to fight the too-high dose by releasing extra glucose into the bloodstream. For example, the black readings you saw on the AM cycle of 28 December were triggered by the 61 on the AM cycle of 27 December. (Note: The 61 Alphatrak reading was also too low, and that's when the data first told you the 1IU dose was too high.)

    Please can you read the FDMB guide to using Vetsulin/Caninsulin. It will help you to better understand how your insulin works, plus how and when the dose needs adjustment. Note that the BG ranges in the Vetsulin guide are for human meters. You will need to work with ranges/thresholds appropriate to the Alphatrak.

    Normal Feline BG Range as measured on Alphatrak:

    68-150mg/dL.

    If BG drops below 68 you need to feed your cat, maybe even give syrup/honey to get numbers back up into a safe range and keep them there. (Please read and print out the Hypo Guide, if you haven't already done so).

    Guidance for Reducing Dose:

    The FDMB guide recommends reducing the dose by 0.25IU any time the BG drops below 90 on a human meter. You might want to consider reducing when BG drops below 100 on the Alphatrak. (NB: This is just a rough guide because, while Alphatrak meters read higher than human ones, there's no fixed mathematical formula for converting readings from one meter type to the other).

    'No shoot' limit:


    200 on a human meter. You might want to consider setting this a little higher, e.g. at 220, if you would feel more comfortable. (Again this is a rough guide.)

    Ketones:

    Well done for getting the ketone testing down. Especially while Casper is running in such high numbers - and also because he's been vomiting - as a general safety precaution I'd strongly recommend testing for ketones every day. (If a cat starts generating ketones they can build to dangerous levels within hours.)

    BG Testing:

    For safety, and also to better determine how Casper is responding to his insulin, it would help you both if you could get a test in somewhere between +3 and +6 on both the AM and PM cycles. (Many cats run lower on one cycle than the other, usually the PM one. One cycle may have a nadir that's safe but the other one might be too low. You can only tell by testing.)


    Mogs
    .
     
    Last edited: Jan 2, 2021
    Reason for edit: Punctuation.
  25. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Hi Nan,

    No, he hasn't been tested for pancreatitis. Unfortunately, my vet office is open for tech issues only, two major animal ERs in the area are full of capacity. I wouldn't be able to get him back into the vet until Monday.
    I just got the records of his previous blood work, will get the data organized and posted to the SS.
     
    Shelley & Jess and Critter Mom like this.
  26. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Hi Mogs,
    Thanks for the advice! We just gave him the AM shot at 0.75U and I will test him at +3 and +6.
     
    Critter Mom and Shelley & Jess like this.
  27. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Hi all, a quick update on Casper. He hasn't vomit today but definitely looks extremely weak, worse condition than we took him in 10 days ago when we found out he has diabetes. But he got up few times and drank water by himself (not much). And he peed outside of the box. He has been hiding all day and resting.
    I tested him at +3 and +6 as suggested after 0.75U dose. Still, we needed to syringe feed him wetfood. He is not responding to his favorite Fancy Feast chicken fillet treat or anything at all. I just pray he could make it till Monday when the vet is back in the office.
    For whatever the reason, I think Vetsulin is make him worse, his condition hasn't been improved one bit, it's getting worse. I wonder how can I get the Lantus without prescription and how much I should give him.
    Pls let me know if there is anything I can do to make my baby feel better. Thanks!
     
    Nan & Amber (GA) likes this.
  28. SashaV

    SashaV Well-Known Member

    Joined:
    Apr 25, 2020
    Are you feeding and testing 30 minutes before giving insulin?
     
  29. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Check for ketones.


    Mogs
    .
     
  30. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Yes,
    Yes, always.
     
  31. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Tested this morning again, negative.
     
  32. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Good evening all,
    So we finally managed to get Casper into one of the ER here in the late morning. Waited for 5 hours, had the vet office to run all the necessary tests and X-ray, turned out it's not just the diabetes we are dealing with, but also the complications of partial kidney failure, liver damage, urinary infection and possibly of pancreatitis.
    We were then offered two options: put him down or being referred to an LA specialty ER for more intense treatments.
    It took us less than 2 secs to decide not to give up on him. We just checked him in to the LA ER and I am praying my baby will work with the treatments and fight this for himself, he is a tough kitty.

    Casper's mom
     
  33. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Oh wow :( :( :(.

    I hope that the specialty clinic can help. That's quite a list, but I think there is hope. UTIs are treatable, and kidney disease (depending on stage) and pancreatitis can definitely be managed. The liver damage is more uncertain (depends on how much, and why), but he's in the right place to figure everything out. You should know more soon.

    Fingers and paws crossed for Casper to show them just how tough he is!
     
