Charlie - Help - Blood in Diarrhea/Lethargy. Scared.

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Re: Meet Charlie

I think you can rub the syrup on her gums. Hopefully the experts will be up soon and can help you more. It is 6:25 am Eastern time here in the US. The important thing to understand is that the danger has not passed even if Charlie's numbers are up on your next test...because the insulin will continue to push her numbers down for the next few hours -- so you will likely have to continue feeding her or giving her syrup to keep her numbers up. I really think it is that Charlie's dose is too high. She may need .5 units or maybe none at all. Hard to say...but again, hopefully the experts will chime in soon.
 
Re: Meet Charlie

I think you can rub the syrup on her gums rather than making her eat it. Hopefully the experts will be up soon and can help you more. It is 6:25 am Eastern time here in the US. The important thing to understand is that the danger has not passed even if Charlie's numbers are up on your next test...because the insulin will continue to push her numbers down for the next few hours -- so you will likely have to continue feeding her or giving her syrup to keep her numbers up.

I really think the problem is that Charlie's dose is too high. She may need .5 units or maybe none at all. Hard to say...but again, hopefully the experts will chime in soon. Can you edit the subject of your post from "Meet Charlie" to "Need help with hypo"...??
 
BG at 2.4

WIth the maple syrup, I could hardly get her mouth open (her blood sugar count is low but she's feisty at the moment). Guess it's normal to be grumpy if you don't feel so good. I used a bigger syringe that the vet gave me to push a small amount of maple syrup in her mouth. That was before when her numbers were at 2.1

I also gave her some more beef and she ate some of that, so that's good. I left more out in case she wants it too.

Still, as her numbers just came out at 2.4 (43 in US numbers), I think I need to give her a bit more maple syrup. I will try that now just to see if that will get her out of this crisis mode and back in the 3-5 zone.
 
Re: Charlie - Need Help with Hypo

Is there anything else she likes that would be considered higher carbohydrate than the beef? Like maybe ice cream, milk, or some food with gravy on it. Any of those would be helpful if you could get her to eat those. Again...I am hoping the experts will be along shortly to help. This is very unusual..as there are usually a few online pretty much 24/7.
 
BG at 2.9

Decided to retest first before giving more syrup. She is now at 2.9 (in US measures 52).

Will wait another 30 minutes then test again to be sure it continues like this and is not just a temporary spike due to the syrup.
 
Re: Charlie - Need Help with Hypo

Yes, I recall reading that the effects of the syrup wear off after a time (not sure if an hour or two), so it is important to keep testing and feeding for the next few hours so that the numbers do not drop again. I don't know anything about Caninsulin's mode of action, so hopefully someone will be here soon to let you know how long you will likely be in the "danger zone" with this. With Lantus, the insulin peaks around 6 hours and then starts to taper off over the next 6; but I just don't know if Caninsulin is similar or not. Hang in there. You are doing great!
 
Re: Charlie - Need Help with Hypo

I did just read where Caninsulin is not as long acting as Lantus, so that should get you out of the danger zone sooner. Any recent readings?
 
Charlie - Need Help with Hypo BG 3.2

We tested just now and she is at 3.2

We haven't found the exact "nadir" moment yet. See our spreadsheet to note that we only did one curve so far but I think from what the vet told us it's somewhere around the +4 mark.

From analyzing her numbers last night, we think we need to lower her insulin dosage to 1 unit max.

Unfortunately, we didn't test yesterday morning before starting, but if you look at where she was at the evening pre-test last night, her levels were at 12, which means that what we gave her in the morning lasted a long time. Last night we didn't give anything. Tried to give .5 but failed. So this morning when it was at 24.2 for her pre-test shot, we thought we should give her the full dosage of 1.2 (even though she had diarrhea and vomited the night before). Now we know this was a mistake.

We will test again before giving the shot at 7, but max amount we will give is 1 and perhaps even .5

If anyone has any thoughts on that, please do chime in.

Let's hope she keeps her food down until then. Thank you for being so responsive this morning, Melanie. We're getting there.
 
