05/22/2021 "New Member" Very Lethargic, No info from Vet

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Target70

Member Since 2021
Hello, sorry if I am giving too much, I just want to cover any info that might be needed.
  • Caregiver & kitty's name: Target & Tack(~16 year old Male) in USA
  • DX: Date : 5/20/2021
  • Name of Insulin: Vetsulin
  • Name of your meter: Don't have one yet
  • Diet Old: free feed (Dry)Royal Canin Urinary SO (and) 1/2 can per day of: Fancy Feast Senior 7yrs+ Classic Pate and Minced Collection (or) Meow Mix Tender favorites
  • Diet New: Same as old minus the Royal Canin, given 2 times per day
  • Dosing: 1.5 units twice per day or half dose if he doesn't eat

Over the last month or so, Tack has been mooching any food I was eating, (even though he always has dry food out) and drinking more than usual. He is inside/outside, but as he has been getting on in years he basically lays around the yard or stays inside. Has been getting thinner though I thought some of it was summer shedding plus age. Last weekend I heard him fighting which is rare, he was very agitated, hissing constantly(never seen him do it before). Didn't see any damage or cuts, but over the next few days he got more and more lethargic. I feed him a half can of wet food when I get home from work and he usually eats all of it (sometimes throwing it back up) before going outside. By Monday he didn't want to eat just go outside, and sat in various secluded spots all night till I couldn't find him when it was time to go to bed. In the morning when I found him he had no energy, moved very slowly, and didn't eat. Took him to the only vet that could see him. Everyone else needed appointments for the next week, or weren't seeing new patients.

Due to covid restrictions they got him while we waited in the car. They came out saying his BG? was 300 and needed to give him insulin and to check back the next day. Each day I called in the morning.
First morning they said it was 275 next 38 and had to keep him longer, by the third day they said it was 76 and still slightly out of tolerance but was eating well so they would release him by end of day.

Since I couldn't go in, I never saw the Vet again only assistants. I was given Vetsulin and told to give 1.5 units twice per day with food or half dose if he doesn't eat. I wasn't told what they were feeding him, or how much to feed him or given any paperwork whatsoever, so I'm kind of in the dark. I found this site and started reading the "getting started" section on the homepage and saw I should let him eat 30 minutes before injection (If I can get him to eat). The Vet never told me so I guess they didn't check for ketones.

current situation after being brought home, I cut out the Dry food, but no matter what wet food I tried, he didn't eat much, maybe 20oz of the fancy feast the first evening, nothing this morning so I only gave him .75 units, and maybe he ate 1/3rd of a can tonight. I'm trying to learn as fast as I can, but He seems very thin, dehydrated, doesn't have much of an appetite, and I don't have a meter yet. Do I need to try taking him to a different vet? Does this behavior sound like complications with the insulin? Ketoacidosis?

It seems I need a meter ASAP, but not sure what to look for. It sounds like a human meter from a drug store would take the least time to get but is any particular one preferred? Are there ones that have relatively inexpensive test strips? Should I try to force feed with a syringe if he doesn't eat?

Anyway, sorry for the novel, Any suggestions would be very appreciated. And Thanks so far for the information I have found on the site.
 
You need to run out and get a meter. Right now. Walmart and the Relion meter for humans and some strips. Vetsulin hits hard and fast, why the food needs to be on board before giving insulin. 38 is WAY too low, and his behavior could indicate a hypo.
And cutting out the dryfood isn't recommended until you're comfortable testing, since it's high carb and the lack there of can be dangerous.
So please, get a meter right now.
 
SashaV said:
You need to run out and get a meter. Right now. Walmart and the Relion meter for humans and some strips. Vetsulin hits hard and fast, why the food needs to be on board before giving insulin. 38 is WAY too low, and his behavior could indicate a hypo.
And cutting out the dryfood isn't recommended until you're comfortable testing, since it's high carb and the lack there of can be dangerous.
So please, get a meter right now.
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Thanks for the reply. 38 was 3 days ago, under the vet's care while trying to dial in the dosage. Unfortunately thanks to covid, Walmart is closed after 11pm now, so I will have to wait at least a few more hours before they open again (it's 5am for me). I'll check out the Relion meter, thanks for the suggestion.
 
