Merry Christmas! Newbie here, your generous advise would be highly appreciated!

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Yuling & Casper (GA)

Yuling & Casper (GA)

Member Since 2020
Merry Christmas everyone! Hope you and your furry babies are enjoying some great time together and stay safe! 2020 has been tough, especially when it closes to the holiday season.

My baby boy- Casper, (16) just being diagnosed with hyperglycemia on 12/20/2020. He had been an extremely healthy and active boy for his entire life until end of September that we noticed he had some gum problem. The vet ended up took out 3 teeth out of him and he has never acts the same from that point. He drinks a lot of water, still being EXTREMELY picky with food and lost weight significantly. We ended up took him in to the vet again on 12/17/202, his glucose read: 538 mg/dl.

Regardless how upset I was (he was a very heathy baby when we first took him in for the gum/teeth problem, all test and numbers came back great), we had him hospitalized for 2 days and took him home with all the supplies before Christmas. We followed all the protocols, OCD being like on the insulin injection time and feeding (ProPlan DM). I started testing his BG on the 23rd. Quite unexpected, instead of seeing it being regulated, Casper's BG raised from 511 mg/dl (first reading from 23rd) to 683 mg/dl (last reading at 10:02 AM PDT, without any food, after 1 unit of VetSulin at 9:00 AM).

I really don't know what is going on, Casper was responding to VetSulin at the vet, they got his BG regulated at 149 mg/dl before discharge him. And now, seems with all those injections (my poor baby)... the insulin is obviously doing absolutely NOTHING. If anyone who is experienced in this type of situation, please kindly advise!
 
Hello Yuling. Welcome to the forum. It's wonderful that you are already able to test Casper's BG.

I don't have the experience to give you any advice, but I did want to point you to BEGINNER'S GUIDE TO CANINSULIN/VETSULIN in case you hadn't already seen it.

Unfortunately, because it is the Christmas holiday there are fewer people online than usual, but I will tag some experienced members who might be online and who may be able to help. @JanetNJ @tiffmaxee @Critter Mom @Nan & Amber (GA)

Enid
 
Hello and welcome!

I'm so sorry you and Casper are having such a rough time :(.

First impressions, I'm wondering about this:

Yuling & Casper said:
still being EXTREMELY picky with food and lost weight significantly.
Click to expand...

does he ever paw at his mouth as if something is bothering him? When he had the teeth out, did the vet take x-rays before and after the extractions? And what was the date of that work?

The reason I ask is because sometimes, little shards of tooth break off and are left behind during an extraction. Bit of a shot in the dark as to what might be going on with him now (especially if it's been quite a while since the extractions), but always worth asking.

Other possibilities to consider: did anything else change around the time of the dental work? Food change? Medication (especially any steroids)?

Last long shot: is the vetsulin you are using a fresh, unopened pen/vial, or did your vet give you something that had been opened (sometimes they do this to help caregivers out with a "bargain", but it does increase the chances that you got some ineffective insulin).

All that said, long shots aside, sometimes the answer just is, "your cat is diabetic now", no real explanation. The good news is that you're doing the right things to get him feeling better (congratulations on home testing, by the way!!!!), don't be discouraged that it isn't happening quickly. A few days is actually a very short period of time in these matters, it can take weeks or even months to find the proper dose and get regulated, so it definitely doesn't mean that something must be wrong.
 
Christmas greetings to you all. :)

Yuling & Casper said:
The vet ended up took out 3 teeth out of him and he has never acts the same from that point.
Click to expand...
Did you get dental X-rays done after the extraction? If not, then it would be a good idea to get some because sometimes fragments of tooth can get left behind and cause problems.

When was the most recent blood work done? Worrying about whether there might be any oral infection present because high BG, iffy eating and possible infection are all risk factors for generation of ketones. As a general, wise safety precaution I'd recommend you start monitoring Casper's urine for ketones. Here are some helpful links:

Ketones and DKA

Tips for collecting pee samples

Any test result higher than 'trace' requires veterinary attention (ketosis and DKA are medical emergencies).

