Charlie - Help - Blood in Diarrhea/Lethargy. Scared.

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charliesmom

Member Since 2012
My little Charlie was diagnosed with diabetes last week. We live in Amsterdam, and the vet told us her blood sugar was at 23.5 at first testing. She is on caninsulin at 2 units twice a day. It has been a week and she still seems to not be herself, which makes me real sad. On Friday we went back to the vet for a follow up test. Her blood test came in at 12.5. This was 4 hours after her morning shot. They tell us that the normal reading is between 3-8, so I guess the insulin is having some impact. The vet suggested we increase the insulin to 2.5 units twice a day, and when we did that last night, she vomited. Again this morning, she vomited after the insulin shot. Not convenient on a Saturday when vets in Europe are closed! I definitely need to learn more about this, get a glucometer, and become more independent, and I hope you guys can help me as when I read some of these posts, it all seems VERY complex. We took Charlie to the emergency vet today and they gave her a shot against vomiting. They also recommended we go back down to 2 units per day. Caninsulin seems to be the only insulin recommended in the Netherlands. I have asked about the other brands recommended on this board, and they say it's not an option so I need to give this one a try and see how it goes. Any simple advice for us parents? She's 12 years old and I hate to see her this way. From one day to the next, our sweetheart is becoming quite sad to watch. Thanks in advance for your advice.
 

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Re: Meet Charlie

Hi guys and welcome to the diabetes board! I'm sorry your kitty has diabetes, but this site is the best place to learn about treating it. It is NOT a death sentence and can easily be treated.

Our kitty mocha was never on your kitties type of insulin, so I'm not sure about dosing .. we started mocha out at 1 unit of insulin, twice a day .. but she was on lantus and that is the recommended amount. On this board it's recommended that you start low, and go slow .. meaning with lantus, you start at a low dose and slowly work your way up, being sure not to miss the "right" dose that evens out their numbers.

Getting a home blood testing meter is a perfect way to test your kitty and know exactly where his numbers are. Not sure if you have walmart over there? But if you do, they sell a meter called the Relion and it's fairly cheap (sorry, it is in the US anyways!) and you can get the test strips right there as well.

I hope others will be by soon, they are so much more knowledgeable about what links to post to answer all of your questions, but I just wanted to welcome you to the board!
 
Re: Meet Charlie

Hi Charliesmom! Charlie is gorgeous! Welcome to the message board! I am relatively new here myself, so don’t have much advice to give you, but here is a link that helped me when I first started.

Newcomers frequently asked questions http://binkyspage.tripod.com/faq.html

Is Charlie eating wet food? One of the early pieces of advice I got was to switch my cat to wet food, as the carbohydrates in dry food fuels their high blood glucose numbers. It is my understanding that some cats can be regulated with just a diet change, though most will require insulin – at least for a time. My cat is a dry food addict, so I am struggling to transition her as well. Charlie’s blood glucose numbers will likely come down to some degree if you can get him on a wet food diet, assuming he has been eating dry food.

I believe Caninsulin is the same as Vetsulin (different names in different counties). You might want to post a new topic with a subject line like, “Need advice about Caninsulin/Vetsulin” that would draw the attention of those board members familiar with that specific insulin. Once you develop some connections this way, things won't seem so scary - and you can benefit from their experience.

The folks on this board are great and have helped me a great deal. Best of luck to you and Charlie!
 
Re: Meet Charlie

Hello Charlie and Mom,

We have a few members in Europe. If you put Netherlands in your subject line, you might attract their attention. I would suggest that you start hometesting today. Then you can see exactly where his blood sugar levels are and that will tell you whether he is getting too much or too little insulin. I don't know what kind of meters you have available in Amsterdam, but you want a regular human one that sips the blood and uses only a tiny sample. You want to buy lancets and a lancet device to poke his ear. (Not sure whether the gauge will be the same, but you want ones that will make a larger hole. The gauge most humans use makes too small of a hole) Make up a rice sack (thin sock filled with raw rice, warmed in the microwave until very warm but not hot) to warm his ear. (Warm ears bleed better) You can also use a prescription bottle filled with very warm water.

Here is a video that shows how it is done: Video for hometesting

If you are feeding dry food, after you get the testing down, you can change to wet low carb food. This thread has possibilities in Europe: http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=64843 You want to be testing first, because the wet low carb can really bring down the sugar levels fast. Our Oliver went down 100 points overnight when we switched.

There do not seem to be many insulin choices in Europe other than Canninsulin. Some of our members in GB were able to get their vets to prescribe human insulins, but it is rare. We have had cats regulate on Canninsulin. The testing will help you figure out exactly how the insulin is working and you can see whether it is going to last a whole cycle or not. Once you see how it works for Charlie, there are ways we can adjust the timing and dose to help.

Keep reading and asking questions. We would love to help. My husband and I traded homes with a Dutch family from Haarlem and thoroughly enjoyed your county - many good memories.
 
