Hypoglycemia - can this cause permanent blindness?

My cat is 16 and diagnosed with diabetes about 2 years ago. I changed the food and he went into remission once. Then it came back along with thyroid problems. I test with a meter before I give him insulin. He was in the high 200 and 300 range about 4 months ago and we were doing 3 units of vetsulin. Then he would be around 100 - 150 early in the day and 200-300 or so in the evening, so I would give him the 3 units only when he was high. Saturday and Sunday, when I tested him with the meter, he didn't need a shot at all. Last night, I tested him and he was 218. I gave him 3 units. I think this was a big mistake since he has been getting lower, he was probably already going into remission or at least staying below 200, so after giving him the insulin, his own body probably went lower and then the insulin made him plummet. I went to bed at 3 AM and got up at 11:30 (I was laid off and I stay up late looking for jobs). He was walking around the house against the walls and furniture acting very strangely sniffing everything. I didn't get it for awhile. I thought it was because we have this other cat he hasn't been getting along with and has been spraying stuff and I thought that is what he was sniffing. I checked his blood sugar and it was 33! Gave him Karo and it went to 42. Took him to the vet and he said his retinas are working and he is just disoriented. He ate lots of food while there and his blood sugar went to 160 so I brought him home. That was around 3 PM. Its almost 6 hours later and he is still walking around the house against the walls and furniture sniffing and getting in strange positions and acting like he can't see. I don't know if this has permanently caused blindness or semi blindness or if he will get better. I checked him again and he is at 202. I am definitely not going to give him any insulin. I think he was starting to go back into remission and I should not have given him that shot at 3 AM. Who knows how low his BS went - it could have been well below 33 while I was sleeping. I should have not given him any or just one unit.

I'm cross posting on the other boards for you. Hang on.

yes, a severe hypo event can cause blindness. often it is not permanent though. it can take some time for all the senses to come back and be fully functioning again so for now, be patient with him and make sure he cannot hurt himself. you may need to confine him to one room for now so he doesn't hurt himself.

in the meantime, yes, dont' give any insulin at this point. let his body sort things out some and in a day or so, see what his levels are and then if he's high enough, start over at a much lower dose. 3 units is usually too high of a dose so let's work on reading and asking questions and learning some more about your insulin and this disease before we reintroduce him to insulin again.

btw, there are others here who have been thru this. i'll try and round some up so they can help with their experiences

I am so sorry you are goign through this.

What food are you feeding? Is it low carb wet food? Most liekly he needs very small amounts of insulin - maybe a half unit or less. But he will probably be very sensitive to insulin for a while. Can get spot checks in to see how low he is going at about 3-6 hours after the shot?. You might wait until he is above 250 and then shoot only .25u then test to see where that takes him.

I hope his vision comes back.

When he was diagnosed two years ago, I was feeding Purino Pro Plan, so I read up on all of the information about food and switched all of my cats to Wellness wet food - 1 can a day in the morning (very low carb) and for dry I free feed Innova Evo. He went into remission about a month after going on the new food, but then the diabetes came back about six months after that. I think maybe he was going into remission or at least not needing as much insulin anymore. I'm also worried about brain damage, but I'm just hoping this is all temporary. He can't jump up on things like he used to right now and he keeps ending up in very weird places.

I am sorry you are going though this. It sounds like he has had a very serious hypoglycemic event and I would call around and find a 24 hour emergency facility who can handle this. He should be getting treatment and they want to ensure he is in a safe place without possibility of future seizures.
There have been cases here where a kitty had several days of disorientation following a serious hypo and they all received aftercare within a medical facility.

Can you perhaps post your general location ( no specifics ) and see if anyone can recommend a good pace that can handle this? you should not have to be dealing with this at home.

He is engaging in any self care ( cleaning/ grooming) and is he able to eat on his own?

(((((hugs)))) this can get better, but my goodness how awful and scary for you all.

I am adding a 911 to your post as this is urgent.
perhaps also change your original subject line to " post hypo, disoriented and unseeing, sent home from vet"

Hang n there...but I would start calling around and see what other facilities recemmend.

Well, several years ago the feeling was if the blindness continue for longer than 72 hrs. it would probably be permanent. Don't know if that has changed but I certainly wouldn't give up hope and I would also be testing and watching to see if he is going OTJ. Would also question using that Vetsulin after the recall on it.

i am so sorry you guys are going through this. did you find any evidence that he might have had a seizure overnight? wet spot on floor from saliva or urine, or his fur is wet around head/chest? since vet checked the retinas, have to assume this semi-blindness and confusion is obviously from the hypo. often that will clear up, really can't tell you definitively one way or the other, but often it does if cat was not in coma (which yours wasn't). going to have to just give him time to see if he snaps out of this. be careful of stairs, balconies and the like, keeping him in one room is probably best. keep testing just in case the numbers drop down again. maybe sit with him and pet him since he is confused and could use some comfort.

