Getting worse, not better

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MClarke087

MClarke087

Member Since 2016
Dennis seems to be getting worse this weekend and I have no money left to bring him to the vet.... In fact I'm still scraping money together to pay off the vet and my relatives for his ER visit a few months ago for DKA. I even had to pick up a second job which will mean Ill have to leave school and I'm only going to sleep a couple hours every night.

Anyways, yesterday he lounged around and looked "out of it"....disconnected. Today he looks the same but he doesn't want to eat which is NOT like him. He will typically eat anything and everything.

Some other thoughts:

-he's been peeing outside the box for weeks
-he's drinking water more than ever (he will drink for 5-10 minutes straight until I make him take a break)
- he was in novolin and regulated but became unregulated
- switched to Vetsulin and is not regulated. In fact his BG barely drops more than a few points (he's almost always over 600)
-no ketones as of 2 days ago (the vet said he won't get them simply because insulin is entering his system, regardless of if its controlling the diabetes)


Im wondering if anyone can think of what's going on here? I have no money left- it's not like I have the money but don't want to spend it. I'm truly all out and I have a bad feeling about him.... I don't think this is going to turn out well.
 
I posted on your other thread, please can you give a timeline of what has been going on, when dose increases took place, on what basis and what tests he had done at the vet.

Also check out the links on this post http://www.felinediabetes.com/FDMB/threads/financial-help-links.131190/

This is guidance for vets from the manufacturers - please look at page 3 and tell us what shaped curves you were getting and if they have changed. 6 units is a big dose in the absence of other health conditions and you may have skipped over the optimal dose and be looking at the effect of too high a dose. http://www.vetsulin.com/PDF/Glucose-Curve-Interpretation.pdf
 
Alexi said:
I posted on your other thread, please can you give a timeline of what has been going on, when dose increases took place, on what basis and what tests he had done at the vet.

Also check out the links on this post http://www.felinediabetes.com/FDMB/threads/financial-help-links.131190/

This is guidance for vets from the manufacturers - please look at page 3 and tell us what shaped curves you were getting and if they have changed. 6 units is a big dose in the absence of other health conditions and you may have skipped over the optimal dose and be looking at the effect of too high a dose. http://www.vetsulin.com/PDF/Glucose-Curve-Interpretation.pdf
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Thank you I'll start reading that material now. I left some more info on his numbers on the other post.
So if I missed his optimal dose, and I'm giving him too much insulin, wouldn't that make his BG too low? Why would it still be so high?
Alexi said:
I posted on your other thread, please can you give a timeline of what has been going on, when dose increases took place, on what basis and what tests he had done at the vet.

Also check out the links on this post http://www.felinediabetes.com/FDMB/threads/financial-help-links.131190/

This is guidance for vets from the manufacturers - please look at page 3 and tell us what shaped curves you were getting and if they have changed. 6 units is a big dose in the absence of other health conditions and you may have skipped over the optimal dose and be looking at the effect of too high a dose. http://www.vetsulin.com/PDF/Glucose-Curve-Interpretation.pdf
Click to expand...

He definitely mirrors the insulin resistance chart. The vet had told me that might be his issue but has only told me to increase the dose....

If he's insulin resistance is this the end of the road for him?
 
ok - has he ever mirrored one of the other charts since he started vetsulin? If so, what dose was he on at that time? Are you checking for ketones? With a history of DKA he is at risk for ketones. I am worried about the advice your vet is giving you. Whereabouts are you located?
 
I myself would increase dose to 8 units and then immediately do a curve. Because of the previous DKA I would not try the other option of reducing dose. The curve posted in the other topic did show some reduction with 6 units.

Also, if you run out of Vetsulin I would go back to the Novolin N as an interim solution.
 
Alexi said:
ok - has he ever mirrored one of the other charts since he started vetsulin? If so, what dose was he on at that time? Are you checking for ketones? With a history of DKA he is at risk for ketones. I am worried about the advice your vet is giving you. Whereabouts are you located?
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I'm testing for ketones, and the test is negative but I'm nervous. Is it true that he won't get them simply because he's receiving insulin?
He mirrored the "Ideal" chart (first row, top right) when he was on 1 unit 2x a day of Novolin. But he's only mirrored the resistance chart since then. The vet said he had signs of remission. Then his numbers just started to climb.

I'm in Rhode Island.
 
Good you are monitoring for ketones - keep testing while he is in high numbers. Ketones can appear even with insulin on board. With the urinary issues and the high glucose I think he should be checked for UTI - was this done when the levels started to climb?

Can you set up a signature and a spreadsheet so we don't keep asking the same questions over and over. It will make it easier to help. If you have problems setting up a spreadsheet someone can help you with it.

