5/13 Copernicus, AMPS 672

Is he conscious and aware? Is he able to stand? I’m not sure what you mean by not being able to pick up his head …Is his head drooping to his chest?

If in doubt, I’d go to the ER.
 
I ask about head drooping because it can be a sign of low potassium. My Charlie had critically low potassium and had to be on an IV drip with supplemental potassium at an ER clinic to get him back into a safe zone. Hanging his head was a sign. (I want to be careful to note that I’m not diagnosing, just sharing our experience).
 
Hey All. We are at ER. He was laying in the floor on his side and he wouldn't sit up or lift his head or eat. He is conscious. There is no IM so they want to keep him overnight and transfer him to IM tomorrow. He did perk up from the adrenaline of riding in the car, so maybe just felt so bad and weak. I can't keep taking him to the ER. Also, when does it make him worse because they refused to accept his own food and they want to give him Rx food. They mentioned hydrolyzed and now I'm worried bc those are high in sugar. For the future, what do you all do for numbers that stay that high for that long and keep rising? Another option is maybe his primary vet could have done some fast acting insulin?
 
CopernicusDM said:
Hey All. We are at ER. He was laying in the floor on his side and he wouldn't sit up or lift his head or eat. He is conscious. There is no IM so they want to keep him overnight and transfer him to IM tomorrow. He did perk up from the adrenaline of riding in the car, so maybe just felt so bad and weak. I can't keep taking him to the ER. Also, when does it make him worse because they refused to accept his own food and they want to give him Rx food. They mentioned hydrolyzed and now I'm worried bc those are high in sugar. For the future, what do you all do for numbers that stay that high for that long and keep rising? Another option is maybe his primary vet could have done some fast acting insulin?
Click to expand...
i'm not savvy in these subjects, I am learning myself but just came to check on how he was doing. let's wait for those who are more experienced to come and advise, but i'm on watch to see updates. stay strong Krista and lil copernicus! ✨☄️
 
CopernicusDM said:
Hey All. We are at ER. He was laying in the floor on his side and he wouldn't sit up or lift his head or eat. He is conscious. There is no IM so they want to keep him overnight and transfer him to IM tomorrow. He did perk up from the adrenaline of riding in the car, so maybe just felt so bad and weak. I can't keep taking him to the ER. Also, when does it make him worse because they refused to accept his own food and they want to give him Rx food. They mentioned hydrolyzed and now I'm worried bc those are high in sugar. For the future, what do you all do for numbers that stay that high for that long and keep rising? Another option is maybe his primary vet could have done some fast acting insulin?
Click to expand...
I’m glad he’s more alert. Been looking for your update and hoping he’s feeling better.
I wonder if @Wendy&Neko or @Bron and Sheba (GA) @Marje and Gracie
Have any thoughts

Sending you both many hugs and prayers Krista 🙏🙏🙏🫂🫂🫂
 
Sending healing vines for little Copernicus.:bighug::bighug: I hope the IM vet can figure this out.

Did the ER at least do blood work? Like JL I've seen low potassium in a cat and supplementation did wonders. It could be other things but they should have at least done basic blood work to rule that in/out.

As far as the food goes, you can always put him back on a diabetic friendly diet when he comes home. At this point, he just needs to eat. Was he eating well at home? I've never had an ER refuse the food I brought, so that is rather surprising. If he refuses what they offer, maybe they'll take what you brought. Cats often don't eat at the vet clinic, so he might need something he's used to. On the topic of familiar things, could you leave a used T-shirt or pajama top with him so he has your smell on it?
CopernicusDM said:
For the future, what do you all do for numbers that stay that high for that long and keep rising? Another option is maybe his primary vet could have done some fast acting insulin?
Click to expand...
Follow TR and keep raising doses as fast as is safe to do so. For every cat there will be a dose out there that brings better numbers. Some of us have also learned to use a fast acting insulin as well. Note for any readers, there is a learning curve to using a bolus insulin (typically R) and it requires an experienced person to help you learn.
 