Re: Charlie - Need Help with Hypo

Wow! You all have had a difficult morning. So glad you were on, Melanie. You were great giving good advice so calmly!

Yes, Melanie is right. Canninsulin should be moving up after that six hour mark, but you want to keep testing just in case. The higher carb stuff she had may bring her up and then she could lower again. Not likely but possible.

It was probably the vomiting as much as the dose that caused her to go so low. Canninsulin without food on board can be very harsh. We need to figure what is making her vomit. How long ago did you change the food? Has she been eating one particular kind? My cats have always reacted badly to beef flavors.

Yes, I would also lower the dose.
 
Re: Charlie - Need Help with Hypo

Sue....soooo glad to see you! When Charliesmom said Charlie had dipped to 38 (US) at +4, that really scared me as I don't know anything about the action of Caninsulin.

To Charliesmom: I found this link about treatment options to using Caninsulin in the Netherlands (I believe that is where you said you are?). Not sure if this will prove helpful or not, but there is a reference to a vet who will prescribe PZI, Lantus or Levemir -- which are superior to the Caninuslin and, I believe, easier to manage (not a strong onset like Caninsulin). Hope Charlie gets along ok.

Here's the link: http://www.diabeticcatcare.com/COK/netherlands.htm

Here is an excerpt from the site:
---------
INSULINS and GETTING PZI
Most vets in European countries are on the “feed Dry Hills and use Caninsulin” plan of treatment. It is very difficult to find a vet who is willing to prescribe another type of insulin. Europaplein Dierenkliniek will dispense Lantus but they are expensive.

Dr.Tannetje Koning (holistic veterinarian) is the greatest hope for treating cats with diabetes (and other chronic symptoms) in the Netherlands. After having little success with regular diabetic protocols, she became very interested in the Tight Regulation approach to diabetes. She has now published a book on diets for carnivorous pets strongly supporting low-to-no carb wet/raw diets and home testing. Please contact Dr Koning regarding the dispensing of PZI or Lantus or Levemir. Her practice is located in Otterlo (Gelderland), however on Mondays she consults at Zoo-Natuurlijk in Amsterdam (Rivierenbuurt). She also consults in Zeewolde (Flevoland). Her website link: www.holistischedierenartsen.nl
----------------
 
Re: Charlie - Need Help with Hypo

The world is an amazing place. You have managed to find a vet in Amsterdam who will prescribe another type of insulin, and we (located here) have not! :lol:

I need to think about that a bit as having a vet who is only available 1 day per week could be a challenge.
Maybe I will try to give her a call this week just to inquire about it as a starting point.

Thanks for chiming in, Sue.

I think what's causing the vomiting is more likely to be the pancreatitis (which we still have no clue about), more than the beef. Guess we can always buy a different kind (chicken?) and try it out.

So far we stopped the hills m/d. We stopped the fish because of what I read about the extremely low quality of fish (& hazards) in cat food. We stopped the veal.

Change is the only constant.
:roll:
 
Re: Charlie - Need Help with Hypo

I have not dealt with pancreatitis, but have these articles bookmarked:

Here's a food articlePancreatitis Diet
Good information on Pancreatitis: http://www.marvistavet.com/html/body_pancreatitis__feline_.html

Good vet article on pancreatitis: http://www.idexx.com/pubwebresource...ng-pancreatitis-and-concurrent-conditions.pdf

It would be so wonderful to have a different insulin. Wonder if the vet that Melanie (amazing Melanie!) found would be your "feline diabetes" specialist and you could keep going to your regular vet for the normal stuff?

I do think you should talk to your regular vet about the complications with Canninsulin (which tends to be a harsher, shorter acting insulin as we have said) and the pancreatitis. Maybe that would prompt him to prescribe a milder, longer lasting one? Wonder if the FD vet would do a consult with you and then speak to your regular vet?

PS Spreadsheet looks great!
 