To get back to the issues today - how much has he eaten? Has he pooped ok? Does he appear to be in pain or bloated?
 
Alexi said:
Good you are monitoring for ketones - keep testing while he is in high numbers. Ketones can appear even with insulin on board. With the urinary issues and the high glucose I think he should be checked for UTI - was this done when the levels started to climb?

Can you set up a signature and a spreadsheet so we don't keep asking the same questions over and over. It will make it easier to help. If you have problems setting up a spreadsheet someone can help you with it.

To get back to the issues today - how much has he eaten? Has he pooped ok? Does he appear to be in pain or bloated?
Click to expand...

Excellent idea on the signature. I'm still learning how everything works here. I'm using my phone now, but I'll switch to my computer and add the signature and I'll try again to understand the charts you use.

Now that you mention it yes, I believe he had some kind of antibiotic injected into him at the vet about 3 weeks ago. I think he had a slight infection (probably a UTI). The issue is that I can't afford another vet visit. I don't know what to do....

Today he had about 1/3 of his meal. A combo of wet and dry D/M. He doesn't not appear to be in pain, but I personally think he looks a little bloated. I believe he is pooping but I do have another cat so it could be her. I'm trying to separate them for the day but that's difficult to do.
 
ok - can you keep monitoring his glucose today? Any chance you can switch him to just the wet DM? The dry is high carb so anything you can do to help bring his numbers down would help, for the longer term - considering the budget issues, you could give him a standard low carb commercial cat food, I am not in the US so not able to help you with that but other members will be able to.

So we may have a UTI on board, another common problem is pancreatitis which can cause loss of appetite and bloating - or he could just be a bit constipated to account for the bloating. Can you observe him closely today and see if he will eat a bit more.
 
Alexi said:
ok - can you keep monitoring his glucose today? Any chance you can switch him to just the wet DM? The dry is high carb so anything you can do to help bring his numbers down would help, for the longer term - considering the budget issues, you could give him a standard low carb commercial cat food, I am not in the US so not able to help you with that but other members will be able to.

So we may have a UTI on board, another common problem is pancreatitis which can cause loss of appetite and bloating - or he could just be a bit constipated to account for the bloating. Can you observe him closely today and see if he will eat a bit more.
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I would love to understand how to get him on a low carb commercial food. I'm nervous to do it without understanding it better so I'll have to ask around on the boards.
Yes, I'll be home with him all day. We are doing an at home curve on him today. I really appreciate your help. I feel so hopeless lately.
 
That's the great thing about this board - there is a wealth of experience here. I transitioned Cappuccino the other way around, she was on a commercial wet cat food but switched to DM to help with some other health issues, I did the transition over a week gradually adding more of the new food to the old at each meal until she was just on the new food and I monitor her weight weekly to check I am giving enough. I have a multi-cat household so now have a strict 12 hourly feeding regime as one of the others is a kibble addict and refuses wet food, I also have to feed Cappuccino in another room as she will eat anything she can find. Other people find the easiest thing is to feed all cats the same food and to feed more smaller meals. What works for one person does not necessarily work for another but consistency with feeding is the key.

I am also around today as I am dealing with a different issue with numbers, but being in a different time zone entirely may not be around after his evening shot. Others will be though so come back with todays numbers and any other questions you have in the meantime.
 
MClarke087 said:
I would love to understand how to get him on a low carb commercial food. I'm nervous to do it without understanding it better so I'll have to ask around on the boards.
Yes, I'll be home with him all day. We are doing an at home curve on him today. I really appreciate your help. I feel so hopeless lately.
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Fancy feast pate is what most people here use. The wet prescription pate DM is also low carb. They must be pate or classic.

The dry food can bloat them. If your home testing you can wean him off the dry but ONLY if home testing. It can drop levels to quickly.
 
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My Callie's numbers shot up when she got a UTI. When we got that cured, her numbers came down and we are able to decrease her dose.

There was a discussion a few days about food. I remember reading that there are a few kinds of 9 Lives cat food that are low carb. With any cat food, read the ingredients. You don't want to feed him anything with corn ,wheat or rice. Also watch out for fruit or vegetables like potatoes. I think that the 9 lives is quite inexpensive compared with the prescription cat food. I hope and pray e everything goes well.
 
Alexi said:
Just wondering how you and Dennis are doing today?
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Thank you for checking in. He's looking better, and acting more like himself! I gave him some Laxatone to relieve any constipation, and it helped.

I think the D/M is part of his problem! I fed him a small amount of D/M last night combined with a bunch of boiled chicken and his BG came down to the 400's for the first time in weeks. I'm now looking into alternative diets for him. I'd like to get him off the D/M to see if that helps. I'm not sure how to pick a commercial brand that won't make his problem worse so I created a new post in which I've asked for advice from those that have done this before. The labels on pet food are difficult to understand.
 
