Not sure what to do (Updating Henry's health)

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Henry's human

Henry's human

Member Since 2016
Henry is almost due for his morning insulin and I cannot, for the life of me, get close enough to him to get blood. He hasn't let me near him since last night. The last reading I got from him last night was 6.6 (without insulin).
So I didn't know what to do this morning. He has a vet appointment today but it isn't until 3.15pm (it's 7.48am now).
 
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I went to the vet this morning with one of my other cats. The vet (who is Canadian), actually told me off for taking Archie's BSL's. She reckons I don't need to be doing them. I quietly explained that I would have hypo'd him several times if we'd still been on the 3 units bd, that was originally prescribed. She still wasn't thrilled about it. o_Oo_O
 
This is the link to your earlier post today. It is best to just do one post a day and change the title if you need more advice. That way all the information is in one spot for people who may not have seen the earlier post:

http://www.felinediabetes.com/FDMB/threads/need-advice-quick-if-possible.158410/#post-1686304

DEFINITELY good that you did not shoot. With the way Henry's numbers are if you are not able to get a preshot test I wouldn't shoot. It really looks like changing to a wet low carb diet from dry food is having a major effect on the glucose levels.
 
Sonya NZ said:
I went to the vet this morning with one of my other cats. The vet (who is Canadian), actually told me off for taking Archie's BSL's. She reckons I don't need to be doing them. I quietly explained that I would have hypo'd him several times if we'd still been on the 3 units bd, that was originally prescribed. She still wasn't thrilled about it. o_Oo_O
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That is so horrible your vet was being like that :/
one of the vets at the vet surgery I go to actually suggested it to me, so I was thankful for that.
 
Just to clarify. You did not give the evening shot because the BG was at 6.5...that would have been about 12 hours ago. His BG is now 4.4 after no insulin today. IS this correct?

Just want to get the information verified and in one spot :)
 
Also did Henry have any sort of infection around the time he was diagnosed..or was he given any steroids for some other health problem??
 
Tuxedo Mom said:
This is the link to your earlier post today. It is best to just do one post a day and change the title if you need more advice. That way all the information is in one spot for people who may not have seen the earlier post:

http://www.felinediabetes.com/FDMB/threads/need-advice-quick-if-possible.158410/#post-1686304

DEFINITELY good that you did not shoot. With the way Henry's numbers are if you are not able to get a preshot test I wouldn't shoot. It really looks like changing to a wet low carb diet from dry food is having a major effect on the glucose levels.
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Sorry, it is a new day for me. Forgot it was still yesterday for a lot of you :)
 
Tuxedo Mom said:
Also did Henry have any sort of infection around the time he was diagnosed..or was he given any steroids for some other health problem??
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He had vomiting and diarrhoea when he was diagnosed and was quite sick from it. He was still sick until he was given fluids on Tuesday. Since then he's been normal Henry again. He would throw up every time I gave him dry food. He is asthmatic as well so was on a steroid puffer, but I stopped that days ago as he seems completely fine now.. it is quite confusing.
 
Tuxedo Mom said:
Just to clarify. You did not give the evening shot because the BG was at 6.5...that would have been about 12 hours ago. His BG is now 4.4 after no insulin today. IS this correct?

Just want to get the information verified and in one spot :)
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His BG was actually 6.4 last night (8pm on may 26). I didn't give insulin. This morning at 8am (may 27) his BG was 4.4 with no insulin.
 
We are all in different time zones but we figure it out. That is why we use the +1 +2 etc to tell how long it is since a shot was given, since giving the time doesn't mean the same to everyone.


DO NOT GIVE ANY INSULIN.... I know you won't but I just want to spell it out. With the numbers Henry is giving, it would be very unsafe to give any insulin.