Re: Meet Charlie

Hi Charlie & Mom,

Welcome to the forum - I am sorry that Charlie has diabetes but you will get an enormous amount of help here. There are a lot of people that are not that particular about Caninsulin. All ii know is that my Scamp was diagnosed in February 2012 and she got put on caninsulin (her vet wouldn't hear of anything else) and I started home testing right away and switched her over to wet food immediately. (Luckily she just likes food and lots of it - wet or dry - lol). It has been 3 weeks now since I have given her any insulin as she is now diet regulated!!

So get Charlie on a low carb wet food as soon as you can because even with caninsulin he can become diet regulated!!

Best wishes,
Alix & Scamp
 
Caninsulin Advice in The Netherlands

Thanks for your welcoming notes. We appreciate the advice and will take it in step by step. Right now we are still trying to get used to giving Charlie her insulin twice a day. It's a transition and we're getting better at it. Things haven't regulated though so I know our next step is to buy the glucose meter like some of you have suggested.

Here is a bit more background about Charlie:

She's a British Shorthair. I found her in Illinois in the year 2000 as a stray so she's now about 12-13 years old. Since then, Charlie has lived in the US and Europe. She is an indoor cat and has always visited the vet on time to get yearly checkups. The only health issue that she had happened about 6 months ago when she had to have 2 teeth removed.

Most of her life she has been a bit chubby. We have had her on prescription weight loss food for about 5 years, but it has not had an effect as we probably did not regulate the quantities as much as we should have back then. Now I feel a bit guilty about that. Charlie's weight was about 5.8 kilos (12.8 pounds) until the diabetes diagnosis. Right now she weighs 5.4 kilos (11.9 pounds). The weight loss, excessive drinking and peeing were warning signs that led us to go to the vet to get her checked out about a week ago.

She was diagnosed on June 24th, and the vet prescribed 2 units of caninsulin twice a day. Since the diagnosis, Charlie has been eating 55 grams of the food each day. It's a dry food called Hills prescription diet M/D Feline Weight Loss Low Carbohydrate Diabetic. This was recommended by our vet and she seemed to like the food and eat it until just recently.

After the follow up vet visit on June 29th, they increased the insulin dosage to 2.5 units twice a day. Charlie's vomiting on Friday night and Saturday afternoon led us back to the emergency vet on Saturday at about 5pm. They tested her blood and said it was at 18.9

This was considered high, but also normal since it was almost time for her next shot at 7pm. Still, the vet was worried that the vomiting wasn't normal, so they advised us to lower the dosage back down to 2 units twice a day for the time being.

The anti-vomit shot (cerenia) on Saturday night stopped the vomiting over the weekend. However, all the shots since then have been challenging as Charlie seems to have lost her appetite.

Sunday morning I woke up and Charlie hadn't eaten ANY of the food that I left her the night before. I tried feeding her the hills' food again, and she didn't eat it, so again we had to wait around for her to eat a little bit and she didn't eat enough. Eventually, we were able to get her to eat a little bit of tuna as that was only other thing we had in the house.

It has now been 2 and a half days of loss of appetite and lowered insulin dosages. Things don't seem normal, or else we just have to get used to a tired, strange kitty. The vet can't take us until Friday, so we have to wait until then to test her blood again.

I will look for the wet food recommended and try some of that if I can't get her to eat the Hills anymore.

Is this loss of appetite normal? When the vet did the initial blood test, they only tested for diabetes. I really don't want to put Charlie through more tests, but I read that other things could be present (pancreatitis, kidney problems, etc) so I am considering asking our vet to do another blood test.

So far I have spent $500 at the vet and the results are not as good as I had hoped for. I do feel I need the vet's help at this point as I don't know how to do this on my own and we are both working, so we don't have so much time during the day to investigate. Thanks again for your tips and if you have more, bring 'em on! We appreciate it.
 
Re: Meet Charlie

I live in Denmark and my vet started Prop on 2 units of caninsulin. First it is very possible that your cat can get otj - of the juice if you just do a few simple things. First as other have said, begin to hometest the cats bg. Caninsulin is a fast acting insulin and it need to be lowered as soon as your cats numbers egin to fall. Then get rid of the dry food. When i changed Props foodcto a 100 % wet, she went of the insulin within 10 days. At www.zooplus.com you can buy felix wet food. If you et the felix as good as it ges and felix twice as nice the carb will be around 4% where now when you are feeding dry you are most likely giving you cat more than30% carbs. But dont change the food before you bloodtest.

I have this homepage www.sukkerkatten.dk where is wrote a diary about what i did with prop to get her otj. If you use google translate i think it could help you. There also is a video of me testing props bloodglucose.

