7/11 Henry WC. AMPS 304 +2 312 +4 400+ +6 363 +8 233 PMPS 309 Ket:0.5

[John & Henry]

Previous: https://www.felinediabetes.com/FDMB/threads/7-10-henry-wc-amps-400-2-400-4-373-6-336.265655/

Henry is acting OK today. BG has been running high for 5 cycles now, the R dose at AMPS +6 has brought him down a bit, hopefully it'll stay down. He didn't eat any of the enzymed food I left out for him last night, he seems to be getting turned off on the Ziwi peak and one of the others ones (can't remember which right now). I broke down and started giving him FF last night and today -- which he totally devours. We're going with the pilling method for now because I just want him to eat as much as possible. Not that he's ever been hard to pill but he's getting better everyday about accepting the pills because he know he's going to get fed right after.

I was at a last second appointment during his AMPS, so my wife had to give the L dose. She tried to get a BG first with the nova and had a heck of a time. After 4 attempts Henry decided that was enough and started hissing and hid (he never does this.. I've never seen him hiss and hide). She thinks its because she took his away food since it had no enzymes and I told her to wait and not to ruin his appetite. She would probably never be able to pill him, so I didn't even have her attempt it. Plus I'm trying to text her all this with her while I'm in a meeting. I told her to give the dose anyway since he'd been running high and just watch him. She wasn't able to check with the libre since the app is on my phone.

Anyway, he's eaten 3 cans of FF since I've been home. I may attempt to lace some FF later and see how he reacts to it.

 

[John & Henry]

So I just gave him his B12 shot for the second time and again (just like last week) it was a partial fur shot Of course, I can't say for sure it was just partial other than the fact it didn't seem like a lot of liquid came out, of course it is hard to tell how much exactly just by looking.

Now if the B12 wasn't bright red, I may not have noticed. Which makes me wonder how often could this be happening with the insulin? I always feel his fur after the insulin shots and never feel any wetness but now I'm really questioning if some of these red and pink numbers we've been seeing for days may not be due to fur shots? I had this problem when I first started doing the subQ fluids several times, but haven't had a problem the last 5 or so times. I tent the skin as is recommended everywhere and I learned with the subQ fluids to not push the needle in very far (just a little past the skin). I guess I need to watch more videos or do more reading to brush up on my technique. The needles she gave me for the B12 is a much larger gauge. It doesn't say what the gauge is, but I wonder if that could factor into catching a fur shot?

His walking isn't great. His hinds just don't move well and he can't jump very far at all. He frequently can't make it up onto my lap, and I put out a small step stool because he was even having a problem getting up in his little sitting chair. It seems worse when his BG has been running high for long periods so I'm assuming it's diabetic neuropathy. I've read the B12 may help with this, so it's pretty disappointing he hasn't been getting the full B12 shot and I can't give him another one for a week.

 

[Hendrick Cuddleclaw]

sorry to hear about the B12 fur shot. If he is having some neuropathy remember it should start to go away as he spends more time on insulin and in lower BGs, at least.

 

[Chrispooky12]

So I just gave him his B12 shot for the second time and again (just like last week) it was a partial fur shot Of course, I can't say for sure it was just partial other than the fact it didn't seem like a lot of liquid came out, of course it is hard to tell how much exactly just by looking.

Now if the B12 wasn't bright red, I may not have noticed. Which makes me wonder how often could this be happening with the insulin? I always feel his fur after the insulin shots and never feel any wetness but now I'm really questioning if some of these red and pink numbers we've been seeing for days may not be due to fur shots? I had this problem when I first started doing the subQ fluids several times, but haven't had a problem the last 5 or so times. I tent the skin as is recommended everywhere and I learned with the subQ fluids to not push the needle in very far (just a little past the skin). I guess I need to watch more videos or do more reading to brush up on my technique. The needles she gave me for the B12 is a much larger gauge. It doesn't say what the gauge is, but I wonder if that could factor into catching a fur shot?

His walking isn't great. His hinds just don't move well and he can't jump very far at all. He frequently can't make it up onto my lap, and I put out a small step stool because he was even having a problem getting up in his little sitting chair. It seems worse when his BG has been running high for long periods so I'm assuming it's diabetic neuropathy. I've read the B12 may help with this, so it's pretty disappointing he hasn't been getting the full B12 shot and I can't give him another one for a week.

Hi John & Henry there is a really good B12 that alot of us give our kitty's. It's called Zobaline & it can be crushed & given in food or I sometimes pill pocket it as well. It's through life link. I search it on Amazon & buy it through there. A month after I started my boy Panzer on it, he was jumping on everything even places I didn't want him jumping on. He would get up on the top cabinet by the ceiling. I started calling him super kitty. We don't live there anymore but he is still jumping up on everything he can & he walks normal.
I've been following Henry's post & I feel for you & your boy, but you are doing everything you can for him & seems to be coming along well. I know all about lack of sleep. Panzer & my other boy have been on mirataz & Cerenia for months otherwise they won't eat, so I get broken sleep & struggle with the both of them. I'm alone no help so I am unable to get to the bottom of what's going on with them. I'm just doing what I can physically for them. I've heard of the B12 shot but was directed early on about Zobaline. It really does work wonders!!! Good luck to you & Henry

 

[JL and Chip]

So I just gave him his B12 shot for the second time and again (just like last week) it was a partial fur shot Of course, I can't say for sure it was just partial.[…]

The needles she gave me for the B12 is a much larger gauge. It doesn't say what the gauge is, but I wonder if that could factor into catching a fur shot?