Re: Charlie - Need Help with Hypo

Im sorry you have had such a difficult morning. With everything going on, vomiting and diarrea i think you should lower the dose to 0,5. The reason for such a low dose is because you dont know if he will eat and vomit. His numbers might get a bit higher, but it will be more safe. After a few day you can raise again.
With Charlie being difficult to test, the most important tests will be the two preshots and then a +4, those are the ones you have to focus on. With him reacting so much to the caninsulin, never shoot insulin without testing.
Hope Charlie is doing better.
 
Re: Charlie - Need Help with Hypo

Hi,
So glad you have a spreadsheet.

I was looking at it and can see the pattern.
I would suggest you lower your next dose because Charlie's body will still be reacting. I would say .75.
Any time you have to skip a dose , your numbers will go up and it takes a couple of cycles to get back to where you would still be IF you hadn't skipped.
Especially since we aren't keeping food down. Food is important with that insulin.

The numbers before you skipped were already reflecting the dosage needed to be adjusted downward just a bit. ( With a few more random bg tests, that would have
shown up )

Will Charlie eat chicken or turkey? Those are more suited to cats.
I haven't seen any cats chasing cows for dinner? :lol:

I'll have to go find the link that says to try to limit beef and fish products . It may have been on www.catinfo.org
And beef doesn't help with pancreatitis. ( I'll find that one too)

So glad you made it thru. I noticed last night that no one was up, including me. I showed up for 5 minutes for a late night nadir.
 
Re: Charlie - Need Help with Hypo

I would agree with Sue above that it would be great to get Charlie on a longer acting insulin. From what I am reading, Caninsulin only lasts about 8 hours in cats and is a lot more difficult to manage (related to the timing of food and onset); so in essence your cat is going untreated for at least 8 hours every day (4 per cycle) -- if I am understanding this correctly. I also agree that you could, perhaps, have two vets - the holistic vet for helping you get a different insulin (she could be your diabetes specialist) while maintaining another vet for emergencies etc. The holistic vet may already have established relationships with other vets in Amsterdam. Don't know, but it is probably worth investigating. Once Charlie is on a better insulin, there should not be a need for as frequent vet visits in any case.

Seems so strange to me that none of the more effective insulins for cats are available in the Netherlands. There are medical studies to support their effectiveness and many thousands of people are using them, more safely than the Caninsulin and more effectively. Why do you think these insulins are not generally accepted there?

I also think Charlotte is probably right about using a much lower dose of the Caninsulin, until you can make sure Charlie is not going to throw up his food; because the Caninsulin onset appears to be quick and dramatic (unlike Lantus) -- and if there is no food balancing against the insulin when it hits, you are going to get a very low drop like you did this morning (at least that is my non-expert analysis...LOL!!). The holistic vet (if you consult with her) may be able to give you some tips on food that a more traditional vet may not know. So many of the traditional vets don't know much about feline nutrition, and prescribe "Hill" prescription food or other similar foods as though they have magic ingredients to help diabetics. Holistic vets typically know better and may have different suggestions for treating the whole pet.

Good luck!!!!!!!! PS: I am an analyst and researcher by profession so am used to finding obscure information online. I hope it is helpful to you and Charlie!!!!

PSS: You might want to remove the "911" icon from your post as the emergency is now past (I believe??). You can always put it up again if you need to. :)
 
Our Vet & Insulin Types

To be real honest, I've already been thinking about switching vets. Couple of reasons for that:

1. Charly had two teeth pulled about 6 months ago (they suspected an infection). Still, they would not prescribe an antibiotic after the surgery.

In general, the Dutch approach is the exact opposite of that in the US. In the US, doctors tend to overprescribe antibiotics (I think due to potential lawsuits). There are studies that show many of the superviruses exist because of this. So on the flip side, in Europe, they tend to take the opposite approach (allowing the body to heal itself first and only giving antibiotics in extreme cases). There's obviously a more balanced approach to both, and that's the middle ground we were looking for with Charly's teeth getting pulled. Still. Our vet would not consider giving an antibiotic. As it was the first time we were challenging something with her, we decided to trust her judgment.

I do not want to blame the vet now, but some of the things I have read about pancreatitis say that there are links with that and dental infections. I don't know.

