Please Help! Don't Know What is Wrong

Hello,

I have posted here in the past about my cat, Todd. But I can't seem to remember my login info, so I had to make a new one.

Back story.. Todd is a 16 year old diabetic orange tabby. He was diagnosed in late 2007 and has been on 2.5 units of Lantus Glargine ever since. He so far, hasn't needed that to be adjusted on that. Each year he goes through something though. 2008 he had what our vets believed was Pancreatitis, last year he had a intussusception and they removed 6 inches of his intestines. Since then he has been doing well, or so it seems.

It's been VERY hot here in Seattle for a few days, and we only have a small A/C in our living room. I've tried to keep all of the cats in here, but they want to be all over the place. Anyway.. On Friday morning, before I gave Todd his food and insulin, he threw up a little. It was clear-ish.. it had what looked like some food in it. Just the color though. I tried to give him his food and shot a bit later, but he wasn't interested. I called our vet and he said to wait a bit and see if he wants anything later. So I did. Around 2pm he ate enough that I felt ok giving him his insulin shot. Throughout the day he wanted food, but didn't want to eat it. That night, no food again and as our vet suggested, no insulin if he doesnt eat. The next morning, Saturday, same thing.. wanted food, didn't want to eat it though. I took him into our vet. They pulled some urine, gave him SubQ fluids, gave him some meds to help him want food and did a full blood panel. They sent us home. They did NOT check his blood sugar though and I do not do that at home. Anyway, within an hour of coming home, he started to tremble a little, so I called them back. They had me bring him in again. they checked his BS level and said it was 61 and they wanted to keep him for an hour and check again (they closed in an hour as well) They called me back 45 minutes later and said it had dropped to 40, so they put in an IV and gave him some sugars through the IV and they asked me to come in. Now, like I said, they were getting ready to close, so I had to bring him home. They lent me a glucose meter, showed me how to use it and told me to check it at 7pm (it was 5 at this time) and again two hours after that. When we tested it at the vet, AFTER the IV sugar, it was 177. The vet said he should be fine now, but if it drops between 50 and 60, to take him to the ER vet. He honestly didn't think it would drop though.

7:30 rolls around and we try testing. I felt so bad.. I think we pricked his ears a dozen times before we got a good enough blood bead. It was 68 at that point. I called the ER vet and told them, they said bring him in right now, so we did. When we got there, about 25 minutes later, they checked him and it was 78 for them. I'm not sure if that means the meter I got from the vet is off or what.

So.. the ER vet said this.. it could be anything. She said he could be going into remission and not needing insulin, he could have thyroid problems or something else. Though she finds it odd he is not eating at all, and how sudden it was. We decided to leave him there for the night, so he can get fluids and they can keep a watch on his levels. I asked them to not do a full blood panel, because the one our vet did today should be coming in sometime in the morning. So we shall see..

I just called the ER vet to see what his latest levels are, because they said they were gonna test at midnight. they are: 159 So.. hmm.. I honestly don't know tons about Diabetes, so that seems unusual to me, though not to the vet at the ER. heh She said they had not given him any food or sugars yet and that was all on his own. So... Oh, and they did to a little blood panel and found that his potassium was very low, so they are giving him that via IV. They are also force feeding him, because he still won't eat. I feel better knowing his BS is going up.. but I am worried about what is causing this.



So right now, it could be anything. I'm scared out of my mind and keep crying. Has this happened to anyone else?.. advice, thoughts, things I should ask?...

He was fine up until Fri morning. I honestly thought maybe it was just the heat. 90+ is not normal around here.

Thank you!

P.S. Sorry about my poor typing skills. I'm very sick right now and am doing this in a hurry.

i am a layperson, not a vet. don't know if there are underlying health issues causing it but seems like nausea caused him not to eat even tho he was hungry. did they do an ultrasound of his pancreas to see if it's another pancreatitis attack or run an fPLI test on him to check for pancreatitis? you can get the results back from that the next day.

when cleo had bad nausea and vomiting her blood glucose was low because she wasn't eating enough. once he starts eating i'd guess his blood sugar will go up. he really has to eat, tho. glad they are force feeding him, because a cat can get fatty liver disease if it doesn't get enough nutrients in 24-48 hours.

the ER really seems to be the right place for him now. best suggestion i can give is to bring his favorite food by to see if that will tempt him more, and bring something that has your smell on it. i put a t-shirt on the night before cleo had a procedure so the vet hospital could keep it in her cage to reassure her. even putting a sock in your bra for a few hours will give it your smell. i don't expect to get such things back from the ER but last time i did they saved it for me. a nice comfy shirt or towel or cloth with your smell can really lift your cat's spirits.

wishing you luck with this.