Low bloodsugar can make a cat vomit and feel really lousy. Hopetesting is the keyword and then get rid of the dry. This is a fight you can win. Good luck
 
Vomiting Kitty

:shock: This morning at 7am, I tried to feed Charly the recommended foot from our vet (Hills M/D prescription diabetes). She did not eat any of it. I needed to give her a shot at this time before going to work, so I continued to try and encourage her. She just wouldn't eat it. I had 1 can of "gourmet gold with salmon - fine mousse" wet food. I tried looking this up on the website to see if it was appropriate to feed Charly this. It wasn't clear. On the list of foods available in Europe, "gourmet gold" seems to be on the list. I tried to use a calculator that I found on the internet to double check the ingredients to see if this was OK. On the back of the can it says: protein 11%, fat 7%, ash 3%, cellulose .1%, humidity/water 77%. From entering these amounts in the calculator, it seemed to be OK to feed her this. Or I did something wrong, as when I came home from work at 5pm, Charly had vomited twice again. Can anyone confirm if I fed her the wrong food?

:shock:

Also, it's now time to give her another shot. Yesterday I bought a glucometer & insulin pen (Freestyle precision was the only type available in Amsterdam at the pharmacy I went to). However, now I read a thread on this site saying that this particular brand is unreliable. UGH! On Friday I will be back at the vet (this is the soonest they can fit us in). While I'm there and they do the blood test professionally, I will also put a little drop of blood on my own glucometer to see if the reading is in line with the professional reading. This could be a way to test it's effectiveness, I think. Thoughts?

In the meantime, for tonight specifically (it's currently 7:30pm here in Amsterdam):

- Should I try to test Charly's blood now (even though I know it will be high because it's time to give her the 2nd shot today)?

Or, should I instead just encourage her to eat more dry food and then give her 2 units of insulin again?

Has anyone had these sorts of bad reactions with caninsulin? Or is this all just normal (and I'm a freaked out kitty momma) as it takes some time and practice to get her regulated properly?

Thanks for your advice, guys. And thank God for this community!
 
Re: Meet Charlie

You want her to eat before you give Canninsulin. It tends to hit hard and fast and it could take her dangerously low if you give it without food on board. The other complication is that, of course, you want to give her insulin. The vomit could have been that she didn't like the food and it upset her stomach. But it also could have been that she went low and vomited. That is why the testing is so important so you can really see what is going on. Yes, testing your meter against the vet on the same sample of blood should give you an idea. You can also test yourself and see if it gets a reasonable reading for you.

I think I would go ahead and feed dry until you can find a low carb she wants to eat. At least she has food in her stomach and you can give some insulin. If she were mine, I would reduce to one unit until you can figure out how low she is going and how the insulin is working. If the vomiting had to do with too much insulin, that is a problem.

Have you been able to get any readings with the meter?

Lots of cats quit eating the DM. It is liver based and they get tired of the taste pretty fast. The nice thing is that the vet should take back any unopened cans.
 
Anticipating First Blood Test at Home + Bought wet food

Thanks for the quick advice, Sue. She ate the dry food and we gave her the insulin. I will do my first blood test in a few hours (after the 4 hours have passed since her shot). We also bought some canned wet food options so we have some backup plans in that regard as well just in case.
 
Re: Meet Charlie

I suggest that from now on you test before you give the shot. That way you know if it's safe to give insulin. If she's too low at the shot time, she could drop too much and become hypoglycemic, or hypo. (viewtopic.php?f=28&t=15887).

Testing part way through the 12 hour cycle gives you information about how low she's going. That lets you know how well the insulin is working.

At some point you will want to do a curve. That means you test every 2 or 3 hours during a 12 hour cycle. That lets you know the duration of the your insulin - how many hours into the cycle she hits her lowest point before she begins to rise again.

And keep a chart of your test results. You can use the one here on FDMB (I don't know the link, can someone else provide it?). Or you can just write it all down.
 
Re: Vomiting Kitty

charliesmom said:
Also, it's now time to give her another shot. Yesterday I bought a glucometer & insulin pen (Freestyle precision was the only type available in Amsterdam at the pharmacy I went to). However, now I read a thread on this site saying that this particular brand is unreliable. UGH! On Friday I will be back at the vet (this is the soonest they can fit us in). While I'm there and they do the blood test professionally, I will also put a little drop of blood on my own glucometer to see if the reading is in line with the professional reading. This could be a way to test it's effectiveness, I think. Thoughts?

I would do that - when you're at the Vet, and they are testing the blood anyway, test your meter too & compare it to theirs. That's what I did. The Vet told me that my human glucometer was going to read at least 100 points higher than theirs.... but it was almost 50 points LOWER. After that, he was all for me testing at home.

Hope Charlie is feeling better :smile:
 
My little tiger

Friday we fed Charly wet food and took her to the vet. Big accomplishment: no vomitting!
I asked the vet to do the full blood test this time (just to be sure there are no other problems happening simultaneously that might have caused the vomitting).

