? Low Glucose Readings

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Milo and Phyllus

Milo and Phyllus

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Milo, 14 this year and my beloved indoor very feral cat, is diabetic and 3 days ago went HYPO with a 31 reading. He is on Novalin N since diagnosis 6 months ago. All tests and blood work good except for diabetes. He went from 2 units to 3 within a month after not responding well to 2.

Everything was going fine until last week his appetite greatly decreased. I gave Karo for the serious HYPO symptoms and called vet, but since he is VERY FERAL, vet decided it wasn't necessary to try to bring him in since it would mean sedation.

Instead, he instructed me to skip evening shot and start fresh next morning with a preshot reading. Here are the readings over the past couple of days with interjected notes:

2/1/17
8am - 404 ps (fed and gave shot-3u)
10:30 am - 120 (vet wants him between 80 and 250, all is good I thought)
12:15 am - Serious HYPO symptoms with 31 reading (gave Karo and food)
Vet ordered skip evening shot even though by 2:00 pm his reading was up to 368.
8:00 PM - down to 250 but following vet orders I skipped shot.
10:30 pm reading was 253.

2/2/17
8:00 am 440 ps (fed, gave shot)
10:00 am - 245
12:00 pm - 90 with same HYPO symptoms as experienced at 31 reading day before (gave Karo and food). Talked to vet and discussed his decreased eating and after much discussion vet finally said decrease to 2u's.
8:00 pm - 495 (gave 2u shot after food)

2/3/17
8:30 am - 183!!! Way to go! (he ate 2 oz. and fearing over dose, I skipped shot)
10:30 am - 265!!! Good! (he at 1 oz.)
12:30 pm - 392 (a half hour after syringe feeding 1oz food)

Please advise about appetite (can I give b12 to help that? and already give probiotics...could he be going into remission. Vet currently has him on antibiotics (Clavamox) in case appetite is infection related. Vet wants him getting 14oz of food a day, and he was getting that until recently. He's down to roughly half that now and is still losing weight. He was 11 lbs. about 6 months ago at diagnosis and though he gained to 12 lbs temporarily, he is now down to 9 lbs. Did I mention his water intake is greatly decreased as well?

Have repeatedly asked vet if he needs different insulin but he adamantly insists no.

Please advise.
 
Does Milo seem to be in pain? Is he nauseated? Is he licking his lips, hanging around his water bowl, going to his food dish but not eating? If he is nauseated your vet can prescribe anti-nausea meds for him. You can also ask your vet for an appetite stimulant to help encourage eating, Cyproheptadine is good and pretty safe to use, but don't use it if he's nauseated, it can cause food aversions.

Are you testing him for ketones? Please do, if you are not, already, and the sooner the better! You can get the test strips at any pharmacy, they usually run around $10. With higher bg numbers and reduced food intake, it is very important to test for ketones. Diabetic ketoacidosis is cause for an emergency visit to your vet, and can be fatal if left untreated!

How long has he been on Clavamox? Clavamox can make some kitties nauseated.

You might want to ask your vet about pancreatitis and CKD, two conditions (among others) that can cause the symptoms you are describing.
 
No pain or nausea that I detect; no hanging around the water bowl or food dish. No running back and forth to the litter pan; no diarrhea. Has less urine output due to less water intake. He just has no appetite and he's wanting to sleep all the time. Haven't checked keytones, but will ask husband to bring a test kit home today. Started Clavamox last night, has only had 2 doses. Vet says no to CKD, but I was wondering about the pancreatitis today. Can we use the keytone test kit sold for humans at Walmart?
 
Phyllus said:
Have repeatedly asked vet if he needs different insulin but he adamantly insists no.

Please advise.
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What reasoning does your vet give you for his refusal in considering another insulin? Novalin is a harsh insulin and is much better suited for dogs.

When Katie was first diagnosed, a crackpot "specialist" (not my regular vet) put her on Novalin. After reading here about Lantus and it's advantages (which I am sure you have read too), I very nicely asked him about Lantus and he nastily told me all he used was Novalin and if I didnt like it I could go somewhere else.

