4/16 Wrigley AMPS 382 | PMPS 210 | 3.5=35 | 45 | 47 | 54 | 98

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ewalker405

ewalker405

Member Since 2015
Yesterday: 4/15 Condo

He had a huge drop last night. I stayed up late to test him a few extra times, and everything was fine. I will be giving him .75 units in 20-30 min before leaving for work.
 
Got home tonight and tested/fed/shot him. His BG was 210. It's a lower pre shot number than the last few. Hopefully the last few were bouncing from the skipped shot and he is going to stay down. I will test in 2 or 3 hours and see what he is. I really hope I don't have to stay up again tonight. I am really tired.

If anyone know about blood work lab number please look at his and give me your thoughts. I have a link above to another thread I started about the labs in the main forum.

Thank you.
 
Hi Eric,
I'm sorry to hear that Wrigley's blood work came back with some irregularities. I'm not good at interpreting blood work, but here is a link to a page that I have bookmarked. I think it has good explanations:
http://zimmer-foundation.org/sch/ajf.html

Many of our board members have experience with blood- test values. I hope @Marje and Gracie , @Sienne and Gabby , @Dyana and others will give you some guidance. I do know that the various labs (ANTECH; IDEXX) have different ranges for the various tests, so it would be good to know which lab your vet uses.

I hope Wrigley will be fine. It's good that the auto feeder will be available to him after tomorrow.

Ella & Rusty
 
From the elevated values, it looks like there's something going on with Wrigley's liver. Do you know if he had a diagnosis of hepatic lipidosis when he was in DKA?

I would definitely encourage you to talk to your vet about these values. There are some supplements that are helpful for liver support (e.g., denamarin, milk thistle).

 
Eric

We've been battling on again/off again elevated ALT in Gracie for the last 2.5 years. Twice, the AST has been elevated and once the alkaline phosphatase and bilirubin have been but she's never been anemic. Wrigley's liver enzymes are not horrifically high but should be further investigated. Elevated bilirubin can be due to hepatic lipidosis (FHL) but Wrigley would have had to be anorexic or at least consuming less than 50% of his normal calories to have FHL. ECID (every cat is different) but I've seen situations where cats have consumed less than 50% of their calories for some time without getting FHL but again.....ECID.

My vet had me take Gracie to an internal medicine specialist (IM) where they did an ultrasound (u/s) and also a bile acids assay to be sure her gallbladder was not obstructed. The bile acids assay test was normal. All of her organs were within normal limits on the u/s and, at first, they felt her common bile duct might be a bit dilated from infection but then decided it was consistent with early ultrasounds she had before she was diabetic and her liver values were all normal.

Elevated liver enzymes can be tough to figure out; it can be cholangiohepatitis (also known as cholangitis) and can involve infection/inflammation of the liver, pancreas, intestines, bile duct, etc. The symptoms Gracie had were occasional vomiting early in the morning...clear, foamy vomit; drinking more water and thus peeing more. Not excessive but I noticed it. She was treated with a 30 day course of clavamox and also water soluble liquid vitamin E which is hard to find without glycerin (not FD friendly) but I found Aqua-E and she still takes 75iu daily. The vets could never diagnose any specific problem since everything was normal on the u/s and with the clavamox and aqua-E, her symptoms disappeared and her liver values gradually came back down. Her ALT tends to run high normal now but she has had no symptoms anti jinx for quite some time. The IM specialist said the only way to definitively diagnose what the specific liver disease is is by biopsy and we refused to do that for a kitty who was eating well and became clinically normal. A lot of info but it might help you not reinvent the wheel or at least give you some things to ask your vet.

Wrigley is fairly anemic; a cat is considered to be anemic when the HCT( hematocrit) is less than 30%, generally, but some labs differ. His rbcs (red blood cells) and HGB (hemoglobin) are also low which definitely point the finger to anemia. The anemia is critical if the HCT is below 20%. It's important to be sure that the lab values of your lab are the same as on the lab tab. The ones on the lab tab are for Antech; IDEXX sometimes differs a bit. There are two types of anemia: non-regenerative and regenerative. Usually cats with chronic kidney disease (CKD) will have the former as their bodies cannot recover on their own from the anemia but cats with regenerative anemia may be able to correct the problem on their own. Although it primarily applies to CKD, here's some info on Anemia. Anemia can be associated with liver disease. I would talk to my vet about giving Wrigley B vitamins. Usually 500 mcg of methylcobalamin a day (divided into two doses) and a multi B like Jarrows B Right (only give 1/10 capsule daily divided into two portions) can help with anemia. But clear that with your vet; he/she might have some other formula he/she prefers.

His kidney values look great so the anemia is not associated with CKD; I suspect it's got something to do with his liver.

I hope this helps some. Let me know if you have any questions. BTW, Gracie took denamarin, too, for quite a while and it never helped.
 
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Wow, just tested at +3.5 and he got a 35. I should give him gravy food right? How is he dropping so low? Should I lower his dose to .5 tomorrow?
 
Feed just some of the gravy from the gravy food. We don't want kitty to fill up if we need them to eat more.
 
Give gravy (generally you start with a teaspoon but I personally might give a little more, maybe two teaspoons because he's in the 30s and you want to get him out of the 30s) and test again in 15 minutes. It can take more than 15 minutes for some cats to bump up, but you want to know that he's not dropping lower.
 
Is the 45 after gravy or before? In any case, you still want to give gravy if he is below 50, so you can give a teaspoon if you haven't already, or another teaspoon if you have and test again in 15 minutes.
 
