[New Member]11/16/20: Diabetic cat drained of energy after insulin shot

[Sophie Decker]

Hello all, my 11 year old female cat was diagnosed w/ diabetes a few days ago and we've been giving her the insulin shots prescribed, but she's been completely drained of energy for the past couple days. Too tired to get up to eat, drink or go to the litter box. Before we started giving her the insulin she was incredibly active and perky as she has been her whole life, but we were alerted to the diabetes because of rapid weight loss, leading to a blood sugar test. She's always been incredibly small and we thought it was because it's just how she is combined with being incredibly active, but is it at all possible that the insulin is doing more harm than good and she's been living with the condition for far longer? The last time we gave her one was at noon yesterday (11/15/20) and she just now ate a hand full of food for the first time since giving her the insulin and seems to be perking up a little bit. Still very weak and tired, but she's sitting with her head up instead of laying down dead, as she had been for the last couple days. Thank you in advance for any help!!

 

[Nan & Amber (GA)]

Oh my, that sounds scary!

What insulin are you giving, and at what dose?

 

[Nan & Amber (GA)]

The two possibilities to be most concerned about here are: insulin overdose (the reason I asked about insulin and dose) and ketones/ketoacidosis. The second is particularly a concern if she hasn't been eating or drinking; the fact that she perked up slightly today and took a couple bites of food is great, but not enough, so fingers crossed she continues to improve...

 

[Critter Mom]

Hi Sophie,

I can understand how worried you must be right now. My Saoirse had a similar reaction to her first insulin: she was completely poleaxed and I was scared out of my wits.

If, as Nan requested above, you can let us know the name of the insulin and the dose your little one (name?) is receiving that will help us to make better suggestions as to what might be going on. Also, could you let us know how much your little one weighs at the moment and whether she is at her ideal weight or still needs to put weight back on.

Could you also let us know what her main diet is, whether she's been eating *anything* before you give her the insulin doses, and whether she has been tested for ketones at all since she was diagnosed.

Safety note: Before giving insulin, make sure she eats enough before each injection. (We can give you more pointers on feeding when we know which insulin you're working with.)


Mogs
.

 

[Sophie Decker]

Oh my, that sounds scary!

What insulin are you giving, and at what dose?

She's getting 3/10 mL of ProZinc insulin twice a day, and her name is Jilly :] she weighs about 5lbs right now and would usually get 3/4 of a cup of dry food over the course of one day. She still needs to put on some weight but I'm not sure exactly how much, but I can get back on that later. I don't think she's been eating anything before the doses so I'll keep that in mind as something to look at.

 

[Sophie Decker]

She's getting 3/10 mL of ProZinc insulin twice a day, and her name is Jilly :] she weighs about 5lbs right now and would usually get 3/4 of a cup of dry food over the course of one day. She still needs to put on some weight but I'm not sure exactly how much, but I can get back on that later. I don't think she's been eating anything before the doses so I'll keep that in mind as something to look at.

The target weight for her to reach is 10 pounds. She was at 7lbs when we checked in the last couple days and I just now weighed her at 5lbs

 

[Critter Mom]

* * * URGENT * * *

She's getting 3/10 mL of ProZinc

I'm hoping the above is a terminology problem because if you've been instructed to give this dose of Prozinc then that would be a MASSIVE starting dose:

* A normal starting dose of Prozinc would be 1 unit [ETA - for cats not on exclusively wet low carb diet].

* 1ml of Prozinc contains 40 units of insulin.

* 0.3ml would contain 0.3 x 40 = 12 units.

Please can you take a picture of the labels on your syringes, and also take a picture of an empty syringe showing a close-up of the position where the plunger is when you draw up her dose.

If you can't post a picture, please post all of the information on the syringe box/pack labels, please. (I am *hoping* they say "U40" somewhere.)


Mogs
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[Nan & Amber (GA)]

3/10mL would be a very large dose. We usually give insulin dosages in "units" (U), so I'm hoping something has gotten lost in translation here.

Could you take a picture of one of your syringes (with the cap on) and the plunger drawn up to where you usually draw?

 

[Critter Mom]

PS:

You can use the "Upload a File" option to add the photos to your post.


Mogs
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[Critter Mom]

@Nan & Amber (GA) - Snap.