Yuling & Casper said:
We ended up took him in to the vet again on 12/17/202, his glucose read: 538 mg/dl.
Click to expand...
Yuling & Casper said:
Quite unexpected, instead of seeing it being regulated, Casper's BG raised from 511 mg/dl (first reading from 23rd) to 683 mg/dl (last reading at 10:02 AM PDT, without any food, after 1 unit of VetSulin at 9:00 AM). [...] I really don't know what is going on, Casper was responding to VetSulin at the vet, they got his BG regulated at 149 mg/dl before discharge him.
Click to expand...
On the blood glucose (BG) side of things, there's not enough info yet to be able to make any solid comments. Levels do vary depending on which point in the 12-hour dose cycle the reading is taken, and from day to day. 149 at nadir is quite good for a starting point on Vetsulin.

Please can you confirm that you fed Casper BEFORE giving the dose of Vetsulin.

The standard routine for each 12-hour cycle is:

* Withhold food for 2 hours prior to preshot test (needs to be a fasting BG).
* Take preshot BG reading.
* Feed substantial meal.
* Wait 30 minutes (Vetsulin hits hard and fast so digestion needs to be well under way before administration).
* Assuming BG is high enough (>200 on human meter when starting out and very little data available) and cat is eating enough, administer Vetsulin dose.

More info:

FDMB Vetsulin Guide

Assuming that you did feed Casper before that dose, the rise in BG could be influenced by food (Vetsulin onset is usually between +1 to +1.5 hours after dose admin), and also sometimes the body can react to BG levels that are too low - or safe but unfamiliarly low - by triggering release of extra glucose from the liver (can affect up to 6 12-hour cycles). When you have more data you'll be better able to understand what's happening. We recommend the use of a standard shareable spreadsheet for recording BG results (so that members replying to your posts can help you interpret what's happening). Here's the info you need to get started:

FDMB spreadsheet instructions

Understanding the spreadsheet grid

For the time being, I recommend testing at AM and PM preshot times and, based on the action profile of Vetsulin, you are more likely to catch the nadir BG (lowest point between doses) between +3 and +6 hours after dose administration. Ideally you'd grab the mid-cycle tests both AM and PM each day. Even if you go to bed soon after giving insulin in the evening a test at +2 hours after dose admin often gives you a warning of whether closer monitoring is going to be needed in the coming hours.


Mogs
.
 
Welcome to FDMB!!

Since I'm assuming the vet's office isn't open, you might check on your bill to see if. you were charged for X-rays. I had the same thought as Nan and Mogs.

Are you feeding Casper canned or dry Pro Plan? The canned is lower in carbs. The dry, however, is a high carb food and could be contributing to the numbers in the 500s.

One other thought. Vetsulin is not recommended by the American Animal Hospital Assn. It has a short duration and can cause a hard, fast drop in numbers. The two insulins that are currently recommended are Prozinc and Lantus. It may be worth discussing this with your vet especially if Casper isn't responding.
 
Pookie said:
Hello Yuling. Welcome to the forum. It's wonderful that you are already able to test Casper's BG.

I don't have the experience to give you any advice, but I did want to point you to BEGINNER'S GUIDE TO CANINSULIN/VETSULIN in case you hadn't already seen it.

Unfortunately, because it is the Christmas holiday there are fewer people online than usual, but I will tag some experienced members who might be online and who may be able to help. @JanetNJ @tiffmaxee @Critter Mom @Nan & Amber (GA)

Enid
Click to expand...
Thank you so much for your promoted response Pookie! I didn't really expect anyone to read my post today but I am so grateful to have so much useful information.
I am slowly reading the post and understand things one by one in between of prep the Christmas dinner. Thank you again for the Vetsulin 101.
 
Nan & Amber (GA) said:
Hello and welcome!

I'm so sorry you and Casper are having such a rough time :(.