    Yuling & Casper likes this.
  34. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Hi everyone, it's been 3 nights since Casper admitted to the ER. I just got a call from the doctor in the middle of the night that he needs blood transfusion. He is claimed stable right now and they managed to get his blood sugar and sodium level under control.
    They put a tube in on Monday to help him with food and water intake along with the IVs and other medical treatments. I have no idea how is this diabetes could end up taking his life so dramatically in such a short time, we did everything per his vet instructions. I am extremely frustrated but keep praying for my poor baby.
     
  35. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Prayers being sent for Casper.

    (((Yuling and Casper)))


    Mogs
    .
     
  36. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
  37. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    Sending prayers for your precious Casper.:bighug::bighug:
     
  38. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Thank you Mogs! Thank you Nan & Amber! Thank you Tyler's mom!
    We just got more updates from the ER, they wanted to do a feeding tube to send him home tomorrow as Casper is not eating on his own. Currently, they are treating his kidney failure with fluid and other medicines. So far his blood transfusion works as it should, RBC comes up to 28. We are getting him one more night there and see where he is at tomorrow. We know Casper will definitely not eat on his own whenever there are unfamiliar people around. He even stops eating or drinking when my 6-year-old gets closer.
    I really don't want to do the feeding tube to him, we managed to feed him with a syringe and it had been working quite well. I am not lazy to take care of baby, but the vet there made it sound it's a mandatory solution for him to even be able to come home. I truly don't think with what he just went through, he could take another procedure like that. Any thoughts?
     
    Critter Mom likes this.
  39. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Your boy is a fighter!

    Feeding tubes sound scary, but those who have experience with them say they are literal lifesavers. Even if syringe-feeding is working for you, it's just one less thing to have to worry about being able to do, and it works for a lot of meds as well as foods. The only thing I'd worry about is, as you say, whether he's strong enough for the procedure, especially if it involves sedation. But if the vets think he is, and think he is strong enough to come home afterward, that's a good sign.

    Do you know what kind of tube they are doing, e-tube or a different type? I'm not actually the best person to be talking about this stuff, as I don't have personal experience. Going to tag @Aleluia Grugru & Minnie, in case she's around she may be able to share some tips and thoughts about this.

    I hope he keeps improving, poor little guy really has been through a lot...

    :bighug: :bighug: :bighug: :bighug:
     
    Diane Tyler's Mom likes this.
  40. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    I was also going to tag @Aleluia Grugru & Minnie , her kitty had a feeding tube.
    I'm glad the blood transfusion helped, continued prayers for your boy ♥:bighug:
     
    Critter Mom and Nan & Amber (GA) like this.
  41. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Yuling,

    I'm glad to read that Casper's transfusion went well.

    As the others above have said, feeding tubes can literallly be life savers, and the thought of them can be much more intimidating than the reality. In addition to helping Casper to get his food, the tube will also help you to reliably administer any medications he may need. Here's a helpful link for you:

    Feeding tubes for cats

    (((Casper)))


    Mogs
    .
     
  42. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Good evening/morning,

    Just wanted to do a quick update on Casper. We finally got him home last night after the ER treatments for a week and a half. He is getting better every day but his BG is still not as regulated as we wished for. The doctor believes he is stable to come home and all we needed to do is to let him have some good rest, allow his little body to recover, keep 1 unit a day on Lantus insulin. Thanks to everyone for all your support, kind words and prayers had kept our furry baby safe on his way to a healthy recovery.

    Casper's Mom
     
  43. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    So glad to hear he is home at long last!
     
  44. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Thanks Nan & Amber! We were so happy last night, the tires were in smoke when we went to pick him up. :joyful:
    On one side we are thrilled to get him back, on the other side we are still struggling on his BG, even now he is on Lantus. The vet from the ER wanted him to come home and at least give him a chance to recover from all the treatments in the past 10 days. The doses were started at 1unit/dose, AM & PM, reduced to 0.5 unit/dose, AM & PM, adjusted to now 1unit/dose, AM only.
    His AMPS number was in the high 400s, while +7 at 57. *Sigh
     
    Nan & Amber (GA) likes this.
  45. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    So glad to hear your baby's home, Yuling! :cat:

    (((Casper)))


    Mogs
    .
     
  46. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    @Yuling & Casper
    Hi I see Casper is on lantus, can you please note that on your spreadsheet and when you switched to Lantus
    I don't see on your SS where you said #44 reduced to 0.5 units AM and PM.
    So right now you are only giving 1 unit at AM only?
     
    Last edited: Jan 14, 2021
  47. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    I bet!!!!

    Well, regardless of how he got here, that 57 means it's time for a reduction already! Next dose, and going forward, shoot no more than 0.75U. And any time he goes that low, he gets some high carb yummy food to bring him back up.

