911 HYPOGLCEMIA

UPDATE ON SASSY! She made it through the night fine...she is still in the hospital room, so at nights its almost 14 hours I don't get to see her. She is about the same as yesterday but the seizures are just a few seconds when she does have them. The doctor said last night she had 4. The doctor in Bangkok said she would need 3-5 days to not have seizures anymore. She is completely limp still. Yesterday she didn't have any insulin. We will start again today. The doctors here dont really know how to manage the kind of insulin I use. So will probably go with 1/4 dose.
Also in regards to offers to help with sassys numbers and dosages. Thanks Ill try and make a page. I actually do know how to give dosages. I kept chart for sassy about 5 years. She just wouldn't eat the day the hypo happened. So maybe has keatosis. But no way to test here. Doctors dot have test stripes and neither do I. Will try and order some online. I just tested her without insulin and she was 340. So about the normal.
 
Hi I just wanted to link your ladt post from 2017
https://felinediabetes.com/FDMB/threads/lantus-ok-with-pancreitus.181108/

Thanks for the update on Sassy, so you got to visit with her today ?
The doctors don't know how to manage the insulin she's on?
What insulin is she on ?
They can't test for ketones either ?
Has she been eating anything?
I'm praying that tomorrow there will be some improvement.:bighug::bighug::bighug:
 
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ThailandKitty said:
The doctors here dont really know how to manage the kind of insulin I use. So will probably go with 1/4 dose.
Also in regards to offers to help with sassys numbers and dosages. Thanks Ill try and make a page. I actually do know how to give dosages. I kept chart for sassy about 5 years. She just wouldn't eat the day the hypo happened. So maybe has keatosis. But no way to test here. Doctors dot have test stripes and neither do I. Will try and order some online. I just tested her without insulin and she was 340. So about the norm
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You don't have to make a page I guess you are referring to the spresdsher we use
Just take care of yourself and Sassy. I am going to ask one of our members to set up the spreadsheet for you and your signature.
We will help you
The signature is at the end of everyone's post in gray which contains information about our kitties. I will contact Bhooma to do this for you, she will send you a private message , look for it in your inbox above .Praying for your girl to pull through. @Bandit's Mom
Bhooma in case you haven't seen what happened to Sassy please read her posts
Thank you Bhooma :bighug::cat:
@Bandit's Mom
 
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ThailandKitty said:
UPDATE ON SASSY! She made it through the night fine...she is still in the hospital room, so at nights its almost 14 hours I don't get to see her. She is about the same as yesterday but the seizures are just a few seconds when she does have them. The doctor said last night she had 4. The doctor in Bangkok said she would need 3-5 days to not have seizures anymore. She is completely limp still. Yesterday she didn't have any insulin. We will start again today. The doctors here dont really know how to manage the kind of insulin I use. So will probably go with 1/4 dose.
Also in regards to offers to help with sassys numbers and dosages. Thanks Ill try and make a page. I actually do know how to give dosages. I kept chart for sassy about 5 years. She just wouldn't eat the day the hypo happened. So maybe has keatosis. But no way to test here. Doctors dot have test stripes and neither do I. Will try and order some online. I just tested her without insulin and she was 340. So about the normal.
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Thanks for update. I’m glad you spoke to the doctor in Bangkok. If you need any help with anything , just ask.:bighug:
 
I hope Sassy continues to improve over time, she and you both went through a very frightening experience. I appreciate that you have been managing her diabetes and dosing for some time, so my only comment is that her severe prolonged symptoms clearly indicated overdose albeit as you say her interest in eating was minimal. It would be important to ensure continued monitoring of her BG levels and definitely start back with a small dose, since as a few of us have pointed out, she will likely be very sensitive to insulin.

My only other thought is a question - do you think Sassy may have gotten into something/eaten some kind of toxin?

Sending all the best positive vines for Sassy's speedy recovery, and I hope you are doing ok yourself.
 
ThailandKitty said:
UPDATE ON SASSY! She made it through the night fine...she is still in the hospital room, so at nights its almost 14 hours I don't get to see her. She is about the same as yesterday but the seizures are just a few seconds when she does have them. The doctor said last night she had 4. The doctor in Bangkok said she would need 3-5 days to not have seizures anymore. She is completely limp still. Yesterday she didn't have any insulin. We will start again today. The doctors here dont really know how to manage the kind of insulin I use. So will probably go with 1/4 dose.
Also in regards to offers to help with sassys numbers and dosages. Thanks Ill try and make a page. I actually do know how to give dosages. I kept chart for sassy about 5 years. She just wouldn't eat the day the hypo happened. So maybe has keatosis. But no way to test here. Doctors dot have test stripes and neither do I. Will try and order some online. I just tested her without insulin and she was 340. So about the normal.
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The doctors should be able to do bloodwork to determine what Sassy’s electrolytes are and what kind of IV fluids she needs - whether she needs her electrolytes re-balanced. What I am saying is that they don’t need ketone test strips to determine if she is in diabetic ketoacidosis. They can run bloodwork to monitor her health. If she is DKA and they aren’t actually treating it, that is dangerous to Sassy.
 