His walking isn't great. His hinds just don't move well and he can't jump very far at all. […] It seems worse when his BG has been running high for long periods so I'm assuming it's diabetic neuropathy. I've read the B12 may help with this, so it's pretty disappointing he hasn't been getting the full B12 shot and I can't give him another one for a week.

There are a couple of important points here.

First, there are multiple forms of B-12, and each serves a different purpose.

Cyanocobalamin is the form of B-12 used for GI issues, such as IBD, cobalamin deficiency (I believe Henry showed a cobalamin deficiency on the TAMU GI panel report), and so forth. This is likely the red liquid you describe and is in injectable form. It is poorly absorbed orally, hence the need for shots.

Methylcobalamin (methyl-B12) is good for diabetic neuropathy. A popular brand for diabetic cats is called Zobaline and is an oral pill. Other brands can be used, but you need to be careful about checking that any additional ingredients are safe for cats as well as aren’t a form of sugar.

The two forms of B-12 aren’t interchangeable (I’ve seen that misunderstanding here a lot over the years). Some cats are on both forms at the same time depending on their medical needs. Henry might be one of those cats.

As for needles, you don’t need special ones for giving the cyanocobalamin B-12 injections. I always used my u-100 insulin syringes, as have others. I find it easier to give the B-12 injections with them. It’s a simple math equation to figure out what line to draw to — it’s been awhile, but I believe the last bottle of cyano-B12 I bought was 1000 mcg/ml, and the prescribed dose was 250 mcg, so I drew to the 25 line on a u-100 insulin syringe. Also, it’s easier to use an insulin syringe (IMHO) and I had plenty in stock at all times, and although I found it easier to be exacting with drawing the appropriate dose, cyanocobalamin is water soluble so any extra the body doesn’t need is simply peed out.

Henry is likely weak from just a sheer lack of nutrition as well, given the EPI.

How are his potassium levels? Low potassium can also make them weak or wobbly.

Is he walking in his hocks? That’s a classic sign of neuropathy. Neuropathy can take awhile to resolve. Here’s a video that shows a pretty bad case of neuropathy and the remarkable recovery that’s possible. https://www.youtube.com/watch?v=XfSWO8a1PlQ

 

[John & Henry]

To anyone following Henry, I didn't make a post today, but I just wanted to let everyone know he's doing alright. Still eating lots. BG has been running high still, but finally came down a few hours ago and it's currently sitting at 179 (nova) and ketones are 0.3... I might not be able to update the SS til tomorrow. Schedule has been a bit hectic, but I'll update it soon and I'll copy and paste his libre data into the libre tab on the SS right now.

There are a couple of important points here.

First, there are multiple forms of B-12, and each serves a different purpose.

Cyanocobalamin is the form of B-12 used for GI issues, such as IBD, cobalamin deficiency (I believe Henry showed a cobalamin deficiency on the TAMU GI panel report), and so forth. This is likely the red liquid you describe and is in injectable form. It is poorly absorbed orally, hence the need for shots.

Methylcobalamin (methyl-B12) is good for diabetic neuropathy. A popular brand for diabetic cats is called Zobaline and is an oral pill. Other brands can be used, but you need to be careful about checking that any additional ingredients are safe for cats as well as aren’t a form of sugar.

The two forms of B-12 aren’t interchangeable (I’ve seen that misunderstanding here a lot over the years). Some cats are on both forms at the same time depending on their medical needs. Henry might be one of those cats.

As for needles, you don’t need special ones for giving the cyanocobalamin B-12 injections. I always used my u-100 insulin syringes, as have others. I find it easier to give the B-12 injections with them. It’s a simple math equation to figure out what line to draw to — it’s been awhile, but I believe the last bottle of cyano-B12 I bought was 1000 mcg/ml, and the prescribed dose was 250 mcg, so I drew to the 25 line on a u-100 insulin syringe. Also, it’s easier to use an insulin syringe (IMHO) and I had plenty in stock at all times, and although I found it easier to be exacting with drawing the appropriate dose, cyanocobalamin is water soluble so any extra the body doesn’t need is simply peed out.

Henry is likely weak from just a sheer lack of nutrition as well, given the EPI.

How are his potassium levels? Low potassium can also make them weak or wobbly.

