7/15 update - Trouble 7/13 seems sick...

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sofietca

sofietca

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Hi everyone,
I have been giving Trouble 1 unit BID for about a week now and have been a bit confused by her numbers. A number of times she has been higher during the insulin's peak, 5-8 hours, than she was at the amps and pmps. I'm not really sure what to make of it. I usually feed her around +8, and it seems weird then for the blood sugar to go down by +12. Or is it not as weird as I'm thinking?

She was unexpectedly high this morning - 405, which I thought might be either rebound from last night (though based on her +6 I doubt she went much below 160 or so), or it might have been because she sneaked some dry food in the morning 2 hours before I tested her. It was just a little bit, like a teaspoon maybe, of Evo 95%. I had to work today, but at +9 I tested and she was 367, I fed the cats, and then at +11 she had gone down to 339. I gave her 1 unit and then fed her dinner - but she only ate a little bit and then walked away. This cat would do just about anything normally for the smallest morsel of food, so her not eating really worries me. I tried feeding her again an hour later and she ate a bit off my finger but that's it. Her BS dropped from 339 to 272 in an hour, but now at +2.5 it's up to 290.

Ok, so I'm worried because she isn't eating - she comes to the plate but then walks away. She has diarrhea pretty bad, I think it started last night, so I thought that might be making her feel yucky enough that she doesn't want to eat. She was just treated with Flagyl for the same thing (ended about a week ago), but my cats keep taking turns getting diarrhea and being treated and I think it's just being passed around. She's being lethargic and feels warm. I would just chalk it up to intestinal upset, but her weird (in my opinion) blood sugar numbers have me concerned that something else is going on. I don't think she has ever been tested for ketones - does this sound at all like symptoms of dka? I'm hyper-worried right now about every little cat sniffle, etc. because recently I've been nurse to my 21 year old CRF kitty who has been having trouble...

So, do her recent BS numbers seem odd to anyone? Should I test for ketones just in case? I read about it and am not sure which would be better - the urine strips or the precision xtra glucometer... I guess I'd do whichever is easiest to get in the middle of the night from Wal-Mart... How do you get urine for testing if the cat isn't drinking? I am set up to do sub-q fluids here for my CRF cat, so I could do them for Trouble if need be. My instincts tell me that I should try to get her blood sugar down as much as I can, but that's hard to do when it rises a few hours after her shot and without eating! I'm sorry if this is rambling and all over the place!

Thanks for any advice,
Sarah
 
Re: Trouble 7/13 seems sick...

Hi Sarah!!! The quickest way to get a ketone test is the pee strips - that is what most use. You can get them from any drugstore (well, most - if you don't see them, sometimes they are at the Pharmacy). Then of course you have to catch them peeing. The meter takes a fairly big blood drop from what I understand, and the test strips are expensive. Mostly I think the people who use those are people who's cats have had ketones in the past, so they need to be able to test when they need to even if they can't catch them peeing.

I'm not sure what the symptoms are, here is the Wiki page on it, hopefully that will help you: http://petdiabetes.wikia.com/wiki/Ketones

It looks like she may be bouncing whenever she sees blue numbers. That's what this morning looks like to me, and if she got into dry food, even a few pieces can raise their numbers dramatically, so that may explain today.

What you mentioned about being higher in the middle of the cycle and then the +12 being similar to the PS can be an inverse curve (if the change is dramatic enough - sometimes it is just a flat curve), which can be a sign of the dose being too high. It's possible you got an inverse curve yesterday (can't say for sure what happened between the shot and +8), and since that shot was on a lower PS, it could be that the dose was too high for that PS. Overnight though, on a similar PS, it looks like you got some drop and then some liver training reaction, so it's not clear that the dose is really too high, but it could be.

I might experiment with doses around 0.8 or 0.9 and see what kind of results you get. You do want to test for ketones though, as generally if they are present you would need more insulin rather than less.