Charly has now figured out that there is nothing fun about the vet. The minute I even bring out her carrying case, she starts getting stressed. Yesterday it took 3 people at the vet to hold her down for the blood test. She screamed SO LOUDLY like a tiger that all the people in the vet's office took notice, and the vet recommended us to stop for the day and not do the glucometer reading as well. So we'll wait until monday for that one.
Hopefully Charly will soon be regulated so we can see some improvements.

In the meantime, I noticed that she likes the wet food better and it seems to help in some way. We are buying one of the recommended brands, but are not sure about 1 thing. How much wet food should she get? She is currently down to 5.3 kilos (11.7 pounds) so weight loss is still important I guess. Thoughts?
 
Re: Meet Charlie

I give Prop 45 grams of wetfood every 6 hours. I put in a little water as well wich is very good for her.this amount keeps her weight stable at 5,3 kg. I want her to keep this weight.

Now that you are feeding wet, there is a big chance the 2 units of caninsulin is way to much. You really need to begin to test at home. The stress you cat is going through going to the vet to have a curve done not good and will affect the numbers by rising a lot. That will have the vt think that the insulin needed is bigger than it really is. Hometesting is th keyword and especially now when you have changed to wetfood. To low bloodsugar can kill you cat within hours, so you just have to begin.
 
We tried doing a home blood test this morning after 4 hours of insulin. Charlie wouldn't allow it and she got all stressed out, so we will try to wait until later tonight and do it again before bed. Maybe she will be more calm then.

Some more background on Charlie (which I forgot to mention):

She is a real sweet animal with us, but ever since I found her in 2000, she has been an extremely anxious, high stress, kitty. The vet has told me she has never seen a cat so stressed. Even with friends who come to the house, Charlie hisses and gets nervous. She is a declawed cat so maybe this is a contributing factor. She doesn't have all the proper mechanisms to protect herself, so when people come around that she does not trust, she gets more nervous. She basically trusts nobody except for the two of us, so this means she is most calm when it is just the 3 of us at home. I realize that her high stress could lead to a misread from the vet (even if they do the blood test there). This is why I would like to start the home testing. However, we are scared and we are struggling a bit with this. I will keep trying. Thanks for your encouragement.
 
Re: Meet Charlie

Two ideas.

Start desensitizing her to the process. Decide on a place where you will test and take her there. Pet her and talk to her and mess with her ears for a few minutes. Then give her a treat and let her go. Do that a few times, then add the warming. (rice sack or prescription bottle filled with very warm water) Few minutes, treat and praise and she goes. Hopefully once she is used to the process, the poke won't be such an isssue.

Not sure how she would feel about the kitty burrito. We used it with Oliver at first and were able to stop once he realized if he would sit still, a treat would be coming. We wrapped him in a towel with only his head showing.

Are you sure using a large enough lancet? Not sure of the European system, but we use 25-28 gauge at first to make a big enough hole. The 30-31 gauge sold for human diabetics don't usually work in the beginning. Also, put something behind the ear when you poke - a folded tissue or paper towel. We used a small makeup songe.

You might start a new thread with your testing problems to get other ideas.
 
Re: Meet Charlie

Hi Charlie's Mom,

It sounds like Charlie is a shy kitty!! My 3 cats are all declawed and do get shy around visitors - just not as badly and they quickly come around and demand attention from the visitors!!

When Scamp was first diagnosed I knew enough (& luckily so did my vet) to know that I had to start home testing as soon as possible!! This was actually before I found this site!! what worked for me is that she on occasion really wanted cuddles and if she wasn't feeling good she REALLY wanted cuddles. I would just pet her and she would settle in and I would play with her ears. Shortly after playing with her ears I would then test her blood. We both found this (quite quickly) to be a comforting and bonding time and now all I have to do is call her and she comes running (usually - she is still a cat!!).

Sue's ideas are great - the most important thing is to BREATHE!! You need to test Charlie to find out his glucose levels so that he doesn't go hypo or anything. You are trying to help him feel better so that you will feel better!! Any way that you can get him tested is good as long as it doesn't turn into a stressful situation for both of you. Scamp and I always go to the same place for her testing and she knows it means cuddles. Try and ease Charlie into a routine and find some treats that he likes (although I still have never given Scamp a treat) and try to make the testing a good experience!!

There are lots of people here that are very knowledgeable and will come up with wonderful ideas - this site has been invaluable to me! And I expect you will learn everything and anything you want to know (about feline diabetes) here!!

Good luck,
Alix and Scamp
 
Charlie has pancreatitis

We found out today at the vet that charly has pancreatitis. The vet told us the key thing we have to do is keep her away from fat. She did not prescribe any other treatment methods.

If we keep her on a wet food diet with the right wet food, I guess this will help. However, it sounds like it is incurable. Also, maybe this explains the vomitting. Is there anything else we need to be aware of?
 
Re: Meet Charlie

Jill, start a new thread with pancreatitis in the subject line. We have lots of people here dealing with it. Be sure to mention you are in Europe so they can give you food ideas.
 
First At Home Blood test accomplished!