And that's exactly what I did.

Katie did go into remission on Lantus for 3 years.
If your vet wont even consider a change, I would seek help elsewhere.
 
Phyllus said:
No pain or nausea that I detect; no hanging around the water bowl or food dish. No running back and forth to the litter pan; no diarrhea. Has less urine output due to less water intake. He just has no appetite and he's wanting to sleep all the time. Haven't checked keytones, but will ask husband to bring a test kit home today. Started Clavamox last night, has only had 2 doses. Vet says no to CKD, but I was wondering about the pancreatitis today. Can we use the keytone test kit sold for humans at Walmart?
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Yes, you can buy the Ketostix or Ketodiastix (which checks for both ketones and sugar) urine strips sold at Walmart or most pharmacies.
 
Thank you! Will update later. His reasoning behind not changing the insulin is that since he went HYPO the other day, that a longer lasting insulin would cause the blood sugar to be too low for a longer period of time.
 
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Not every insulin acts the same way, just as not every heart drug acts the same way.

IMHO, you need a different, i.e. better, vet.
 
Red & Rover (GA) & "Cat" said:
Not every insulin acts the same way, just as not every heart drug acts the same way.

IMHO, you need a different, i.e. better, vet.
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Right, but which might be hard to come by in my area. The problem with my cat is he is extremely wild and very frail and 14 years old. However, he becomes dangerous outside of his room here. He has been known to pounce across the room and attack veterinarians. Only one that has been able to successfully handle him is the one I use now. Milo's such a high stress patient that we are both afraid we will send him to the point of no return with vet visits. Other vets in the area have in the past used extreme methods to deal with him; methods that could harm him now in his current condition. So I'm kinda stuck between a rock and a hard place trying to give him the best care possible since his diagnosis.
 
Phyllus said:
Thank you! Will update later. His reasoning behind not changing the insulin is that since he went HYPO the other day, that a longer lasting insulin would cause the blood sugar to be too low for a longer period of time.
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Your vet's reasoning is incorrect. Lantus is a long-acting insulin, yes, but cats metabolize insulin much faster than humans do. Frequently the intermediate-acting insulins do not last a full 12 hours in cats, while the long-acting insulins are more liable to, giving you better control of your kitty's diabetes. The intermediate-acting insulins also have a tendency to cause sharp, steep drops in BG, where the long-acting insulins have a gentler, shallower curve.

This is a quote from the company that makes Novolin:

"Novolin N is an intermediate-acting insulin. The effects of Novolin N start working1½ hours after injection. The greatest blood sugar lowering effect is between 4 and 12 hours after the injection. This blood sugar lowering may last up to 24 hours." - In humans!

From petdiabetes.wikia.com:

"Because of cats' faster metabolism, long-acting insulins like Lantus (and perhaps Levemir) are gaining a good reputation in veterinary research for regulating cats for a full 12 hours at a time, often better than some of their shorter-acting cousins.

Proponents of Lantus in feline use point out that it lasts a full 12 hours in many cats, has a very gentle onset, a negligible peak, and (some claim) less chance of triggering hypo or rebound than faster-acting insulins. The famous Queensland University studies[11] showed that a simple protocol (in a 24-hour monitored, veterinary environment, with a Low-carb diet) could bring many cats into remission in a few weeks."

From the Integrative Veterinary Care Journal:

"Feline DM is treated with Rx insulin injections twice a day (BID) combined with home BG monitoring. Cats metabolize insulin twice as fast as dogs or humans, and ideally, a cat with DM should be eating a very low carbohydrate diet twice a day. Hence the ultra-long-acting human insulins, Glargine “Lantus” or Detemir “Levemir”, work best for these cats."
 
Squalliesmom said:
Your vet's reasoning is incorrect. Lantus is a long-acting insulin, yes, but cats metabolize insulin much faster than humans do. Frequently the intermediate-acting insulins do not last a full 12 hours in cats, while the long-acting insulins are more liable to, giving you better control of your kitty's diabetes. The intermediate-acting insulins also have a tendency to cause sharp, steep drops in BG, where the long-acting insulins have a gentler, shallower curve.

