cat back to diabetic

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Hoping I posted this in the right place - am running around to see if I have insulin still and hypos - it's been so long since he's had any issues. He's lethargic and acting strange - not sure if this number is so serious to take him to vet, try a small dose of insulin or what... Hope someone sees this soon.
 
Does breath smell like nail polish remover? If yes, take cat to vet asap - could be heading towards ketoacidosis. Otherwise, have you got urine ketone test strips? If not, get at pharmacy and get some to monitor for that.

What insulin do you have? Use caution if you decide to shoot - 0.5 units to start, unless you know the cat can successfully used a lower amount, which you'd need to eyeball.

Look for triggers of glucose increase - dental infection is common, bladder infection sometimes. Make vet apt to rule in / rule out possible triggers.
 
If this is one test out of a long time of being in remission, I would not advise administering insulin just yet. Take a breath, catch some more tests (getting them in relevance to when he's eaten would be good to find out if that 300 is a food spike or if food is sending him higher, etc..).

If you have some ketostix or can get some to check to see if there are ketones present that might be a good idea. Then gather some data and set up an appointment with the vet to get things checked out. If he's acting strange and there is a jump in BGs, there is likely something causing it like an infection or something. Unless there is a chance he is getting into high carb food and the high BG is just because of that and getting him back to low carb might right things.
 
Just spoke to an ER Vet who I can't get to as my car is being serviced and my husband is working till about 2am (I will take him than if I have to) and they said since he hasn't eaten since 5pm I should not give insulin. He's at 324 - when he was in the midst of this before he was that high and higher some times - clearly I have to get to my vet but I guess my main concern is at 324 could something awful happen before tomorrow morning? Highly likely, possible, not likely??? Any input is much appreciated.
 
Does the breath smell like nail polish remover?

If yes, get a cab now.

If not, you may be OK to wait.
 
thank you melanie - I think he has been getting to his sister's food - and I've noticed over the past week that he's been drinking the dogs water - I kind of thought "isn't that cute" but now I think it's because he was thirsty and it's really convenient (his food is up high so the dog won't eat it) He is acting lethargic and not walking around crying for his 11pm "snack" and just plain not himself. He was a bit off last night but fine this morning - I thought he might be constipated (which is also an issue with him) and gave him some of the medicine that is for that which could have raised his level some what but I checked his BG so soon after giving him that I doubt it. I will take a deep breath (I tend to panic he is my soul kitty) and re-check his level soon.
Please forgive my confusion I'm sick myself with a tooth infection, on antibiotics and alone with him with no car so I'm beyond frustrated and a bit out of it.
 
Would it be really noticable? His breath smells fishy, maybe a tad sweet but not like nail polish remover to me at all. Cabs aren't easy in my neck of the woods but if I have to wake a friend I will.
 
There's no way to know based on one number. Is that 324 the low for the day or the high? Is it the only time he's been there in the last week? See where the problem is with only knowing one number? 324 by itself is not completely off the charts, its not a good number, buts its not an ER number either. But since its only one number it doesn't really mean much either.

If ketones are not present, and that his a high for BGs, and diabetes is the only issue going on, then there shouldn't be anything scary going on overnight. But that is a lot of ifs with no answers right now. I'd continue to try to catch some numbers as long as you are awake, maybe every 2 hrs, to try to see where he goes.

Getting him to eat is important. Ketones develop when there is a lack of insulin, a source of infection/inflammation, and a lack of nutrients. Food and water will help reduce the risk of DKA.
 
Ketones (an acetone smell) are pretty distinctive.

Encourage water consumption to help process the glucose.
 
Just saw he may be getting into high carb food. A diabetic cat will usually go up after eating without the assistance of insulin. A cat with a working pancreas however, will often start to come down on their own a while after eating low carb food. Getting some good low carb food into him could help him bring down that BG all on his own.
 
He won't eat we tried. He drank some water right after I tested him - I'll bring some to him now and keep it close by.
 
How are the 5 Ps?

Peeing
Poohing
Playing
Purring
Preening

Bascially - what behavior changes are you observing, other than the elevated glucose.


My apologies and I have to sign off - I don't feel well right now.
 
OK thank you here is the progression if it helps with the advice.