Target70 said:
Thanks for the reply. 38 was 3 days ago, under the vet's care while trying to dial in the dosage. Unfortunately thanks to covid, Walmart is closed after 11pm now, so I will have to wait at least a few more hours before they open again (it's 5am for me). I'll check out the Relion meter, thanks for the suggestion.
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When did you remove the dry?
 
SashaV said:
When did you remove the dry?
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I don't know what the vet was feeding him while he was boarded for Mon-Wed. I got him back Wed afternoon and still had it then. I left it out for him Thursday along with multiple wet foods since I couldn't get him to eat before I went to work. I don't think he ate much or any of it from the look of the bowl. I removed it Thursday night so I guess maybe 30 hours ago.
 
I would also recommend you but a bottle of Ketostix from Walmart while you are there so you can test the urine foe ketones.
It is really really important that he eats and eats well. Otherwise you will run into other problems.
Let him eat whatever he wants at the moment. Any food is better than none. It is fine to let him eat the dry food at the moment. Eating trumps everything else.
If he doesn’t eat, you run the risk of ketones or hepatic lipidosis, both I’d which are serious and if he ends up in hospital, can be expensive.
Here is a link to things to do to try and get him to eat.
https://www.felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/

If he is still not eating, he may be nauseated and may need some antinausea medication such as cerenia or ondansetron. You can ask the vet for those. But do not leave him and think it will just get better. You need to get him eating.
The other thing you can do is syringe feed him
https://www.felinediabetes.com/FDMB/threads/syringe-assisted-feeding-videos-and-tips.144367/

How long is it since you have seen him eat?

It is very frustrating when you don’t get to talk to the vet and get proper instructions. I think that is very poor.
I am glad you are getting a meter to test the blood glucose.
Please keep posting and asking for help
 
I thing I would take him to another vet now if you can or an ER and get him tests for ketones and dehydration. If he does have ketones they can easily increase rapidly and it is much better to catch them early if you can.
 
I agree with everything said above, and in addition to checking blood glucose, I just want to stress what Bron said about ketones-- it's critical to test for ketones with those symptoms, and get him to a (better) vet ASAP if that is the problem. Those symptoms are concerning.

After his fight, is there any chance he was wounded? Any tender spots, swellings, areas that seem hot?
 
Bron and Sheba (GA) said:
I would also recommend you but a bottle of Ketostix from Walmart while you are there so you can test the urine foe ketones.
It is really really important that he eats and eats well. Otherwise you will run into other problems.
Let him eat whatever he wants at the moment. Any food is better than none. It is fine to let him eat the dry food at the moment. Eating trumps everything else.
If he doesn’t eat, you run the risk of ketones or hepatic lipidosis, both I’d which are serious and if he ends up in hospital, can be expensive.
Here is a link to things to do to try and get him to eat.
https://www.felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/

If he is still not eating, he may be nauseated and may need some antinausea medication such as cerenia or ondansetron. You can ask the vet for those. But do not leave him and think it will just get better. You need to get him eating.
The other thing you can do is syringe feed him
https://www.felinediabetes.com/FDMB/threads/syringe-assisted-feeding-videos-and-tips.144367/

How long is it since you have seen him eat?...
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thank you so much for the information. I will put the dry food back out. I had tried spooning food in his mouth and he just spit it back out, so if he refuses to eat I can try the syringe method. Let's see.. I got him to eat about 1/3 can of the fancy feast pate at 1am or about 6 hours ago, gave him his shot 1.25 units at 1:30am, and then he went and hid. Came back out about 2 hours later refused to eat more, then went outside and laid down. I brought him back in at about 5am and luckily got him to eat a little more, making it about half the can total. I'll try to put some more food in front if him now, but i'll be going to sleep soon, and if it is anything like yesterday he will sleep with me all night. I'll try to feed/ inject him again at 1pm. But in the meantime I'll leave out more food incase he does get up and wants to eat.

Thanks for all the help so far
 
Nan & Amber (GA) said:
I agree with everything said above, and in addition to checking blood glucose, I just want to stress what Bron said about ketones-- it's critical to test for ketones with those symptoms, and get him to a (better) vet ASAP if that is the problem. Those symptoms are concerning.

After his fight, is there any chance he was wounded? Any tender spots, swellings, areas that seem hot?
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not that I could tell but while the vet had him I think he gave him antibiotics. The bill lists Excenel injection and Onsior injection. He may have hurt his throat screaming because he is usually very vocal, but now just silent meows, except for the car ride to the vet where he was doing the panic yowl. The good thing is that he is laying 5 feet from me and just purring without me even touching him.
 