If you are really concerned that something seems very wrong with her I would take her to the ER, or if she seems ok tonight but you are still worried, take her to the vet tomorrow. They can certainly test for ketones there - either blood or pee or both, and of course can test for other things too.
 
Re: Trouble 7/13 seems sick...

Just wanted to mention too that sometimes the PZI forum can be a little slow, so you may want to post on Health if you want more immediate answers, and definitely post there if you have any emergencies. Probably the East Coasters have already signed off for tonight, but I'm sure you will get more people chiming in tonight or definitely tomorrow.
 
Re: Trouble 7/13 seems sick...

Thanks Joanna, it's amazing how much it helps just to know other people are out there. :) I went and got some ketone urine strips, and I just gave some sub-q fluids (first time doing it by myself!) and have set her up in the bathroom with a empty litter pan... I just hope she'll use it. I figure she'll need to pretty soon once those fluids go through her. I tested her blood sugar again and it's gone down a little more to 251, so that's good news. I'm going to just stay up for a while and keep testing and hopefully will test for ketones soon too.

I do agree that her curve has seemed pretty inversey lately. And it does seem like anytime she gets down into blue she shoots right back up, which is unfortunate. I assume that will stop happening eventually. I just hope there are no ketones and she's just feeling icky from intestinal bugs or something.

I'll post this over to Health too. Thank you for your thoughts and wisdom!

Sarah
 
Re: Trouble 7/13 seems sick...

Sarah, I totally feel your pain! I took care of my two CRF cats back to back (one passed then another was diagnosed) and at the same time was juggling my diabetic cat that developed ketoacidosis. Ketones are mega scary so test as often as you feel you need to if your kitty isn't acting right!

About the empty litter box....most cats will not go in a completely empty box. It usually helps to put a little shredded paper in there so that there is substance in the box that the cat feels he can pee on while at the same time not being so much substance that it will absorb all the urine. Probably scatter a little bit in the middle of the box since most cats pick a corner to pee in. I just would hate for your cat to hold it or pick a rug to pee on because it doesn't like the option! Plus you really do need to check for ketones asap because if they are in the blood it can go south real fast.

Good luck!
 
Re: Trouble 7/13 seems sick...

I had the same take that Joanna had here looking at your SS -- the dose may be a tad high, and it does seem that she'll bounce on blues a little. A slightly lower dose may get you where you need to go. If not, you can always go up, right?

Do you know what your cats are passing around? Flagyl is good, but knowing what the problem is helps to ensure it is being treated properly. Did Trouble ever has diarrhea prior to this? The appetite loss could be nausea or even from the flagyl itself. Make sure you give it with food and in an empty capsule, as it tastes awful and can make cats feel badly. If the diarrhea is bad enough, then dehydration can also contribute to nausea, so you do want to get a handle on things. If she's lethargic, feels warm, and is not eating, I'd think a vet visit is in order. I assume the vet has done tests for parasites and other things?

NOTE: If it does turn out that Trouble has an infection (elevated white count), that can also make your glucose numbers higher and less predictable. That may be playing a role too. Do not let the appetite loss go on however, as cats can get themselves in trouble quickly with hepatic lipidosis even if their appetite goes off for a short period of time. Has Trouble lost weight at all?
 
7/15 Update- Trouble 7/13 seems sick...

Hi everyone, just wanted to post an update on Trouble. I took her to the vet yesterday and she had a bladder infection and a possible intestinal infection of some sort (not sure yet), but definitely intestinal inflammation. She's taking Convenia now. And she had no ketones in her urine, so yay! The vet recommended I switch to Lantus because since April she hasn't been well-regulated with the ProZinc, and he's had better luck with Lantus. So, tonight she's making the switch to Lantus - just when I started thinking that ProZinc was making some sense to me too! Cross your fingers for her. :) Thank you for all your help and encouragement!

Sarah
 
I'm glad they were able to identify what is going on with her. Hope she if feeling better soon, and that things go great on Lantus!
 
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