Henry's human said:
He had vomiting and diarrhoea when he was diagnosed and was quite sick from it. He was still sick until he was given fluids on Tuesday. Since then he's been normal Henry again. He would throw up every time I gave him dry food. He is asthmatic as well so was on a steroid puffer, but I stopped that days ago as he seems completely fine now.. it is quite confusing.
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If Henry was sick that could have raised glucose levels just from the illness. Also steroids can cause a steroid induced diabetes that often corrects on its own once the steroids are stopped. With Henry being so young and having been on steroids that could be the reason for the diabetes...which could very well be transient. I would certainly discuss that with your vet when you show them the numbers. It looks like Henry's numbers are going back into normal ranges now that you have stopped the puffer
 
I have to leave for awhile but you are fine. You won't give an insulin and you will be seeing the vet later. GREAT job on home testing!!!!

I would do another test in an hour or so just to see how Henry is reacting to no insulin.

If you have any questions I am sure there will be others by soon.
 
Tuxedo Mom said:
We are all in different time zones but we figure it out. That is why we use the +1 +2 etc to tell how long it is since a shot was given, since giving the time doesn't mean the same to everyone.


DO NOT GIVE ANY INSULIN.... I know you won't but I just want to spell it out. With the numbers Henry is giving, it would be very unsafe to give any insulin.




If Henry was sick that could have raised glucose levels just from the illness. Also steroids can cause a steroid induced diabetes that often corrects on its own once the steroids are stopped. With Henry being so young and having been on steroids that could be the reason for the diabetes...which could very well be transient. I would certainly discuss that with your vet when you show them the numbers. It looks like Henry's numbers are going back into normal ranges now that you have stopped the puffer
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Ahh, I didn't know about the 1+ and +2. :)

Yes I am definitely talking to the vet about it. It all seems too crazy to me.
 
Tuxedo Mom said:
I have to leave for awhile but you are fine. You won't give an insulin and you will be seeing the vet later. GREAT job on home testing!!!!

I would do another test in an hour or so just to see how Henry is reacting to no insulin.

If you have any questions I am sure there will be others by soon.
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Thank you for all your advice. I appreciate it. This forum is really great!
 
Critter Mom said:
Be sure to let us know how things go at the vets.


Mogs
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I shall. I tried to update this post but not sure it worked (no idea what I am doing hehe)
Henry's been without insulin for 16 & 1/2 hours and his latest bg was 7.3
I'm not sure what that means but I'm still glad I didn't give him insulin this morning :)
 
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And I have to add that Henry just went to the litter and produced the biggest, firmest poop I have seen him ever produce (I know, gross, but poop matters!) He's been on dry food all his life (when I rescued him that is what he was eating) and I now really believe his tummy can't tolerate it at all. So I am glad I've changed his food. :) feeling very happy for my boy.
 
OK....he's creeping up, but that's only 131 in US terms (just multiply your number by 18 to get US numbers) so he's still below where we'd give insulin for now.

You might try feeding him (low carb canned of course) and then testing again at about +3 (3 hours after food)....if the number comes down, his pancreas is working!!
 
Chris & China said:
OK....he's creeping up, but that's only 131 in US terms (just multiply your number by 18 to get US numbers) so he's still below where we'd give insulin for now.

You might try feeding him (low carb canned of course) and then testing again at about +3 (3 hours after food)....if the number comes down, his pancreas is working!!
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Well he has eaten (only wet food now) and I am taking him to the vet in one hour, so Dr Paul can take his blood and test it. Fingers crossed it is down.
 
Well just the trip to the vet can raise the blood glucose number quite a bit....that's one of the reasons we do all the testing at home

If their numbers are higher at the vet, vets tend to increase the dose (or have you give insulin when it might not be needed in Henry's case) and then when you get home and the stress is gone, they go a lot lower

With him recovering from an infection, you stopping the inhaled steroids and him going onto low carb food, that may be enough....for a few very lucky cats, it can be!
 
Chris & China said:
Well just the trip to the vet can raise the blood glucose number quite a bit....that's one of the reasons we do all the testing at home

If their numbers are higher at the vet, vets tend to increase the dose (or have you give insulin when it might not be needed in Henry's case) and then when you get home and the stress is gone, they go a lot lower

With him recovering from an infection, you stopping the inhaled steroids and him going onto low carb food, that may be enough....for a few very lucky cats, it can be!
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I mainly wanted the vet to do it because I feel like such a meanie for doing it. But I will do a quick test just before we leave for the vet then just to make sure he's going ok. I will take my list with me to the vet to show him all the readings.
 