He was fine this morning - has been OTJ for a very long time (2 years? I can't even think right now)
but I have noticed he's been drinking more water for the last few days to a week- some large pee clumps in the litter box but no other symptoms
He was last checked by vet (full blood work up) about 6 months or less ago and he was A OK - no sign anything
He was acting so strange tonight I couldn't figure out what was wrong. He ate dinner at about 5pm but normally starts buggingme around 10pm for more food - which he did not.
He had some steak scraps at dinner (very small shreds, couple pieces)
When he started staring off into space and looking wobbly I checked his blood with MY meter and equipment which is what I always used with him.
It was 324 - and I was shocked. I couldn't even remember what was a really bad number etc. and pulled his old chart (thank you to this forum for making me do that) - saw that he'd been higher before but was on the insulin than.

I just offered him some chicken (he wouldn't touch his low carb cat food) and he GRABBED it. He perked up and is now in the litter box where he urinated some.
I have fresh water right at his bed and he's drinking it right now as I type this.
I will re-check his blood in 15 minutes
 
Thank you BJM as always for your help.
5 P's
He's been peeing (probably more than usual - ) and just did so now
He's pooping OK (he has constipation issues but seems OK in that area - I keep my eye on that)
He purrs a lot but didn't purr as much earlier tonight as normal - but was purring great when I came home at 5ish
He was playing with the dog this morning but nothing tonight except a bit of licking a catnip toy
I was cleaning himself earlier - but again - not as much as normal.

He is sitting staring into space again right now.
 
Just checked he's been OTJ since October of 2010 - not as long as I thought. He was only on insulin from August of that year.
 
Just checked again he's up 10 from 324 to 334 - I'm worried now that the lactulose I gave him thinking he might be constipated is elevating the numbers too - the vet said it wouldn't be a problem but that was when he was fine and hadn't had any issues in over 6 months. So now I'm concerned there. Got a hold of my husband he won't be home till 2am - this hour long trip to the ER is VERY stressful for this cat and expensive for us - I hate to make these kind of calls based on money and I won't but it is a factor no matter what as they require payment on the spot and I might not have that kind of money or credit available. So I'm going to stay up and check him again - he's awake and purring right now but doesn't look very happy.
 
Definitely sounds like he should probably see the vet for a checkup.

Getting food into him is good. Avoiding ketones is the most important thing with high BGs, that is what can get dangerous quickly. To do that, water and food.

Keep in mind that his acting funny might not have anything to do with diabetes. He could have eating something that made him feel icky. Has he eaten the steak you cook before? Onions and garlic can be toxic to cats if there is anything like that on the steak and he has had it before for you to know how he'd react to it. Any new plants around that he might have munched on? Its that time of year for Easter Lilies, one the worst for toxic plants to cats.

Glad he seems to be perking up a bit with the food and water. Keep an eye on him for a bit and see if he will eat and drink any more.

Lactulose could elevate numbers. But so will constipation so it is sometimes a call you have to make.

A 10pt change really isn't much of a change, small enough that with meter error it is considered to be pretty much the same number so it sounds like he is hanging steady. I don't know an ER trip is warranted on the BG alone. His overall behavior and how you think he feels would make that call. If you think he is sick enough that he can't make it to morning, then go.
 
OK thank you - when I spoke to my husband he said he did have some sliced garlic in the marinated but I gave him so little and it was BBQ'd so the garlic was basically cooked out I am sure - but that is something I should have been more careful about- I can't really eat garlic so I never use it but husband did the marinade and since he knows I can tolerate it when it's BBQ's (charred) he did put some in the marinade the steak sat in for a couple of hours.
He just ate a bit more chicken meat and drank more water - still looking kind of vacant but I think we can make it thru the night. I'm going to stay awake or set an alarm for 2am and check him again - no odd smelling breath so that's a good sign. His "sister" just came out and headed for his food and he went right over to guard his food - so he's more interactive right now.

Thank you again - I can't believe he's slipped back to this - I let my guard down for sure on him getting to the other cat food. Very upset with myself.
 
I know how you feel. Smokey got into the foster's food twice (the stuff that landed us in lantus land in the first place so we knew not to let her get into it) and bam back on insulin we went. Now everyone in the house eats what Smokey can have, no exceptions so there is nothing for her to sneak. Tiger mourned the loss of his food for a week. Nothing we can do but learn and move on doing better at keeping the sneaky little buggers out of the contraband.

The blessing in our case is that we were monitoring her closing because of the diabetes and we cause her very aggressive cancer really early on and appear to be ahead of it.

My cats have always eaten food cooked in garlic and onions - I LOVE them both and have always cooked with both and they steal my food. So some cats can tolerate it. Just something to be aware of when a cat is feeling off as a possible reason they aren't feeling good. Getting food and water through his system, and his using the LB, might be helping flush something out that made him feel sick.
 