First impressions, I'm wondering about this:



does he ever paw at his mouth as if something is bothering him? When he had the teeth out, did the vet take x-rays before and after the extractions? And what was the date of that work?

The reason I ask is because sometimes, little shards of tooth break off and are left behind during an extraction. Bit of a shot in the dark as to what might be going on with him now (especially if it's been quite a while since the extractions), but always worth asking.

Other possibilities to consider: did anything else change around the time of the dental work? Food change? Medication (especially any steroids)?

Last long shot: is the vetsulin you are using a fresh, unopened pen/vial, or did your vet give you something that had been opened (sometimes they do this to help caregivers out with a "bargain", but it does increase the chances that you got some ineffective insulin).

All that said, long shots aside, sometimes the answer just is, "your cat is diabetic now", no real explanation. The good news is that you're doing the right things to get him feeling better (congratulations on home testing, by the way!!!!), don't be discouraged that it isn't happening quickly. A few days is actually a very short period of time in these matters, it can take weeks or even months to find the proper dose and get regulated, so it definitely doesn't mean that something must be wrong.
Click to expand...
Hi Nan & Amber,
Hope you are enjoying your Christmas! Thank you so much for your promoted response.

Casper doesn't paw at his mouth, he was taking a small amount of dry food (ACANA and Royal Canin) a week after his procedure. Casper had his tooth extraction done on November 6th, 2020. There is no X-ray done before or after the procedure. We went home with Onsior (pain relief), anitibiotic Amoxi w/Clavalanate and Gabapentin (anticonvulsant and Nerve pain medication). But your suspicion maybe just right, I am going to ask the vet for the X-ray when we go back (tomorrow at 9 AM).

The only change to his life after his teeth pulled out is that we stopped dry food but offer him Fancy Feast Savory Center and Gourmet Natural, all in pate, no chunks.

The vetsulin, syringe everything we got is brand new. Although I store the vetsulin in the fridge at 7 degrees Celcius (highest setting). AlphaTrack meter and primed per instruction.

We really think it could be an insufficient vetsulin. I didn't think like that until this morning, since his BG was so high, I gave him his AM shot at 9AM without giving him any food (very risky I know). One hour later, we tested him again, only came down 34 mg/dl. Either way, I understand this will be a roller coaster journey, but I will do whatever I can in my abilities to get him better.

Thank you again for your kind advice, will post more updates later. Merry Christmas!
 
Critter Mom said:
Christmas greetings to you all. :)


Did you get dental X-rays done after the extraction? If not, then it would be a good idea to get some because sometimes fragments of tooth can get left behind and cause problems.

When was the most recent blood work done? Worrying about whether there might be any oral infection present because high BG, iffy eating and possible infection are all risk factors for generation of ketones. As a general, wise safety precaution I'd recommend you start monitoring Casper's urine for ketones. Here are some helpful links:

Ketones and DKA

Tips for collecting pee samples

Any test result higher than 'trace' requires veterinary attention (ketosis and DKA are medical emergencies).



On the blood glucose (BG) side of things, there's not enough info yet to be able to make any solid comments. Levels do vary depending on which point in the 12-hour dose cycle the reading is taken, and from day to day. 149 at nadir is quite good for a starting point on Vetsulin.

Please can you confirm that you fed Casper BEFORE giving the dose of Vetsulin.

The standard routine for each 12-hour cycle is:

* Withhold food for 2 hours prior to preshot test (needs to be a fasting BG).
* Take preshot BG reading.
* Feed substantial meal.
* Wait 30 minutes (Vetsulin hits hard and fast so digestion needs to be well under way before administration).
* Assuming BG is high enough (>200 on human meter when starting out and very little data available) and cat is eating enough, administer Vetsulin dose.

