GA 5/4 Vlad AMPS 249, 79 @ 3+!

at +7 vlad went hypo at 45. I gave him 1/2 ml of maple syrup. He was just super lethargic and laying around. He is walking very slowly and unsteadily now. What should my testing interval be until his BG starts going up? Should I cut his dose already? he's only on day 2 of Basaglar. I guess I went too high, I was just trying to dose similarly to the vetsulin. Mistake!
 
Test in 20mins-half hour. You don't want to let him go too long, especially with overt hypo symptoms.

Edit: 31!!!!!:eek: :eek: :eek:

Bring the syrup, and if you have someone else to drive while you take care of him, even better.
 
Kyle&Vlad said:
Should I cut his dose already? he's only on day 2 of Basaglar. I guess I went too high, I was just trying to dose similarly to the vetsulin. Mistake!
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Yes, he has definitely earned a reduction, and don't beat yourself up about this. Most cats can do a pretty straight transfer in dose from one insulin to another, there's no way to have predicted in advance that Vlad would have had such a strong reaction to basaglar!
 
So glad you were testing regularly today and caught this! And please, once things have calmed down, let us know how he did at the vet, we worry!!!!
 
Give some maple syrup - a good swipe along the gum line - before you leave for the vet.

Take your test kit and some maple syrup with you in the car. Protocols have changed now and there might be a small wait in your car at the vet's office.

If it is a long drive to the vet, get a household member to drive so you can get a test in along the way.

Wishing for the best.
 
Made it to the vet ok, they took him, he was still responsive. Once they got him in he had a seizure. they gave him oral glucose and have him on a super high glucose IV. He may not make it they said. They did encourage me, saying he's a fighter and he's made it through a lot. I would be lying if I said I wasn't scared. I feel terrible.

They are taking him to an emergency over night clinic since they close shortly. I'm going to pray to every diety I can think of. Thank you for your replies.
 
Oh wow.... I'm so sorry he had such a strong reaction, but so glad you got him in there before the seizure. Absolutely terrifying.

You did everything right. You were testing, detected the hypo immediately, got him the syrup and got him to the vet. He's where he needs to be now to have a chance to pull through. :bighug: :bighug: :bighug:
 
I know it's only been a couple hours, but have you been able to talk to the overnight vets at all to see how he's doing on the glucose drip?

And, how are you doing?
 
Nan & Amber (GA) said:
I know it's only been a couple hours, but have you been able to talk to the overnight vets at all to see how he's doing on the glucose drip?

And, how are you doing?
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Just got a call from the vet transferring him to overnight. She said this is the worst she's seen him. His sodium was through the roof, I suspected he might be dehydrated. She said he didn't seize anymore after that first time. His BG spiked to 600+ after all the syrups and IV glucose, but that it came back into the 300's, and he's on regular saline now.

She wants to keep him overnight since he still might go hypo again with the basaglar in him. He is more responsive atm. I am feeling optimistic. Going to try as hard as I can to get him hydrated at home. It is difficult, he has a tooth infection that seems to hurt him when he eats and drinks, but they don't want to do the dental until he is more stable. I don't blame them, he lost like half his body weight and is just skin and bones. Feel like I'm stuck between a rock and a hard place.

In other news I've let all my other social and familial relationships go trying to tend to Vlad, and people have been less than understanding. I have been worse, but I have been a hell of a lot better, that is for sure. Life is complicated. ugh. It will be worth it if I can get vlad back to his normal self. Poor baby.
 
Glad to hear that he is more responsive, and getting the care he needs on the dehydration, etc. That is very encouraging! Maybe ask them about doing sub-Q fluids at home for the hydration. It'll be easier than trying to get him to drink water with a sore mouth, and could make him feel better overall.

It's rough being cut off from your normal support system (and the whole virus situation doesn't help!). I think it's a pretty normal thing to happen, unfortunately a lot of people won't understand how important giving Vlad the best care is to you. Try to remember, they are your friends and family, and they still love you, even if they don't understand what you are doing right now. Maybe some of them will be able to lend some general support to you, despite not really 'getting' what you are going through.

Hang in there, keep us updated on Vlad's progress! He is a tough little guy, for sure!

