7/29 Copernicus hospital dose update.

Krista & Copernicus

Krista & Copernicus

Member Since 2026
PP
Good morning,

I had them run a serum BG and his number was 333. His BGs are back up 210-479. They think the 100 reading (not verified on a second meter) means I was giving him too much insulin and he was at a risk for hypo. So they switched him to 14 units and sometimes they give him 10. His dosing is all whack now. 😞

And I got my hand slapped for tight regulation even after supplying the PubMed paper. So I feel confused and defeated again. They said a cat's body can't handle increases that fast. My head is spinning with you need to increase him faster, you need to increase him slower, he doesn't have enough insulin, you're giving him too much insulin. All the while Copernicus is suffering as all the different comorbidities are destroying his little body. I need you this group and I need his vets to continue to treat him.

I see so much positive on this forum. I think a lot of kitties are winning. But Copernicus has an anxious Mom with her own health problems and I could never find a vet to support his care with the fluids and meds you all get and give. If I do, I am charged high markups just for a single bag of fluids. I get my hand slapped for trying to do subq at home because of the risks. Copernicus is in the hospital almost every other week with ketones, severe dehydration, acute kidney injury, and now cystitis. And every time I hear about how much insulin he is on. It comes to almost $3000-4000 each time. I know we can't sustain that and my husband had to step in for a "financial reality check" because i would just keep going if I could. I also think no one wants to hear all of this doom and gloom while you all celebrate your kitties. People want positivity in their lives.

The SRT treatment here starts at $8000 just for the imaging and goes up to $15,000 for one session of radiation. Thats not just one estimate. Thats two estimates. They are booked out until September just for the consult. I think his kidneys are too damaged because his electrolytes barely move even days on IV fluids. And I don't even know if would survive the anesthesia and SRT is not immediate. They already sent an email saying to get him healthier before they would do the treatment. Well, I've been trying. I'm failing.

Thanks for listening. 🥺💔
 
So sorry, Krista. What do they say when you show them the paper? 100 might be too low for a caregiver who's not testing at home and is less committed. I feel like sometimes they don't take that into account. You're keeping him safe and following research and years of experience.

Will be thinking of you and him :bighug: I sure it's hard to stay positive. Maybe there are some alternatives to the SRT? Will this hospital help with the fluids, pain and nausea meds at least?
 
I’m so sorry this is so difficult and heartbreaking, Krista, that you get such challenges at every turn.
There’s no consistency with any of the vet teams.
And they won’t listen to your solid reasoning and experience, based information.

Anyone would be hard pressed to know what to do. And you are doing absolutely everything you can for your sweet boy 🥰

I hope you can get some answers and suggestions here on what to do about these difficult situations.
@Wendy&Neko
Do you know any options?

I’m sending you many hugs to both of you. Thinking about you and Copernicus with many prayers 🫂🙏💞
🍃🍃🍃🍃🍃🍀🍀🍀🍀🍀🍃🍃🍃🍃🍀🍀🍀
 
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His BGs are 519 and 565 since they reduced him. 😡 they said he needs to stay on each dose for 5-7 days and her only comment to the paper was that just to be careful increasing him so fast. They have my spreadsheet. How can you ignore facts and numbers? I had him with more yellows and purples. They have him the black. Also, his kidney values went up and they are literally looking at the reason why. I can't just go get him because he would have to be titration off his fluids.
 
Many people with acrokitties can not afford the SRT treatment. Back in the day, it cost me about $4K at Colorado State University. Times have changed, it is way more expensive now. I had a cat (not acro) have 3 sessions of SRT in Victoria this year, cheaper than NSCU, but still ouch! Thank goodness for cabergoline. Many kitties do quite well on it, you give it at home, and it is so much cheaper. The one downside to cabergoline is that how every cat reacts differs by cat. Copernicus has only been on it a month and a half. Remind me, is he getting it daily or every other day? I've seen cats take as long as 2-3 months to start seeing changes. You should probably add cabergoline and the start date to your signature, as it can have a drastic effect on blood sugar needs. It's also possible that 100 was from cabergoline, but that meant "hold the dose longer", not "drastically reduce the dose".

Krista & Copernicus said:
They have my spreadsheet. How can you ignore facts and numbers?
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They have obviously never had an acrocat. The folks at Colorado State University were fine with faster increases and following TR. As was the great IM vet who used to work at NCSU (before that CSU) and has since moved to England a few years ago. 😢

I hope Copernicus can come home soon and you can give him the proper care that he needs. How is he doing in hospital? What is the reason they are keeping him there?
 
They said his kidneys value continue to go up. So they said he needs to be on IV longer. But I think he needs to come home and I try phosphorous binders and start preparing him for end of life. We have used our savings and some of our retirement. If he's getting worse even on IV fluids since Sunday night, then I don't see what else I can do. His SRT consult is not until September and NC state raised the price. I'm getting estimates of 8000 for MRI, 1600 for CT, 9000 per treatment. 15,000 for treatment at blue pearl.
 
:bighug: :bighug: :bighug:
If you can get him home, get him on fluids (as long as his heart is OK with that), increase his dose and give binder and be patient with the cabergoline, that sounds like a plan. I suspect he hasn't had cabergoline since he went into hospital?
 
They did do the cabergoline. He's due for a dose tonight. And the other vet said he has a murmur so there's that. I guess they can't always hear it.
 
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Wendy&Neko said:
:bighug: :bighug: :bighug:
If you can get him home, get him on fluids (as long as his heart is OK with that), increase his dose and give binder and be patient with the cabergoline, that sounds like a plan. I suspect he hasn't had cabergoline since he went into hospital?
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To safely increase again, do 6 cycles at each dose again?
 