More info:

FDMB Vetsulin Guide

Assuming that you did feed Casper before that dose, the rise in BG could be influenced by food (Vetsulin onset is usually between +1 to +1.5 hours after dose admin), and also sometimes the body can react to BG levels that are too low - or safe but unfamiliarly low - by triggering release of extra glucose from the liver (can affect up to 6 12-hour cycles). When you have more data you'll be better able to understand what's happening. We recommend the use of a standard shareable spreadsheet for recording BG results (so that members replying to your posts can help you interpret what's happening). Here's the info you need to get started:

FDMB spreadsheet instructions

Understanding the spreadsheet grid

For the time being, I recommend testing at AM and PM preshot times and, based on the action profile of Vetsulin, you are more likely to catch the nadir BG (lowest point between doses) between +3 and +6 hours after dose administration. Ideally you'd grab the mid-cycle tests both AM and PM each day. Even if you go to bed soon after giving insulin in the evening a test at +2 hours after dose admin often gives you a warning of whether closer monitoring is going to be needed in the coming hours.


Mogs
.
Click to expand...

Hi Critter Mom,

Thank you for your promoted response! Quite informative. I do have a lot to learn to do this. I didn't discover this forum and all of you wonderful people until later today. I was doing my own recording but updated the FDMB spreadsheet to my signature as I start learning more on this site.

He did not get any X-ray before or after the extraction. I am learning on the Ketones test and will get the supplies tomorrow when the stores resume normal business hours. I will post more updates after his follow up with the vet tomorrow and start on +3 and +6 monitoring.

Thank you again for your kind advice, Merry Christmas!
 
Sienne and Gabby (GA) said:
Welcome to FDMB!!

Since I'm assuming the vet's office isn't open, you might check on your bill to see if. you were charged for X-rays. I had the same thought as Nan and Mogs.

Are you feeding Casper canned or dry Pro Plan? The canned is lower in carbs. The dry, however, is a high carb food and could be contributing to the numbers in the 500s.

One other thought. Vetsulin is not recommended by the American Animal Hospital Assn. It has a short duration and can cause a hard, fast drop in numbers. The two insulins that are currently recommended are Prozinc and Lantus. It may be worth discussing this with your vet especially if Casper isn't responding.
Click to expand...

Hi Sienne and Gabby,

Thank you for your warmly welcome! My 2020 Christmas couldn't be any better than I feel so supportive with so many nice people like you, Pookie, Nan, Mogs, Critter's mom, and Lisa, despite of Casper's condition.

I am giving Casper ProPlan DM can food, no dry at all. Of course, he is a BIG shrimp lover, we gave him 2 baked shrimp last night. I will talk to the vet tomorrow about Prozinc and Lantus. Obviously, the vetsulin was doing something, then to absolutely nothing.

He had his blood work done on 12/19/2020, the day before he came home. Because I saw some antibiotics on the bills, I asked vet if Casper has any infection that I should be aware of (as he didn't mention any infection when we were there). He told me Casper was doing well, BG was brought under control. There is no infection, the antibiotics (6 of Unasyn in two nights) is solely for pre-caution purposes. I doubt Casper can develop a serious infection in less than 3 days at home.
 
Welcome and I just want to say that Vetsulin, also called caninsulin because it was made for canines not cats who have higher metabolism. It could just be that Vetsulin is not the best insulin for him, but as it’s been said already it takes a while to get your cat regulated. As we like to say here, feline diabetes is a marathon not a sprint. I know you’re getting high numbers now, but Vetsulin is a harsh fast acting insulin and it hits hard and fast. Please do not continue to shoot before giving food. With Vetsulin you need to test and feed at least 30 minutes before shooting so your cat has food onboard.

happy holidays!!
 
Hi there, just wanted to give you all a quick update on Casper.
We went in yesterday at 9 for his follow up check up, asked the vet to do the blood work just in case there was any infection developed within 2-night after he was discharged from the vet. There is no infection, and his kidneys are doing well too. His BG was 509 in the morning, the morning insulin dose was missed yesterday as we were at the vet and I just don't think it makes any sense to poke my poor baby when I know indeed the medicine is no good.
Unfortunately, the vet doesn't carry Prozinc or Lantus. So, to prove the vet that we were given an defective bottle of insulin at the first place, I purchased another one and we are going to do the curve for 2 days just to make sure the dose is sufficient for Casper.
BG before this morning shot, it was 611 mg/dl; 2 hours later after morning 1-unit dose, we tested again at 11:00 AM, it comes down at 229 mg/dl.
 