You and Sassy have been through so much. I have read every post and how the wonderful people here at FDMB have helped you, stayed with you, prayed for you and Sassy. I wanted to add my loving prayers that Sassy improves. I pray she gets through this crisis. I will continue to check for updates. I hope you can find time to take care of yourself, Sassy will need a healthy rested mom, you have my continued prayers. ❤️:bighug:❤️:bighug::bighug:❤️:bighug:
 
I hope your girl Sassy is ok. Reading through these messages, I am just in tears for you both. I hope she pulls through. You did an amazing job through her crisis and you obviously love her so much ♥️♥️♥️
 
Sassy UPDATE - I have spoken to several doctors online in Bangkok and the vets on my island. Everyone seems to hold the same opinion. That the 8 hours of seizures probably caused brain damage that cannot be fixed. They said even 10 min of a seizure could do this. And her very first seizure was over an hour. They said that she could stay alive but would probably be a vegetable and need to be fed, diapered etc. Her seizures finally have completely stopped today (which they said was good) and she received many IV's for dehydration, seizure medicine and brain swelling medicine. She is also eating food in syringes so some progress. But most defiantly seems unresponsive in every way. If I call her doesn't notice, cant purr, no response to pets, only responds if I rub her ears. Can only blink. It's been 72 hours. They gave her some insulin 1x yesterday (when she wasn't eating yet) 1line on a 0.5ml needle (her usual dose was 2-3 lines). She was fine with this dosage but again they only gave it 1x yesterday. Her numbers were 126 when she got the shot. Today with food intake I just tested her and she was 450 so I gave her 1 line again. Probably too little but wanted to be safe....

In regards to someone question no I don't think she got into some toxins....because she is an indoor cat. I do think she had ketosis cause I was just reading the symptoms and she had most of them. Wish I would have seen that earlier. I took her to the doctor a few days before for a blood workup cause she wasn't eating and she said everything was normal.

I have her at a hotel with me now because the vet is closed today and I want to spend her days with mommy. I am feeding every 4 hours. Just gave the insulin now. She is breathing fine. The current plan is to Euthanasia her tomorrow if she isn't better. Which I would prefer not to do....but don't seem to have any optimism coming in? Or other cats that maybe had the same thing and survived. Any stories anyone can share?

Also now that she isnt having seizures she is safe to travel so could go to Bangkok for more tests....but not sure it would do any good. I dont know enough about the brain to know if it needs time to recover? How much?
I just lost her sister last month too. All of us were together for 15 years. Unless anyone has some pearls of wisdom, or other suggestions....I don't know what else to do.
 
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Bron and Sheba (GA) said:
I am so sorry Sassy is not improving. I think it could take longer than this for things to improve but you must do what you think is best for her and for you. We will support you whatever you decide.
You are a wonderful cat mom
:bighug::bighug::bighug:
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Yes I mean I dont want to....but seems a little hopeless. If someone could give me some flash of hope i would gladly take it!
 
ThailandKitty said:
Yes I mean I dont want to....but seems a little hopeless. If someone could give me some flash of hope i would gladly take it!
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As long as she's not in pain it's OK to take an extra day or two to decide and feel comfortable with whatever decision you make. Her quality of life needs to be strongly considered. So sorry you are going through this.

I will say when my mother had a seizure she didn't remember any of it and was surprised to find herself in the hospital. It was a grand mal seizure that lasted about 1-2 minutes... Never had one before or since. It took about a month for her short term memory to come back. We had to explain to her a hundred times what happened and the week following it, her personality was different.
 
