New Member - questions about hypoglycemic episode

[Debbie and Spencer]

Hi - I am a new member! My 12 year old cat Spencer had a hypoglycemic episode last week. When I got him to the ER his blood glucose was 34 or 36? Can’t remember which. He was confused but I did not see any seizure activity on the drive to the ER. He was in the ER for a few nights - the wanted to do an abdominal ultrasound which was indicative of inflammatory bowel disease which we already knew he had. When I got him home he was not acting like the cat he was before the hypoglycemic event - he seems confused and can’t remember how to really be a normal cat - he sleeps in a weird position on the floor with his head pushed under the cabinet, his legs are weak and splay out. He can’t really relax and settle down and sleep unless I’m holding him. It seems like he’s had a stroke or suffered brain damage from lack of glucose to the brain. He can still eat, he has a little trouble drinking, but can do it, he uses the litter box fine. Any thoughts, ideas would be much appreciated! Thank you!

 

[Critter Mom]

Hi Debbie, and welcome to yourself and Spencer.

I'm really sorry to hear that Spencer had a hypo last week and that he's still not himself yet. (((Spencer)))

What you're describing is outwith my experience so I'm going to tag some extremely knowledgeable members to ask whether they can give you advice about Spencer's current clinical signs following the hypo episode:

@Wendy&Neko
@Marje and Gracie

While you're waiting to hear back, please can you provide a little more information, as follows:

1. When did Spencer start insulin treatment?
2. Which insulin is Spencer being treated with?
3. What dose was he on when he had the hypo episode?
4. Is Spencer still receiving insulin?
5. If 'yes' to question 4, what dose is he on now?
6. Do you home test Spencer's blood glucose levels? If yes, please can you give us an indication of the range he has been running in since he came home from the ER.


Mogs
.

 

[Dyana]

Is his eyesight fine?

 

[Critter Mom]

Helpful link:

How to test a cat's vision


Mogs
.

 

[Marje and Gracie]

Hi - I am a new member! My 12 year old cat Spencer had a hypoglycemic episode last week. When I got him to the ER his blood glucose was 34 or 36? Can’t remember which. He was confused but I did not see any seizure activity on the drive to the ER. He was in the ER for a few nights - the wanted to do an abdominal ultrasound which was indicative of inflammatory bowel disease which we already knew he had. When I got him home he was not acting like the cat he was before the hypoglycemic event - he seems confused and can’t remember how to really be a normal cat - he sleeps in a weird position on the floor with his head pushed under the cabinet, his legs are weak and splay out. He can’t really relax and settle down and sleep unless I’m holding him. It seems like he’s had a stroke or suffered brain damage from lack of glucose to the brain. He can still eat, he has a little trouble drinking, but can do it, he uses the litter box fine. Any thoughts, ideas would be much appreciated! Thank you!

My concern is that he needs to be seen by a vet. Had he been alone before you got the 34; is it possible he had already had more serious symptoms?

 

[Critter Mom]

@Marje and Gracie - Can hypos trigger petit mal or focal seizures?


Mogs
.

 

[Marje and Gracie]

@Marje and Gracie - Can hypos trigger petit mal or focal seizures?

Mogs
.

It’s not as common as a generalized seizure in cats due to a hypo but, yes, it can occur.

 

[Critter Mom]

It’s not as common as a generalized seizure in cats due to a hypo but, yes, it can occur.

Thank you for this information, Marje.


Mogs
.

 

[Marje and Gracie]

Thank you for this information, Marje.


Mogs
.

You’re welcome. I hope everything is ok with Spencer.

 

[Debbie and Spencer]

Hi Debbie, and welcome to yourself and Spencer.

I'm really sorry to hear that Spencer had a hypo last week and that he's still not himself yet. (((Spencer)))

What you're describing is outwith my experience so I'm going to tag some extremely knowledgeable members to ask whether they can give you advice about Spencer's current clinical signs following the hypo episode:

@Wendy&Neko
@Marje and Gracie

While you're waiting to hear back, please can you provide a little more information, as follows:

1. When did Spencer start insulin treatment?
2. Which insulin is Spencer being treated with?
3. What dose was he on when he had the hypo episode?
4. Is Spencer still receiving insulin?
5. If 'yes' to question 4, what dose is he on now?
6. Do you home test Spencer's blood glucose levels? If yes, please can you give us an indication of the range he has been running in since he came home from the ER.

Spencer started insulin treatment about 8 years ago after a bout with pancreatitis. He has always been on Lantus insulin.

Hi Debbie, and welcome to yourself and Spencer.

I'm really sorry to hear that Spencer had a hypo last week and that he's still not himself yet. (((Spencer)))

What you're describing is outwith my experience so I'm going to tag some extremely knowledgeable members to ask whether they can give you advice about Spencer's current clinical signs following the hypo episode:

@Wendy&Neko
@Marje and Gracie

While you're waiting to hear back, please can you provide a little more information, as follows:

1. When did Spencer start insulin treatment?
2. Which insulin is Spencer being treated with?
3. What dose was he on when he had the hypo episode?
4. Is Spencer still receiving insulin?
5. If 'yes' to question 4, what dose is he on now?
6. Do you home test Spencer's blood glucose levels? If yes, please can you give us an indication of the range he has been running in since he came home from the ER.


Mogs
.

Mogs
.