Yuling & Casper said:
BG before this morning shot, it was 611 mg/dl; 2 hours later after morning 1-unit dose, we tested again at 11:00 AM, it comes down at 229 mg/dl.
Click to expand...

That is really interesting! So maybe it was bad insulin after all (pretty rare, but it does happen).

One caution: the other possibility is that he's dipped down like this before when you haven't caught it, and then spent a couple of days "bouncing" in consistently high numbers afterwards. That's a pretty common reaction in the early days. Right now, that 229 probably looks alarmingly low to his body (it isn't, but if he's been in high numbers for a while, that's what he's used to).

Time will tell what's really going on here, but in the meantime, it's nice to see him down to yellow numbers at least!

Vetsulin typically works pretty fast and hard in the first half of the cycle, so after that speedy drop I might test at +3 rather than waiting another two hours to +4. You want to keep him above 100 on an AlphaTrak with Vetsulin, I think (vetsulin users, please correct me on the cutoff), just to keep a safety buffer. The "take action with high carb food" number is 68.
 
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Oh my!

Just peeked at Casper's spreadsheet, and saw that 61 at +4!!!!!

Please give him a little high-carb snack, and test again soon-- ideally 30mins after that 61, if it's already been longer then please test immediately. That's too low on an Alphatrak, so we want to bring him up asap.
 
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Hi everyone, so sorry I haven't been keeping up with the posts, as a newbie, I have to admit that I am truly overwhelmed with the situation.
As you might noticed, his BG is all over the place. I only skipped 1-dose on the night of 12/27/2020 as his BG was 126. I also stopped test him so frequently after building his 2-day curve, just wanted to have his paws, ears to have a chance to heal. Unfortunately, I still don't hear anything from his vet yet as he supposed to provide a plan for Casper's treatment. I might just need to walk in tomorrow for a solution.
Something new happened today: Casper threw up twice, once in the lunch time, once in the night, both happened within 30 mins of feeding- Proplan DM wet for lunch and Tiki Velvet Mousse for dinner.
We also noticed he barely eat by himself anymore with insulin and he absolutely hates Proplan DM . We usually syringe feed him and leave a small amount of food (1/3 can) in the night, since we have multiple cats, I can't really pinpoint if the food was finished by Casper or not.
On the positive side, so far, his ketones test came back negative (tested twice) and I will keep monitoring his urine while he battles this disease.
 
Hi---

Yuling, you must reduce the dose-- that 42 is Casper telling you that 1U is much too high.

Yuling & Casper said:
We also noticed he barely eat by himself anymore with insulin and he absolutely hates Proplan DM .
Click to expand...

OK, the Proplan DM is off the menu! For now, just find something he wants to eat-- even if it is high carb, that is much better than not eating. Let's get him through this rough patch.

Has he ever been tested for pancreatitis?
 
Nan & Amber (GA) said:
Yuling, you must reduce the dose-- that 42 is Casper telling you that 1U is much too high.
Click to expand...
I agree 100% with Nan. The 1IU dose is too high and needs to be reduced immediately by 0.25IU, according to the FDMB Vetsulin guide (see below for link). See also the important note about BG testing below.

The reason you've been seeing blacks in the spreadsheet is because the 1IU dose has been taking Casper too low and the body is trying to fight the too-high dose by releasing extra glucose into the bloodstream. For example, the black readings you saw on the AM cycle of 28 December were triggered by the 61 on the AM cycle of 27 December. (Note: The 61 Alphatrak reading was also too low, and that's when the data first told you the 1IU dose was too high.)