2. My vet is quite young and seems to be inexperienced with diabetes. She is open to my input and is patient with me asking lots of questions in a language that is not her own, so that has been good. However, she has made some poor decisions in my opinion (raising the insulin to 2.5 ... also encouraging us to bring it back up to 2.5 after another, emergency room vet told us to bring it down to 2... etc). When my vet told us to bring it back up to 2.5, I told her NO. I insisted, gave her rationale for this, and eventually, she let it go (until next blood test, when she essentially said she would "prove to me" that I was wrong). At next blood test, Charly came out at 4 (right in the perfect range), so the vet let me stick with a 2 unit dosage.

3. My vet seems to be deathly afraid of our cat, and this rubs off on all her assistants except 1. I found Charlie 12 years ago and at the time she was a near-feral cat. It has taken her a LOT of time to trust people. She really is a big sweetheart and is wonderfully friendly with us, but there is hardly a single friend that Charlie will warm up to. So you can imagine how she is with going to the vet. She now associates the place with blood tests, rough treatment, etc. There are literally 3 people who have to hold Charlie's head, feet, and body down for my vet to give a blood test, and Charlie tends to scream like a lion. I realize she will have this reaction with most vets, but it was eye opening when we took her to the emergency vet and a new person started fresh with her. That vet was firm but not afraid.

4. In discussing caninsulin with my vet, she basically told me that the most important, serious university of veterinary medicine in the Netherlands still keeps caninsulin as their recommended insulin to prescribe. Thus, she says that all vets in this country use it. She even told me there is no other option that she prescribes or has experience with. When I mentioned some of the ones I read about on this board, she told me that some of those aren't even available in this country (or may have other names). So for the time being, as I had purchased 4 bottles of caninsulin and wanted to give this whole thing a chance, I have been sticking with it.

Most vets are closed here on Saturdays and Sundays, but I already sent an email to the vet noted above just to see if it's possible to come in and talk to her on Thursday.

This Tuesday we have another appointment with our own vet, so we will also plan to discuss a few things with her while we're there:
- We will ask for a urinalysis to test ketones (still can't find ketone strips here yet)
- We will test our home blood glucometer against the one she has to see if it's working properly
- We will inquire about another type of insulin and tell her we plan to make an appointment with a specialist

As we have already spent over 1000 Euros at the vet ($1200), I want to be cautious about too many expensive vet visits. Still, as I don't have pet insurance and am paying cash anyway, I think it's better to work with a specialist rather than a generalist. I will tell my vet this to see if she will agree to share all charlie's records with the other vet and stay on as a generalist for more emergency situations. Let's see how it goes.

We're about to do our evening test now. Based on the figures, we will likely give between .5 to .75 units. I will come back to you guys to get a final reco on that and make the call.

I cannot thank all of you enough for being there for us through this. The warmth, advice, helpfulness, and all around welcoming has made this time a bit easier on us. We thank you from the bottom of our hearts, and Charlie is better off because of your help and overall responsiveness. Seriously. Thanks a billion. ;-)
 
Re: Charlie - Need Help with Hypo

When I mentioned some of the ones I read about on this board, she told me that some of those aren't even available in this country (or may have other names).
Click to expand...

Next time you talk to her, mention "glargine" and "detemir" (rather than Lantus and Levemir) and they might ring a bell.

Carl
 
Re: Charlie - Need Help with Hypo

Evening pre-test before her 7pm shot came out at: 12.3

What do we do guys?

.5 units?
.75 units?
nothing?

:?
 
Re: Charlie - Need Help with Hypo

0.5 if you ask me. After a hypo a lot of cats are a bit sensitive to insulin, and since it is a low preshot as well i would not give anymore.
 
Re: Charlie - Need Help with Hypo

That's what I was thinking as well.

I just refer to the post above that indicated this board does not recommend shooting if results are around the 12 point mark.

With that in mind, is .5 OK if she will not eat very much?

She has been eating small amounts in the day but is not seeming very hungry.
 