We succeeded in doing our first blood test tonight! It has taken us many attempts over the past weeks, but we got it this time! Blood results were 23.8 just before her 2nd insulin shot of the day. We will try to do a mini-curve tonight (or as many tests as we can achieve) to see where her lowest point is and when she reaches it.

Thank you everyone, for encouraging us to do this. We're getting there. Baby steps!
 
Glucose curve - low numbers?

Charlie's blood glucose curve results thus far today:

6:45 pm (just before her insulin shot) = 23.8
7:45 pm = 17.6
8:45 pm = 15.5
11:00pm = 3.0

We haven't yet correlated our home glucometer to the vet's machine. We will do that on Tuesday July 24th at our next appointment.

For tonight, we will test again at 12am to be sure, but still, I'm already a bit concerned that her numbers are so low.
We are currently administering 2 units of insulin. I assume we should decrease the amount slightly for tomorrow morning's shot. And probably we should leave some of the M/D dry food out for her tonight. Agree? Right now Charlie is sleeping. She seems ok but her pupils look a little dilated to me.

Thoughts on next steps? This is the first time we have done a curve so I don't want to make mistakes.
Thanks for your help in advance.
 
Glucose curve

Charlie's glucose at 12am was: 3.6
Just prior, I gave her a couple kernels of the m/d dry food. I will leave a bit more out for her tonight just to be on the safe side.
 
Re: Meet Charlie

For tonight, we will test again at 12am to be sure, but still, I'm already a bit concerned that her numbers are so low.
We are currently administering 2 units of insulin. I assume we should decrease the amount slightly for tomorrow morning's shot. And probably we should leave some of the M/D dry food out for her tonight. Agree? Right now Charlie is sleeping. She seems ok but her pupils look a little dilated to me.

Thoughts on next steps? This is the first time we have done a curve so I don't want to make mistakes.

Wow, that was a significant drop. With a +4ish that low, even though you saw a small rise at the last test, can you check her again in 30 minutes? Doing the math in my head, but the 3.0 would be a 54 to us. 3.6 is only 65. You want to make sure that she's rising. Did she eat okay tonight? Keep an eye on her pupils. The numbers are not in "hypo" territory, but they are low.

Carl
ETA - yes I think reducing in the morning would be a good idea since you've just started testing.
 
Ate wet food before insulin shot

She ate a full can of wet food (beef) at 7pm just before her insulin. I will test once more in ten minutes as advised.Thanks for the quick response.
 
Re: Meet Charlie

Your 3 is a number that is still safe for nadir although we wouldn't want it to be much lower. (Multiply your numbers by 18 to get US numbers.) The more concerning issue to me is that she went down from quite high numbers to quite low ones. Unfortunately this is not uncommon with Canninsulin; it hits hard and is a bit of a roller coaster. However, I am encouraged that it is seeming to be lasting longer than it does in many cats, so it is possible that you can manipulate the dose to work for her. It's only one cycle so we can't tell if she is bouncing from the low numbers up to the high, but it is a possibility. (Her body responds to a lower number that it has seen by releasing extra glucose into her system, making her numbers rise sharply)

I would reduce the dose. IMHO I would go down to one unit and work my way back up. (Much safer to start lower and add as needed based on her numbers. You can't get the insulin out once it's shot if it was too much.) You might make food available in the 4-6 hours after the shot to slow the curve and maybe stop that drastic drop. If you decide to lower the dose, be sure to test for ketones.

Can we help you set up a spreadsheet? The World version will convert your numbers to US numbers and is a great way for us to see your dose historty when you have a question. Here are the directions: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207 If you have trouble, send me a private message (PM button on the bottom LH side of this post.
 
BG at 4.2

Her glucose levels at 12:30 were: 4.2
It's going in the right direction.

We will go to bed now and leave some dry food (m/d) out for her.
I will reduce the amount in the morning before work and look into setting up the spreadsheet tomorrow night.

Thanks everyone for your help and advice.
 
Re: Meet Charlie

Sounds like a good plan, Jill!
Carl
 
Reduced Insulin to 1.5 Units + ?'s Wet Food

We reduced Charlie's insulin to 1.5 units.
Today we slightly misfired & a very tiny bit of insulin didn't make it into the cat. This means we have to wait until tomorrow to get a true reading based on the new dosage, but generally, charlie seemed a bit more normal today so that was good.

Charly is still 5.3- 5.4 kilos. The vet told us the goal is to get her between 4 to 4.5 kilos.
Thoughts?

Also, we are thinking of switching entirely to wet food. Lately our routine is to feed 1 can of wet food with each shot, and for the in between snacks/ mini meals, to give some of the m/d hills diabetic food.
How do we determine the exact amount Yof wetfood to give in total each day? We want to be sure charlie gets enough food with each shot & avoids hypos, but also to enable the weght loss needed. How do we find that balance? 2 cans total per day (split into 4 meals)?

Do we need to stick with 1 particular kind of wet food or can we switch it up as long as they are all on the list and have low carb percentages?
 