This is a quote from the company that makes Novolin:

"Novolin N is an intermediate-acting insulin. The effects of Novolin N start working1½ hours after injection. The greatest blood sugar lowering effect is between 4 and 12 hours after the injection. This blood sugar lowering may last up to 24 hours." - In humans!

From petdiabetes.wikia.com:

"Because of cats' faster metabolism, long-acting insulins like Lantus (and perhaps Levemir) are gaining a good reputation in veterinary research for regulating cats for a full 12 hours at a time, often better than some of their shorter-acting cousins.

Proponents of Lantus in feline use point out that it lasts a full 12 hours in many cats, has a very gentle onset, a negligible peak, and (some claim) less chance of triggering hypo or rebound than faster-acting insulins. The famous Queensland University studies[11] showed that a simple protocol (in a 24-hour monitored, veterinary environment, with a Low-carb diet) could bring many cats into remission in a few weeks."

From the Integrative Veterinary Care Journal:

"Feline DM is treated with Rx insulin injections twice a day (BID) combined with home BG monitoring. Cats metabolize insulin twice as fast as dogs or humans, and ideally, a cat with DM should be eating a very low carbohydrate diet twice a day. Hence the ultra-long-acting human insulins, Glargine “Lantus” or Detemir “Levemir”, work best for these cats."
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Wow! My vet's info is obviously not in line with this or his info is perhaps a bit out-dated? This greatly worries me and I appreciate the info from these well respected informational sources. I had not run across this info yet. Now how to approach my vet without insult...after testing ketones this weekend.

Incidentally, I just remembered that his loss of appetite coincides with a mysterious illness being passed around amongst a semi-feral colony I care for. Will share that information this evening.
 
Don't be too hard on your vet. Lots of vets have very little practical experience treating Feline Diabetes, so may not be up-to-date on all the current information. If you google "Lantus for feline diabetes" or "Lantus for cats" you'll get lots of information you can share with your vet that may help him change his point of view!

Please do test Milo for ketones as soon as possible, just to rule out DKA (diabetic ketoacidosis).

Are the ferals you care for exhibiting the same symptoms as Milo?
 
Squalliesmom said:
Don't be too hard on your vet. Lots of vets have very little practical experience treating Feline Diabetes, so may not be up-to-date on all the current information. If you google "Lantus for feline diabetes" or "Lantus for cats" you'll get lots of information you can share with your vet that may help him change his point of view!

Please do test Milo for ketones as soon as possible, just to rule out DKA (diabetic ketoacidosis).

Are the ferals you care for exhibiting the same symptoms as Milo?[/QUOTE

The symptoms are very similar, indeed! If it had not been for the low blood count that coincided with the weakness I would have thought that's exactly what it is, because the main similar symptoms is the complete lack of appetite, lethargy, and decreased water intake. I had to syringe feed and water 3 semi-feral cats in the same week. Two of which I've never been able to handle before. Their illnesses each lasted 3 to 4 days and then they bounced back ravenous for food and water as though nothing had happened. All 3 had to have clavamox and all 3 are normal today. One notable symptom in all of them was the fact that they all had limb weakness, barely able to stand, and they refused to get out of their shelters. One ran a high fever; One had 2 days of closed mouth rapid breathing, and the other had a gloopy eye over night. There are many similar cases of this type illness circulating on facebook this past week or so. It is perplexing the vets in that there is no diarrhea or vomiting, but they are all diagnosing a stomach bug. I would say my indoor sugar baby will be in his 4th day of decreased appetite tomorrow. We shall see how he does.
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I hope he does well! It's good that you are familiar with syringe feeding; obviously you already know how vital it is that cats not go long without food. I'll keep Milo in my prayers. :bighug:

Please keep us posted! :)
 
Squalliesmom said:
I hope he does well! It's good that you are familiar with syringe feeding; obviously you already know how vital it is that cats not go long without food. I'll keep Milo in my prayers. :bighug:

