Newly diagnosed, Ellie

Discussion in 'Caninsulin / Vetsulin and N / NPH' started by KatieKat3838, May 18, 2019.

  1. KatieKat3838

    KatieKat3838 New Member

    Joined:
    May 17, 2019
    Any thoughts on this cat? Wondering why her numbers are so high once she got started on Vetsulin? She is also feeling bad, laying around, not eating/drinking or using box very much. She was acting better pre-insulin, but huge urinations, excessive drinking, weight loss, hair loss, flaky skin which I why I got her to the vet.

    This is a rescue cat, 11 years old. Has been fostered here 3 years. Doesn't have the personality for adoption.

    I care for 15+ animals, most special needs. I need to work Ellie's shots into a 10 o'clock -12 o'clock window.

    The options the rescue gave me, do nothing or put her down. I've chosen to try to help Ellie with insulin through my personal vet. I can't be perfect and I will have limited support from the rescue.

    Money is an issue.

    For now I can't use the spreadsheet (limited ability and time on my part and my vet prefers a log), though I know it would be the best source of info for getting help on this board, so I'll try to work at it.

    I'm wondering if the syringe feeding is throwing off the numbers, but at this point she will not eat on her own either, so I'm concerned about that too. I make cat "pudding" with a NutriBullet and canned food. I'm no fan of jarred baby food, but use it if they need something extremely mild, especially with vomiting.

    Here's the info:
    May 9, 2019 Ellie dxed diabetic through blood work labs. BG 489.
    All other labs good, including thyroid and kidney function.
    May 15 Sent out UA. Came back with +3 glucose. Got Vetsulin. (my insulin of choice is Lantus, but that story is another post)

    Before insulin, after dx
    5/12 7am 333
    5/14 6:45am 332
    5/15 4am 296
    5/15 1pm 522
    ------------------------------------------------------
    5/16
    1am 286 (fed FreshPet with syringe)
    2am 1u FIRST INSULIN SHOT
    3:30am (+1.5 hr) 311
    11am (+ 9hr) 270 (syringe fed small amount)
    11:45am (+ 9.75 hr) 252 1u
    3:45pm (+ 4 hr) 260
    11pm (+11.75 hr) 322 (syringe fed Pro Plan chicken and rice)

    5/17
    12 am (+12.25 hr) 398 (syringe fed Pro Plan chicken and rice) + 1u
    5/17 3am (+3 hr) 378
    5/17 9am (+ 9hr) 474
    5/17 10am (+10 hr) 512 (fed Pro Plan Salmon, syringe and ate small amount on her own) +1u
    5/17 11:30am (+ 1.5 hr) 459
    -----(New meter Relion Premier)------ ( Walmart out of Relion Prime strips)
    5/17 1:30pm (+3.5 hr) 427
    5/17 7:30pm (+9.5 hr) 500
    5/17 8:30pm (+10.5) HI reading (indicates over 600), error, error, 539
    9:30 pm talked to vet, yes, feed and shoot, takes time for the body to adjust to the insulin
    10pm fed Instinct tuna pudding, threw up about 20 minutes later
    11pm (+11) HI reading (over 600) 1 u

    5/18
    3am (+ 4 hr) 562 , extremely dehydrated, called vet, said 50 ml sub q would be OK, did that, almost immediate absorption, no bump, she said wait a few hours, check, could give 50 more
    4am .5cc Science Diet chicken canned with water, threw up almost immediately,
    waited 20 minutes, .25 watered down chicken baby food, she just looks and acts like she feels bad
    5am (+6) HI reading. still doing .25cc baby food every 20 minutes, holding it down, acts a bit more alert 5:15am super slow drip about 25 ml sub q, few more .25cc's baby food. Ellie resting comfortably on desk
    9:30am (+10.5) 594 seems to be more alert, 1 cc baby food syringe, not interested in eating on her own, hydration is improved, more baby food small amounts,
    10am 50 ml sub q
    1 hr trip to get reg. strips so I can see if there is a problem with the new meter. Ellie had thrown up the small amount of food I gave her.
    11:30am (+12.5) Relion Prime HI, Premier 3 errors, then 598 so looks like readings are accurate (poor Ellie, so many sticks) 1u
    12:45 got off desk, went to water bowl, but did not drink, laying on floor.
    1:30pm (+ 2) 579
     
  2. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    Welcome. I'm finding it hard to follow when you gave insulin. I'm not familiar with Vetsulin so can't comment on dose.

    You are giving insulin every 12 hrs correct? The dose?

    I saw you are limited to doing a spreadsheet, however if you did the one here you can print out the page for the vet. It's still a log , our just goes across the page where vets usually go down the page. Once you explain it, they pick it up quickly.

    try sprinkling parmesan cheese on the food. Fancy Feast pate food is what most people use here as it's low carb but you need to get kitty to eat first and foremost. And get enough insulin in.

    Subq fluids will help.

    Also check for ketones. You can get strips at any pharmacy, usually need to ask at counter for them. You just dip under kitty If they let you when they go, some people catch the urine in a ladle, or just an empty clean box. If you get a reading over trace you will need to see a vet right away. Diabetic Ketone Acidosis (dka) is a critical condition and happen extremely quick.
     