Krista & Copernicus said:
They said his kidneys value continue to go up. So they said he needs to be on IV longer. But I think he needs to come home and I try phosphorous binders and start preparing him for end of life. We have used our savings and some of our retirement. If he's getting worse even on IV fluids since Sunday night, then I don't see what else I can do. His SRT consult is not until September and NC state raised the price. I'm getting estimates of 8000 for MRI, 1600 for CT, 9000 per treatment. 15,000 for treatment at blue pearl.
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This just brakes my heart 💔😭
I know how hard you are advocating for him 🫂
 
Yes on six cycles, as long as you see nothing below 200 and you are getting a second test each cycle. You can also go back to the last dose you had him on directly, you don't need to slowly go back up from 14. If you want to be a little conservative, you could go back to 18.

Good luck.
 
JL and Chip said:
Any update on Copernicus? Is he home yet?

I’m curious where his phosphorus and magnesium levels landed after this hospitalization. So sorry to hear what you’ve been through.
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He didn't come down at all so they think this is his new normal and the damage is done. I just have to try and prevent progression to stage 3. I'll get the labs tomorrow but everything was still high. They put in big bold letters to leave his dose for 5-7 days and don't increase without vet supervision. They said the goal is to get is BG under control. I was like ummm I was doing that at the 19 units. I need to get his BGs too while he was there to see what happened.
 
Krista & Copernicus said:
He didn't come down at all so they think this is his new normal and the damage is done. I just have to try and prevent progression to stage 3. I'll get the labs tomorrow but everything was still high. They put in big bold letters to leave his dose for 5-7 days and don't increase without vet supervision. They said the goal is to get is BG under control. I was like ummm I was doing that at the 19 units. I need to get his BGs too while he was there to see what happened.
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I’m so sorry, Krista. His last labs you posted, other than phosphorus, his kidney values were not bad. Cats can be stable in Stage 3 a very long time as long as you can keep the phosphorus and anemia under control and keep them hydrated.

I would trust Wendy’s advice on acro over any of the vets there. I bet Copernicus would be much happier at home.
 
Marje and Gracie said:
I’m so sorry, Krista. His last labs you posted, other than phosphorus, his kidney values were not bad. Cats can be stable in Stage 3 a very long time as long as you can keep the phosphorus and anemia under control and keep them hydrated.

I would trust Wendy’s advice on acro over any of the vets there. I bet Copernicus would be much happier at home.
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thank you. He was partially obstructed from cystitis so we did the 48 protocol and then an additional day on fluids to make sure he did not re-obstruct. He's home tonight. I haven't posted his labs since his acute kidney injury on Sunday night. I need to get them from medical records.
 
Krista & Copernicus said:
He eats at 11 so he just had a meal of low carb food. Any Karo? How much karo?
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I don’t know where in the cycle 11 is. I’m not on your time zone. Do you just have HC food? I wouldn’t give karo yet.

I see the 72. If he will eat a little more HC, that would be good. Then retest about 30 mins after.
 
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As much as you can guess, it would be really helpful to add the insulin doses given at the hospital. As it is, I have no idea how large the depot is and whether these normal BG numbers you are seeing today are from his insulin dose or the cabergoline. Rule of thumb if cabergoline is working, reduce if he goes under 70.
 
Wendy&Neko said:
As much as you can guess, it would be really helpful to add the insulin doses given at the hospital. As it is, I have no idea how large the depot is and whether these normal BG numbers you are seeing today are from his insulin dose or the cabergoline. Rule of thumb if cabergoline is working, reduce if he goes under 70.
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Done. Monday night he got 19, they skipped his dose Tuesday a.m., reduced dose Tuesday p.m.(I think she said 10), Wednesday a.m. 14 and Wednesday p.m. 15. Thursday a.m. 14 and I did 15 tonight. I put in spreadsheet. He's about 7 weeks on cabergoline. And IV fluids have always diluted his sugars but never like this.
 
I don't know what I'm doing. The vet put the fear of god in me. The vet and the internet said below 70 is hypo. This group just taught me 50. I gave him just a dab of karo and he's 89 now. I hope I didn't send him right back up. Now I know for next time. This seems so out of the blue.thank you all for the replies.
 
Krista & Copernicus said:
I don't know what I'm doing. The vet put the fear of god in me. The vet and the internet said below 70 is hypo. This group just taught me 50. I gave him just a dab of karo and he's 89 now. I hope I didn't send him right back up. Now I know for next time. This seems so out of the blue.
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HC and Karo wear off after two hours so you’ll need to check him again. Don’t assume his BG will stay up all night.

I don’t know why they said 70 is a hypo. We don’t even call 40 on a human meter a hypo unless a cat has symptoms. Perhaps because of his depot, they don’t want him going lower than 70.

I won’t be able to stay up for your next test but please be sure you test him again 1.5-2 hours max after his last food although Wendy might have another suggestion with him having such a huge depot.
 
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Marje and Gracie said:
HC and Karo wear off after two hours so you’ll need to check him again. Don’t assume his BG will stay up all night.

I don’t know why they said 70 is a hypo. We don’t even call 40 a hypo unless a cat has symptoms. Perhaps because of his depot, they don’t want him going lower than 70.

I won’t be able to stay up for your next test but please be sure you test him again 1.5-2 hours max after his last food although Wendy might have another suggestion with him having such a huge depot.
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What do you mean when you say such a huge depot? Does depot =dose?
 
JL and Chip said:
Probably because she’s using an AlphaTrak meter. And for anyone reading, Marje’s numbers apply only to a HUMAN meter. For pet meters, the ranges are higher.
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Thank you. Corrected.
Krista & Copernicus said:
What do you mean when you say such a huge depot? Does depot =dose?
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No, they aren’t the same. The dose is how much insulin you give him at each shot. Here is info regarding the depot.
 
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