Re: Charlie - Need Help with Hypo

It should be ok, but see if you can encourage her to eat, maybe try some tuna if she is not too hungry. Have you tried to feed her Felix as good as it seems or twice as nice. It is really low in carbs and none of my cats are having any problems with it.
 
Re: Charlie - Need Help with Hypo

We haven't found those 2 felix types yet. She is eating a little bit more. We will try giving her something else like you say and keep watching her real closely.
 
Re: Our Vet & Insulin Types

charliesmom said:
We have already spent over 1000 Euros at the vet ($1200), I want to be cautious about too many expensive vet visits. Still, as I don't have pet insurance and am paying cash anyway, I think it's better to work with a specialist rather than a generalist. I will tell my vet this to see if she will agree to share all charlie's records with the other vet and stay on as a generalist for more emergency situations. Let's see how it goes.
Click to expand...

Speaking from my experience, I have found that finding a vet knowledgeable in feline diabetes has been a lot less expensive than dealing with my first, less experienced vet. My first vet did not encourage me to home test, and wanted me to bring Ninja into his office for weekly curves to get her regulated. The first thing he told me was that treating diabetic cats was expensive; and he was right-- with him it was. After I found a new vet, my costs went down dramatically. In fact, I have taken Ninja to see the new vet only once for an initial exam. My new vet used the records from my old vet (so we didn't have to re-do the blood work). And now I just let the new vet know what numbers Ninja is running and she helps me with dosage adjustments by phone. She does not charge me for this. My total expense thus far with the new vet is one $59 office visit.

I can't say the same will be true of you if you switch vets; but it stands to reason that a specialist who is an expert in feline diabetes should (hopefully) be able to coordinate treatment for you that will result in fewer emergency vet visits which should save you money in the long run. As a PS: if you do consult with the new vet and get prescribed Lantus, don't be shocked by the sticker price. It runs $120 a vial here in the US and presumably there would cost more -- but it should last up to 6 months if stored in the refrigerator. Just throwing that in. :)
 
Re: Charlie - Need Help with Hypo

Charlie is GORGEOUS!!!!!!!!!! PS: Your spreadsheet shows how difficult working with Caninsulin can be -- on 7/15 Charlie went from a preshot of 428 down to a 54 within 3 hours. Same with today...from 436 preshot to a 38 within 4 hours. How can anyone reasonably manage that kind of drop? A lot of us (using other insulins like Lantus) don't even test till +5 or +6, and by that time (if using Caninsulin) the cat would be in severe hypo or worse. With Lantus it has a gradual onset so you can better see trouble coming. This 300-400 point drop on Caninsulin within a 3-4 hour period -- I do not see how people manage that without hovering over their cat and testing every hour, indefinitely. Just commenting.
 
Re: Charlie - Need Help with Hypo

Rhannon and Shadow: thanks for the feedback! Just wanted to make sure that the link I posted takes you to the version of the spreadsheet that can only be edited by me. Please let me know if you can edit also... :) If you can I need to change a few settings... :)
 
Re: Charlie - Need Help with Hypo

I can't edit the ss, so it looks like the right one.
Beautiful pics, especially the last one!
Carl
 
Re: Charlie - Help - 2 days of diarrhea & vomiting. Scared.

Hi guys. Starting to really worry now. I woke up at 5am to the sound of more throwing up. Liter box is full of diarrhea. I'm really worried for my sweet girl who has been sick for 2 days straight. nailbite_smile

:YMSIGH:
 
Re: Charlie - Help - 2 days of diarrhea & vomiting. Scared.

This is very worrying. I think I would take her to the vet and get her checked. A diabetic kitty can fail fast when she doesn't eat and has diarrhea.
 
Re: Charlie - Help - 2 days of diarrhea & vomiting. Scared.

Is there anything Charlie will eat -- say, the food she ate prior to her diagnosis? Even if it is dry food, I am thinking that it may be better for her to eat something than nothing at all (for days). When Ninja wasn't eating, my vet advised me to, "let her eat whatever she will eat" and we will worry about the rest later. Would the experts agree?
 