Please keep us posted! :)
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Thank you all for your advise, prayers and recommendations. Husband got home with the Ketone test strips and I had a test completed within the hour. Yay! The result was negative! Updates tomorrow.:cat:
 
Phyllus said:
Thank you all for your advise, prayers and recommendations. Husband got home with the Ketone test strips and I had a test completed within the hour. Yay! The result was negative! Updates tomorrow.:cat:
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It's amazing how quickly we learn to do the things we never thought we'd do! ;)
 
Just wanted to say what a beautiful boy! He does have that "bet me and lose!" look in his eyes! I imagined him leaping across the room to teach the vet who runs the show. I had a little giggle over how such little beings can and do really run the show! Hope his appetite comes back and he feels better soon!
 
UPDATE: Hi everyone. Just wanted to give an update and ask a question or 2. First of all, I'm at a point now where I'm thinking that my cat may have had a stroke along with the hypoglycemic episode he had on the 2/1; unless it takes a while to recover from such episodes. The reason I say this is because he is still wobbly on his feet, still wanting to sleep, and still acting "depressed" with a lack of or decreased appetite. He has slightly improved, though. His appetite is very slowly getting better and he is also drinking. I "caved" last night and offered him some dry food because I was so worried about his lack of eating. He actually ate 1/8 cup dry food and drank some water before going back to his bed. However, he tires easily when sitting up to eat, so some of his food intake is actually while lying in his bed. He has gone from being syringe fed wet Sheba pate (vet recommended for higher calorie content and digestibility) to half eating on his own and then half being spoon fed when he goes back to bed. He managed to get down 1.5 oz in one sitting this evening where he was previously eating 1/2 to 3/4 oz per sitting. I do still feel this is an improvement

The thing is; I am currently terrified to give him any insulin since it tends to drop him so far so fast. Although his glucose is somewhat up, the readings I have over the past 24 hours is after food since I don't want to stress him prior to trying to feed. With his decreased food intake I am afraid I will over dose him. The readings 30 minutes to an hour after food has been a steady low to mid 400's. I realize this is slightly elevated from the food, but I am not sure by how much as of yet. The lowest after food reading I recorded was 12:30 yesterday afternoon; 392 as shown in the post below.

His average drop has been 200 to 250 at +2 and another 75 at +4. If my calculations serve me right, this could actually put him below 80 if I give him the vet prescribed 2u's of Novalin N. What would you all do? I am currently giving him a supplement that promotes healthy glucose levels twice daily and I also added 250 mg of B12 to his routine to help get his appetite up. He seems to have started feeling better and is definitely eating better since making these changes, but it would be great to hear what you all have to say and/or recommend.



Phyllus said:
Milo, 14 this year and my beloved indoor very feral cat, is diabetic and 3 days ago went HYPO with a 31 reading. He is on Novalin N since diagnosis 6 months ago. All tests and blood work good except for diabetes. He went from 2 units to 3 within a month after not responding well to 2.

Everything was going fine until last week his appetite greatly decreased. I gave Karo for the serious HYPO symptoms and called vet, but since he is VERY FERAL, vet decided it wasn't necessary to try to bring him in since it would mean sedation.

Instead, he instructed me to skip evening shot and start fresh next morning with a preshot reading. Here are the readings over the past couple of days with interjected notes:

2/1/17
8am - 404 ps (fed and gave shot-3u)
10:30 am - 120 (vet wants him between 80 and 250, all is good I thought)
12:15 am - Serious HYPO symptoms with 31 reading (gave Karo and food)
Vet ordered skip evening shot even though by 2:00 pm his reading was up to 368.
8:00 PM - down to 250 but following vet orders I skipped shot.
10:30 pm reading was 253.