Target70 said:
The bill lists Excenel injection
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That is an uncommon antibiotic for companion animals. Per the manufacturer's .website, that antibiotic is used for:
EXCENEL RTU is indicated for treatment of:

  • Acute postpartum metritis (uterine infection) caused by organisms susceptible to ceftiofur
  • Bovine respiratory disease (pneumonia, shipping fever, BRD) due to Mannheimia spp. (Pasteurella haemolytica), Pasteurella multocida and Haemophilus somnus
  • Acute bovine interdigital necrobacillosis (foot rot, pododermatitis) associated with Fusobacterium necrophorum and Bacteroides melaninogenicus
  • Acute metritis (0–14 days postpartum) associated with bacterial organisms susceptible to ceftiofur.
https://www.zoetisus.com/products/dairy/excenel.aspx#
 
Update for today so far: I weighed Tack, I thought It was a good thing to keep on record, he is 8lbs 12oz(.453kg), he used to be heaver but I don't have any definitive records.
I got the ReliOn Premier Classic,(I forgot to get control solution) and some ReliOn ketone test strips. I got him to eat about 1oz of food before he lost interest at about 1:30pm, gave him his shot 1.25U at 2pm, then syringe fed him maybe another .5oz. Got back with the Meter and tested him at 4pm, or 2 hours after the shot (he read 65mg/dL). I assume this is low but without a tight control tolerance I'm not sure the meter is reading correctly.(I think I'll use myself as a control) Does the meter read differently because it is for a human? I read somewhere that the (AlphaTrak II would read different than a human meter)

He seems interested in eating but looses interest after eating a little, and goes to hide when done. I've force feed him after a few hours of not eating, but I have a small 6cc/ml syringe that I had to cut the tip off of, and am not sure how much I should give him in one feeding, also he starts to just spit it out and fight back after a while. If I need to cram 3 cans of wet food into him a day I will, but between last night and now he has only eaten 1.3, 3oz cans, and a few kernels of dry food.

the Ketone strips will be difficult, he has a larger bladder than I do. He won't pee all day. He will not use the litter box unless absolutely necessary, and just waits to go outside. (has always been like this) I'll try to get a reading the next time he wants to go out, hopefully I can trail him and push a shallow dish or something under him.

I'll have to read the instructions on the meter and start the spreadsheet or glucose curve once I figure it out.

Thanks again for the help so far
 
Hello--

Glad to hear that he's still eating a bit, and congratulations on your first test!

Target70 said:
2 hours after the shot (he read 65mg/dL).
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This is low for two hours after a shot, and low for Vetsulin. We like to keep BG above 80-90 or so with that insulin, as it can have very strong effects so it's tough to reverse course if they start to dive down.

Vetsulin usually peaks later than +2, more like +4 or +5, so he has a ways to go yet, and he's not very far above the hypoglycemia line (50 on a human meter), so it's important to keep a close eye on him and bump up the BG with carbs if necessary.

Do you have any food with lots of carbs in it that you could tempt him with? The dry food is probably high carb, then any canned food with gravy is also likely high carb.

It really seems like that 1.25U dose is too high for him. If you can test him again now (I don't know how long it's been since his shot at this point), that would be great.
 
Nan & Amber (GA) said:
Hello--

Glad to hear that he's still eating a bit, and congratulations on your first test!



This is low for two hours after a shot, and low for Vetsulin. We like to keep BG above 80-90 or so with that insulin, as it can have very strong effects so it's tough to reverse course if they start to dive down.

Vetsulin usually peaks later than +2, more like +4 or +5, so he has a ways to go yet, and he's not very far above the hypoglycemia line (50 on a human meter), so it's important to keep a close eye on him and bump up the BG with carbs if necessary.

Do you have any food with lots of carbs in it that you could tempt him with? The dry food is probably high carb, then any canned food with gravy is also likely high carb.

It really seems like that 1.25U dose is too high for him. If you can test him again now (I don't know how long it's been since his shot at this point), that would be great.
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Other than the Royal Canin Dry (39.5% carbs if my math is right) the best I have is Meow Mix tender favorites, turkey and giblets 16% carb according to https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

Alright, got him to eat almost 2/3's of a can of fancy feast. he finished at about 9:40pm, and I just finished the second test now at 10:05pm, ~8hours after last shot, measured 133mg/dl.

