? Need some help please

Status
Not open for further replies.
Peppersmom72

Peppersmom72

Active Member
I'm done! Pepper did not get her shot this morning. I can't handle this anymore and neither can Pepper. No one responds from anywhere to help, so, I don't know what else to do. I'm back at square one watching my baby suffer. This is no kind of life for her.
 
Peppersmom72 said:
I'm done! Pepper did not get her shot this morning. I can't handle this anymore and neither can Pepper. No one responds from anywhere to help, so, I don't know what else to do. I'm back at square one watching my baby suffer. This is no kind of life for her.
Click to expand...
Why wasn't she able to get a shot this morning?
 
Peppersmom72 said:
I'm done! Pepper did not get her shot this morning. I can't handle this anymore and neither can Pepper. No one responds from anywhere to help, so, I don't know what else to do. I'm back at square one watching my baby suffer. This is no kind of life for her.
Click to expand...
Who isn't responding to you? You mean your vet isn't calling you back?

You need to raise that dose a bit.

If it makes you feel any better, my cat didnt even see a yellow number mid cycle until almost 3 months into giving insulin. I didn't see results in her preshots until she was up to 3 units.
 
Last edited:
One other idea that hasn't been explored yet is dosing 3 times a day. This works for cats getting 8 hours or less action from their insulin... The obvious downside being it's a pain in the ass for the owner to inject every 8 hours. I don't know what your schedule is like or if that's even feasible for your situation. Again ideally a longer acting insulin would be a more practical solution.
 
Yes. I probably won't get a call back for 2 days. I understand that we just got off a holiday, and I understand that this is not a sprint but enough is enough. How long is she supposed to go with high numbers and feel like S*&^ before something is done. Sorry for the venting, but I feel helpless.
 
JanetNJ said:
One other idea that hasn't been explored yet is dosing 3 times a day. This works for cats getting 8 hours or less action from their insulin... The obvious downside being it's a pain in the ass for the owner to inject every 8 hours. I don't know what your schedule is like or if that's even feasible for your situation. Again ideally a longer acting insulin would be a more practical solution.
Click to expand...

I am gone 11-1/2 hours a day at work. So that will not work
 
Peppersmom72 said:
I am gone 11-1/2 hours a day at work. So that will not work
Click to expand...
I thought that was the case. I guess you are testing on a lunch break, or is a family member testing mid day?

It's possible you just haven't found your breakthrough dose yet. Raise to 2.75 for 6 cycles (3 days) and then reevaluate. If it's not enough then we go to 3.
 
I was told not to give insulin if she doesn't eat. This is where all of the confusion is coming in. I can't get a straight answer. The vet told me not to shoot if she is below 300. Now she tells me to shoot 2.5 no matter what number she is at. This is crazy. I'm supposed to shoot no matter what number she is at? (Per the vet)and I supposed to shoot if she's puking and I'm supposed to shoot if she doesn't eat? I'm getting all these different answers and in the mean time I feel like I'm making Pepper suffer. I'm on the verge of tears and feel so alone.

This is no quality of life for her. I don't have the funds to be vet jumping.
 
Peppersmom72 said:
No one responds from anywhere to help
Click to expand...

This is a bad time, with the Christmas holidays many people are away! Unfortunately our cats don't choose their time to our convenience...

Peppersmom72 said:
I was told not to give insulin if she doesn't eat. This is where all of the confusion is coming in. I can't get a straight answer. The vet told me not to shoot if she is below 300. Now she tells me to shoot 2.5 no matter what number she is at. This is crazy. I'm supposed to shoot no matter what number she is at? (Per the vet)and I supposed to shoot if she's puking and I'm supposed to shoot if she doesn't eat? I'm getting all these different answers and in the mean time I feel like I'm making Pepper suffer.
Click to expand...

Getting conflicting information is hugely stressful, particularly when you don't yet know enough to make an informed decision and know who to trust. It is possible your vet is adjusting her response to how Pepper is doing. I am not familiar with the insulin you are using, but the reason to "not shoot" when the cat isn't eating is that we don't want to risk the cat's BG becoming too low. It seems your kitty's numbers are so sky-high that the vet is considering that you should still shoot, because the risk of her coming down to a dangerous level from where she is is quite low. That would be my interpretation in any case.

Do we have any hypothesis as to why she is not eating? Is this something she does regularly? Could she be ill with something else (pancreatitis?) Could she have ketones? (I don't know if you have stix to test at home; I also am not sure if ketones will make a cat puke or not). Do you have anything in her medicine cabinet against nausea?