while you are here......is it really important to not only test before every shot but to do spot checks whenever you can since insulin dosing is best done off nadir (the lowest number of a cycle) than pre-shot numbers. say for example the PS number is 350 but if 5 hours later it is 40 then one would know the vetsulin dose is too high, and numbers can bounce back up to 350 by next shot. if you don't catch the low number there in between the PS's then you can be lead to think that your dose is not too high (in fact that is often why it is raised again and again since all that was seen was those 300's when in actuality there was no room to raise dose at all). no one does a curve everyday, but it is recommended to do spot checks everyday since they tell the real story. if you do end up having to give insulin again after this episode has passed then a better plan rather than giving one big shot every few days is to give tiny doses more frequently. talking about doses far under 1 unit, just a drop of insulin and testing often to see what action you get. vetsulin is an insulin that packs a big punch and 3 units is a pretty big dose. also i don't know if you and your vet have heard but there has been manufacturing problems with that insulin and inconsistencies in product. your vet should have been notified to switch clients off of it. http://www.fda.gov/AnimalVeterinary/new ... 188752.htm there is an ISG forum on this board for vetsulin users, good place to get more info.

hope your kitty gets his vision back soon, let us know.
~jojo

We have an emergency facility in town, but I was recently laid off from my job of 17 years and I went from making $60K to $345 a week, so at this point, I have no money. I stocked up on meds and strips before my severance ran out. I have an elderly dog that grew up with this cat who has heart disease. The vet was supposed to call me tonight, but I haven't heard from him yet. I could have left him there overnight, but I had to question whether I would have been able to afford to pay them. He said his temperature and all functions were normal, so as long as his blood sugar stays fine he should be okay. I guess since he knows I check him with a meter I could keep a watch on it. He is at 249 now.

Oh good..I 911'd your post hoping to bring Jess or Jojo ( well known vet techs to the board who have helped countless kitties over the years) to this thread.
If Jojo is saying watch and observe, i would believe her. I will remove the 911 now.

It is really good you are home testing.
Now as to the vetsulin. Is your vet aware it is being advised to not use by the FDA?
I would strongly encourage you to read through the stickies on the vetsulin insulin support group and talk with vet about the possibility of an insulin switch ( should insulin even be needed ) viewforum.php?f=19

I would let the levels stabalize a bit following this event before thinking about any more insulin for the moment though. The numbers will be a bit all over for 2-3 days,but you do not want to make dosing decisions around the higher levels following a hypo. Have a look and see if levels drop 90 minutes or so after eating, evidence the pancreas is working and then think about what a dose ay look like and only above about 200 right now.

I would come back and share this history and get some feedback before going ahead with a dose.

I personally would not want to see anything more than about 0.25- 0.5 right now, and only if levels above about 200 ongoing and rising.

How is he doing now?

Another thought. My kitty is also Hypoer Thyroid and she had an incident like this when she became hyper tensive due to high blood pressure. She became blind and walked into things with a bit of a head tilt.
I am thinking outloud here for others to chime in about, but I am wondering if your kitty is on thyroid meds and when the levels were last checked.
I do not know the answer, but I am wondering aloud what the stress of the hypo may have done to her blood pressure levels and if there is any physiological connection.
I do not wish to underplay what a hypo can cause, but I saw the result of the hypertension in my cat and it does a lot like what you are describing.

A question for your vet for sure.

Nvermind..I see the vet checked the retinas so the hyper T should not be playing of this here or he would have seen it then.
Hope things are looking much brighter in the morning.
Give your kitty some scritches for me.

My vet has told me about the Vetsulin issues. However, I had just purchased some shortly before he told me and I can't afford to buy the other one now since I don't have a job. As soon as I find a job I am going to take my cat in to have the panel done that shows what his levels have been at and then discuss the insulin.

Sorry about your job, this economy has done a lot of damage to a lot of people (and their pets)...

Save your money though on the fructosamine, as it won't tell you how high and low your cat was going. Rather, start doing spot checks as others have suggested. And if symptoms don't subside in the next day or two talk with your vet about what to do next, including phenobarbital, etc. (not a vet tech, just know that sometimes this is used after hypos).

Jen

Happy to report that Tommy is back to normal. I held him last night (he is the only cat that lets me hold him and fall asleep) and then he slept on my nightstand on his blanket I put there for him. He is back to jumping up on the computer desk where I sit and everything else he normally does. He is sleeping alot. Probably recovering from the episode. The vet called and said I should only give him one unit and only if he is over 200. Then I'm going to do a curve on him in about a week at home - taking his BS every two hours.

I'd not wait to do the curve, I don't think you have that luxury right now; instead, I'd do spot checks around +4 to see how low he's going if you do give insulin...

but glad to read he is feeling better!!!!!!!!!!!