Please can you read the FDMB guide to using Vetsulin/Caninsulin. It will help you to better understand how your insulin works, plus how and when the dose needs adjustment. Note that the BG ranges in the Vetsulin guide are for human meters. You will need to work with ranges/thresholds appropriate to the Alphatrak.

Normal Feline BG Range as measured on Alphatrak:

68-150mg/dL.

If BG drops below 68 you need to feed your cat, maybe even give syrup/honey to get numbers back up into a safe range and keep them there. (Please read and print out the Hypo Guide, if you haven't already done so).

Guidance for Reducing Dose:

The FDMB guide recommends reducing the dose by 0.25IU any time the BG drops below 90 on a human meter. You might want to consider reducing when BG drops below 100 on the Alphatrak. (NB: This is just a rough guide because, while Alphatrak meters read higher than human ones, there's no fixed mathematical formula for converting readings from one meter type to the other).

'No shoot' limit:

200 on a human meter. You might want to consider setting this a little higher, e.g. at 220, if you would feel more comfortable. (Again this is a rough guide.)

Ketones:

Well done for getting the ketone testing down. Especially while Casper is running in such high numbers - and also because he's been vomiting - as a general safety precaution I'd strongly recommend testing for ketones every day. (If a cat starts generating ketones they can build to dangerous levels within hours.)

BG Testing:

For safety, and also to better determine how Casper is responding to his insulin, it would help you both if you could get a test in somewhere between +3 and +6 on both the AM and PM cycles. (Many cats run lower on one cycle than the other, usually the PM one. One cycle may have a nadir that's safe but the other one might be too low. You can only tell by testing.)


Mogs
.
 
Last edited:
Nan & Amber (GA) said:
Hi---

Yuling, you must reduce the dose-- that 42 is Casper telling you that 1U is much too high.



OK, the Proplan DM is off the menu! For now, just find something he wants to eat-- even if it is high carb, that is much better than not eating. Let's get him through this rough patch.

Has he ever been tested for pancreatitis?
Click to expand...
Hi Nan,

No, he hasn't been tested for pancreatitis. Unfortunately, my vet office is open for tech issues only, two major animal ERs in the area are full of capacity. I wouldn't be able to get him back into the vet until Monday.
I just got the records of his previous blood work, will get the data organized and posted to the SS.
 
Critter Mom said:
I agree 100% with Nan. The 1IU dose is too high and needs to be reduced immediately by 0.25IU, according to the FDMB Vetsulin guide (see below for link). See also the important note about BG testing below.

The reason you've been seeing blacks in the spreadsheet is because the 1IU dose has been taking Casper too low and the body is trying to fight the too-high dose by releasing extra glucose into the bloodstream. For example, the black readings you saw on the AM cycle of 28 December were triggered by the 61 on the AM cycle of 27 December. (Note: The 61 Alphatrak reading was also too low, and that's when the data first told you the 1IU dose was too high.

Please can you read the FDMB guide to using Vetsulin/Caninsulin. It will help you to better understand how your insulin works, plus how and when the dose needs adjustment. Note that the BG ranges in the Vetsulin guide are for human meters. You will need to work with ranges/thresholds appropriate to the Alphatrak.

Normal Feline BG Range as measured on Alphatrak:

68-150mg/dL.

If BG drops below 68 you need to feed your cat, maybe even give syrup/honey to get numbers back up into a safe range and keep them there. (Please read and print out the Hypo Guide, if you haven't already done so).

Guidance for Reducing Dose:

The FDMB guide recommends reducing the dose by 0.25IU any time the BG drops below 90 on a human meter. You might want to consider reducing when BG drops below 100 on the Alphatrak. (NB: This is just a rough guide because, while Alphatrak meters read higher than human ones, there's no fixed mathematical formula for converting readings from one meter type to the other).

'No shoot' limit:

200 on a human meter. You might want to consider setting this a little higher, e.g. at 220, if you would feel more comfortable. (Again this is a rough guide.)