:bighug: :bighug: :bighug:
 
Wow, you've had a very scary day!! So sorry you're not getting any support from your friends and family too. I've been there. My family didn't understand why I was doing so much for China either ….I mean she's "just a cat"...GRRRRRRRR

Canceling coming for Christmas dinner was the last straw...they just didn't understand why I'd stay home just because her glucose was dropping too fast for me to be comfortable leaving the house for 6-8 hours.

But you have your family here and we all totally get it!!

Prayers for Vlad and hope he's doing much better by morning.
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Just got an update from the vet. It seems they have his blood sugar under control, but his sodium is all out of whack. Apparently he has had multiple seizures this morning because of his sodium levels, and they gave him something for the seizures and are trying to get his sodium levels under control. I don't understand what is going on with his sodium, he's been on IV fluids a lot of yesterday, all night, and this morning. I wish I knew what was causing this.
 
:(

It's good his BG is back under control, but that is really scary. I don't know anything about what could be causing that with the sodium levels... I hope they can figure it out soon and get him feeling better. :bighug:
 
Looks like he is going to pull through. He is going to likely have to stay hospitalized the rest of the week. His sodium is still high. The seizures were likely caused by his sodium dropping too fast once fluids were started. He is still dehydrated, but they are hydrating him slowly so as not to aggravate any more seizures. Thus the stay for the rest of the week.

they also expressed concern about hydrating him because he is already very anemic, and don't want to dilute his RBCs too much. They started him on a medication to increase his RBC count. They think he might be anemic because of ckd. Last couple of times they checked his renal numbers, nothing was out of range. He also has multiple active tooth infections, his BG hasn't been well controlled on vetsulin, and he's got some blood in his urine for unknown reasons. So there are lots of reasons he might be anemic.

They said he is eating when fed by hand, and taking water from a syringe, but he's not lapping up water when provided. If he doesn't start drinking on his own at some point I don't know what else could be done. We'll just have to wait and see.

I'm glad to do what vlad needs to give him a good chance. But I am concerned at how expensive his vet bills are getting. I wish it wasn't an issue. I guess we all have to deal with that though at some point.
 
Glad to hear that Vlad is likely going to pull through! The bills... ugh. Believe me, I know what you mean, it's a painful situation...

I wish I had some idea of what is going on with the sodium levels. I'm going to tag @Marje and Gracie, just in case she has some thoughts about this. Really seems like the ER is the best place for him right now with the seizures :(, but maybe Marje might have some questions you could ask the vet that might help speed his return home.

Hang in there!
 
So, update, he is likely going to have to stay at the vet's for the rest of the week. Luckily they think he is stable enough to leave alone over night instead of taking him to the overnight ER, the one night alone was pricey. She said it was a little bit of a risk, but that she feels like its the right choice.

Doc also thinks his sodium has been high for a while and that is why she wants to keep him through the week, she wants to carefully and slowly reduce his sodium so that he doesn't get any swelling in his brain.

He's not out of the woods yet, but he seems like he's through the worst of it. I wish I could squeeze on him. Thank you everyone for your support and well wishes. I appreciate all of you, especially knowing many you would and have gone to great lengths for your feline families.
 
Nan & Amber (GA) said:
Glad to hear that Vlad is likely going to pull through! The bills... ugh. Believe me, I know what you mean, it's a painful situation...

I wish I had some idea of what is going on with the sodium levels. I'm going to tag @Marje and Gracie, just in case she has some thoughts about this. Really seems like the ER is the best place for him right now with the seizures :(, but maybe Marje might have some questions you could ask the vet that might help speed his return home.

Hang in there!
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True high sodium levels are not common but high sodium due to dehydration can occur because the blood volume is lower. High sodium can also be caused by diabetes insipidus where large amounts of water are consumed but also eliminated. It can cause seizures. I don’t know if this has been an issue.

I’m so sorry about Vlad and I hope he gets better. You did switch from U40 to U100 syringes when you switched from Vetsulin to Basalgar, right? Just needed to ask.

Tons of vines coming his Waac.
 
Marje and Gracie said:
True high sodium levels are not common but high sodium due to dehydration can occur because the blood volume is lower. High sodium can also be caused by diabetes insipidus where large amounts of water are consumed but also eliminated. It can cause seizures. I don’t know if this has been an issue.