 

[Debbie and Spencer]

Hi Debbie, and welcome to yourself and Spencer.

I'm really sorry to hear that Spencer had a hypo last week and that he's still not himself yet. (((Spencer)))

What you're describing is outwith my experience so I'm going to tag some extremely knowledgeable members to ask whether they can give you advice about Spencer's current clinical signs following the hypo episode:

@Wendy&Neko
@Marje and Gracie

While you're waiting to hear back, please can you provide a little more information, as follows:

1. When did Spencer start insulin treatment?
2. Which insulin is Spencer being treated with?
3. What dose was he on when he had the hypo episode?
4. Is Spencer still receiving insulin?
5. If 'yes' to question 4, what dose is he on now?
6. Do you home test Spencer's blood glucose levels? If yes, please can you give us an indication of the range he has been running in since he came home from the ER.


Mogs
.

Spencer started on insulin about 8 years ago after he had pancreatitis. He has always been on Lantus insulin. He had gotten one unit in am about 7 am and then I noticed he was hypoglycemic about 11am. I'm not sure how long he had been hypoglycemic before I saw him. After I got him home I found a woman who could help me learn how to test his blood sugar, so I just started tested about a week ago, and she has him on a Fat0 now which is very slightly below the zero line on the syringe. With that dose he has been staying 199-309. I have taken him back to the vet several times and told them about the symptoms he is having and I have asked them if it could be the result of the hypoglycemia, but they all keep saying that once the blood sugar comes back up they should be fine, but he is not fine at all.

 

[Critter Mom]

Hi Debbie,

Thanks for the additional info. I feel for you. You must be so worried. I'm sorry the vets haven't done much yet. "He should be fine" isn't exactly a helpful response when it's clear that something's not right.

It's great that you're home testing Spencer's BG levels now. Would you be interested in recording his BG levels and insulin doses in one of our shareable spreadsheets? If yes, then we might be able to help you interpret what's currently happening on that side of things. Here are the how-to guides:

How to set up a spreadsheet for your cat

How to use your cat's spreadsheet

If you'd like assistance with this, just shout and we'll find someone to help you get it going.

By way of general information, it is possible for cats who've been on insulin for a long time to start going into remission.

As I mentioned last night, I've not got any experience of dealing with clinical signs such as those you've observed in Spencer so all I can do is make some general speculative suggestions based on what I think I might do myself in such a situation (with no idea of whether or not the suggestions have any merit whatsoever - just throwing ideas out):

* If they haven't already done so, perhaps ask the vets to run blood tests/other diagnostics to investigate whether there's anything else that might be going on which may be responsible for the clinical signs you're observing.

* Seek a second opinion from a different vet.

* Ask the vets for a referral to a veterinary neurology specialist.

I wish I had something more concrete to suggest. (((Spencer)))

@Marje and Gracie - is there anything you can think of that Debbie might try next?


Mogs
.

 

[Marje and Gracie]

Hi Debbie,

Thanks for the additional info. I feel for you. You must be so worried. I'm sorry the vets haven't done much yet. "He should be fine" isn't exactly a helpful response when it's clear that something's not right.

It's great that you're home testing Spencer's BG levels now. Would you be interested in recording his BG levels and insulin doses in one of our shareable spreadsheets? If yes, then we might be able to help you interpret what's currently happening on that side of things. Here are the how-to guides:

How to set up a spreadsheet for your cat

How to use your cat's spreadsheet

If you'd like assistance with this, just shout and we'll find someone to help you get it going.

By way of general information, it is possible for cats who've been on insulin for a long time to start going into remission.

As I mentioned last night, I've not got any experience of dealing with clinical signs such as those you've observed in Spencer so all I can do is make some general speculative suggestions based on what I think I might do myself in such a situation (with no idea of whether or not the suggestions have any merit whatsoever - just throwing ideas out):

* If they haven't already done so, perhaps ask the vets to run blood tests/other diagnostics to investigate whether there's anything else that might be going on which may be responsible for the clinical signs you're observing.

* Seek a second opinion from a different vet.

* Ask the vets for a referral to a veterinary neurology specialist.

I wish I had something more concrete to suggest. (((Spencer)))

@Marje and Gracie - is there anything you can think of that Debbie might try next?

Mogs
.

Mogs has covered it very well but, Debbie, it is our experience here that cats can have long-term residual effects from a hypo especially if you do not know how long he might have been having a symptomatic hypo before you saw him. For any vet to say that once the symptoms are over, he’s fine, is really very sad.

I would absolutely find another vet and Mogs has some good suggestions. Also, we can help you more if you have a spreadsheet. Cats who have had symptomatic hypos are sensitive to insulin. With a SS and some testing data, we can help you determine if he perhaps doesn’t need insulin or if there is a better dose.

 

[Critter Mom]

@Marje and Gracie - Thank you.


Mogs
.

 

[Marje and Gracie]

@Marje and Gracie - Thank you.


Mogs
.

You’re welcome, Mogs.

 

[Critter Mom]

Hi Debbie,

How is Spencer doing today? (((Spencer)))

There's a general cat health forum called thecatsite.com. I'm not a member of that community but there have been several times I've found useful information in their discussions when searching the web for cat health topics and some of the members there seem to be quite knowledgeable. I wonder whether it might be an idea for you to ask on that site about the worrying clinical signs you're observing in Spencer (might be a wider audience than FDMB for your question).




Mogs
.