I plan to give the next shot at 1:30am, so I'll do a reading before the shot, I won't have time tonight, but should I try to do a test every hour to plot the curve or should I concentrate on looking for the lowest point (nadir?) (I know there was a list of terms for the curve but I can't seem to find it)
 
Phew! 133 is much better! And those foods are good for carbs. Some treats, like Temptations if he likes them, are also good for quick boosts.

Yes, a pre-shot test before the next shot would be great. No need to test between now and then tonight-- he's on the way up, and the Vetsulin is probably petering out.

You don't have to test every hour for a curve, but getting some tests in the first half of the cycle (starting around +2, 2hrs post-shot) in addition to pre-shots is usually most helpful for Vetsulin, it gives you some warning if it's going to be a busy day.

Some terminology info copied from BEGINNER'S GUIDE TO CANINSULIN/VETSULIN:

-----------------
Some key terms/acronyms that you need to know:

  • BG: Blood glucose. Sometimes called blood sugar.
  • Bounce: a sharp increase in blood glucose. It can be caused by a drop int low numbers, a fast drop in numbers, or a drop into numbers your cat is no longer used to. Bounces can take up to 3 days to resolve.
  • Curve: The shape that the graph makes when the BG numbers are graphed. Generally a full curve refers to testing every 2-3 hours throughout a cycle.
  • Cycle: A cycle is 12 hours. It is the time between shots. There are two cycles each day – an AM and a PM cycle
  • Don’t shoot and ask for help number: This is what you do when you get a pre-shot number that is initially below your comfort level for giving a shot. Do NOT feed your cat. You will want to consider whether to delay, reduce, or skip the shot. Post and other members will walk you through the options. In the first three months, we recommend using 200 as your point for asking for help number. As you collect more data and are confident in your cat’s response, you will be able to shoot lower numbers.
  • ECID: Every cat is different. While these guidelines will help you get started, ultimately you need to learn how your own cat reacts and learn to make adjustments to meet the needs of your cat. This takes time and data.
  • Mid-Cycle: The BG tests that are done between the two shots. Getting tests at different times is important to creating a full picture of how your cat is responding. So some days you can get a +6 test, some days a +4 test, some days a +9 test, etc...
  • Nadir: the lowest blood glucose number during the cycle. With Caninsulin/Vetsulin, this generally falls somewhere around 4 to 4.5 hours after the shot is given.
  • Normal BG: Normal BG for a non-diabetic cat is between 50-120 on a human meter and 68-150 on a pet meter. You will find different ranges listed throughout the internet, but this is the range we’ve found to be most accurate.
  • PS: Pre-shot. This is the BG number that you get right before you give the injection. It is used to make sure that the BG is high enough to safely inject the cat.
-----------------

Note in particular the "no-shoot" number, which in the beginning is usually 200. Not sure if Tack is going to make it there in the next four hours, to be honest, but with the worry about possible ketones we don't want to skip if at all possible. I'm not going to be awake then, but I'm tagging @Bron and Sheba (GA) in case she is around to help out then.

I do think a dose reduction is needed, since he went under 90 today (the usual trigger for a reduction on Vetsulin). We usually change doses in 0.25U increments; do you think it would be possible to measure 1.25U on your syringes? [edit: sorry, you are already shooting 1.25U! So, your new dose would be 1.0U]
 
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Hi, I can be around if needed. I’m calculating that it will be in about 3 hours from now that the next dose is due....is that correct? @Target70
I also going to tag @Bandit's Mom to ask her if she can help you setting up a spreadsheet. We really need to be seeing the data on a SS to be giving dosing advice. can you keep an eye out for a message from her....she will want you to PM (private message) her about some details.
I agree you need to reduce the dose down to 1 unit after the low of 65.
Keep trying to get that urine ketone test done if possible.
 
Nan & Amber (GA) said:
Phew! 133 is much better! And those foods are good for carbs. Some treats, like Temptations if he likes them, are also good for quick boosts.

Yes, a pre-shot test before the next shot would be great. No need to test between now and then tonight-- he's on the way up, and the Vetsulin is probably petering out.