2/2/17
8:00 am 440 ps (fed, gave shot)
10:00 am - 245
12:00 pm - 90 with same HYPO symptoms as experienced at 31 reading day before (gave Karo and food). Talked to vet and discussed his decreased eating and after much discussion vet finally said decrease to 2u's.
8:00 pm - 495 (gave 2u shot after food)

2/3/17
8:30 am - 183!!! Way to go! (he ate 2 oz. and fearing over dose, I skipped shot)
10:30 am - 265!!! Good! (he at 1 oz.)
12:30 pm - 392 (a half hour after syringe feeding 1oz food)

Please advise about appetite (can I give b12 to help that? and already give probiotics...could he be going into remission. Vet currently has him on antibiotics (Clavamox) in case appetite is infection related. Vet wants him getting 14oz of food a day, and he was getting that until recently. He's down to roughly half that now and is still losing weight. He was 11 lbs. about 6 months ago at diagnosis and though he gained to 12 lbs temporarily, he is now down to 9 lbs. Did I mention his water intake is greatly decreased as well?

Have repeatedly asked vet if he needs different insulin but he adamantly insists no.

Please advise.
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StephG said:
Just wanted to say what a beautiful boy! He does have that "bet me and lose!" look in his eyes! I imagined him leaping across the room to teach the vet who runs the show. I had a little giggle over how such little beings can and do really run the show! Hope his appetite comes back and he feels better soon!
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LOL! Yes...he is definitely a force to be reckoned with.
 
Phyllus said:
UPDATE: Hi everyone. Just wanted to give an update and ask a question or 2. First of all, I'm at a point now where I'm thinking that my cat may have had a stroke along with the hypoglycemic episode he had on the 2/1; unless it takes a while to recover from such episodes. The reason I say this is because he is still wobbly on his feet, still wanting to sleep, and still acting "depressed" with a lack of or decreased appetite. He has slightly improved, though. His appetite is very slowly getting better and he is also drinking. I "caved" last night and offered him some dry food because I was so worried about his lack of eating. He actually ate 1/8 cup dry food and drank some water before going back to his bed. However, he tires easily when sitting up to eat, so some of his food intake is actually while lying in his bed. He has gone from being syringe fed wet Sheba pate (vet recommended for higher calorie content and digestibility) to half eating on his own and then half being spoon fed when he goes back to bed. He managed to get down 1.5 oz in one sitting this evening where he was previously eating 1/2 to 3/4 oz per sitting. I do still feel this is an improvement

The thing is; I am currently terrified to give him any insulin since it tends to drop him so far so fast. Although his glucose is somewhat up, the readings I have over the past 24 hours is after food since I don't want to stress him prior to trying to feed. With his decreased food intake I am afraid I will over dose him. The readings 30 minutes to an hour after food has been a steady low to mid 400's. I realize this is slightly elevated from the food, but I am not sure by how much as of yet. The lowest after food reading I recorded was 12:30 yesterday afternoon; 392 as shown in the post below.

His average drop has been 200 to 250 at +2 and another 75 at +4. If my calculations serve me right, this could actually put him below 80 if I give him the vet prescribed 2u's of Novalin N. What would you all do? I am currently giving him a supplement that promotes healthy glucose levels twice daily and I also added 250 mg of B12 to his routine to help get his appetite up. He seems to have started feeling better and is definitely eating better since making these changes, but it would be great to hear what you all have to say and/or recommend.
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It's very difficult to suggest anything with so little data to go on. We're very reliant on the spreadsheet in use here to see the array of BG values at key times though the cycles. You can't rely on the BG to drop X amount based on how much it dropped in haf the time on a given day. Most cats aren't that predictable. The issue with Novolin is that can cause fast steep drops. You need to track BG over time to be able to decide on an effective dose. Were the numbers you gave in this post from a 2 u dose?
 
Kris & Teasel said:
It's very difficult to suggest anything with so little data to go on. We're very reliant on the spreadsheet in use here to see the array of BG values at key times though the cycles. You can't rely on the BG to drop X amount based on how much it dropped in haf the time on a given day. Most cats aren't that predictable. The issue with Novolin is that can cause fast steep drops. You need to track BG over time to be able to decide on an effective dose. Were the numbers you gave in this post from a 2 u dose?
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I uploaded the SS...not a lot there but will keep it up to date for reference
 
Are you still testing for ketones? As long as he's higher in numbers it's best to get a test. I'm not sure on how much insulin to give but I think it would be best for him to get at least a tiny bit of insulin to help get his numbers lower. You could start low and see how much works the best for him on the amount of food he's eating.