Just keep posting his numbers as you get them and we'll let you know what to do next. You're doing great. And remember to breathe - it's scary I know, but he will come back up.
 
That's okay, glad to see there are more people around to help! I just saw the 911 and haven't visited Wrigley before, so forgive me if I'm telling you things you already know, but it always helps me to read over this from the Handling Low Numbers Sticky:

If your cat is testing in low numbers and you are not getting a quick response to your post, there are several things you need to do. (Low numbers are under 50mg/dL or 2.8 mmol/L.)

  • Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only.
    (If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
  • Test again in 15 – 20 min. Depending on the numbers, give more HC food.
  • Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
  • Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
  • Test in an hour and follow the same steps.
DO NOT become complacent. If number have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.

In the case of an accidental overdose or should there be symptoms of hypoglycemia, even if you have caught this in the early stages, you may need to monitor for literally 16 or more hours. Lantus and Levemir are long acting types of insulin. This means if your cat is over dose, you will need to stay alert for hours in order to closely monitor and to keep your cat safe.

Please post your numbers. Those people who are helping you will not abandon you. In fact, they are staying up with you. The experienced people will even work in shifts to make sure your cat is safe and you have the support you need. Remember to refresh your browser to see new posts and keep posting so we know all is well.
 
Thanks everyone. Is he dropping this low because the .75 unit dose is still too much?

He is eating quite a bit of food so it's not like he isn't getting food in him. He is eating 2-2.5 cans of FF classics a day. He will eat more if we give it to him too. Should he be eating more?
 
I'm not sure which protocol you are following, but in either TR or SLGS, he earned a reduction! What is his BG 15 minutes post gravy? Has he eaten all the dinner he would eat? If you would normally give him more FF around this time, you could give him some, but you don't want to overfeed him because you want him to have an appetite if you have to continue feeding low numbers for a while. I have found that at least with Billie, LC along with gravy helps her surf safely. I usually give her a tablespoon of LC along with gravy, but ECID. Let us know what his BG is after the next test.
 
At this point he has earned another reduction, yes. It's not that the 0.75 was too much to begin with, it's because once a cat starts coming down the dosing scale they tend to come down more than one dose over a period of a few weeks so it's not completely unexpected that he would earn another reduction 3 or 4 days after the last one. The good thing is that because he's had 6 cycles at 0.75 we can be fairly sure that he's not being influenced by the depot from the bigger dose he was on previously, so taking the reduction tomorrow morning (to 0.5) will be fine. :)

It looks as though he hasn't been on insulin for long and he's earning reductions already which is great - it's possible that his pancreas is healing already and will start to work.

If he's underweight then you could feed him more, but the amount he's getting is fine for an average cat with its BG under control which his looks like it is at the moment. A little more probably wouldn't hurt him while he's getting numbers in the 300s some of the time as he won't consistently be using all the fuel from his food at that level but as long as he's not losing weight it sounds like you're giving him enough food.
 
+4.25 and he is 47. I am going to give him a little LC fancy feast classic now.

He is a little underweight so I think we are going to start feeding him 2.5 cans of FF a day now instead of 2.
 
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Can you give him some more gravy with the lc - we'd really like to see him come up above 50 and the lc alone might not be enough to do that.
 
Because he is still under 50, give him another teaspoon of gravy too. Or, add 2 drops of karo to the FF. Test again in another 15 minutes and post the number.

ETA @manxcat419 we are clearly on the same wavelength!:)
 
We are indeed! :D It's all good - I always prefer to have information passed along twice than something get missed! :)
 
Great! You're doing an awesome job, and Wrigley is responding very well to Lantus! You will probably need to stay up for a while tonight, but it will be worth it :D
 
That's great - he's above 50 which is good news. :)

If you're really tired from last night and needing to sleep, the other option you have at this point is to give him a lot of carbs to abort the cycle so you can get some sleep - it's not as if he has anything left to prove tonight...that reduction was well and truly earned! :D
 
I would not go to sleep yet. It's still early and he could still drop as the HC wears off. You'll want to test again in another 20 minutes to see if he is staying above 50. If he goes below 50, he'll need more gravy. If he stays above 50, that's great, but you'll still need 2 consecutive tests that are not food influenced above 50.

ETA: I can imagine how tired you are since you have done this two nights in a row! If you are having trouble staying awake, set some alarms for yourself so you can keep testing.
 
I was just about to edit my post to add that even with an aborted cycle I'd want to see him out of the 50s at least just in case and he'd need a whole lot of hc left out to snack on overnight. It's something I only did once and I wasn't all that comfortable with it even though it was daytime and Michael was able to keep an eye on Rosa but I know other people have had to do it when they just can't stay awake.
 
The high carb usually about an hour to an hour and half from the last time he had gravy. We really want to see them rising for all of that time to make sure they don't drop back as it wears off.
 
It depends partly on the cat. High carb food lasts about two hours with Neko so I always have to test a couple hours after I give HC.
 
That's a good rise in numbers in the last half hour or so - he's probably safe but we'd usually ask you for another test in an hour as we really want to see 3 tests above 50 and rising. Do you feel up to doing that? You could nap for an hour if that helps at all.
 
Oh, one more thing - if you can take the 911 off your post now as there are people watching out for you at this point and he's looking pretty safe right now. :) I'll make sure I check back with you in an hour to make sure his last test comes up OK.
 
No worries - I'll be back on to make sure you don't have any concerns with his last test for the night. Though don't be too surprised if he starts going higher quickly - he might well bounce for at least a few hours after the low numbers tonight.
 
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