You don't have to test every hour for a curve, but getting some tests in the first half of the cycle (starting around +2, 2hrs post-shot) in addition to pre-shots is usually most helpful for Vetsulin, it gives you some warning if it's going to be a busy day.

Some terminology info copied from BEGINNER'S GUIDE TO CANINSULIN/VETSULIN:
"..."
Note in particular the "no-shoot" number, which in the beginning is usually 200. Not sure if Tack is going to make it there in the next four hours, to be honest, but with the worry about possible ketones we don't want to skip if at all possible. I'm not going to be awake then, but I'm tagging @Bron and Sheba (GA) in case she is around to help out then.

I do think a dose reduction is needed, since he went under 90 today (the usual trigger for a reduction on Vetsulin). We usually change doses in 0.25U increments; do you think it would be possible to measure 1.25U on your syringes? [edit: sorry, you are already shooting 1.25U! So, your new dose would be 1.0U]
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Unfortunately he never really cared for the temptations.. he would "eat" them, but he just swallowed them whole, mostly does that with his dry food too, but I might grab a pack for emergencies.

Got it, I'll try to get a pre-shot test, +2, +4, and +5.

Yes thank you, that was the list I had read

Maybe I wasn't supposed to, but since I'm struggling to get him in a stable diet, I dropped that dose -0.25U when I didn't think he ate enough before the shot. I don't want to vary the amount too quickly, but if his numbers are below 200, and depending on how much I can get him to eat, I'll try to adjust. But assuming he eats another at least another half a can of food and he is around 200BG I'll try giving him 1.0U.

I'm not sure how much he should eat or how many times per day is ideal. He has been free feeding his whole life so I just always kept the bowl full. If I get him to eat another 1/2 can today that will be about 2 full cans or 6oz. The can's say 1 can for every 3 pounds so I guess 3 cans would be about right. I'll just try to keep feeding him at least 2 cans and wait to see if his appetite recovers.

I know attempting to feed him every few hours will make this inconsistent, so I really appreciate the help and advice you all have given me so far.
 
Bron and Sheba (GA) said:
Hi, I can be around if needed. I’m calculating that it will be in about 3 hours from now that the next dose is due....is that correct? @Target70
I also going to tag @Bandit's Mom to ask her if she can help you setting up a spreadsheet. We really need to be seeing the data on a SS to be giving dosing advice. can you keep an eye out for a message from her....she will want you to PM (private message) her about some details.
I agree you need to reduce the dose down to 1 unit after the low of 65.
Keep trying to get that urine ketone test done if possible.
Click to expand...
It's now 12am, so I'll give the shot in an 1, and 1/2 hours
 
Bandit's Mom said:
I think the SS is set-up? @Target70, let me know if you need any help on that front. :)
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I'm not sure if it's all right, but I just followed the guides in the spreadsheet/tech section. I'm don't know what the dosing methods mean though. Guess I'll stall on the shot, BG is reading 140. I can't stall too long, I want to keep shots at 1:30 or earlier, as I have work after that.
 
How does Tack seem? is he lethargic?
have you managed to test for ketones yet?
140 is too low to give any Vetsulin. Let’s see where he is in 20 Mins.
 
I have just seen 165 in this SS.
I also saw that Tack was wheezing? Does he do this often? Do you think you need to take him to the vet?
You also said he was not eating much. Can you comment on that please?
 
Bron and Sheba (GA) said:
How does Tack seem? is he lethargic?
have you managed to test for ketones yet?
140 is too low to give any Vetsulin. Let’s see where he is in 20 Mins.
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I'm not really sure. He looks like he is trying to sleep, but is weezing, and stomach gurgling, maybe burping, keeps shifting trying to get comfortable. I haven't tried to feed him since about 1am. I tested him again and got 165@+12.25. Still stalling
 
Target70 said:
I'm not really sure. He looks like he is trying to sleep, but is weezing, and stomach gurgling, maybe burping, keeps shifting trying to get comfortable. I haven't tried to feed him since about 1am. I tested him again and got 165@+12.25. Still stalling
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Do you think he needs to see a vet with the wheezing?
I wonder if the vet tested him for pancreatitis?
I think he is still too low to give vetsulin to atm especially as his appetite is not great.
Do you manage to get the ketone urine test done.?
 