That's really good to hear! Have you looked at setting up a spreadsheet yet? If you have any difficulty there are people that can help with that and we can look at Dennis's numbers and help you get back on track.
 
Alexi said:
That's really good to hear! Have you looked at setting up a spreadsheet yet? If you have any difficulty there are people that can help with that and we can look at Dennis's numbers and help you get back on track.
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Thank you! I haven't had much time between work and school, but it's on my to-do list. I really want to understand how to make the chart! Thank you for being so helpful :) :)
 
Can anyone speak to the effectiveness of switching from Vetsulin to Prozinc? We have gone through one vile of Vetsulin and we have not seen results (6u 2x day). The vet said we can switch to Prozinc if I want to try that.
I would hate to buy another vile of Vetsulin just to switch to Prozinc before we use up the Vetsulin.....But I'm also not sure if Prozinc is a common/useful insulin.....
 
MClarke087 said:
Can anyone speak to the effectiveness of switching from Vetsulin to Prozinc? We have gone through one vile of Vetsulin and we have not seen results (6u 2x day). The vet said we can switch to Prozinc if I want to try that.
I would hate to buy another vile of Vetsulin just to switch to Prozinc before we use up the Vetsulin.....But I'm also not sure if Prozinc is a common/useful insulin.....
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Lots of people here use Prozinc. I can't print out a link, but someone will send you to the Prozinc discussion soon.
 
Do you have the numbers from your curve? How is Dennis doing apart from the numbers?
 
Okay I've done the spreadsheet and I'm hoping it'll work when I paste the link here.
**Please note: when I put in "600" for his BG it is actually over 600, but our meter only says "HI" when the BG is over 600, so I don't know what the actual BG is.

I want to mention he was very well regulated on Novolin after DKA. He was on 1u 2x a day and his BG before his insulin would be in the 150-300 range. However his BG kept rising, as did his dose. We made it unto 3 u 2x a day before the vet suggested we switch to Vetsulin (you can see the switch happen in the first couple days on the spreadsheet). We started at 3u of Vetsulin and now we are up to 6 u 2x a day. He's almost always over 600 pre shot....
He has been on Vetsulin for a month and he is almost out of insulin. I'm contemplating switching to Prozinc but I'm not sure what the best decision is. I hope the spreadsheet link works, and that the info is helpful.


https://docs.google.com/spreadsheets/d/1YDR4LG98YPXtukGLkQNzZU7Lo6NsUBEXZST2o9u_N24/pubhtml
 
The SS link works! You say that Dennis was regulated before, do you have any numbers from that time? Usually when they fall out of remission suddenly, there's an infection somewhere. Your vet gave an antibiotic shot, but have you followed up to see if the infection has cleared? If it is still present, a change in insulin will not help. If the infection has cleared, then definitely consider a switch to ProZinc, Lantus or Levemir.
 
Sharon14 said:
The SS link works! You say that Dennis was regulated before, do you have any numbers from that time? Usually when they fall out of remission suddenly, there's an infection somewhere. Your vet gave an antibiotic shot, but have you followed up to see if the infection has cleared? If it is still present, a change in insulin will not help. If the infection has cleared, then definitely consider a switch to ProZinc, Lantus or Levemir.
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No, I have not been back since his antibiotics were administered.... I don't have any money left :( I still owe the vet about $300 but I'll ask about bringing him back and making a payment plan.
I can post the numbers from when he was regulated on Novolin. Should I do that on the same spreadsheet? If so, I can do it in the morning (it's 11pm here).
 
Seeing some numbers from when he was regulated might help. I don't know how much data you have, but maybe show the last few weeks before he fell out of regulation and any data since then. There's also a tab on the SS for any labs Dennis may have had.
 
I agree and can you also indicate when the UTI was diagnosed? My cat was not doing so well until she had a UTI diagnosed and treated, she ended up with 2 weeks of antibiotic after urine was taken direct from her bladder and cultured to make sure she got the right antibiotic, she then had to have the same again to check it had cleared. My gut feeling it is another health issue pushing up his levels, hopefully one which is straightforwards to treat. Maybe check out the financial help link to see if you are eligible for some support with the vet costs?
 
Thanks everyone. I've started feeding Dennis boiled chicken breast with a small amount of his D/M mixed in because I had a feeling the food was making his BG rise. So far, he has been on this diet for about a week and his BG is coming down!! Instead of being over 600 before insulin he is between 400-500. Two nights ago, he went as low at 176 at the 7 hour mark! His numbers are still irregular, and I think that you are right that he may have another issue going on....but for now, this is a step in the right direction.