I’m so sorry about Vlad and I hope he gets better. You did switch from U40 to U100 syringes when you switched from Vetsulin to Basalgar, right? Just needed to ask.

Tons of vines coming his Waac.
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Yes, we are using U100 syringes. I thought about diabetes insipidus, but he does not drink much at all, in fact I've been trying to give him water by syringe recently. With his bad teeth it seemed like it was hurting him to drink water. Even giving him water with a syringe he winces, so I've been thinking he's getting dehydrated because of an aversion to drinking water, because of the pain. I wish I could get the teeth taken care of, but he's been unstable enough they don't want to do the dental. :(
 
Kyle&Vlad said:
Yes, we are using U100 syringes. I thought about diabetes insipidus, but he does not drink much at all, in fact I've been trying to give him water by syringe recently. With his bad teeth it seemed like it was hurting him to drink water. Even giving him water with a syringe he winces, so I've been thinking he's getting dehydrated because of an aversion to drinking water, because of the pain. I wish I could get the teeth taken care of, but he's been unstable enough they don't want to do the dental. :(
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What are his blood ketones?
 
I don't know about blood ketones, I don't have a ketone meter, but the last urine ketone test I did was negative for ketones. I'm sure he's had some ketones in his urine, like the day his BG was over 600+ all day last week, though.
 
Call from vet this morning. I did not know the reference range for sodium in cats. The upper end is 129. Apparently their machine can only read to 180, he only just came below 180 this morning, now down to 171. He is currently unresponsive. They are not hopeful, and we don't know if there has been any brain damage. They are intentionally bringing it down slowly because too quick of a change and it causes fluid to collect in the brain, which would cause swelling and probably kill him out right.

They are going to keep trying today, but they let me know it is likely this is it for my little man. I am wrecked. I have had him since he was about a week old, and he is 16 now. I've had him for almost half of my life. Its frightening to me how quickly he spiraled. A couple months ago he was doing great, normal BG, good weight, happy and healthy.

He's not done yet, but it is looking like he is getting close. Thank you again for all of the kind and encouraging words you've shared.
 
Update from vet. No update on his lab numbers yet, but he became responsive this morning. He is not standing or anything, just been lifting his head up and looking around.

Since they've got him hydrated and reduced his sodium levels some, his urine has been completely clear of blood. I will take any small wins at this point.

They said they would call one more time today with updated labs.
 
Update, but not much of one. Vlad's sodium numbers are going down, but very slowly. he's at about 170, they'd like to get him at minimum into the 160s, preferably in the 150s.

The vet is recommending I start considering euthanasia. The main reason is that she said he has not been urinating on his own and that they have been having to express his bladder. She is not confident that he will have a good quality of life even if he does recover.

She is unclear whether the weakness is due to neuropathy, the high sodium, or what. I told them I don't want to make a decision without seeing him first. He may act differently with me than with them, but maybe not. They said it was safe to bring him out to me for half an hour off of fluids to be with him. I think it will be hard to be objective about his condition, but I'm going to try. If I can tell he's cognitively not there anymore, or that he is really suffering I suppose I need to gather the courage to let him go. We'll see in a few hours. Thank you again for your kind words.
 
I would ask for a litter box to be put out near you:):) Amethyst did not go to the bathroom for 2 DAYS and NIGHTS when she was in the hospital because she was so traumatized!!:bighug::bighug::bighug:
 
Thanks Pamela, I wish I would have seen this in time, I didn't think of that at all. I really wish I had, or had brought my own.

So, before the visit, this morning, I was told he hadn't shown any progress, he could lift his head and that was it. He was eating out of their hands but not on his own, and I'm not sure the water status, but last they told me a few days ago they were syringe feeding him water, but he was drinking it down just fine. I decided to love on him some, and let him relax on my chest in the car for a few minutes (no inside visits, because of covid), and then get out and see if he could hold any of his own weight. I figured, he's a cat, he wants to walk, he doesn't want to lay in a cage all day. I took video.

https://photos.google.com/share/AF1...?key=OURmTmhpWnZxMDdnTEVoN3pCM042ZkJCaFIyU3ZB

I sent it to his doc. His front left paw is swollen twice its normal size, and his right let has a needle in it and it was bandaged really tight, and he was having issues with the bandaged foot. I know he is very wobbly, and he's bracing himself on the wall frequently. But it seems like he can do more than just hold his head up. We'll see if the doc thinks this is encouraging enough to warrant anything. No matter what, I am very proud of my strong little man.
 