I’m glad you got him to the vet. I think Wendy is spot on about food. He is your cat so if you want him to have a specific food he will eat and it does no harm for what is going on with him, they should feed what you want.

For insulin, they should give him 3.5u and a fast acting insulin. That’s because he hasn’t even built a good depot with 3.5 and we need to focus on that. If they want to give home more Lantus, that will not quickly bring his BG down. If they give R insulin, and they give it at the right time, they can bring down his pre shots so the Lantus then insets at a lower BG.
 
They really need to know the potassium level (along with other electrolytes). Agree with Wendy — I hope they did at least basic bloodwork. I’d ask for a copy of any bloodwork they did. It can be helpful to keep that in a file for reference (and in case you end up at another clinic or ER in the future).
 
Marje and Gracie said:
I’m glad you got him to the vet. I think Wendy is spot on about food. He is your cat so if you want him to have a specific food he will eat and it does no harm for what is going on with him, they should feed what you want.

For insulin, they should give him 3.5u and a fast acting insulin. That’s because he hasn’t even built a good depot with 3.5 and we need to focus on that. If they want to give home more Lantus, that will not quickly bring his BG down. If they give R insulin, and they give it at the right time, they can bring down his pre shots so the Lantus then insets at a lower BG.
Click to expand...
The hospital said they don’t use R.
They want to take him up to 4.5 units tonight.
What should she tell them?
 
It's a teaching vet school ER. They gave him 4.5. I'm beside myself. I am so worried about him. They said they consulted with faculty. They said they have done this before and they don't use H because they don't like to mix insulins and they like to use what they are on. The only reason I took him somewhere was bc I wanted him to get H while we adjusted him up and gave his Lantus time to work.
 
CopernicusDM said:
It's a teaching vet school ER. They gave him 4.5. I'm beside myself. I am so worried about him. They said they consulted with faculty. They said they have done this before and they don't use H because they don't like to mix insulins and they like to use what they are on. The only reason I took him somewhere was bc I wanted him to get H while we adjusted him up and gave his Lantus time to work.
Click to expand...
Sending big hugs Krista. I know how hard it’s been lately and how worried you are 🫂🥰

Hoping they can help get him to feel better and a more stable situation so you can manage him at home 💕💕🍀🍀🍀🍀🙏🙏🙏🙏💕💕💕
 
CopernicusDM said:
It's a teaching vet school ER. They gave him 4.5. I'm beside myself. I am so worried about him. They said they consulted with faculty. They said they have done this before and they don't use H because they don't like to mix insulins and they like to use what they are on. The only reason I took him somewhere was bc I wanted him to get H while we adjusted him up and gave his Lantus time to work.
Click to expand...
oysh Krista that sounds really rough. we are here for you guys. we know how distressing it is when you just want the best for your baby. sending tons of kitty love and air biscuits so that he pulls through and they can stabilize him. ❤️‍🩹❤️‍🩹
 
By "H", is that Humulin R? We call it R.

When Neko was at a university teaching school (twice) for radiation therapy, they were pretty good at testing regularly. I had a student contact who gave me her cell phone number and said I could call with any concerns. Universities may vary in practice.
 
Krista let me know the vets are wondering if Copernicus has acromegaly since he’s in the 700s and not responding to insulin.
They sent out the test to MSU but I believe cats must be on insulin for a minimum of a specific number of days before testing.
Does someone have a link for MSU with that information or that information to give to Krista?
Wendy can you let her know about testing for acro?
@Wendy&Neko
 
Staci & Ivy said:
Krista let me know the vets are wondering if Copernicus has acromegaly since he’s in the 700s and not responding to insulin.
They sent out the test to MSU but I believe cats must be on insulin for a minimum of a specific number of days before testing.
Does someone have a link for MSU with that information or that information to give to Krista?
Wendy can you let her know about testing for acro?
@Wendy&Neko
Click to expand...
thank you for the update!!!
 