*The following doesn't apply to her because she's using u100 insulin* just wanted to clear this up for anyone just reading posts. Sorry for any confusion!
If you have U100 syringes you can measure by .2 increments. So you could start very low and go from there. If you use u100 syringes you have to use the conversion chart. I can look for it on here and share it with you.
 
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StephG said:
Are you still testing for ketones? As long as he's higher in numbers it's best to get a test. I'm not sure on how much insulin to give but I think it would be best for him to get at least a tiny bit of insulin to help get his numbers lower. You could start low and see how much works the best for him on the amount of food he's eating. If you have U100 syringes you can measure by .2 increments. So you could start very low and go from there. If you use u100 syringes you have to use the conversion chart. I can look for it on here and share it with you.
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Yes please, thank you. I am not comfortable giving him even the 2 units in his condition. I will be trying to get another ketone test tomorrow.
 
Phyllus said:
Yes please, thank you. I am not comfortable giving him even the 2 units in his condition. I will be trying to get another ketone test tomorrow.
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He does need insulin. I see you aren't shooting at night. Is it because he isn't eating well? I am going to suggest two things....


First if you are afraid of hypo, please at least give him 1 unit. Your cats bg are very high.

Second, to help with his energy and appetite start giving b12 supplements!!! It will do a world of good. It can help with muscle weakness from neuropathy , anemia, and appetite loss. Just sprinkle it on his food.
 
JanetNJ said:
He does need insulin. I see you aren't shooting at night. Is it because he isn't eating well? I am going to suggest two things....


First if you are afraid of hypo, please at least give him 1 unit. Your cats bg are very high.

Second, to help with his energy and appetite start giving b12 supplements!!! It will do a world of good. It can help with muscle weakness from neuropathy , anemia, and appetite loss. Just sprinkle it on his food.
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Thank you...I was afraid to give him insulin at night because of the hypoglycemic episodes he recently had. I realize his numbers can't stay high and that he needs insulin. I did end up giving his insulin last night because the numbers kept creeping up, but he bottomed out at 78 again. Today I will try 1 unit instead of 2 and see how he does with that. I agree with you that he needs less insulin right now due to his not eating. He seems very stable, but is just not eating. I'm hoping it's just a stomach bug and have been adding probiotics to his food. I will do the B12 as well.
 
Phyllus said:
Thank you...I was afraid to give him insulin at night because of the hypoglycemic episodes he recently had. I realize his numbers can't stay high and that he needs insulin. I did end up giving his insulin last night because the numbers kept creeping up, but he bottomed out at 78 again. Today I will try 1 unit instead of 2 and see how he does with that. I agree with you that he needs less insulin right now due to his not eating. He seems very stable, but is just not eating. I'm hoping it's just a stomach bug and have been adding probiotics to his food. I will do the B12 as well.
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78 is a perfect lowest number! That's what we want to see. Are you using a human meter?
 
@Phyllus, may I ask where you are at? I know you said that the current vet is the only one that has been able to handle him. Maybe you could find one that makes house calls, since you said there is one room he is comfortable in. And you are able to test quite a bit, so that is a good sign.
 
78 at +4 is probably a bit on the lower side if he's not eating well. Do your syringes have half unit marks? You could try 1.5 units before dropping to 1. But if you're more comfortable with 1 unit that is OK too.
Did you feed him to bring him up from that +4 78 reading? I see he was 205 at +5.
 
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Just read your comments on his SS. If you didn't feed him that 205 and climb to 507 PMPS is probably a bounce from the fast drop to 78. Get your usual readings even if he's higher today. That way you can see how long his bounce lasts.
 