    I think you'll like the Lantus much better than Caninsulin, once you find the proper dose for your little guy. Fingers crossed that he does well on the lower dose.

    It's possible that one reason he went low today is that his numbers have been artificially high due to stress at the vet, and he's just happy to be home now :cat: and needs less insulin than they thought :).
     
    Diane Tyler's Mom likes this.
  48. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I just had a look at Casper's spreadsheet.

    Has he eaten since the 57 reading?

    * * * Please can you test him again immediately because 57 is TOO LOW on an Alphatrak. * * *

    If the reading is under 68 please give Casper a couple of teaspoons of high carb food and then post the test result here as soon as you've done that so that we can help you further.


    With 57 on an Alphatrak, the 1IU dose is too high. The lower bound of the normal reference range is 68, so please go back to the vets first thing about the dose, and please don't give another 1IU dose. It needs to be reduced.


    Mogs
    .
     
  49. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    @Nan & Amber (GA) - Could you keep an eye out for Yuling and Casper for a while, Nan? (It's just before 2am here and I won't be able to stay the course. I'm knackered.)


    Mogs
    .
     
  50. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    On an AT2, the take action number is 68.
    That 57 is too low on the alpha trak meter please feed him a couple teaspoons of high carb food and test again
     
    Last edited: Jan 14, 2021
  51. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Will do, Mogs.

    @Yuling & Casper , can you let us know where you are in the cycle right now, and how long ago that 57 was? Mogs is correct, whenever you get that kind of number you need to bring it back up with high-carb food. If you did that already, please re-test 30mins or so after the food to make sure it worked.
     
  52. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    @Nan & Amber (GA)
    Hi Nan did you happen to notice #44 she said

    adjusted to now 1unit/dose, AM only. I assume she's only giving one dose a day by what she said #44
     
    Nan & Amber (GA) likes this.
  53. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Good point, we'll have to talk about that too after we make sure that the 57 is taken care of... Yuling, just so you know, Lantus in particular works much better with twice-a-day dosing. It may be that what Casper needs is an even lower dose (maybe 0.5U), but twice a day.

    But let's make sure he's safely up, first!
     
    Diane Tyler's Mom likes this.
  54. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    @Nan & Amber (GA) - Thank you, Nan. :) :bighug:

    I hope Yuling checks the thread soon.


    Mogs
    .
     
  55. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    I agree safety first , I hope she comes s back on
     
  56. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    Me too Mogs
     
    Critter Mom likes this.
  57. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Hmmm, it's now two hours since the post mentioning the 57, so I'd guess we're well beyond it now.

    Please check in with an update when you are back on, Yuling!
     
    Diane Tyler's Mom likes this.
  58. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Good afternoon all from CA! So sorry to get back to you late, I just got a chance to read all the replies.

    Yes, I gave him 1 unit every single morning since he's home on the 13th night. So, 1 unit yesterday morning at 9 AM and 1 unit this morning at 9 AM. I even called the vet this morning about his dose, I was told to give 1. Got me wonder how much these vets really know about insulin and FD.
    When I got his number at 57 yesterday afternoon at +7, I gave him 2 drops of honey, 2 tbsp of cat milk, followed by 30ML Forza10 Actiwet food. Tested him again at +9, his number went up to 161 mg/dl. The PM dose is skipped.
    The AMPS today is 684, he had 40 ML ProPlan DM can food; 30 mins later at 9 AM, he received his 1 unit dose. 2 hours later, retested, BG reads at 684 still; feed him more DM, now he is resting. I would need to test him again at +6, as I read the Lantus works at its peak at +6.
    Other than the diabetic food, he is eating and drinking well; tested keystone last night, negative.
     
  59. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Hi Mogs, so sorry not be able to get back to you ladies yesterday. I feel terrible now as I really can sense how much you care about Casper.
    I had been having full-day meetings, followed by team activities from 6 AM to 9 PM, Monday to today. Just glad it's finally done and I could devote my full attention to Casper now. I also have home instruction for other family members on how to care for Casper when I am out, but I haven't been stepped out of home for more than 2 hours recently, as soon as I found an issue, I can act immediately based on the knowledge you all have given me.
    As I mentioned in the previous reply, I plan to test him again at +6, record it and test him again around 8 PM right before his PM dose (although the stupid vet told me not to worry about it)...Gosh! I am so pissed off right now. We paid them $13k to figure out the right treatment for him and I ended up received more professional advice and knowledge here. Thank you all!!!!!!!!!!!!
     
    Nan & Amber (GA) and Critter Mom like this.
  60. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Good to hear from you and Casper!