Kyle&Vlad said:
Thanks Pamela, I wish I would have seen this in time, I didn't think of that at all. I really wish I had, or had brought my own.

So, before the visit, this morning, I was told he hadn't shown any progress, he could lift his head and that was it. He was eating out of their hands but not on his own, and I'm not sure the water status, but last they told me a few days ago they were syringe feeding him water, but he was drinking it down just fine. I decided to love on him some, and let him relax on my chest in the car for a few minutes (no inside visits, because of covid), and then get out and see if he could hold any of his own weight. I figured, he's a cat, he wants to walk, he doesn't want to lay in a cage all day. I took video.

https://photos.google.com/share/AF1...?key=OURmTmhpWnZxMDdnTEVoN3pCM042ZkJCaFIyU3ZB

I sent it to his doc. His front left paw is swollen twice its normal size, and his right let has a needle in it and it was bandaged really tight, and he was having issues with the bandaged foot. I know he is very wobbly, and he's bracing himself on the wall frequently. But it seems like he can do more than just hold his head up. We'll see if the doc thinks this is encouraging enough to warrant anything. No matter what, I am very proud of my strong little man.
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I firmly feel and believe that he is going to be fine!!! If I had listened to them at the hospital the last time Amethyst was there she would have gotten worse!! She needed to be home with me and her brother to fully heal!!:bighug::bighug::bighug:
 
Pamela, you keep saying all the right things. :) . The vet doesn't want me bringing him home at least until his sodium is within a reasonable range, and I think I would feel safer if they kept him until that happened at least, but I am thinking, if they can get his sodium corrected I may request to bring him home for a few days and see how he does with me. Obviously being in a familiar place would be a big difference for him.
 
Will they let you bring him something familiar-smelling, like his favorite blanket or a t-shirt you have worn? I know they've changed all kinds of rules with the virus, but if you can do that, it may help to comfort him while he's at the vet.
 
Nan & Amber (GA) said:
Will they let you bring him something familiar-smelling, like his favorite blanket or a t-shirt you have worn? I know they've changed all kinds of rules with the virus, but if you can do that, it may help to comfort him while he's at the vet.
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That is a fantastic idea, I will ask as soon as I can.
 
Vet didn't watch the video I sent, said she hadn't had time yet, but I told her he was able to half ass walk himself down the length of their wall, bracing himself on the wall. She was very surprised and I think slightly encouraged. I told her I would go there every day and do a cat PT session with him, and bring him something familiar to lounge on. She didn't promise anything, but said that she would like to be able to send him home for at least the weekend if he is stable enough Saturday morning.
 
Visited vlad again today, was hoping I could get him walking. They said he stopped eating today, so I brought food and some chicken broth. He didn't seem to respond to his name, could get him to take a little broth, but no food. He could hold himself up on his front paws today, but otherwise he wasn't standing. I opened up his mouth, and he was bleeding pretty good from a tooth that was just dangling from a thread. I imagine that is largely why he's not eating. I pointed it out to a technician and they said they would tell the vet when they get back.

Before this happened I noticed sometimes he would walk in circles on the side where his tooth has been pretty infected. I've wondered if the pain could make him do that, no idea. And I noticed today his body kind of wants to twist in that direction too. It looked pretty painful regardless.

At this point I'm not sure what to do. He might get better if they could yank his teeth. He might just be gone, mentally, after that hypo seizure. He's been in the hospital since Monday now. He's well hydrated, his sodium is pretty much corrected. But his condition today seems much worse than yesterday. I'm trying to decide if I am doing wrong to keep him going when he may have checked out already. I've got a lot to think about today.

His BG this morning was 500+, they have not been able to control his BG well. I could do better at home. I'm wondering if I should bring him home for a few days if his electrolytes are stable enough and see if there is any change. I don't know how much better he can get with a bleeding mouth like that. Part of me is thinking it may be his time.
 
My thoughts would be along your lines also....I do not know how I would proceed. I hope your vet (who actually missed his tooth!!) will take care of the teeth is if is not too much for Vlad. Wishing you divine guidance in your decision. :bighug::bighug::bighug::bighug:
 
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