When was the last time you had full bloodwork done? Vet may see something there.

My Tom is 17 and he had been vomiting quite often so we started giving Pepcid and it seems to have improved now. ETA: Vet ran a series of tests first and thinks his vomiting is only due to excessive stomach acids because of his CRF. We have NOT tested for pancreatitis and should as well. (SEE post below).

Do you think you could check his blood sugar more frequently when he's home to get a better understanding of how he reacts to the insulin?

Hi Todd's Mom,

It really messes up a cat's system when they stop eating. Liver problems, potassium problem, and with a diabetic, sugar problems.

One thing you might check with the vets about is a feeding tube. It sounds scary, but it has saved many a cat's life. See this page from Dr. Lisa's web site.

My best to Todd, and to his worried Mom.

Poor Todd! Since Todd's having hypoglycemia, I would encourage you to do the following:

1. refresh yourself on the symptoms and treatment of hypoglycemia. You can find Melissa and Popcorn's post on that here, and Jojo and Bunny's post on stocking your hypo toolkit is here.

2. since your current glucometer is a loan from your vet, I'd suggest that you get one for your house. For my first meter, I got WalMart's ReliOn for $10, 100 lancets for $4, and 50 test strips for $22. It's not that expensive, it can help save Todd's life and can certainly help cut down on those costly visits to the emergency vet.

3. I'm not sure when the last time you visited the boards were, but there's been a lot of experience accumulated in best using Lantus in cats. I would encourage you to visit the Lantus forum here and read the stickies at the top of the forum. Ones you'll be especially interested in are the ones labelled "New to the group - Start here", "Proper Storage and Handling", and "Insulin Depot AKA Storage Shed".


Regarding the recurrent vomitting, I would encourage anyone who's diabetic cat has vomitting issues to read Jojo's post on pancreatitis here.

Re: Please Help! Don't Know What is Wrong (Update)

Update!


Ok, so.. I called the ER vet at 7:30am to get an update. They did a glucose test at 4am and it was at 228 with a syringe feeding of a/d cat food. They did another at 8am and I believe it was 219. Not sure off the top of my head, I was so tired. But it was in the low 200's. Throughout the night they simply gave him IV fluids, two syringe feedings and some potassium. I picked him up and took him to our regular vet, so they could watch him for the day. I dropped him off at 10am and got a call around 2:30pm. They gave him fluids only and checked his glucose level at 2ish. It was down to 190. They told me he hadn't eaten anything on his own, and they hadn't fed him, so I said I would come over and see if he'll eat for me. So when I got there, he was still hooked up to an IV/pole and they brought him into a room with several different foods. He didn't want canned, but he did eat several bites of dry foods for me. Not tons, but more than he has in the last few days! The vet said I should bring him home. So they unhooked him and let me bring him home for the night. I had them check his glucose level once more before I left. It was 202. Oh.. the blood work from yesterday.. Ok, so, everything was fine, except for the potassium, of course. Now, I don't know what this test is called, but he told me it can track what his blood sugar levels have been over the past few weeks?.. or something along that line. He said its been in the 200's. So he believes that Todd has gone into remission and no longer needs insulin. The only issue is he still doesn't want to eat. Though he ate for me at the vet, and was super perky and purring.. now that we're home, he seems kinda down. He wouldn't eat for me, so I syringe fed him some a/d as suggested by the vet, about an hour and 20 mins ago. I thought, better safe than sorry. He has gone to the water dish a few times, so I am glad he is getting some water. I don't have a meter here, so I cant check him at home. I am suppose to bring him back in the morning for a recheck.

Right now, as of 7pm, he is snuggled next to me on the couch. like I said, he seems kinda down. Probably tired from all the pokes and car trips.

So.. if he truly doesn't need insulin anymore, what am I in for? Both our vet and the one at the ER seem to really think this is what is happening, though they find it odd he doesn't really want to eat on his own.

For the moment, I'm going with he is getting better and just needs a few days to get back to his old self.

was it a fructosamine test?

he needs to eat...could you syringe feed some watered down babyfood?

Jen & Squeak- Yes, it was! Thank you..