I agree with JanetNJ. If she doesn't appear to be in any pain it would probably be okay to take and extra day or two just to see if she starts coming around. But I believe in miracles - others may not. As she said, we will support any decision you make. Thank you for the update and wonderful to hear her tail started moving! :bighug::bighug::bighug:
 
Summer and Susie (GA) said:
I agree with JanetNJ. If she doesn't appear to be in any pain it would probably be okay to take and extra day or two just to see if she starts coming around. But I believe in miracles - others may not. As she said, we will support any decision you make. Thank you for the update and wonderful to hear her tail started moving! :bighug::bighug::bighug:
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I most definatly believe in miracles...I may take her back in tomorrow and get some more IV drips and meds and then bring her home at night again. But she is grabbing a little if I push on her paws a bit. Which is a first
 
Also, I am glad you are syringe feeding her. If she is swallowing, then that part of her brain is working. It is important to get food into her to prevent hepatic lipidosis, which also requires intensive veterinary care.

I agree that you should take as much time as necessary so that you feel comfortable with your decision. She may be a miracle kitty. I will pray that she is!
 
ThailandKitty said:
Sassy UPDATE - I have spoken to several doctors online in Bangkok and the vets on my island. Everyone seems to hold the same opinion. That the 8 hours of seizures probably caused brain damage that cannot be fixed. They said even 10 min of a seizure could do this. And her very first seizure was over an hour. They said that she could stay alive but would probably be a vegetable and need to be fed, diapered etc. Her seizures finally have completely stopped today (which they said was good) and she received many IV's for dehydration, seizure medicine and brain swelling medicine. She is also eating food in syringes so some progress. But most defiantly seems unresponsive in every way. If I call her doesn't notice, cant purr, no response to pets, only responds if I rub her ears. Can only blink. It's been 72 hours. They gave her some insulin 1x yesterday (when she wasn't eating yet) 1line on a 0.5ml needle (her usual dose was 2-3 lines). She was fine with this dosage but again they only gave it 1x yesterday. Her numbers were 126 when she got the shot. Today with food intake I just tested her and she was 450 so I gave her 1 line again. Probably too little but wanted to be safe....

In regards to someone question no I don't think she got into some toxins....because she is an indoor cat. I do think she had ketosis cause I was just reading the symptoms and she had most of them. Wish I would have seen that earlier. I took her to the doctor a few days before for a blood workup cause she wasn't eating and she said everything was normal.

I have her at a hotel with me now because the vet is closed today and I want to spend her days with mommy. I am feeding every 4 hours. Just gave the insulin now. She is breathing fine. The current plan is to Euthanasia her tomorrow if she isn't better. Which I would prefer not to do....but don't seem to have any optimism coming in? Or other cats that maybe had the same thing and survived. Any stories anyone can share?

Also now that she isnt having seizures she is safe to travel so could go to Bangkok for more tests....but not sure it would do any good. I dont know enough about the brain to know if it needs time to recover? How much?
I just lost her sister last month too. All of us were together for 15 years. Unless anyone has some pearls of wisdom, or other suggestions....I don't know what else to do.
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This is heartbreaking for you and the rest of us who have followed this episode, having fears the same could happen to our fur babies. Still praying there is hope and improvement. Love her well these next few hours and know you did your best for her no matter the outcome.
 
My heart is breaking right now! I'm praying for both of you, to hear that her tail is moving and she is grabbing a little with her paws is a sign of hope. I'm praying for a miracle for Sassy and I'm sorry you lost her sister last month ♥We are all here for you and support any decision you make. Please sweet Sassy we are all praying for you to improve :bighug::bighug::bighug::bighug:♥♥
 
ThailandKitty said:
Some good news her tail just started moving!!! The 1 line of insulin was not enough...so she is high +3 400.
Does anyone know is ketosis could have caused this coma (with eyes open) she is sort of in? Any treatment options I can try?
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well that's a good sign!!!!
Are you sure you can't get testing strips for ketones in the pharmacy in your country? Did you ask the pharmacists? They are made for people. You may be able to find ketone reading meters (although probably only online) that work with a blood sample the same as a glucose meter. This is what I used because it was much easier than waiting for her to use her box.
 
Hello I will ask about the ketones stripes in the pharmacy. They didnt have at the doctor. Thank you for the music. I will play it later....but it seems maybe sassy hearing is not working yet again. But she is making some progress with her tail and paws still...and responding little to pets. So that good. The insulin at +6 was 450....almost didnt seem like I didnt give it at all. The doctors dont really know how to give the insulin here...and dont want to listen. So think I will have to be in charge of it only. I will try 1.5 lines at her next shot.
 