We all feel like that at the beginning....What most cats aren't happy with is that we're fooling with their ears, not the actual poking, but with the right "reward", most of them will actually come when it's time to test!!

China's Achilles Heel was baked chicken...she'd come anytime I touched the testing materials and jump right up on her "testing spot" and wait for me!
 
That could be a food spike....we expect the number to go up a little after food...then, if the pancreas is working, it starts to release insulin in response to the influx of carbs from the food

That's why we suggest waiting for about 3 hours after food...that's 156 so only about 20 points higher

It will really help if you'll start to keep track of your numbers on our spreadsheet...It's one of our most valuable tools and people will want to see it before giving much in the way of advice if Henry ends up needing to continue with the insulin

Here are the Instructions on getting the FDMB spreadsheet ...All you need is a Google account. Since you're in Australia, you'd use the World version...that way you just enter the numbers like you get them and it automatically converts them to US numbers for those of us in the states that are used to seeing them in "our" numbers
 
Chris & China said:
That could be a food spike....we expect the number to go up a little after food...then, if the pancreas is working, it starts to release insulin in response to the influx of carbs from the food

That's why we suggest waiting for about 3 hours after food...that's 156 so only about 20 points higher

It will really help if you'll start to keep track of your numbers on our spreadsheet...It's one of our most valuable tools and people will want to see it before giving much in the way of advice if Henry ends up needing to continue with the insulin

Here are the Instructions on getting the FDMB spreadsheet ...All you need is a Google account. Since you're in Australia, you'd use the World version...that way you just enter the numbers like you get them and it automatically converts them to US numbers for those of us in the states that are used to seeing them in "our" numbers
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Sorry, I will do the spreadsheet tonight when I'm on my laptop. I don't even want to attempt it on my phone hehe.
 
Update after vet visit:

Dr Paul was so happy I was doing the home testing. He was so shocked at how well Henry is doing. He has gained 200 grams and he said he is not too worried about his glucose level. He told me that if he is under 12, not to give insulin. If he's over 15 to give half a unit once a day. If it gets higher, give half a unit twice a day.

I was really impressed with the vet and how he reacted to everything. I've heard so many horror stories about vets, so I really am lucky I have a good one.

The only thing that annoyed me was he was telling me Henry has to be on the diabetic food - which only comes in dry. I told him Henry vomits when he has dry food and he told me to wet the food. :/

He also said perhaps Henry has low grade pancreatitis but he said that is really hard to diagnose.
 
Henry's human said:
The only thing that annoyed me was he was telling me Henry has to be on the diabetic food - which only comes in dry. I told him Henry vomits when he has dry food and he told me to wet the food. :/
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Sometimes all you can do is nod your head, smile and say "I'll have to think about that for now" and stand your ground

He is wrong about a few things though...Lantus only lasts about 12 hours in cats, so we look for a dose that's safe to give twice a day (even if that means tiny doses like .1 and .25)

12 is also too high...that's 216 for us...The key to possible remission is getting them into normal numbers (50-120 on a human meter..2.8 to 6.7 on your scale) as soon and as safely as possible so the pancreas can heal. Most vets are like yours though...they don't think people will home test and they'd rather they run too high than too low. Their goal isn't usually remission, just safe control.

Depending on the cat, anything over about 150 (8.3) is above renal threshold, so is continuing to do slow damage to the kidneys. Kidney failure is one of the #1 complications that comes with diabetes....and can be the reason we lose them earlier than we have to.
 