I did syringe feed him some a/d around 5:45pm today (2 hours ago) and I will be doing it again in a few minutes. I wasn't told how much or how often to do this, so I am using my best judgment with that. Our vet said to feed him ANYTHING he will eat, so I got a bunch of different foods, but I figure the best thing to do is force feed the a/d until the morning. I'm not sure how much water he needs, but I wonder if I should force feed some water too?.. it's not as hot as it has been here. It's upper 60's, low 70's in the house right now. His nose is a touch dry, but I know old age (he's 16) can cause that as well. He was on IV fluids all night and all day, until about 3 hours ago. I've seen him at the water dish twice since we got home.

He's still snuggled next to me on the couch. I think he's just tired from all of the car rides, HOT weather, IV's, people, ear pricks and such.

a/d watered down should be good; hope things are better in the am

Jen

I just gave him a syringe of watered down a/d. Before that, he took about 3 little nibbles of dry food and had some water. He's not trembling or anything, he doesn't look confused like he did yesterday. He just looks tired and not sure what to do with himself. He also peed a good amount.

Anyway.. just gonna hang out and watch a movie with him. Thank you for all of your support folks! Keep him in your thoughts.


*edit.. and now he is having more water. I'm glad to see that.

Sending Angels & Prayers to help your Toddy hope he will up and about in no time Keep giving him little bits of food and soon he will be back to normal LOL Kath :mrgreen:

Because I never sleep. heh

Todd ate a huge spoonful of canned Friskies and then he ate some of his own dry food!! He seems perky, which is great. He also had a BM, which I haven't seem him do in about three days.

I'll wait a bit before I decide to force feed again.

I got a bit of sleep and then got up around 4:30am. Decided I would try to see if he wants to eat. Not into the dry food, though he took two bites of it. Gave him more of the Friskies in gravy. He did go for that. Mostly I think he is just after the gravy and in licking up the gravy, he is getting some of the actual food. Not tons, but a bit. Before I went to bed at 1am, he did have more Friskies (mostly gravy) and a few bites of his dry food. He seems ok right now. I woke him up, which I am sure he didn't want. I think he is ok until 8:30 when the vet opens. I don't want to force feed him at the moment. Normally he doesnt eat in the middle of the night.. so.. that could be why no interest right now.

Mash the Friskies in Gravy with the back of a fork and mix the gravy into the
food.

He might eat more of the actual food, trying to get at the gravy.

It sounds like you are giving him way too much insulin and he is Hypo-ing--or coming close. I have found that when Fred either rises to high or to low FAST--then it makes him nauseous and he throws up....You need to do regular blood tests, not only before each shot--but thru out the day to see what his numbers are...Fred is on Lantus for 4 1/2 years now and I've never once given hiim a shot without knowing his blood number....if I did I would have given him one on many many occasions when he was as low as 60 or 70...

and you don't have to take your cat to the vet at this number--you can feed hiim--and monitor every 30 minutes--60-70 is 'normal'...but you must, of course, monitor to make sure he's going up not down and give him Karo syrup if he's going down....

don't worry it's not as hard as it sounds...I'd be happy to talk you thru it on the phone if you need. Just PM me for contact info.

OH, when their blood sugar is in low to normal levels, typcially they are not very hungry--so if he's in the 100s, and he's already eaten a little-he's probably not going to gobble something up. When it's super high--400s and above--they get ravenous--and when it's very low--generally they will try to eat as well. But most important is that you see his numbers and test every shot, every day and at peak times...lantus has very strange peak times, sometimes 6 hours after the shot--sometimes, WAY later, like 10 or 15 hours....so you must test....

I wanted to give an update.

As yesterday went on, he became more and more interested in food. He was drinking on his own just fine and by 10pm last night, he was being very pushy about wanting his diabetic food. This morning, same thing. he woke me up at 8:30am and ate all of his food. I spoke with our vet yesterday and he said to wait a day and bring him in today (Tuesday) to get a spot check and we'll see how he is doing.

So far though, I am pleased. He is eating again and acting pretty normal. I'll know more after the test today.

Good news!

Now are you wiling to consider testing at home?

Hi there, great to read that he's doing better!

If you add your location to the profile, there might be someone nearby that could teach you how to home test. A member here from the same city taught me, and it made such a huge difference since I was struggling to learn on my own.

Oh yes, I will be testing at home. I have to wait until Thursday to buy the meter though. I'm afraid the weekend ER vet trip kinda cost us most of our extra cash. Gotta wait till payday.