Mogs
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[Nan & Amber (GA)]

U-40 syringes have a red cap, I believe, but I worry that these aren't standard insulin syringes given the units.

Please, include as much info as you can get in the photo (any writing on the syringe, multiple photos if you have to, the box, whatever you have). I am just as worried as Mogs about this and hoping it's just a lost in translation issue and a safe dose, but we want to be sure!

 

[Sophie Decker]

Here's the box and bottle we keep in the fridge, and here's the syringes we use that we keep in the cupboard

 

[Critter Mom]

Here's a pic of the button you need to click to upload a picture:

Or you could try copying the picture to the clipboard of your computer/device and pasting it into the reply box.



Mogs
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[Nan & Amber (GA)]

OK, great! I see the boxes/vials and looks like you are using U-40's (albeit a 1/2cc size, which seems large to me, but I am more familiar with U-100's)

Can you do a pic of a syringe showing where you usually draw to? Or perhaps just tell us the number on the line you draw to?

 

[Critter Mom]

Thank you for the pix. They're U40 syringes! That's good.

Now can you please post a picture of one of the syringes with the plunger pulled back to the position for the dose you're currently measuring.


Mogs
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[Nan & Amber (GA)]

Mogs, we are sharing a brain and typing fingers again tonight...

 

[Critter Mom]

Mogs, we are sharing a brain and typing fingers again tonight...

Quite. If you keep reading my mind like this, Nan, I'm gonna go grab some tin foil from the kitchen and make myself a hat.


Mogs
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[jt and trouble (GA)]

Oh my gosh its a good thing you found us! You are in VERY CAPABLE hands. I'm posting this for LATER
Once you get over this emergency and things have calmed down please check out this link
It will give you all the info to how things work around here.
New? How You Can Help Us Help You!

WELCOME TO OUR FAMILY
We want you to know you've landed in a very safe place for you and your kitty.

We are dedicated to helping anyone who needs help.
I wish it was under better circumstances but you've found the best place there is.
jeanne

 

[Sophie Decker]

OK, great! I see the boxes/vials and looks like you are using U-40's (albeit a 1/2cc size, which seems large to me, but I am more familiar with U-100's)

Can you do a pic of a syringe showing where you usually draw to? Or perhaps just tell us the number on the line you draw to?

This is how much we are currently giving her. When she was diagnosed a week ago we were giving her one line less than this, but when we took her back for a check up a few days ago it was upped to this current dosage.

 

[jt and trouble (GA)]

hope my post isnt out of line for the situation sigh

 

[Nan & Amber (GA)]

OK!

So, that looks like 3U. It's still probably too much insulin for such a tiny cat, but much better than 0.3mL!

 

[Critter Mom]

It looks like the dose measured is 3 units of Prozinc. That's still very much on the high side for a starting dose. Even 2 units is a high starting dose, especially given Jilly's current weight.

Was Jilly less lethargic on the lower dose, Sophie?


Mogs
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[Nan & Amber (GA)]

So, it sounds like you were started on 2U, and then upped to 3U after only a few days? That is 1) too large a starting dose for a 5lb cat, and 2) much too fast and large of an increase.

I am going to step out of this discussion now because Mogs and I are saying basically the same things all the time , and I am not familiar enough with the ins and outs of Prozinc to give detailed advice from here anyway.

So glad you found us!

 

[Critter Mom]

BTW, Sophie, the reason Nan and myself went into overdrive just now is that we have had members post here in the past who were given the wrong syringes, so when there's a worry about terminology we automatically check to make sure what actual dose is being measured.


Mogs
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[Critter Mom]

I am not familiar enough with the ins and outs of Prozinc to give detailed advice from here anyway.

I can do the general principles stuff OK, Nan, but I don't know any specifics about Prozinc other than what's in the FDMB guide. I'm going to tag @JanetNJ and @Deb & Wink to ask whether they can help Sophie on the dosing specifics. I'll see what I can do to help Sophie in the interim.


Mogs
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[Nan & Amber (GA)]

BTW, Sophie, the reason Nan and myself went into overdrive just now is that we have had members post here in the past who were given the wrong syringes, so when there's a worry about terminology we automatically check to make sure what actual dose is being measured.