Bron and Sheba (GA) said:
I have just seen 165 in this SS.
I also saw that Tack was wheezing? Does he do this often? Do you think you need to take him to the vet?
You also said he was not eating much. Can you comment on that please?
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Ketones: Has only went out once in the last 12 hours, if he peed, he waited for me to stop watching him to do it. He does it sometimes, It seems to have come on in the last few years. I don't think he needs a vet. Just seems restless, and or uncomfortable.
Not eating: This all started about a week ago, when he didn't eat one day and instead went outside and hid till the next day. I took him to the vet when I got up, and was diagnosed diabetic. The vet kept him for 3 days dialing in the insulin, they said he eventually regained his appetite, When he came home the first day he didn't really eat, just relapsed into hiding. I have gotten him to eat some, and today I managed to get him to eat 2 cans of wet food sometimes using a syringe to force feed him, and trying out 3 different flavors/brands. he tried some dry food but only ate a few pieces and walked off. he usually loves the dry food, even ignores the wet food for it some times. I was holding off on the food since 1am and stalling like you said. Right now he is sleeping, the "wheezing" is like a whistle, and sometimes a snort, might be snoring.
 
Bron and Sheba (GA) said:
Do you think he needs to see a vet with the wheezing?
I wonder if the vet tested him for pancreatitis?
I think he is still too low to give vetsulin to atm especially as his appetite is not great.
Do you manage to get the ketone urine test done.?
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amylase is dead center in the blood panel (my sister is a med tech, I have no idea what the list means, but she said everything else is fine)
 
I think he could be nauseated. I would ask the vet for some cerenia and / or ondansetron tablets to see if that helps with him eating.
He may need a pancreatitis test....FPL snap or a f PL spec test. These tests are not in the routine blood tests done at the vet. They are separate tests.

Target70 said:
amylase is dead center in the blood panel (my sister is a med tech, I have no idea what the list means, but she said everything else is fine)
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What test was this?
 
Bron and Sheba (GA) said:
I think he could be nauseated. I would ask the vet for some cerenia and / or ondansetron tablets to see if that helps with him eating.
He may need a pancreatitis test....FPL snap or a f PL spec test. These tests are not in the routine blood tests done at the vet. They are separate tests.


What test was this?
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the receipt calls it a "COMP BLOOD PROF", The slip He showed me when he told me about the glucose reads "VETSCAN VSZ" at the top and lists 14 items, their measurements, and the upper and lower range on a receipt like strip of paper. for example [GLU 297 * 70-150 mg/dL] another is [AMY 730 300-1100 U/L], my sister said that was amylase, secreted by the pancreas.
 
Target70 said:
the receipt calls it a "COMP BLOOD PROF", The slip He showed me when he told me about the glucose reads "VETSCAN VSZ" at the top and lists 14 items, their measurements, and the upper and lower range on a receipt like strip of paper. for example [GLU 297 * 70-150 mg/dL]
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Ok thanks. I didn’t know if you were telling me you had got a ketone test or something else. That’s good everything else was ok.
Do you know if they did a fructosamine test for the diabetes?
Have you taken another BG yet?
 
Bron and Sheba (GA) said:
Ok thanks. I didn’t know if you were telling me you had got a ketone test or something else. That’s good everything else was ok.
Do you know if they did a fructosamine test for the diabetes?
Have you taken another BG yet?
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If he did any other tests he didn't tell or charge me for them (I only saw the vet once on the first day, covid rules were to wait in the car. He only came out to give me that test slip, say he had diabetes, and they would hold him overnight) I called everyday to see his progress and see if he could come home, but I really didn't get any other info except to dose as instructed on the vial. We have used them before, and no other vets were open for walk-in or seeing new patients, earliest appointments were a week away, and If there is an emergency vet around me I'm not sure I could afford it. Since we were not allowed in, I don't know what was done, only what the receipt lists and the costs:

OFFICE CALL/EXM
COMP BLOOD PROF
Hospitalization
VETSULIN
SYRINGES
EXCENEL INJ.
ONSIOR INJ.
BLOOD GLUC TEST

Been holding off on the BG, I hate to keep waking him up, but I'll do another one.
 
also, he didn't seem to have any nausea for most of the day. I was feeding him fancy feast pate all day without issue, even got him to almost bat at a string. when he stopped wanting either beef or chicken pate, I put down everything I had, and he "picked" Meow Mix tender favorites, turkey and giblets 16% carb. ate about 1/3rd of it, I guess that was about 2.5 hours ago, and has been trying to sleep/sleeping ever since, only waking up when I get up from my chair or test him.