I wish we could move our other cat to Robbie's food but she has a skin reaction to high protein so she is on a low protein food (high carbs) adn is doing well on that. they eat in totally different rooms and generally it's easy but I just got too casual about it. I'm nodding off - set my alarm for 2:15 to check him again. He's just sitting on the floor now - not sleeping - I'm getting the sneaking suspicion he's having some minor constipation issues even though he has pooped in the last 24 hours - I can usually tell when he's feeling backed up and now he's got that look too....
 
2:45am and he's down 100 to 275 and acting much more like himself. I am going to bed and will check on him by 6am and will be at the vet tomorrow at some point as long as they will fit me in. Thank you for the support - this forum is invaluable.
 
Just checking in on you, got home and spent some time downstairs with my girl where we have her isolatedafter surgery. Glad to see his numbers have come down and he see's acting better. Hope your vet can fit you in soon just to make sure that everything is ok and to see is a short time back on insulin might be needed.
 
Glad he's come down some.

Today, I'd suggest doing a curve, if he is otherwise stable and you want to wait on the vet visit until you have more data to share with the vet.
 
RobbiesMom said:
I wish we could move our other cat to Robbie's food but she has a skin reaction to high protein so she is on a low protein food (high carbs) adn is doing well on that. they eat in totally different rooms and generally it's easy but I just got too casual about it. I'm nodding off - set my alarm for 2:15 to check him again. He's just sitting on the floor now - not sleeping - I'm getting the sneaking suspicion he's having some minor constipation issues even though he has pooped in the last 24 hours - I can usually tell when he's feeling backed up and now he's got that look too....

I've never heard of a cat having an allergic reaction to high protein--the allergy is usually to a specific protein source, like Fish, Beef, or Chicken. Have you tried a limited ingredient diet, with a food like Natural Balance Venison? If you can figure out the source of the allergy, you can find a low carb food to feed. What food are you feeding her now? Ultra-low protein diets are not good to feed cats long term because they can cause muscle wasting.

If Robbie got into the other cat's high carb food, that could definitely cause a number in the 300s. The other day Bandit knocked over the garbage and ate some pizza crust and stale bread--his BG that night was in the 300s, but he was back to normal by the next morning. Occasional incidents aren't going to hurt much. However, if Robbie is eating the other cat's food on a frequent basis, that can cause him to go out of remission.
 
Thank you all as always for your kind and well thought out advice. I am taking it all to heart and will re-consider the food for our other cat - she eats Fancy Feast with gravy and LOVES it and she's super healthy (our vet swears he'd say she's no older than 7 if he didn't know she was 12) except for this skin (hot spot type thing) that started when we got our dog and APPEARED to be worse when she ate the same high protein low carb food we have Robbie on. Plus the she just had surgery to remove a very large but benign tumor from her side so once she's all fine after that I'll change over her food and see what we can figure out.
Robbie went to the vet today - he was 245 last night at 2:45am (ironic) and again at 5am and ate some food at 7am (wasn't as interested as he normally is but ate some anyway with my coaxing). Tuesdays are a 12+ hour work day for me so I had to leave him and come back for the vet trip. Had an 11am visit with the Vet - they checked him and he was 311 (that was 3 hours after he ate a few bites of his low carb food, maybe he ate more after I left but it didn't look like it). We had a long talk about how much insulin to start him on - (some may remember this vet went way too high last time around) and I was advised to give him 4 units 2x a day. I am nervous as I feel this is high (considering how Robbie responded last time around) but agreed for them to give him the shot there in the office and they want to see him again in a week. We also did a full blood work up (which less than 6 months ago was all FINE). I remain convinced that this slip back is due to my stupidity of using some of the high carb food (about a tablespoon each am) to get him to take his Cosquine for his arthritis (which has gotten much worse in the past year) and am hoping this will jump start him back on a good course. Not something I want to do again - EVER so I'm never going to give him anything but the tried and true low carb Fancy Feast that he enjoys and was so successful on.
I will begin self testing him but can't do a curve really as I'm not home till about 10pm tonight. I have to adjust his med times as right now it's 11:30 and 11:30 which won't work so I'm planning on giving him his shot around 10pm tonight and than his morning shot at about 9am - unless anyone feels that's too drastic a change. Only thing I'm concerned about is I would have felt more comfortable starting him out at 1 or 2 units - I feel 4 is way to aggressive. I couldn't speak to the vet again as he was in surgery and the Vet Tech was adamant that this was not a huge amount for a cat his size (he's 20.5 lbs) - thank you for your help with all this.
FYI - since finding this group almost 2 years ago I have successfully gotten about a dozen cats off dry food and coached 2 cat owners into trying home testing for their diabetic cats. The pay it forward works and I will continue to do what I can in thanks to all this group has helped me with.
 
