Too much insulin

Jade & George

Jade & George

Member
I messed up. I just gave her 1.5 units of insulin after testing at 179. ****. I guess I’m not sleeping tonight. She doesn’t tolerate any food besides Koha LID Rabbit. I can give her a little Tiki Dark Rabbit w Chicken liver but I’m thinking I should reserve that for her nadir. I can’t believe I screwed up. My mom had just called crying so I was not focused. I’m so mad at myself.
 
I’m so sorry this happened. I checked your spreadsheet. What tests did you get after the +1. This is all I can see. I am on Eastern time and I assume you are on Pacific time? This message came in at just after midnight my time. Have you handled low numbers before? Since she can only eat the one food, you will need to use Karo Syrup (which is corn syrup, or honey or pure maple syrup to manage low numbers.). The main thing is that we don’t want her to drop below 50. Other green numbers above 50 may seem scary at first if you are not used to them, but she will not be in danger.
 
Is your mom in the hospital? I know she had the hip surgery in January (17th?). You have been going through a lot of very stressful things recently. Just always be sure to slow down and breathe for a moment and focus before you shoot the insulin. Never be in a hurry when you’re giving the dose. Just take a moment to look at the syringe one more time to make sure you drew the correct amount before you shoot. I hope Georgia is okay this morning.
 
Okay. We need to get you up to speed on how to handle low numbers. Most can be managed at home. Did the ER vet say that they measured her BG while she was there? I do not think that the 1.5 units was going to be catastrophic with that higher yellow preshot, but I would have liked to have lots of tests to see how it went. I honestly think .5 would not have been enough insulin, but it also would have been a good opportunity to get tests with the .5 dose and see because we don’t have enough spreadsheet data yet. Is she at home with you now?

What is your shot time then… since you are also on Eastern time.
 
Yes. They had to sedate her bc she’s turns feral at the vet. They gave her an iv and by then it was 100. It had gone from 179 to 70something down to 58 so quickly, and she was still two hours from nadir.

I check her bg and give her insulin when I first get up. Usually that’s 9/10am but recently it’s been hard to get out of bed so it’s been 12/1pm. I go back to work (remotely) on Tuesday so I’ll have to get with the program.
 
It’s the worst when they won’t eat. Did you get her to eat at all last night? Do you know why she’s not eating? Does she have any other conditions besides the diabetes? Pancreatitis? IBD? Anything? Do you have any anti-nausea medication on hand? Appetite stimulants like Mirataz? Is she vomiting? Do you test for Ketones?
 
She ate about a tablespoon of food during the day on Tuesday. Tuesday night a friend came over and we were able to look in her mouth and the tooth is more swollen. So I called the vet this am and they put me on the calendar for the first avbl appt on Tuesday of next week and prescribed Mirataz which I gave her just now for the first time. She’s been eating a very small amount of food only off my finger but otherwise is acting normally. The parallels to the end of my dad’s life is weighing very heavily on me. Last night she seemed a little lethargic but at 3am she woke me up to snuggle and even licked her food once or twice on her own. My local vet said if the appetite stimulant doesn’t work or if she gets worse I should take her to the emergency vet but I’m having a hard time knowing when and how to make that decision. I will update her spreadsheet as soon as I can. ❤️
 
I’m concerned that Tuesday is a very long time from now. If she’s only eating a teaspoon or even a tablespoon of food per day then she’s in danger of Hepatic Lipidosis, which would further endanger her.
 
I sent that message before I was finished. Sorry. I think you should get some Hill’s A/D critical care (which is very high calorie) from your vet — a few cans — and some feeding syringes and”assist feed” her to make sure she’s taking in some more calories.
 
I could take her to the emergency vet but I’m not even sure the tooth is the reason she’s not eating. She does not tolerate any food at all other than rabbit including Hydrolyzed protein.
 
Jade & George said:
I could take her to the emergency vet but I’m not even sure the tooth is the reason she’s not eating. She does not tolerate any food at all other than rabbit including Hydrolyzed protein.
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Oh, right. The rabbit. It’s okay. You can take an put it in the blender with water and mix it into a very smooth mixture that can be put into a feeding syringe and syringed into the side of her mouth. There are lots of videos on youtube about syringe feeding your cat if you’ve never done it before.
 
I was wondering if the tooth is also the reason she’s not eating. Do you have recent lab work on her? Maybe she is nauseated? Have you been testing her for ketones? Any time a diabetic cat is lethargic and won’t eat or is vomiting it’s cause for concern. Ketones should be tested.
 
The appetite stimulant seems to have kicked in and she just ate a little over half a 3.5 oz can of food. I tested for ketones yesterday and it was negative. My current plan is if she’s not eating well overnight and tomorrow am I will take her to the ER. The thing I’m afraid of is she hates the vet so much that if this is the end I’d rather her stay home bc she seems comfortable and I don’t want to torture her. I love her so much I would do anything for her I just don’t know what the best option is.
 
Do you really feel like this could be the end? Or is it just a bit of a time of inappetance. Are you sure that you are not thinking more negatively because of your recent losses. I didn’t think she was in that bad of shape.
 
I think it’s encouraging that she has eaten a little more. Sometimes if you can get them eating, it makes a world of difference and they will start eating more. Not eating can make them feel really ill. Ondansetron (anti-nausea) can help a lot if there is any possibility of nausea or Cerenia can sometimes be helpful.
 
I am definitely not thinking clearly. That’s the only thing I know for sure.

Yes to no insulin bc not she wasn’t eating. I tested again at 630pm and it was high so I gave her insulin then. I’m probably a little more hesitant than usual bc of the experience this weekend. I’m really struggling. Thank you so much for all your help.
 
So if you do take her in, they probably should run some basic bloodwork (CBC and Chemistry panel) UNLESS you already have recent bloodwork for her? If you do, then I would not repeat it. I would ask them to test her for Pancreatitis (that is a specific blood test.) I would have them check Ketones. Do they give her a sedative at the vet or do you give her some Gabapentin before you take her to the vet? Hopefully, if they examine her thoroughly, they will have some idea about why she does not want to eat. They can show you how to syringe feed her as well. It’s crucial that she eats more than she has been (although last night’s eating was encouraging!) I am hoping she will be much better this morning and you won’t even need to take her in.
 
I did end up bringing her in and they did a BUNCH of tests and found nothing. They shaved her front leg and entire tummy but this seems to have acted as exposure therapy and it didn’t upset me which I’m very thankful for. They fully sedated her, did an abdominal ultrasound, and looked closely at her tooth, and all is well. When she got home I continued the Mirataz and started mixing in Tiki Cat Chicken and Pumpkin and she is eating well! Of course she has very loose stools 2x/day but I knew that would happen bc she’s sensitive to everything but rabbit. But she won’t eat the rabbit. I’m thinking of ordering two new novel proteins from Koha: venison and kangaroo. I wish she could eat “normal” food and more of a variety bc she really seems to enjoy it. Any sensitivity-tummy kitties out there have advice? I’ve tried chicken, tuna, turkey, guinea fowl, pork, beef, salmon, haddock, LID and not, added pumpkin and not, dozens of brands, mostly patè bc that seems to be her preference. Thank you ❤️
 
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