Re: Meet Charlie

You are testing at home, right? If so, yes, I would switch to all wet low carb. When we took Oliver completely off dry, not only did his glucose levels come down 100 points, but over the next 6 months, he lost 2 needed pounds. Just watch the numbers carefully and be ready to adapt the dose.

Here's is my favorite formula for how much to feed: (Thanks, Carl)
20-30 calories per pound of ideal body weight, per day. That will keep a healthy cat at its ideal weight. The range of calories is dependent upon a few factors, one of which would be level of activity.

Some cats want variety; some would happily eat the same kind every day. Whatever makes her happy!
 
Re: Meet Charlie

Charly is doing much better with the lower dose. She is moving around more, cleaning herself, and even ran to the door to greet us today like she used to do. We gave her 1.5 units for the past 2 days. Today we also started feeding her only wet food in total. Her blood test just came out at 6.6!

Little victories. Yeah!
:)
 
Re: Meet Charlie

That's a very nice number - when in the cycle did it come? Remember that if you get 200 or below (around 12 metric) wait 20 minutes without feeding and test again to be sure the number is rising. Even if it is rising, it's a signal to drop the dose a little.
 
Re: Meet Charlie

That test was 4 hours after her evening shot.

Not sure what you mean by 'if you get a reading of 12 wait' to make sure it's rising before feeding. Wouldn't feeding her help it rise actually?

Also, 12 seems mid range on the high side, not low. Why would that be a signal to lower her dosage? Bit new to this still so sorry for too any questions here. Just trying to make sure I understand.

This morning's pre-shot blood test at 6:30am was at 19.3. We gave her 1.5 units.
 
Re: Meet Charlie

Our arbitrary cutoff for new diabetics not to shoot is 200 so your 12 is in that same range.

We suggest waiting 20 minutes without feeding because we want a "true" number to base the dose on - not one inflated by food. For example, if food makes her number rise by 100 points and you shoot that number with a dose that would match it, you will be giving more insulin than she needs. If you didn't give food and her number was 100 points lower, the dose would be lower. (Hard to type out an explanation - does that make sense?) it's just a way we use to make this dance safer for diabetics, particularly in the beginning.

The other reason to wait and retest is that the number may be going down, not up. She could still be afected by her last dose and still be going down. You don't want to shoot a number that is still affected by insulin because then you can have overlap of the insulin and create even lower numbers. This is not likely to happen with Canninsulin as it usually does not last the 12 hours, but some cats have had longer cycles with it.

Once you have some data and can see how she reacts to a given dose on a given number, you can be more daring with the dose and perhaps shoot lower at preshot. But you want lots of data because Canninsulin does have that fast drop.

Can we help you set up a spreadsheet so when you come on needing dose advice we can see her history at a glance? Here are the directions: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207 Use the World version so it will convert for you and for us. If you need help, send me a pm.
 
Re: Meet Charlie

Hi Sue. Really not sure I get it. I'm sorry. In a moment I will get that spreadsheet uploaded so everyone can see things quickly at a glance.

Current status is:
- We gave Charlie 1.5 units this morning at 7am.
- Tonight she had diarrhea just before her 7pm shot, so just to be on the safe side, we just gave her a blood test. The test came out at 11.2

If I understand your post correctly, are you saying that anytime her blood test comes out below 12 at pre-shot, we should be cautious and not do the shot? I will do as you indicated and wait another 20-30 minutes to do another blood test then.

In the meantime, we'll also work on posting the chart to give an overview of the data we have at this stage.
Thanks again for all of your input along the way. This really is a roller coaster but we love her so we will do whatever it takes.
 
Re: Meet Charlie

Just prior to the first blood test at 7pm, Charlie ate dinner. We were supposed to give the shot right after, but when we saw the diarrhea, we decided to test her blood and the figures were at 11.2

We waited 30 minutes to do another blood test just now and her blood is now at 12.3

We need help to decide what to do next as this is supposed to be the time of her evening shot:
- Give no insulin until morning?

- Give the 2nd shot of the day of insulin (but just lower the dosage)? To 1 instead of 1.5? I read somewhere that it's also not good to raise or lower insulin amounts by more than 20%, so going to .5 does not seem like a good idea. Even lowering the dose arbitrarily seems concerning in a way.

- Give the normal amount (1.5)?

I am leaning towards not giving her anything until morning, but I am no expert in any of this so I really could use some advice. Thoughts?
 
Re: Meet Charlie

Lower the dose. I would probaly give 0,5. Since you are now on all wet, the need for insulin will be much less. So give him a small amount 0,5 andcthen by morning, see what the preshot is and maybe then deside to raise a bit
 
Re: Meet Charlie

When Someone suggest not to shoot when he is under 200 it is because in the beginning it is very difficult to know how the reaction to the dose will be, and with at fast acting insulin like caninsulin it can be dangerous to shoot on a lower number unoess you reduce the dose and continue to test during the cycle.