4u is WAY too high a starting dose. 245-311 is not terribly high BG. I would not start at more than 1u. You say he's 20.5 lbs--is that what he's supposed to weigh or is he overweight?

According to the AAHA guidlines, no cat should be given more than 2u as a starting dose http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf.

If he's been regularly getting high carb food, that could be what caused the relapse. I would also make sure that there's no dental problems or infections brewing anywhere--that's also a big reason why cats relapse. If he's overweight, that can also contribute to high BG. If you take care of whatever is causing the problem, then he can go back into remission again. I would not follow your vet's dosing advice given the dangerously high starting dose--4u could have easily hypoed your cat. Head over to the prozinc forum instead.

I may have missed it, but have you or the vet tested him for ketones?

As for your other girl, I think it was just coincidence with the food. Or she could have been allergic to a specific ingredient in that food--but if she does fine on the gravy fancy feast, then I doubt it was a food allergy, unless you changed the protein source (for example, gave her a low carb fishy food, and then switched her to a high carb turkey food--in that case the fish might have caused the allergy). Fleas are the #1 cause of dermatitis, so that could have caused it. You don't even have to be able see the fleas for a cat to suffer from it--one single flea can cause scab every place it bites. Gabby had a flea allergy--her skin would break out LONG before you could find a single flea on her, so I just treated her with frontline the moment I noticed the scabs.
 
Thank you Julia I think I'm going to cut back for his evening dose but I'm going to go home soon and test him - my husband was there mid day and he was fine - playing with the dog etc.
He should probably ideally weigh about 19.5 lbs - he's a BIG boy (Maine Coon) but he's a tad over weight maybe and he was at one point 24 lbs but we got him down - than when he was first diagnosed he dropped to 18 and he looked like DEATH - way too skinny.
They couldn't get urine out of him he has very small kidney's - I don't know how I'll get to test either as he will NOT pee if I'm anywhere around and last time we went thru this I tried all sorts of urine collection methods which only resulted in him peeing on the floor. However his breath is fine - they are doing a full work up (sorry forget the phrase for this) the lab test that I won't have results from for a couple of days ??
So I'll see where he is when I get home but my gut tells me 2u would have made more sense. They checked his teeth, gums etc. all looked fine and like I said he just had a full checkup with complete blood work and teeth checked etc. about 6 months ago and he was in good shape.
As for our girl it could very well have been a coincidence but since she did improve when we switched her BACK to the Fancy Feast Salmon with gravy and was worse on the Fancy Feast he eats (I think his is called Savory Salmon Feast? his is darker green can her's is like a lime color) and we'd taken care of any flea issues (very careful about checking for flea dirt, dog is front lined and on pills and she was given a shot for flea protection too as this was our first guess at the cause of the dermatitis). Our basic thought is she was PO'd that we got a dog, probably DID get a flea or two on her before we treated her and started watching out carefully and by than it had become a psychological thing. It's complicated and I won't waste time here but we've been dealing with this issue for 2 years pretty carefully. I felt saver not going back to that particular food.
Boss just told me I can leave early so I'm out of here to go home to my boy and see how he's doing. Thank you again.
 
Also scared of seeing Red or worse Black

It's 4:45am here in our house and Robbie is screaming for food (not unusual) so up I get at basicaly PMPS+9.5 and test him. 399. OK if we follow any similar pattern I'll be waking up at 7am (AMPS) to a big RED number in the 400's -he just got about a 1/4 of a can or less of FF with lots of water in it - FF soup as we now call it and hope it keeps him sated - he also got a puff of albuterol on his inhaler as his breathing was a bit labored and congested sounding (we've had this checked 100 times - it's not in his lungs, it's upper resp. and it's a kind of asthma which is somehow triggered by his purring and is also somewhat seasonal in nature so probably allergy related).
My FEAR - I can handle red as long as it's a reasonably low numbered red but I've never seen him in the +500 black range. I cannot at this point check him for Ketones - I'm trying to figure out how to do that (he will NOT pee with me hovering, nor into those non absorbent pebble things - he peed in our laundry pile when I tried that 2 years ago) - and just like not wanting to see him dip down to some number under 45 and become a staggering, lethargic mess like he did that one time our first ride thru here - I don't want to be on that other end -
So I'm making sure I'm up in 2 hours to check him and praying it's not TOO bad but would love thoughts, support, advice, or shared experiences on this subject if anyone is feeling up to it.
 
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