Ketones:

Well done for getting the ketone testing down. Especially while Casper is running in such high numbers - and also because he's been vomiting - as a general safety precaution I'd strongly recommend testing for ketones every day. (If a cat starts generating ketones they can build to dangerous levels within hours.)

BG Testing:

For safety, and also to better determine how Casper is responding to his insulin, it would help you both if you could get a test in somewhere between +3 and +6 on both the AM and PM cycles. (Many cats run lower on one cycle than the other, usually the PM one. One cycle may have a nadir that's safe but the other one might be too low. You can only tell by testing.)


Mogs
.
Click to expand...
Hi Mogs,
Thanks for the advice! We just gave him the AM shot at 0.75U and I will test him at +3 and +6.
 
Hi all, a quick update on Casper. He hasn't vomit today but definitely looks extremely weak, worse condition than we took him in 10 days ago when we found out he has diabetes. But he got up few times and drank water by himself (not much). And he peed outside of the box. He has been hiding all day and resting.
I tested him at +3 and +6 as suggested after 0.75U dose. Still, we needed to syringe feed him wetfood. He is not responding to his favorite Fancy Feast chicken fillet treat or anything at all. I just pray he could make it till Monday when the vet is back in the office.
For whatever the reason, I think Vetsulin is make him worse, his condition hasn't been improved one bit, it's getting worse. I wonder how can I get the Lantus without prescription and how much I should give him.
Pls let me know if there is anything I can do to make my baby feel better. Thanks!
 
Good evening all,
So we finally managed to get Casper into one of the ER here in the late morning. Waited for 5 hours, had the vet office to run all the necessary tests and X-ray, turned out it's not just the diabetes we are dealing with, but also the complications of partial kidney failure, liver damage, urinary infection and possibly of pancreatitis.
We were then offered two options: put him down or being referred to an LA specialty ER for more intense treatments.
It took us less than 2 secs to decide not to give up on him. We just checked him in to the LA ER and I am praying my baby will work with the treatments and fight this for himself, he is a tough kitty.

Casper's mom
 
Oh wow :( :( :(.

I hope that the specialty clinic can help. That's quite a list, but I think there is hope. UTIs are treatable, and kidney disease (depending on stage) and pancreatitis can definitely be managed. The liver damage is more uncertain (depends on how much, and why), but he's in the right place to figure everything out. You should know more soon.

Fingers and paws crossed for Casper to show them just how tough he is!
 
Hi everyone, it's been 3 nights since Casper admitted to the ER. I just got a call from the doctor in the middle of the night that he needs blood transfusion. He is claimed stable right now and they managed to get his blood sugar and sodium level under control.
They put a tube in on Monday to help him with food and water intake along with the IVs and other medical treatments. I have no idea how is this diabetes could end up taking his life so dramatically in such a short time, we did everything per his vet instructions. I am extremely frustrated but keep praying for my poor baby.
 
Thank you Mogs! Thank you Nan & Amber! Thank you Tyler's mom!
We just got more updates from the ER, they wanted to do a feeding tube to send him home tomorrow as Casper is not eating on his own. Currently, they are treating his kidney failure with fluid and other medicines. So far his blood transfusion works as it should, RBC comes up to 28. We are getting him one more night there and see where he is at tomorrow. We know Casper will definitely not eat on his own whenever there are unfamiliar people around. He even stops eating or drinking when my 6-year-old gets closer.
I really don't want to do the feeding tube to him, we managed to feed him with a syringe and it had been working quite well. I am not lazy to take care of baby, but the vet there made it sound it's a mandatory solution for him to even be able to come home. I truly don't think with what he just went through, he could take another procedure like that. Any thoughts?
 
Your boy is a fighter!

Feeding tubes sound scary, but those who have experience with them say they are literal lifesavers. Even if syringe-feeding is working for you, it's just one less thing to have to worry about being able to do, and it works for a lot of meds as well as foods. The only thing I'd worry about is, as you say, whether he's strong enough for the procedure, especially if it involves sedation. But if the vets think he is, and think he is strong enough to come home afterward, that's a good sign.