Is he walking in his hocks? That’s a classic sign of neuropathy. Neuropathy can take awhile to resolve. Here’s a video that shows a pretty bad case of neuropathy and the remarkable recovery that’s possible. https://www.youtube.com/watch?v=XfSWO8a1PlQ

Thanks for that video, JL. After watching it, I can say it looks nothing like the way Henry is walking. His back legs are more stiff looking and he kind of wobbles back and forth on them. With his Ketones still occurring (albeit less than before) and seeing how much better he is after getting subQ fluids, I suspect a potassium deficiency could be the cause. Thanks for explaining the different types of B12, the doctor had said there was an oral form and an injectable, but I didn't realize the difference. Is there an oral form of Cyanocobalamin too, or is it just Methylcobalamin? I opted for the injectable figuring it may be more effective if he was having absorption problems. I wish I knew what form the injectable was she gave me, but the bottle simply says B12. A google search for "injectable Cyanocobalamin" shows bottles with red liquid, so I assume that's what it is. I'll use the insulin syringes for his injection next week. Yes, it's .25ml @ 1000mcg/ml

Hi John & Henry there is a really good B12 that alot of us give our kitty's. It's called Zobaline & it can be crushed & given in food or I sometimes pill pocket it as well. It's through life link. I search it on Amazon & buy it through there. A month after I started my boy Panzer on it, he was jumping on everything even places I didn't want him jumping on. He would get up on the top cabinet by the ceiling. I started calling him super kitty. We don't live there anymore but he is still jumping up on everything he can & he walks normal.
I've been following Henry's post & I feel for you & your boy, but you are doing everything you can for him & seems to be coming along well. I know all about lack of sleep. Panzer & my other boy have been on mirataz & Cerenia for months otherwise they won't eat, so I get broken sleep & struggle with the both of them. I'm alone no help so I am unable to get to the bottom of what's going on with them. I'm just doing what I can physically for them. I've heard of the B12 shot but was directed early on about Zobaline. It really does work wonders!!! Good luck to you & Henry

Thanks for the info Chris. Did Panzer have neuropathy? After watching the video JL posted I don't think it's neuropathy anymore. Seems like it couldn't hurt to give him the oral form too tho. Henry is pretty good at taking pills. I'm to the point I can just gently toss them in his mouth and 75% of the time he'll just swallow them right down thinking he's getting a meal immediately afterwards. Thank you for your words of support. Yes, my sleep cycle has been severely disrupted, but it makes me feel good seeing Henry doing better and eating lots, paws crossed he keeps it up. Hope your able to work out whats going on with Panzer and your other kitty.

 

[Bron and Sheba (GA)]

The injections of B that the vet gave you would be cyanocobalamin. He probably needs that for his gut issues.
The Methyl B12 which is good for neuropathy can’t be obtained from the vet. You can buy that from lifelink.com and it’s called Zobaline.
so as @JL and Chip said…they are not interchangeable… they are for different things.

 

[Chrispooky12]

To anyone following Henry, I didn't make a post today, but I just wanted to let everyone know he's doing alright. Still eating lots. BG has been running high still, but finally came down a few hours ago and it's currently sitting at 179 (nova) and ketones are 0.3... I might not be able to update the SS til tomorrow. Schedule has been a bit hectic, but I'll update it soon and I'll copy and paste his libre data into the libre tab on the SS right now.



Thanks for that video, JL. After watching it, I can say it looks nothing like the way Henry is walking. His back legs are more stiff looking and he kind of wobbles back and forth on them. With his Ketones still occurring (albeit less than before) and seeing how much better he is after getting subQ fluids, I suspect a potassium deficiency could be the cause. Thanks for explaining the different types of B12, the doctor had said there was an oral form and an injectable, but I didn't realize the difference. Is there an oral form of Cyanocobalamin too, or is it just Methylcobalamin? I opted for the injectable figuring it may be more effective if he was having absorption problems. I wish I knew what form the injectable was she gave me, but the bottle simply says B12. A google search for "injectable Cyanocobalamin" shows bottles with red liquid, so I assume that's what it is. I'll use the insulin syringes for his injection next week. Yes, it's .25ml @ 1000mcg/ml



Thanks for the info Chris. Did Panzer have neuropathy? After watching the video JL posted I don't think it's neuropathy anymore. Seems like it couldn't hurt to give him the oral form too tho. Henry is pretty good at taking pills. I'm to the point I can just gently toss them in his mouth and 75% of the time he'll just swallow them right down thinking he's getting a meal immediately afterwards. Thank you for your words of support. Yes, my sleep cycle has been severely disrupted, but it makes me feel good seeing Henry doing better and eating lots, paws crossed he keeps it up. Hope your able to work out whats going on with Panzer and your other kitty.

Yes he did have neuropathy & that Zobaline is a miracle worker, I even thought about buying him a cape super kitty Lol that's good that he's easy to pill. I hope I can figure out what's going on with them soon too,probably have to do some door dashing job a couple of hours at night in between testing & feeding, gotta do what I gotta do for my boys! Hope you figure out what's going on with Henry. I'm not sure what you do if it's low potassium. Have a good day sounds like your going to be busy. I will be following you & Henry, your such a wonderful cat dad hugs to you both

 

[FrostD]

Only other thing I'd add - as long as your nose works, you'd smell the insulin from a fur shot. It smells sort of like brand new tires, like a tire show room if you've ever been in one. Potent, unmistakable. You probably smell it when you draw up too much insulin and have to let some out.