Other than not eating and puking, how is she?

(Sorry if you mentioned answers elsewhere. Also are you home now, or did you have to leave for work?)
 
JanetNJ said:
I thought that was the case. I guess you are testing on a lunch break, or is a family member testing mid day?

It's possible you just haven't found your breakthrough dose yet. Raise to 2.75 for 6 cycles (3 days) and then reevaluate. If it's not enough then we go to 3.
Click to expand...

Even if the yellow sticky says to wait an hour to make sure she doesn't throw up? Even if the yellow sticky says to wait at least a week before switching doses?
 
Peppersmom72 said:
I was told not to give insulin if she doesn't eat. This is where all of the confusion is coming in. I can't get a straight answer. The vet told me not to shoot if she is below 300. Now she tells me to shoot 2.5 no matter what number she is at. This is crazy. I'm supposed to shoot no matter what number she is at? (Per the vet)and I supposed to shoot if she's puking and I'm supposed to shoot if she doesn't eat? I'm getting all these different answers and in the mean time I feel like I'm making Pepper suffer. I'm on the verge of tears and feel so alone.

This is no quality of life for her. I don't have the funds to be vet jumping.
Click to expand...
My vet initially told me don't shoot under 200, and that's our recommendation for new folks here too. Once there's data you can though. My cat was 184 this morning and she got her 2.5 units. You can see that got her to a nice 91. I shoot my cat any time her preshot is over 125.
Of course I would never recommend that to someone only a few months in.

Now if your cat was only like 200-240 preshot and not eating I would say skip the shot... But with numbers over 500 she needs that insulin. She's never been close to being too low so it would have been ok. If it really makes you nervous to shoot her without food you could always reduce it slightly to say 2.25... But at these levels that's not really necessary.

You may be alone there with her, but you are not alone. You have a community of people, with lots of experience and support for you... Who care for the well being of cat. It is a marathon you have to run one step at a time.
 
I'm at home today, which this is making it very convenient for this to be happening. The vet said she checked her pancreas. (Per the SS lab results) She said no pancreatitis. Pepper has always been a puker. At her last vet visit she had trace ketones. She was doing great the last couple days and then BAM, she hits this wall.....AGAIN.
 
Peppersmom72 said:
I'm at home today, which this is making it very convenient for this to be happening. The vet said she checked her pancreas. (Per the SS lab results) She said no pancreatitis. Pepper has always been a puker. At her last vet visit she had trace ketones. She was doing great the last couple days and then BAM, she hits this wall.....AGAIN.
Click to expand...

I'm not a specialist in ketones but I'd say that's another argument for giving her a shot. How far behind schedule are you? If you're at home, you can keep an eye on her levels if you're worried she may drop too low without food. But she has enough sugar in her blood to keep a load of insulin going for a while, methinks. (And what @JanetNJ says above.)

Regarding no food => no shoot, just stumbled upon this old thread on the topic: http://www.felinediabetes.com/FDMB/threads/some-bad-advice-for-newbies.9070/
 
Peppersmom72 said:
I use a pet meter, so that's where the 300 came from. (The sticky for Novulin N and the vet agreed). I need an insulin that lasts longer, not one that drops her so drastic and makes her sick and then shoots right back up..... the way Novulin is seeming to do.
Click to expand...

Definitely makes sense! She might be stuck on the trampoline.

Regarding the puking and ketones: I remember reading somewhere that even trace ketones required calling the vet to determine course of action. Be on the lookout for other signs: http://petdiabetes.wikia.com/wiki/Ketoacidosis -- I would definitely give her at least a reduced dose as you are there to monitor.
 
Stephanie & Quintus said:
Definitely makes sense! She might be stuck on the trampoline.

Regarding the puking and ketones: I remember reading somewhere that even trace ketones required calling the vet to determine course of action. Be on the lookout for other signs: http://petdiabetes.wikia.com/wiki/Ketoacidosis -- I would definitely give her at least a reduced dose as you are there to monitor.
Click to expand...
I'm inclined to agree. How long ago was her shot usually?
 
At her vet appointment a week ago, the vet gave her a appetite stimulant, an anti nausea injection and Sub q fluids. She was fine for the next week, until today.
Today I am home from work for the holiday (I am usually gone 11-1/2 hrs a day) and am able to monitor her for myself. She would not eat this morning. She did not receive her shot because that's what I thought I was supposed to do per the sticky for beginners guide to Novulin N.
I gave her her appetite stimulant and she ate but she is already past mid cycle, so I am waiting until 6pm to give her her shot.
 