Chris & China said:
Sometimes all you can do is nod your head, smile and say "I'll have to think about that for now" and stand your ground

He is wrong about a few things though...Lantus only lasts about 12 hours in cats, so we look for a dose that's safe to give twice a day (even if that means tiny doses like .1 and .25)

12 is also too high...that's 216 for us...The key to possible remission is getting them into normal numbers (50-120 on a human meter..2.8 to 6.7 on your scale) as soon and as safely as possible so the pancreas can heal. Most vets are like yours though...they don't think people will home test and they'd rather they run too high than too low. Their goal isn't usually remission, just safe control.

Depending on the cat, anything over about 150 (8.3) is above renal threshold, so is continuing to do slow damage to the kidneys. Kidney failure is one of the #1 complications that comes with diabetes....and can be the reason we lose them earlier than we have to.
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I thought 12 was high too. But I didn't say anything because I am quite new to it all and don't know what's high and what isn't.

He does talk a lot about remission and he wants Henry to get into remission.

So do you think if he's 8.3 at his insulin time I should give him the half a unit?
 
OK...some of our European members and the Australia ladies may be around then, so if you need some help, edit your subject line to something like "PMPS ###, New to Lantus...Need advice please!" and hopefully some of the members will be around to help guide you then and get your evening off to a good start.

I don't know if @Tricia Cinco(GA) & Harvey will still be on that late or not...sometimes she's here really late though.

Good luck...I have to get off here for tonight ..it's after 2am and I have to be our early in the morning. I'll look in on you tomorrow
 
Chris & China said:
OK...some of our European members and the Australia ladies may be around then, so if you need some help, edit your subject line to something like "PMPS ###, New to Lantus...Need advice please!" and hopefully some of the members will be around to help guide you then and get your evening off to a good start.

I don't know if @Tricia Cinco(GA) & Harvey will still be on that late or not...sometimes she's here really late though.

Good luck...I have to get off here for tonight ..it's after 2am and I have to be our early in the morning. I'll look in on you tomorrow
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I am not sure how to edit the subject line. I tried earlier but failed.
Thank you though. I appreciate all the advice. So does Henry :)
 
Hi Emily.

Welcome to Lantus & Levemir Land - the nicest place you never wanted to be. If you're on your PC or tablet now, you should be able to edit your subject line by going up to your first post. In the upper right hand corner you'll see the words "Thread Tools". If you put your cursor over it, you'll see "edit title'. Click on that and you'll be able to make any changes you need to the subject line.
 
To edit the subject line go to the first post in your thread. Right below the title to the right there's a little drop down that says thread tools. Click that and then edit title. A black box pops up. On my phone I can barely see the corner of it to the right upper but if I pull it down it centers itself. You can edit it there. There may be an easier way but it works.
 
I feel like crying. Henry's latest bg was 15.8 I was so shocked. I don't know if it was because he was extremely upset when I was trying to get the blood (I had to fight him to stay still). I don't know. I feel bad.
Anyway I gave him the half unit of insulin.
 
Henry's human said:
I feel like crying. Henry's latest bg was 15.8 I was so shocked. I don't know if it was because he was extremely upset when I was trying to get the blood (I had to fight him to stay still). I don't know. I feel bad.
Anyway I gave him the half unit of insulin.
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It may well be that the stress of being tested caused a rise in BG, yes - or at least, stress could be partly the reason he's gone higher. But it could also mean that the insulin in his system has been "used up" so it looks as if a dose is now in order. (Go by what the other members have suggested above, I don't give dosing advice).
Try not to feel bad - all these ups and downs are normal while you are working out a pattern for how Henry's system copes with insulin given. Some days will be better/easier than others, but you will get there in the end.
Diana
 
Hi Emily,
Henry could also be bouncing after his AMPS of 4.4 this morning. That is his body's reactions to the low preshot when his liver releases hormones to "save himself". A lot of cats bounce.
I would test at +4 and that will give you an indication if he is bouncing or going to respond to the insulin. There is nothing you can do about bouncing except wait it out. It can last up to 6 cycles...3 days.
I will keep an eye out for your next BSL.
 