Shiloh & Rhonda said:
@Phyllus, may I ask where you are at? I know you said that the current vet is the only one that has been able to handle him. Maybe you could find one that makes house calls, since you said there is one room he is comfortable in. And you are able to test quite a bit, so that is a good sign.
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I am in Monticello, GA. And there are some that might make a house call, current vet included, but Milo will not allow being handled by anyone but me. Even my husband can't handle him. Have been thinking of attempting a house call, but am not very confident it will work. I may end up risking the sedation to have him checked for pancreatitis. Good news is he is moving around a bit more today which I see as a good sign.
 
StephG said:
78 at +4 is probably a bit on the lower side if he's not eating well. Do your syringes have half unit marks? You could try 1.5 units before dropping to 1. But if you're more comfortable with 1 unit that is OK too.
Did you feed him to bring him up from that +4 78 reading? I see he was 205 at +5.
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Yes I did feed him as much as he would take (1 oz) to get that reading up just a bit. I was comfortable enough with the 205 at +5 to take a nap. My U-100 syringes do have half units. I went ahead with 1 unit, but may bump it up a half if it doesn't seem to bring it down enough.
 
Oh! Sorry my brain got a bit scrambled there! Apparently earlier too! You don't need the conversion chart. Sorry if I confused you.
 
Phyllus said:
Updates this evening...
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I'm glad you started some b12. I think you find it really helps him. You commented that he had a near hypo. 78 is a safe number, esp on a human meter. (It could easily be 100+ on an alpha track) although his body may interpret it as low as he's used to being in higher numbers, so he could bounce. I'm glad he got some insulin tonight.
 
UPDATE: Milo started developing a stuffy nose last evening and by morning he was refusing food and water, so no insulin was given even though his glucose level was up. I was thinking he looked as though he was developing some breathing issues and so I decided it would be best to stress him somewhat with a vet visit than to risk losing him due to my fear of pushing him over the edge transporting him to the vet and back. He was generally weak this morning and still wobbly and the vet allowed me to come immediately. Milo was too weak to put up much of a fight, so the trip was a success.

It turns out that Milo does, in fact, have an infection, and it is more than likely the same infection that the other outdoor cats were passing around. I also had 1 isolated indoor cat on the other end of the house come down with it and he rebounded with nothing more than amoxicillin. Milo is having a more difficult time and is lethargic because he is running a fever of 104 which also explains his lack of appetite, and which dehydrated him.

The vet changed his insulin routine until we get through this. 2u's once a day at where ever his highest level comes whether morning or night and to inject at the same time each day unless under 250. Though the vet says he would prefer to hospitalize, he doubted Milo would allow the handling, and that the stress on the cat would be less at home, and so I would have to commit to a very arduous task. Thankfully, I am available to Milo around the clock and so I have been assigned a rigorous schedule to re-hydrate with Pedialite then feed with Pedialite/food mix until well hydrated and at such time he is eating and drinking well on his own; and to continue the B12.

He doesn't suspect stroke or pancreatitis, but if it were pancreatitis the treatment would be the same. He said that the only difference in treatment would be the withholding of food for 24 hours if pancreas related, but he didn't think that was a good idea in this case.

I will continue to update the SS and this thread on his progress and thank all of you for your continued support and help.
 
UPDATE: Milo started developing a stuffy nose last evening and by morning he was refusing food and water, so no insulin was given even though his glucose level was up. I was thinking he looked as though he was developing some breathing issues and so I decided it would be best to stress him somewhat with a vet visit than to risk losing him due to my fear of pushing him over the edge transporting him to the vet and back. He was generally weak this morning and still wobbly and the vet allowed me to come immediately. Milo was too weak to put up much of a fight, so the trip was a success.

It turns out that Milo does, in fact, have an infection, and it is more than likely the same infection that the other outdoor cats were passing around. I also had 1 isolated indoor cat on the other end of the house come down with it and he rebounded with nothing more than amoxicillin. Milo is having a more difficult time and is lethargic because he is running a fever of 104 which also explains his lack of appetite, and which dehydrated him.