ThailandKitty said:
Hello I will ask about the ketones stripes in the pharmacy. They didnt have at the doctor. Thank you for the music. I will play it later....but it seems maybe sassy hearing is not working yet again. But she is making some progress with her tail and paws still...and responding little to pets. So that good. The insulin at +6 was 450....almost didnt seem like I didnt give it at all. The doctors dont really know how to give the insulin here...and dont want to listen. So think I will have to be in charge of it only. I will try 1.5 lines at her next shot.
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Hello, so nice to hear Sassy has made a few positive movements, her tail, her paws. I can’t begin to imagine what a scary journey this has been for you. I have watched you through your words and actions display the the most incredible love you have for Sassy. You put your heart and soul into every action to help her. Only you (and the vet) and Sassy will know on a day to day basis what is best for Sassy and her quality of life. You have all of us here supporting whatever decisions you make as each day comes. You have my loving prayers that both of you can heal from this trauma. You are the the most loving, patient mom. Sending giant loving hugs to surround you both. :bighug::bighug::bighug::bighug::bighug:
So deeply saddened about the loss of Sassy’s sister just a month ago. 15 years is a long time and you are still probably grieving for her. She is happy, flying free and I’m sure watching over her sister Sassy and you from the Rainbow :rb_icon:Bridge.
 
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I am so sorry for what you and Sassy are going through.

I don't have any experience with seizures or brain trauma related to a hypo event or DKA but my non-diabetic cat JJ had a severe stroke with seizures some years ago. When I brought her to the ER, JJ was completely unresponsive and honestly, I wasn't sure she was even still alive. She was but she was in really bad shape - they had to wait a few days to even chance putting her under to get an MRI done and when they did, the neurosurgeon told me that he had not seen a scan that bad on a live cat before. BUT he also told me that cats have an incredible ability to recover from strokes and that I shouldn't lose hope. Amazingly, after getting supportive care in the ER for about a week, JJ was able to come home. She was very very tired and slept a lot at first but over the next few months, she made almost a 100% recovery. It was a miracle.

Of course, Sassy's circumstances are different and I don't want to give you false hope but I did want to share this story about JJs stroke/brain trauma because based on what JJ was like immediately after the stroke, I really did not believe that recovery would ever be possible.

I think Sassy's paws and tail moving and her swallowing are all good signs. But like others have said, we are here to be with you and support you in whatever decision you make. Sending prayers and hugs. :bighug::bighug::bighug:
 
ThailandKitty said:
Hello I will ask about the ketones stripes in the pharmacy. They didnt have at the doctor. Thank you for the music. I will play it later....but it seems maybe sassy hearing is not working yet again. But she is making some progress with her tail and paws still...and responding little to pets. So that good. The insulin at +6 was 450....almost didnt seem like I didnt give it at all. The doctors dont really know how to give the insulin here...and dont want to listen. So think I will have to be in charge of it only. I will try 1.5 lines at her next shot.
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Calming music may help with YOUR stress as well which she may pick up on. Even not hearing she may be able to feel vibrations.
 
Jessica A said:
I am so sorry for what you and Sassy are going through.

I don't have any experience with seizures or brain trauma related to a hypo event or DKA but my non-diabetic cat JJ had a severe stroke with seizures some years ago. When I brought her to the ER, JJ was completely unresponsive and honestly, I wasn't sure she was even still alive. She was but she was in really bad shape - they had to wait a few days to even chance putting her under to get an MRI done and when they did, the neurosurgeon told me that he had not seen a scan that bad on a live cat before. BUT he also told me that cats have an incredible ability to recover from strokes and that I shouldn't lose hope. Amazingly, after getting supportive care in the ER for about a week, JJ was able to come home. She was very very tired and slept a lot at first but over the next few months, she made almost a 100% recovery. It was a miracle.

Of course, Sassy's circumstances are different and I don't want to give you false hope but I did want to share this story about JJs stroke/brain trauma because based on what JJ was like immediately after the stroke, I really did not believe that recovery would ever be possible.

I think Sassy's paws and tail moving and her swallowing are all good signs. But like others have said, we are here to be with you and support you in whatever decision you make. Sending prayers and hugs. :bighug::bighug::bighug:
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Thank you what a great story of survival! Thank you for sharing and your kind words
 
Our Dolly Girl (GA) said:
Hello, so nice to hear Sassy has made a few positive movements, her tail, her paws. I can’t begin to imagine what a scary journey this has been for you. I have watched you through your words and actions display the the most incredible love you have for Sassy. You put your heart and soul into every action to help her. Only you (and the vet) and Sassy will know on a day to day basis what is best for Sassy and her quality of life. You have all of us here supporting whatever decisions you make as each day comes. You have my loving prayers that both of you can heal from this trauma. You are the the most loving, patient mom. Sending giant loving hugs to surround you both. :bighug::bighug::bighug::bighug::bighug:
So deeply saddened about the loss of Sassy’s sister just a month ago. 15 years is a long time and you are still probably grieving for her. She is happy, flying free and I’m sure watching over her sister Sassy and you from the Rainbow :rb_icon:Bridge.
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Thank you! Yes these pets are my best family! I have loved them soooo much! Still loving sassy now!
 
