New Member: 1/13 McKinley Need Care/Dosage advice?

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BScott

Member Since 2024
Hello. First time posting.

Long story short: McKinley (about 13-1/2 yrs young) was diagnosed on 11/9/23 along with bad kidneys. Our vet told us to give 2 units of insulin (Lantus) twice a day and that was it. We have been doing just that up until yesterday night (1/12/24). Little bit of a back story first, It "seems" like he temporarily lost his eye sight on 11/25/23. I say "seem" because he constantly was sniffing around and staying near walls or sometimes walked in circles, but at the same time he went down stairs and maneuvered other obstacles with no problem during this time. It almost seemed like he was in a trance. I didn't know what to do. Called the Vet. Vet checked BG, it was at 144 (taken around 4pm, he had insulin at 830am and he started this episode around 3pm). The vet said this episode was most likely caused by high blood pressure from stress because of him having bad kidneys. He has never done this before. Same thing happened 12/16/23, 12/21/23, and lastly 01/12/24. Each time, the loss of eyesight only lasted from a period of 2-4 hours. We always thought it was derived from high blood pressure until the last episode that happened yesterday. I saw McKinley lying under the table with his mouth slightly cracked opened (he was breathing normally), periodically he had an ever so slighlty twitch of his ear and sometimes head (not normal), he walked across the room to go lay down in another spot and was lightly stumbling on his way. His eyes were not dilated (previous times they were), but he seemed like he was in a trance. I started to suspect he might be having a hypo-event. At this time I got some wet food and he ate it. He was still showing the symptoms. 30-min later gave him another spoonful of wet food and he ate it. At this time, I went to the store to get a BG meter and the rest of the items to take his measurements (as it seems, I should have had this long time ago). In the meantime while I was at the store, my wife gave him another spoonful of wet food and he ate it. At some point shortly after eating, his eyes got dilated and he seemed to lose vision once again (all prior symptoms were continuing as well). I got home and it had seemed he immediately snapped out of vision loss but still wad showing the initial symptoms. My wife and I tried, but failed getting blood from his ear at that time. He got back to his old self shorty after that time. We tried to get blood again later that night before his feeding, but again failed. We decided not to give him any insulin fearing Low BG. This AM (01/13/24) we didn't give him any insulin because we usually have a little bit of dry food down during the day and night because of his grazing habits. He has always (been a grazer) ate small amounts of food since he was a kitten. This PM, we were successful at getting blood before his dinner meal (we put the dry food dish away over 2-hours prior). His BG was at 78. Again, we decided not to give him any insulin. This is now the third consecutive cycle he hasn't been given insulin, fearing another episode of sorts. I really don't know where to go from here except knowing that more BG testing will be required. He has been acting normal ever since the end of his episode from yesterday. I have been reading, reading, reading, and reading information about this illness and had no idea how complicated it is. I am very surprised our Vet didn't give us any additional information on any steps on what to do. I know there are plenty of holes that need to be filled with my story, but figured I needed to start somewhere. Any help is much appreciated. Thanks for reading the novel.
 
Don't be surprised that the vet didn't give additional information. That's not uncommon. I got all sort of bad suggestions from the locum vet who first showed us how to shoot. And with an insulin not great for cats too. Unlike for you, as Lantus is a good insulin for cats. It took me over 2 months to get switch to Lantus. Fast forward, I landed here and folks here got us sorted out. In fact, a different locum vet who got me started on Lantus pointed me here - but I was already lurking.

It is possible your kitty has been having hypo episodes when he's lost his vision. 2 units is a higher dose than we'd start a cat on here. A couple posts you might want to review and keep around - you will note vision issues is listed:
Cats who have overdosed can be more sensitive to insulin after they hypo. It's also possible that the Lantus depot is helping to keep his numbers lower. I would keep withholding insulin unless his numbers start creeping up.

I'm glad to see that you have been home testing. A tool that can really help us help you and McKinley is a spreadsheet showing his blood sugar values. You will see most of us have one linked in our signature. More details here:
New? How You Can Help Us Help You!
 
In addition to all of the information Wendy provided, I'm linking a post on home testing. It takes a bit to get used to the process and at the outset, it's more difficult to get blood. It can take a few weeks for the capillary bed along the edge of the ear to build up. Once it does, it's easier to draw blood. It will also be easier in the beginning if you're using a wider gauge lancet -- roughly a 28 gauge (the lower the number the wider the poke). Once McKinleys ears are bleeding more easily, you can switch to a thinner lancet (e.g., 30 or 31 gauge).

And finally, please give McKinley low carb treats. The best way to get him used to the process is by rewarding him regardless of whether the poke is successful or not. Many people here use a freeze dried protein, such as chicken, as a treat. If your cat likes cooked chicken, that's fine. As long as the treat is low in carbohydrates, you're good.
 
Thank you for your replies, tips, and recommendations. We tried again this morning four times to get blood with no luck. I did go out to get 25Ga lancets and will try again this evening. I will try to get a spreadsheet going as soon as I am able to.
 
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We were able to get a BG reading tonight before his meal and it was 90. I did take away the dry food two hours prior to the testing. We did not give insulin this AM and will do the same this PM. We will try to get more tests tomorrow through out the day.

My question is, he has always been a small eater. I give him about 2oz of wet food in the morning, noon, and for dinner. He grazes/nibbles on dry food between meals. Should I keep the dry food down while taking the tests? Or should I put up the dry food and I give him his AM meal, testing around 2 hrs after, give him his lunch, test a 2-3 hours later, same with dinner? Also trying to get shots before each wet food feeding? Thank you.
 
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