You should be ok with a reduced dose, but get a +2and a + 4 so you can see his reaction to the lower dose. You need the data for the next time youvare in a similar situation. If his nadir is later than +4, then try get a later test as well.
 
Re: Meet Charlie

Unfortunately, we misfired while trying to give the .5 unit so we stopped. Charlie has had diarrhea all night tonight and did not eat much of her food. :?

She is sleeping now so we will let her rest until morning. We left a few extra dishes of water out for her so she doesn't dehydrate. We just finished updating the spreadsheet and will try to upload now. Thanks for your quick responses as always. Doing what we can here but we can and will do better! While rewriting the spreadsheet into google docs, we noticed that a few of the times she vomited or had diarrhea were when she ate the Almo nature veal. We will try to stay away from that for awhile to see if that will help. However, it may just be a reaction to the pancreatitis. Not sure. Step by step we continue our journey to make our girl feel better.
 
Re: Meet Charlie

I can see the metric numbers but not the button we can hit to convert to US. Did you sure use the World Version of the spreadsheet?

I think you are wise to skip if she is having tummy troubles. With Canninsulin you definitely want food on board. Hope it was the one flavor that didn't agree with her.
 
Re: Meet Charlie

The spreadsheet was the one you provided. Not sure what went wrong.
We will test in the morning pre-shot and hope for a better day.
 
Re: Meet Charlie

The tech link has two different spreadsheets , the regular version and the World one. If you have the regular (and darn, it looks like you do, send me a pm and we'll fix it.
 
Re: Meet Charlie

Shoot! I am been trying to work with the world spreadsheet from the Tech forum and the one in the regular google templates. Neither one will switch from metric to US or vice versa. I'll see if some of the people more computer wise than I can help.
 
Re: Meet Charlie

charliesmom said:
The spreadsheet was the one you provided. Not sure what went wrong.
We will test in the morning pre-shot and hope for a better day.


The way the world spreadsheet in the link Sue gave is supposed to work is that there are two tabs, one for World (mmol) numbers and one for US (mg/dl) numbers. When you enter a number in mmol in the World tab, it is automatically converts that mmol number into mg/dl on the US tab. The tabs are listed at the top bottom of the SS and you can switch between the two. For some reason your SS does not have tabs.

Here is the World SS I just tried out: https://docs.google.com/spreadsheet/pub?key=0AktEyoSYQciQdFN6NGpnQ09PeHI1RXF1dWJEUjdsekE&output=html It works just fine.

Please try setting up a new SS. Click here to get the World template Click on the Use This Template button that is at the top. It may take a couple of seconds or longer for the template to load and to get a copy to use so be patient.

Then follow the rest of the SS instructions to get the SS published and into your signature. You can re-enter Charlie's numbers into the new SS and then delete the old SS since it doesn't work as it's supposed to.


EDIT: It looks like some of the cells in the World template aren't converting the numbers from the World tab to the US tab confused_cat You can see that in my test SS in link above by flipping between the two tabs. Whoever set up that template and posted it might not have applied the auto rule/function/whatever it is to all the cells.

I suggest using the World template in this thread instead: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=50130
 
Need Help with Hypo

This morning when we did the pre-shot blood test, Charlie came out at 24.2 (436 in US measures). She had vomited during the night and there was more diarrhea, but as we found this quite high, we decided to give her 1.5 units of insulin again. Within an hour and a half, Charlie vomited once more, so we gave her lots of water and gave her more food. Still, as we were a bit worried about how it has gone in the past few days, we decided to test a few times. 2 hours after the morning shot, her test results came out at 10 (180 in US measures). Now we just tested again 4 hours after the morning shot, and it seemed extremely low at 2.1 (38 in US measured).

We gave her a bit more food as I hope that will help stabilize things a bit and bring her up a notch. Still, I'm not sure things are on the right track. We have a vet appointment on Tuesday again, but until then, any thoughts on how we should proceed?

I'm thinking about doing another blood test in 1 hour to make sure it's going up. Then test once more before the evening shot. My gut tells me that 1.5 is too much right now (maybe just because she has been puking with diarrhea, but still). I'm leaning towards giving her 1 unit rather than 1.5 if the blood test comes out above 20 again.

Thoughts on how much should I give her if it's below 20?
If under 12, I understand we should give no shot.
 
Re: Meet Charlie

You might want to edit your post to include the "911" emergency tag as a BG of 38 (US) is an emergency -- and you will get quicker responses from the experts.

I am not an expert by any means, but in reading this board for the last month, the lowest point is going to hit Charlie at about 6 hours after you gave the shot (the nadir) -- so if he is at 38 (US) at +4, he is going to be even lower at +6 - so this could be a dangerous situation. The advice I have seen is to give high carb food and test every 15 minutes for at least the next few hours. I hope the experts will be along shortly to give you more exact advice. If you don't have any high carb food, maybe something like milk would bring the blood glucose up quickly. Also, I would say that the 436 (US) number you got this morning was probably related to the fact that you didn't give Charlie a shot last night -- so maybe the dose you are giving him of 1.5 is just too high. Again, the experts will chime in shortly, but since I was up and no one else has responded yet...I wanted to try to help.
 