    Yikes! But, it's important to keep in mind, we're really just focused on feline diabetes here, while your vet is treating the whole cat. Ideally, the two approaches complement each other.

    Looks like he's in a serious bounce from that 57! You're still planning on reducing the dose, right?
     
    Critter Mom likes this.
  61. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Absolutely! I am not sure why the morning dose did nothing to him today, the last time I checked was 694 at +6. Other than that, he is drinking, eating just fine. Plan to test him at 8 PM which would be +11, then make a decision whether or not to give him 0.75U this evening.
     
    Nan & Amber (GA) likes this.
  62. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Like this! :cat:

    (((Casper)))


    Mogs
    .
     
  63. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Looks like the insulin takes it's time to do the work today. At 8 PM, +11, BG reads at 383 mg/dl. Guess I will give him the PM dose at 0.75 unit and get up at 3 AM to check his BG again.
    Afraid his BG dropped way low with two doses during sleep and this is the issue the vets are having: 2 doses, BG dropped way low (lowest at 26 mg/dl).
     
  64. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Shall I go 0.25 or 0.5 unit for him tonight? Also, should I check his number at +2, +4, +6, +8 just in case?
     
  65. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    @Bron and Sheba (GA) - Would you be able to help Yuling with Casper's Lantus dose? (I'm about to pass out from sleep meds.)


    Mogs
    .
     
  66. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Sweet dreams, Mogs!
    I just did 0.5 unit to be on the safe side after test him again at PMPS: BG reads at 552 mg/dl. I will test him at +2 again. Feel so bad for him, his ears are all bruised up and paws are poked so many times.
     
    Critter Mom likes this.
  67. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Yuking,
    Have you been giving Casper insulin twice a day every day?....just asking because there are blank spots in both the am and pm spots.
    Casper is bouncing at the moment from that 57 yesterday. He could bounce for up to 6 cycles.
    You need to stick to the one dose and also take a reduction from the 57 yesterday.
    I’ve just looked at your thread on the Lantus forum and see you were advised to shoot 0.5 units tonight.

    Haveyou looked at the two dosing methods. Have a look at them as it will be much easier for you and easier fro us to advise you if we know which method you are following ,
    https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

    Are you able to get any tests in during the PM cycle?
     
    Critter Mom likes this.
  68. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Hi Bron and Sheba,
    After he came home on the 13th, we followed the vet's instruction: 1-unit/day ONLY, morning dose until tonight.

    Before he was rushed into the ER on the 3rd, we always did his Vetsulin shots at 1U/dose, 2 doses/day, 12-hours in between.

    He started with Lantus on 01/08/2021, the initial instruction was: 1 unit/dose, 2 doses/day. However, the vets experienced high (so high and extremely low numbers (32, 47 etc.). On 01/20, the vet changed to 0.5 unit/dose, 2- doses/day; the following day, we were told that 2 doses are too much for him, then changed to 1 unit/dose, 1 dose a day in the morning only. They kept him at the ER for another 24-hour, discharged him on the 13th evening after one- more round of testing.
    We were told to follow up in 4 weeks, no meds were given, told not to worry about his HCT. Keep an eye on the low BG. That's bit.
     
  69. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    You must be feeling very frustrated. I don’t get their reasoning when they say that 0.5 unit twice a day is too much so give 1 unit (double the dose in one hit) once a day!:eek: I don’t think they must realise that Lantus only lasts around 12 hours in a cat.
    And then just follow up in a month! And don’t worry about the HCT!
     
    Last edited: Jan 16, 2021
    Critter Mom likes this.
  70. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Good evening all,

    Just wanted to give you an update on Casper:

    The ladies in Lantus section have been helping us fine tuning in his dose. We just did 2 cycles on 0.5U/dose, 2 times a day. So far so good, the numbers look quite promising.
    Other than he's still stubborn and picky on food, we do see a tremendous improvement in his status. Just wanted to thank you all for the support and advise when I was lost.
    Love from Casper and my family!!!:bighug:
     
  71. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Yuling,

    What an encouraging update about Casper! :cat: It's good to hear how he's getting on.

    I'm glad to see that his BG levels are improving too after his roller coaster ride a few days ago. :nailbiting:

    Now, Casper, pay attention: you need to eat your fudz for your mama!!! ;)

    (((Casper and family)))

    :bighug:


    Mogs
    .
     
  72. Yuling & Casper

    Yuling & Casper Member

    Joined:
    Dec 25, 2020
    Good evening everyone,

    Just wanted to seek for some guidance here, Casper has been having HI readings for 2 nights. He doesn't eat himself anymore and he barely drinks any water, we are syringe feeding him all these time.

    I am in the process of TR, but are these type of HI readings normal? Casper has been on antibiotics for 4 days now.
     

Share This Page