I know that I have to better understand what nutrients he will need since I'd like to keep him on this boiled chicken diet so I'm looking into supplements. Other than that, has anyone experienced any issues with putting their cat on a similar diet: litter box problems, lacking nutrition, negative side effects? I want to stay away from the raw food diet- that just won't work for us.
 
Yay and a big cheer for Dennis! :)
Glad to hear he is turning the corner. I can't help with the food issue, my understanding is he may need some supplements but there are people on the board who can advise on what is needed. I am not seeing the up to date numbers on the spreadsheet but he may earn a dose reduction soon at this rate.
 
Glad Dennis is improving. I make my homemade raw food for Fritz.
There are two really good places to buy pre made supplements.
If your going to feed without bone (raw) never cooked bones, I buy from Food Fur Life EZ Complete Fur Cats for raw or cooked meat. www.foodfurlife.com 866- 543- 8754
If your going to feed raw food with bones I buy from knowwhatyoufeed.com Alnturin for meat with bone.
You can also buy the ingredients and make your own. Lisa Piereson has a great recipe I use to make Fritz food from her recipes.
I saw your post about the raw not working for you. You can use the EZ Complete Fur for cats for cooked meat:cat:
Cats on raw food don't have smelly poop.
It's important that our kitties get probiotics I give Fritz Ultimate Flora Probiotic 25 Billion Live Per Capsule.
With Fritz I rotate his proteins he eats Rabbit, Vension, Chicken, Quail, Soon to add Buffalo , Lamb and Kangroo.
Hope this info helps!:)
 
Nice job on treating Dennis. It can be very challenging. Food is a crucial component to treatment.

If your money is tight, you may consider Lantus instead of Prozinc (PZI). I just did a quick cost comparison, as I recently switched from Lantus to PZI. Following assumes a high 10u dose per shot.
$260 Lantus 10ml vial = ~2.5 months worth = ~$100/month
$130 PZI vial = 1 month exactly = $130/month

Note that Leo uses very high doses (10u). I see Dennis is on 6u right now, but you may have to increase that dose to get the numbers down. Keep up the great work with Dennis. I can see you really care about him.
 
JeffJ said:
If your money is tight, you may consider Lantus instead of Prozinc (PZI). I just did a quick cost comparison, as I recently switched from Lantus to PZI. Following assumes a high 10u dose per shot.
$260 Lantus 10ml vial = ~2.5 months worth = ~$100/month
$130 PZI vial = 1 month exactly = $130/month
Click to expand...

And if you buy your Lantus from Canada, you're looking to save even more

$149.99 for 5 Lantus pens (1500 units) or $99.99 for a vial (1000 units)...plus $25 shipping

Using the 10 unit dose (a huge dose) that breaks down to $30/month for the pens, $40 for the vial
 
DebG said:
Glad Dennis is improving. I make my homemade raw food for Fritz.
There are two really good places to buy pre made supplements.
If your going to feed without bone (raw) never cooked bones, I buy from Food Fur Life EZ Complete Fur Cats for raw or cooked meat. www.foodfurlife.com 866- 543- 8754
If your going to feed raw food with bones I buy from knowwhatyoufeed.com Alnturin for meat with bone.
You can also buy the ingredients and make your own. Lisa Piereson has a great recipe I use to make Fritz food from her recipes.
I saw your post about the raw not working for you. You can use the EZ Complete Fur for cats for cooked meat:cat:
Cats on raw food don't have smelly poop.
It's important that our kitties get probiotics I give Fritz Ultimate Flora Probiotic 25 Billion Live Per Capsule.
With Fritz I rotate his proteins he eats Rabbit, Vension, Chicken, Quail, Soon to add Buffalo , Lamb and Kangroo.
Hope this info helps!:)
Click to expand...
Thank you, that's really helpful!
 
JeffJ said:
Nice job on treating Dennis. It can be very challenging. Food is a crucial component to treatment.

If your money is tight, you may consider Lantus instead of Prozinc (PZI). I just did a quick cost comparison, as I recently switched from Lantus to PZI. Following assumes a high 10u dose per shot.
$260 Lantus 10ml vial = ~2.5 months worth = ~$100/month
$130 PZI vial = 1 month exactly = $130/month

Note that Leo uses very high doses (10u). I see Dennis is on 6u right now, but you may have to increase that dose to get the numbers down. Keep up the great work with Dennis. I can see you really care about him.
Click to expand...

One of my kitties is at 6.0 units per shot. I started with Lantus and as the dose went up he started flinching more.Once I changed to Levemir he had no more problems. Some higher dose kitties find the Lantus can have more of a sting, but every cat responds differently. Levemir can also be ordered from Mark's Marine Pharmacy.
 
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