Re: Meet Charlie

Here are the guidelines for treating hypo from this board: See the "very low numbers without symptoms. And again, please edit your post to include the 911 icon above and you might want to include the words "Possible hypo" in the subject line. This will draw the attention of the experts.

TREATMENT

During treatment for hypoglycemia, try to test every 15 minutes until you see the bgs begin to rise. Then continue to test until you are satisfied that the cat is out of danger.

VERY LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a very low number (under 40 mg/dL or 1.9 – 2.2 mmol/L) administer a tablespoon of corn syrup, liquid glucose, pancake syrup or honey, or INSTA-GLUCOSE and follow with food until the blood glucose numbers rise to acceptable levels. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If using liquid glucose, dilute with water for a thinner consistency.

LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a low number (40 – 60mg/dL or 2.2 – 3.3mmol/L) give food or treats until the blood glucose numbers rise to an acceptable level. If the cat refuses to eat even his/her favorite foods, you can syringe feed or administer a small amount of syrup.

LOW NUMBERS – MILD SYMPTOMS
Try feeding first or give a little syrup or honey followed by food until the blood glucose numbers rise to an acceptable level and the symptoms disappear. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If the cat will not eat, syringe feed. If your cat will eat dry, feed this first as the high carbs will help to increase his/her bgs quickly. You can then follow with his/her favorite canned food. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.

LOW NUMBERS – MODERATE SYMPTOMS
Give a tablespoon of syrup, a teaspoon of liquid glucose, a tablespoon of honey or a tablespoon of sugar syrup followed by food and continue doing so until you see the blood glucose numbers rise to an acceptable level and all symptoms disappear. The syrup, honey, or glucose can be rubbed against the inside of the cat’s cheeks or on the gums for quick absorption. You can also mix the syrup with wet food or pour over dry if the cat will eat it. Continue to give syrup and food as needed and observe your cat for signs of recurring hypoglycemia. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.

LOW NUMBERS – SEVERE SYMPTOMS
Rub syrup, honey, or glucose on the gums and cheeks if your cat will allow it. Another option for administering syrup, diluted liquid glucose, honey or sugar syrup to a cat who is seizuring is to fill a needleless syringe with the mixture and insert via the rectum.
NEVER TRY TO SQUIRT SYRUP, HONEY, OR GLUCOSE TO A CAT WHO IS SEIZURING AS THE CAT COULD CHOKE ON IT! RUSH TO EMERGENCY.

AGAIN! ANYTIME YOU CAT IS SEIZURING OR LIMP, RUB KARO, GLUCOSE OR HONEY ONLY ON GUMS OR ADMINISTER RECTALLY AND GET TO EMERGENCY OR YOUR NEAREST CLINIC IMMEDIATELY!!!

Remember that syrup or any other sugared syrup/preparation will spike the blood glucose ONLY for a short period of time, so food is really important with mild and moderate symptoms. Dry food (high carbohydrates) will keep the blood glucose numbers elevated longer, so it’s a better food to give during a hypoglycemic episode.

After a hypoglycemic episode cats may be more sensitive to insulin, so a reduction in dosage is generally required, especially considering too much insulin – whether due to dosage, inadequate food intake, or the cat’s changing insulin requirements – caused the hypoglycemic event in the first place. With moderate to severe episodes, your Vet may have you skip the next injection altogether.
IT IS VERY IMPORTANT THAT YOU DISCUSS YOUR CAT’S HYPOGLYCEMIC EVENT WITH YOUR VET, SO TOGETHER YOU CAN DECIDE UPON THE NEXT COURSE OF ACTION.

Always keep in mind that with low blood glucose and no symptoms, the BG you get is not as important as where it is headed. In other words, if you get a BG of 100 mg/dL or 5.6 mmol/L or less and there are still several hours or more before the insulin peaks, your need to watch your cat (and the numbers) carefully and take appropriate steps. With very low numbers and NO SYMPTOMS, a cat can be fine one moment and seizuring the next.

BE PREPARED! KNOW THE SYMPTOMS AND KNOW THE TREATMENT!
 
Re: Meet Charlie

Thank you Melanie and Ninja. We tested again. It's very difficult to test her right now as not a lot of blood is coming out of her ears even after a few pokes. We managed to get a small drop of blood and it's still coming out at 2.1 That worries me, as it makes me think that in that in between time, I wonder if her numbers went lower and they are now beginning to rise. I just gave her a tiny bit of maple syrup with a syringe in her mouth (not an easy task but she took a tiny bit). Will try to also give food and we will test again in 15 minutes.

I must admit, for Charlie's sake, this is one roller coaster ride that I wish I never got on.

:cry:
 
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