Bron and Sheba said:
Hi Emily,
Henry could also be bouncing after his AMPS of 4.4 this morning. That is his body's reactions to the low preshot when his liver releases hormones to "save himself". A lot of cats bounce.
I would test at +4 and that will give you an indication if he is bouncing or going to respond to the insulin. There is nothing you can do about bouncing except wait it out. It can last up to 6 cycles...3 days.
I will keep an eye out for your next BSL.
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By +4 do you mean 4 hours after I gave the insulin? (Sorry I am still learning all the terms used hehe)
 
Henry's human said:
By +4 do you mean 4 hours after I gave the insulin? (Sorry I am still learning all the terms used hehe)
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Yes +4 means 4 hours after the insulin shot. Since we are all in different time zones time is all related to shot times...+1 one hour after shot +2 2 hours after shot etc. AMPS means morning glucose test before shot PMPS means evening glucose test before shot. a cycle is the time between shots which would be 12 hours. You'll get all the lingo pretty soon.

If you have trouble setting up your spreadsheet just ask and there are a couple of "spreadsheet gurus" that can help you out, Now that you are back to giving insulin shots having a spreadsheet will be VERY useful to help with making dose decisions and to watch that Henry stays in safe numbers.
 
Henry's human said:
He also said perhaps Henry has low grade pancreatitis but he said that is really hard to diagnose.
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There are two IDEXX tests for pancreatitis; SNAP fPL (some vets offer this as an in-house test) and Spec fPL (has to be sent out to a lab). Here are two helpful links (learn the signs of nausea from the second one and watch for Henry crouching in an 'uncomfy meatloaf' position or possibly seeking out cooler floor surfaces after eating.

IDEXX pancreatitis treatment guidelines

Nausea symptoms and treatments

Cholesterol markers in blood tests may be raised in pancreatitis kitties, and sometimes markers for the thyroid are off (sometimes just under lower end of reference range - research Euthyroid Sick Syndrome).


Mogs
.
 
Critter Mom said:
There are two IDEXX tests for pancreatitis; SNAP fPL (some vets offer this as an in-house test) and Spec fPL (has to be sent out to a lab). Here are two helpful links (learn the signs of nausea from the second one and watch for Henry crouching in an 'uncomfy meatloaf' position or possibly seeking out cooler floor surfaces after eating.

IDEXX pancreatitis treatment guidelines

Nausea symptoms and treatments

Cholesterol markers in blood tests may be raised in pancreatitis kitties, and sometimes markers for the thyroid are off (sometimes just under lower end of reference range - research Euthyroid Sick Syndrome).


Mogs
.
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Henry actually stopped vomiting when I stopped giving him the dry food. (both the science diet indoor and the prescription one for diabetes). The vet told me the only reason he's vomiting is he is eating too fast. That simply is not true. (The vet was trying to tell me he was just regurgitating which annoyed me as he doesn't live with me and hadn't seen said vomit).
 
Henry's human said:
Henry actually stopped vomiting when I stopped giving him the dry food. (both the science diet indoor and the prescription one for diabetes). The vet told me the only reason he's vomiting is he is eating too fast. That simply is not true. (The vet was trying to tell me he was just regurgitating which annoyed me as he doesn't live with me and hadn't seen said vomit).
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If Henry stopped vomiting once you stopped dry food then the dry food looks like it is the problem. You would know best since you are the one who is there with Henry all the time. If Henry is eating the low carb wet food with no problem and not throwing up then I would not worry about pancreatitis at this time.
 
Henry's human said:
Henry actually stopped vomiting when I stopped giving him the dry food. (both the science diet indoor and the prescription one for diabetes). The vet told me the only reason he's vomiting is he is eating too fast. That simply is not true. (The vet was trying to tell me he was just regurgitating which annoyed me as he doesn't live with me and hadn't seen said vomit).
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Keep a note of the ingredient lists in the problem foods for future reference (in case any of the ingredients are irritating to Henry).


Mogs
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Henry is doing really well. He is happy and playing hard a lot of the time. He is wanting cuddles (by cuddles I mean pats - that is his cuddles hehe).
I am really happy with him. :)
 
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