Do you know what kind of tube they are doing, e-tube or a different type? I'm not actually the best person to be talking about this stuff, as I don't have personal experience. Going to tag @Aleluia Grugru & Minnie, in case she's around she may be able to share some tips and thoughts about this.

I hope he keeps improving, poor little guy really has been through a lot...

:bighug: :bighug: :bighug: :bighug:
 
Hi Yuling,

I'm glad to read that Casper's transfusion went well.

As the others above have said, feeding tubes can literallly be life savers, and the thought of them can be much more intimidating than the reality. In addition to helping Casper to get his food, the tube will also help you to reliably administer any medications he may need. Here's a helpful link for you:

Feeding tubes for cats

(((Casper)))


Mogs
.
 
Good evening/morning,

Just wanted to do a quick update on Casper. We finally got him home last night after the ER treatments for a week and a half. He is getting better every day but his BG is still not as regulated as we wished for. The doctor believes he is stable to come home and all we needed to do is to let him have some good rest, allow his little body to recover, keep 1 unit a day on Lantus insulin. Thanks to everyone for all your support, kind words and prayers had kept our furry baby safe on his way to a healthy recovery.

Casper's Mom
 
Nan & Amber (GA) said:
So glad to hear he is home at long last!
Click to expand...
Thanks Nan & Amber! We were so happy last night, the tires were in smoke when we went to pick him up. :joyful:
On one side we are thrilled to get him back, on the other side we are still struggling on his BG, even now he is on Lantus. The vet from the ER wanted him to come home and at least give him a chance to recover from all the treatments in the past 10 days. The doses were started at 1unit/dose, AM & PM, reduced to 0.5 unit/dose, AM & PM, adjusted to now 1unit/dose, AM only.
His AMPS number was in the high 400s, while +7 at 57. *Sigh
 
@Yuling & Casper
Hi I see Casper is on lantus, can you please note that on your spreadsheet and when you switched to Lantus
I don't see on your SS where you said #44 reduced to 0.5 units AM and PM.
So right now you are only giving 1 unit at AM only?
 
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Yuling & Casper said:
Thanks Nan & Amber! We were so happy last night, the tires were in smoke when we went to pick him up. :joyful:
Click to expand...

I bet!!!!

Yuling & Casper said:
The doses were started at 1unit/dose, AM & PM, reduced to 0.5 unit/dose, AM & PM, adjusted to now 1unit/dose, AM only.
His AMPS number was in the high 400s, while +7 at 57. *Sigh
Click to expand...

Well, regardless of how he got here, that 57 means it's time for a reduction already! Next dose, and going forward, shoot no more than 0.75U. And any time he goes that low, he gets some high carb yummy food to bring him back up.

I think you'll like the Lantus much better than Caninsulin, once you find the proper dose for your little guy. Fingers crossed that he does well on the lower dose.

It's possible that one reason he went low today is that his numbers have been artificially high due to stress at the vet, and he's just happy to be home now :cat: and needs less insulin than they thought :).
 
I just had a look at Casper's spreadsheet.

Has he eaten since the 57 reading?

* * * Please can you test him again immediately because 57 is TOO LOW on an Alphatrak. * * *

If the reading is under 68 please give Casper a couple of teaspoons of high carb food and then post the test result here as soon as you've done that so that we can help you further.


Yuling & Casper said:
The doses were started at 1unit/dose, AM & PM, reduced to 0.5 unit/dose, AM & PM, adjusted to now 1unit/dose, AM only.
His AMPS number was in the high 400s, while +7 at 57. *Sigh
Click to expand...
With 57 on an Alphatrak, the 1IU dose is too high. The lower bound of the normal reference range is 68, so please go back to the vets first thing about the dose, and please don't give another 1IU dose. It needs to be reduced.


Mogs
.
 
On an AT2, the take action number is 68.
That 57 is too low on the alpha trak meter please feed him a couple teaspoons of high carb food and test again
 
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