? Dehydration and Insulin

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For Jack

For Jack

Member Since 2014
Hello everyone. I posted on the FB group earlier today to mention that my sugar boy is at the emergency vet where he's been diagnosed as having kidney failure. He is still there right now. I just called a little while ago because he would have been due for his PM shot. His glucose this morning was over 600 and it is now down to 352 (which the vet considers a good range...). Anyway, they had not given his shot and when I asked why they said it was because he was dehydrated and that giving him his shot could cause his numbers to plummet. I asked if this was true for a longer lasting insulin like Lantus and I was told yes. Is this accurate? I don't fully trust them and if not for the fact that my car is in the shop I would have gone to a different emergency vet this morning.

This is the emergency vet where Jack was first diagnosed about 3 years ago now. They put him on vetsulin and tried to sell me on the prescription food (which they were adamant he needed to have). They had actually tried Lantus on him back then but to quote them, it "worked too well" on him.

I don't think they are used to a pet parent asking so many questions and wanting so much info.
 
Hi there, sorry Jack had to go to the ER. Some cats, but not all, have their blood sugar go down with subs fluids. Will they monitor his blood sugar? Given that he can see greens on this dose, I might be conservative, maybe a reduced dose. That 352 they quoted you might be on a pet meter, which would make it a little lower in the human meter.
 
For Jack said:
His glucose this morning was over 600 and it is now down to 352 (which the vet considers a good range...)
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Really? That's a good range? For what? Further kidney damage? Sounds like your vet isn't very familiar with Lantus, and therefore not comfortable with how it works. Once the numbers get above 300, the difference between a human and a pet meter is huge, so it's hard to say what you would have gotten.

I think it's an ECID thing with fluids and BGs. I've seen several people here say it brought the numbers down, and others say not. Of course, since Jack was dehydrated, that makes sense because his numbers probably would be higher, and as the fluids got in his system, it would bring him down. I don't know if they would "plummet", though. Fortunately, I haven't had to give fluids to my diabetic cats, so I can't speak from experience on that.

I'm sorry Jack is having this issue. We're sending our best healing vines his way.
 
They have been checking his glucose every 2 hours. 352 was the most recent number. The person I spoke to made it seem it was the dehydration and not the fluids that would cause a "plummet". In my mind it just didn't make sense especially since he did get his insulin this morning and was then at the vet and on fluids about 2 hours later. I feel like if there would have been a "plummet" it would have occurred this morning as well. Maybe it just wasn't explained very well to me.
 
Tricia Cinco(GA) & Harvey said:
Really? That's a good range? For what? Further kidney damage? Sounds like your vet isn't very familiar with Lantus, and therefore not comfortable with how it works. Once the numbers get above 300, the difference between a human and a pet meter is huge, so it's hard to say what you would have gotten.
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Yeah, I don't consider that to be a good range either lol so the first bells started going off in my mind when she said that. This Message Board has gotten me to be really comfortable with numbers on a human meter lower than 100. That was the issue with when he was first diagnosed and they tried him on Lantus. I think it took half a unit for him to get into the 100s and stay there. I wish I had been more knowledgeable about Lantus at that time and how it works because I would have requested he stay on that instead of being switched to Vetsulin which never regulated him.
 
I have once had Neko come down, but not plummet, after fluids, when they were given in the same general area as her shot. And it was a couple hours after her shot, so yes, I think you would have seen numbers come down today if they were going to. I have seen some people give the shot in a different location if they were doing fluids in the scruff.
 
No help with your questions. Polly has had fluids with her p'titis episodes, but it's hard to say if the fluids or her lack of appetite moved her numbers down.

I can, though, send lots of vines to your boy. They're on the way.

Marilyn and Polly
 
pollydoodle said:
No help with your questions. Polly has had fluids with her p'titis episodes, but it's hard to say if the fluids or her lack of appetite moved her numbers down.

I can, though, send lots of vines to your boy. They're on the way.

Marilyn and Polly
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Did her numbers move down drastically or was it a gradual decline? Did it ever go too low?
 
I never noticed a difference in BG with Rover. I tried my best to stagger the Lantus injection and the subq fluids by a couple of hours. Sometimes, though, they were given back-to-back. I stared at his spreadsheet often enough. Nothing stuck out. But as per: ECID.

Hoping the subq fluids help Jack.
 
Red & Rover (GA) said:
I never noticed a difference in BG with Rover. I tried my best to stagger the Lantus injection and the subq fluids by a couple of hours. Sometimes, though, they were given back-to-back. I stared at his spreadsheet often enough. Nothing stuck out. But as per: ECID.

Hoping the subq fluids help Jack.
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Thank you :)

They seem to be helping. When I called they said he was doing well.

At this point I'm just trying to decide if I should transfer him to his primary care vet. They have a well equipped office with an in house lab. I'll be calling them tomorrow morning as soon as they open. Plus, it'll probably be significantly less expensive.
 
For Jack said:
Thank you :)

They seem to be helping. When I called they said he was doing well.

At this point I'm just trying to decide if I should transfer him to his primary care vet. They have a well equipped office with an in house lab. I'll be calling them tomorrow morning as soon as they open. Plus, it'll probably be significantly less expensive.
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Yes, probably you should. But right now, your big question might be whether or not his kidneys are in bad shape because of an infection, in which case they'll recover, or if he has Chronic Kidney Disease. As to transferring him, well, if he simply has to go back tonight to the emergency vet, I don't know. Has your primary vet got overnight care and someone to monitor Jack while he is there overnight?

My vet , at one point, found the 300s acceptable - that was on a pet meter. The thing is kidney failure kills, and they clearly are being cautious, because the last thing Jack needs now is kidney failure and a hypo. They don't sound great, but then I don't trust many emergency room vets. A lot of them are working nights for extra money, after being up all day during their regular vet job.

They have him on iv fluids, they are monitoring his BG, and they are saving his life. They don't sound like the greatest, but neither do they sound terrible.

I'm sending you and Jack some healing energy. Or vines.
 
ECID for sure, but my Trixie is one of those cats whose BGs plummets when she got fluids while on insulin (she's OTJ now). The only thing that prevented the drop was separating her shot and fluids on her body - I did fluids over her shoulder and her insulin in her flank. Even doing fluids and her insulin 4 hours apart didn't prevent the drop in BGs if I did both in the shoulder area. So it's just something to be aware of if you do fluids at home.

If you're personal vet is well-equipped and you are more comfortable with Jack being there, then I would transfer him. Is your vet's office staffed 24/7? That's something to consider, too.

Prayers from us as well...please keep us posted!
 
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