@Peppersmom72 not sure how much you know about ketones. When the body cannot feed its cells using insulin and sugar, it converts fats to ketones. In small amounts that's not a disaster, but if it goes on, the amount of ketones in the blood build up too fast for the body to flush them out, and everything starts falling apart.

This means a cat with either really not enough insulin or not enough food is at risk. In your case Pepper's high BG levels tell us that as a general rule her cells are not being fed correctly. Insulin brings BG into the cells. So even if she's not getting food right now, she still has a pile of BG floating around that insulin can use to carry into her cells. It can only help her feel better. In the worse case scenario, if she starts to drop, you can try feeding again (she might be hungrier, they tend to get hungry just as we do when their sugar drops), or if worse comes to worse, get some honey into her.
 
JanetNJ said:
Has she eaten at all today? Now that you mentioned she had trace ketones I'm a bit concerned they may have increased. Do you have any ketone reading strips?
Click to expand...

I was able to get her to eat after I gave her an appetite stimulant. She has always had nausea, vomiting and constipation issues since she was a kitten. I have ketone strips but I cannot get a urine sample from her. I've tried everything.
 
Peppersmom72 said:
At her vet appointment a week ago, the vet gave her a appetite stimulant, an anti nausea injection and Sub q fluids. She was fine for the next week, until today.
Today I am home from work for the holiday (I am usually gone 11-1/2 hrs a day) and am able to monitor her for myself. She would not eat this morning. She did not receive her shot because that's what I thought I was supposed to do per the sticky for beginners guide to Novulin N.
I gave her her appetite stimulant and she ate but she is already past mid cycle, so I am waiting until 6pm to give her her shot.
Click to expand...
Can you push up the shot by an hour or two? Like do it at 4pm tonight and the 5 am tomorrow morning then 6pm tomorrow night to get her back on schedule?
 
My hypothesis would be that if it's an "in and out" insulin (like vetsulin) that doesn't act very long (I think I saw you say that) and her numbers are so high anyway, you could do the shot an hour or two earlier, and either she'll have a longer than 12h wait until tomorrow morning, or you can split the difference and do the shot 30 minutes or an hour earlier tomorrow morning, if your schedule allows. (This is just a suggestion, see if you're comfortable with the idea.)
 
Peppersmom72 said:
I was able to get her to eat after I gave her an appetite stimulant. She has always had nausea, vomiting and constipation issues since she was a kitten. I have ketone strips but I cannot get a urine sample from her. I've tried everything.
Click to expand...
There are ketone blood meters of getting the urine is impossible.

Some folks have success by putting bunched up plastic wrap where the cat pees in the box, or by using along handled laddle to catch it mid stream.
 
Peppersmom72 said:
I have ketone strips but I cannot get a urine sample from her. I've tried everything.
Click to expand...
Sorry if this is included in the "everything", but did you try:
- sticking the stick in wet litter to see if it affects the reading => you can then stick it in the pee-wet litter when she's just done
- tried the thing with the spoon to collect pee? (won't work for getting a sample now as this takes time to habituate the kitty)
- last ditch: can you slip a piece of paper under her when she's peeing? (probably useless, I'm suspecting you have troubling approaching her when she's peeing)
 
Peppersmom72 said:
I can do that. But won't that make her last longer for her pm shot tomorrow?
Click to expand...

It will, but at the moment I think what we're most concerned with is how high she has been since her last shot, and ketones. Better to split the difference, I'd say. Think of the time between the last shot and this one, and this one and the next...
 
JanetNJ said:
There are ketone blood meters of getting the urine is impossible.

Some folks have success by putting bunched up plastic wrap where the cat pees in the box, or by using along handled laddle to catch it mid stream.
Click to expand...

I've tried the plastic wrap and the ladle. She is such a modest bathroom kitty. She refuses to go if I try to get under her with a ladle and I can't get the plastic wrap to work with clumping litter. I even tried to throw ketone strips in the litter box with hopes that she would pee on one of them, but she just kicks them aside.
 