The vet changed his insulin routine until we get through this. 2u's once a day at where ever his highest level comes whether morning or night and to inject at the same time each day unless under 250. Though the vet says he would prefer to hospitalize, he doubted Milo would allow the handling, and that the stress on the cat would be less at home, and so I would have to commit to a very arduous task. Thankfully, I am available to Milo around the clock and so I have been assigned a rigorous schedule to re-hydrate with Pedialite then feed with Pedialite/food mix until well hydrated and at such time he is eating and drinking well on his own; and to continue the B12.

He doesn't suspect stroke or pancreatitis, but if it were pancreatitis the treatment would be the same. He said that the only difference in treatment would be the withholding of food for 24 hours if pancreas related, but he didn't think that was a good idea in this case.

I will continue to update the SS and this thread on his progress and thank all of you for your continued support and help.
 
If the vet suspects infection (or, as you said, Milo has an infection) are you giving him antibiotic?
I heard that methylcobalamin form of B12 is much better for cats than cyanocobalamin form - just wondering what you have. Bailey, my cat, had an episode of extreme weakness in back legs a few weeks ago, to the point he was practically dragging his behind. I upped his B12 (Zobaline) to 2 tablets twice daily and was giving him injection of B12 (cyano - form) once every two days. He recovered, though not to being young again :( but still...
Wish Milo the best! Give it at least a couple of weeks to see any changes.
 
Yes, Milo does have some type of infection as he has a fever and the symptoms coincide with the symptoms that just ran their course in 4 semi-feral cats I care for; one of which is currently confined to a small bathroom on the opposite end of my house from where Milo is. I believe it's a type of cat flu and it seems to be hitting the older cats hardest and it now appears it is even worse on diabetics. My sugar baby, Milo has been sick longer than the others. The others bounced back very quickly (2-3 days) after dosing with amoxicillin, a single prednisone tablet or depomedrol injection, and one probiotic capsule added to their syringe meal. The only difference in treatment between Milo and the other ill cats is that Milo is on clavamox; not amoxicillin, and he hasn't received the prednisone due to the diabetes, but I am seriously considering giving it to him anyway. He also is not responding to the B12 although his appetite and interest in water has increased in that he eagerly laps both from syringe when offered. He still does not feel like getting out of bed and only does so for a potty break.

I am finding these same symptom complaints all over facebook and read an article about a flu in New York with basically the same symptoms that quarantined a feline shelter for a week. For those experiencing unexplained hind leg weakness, it might be worthwhile to look at additional symptoms and start antibiotics:

The symptoms I have observed include the following:
  • Sudden lost of appetite
  • Sudden disinterest in water leading to dehydration
  • Sudden unexplained weakness with hind leg weakness accompanied by staggering and occasional limb twitching
  • Fever between 103 and 104
  • General body limpness
  • Two of my sick ones had sudden large amounts of vomit at the onset of illness
  • Depression (complete loss of interest in surroundings ie. staring at nothing)
  • Growling when medicating and syringe feeding.
  • No diarrhea

Should I give a dose of prednisone?
 
UPDATE: I can hardly believe that Milo is still disinterested in eating on his own; still showing wobbly weakness and all he wants to do is sleep. Vet isn't sure if the virus is neuro or musculo skeletal related. I fear H7N1 at this point but he is doubtful of that. he did say go ahead and try a dose of prednisone, which I did, but I have not noted any improvement yet. I did find that Milo now has a runny crusty nose so I am pretty sure of flu at this point. He is doing great on 1 dose of insulin a day. It actually seems to work for the better part of 12 hours
 
UPDATE: WOOHOO! I think we have definite improvement (knock on wood). Milo is up and about. He is making trips all the way to the kitchen water fountain and drinking a LOT of water on his own. Although he is still not eating on his own yet, I was able to easily feed 3 ounces of barely diluted food this morning with a short 10 minute break at a midway point. He is definitely a little stronger and more steady on his feet. I attribute that to Pedialyte every 2 hours. I'm hoping things will only get better from here so we can get back to our regular schedule. :cat:
 
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