  3. KatieKat3838

    KatieKat3838 New Member

    Joined:
    May 17, 2019
    Thank you for taking the time to reply.
    Yes, trying to do 1u at 12 hours, but that isn't always going to be possible. All lines in bold are when I gave insulin.
    Checking for ketones is unfortunately not going to be possible at this stage. I am taking care of way too many animals to try to catch one cat in the litter box. I do hope to get an isolation cage set up for her and I've read you can put crinkled plastic wrap in one end of a pee pad lined litter box to try to catch a sample. I can try various things as I go forward, but I know right from the start, I can't come close to any perfect protocols.
    Time permitting, I'm hoping to eventually transfer my log to a spreadsheet for the folks here. I know for a fact my vet won't even try to interpret it, but it is invaluable information.
     
  4. KatieKat3838

    KatieKat3838 New Member

    Joined:
    May 17, 2019
    Ellie update:
    Numbers still in HI all day. Vet thinks I should up to 2 u. I'm worried about this being too much insulin vs not enough. Vet didn't really have time to talk. So getting ready for 11pm shot and still can't get her to eat except by syringe. Dehydrated again. Call 24 hour vet and talk to a vet who seems to know his stuff. Asks me to bring her in to do a blood ketone check. NO ketones, which is good, but he too gets a HI. He gives .5 Humulin plus Cerenia injection and says for me to go up to 2u when I get home, after I feed her some more. She has no interest in food, so syringe feed her the kitty pudding. Give her shot at 2am. Way past due. He says check her in 4-6 hours, but being the crazy pet parent, I check now. Still HI.
    Ellie is laying on the floor next to the water bowl and full plate of canned foods. I need to get to bed!
    I feel so frustrated that I don't seem to be helping her, but everyone keeps saying be patient that for some cats finding the correct dose can be quite a journey.
    And, HUGE blessing, overnight vet did not charge me anything!
     
  5. KatieKat3838

    KatieKat3838 New Member

    Joined:
    May 17, 2019
    Phew! + 4 after upped dose of 2 units and finally a "decent" number: 341. I'll take it. Kissed all over Ellie and told her how proud I was of her. There was a large urine pool by the front door, thinking it may be hers. If so, goes to show how crummy she is feeling as I've never known her to go outside the box. She was severely dehydrated. Sticky all over body so gave 50 ml sub q as the vet instructed. Grateful that I have the supplies on hand. Will keep an eye on that. She's sleeping in the big cat bed on my desk and I realized that is a great place to put a large cage so I can better monitor her and also not have to find her and get her out from her hidey holes when it is time to check BG or give her her shot. First time I feel hopeful.
     
  6. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    Glad she finally came down some. They really feel crappy when glucose is high. Glad you can do fluids.

    Can you add to your signature the type of insulin, meter you are using? Also the food you give her?

    We are all about data and history here. If you could create your spreadsheet and full in the data you have anyone will have her background and can offer advice and tips.

    Yes it does take time to help Ellie. It doesn't happen overnight or even in one week. For now being new logging in daily for advice and ask questions is you best path.
     
    KatieKat3838 and CandyH & Catcat like this.
  7. KatieKat3838

    KatieKat3838 New Member

    Joined:
    May 17, 2019
    Paula, I did a sig, did a bit on the profile. At 5.5+ today she had a 256. Best number yet for her, but still won't eat and still dehydrated. gave 50ml sq and Cerenia and mirtazapine. She got zonked out with the Mirtazapine and has not eaten on her own that I know of. Had to go do a cat obligation today so not able to monitor and assist her most of day. Mad at myself for not syringe feeding when I got home. Talked to ER vet tonight and she wants me to continue sub q, but says Ellie needs to get in for IV fluids to get a good solid hydration now that we have a working insulin amount. Rescue called me at 3am and will try to get a place for me to take her in the am so she can have at least a day of IV.
     
  8. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    Is the IAMs dry food? Can they test for pancreatitis?
     
  9. KatieKat3838

    KatieKat3838 New Member

    Joined:
    May 17, 2019
    Not IAMS dry. I too am worried about pancreatitis. Ellie was flat out at about 7:30 this morning. We're at the emergency vet waiting to see a specialist now.
    Even with Sub-Q fluids, I can't maintain her hydration and she will not eat. Bad diarrhea this morning.
    Neither me or the rescue can afford hospitalization. So I may be looking at EU.
     
  10. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
  11. KatieKat3838

    KatieKat3838 New Member

    Joined:
    May 17, 2019
    After the consult with the specialist, I decided to let Ellie go.
    Fly free sweetie.
     
  12. CandyH & Catcat

    CandyH & Catcat Well-Known Member

    Joined:
    Apr 23, 2019
    :bighug::bighug::bighug: -- I sent a message to Krispy (GA) to meet her the other side of the rainbow bridge -- am sure there will be a clowder there too
     
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  13. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    So sorry. :bighug::bighug::bighug:
     
    KatieKat3838 likes this.

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