BG: 137 @ 3:30 - 14.5 hours after last injection
 
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Target70 said:
also, he didn't seem to have any nausea for most of the day. I was feeding him fancy feast pate all day without issue, even got him to almost bat at a string. when he stopped wanting either beef or chicken pate, I put down everything I had, and he "picked" Meow Mix tender favorites, turkey and giblets 16% carb. ate about 1/3rd of it, I guess that was about 2.5 hours ago, and has been trying to sleep/sleeping ever since, only waking up when I get up from my chair or test him.

BG: 137 @ 3:30 - 14.5 hours after last injection
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I think you should skip the dose and feed him now. He is probably dropping now because he needs to eat.
If you need to change you schedule of shooting, this is a good time to do it, after a skipped dose. try and get him to eat well during this cycle.
 
Alright, so for that last test, I walked over to him, he woke up and started purring, seemed like he felt better. I did the test, which made him unhappy, and he ran out of the room and sat in front of the door (he wanted out). I made a tinfoil bowl and just followed him around for about 20 minutes. He stopped ate grass, and eventually started pee/spraying. He was standing, peeing on the fence, but not shaking his tail or dancing. I collected some in the tub brought it inside and tested it.. twice. It doesn't look like the test strip had any reaction.
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Bron and Sheba (GA) said:
Just seen in the SS the urine was strong smelling, bright yellow and cloudy. Tack could have a UTI and be dehydrated. Worth following up
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Agree. New development, He is hiding outside again. I found him but he doesn't want to be found. I saw him try poop and walk off. Brought him inside and tried to feed him, turned around and he was gone, heard him grown in the litter box room and he was trying to poop again, only to give up and lay down on the floor. So constipation. I will try a different vet if I can find one, I doubt any are open today (Sunday), so It may have to wait till Monday. I wish I didn't need a prescription for IV fluid. My sister and I had to give subcutaneous fluid to her cat so we know the drill. I wonder if I should try to give him an enema?
 
I would wait until you see a vet and get the constipation confirmed.... I don’t doubt he has it but you have only just discovered it I would try and get him to drink more at the moment. I would also check with the vet if it is ok to give him SubQ fluids before giving them. If a cat has a heart issue, subQ fluids can be dangerous.
 
Don’t forget the new dose is 1 unit if the BG is high enough. I would post and ask fir thoughts on it anyway.
I’m Going to tag @Deb & Wink to get her thoughts on the next dose as I’m not a Vetsulin user.
 
Some cats have some tummy issues when switched over to canned food and even if you switch around a canned food that they are used to. The change in food may be contributing to Tack's discomfort.

If constipation is an issue, adding more water to Tack's food may help until you're able to see a vet.

FYI - amylase is not a reliable test for pancreatitis in cats. You need a test called an fPLI. There are two forms. The Snap fPLI will give a +/- result much like a pregnancy test. The Spec fPLI is sent out to a lab and gives a numeric result.
 
just got back from the emergency vet. Unfortunately I am unable to afford many of the diagnostic tests. Based on the BC numbers I was recording, they told me to stop with the insulin at this time, but to monitor the BG if possible. They treated the symptoms for now, SQ fluids, Cerenia injection for vomiting, Enema and Lactulose for constipation. If he stabilizes or shows improvement, I can get more SQ fluid. If he continues to refuse to eat there won't be much I can do. If it holds him over till Monday I can see if the regular vet can order that fPLI or do some of the other tests: white/red cell count, x-ray, at a less expensive price.

I appreciate the help and support all of you have offered
 
I’m glad you were able to see the vet and get some treatments for Tack. I hope he starts eating for you.
I would keep testing daily for ketones at the moment, and monitor the BGs. It is possible he may need more insulin. Vets often stop insulin prematurely.
 
If nausea from pancreatitis is the problem, the Cerenia and the subQ's should help him feel better. Treatment for pancreatitis is just symptom management, so the only thing that would change if you got a positive test is that he'd be getting some dedicated pain meds (Cerenia, while largely an anti-nausea med, also has some pain control properties). If the root problem is constipation, you've got the tools for that, too.

I think this was a pretty productive vet visit, I hope it helps Tack to feel better soon!
 
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