Staci & Ivy said:
Krista let me know the vets are wondering if Copernicus has acromegaly since he’s in the 700s and not responding to insulin.
They sent out the test to MSU but I believe cats must be on insulin for a minimum of a specific number of days before testing.
Does someone have a link for MSU with that information or that information to give to Krista?
Wendy can you let her know about testing for acro?
@Wendy&Neko
Click to expand...
It’s too soon to do high dose conditions testing. From Wendy:

From this paper: 2025 iCatCare consensus guidelines on the diagnosis and management of diabetes mellitus in cats

As insulin is required for normal hepatic synthesis of IGF-1 in response to GH stimulation, serum IGF-1 concentration is very likely to be lower when there is insulin deficiency. Consequently, measurement after 6–8 weeks of DM treatment (either with insulin or with an SGLT2i) is likely to provide a more reliable result.

And:

Clinical presentation​

Most cats with HST (75%) have no phenotypic changes that can be identified through a physical examination that distinguish them from regular diabetic cats.<a href="https://journals.sagepub.com/doi/10.1177/1098612X251399103#bibr37-1098612X251399103" data-xml-rid="bibr37-1098612X251399103">37</a>
Although testing for HST was traditionally reserved for those cats showing a poor response to insulin therapy, screening for this condition should be discussed with caregivers of all diabetic cats, particularly as non-insulin therapies are now available and identification of insulin resistance may not occur to prompt further testing. Weight gain despite suboptimal diabetic control, extreme polyphagia or a recent onset of respiratory stridor or cardiac changes in a diabetic cat should raise suspicion of HST. However, these clinical signs are not consistently present and thus their absence should not deter practitioners from offering the screening process
From the Royal Vet Clinic, Dr. Virginia Woolhead found that up to 1/3 of cats tested false negative if tested before 73 days after starting insulin. However, the part about IGF-1 being lower when there is insulin deficiency is interesting.
Click to expand...
 
If they've already sent out the blood to MSU, so be it. But if the test comes back negative, he may have to be retested again later. There is still some cases that will test positive this early. What didn't get included in my quote above is that we had one kitty who got tested at 3 months, and was negative, but insulin dose went a lot higher. When he was retested 3 months after that, he was positive.

I hope the vets also asked for the IAA (insulin auto antibodies) test at MSU. Some insulin resistant cats have one condition but not the other. Neko had both.
 
Last edited:
Wendy&Neko said:
There is still some cases that will test positive this early.
Click to expand...
If I recall, Tubby tested positive for acro before he even went on insulin. He had the hallmark physical changes and we were suspicious. He was later retested and the diagnosis was confirmed.

I don’t think the 73 day benchmark was a known thing back then, or at least not widely known.
 
I don't think Copernicus has the hallmark physical changes. They are going based off of enlarged organs. But what I'm finding is that hyperglycemia alone can cause enlarged organs.
 
Wendy&Neko said:
If they've already sent out the blood to MSU, so be it. But if the test comes back negative, he may have to be retested again later. There is still some cases that will test positive this early. What didn't get included in my quote above is that we had one kitty who got tested at 3 months, and was negative, but insulin dose went a lot higher. When he was retested 3 months after that, he was negative.

I hope the vets also asked for the IAA (insulin auto antibodies) test at MSU. Some insulin resistant cats have one condition but not the other. Neko had both.
Click to expand...
Before I read this message I asked for GH assay too but they refused. I will ask for this.
 
There is no GH assay for cats available. Though oddly enough, they can detect excess GH in human urine now. Note that I corrected my above, the one cat tested negative at 3 months after, positive at 6 months. Also, only 25% of cats have clinical signs at diagnosis. Neko's only indication was ravenous hunger. Which got dismissed as "unregulated diabetes".

The 73 day thing was discovered well after Tubby's time, or even Neko's.
 
You must log in or register to reply here.
Back
Top