I also have had two cats now who have had brain seizures. They were not diabetic, but they had problems afterwards. In one case, the vet at the ER said to put my Tabitha down. I refused and took her home. She couldn’t walk. She did recover and slowly began to walk again (weakly at first with falling down). She was blind for a time as well but recovered her eyesight.
Now with my boy Maverick, he couldn’t walk either and slowly learned to walk again… like a drunken cat at first. He was also blind and learned to navigate around without sight. He eventually recovered his eyesight. This all took time.

I know this is not exactly the same as what happened to Sassy, but I thought I would share anyway.
 
I would caution you to be very careful with the insulin at this point. Just because she had a reading in the 400s doesn’t mean she needs an increase in dose just yet. That was a catastrophic hypo situation, and depending on how often you were testing before and whether you were adjusting dose according to a slow and methodical protocol, it’s possible that she was being overdosed for quite some time and her body’s compensatory defenses were overwhelmed. I’m not saying that happened, but without comprehensive data, it’s possible. We’ve seen it before.

What insulin are you using? What is the strength? What syringes are you using? Photos are great if you can post them (copy/paste into the message if you can because the upload function is broken). I believe I saw reference to Lantus (100 mg/ml is typical strength) but it’s worth verifying. In some countries, we’ve seen vets prescribe insulins that are harsh and not really appropriate for cats as well as syringes that aren’t ideal for drawing small doses.

It’s important to have a clear understanding of what insulin you’re using as well as the syringe type in order to understand what “one line” means as far as units of insulin. Also, different insulins have different “action” and that matters too. You’re working with a very delicate situation so details really matter right now. And the more BG values you can collect over the next few days, the better it will help paint the picture of what’s happening.

Again, please be very, very careful about increasing the dose just yet. Especially if she’s on Lantus, you’ll want to allow time for the depot to fill. You absolutely don’t want to find yourself in another hypo situation. I doubt she’d have the strength to survive it.

It sounds positive that you’re seeing little improvements. Recovery takes a very long time, and we just don’t know what’s possible if we don’t try. She’s obviously wrung out from the experience but it doesn’t sound like she’s suffering, so if she continues to be stable, and if you have the time and resources to see how this plays out, I don’t think it’s wrong. You can always make the decision to let her go if things start going the wrong direction.

We had a cat on the board many years ago who was massively overdosed (30x normal dose) by a worker at a vet clinic. Toonces seized for hours while no one was around and nearly died. He recovered up to a point but did have permanent injuries as a result. I don’t think Stefani comes around much these days (Toonces passed away approx 15 years ago) but she moved heaven and earth to help Toonces and she might be able to provide insight into what the recovery looked like and how long things took to happen. @Stefani Olsen

Best wishes. I’m pulling for you.
 
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Sassy Update - Decided to give her a few more days see if she recovers more. Just took her to the vet for IV fluids, medicine for the brain swelling again. She has very high number 400-500 all through the night. High fat...with low insulin dose. Just figured out why...cause vet sent me home with kitten food in the syringes. oops. Not exactly sure what to do about that....need her to eat most importantly. Doctor had told me 3x 3ml of food every 4 hours, 1ml chicken broth, 3ml of water. Have some of her normal food at home...but staying in a hotel the opposite side of the island...next to the vet. Sassy on the bright side peed...which the doctor said she couldn't do.

will post some pics of the dosages in the next message.
 
I am so happy and relieved for you and Sassy! And she peed! A cause for celebration! I hope she continues to improve. She seems like a fighter. Wishing all the best for you both. :bighug::bighug:
 
ThailandKitty said:
Sassy Update - Decided to give her a few more days see if she recovers more. Just took her to the vet for IV fluids, medicine for the brain swelling again. She has very high number 400-500 all through the night. High fat...with low insulin dose. Just figured out why...cause vet sent me home with kitten food in the syringes. oops. Not exactly sure what to do about that....need her to eat most importantly. Doctor had told me 3x 3ml of food every 4 hours, 1ml chicken broth, 3ml of water. Have some of her normal food at home...but staying in a hotel the opposite side of the island...next to the vet. Sassy on the bright side peed...which the doctor said she couldn't do.

will post some pics of the dosages in the next message.
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She’s already proving the doctors wrong!!
 
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