And not just that, but especially now with covid restrictions, vets sometimes don't have the chance to do a proper demo, and somehow 1U gets measured as 10U, or 3 as 30 .

So it's a relief to learn that Jilly's dose is just high, not outrageously high!

 

[Sophie Decker]

And not just that, but especially now with covid restrictions, vets sometimes don't have the chance to do a proper demo, and somehow 1U gets measured as 10U, or 3 as 30 .

So it's a relief to learn that Jilly's dose is just high, not outrageously high!

Awesome thank you for all your help! I think we've got a better grasp on the situation and are going to call our vet tomorrow and ask about going back to a smaller dose. Thank you so so much I feel a lot better about the situation now :]

 

[jt and trouble (GA)]

remember to tell the vet how kitty was reacting to this dose.

 

[Ale & Bobo & Minnie (GA)]

You shouldn’t change food with such a high dose, but has your vet told you that dry food is too carby for diabetic cats? They should be eating food that is 10% or less in carbs and dry is typically much higher. Again, I wouldn’t change the food with a high dose without home testing to make sure she’s safe.

you also mentioned she needs to gain weight and her ideal weight is 10 pounds. A good rule of thumb is ideal weight, 10, times 20 to get the daily calorie count so she should be eating at least 200 calories a day bit about 20-30% more to gain. Diabetic cats who are unregulated have a hard time gaining weight because they can’t process the nutrients in food well so they eat but still lose weight. They also burn calories just by peeing since there’s sugar in their urine.

 

[Deb & Wink]

Have you thought about home testing, to see what this dose of insulin does for your cat Jilly?

Not sure why your vet told you to increase the dose already. Would you please explain what the vet based the increase on? That would help us to understand better. Thanks.

 

[Critter Mom]

Important Safety Info: ------------------------------------------------------------------------------

How to Treat Hypos

It's a good idea to read the above through a few times so that it becomes familiar, and also print a copy out and place it somewhere it can be grabbed quickly should it ever be needed.

Here are another couple of resources to help you learn more about Jilly's Prozinc insulin:

Prozinc Basics

Prozinc Dosing Method


Mogs
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[JanetNJ]

Awesome thank you for all your help! I think we've got a better grasp on the situation and are going to call our vet tomorrow and ask about going back to a smaller dose. Thank you so so much I feel a lot better about the situation now :]

So glad you are going to reduce the dose. 1 u is the recommended starting dose and it is increased in 0.25-0.5 increments at a time rather than whole units.

i have a video in my signature showing how I test my cat CC at home.

 

[Sophie Decker]

I appreciate everyone's help, but we realize now she is on her way out :[ I've been sitting with her for hours and she's not eating or drinking anything and she's been laying in her corner all day. We're taking her in tomorrow to be put to sleep. I appreciate everyone's help with this, have a good evening

 

[Chris & China (GA)]

Nobody knows your kitty as well as you do, and if you feel it's her time and she's telling you there's no joy in her life, then releasing her is the loving decision to make but 11 is still a young cat who should have years of life left in her.

Something to consider before you make that final decision is that we hear quite often that cats act "drained and lethargic" when they first start insulin. The best way I can describe it is like this....If you were used to drinking an entire pot of coffee every day, your body would get used to living in that high caffeine state....then one day somebody comes along and gives you a medication that blocks the action of most of the caffeine. You'd feel pretty bad too.

With the high dose you were started on, it's possible it was just too much for her which drove her blood glucose down too low and made her feel awful. Her body is used to living in high glucose numbers....at that high a dose, it could have taken her very low and then she may have bounced high again. That can make a cat act like they don't feel too good too.

If you want to try, we'll be here to help you. If you truly think it's her time, we'll support you in that decision too. Any decision made out of love is the right decision.

 

[Nan & Amber (GA)]

I am so sorry to hear this. As Chris said, you know your cat best, and we'll support any decision you make. Let me throw out one other possible explanation, though-- both Mogs and I mentioned ketones earlier. A cat with ketones or in diabetic ketoacidosis will behave in exactly the way you describe. It is a life-threatening condition, but if caught early, can be treated successfully. When you bring her to the vet tomorrow, they can give you an assessment of her situation and what might be going on.

 

[JanetNJ]

Of course it's your decision, but something as simple as an appetite stimulant might help.