Peppersmom72 said:
I've tried the plastic wrap and the ladle. She is such a modest bathroom kitty. She refuses to go if I try to get under her with a ladle and I can't get the plastic wrap to work with clumping litter. I even tried to throw ketone strips in the litter box with hopes that she would pee on one of them, but she just kicks them aside.
Click to expand...
Care Touch Ketone Testing Kit - Blood Glucose and Ketone Meter w Strip Ejection, 10 Ketone Blood Test Strips, 10 Lancets, Lancing Device, Carrying Case for Diabetics and Ketogenic, Paleo, Atkins Diet https://www.amazon.com/dp/B076VRLBWK/ref=cm_sw_r_cp_api_Q8OqAbRN7S3VN
 
She has eaten today, right? How low does she usually go, and when? Would you be able to get a test or two in on the way or around that time to make sure she's not getting into trouble? (I don't have that much experience but looking at your spreadsheet it seems kind of unlikely she would soar down.)

Do you have "higher carb" food that you can give her if you see that she is heading downhill "too fast" for your liking?
 
Stephanie & Quintus said:
She has eaten today, right? How low does she usually go, and when? Would you be able to get a test or two in on the way or around that time to make sure she's not getting into trouble? (I don't have that much experience but looking at your spreadsheet it seems kind of unlikely she would soar down.)

Do you have "higher carb" food that you can give her if you see that she is heading downhill "too fast" for your liking?
Click to expand...

Yes, she ate 4 hrs after she was supposed to get her insulin but not until after I gave her an appetite stimulant.

Yes, I have some higher carb "delectable bisque lickable treat" that I can pour on her food or just syringe feed her if needed. I also have karo syrup, maple syrup, etc. for emergencies.

She typically eats every 4 hours unless she wants more, then I give it to her. I was told if a diabetic kitty is hungry to feed them.
 
But the question remains....... do I still try to work with this insulin that only give a nadir for 1-2 hours or do I get the vet to switch her insulin and start over?
Does any one have any experience with vetsulin? ( I heard that was made for cats)
 
Just to clarify: I can see the data in your spreadsheet, the questions above are the questions you need to ask yourself to figure out how you feel comfortable dealing with this (at least that's how I'd approach it).
 
Peppersmom72 said:
But the question remains....... do I still try to work with this insulin that only give a nadir for 1-2 hours or do I get the vet to switch her insulin and start over?
Does any one have any experience with vetsulin? ( I heard that was made for cats)
Click to expand...

So, I tried out vetsulin initially. If you look at Quintus's spreadsheet, the first two curves before Lantus are vetsulin. My vet wasn't happy because Quintus wasn't spending enough time under 350. He says that what counts is not how far down you go, but how long you stay under a certain threshold (he likes 350, you'll find other values).

So if you have a cat who tends to do a sharp dive down and up on a certain insulin, that would indicate that insulin is not a good choice for the cat.

Vetsulin is the only one that was "designed" for cats, but it doesn't mean it's the best choice (though lots of vets are familiar with it). When I read up on diabetes and found guidelines and stuff, most of the time glargine (=Lantus) was recommended as the first choice for cats.

Here are two links:
- this one is in French, but you can try and google translate it, it's written by a vet who was Chair of Internal Medicine at one of our two veterinary teaching hospitals in the country: http://www.vetup.com/articles-veterinaires/82-royal-canin-alimentation/331-diabete-sucre-felin
ETA here is the google translate link: https://translate.google.com/transl...on/331-diabete-sucre-felin&edit-text=&act=url
- this one is in English, the IFSM consensus guidelines for diabetes: http://journals.sagepub.com/doi/pdf/10.1177/1098612X15571880

They're technical articles but I think they lay down things quite well.
 
Summary for those catching up: didn't eat this morning, didn't shoot, ate four hours later with appetite stimulant, we're roughly mid-cycle now, discussion is about whether to shoot an hour or two early tonight, and also whether to ask the vet to switch insulins. There was some talk in there about ketones and puking cats.
 
Stephanie & Quintus said:
Vetsulin is the only one that was "designed" for cats
Click to expand...
For general information, Vetsulin was originally developed for canine diabetics. (It's marketed under the brand name Caninsulin in the UK.) Dogs don't metabolise insulin as quickly as cats so they get better duration on it. For the majority of cats Vetsulin/Caninsulin doses tend to poop out around the +8 mark. That said, there are some cats who do OK on this insulin - even achieving remission in some cases.

As noted above, Prozinc was developed for feline diabetics:

http://www.bi-vetmedica.com/species/pet/products/prozinc.html


Mogs
.
 
Status
Not open for further replies.
Back
Top