Re: Charlie - Help - 2 days of diarrhea & vomiting. Scared.

I looked back to your earlier posts on page 1, and it looks like Charlie has a history of vomiting after you give the Caninsulin. Is that correct? Maybe her system just can't tolerate this type of insulin. Is it possible she is allergic to it (or otherwise cannot tolerate that type?). Experts, would it make sense to discontinue the insulin for today, until she can get Charlie checked, and just feed her anything she will eat for now? She is only giving .5 of insulin anyway. What does everyone think?
 
Re: Charlie - Help - 2 days of diarrhea & vomiting. Scared.

For sure we will give no more insulin this morning at the normal 7am slot. We just called the emergency vet and they can see us at 9am. It is 5:40am now. In the meantime, we will try to give her more food and water and monitor her. Should I do another blod test now? Or is that just distirbing an already very uncomfortable little sweet kitty? :cry:

We Are both really sad over here seeing her like this.
 
Re: Charlie - Help - 2 days of diarrhea & vomiting. Scared.

When was the last time you tested her? Probably wouldn't hurt to have a current BG reading. I'm guessing the Caninsulin would have worn off by now, from last night - so Charlies BG may be high. But until you can see the emergency vet in a few hours, you might want to hold off on the insulin. Seems from reading your posts, that you give the Caninsulin and then Charlie often vomits afterwards -- a dangerous combination. But you also changed her food around the same time, so it could be the new food causing this -- or a combination of both. Keeping her hydrated would be important at this point (due to the diarrhea). And, just me (and I am no expert), I would let her eat whatever she wants today (whatever she will eat). Experts, what do you think????

I wish you had had a chance to consult with the new holistic vet before this happened, as I really feel that could be the answer -- different food and different insulin that Charlie's system can tolerate better. If Charlie's BG numbers are not running dangerously high (after your vet check today), you might want to hold off on the Caninsulin for a couple of days until you can consult with the other vet (who can prescribe other types of insulin). It's a hard decision though and one only you can make. See what the emergency vet thinks. Experts please chime in.
 
Re: Charlie - Help - 2 days of diarrhea & vomiting. Scared.

If you are not going to give any insulin this morning, then maybe just one test so you'll know what her number is, then let her ears have a break until you find out what the vet thinks.

It could be a reaction to the insulin, it could be to the food, it could be all sorts of things, and seeing the vet is your best course of action. Not eating for any length of time, and diarrhea that goes on for days are both bad things. She could also be dehydrated from the diarrhea. Hopefully it's just some sort of digestive tract infection or maybe an issue with a parasite - something that can be treated with an antibiotic or other medication.

Please let us know when you find something out,
Carl
 
Re: Charlie - Help - 2 days of diarrhea & vomiting. Scared.

I am so glad you can get her into the vet. It's so hard to figure out what might be happening. Maybe it could be a bad reaction to some of the food or maybe a pancreatits flare up. It should be okay if she will eat a little - maybe off your finger. If you got a test before you go, you could compare it to the test at the vet.

I hope they can figure out what is wrong, hopefully it will be something easy to fix. We'll be thinking about you and Charlie.
 
Re: Charlie - Help - 2 days of diarrhea & vomiting. Scared.

Did Charlie have a history of vomiting before she started the Caninsulin? Did she have a history of vomiting when you changed her food in the past?
 
Re: Charlie - Help - 2 days of diarrhea & vomiting. Scared.

How is Charlie??? I could not access this site all last night and it just came back up.
 
Re: Charlie - Help - 2 days of diarrhea & vomiting. Scared.

Hi guys,

Thank God the board is back up and running again. This has been a really rough day for all of us and we are hoping to get a good night sleep soon.

In the notes on Charlie's spreadsheet you can see some comments about what happened today. In general, however, it hasn't improved so much. She now looks like a completely drunk kitty (dilated pupils, has been hiding behind the couch all night, etc). The ER vet gave her a shot to help with the pain and a shot to help stop the vomiting. She did not give us anything against the diarrhea though, and that Charlie still has so that part is still a bit concerning.

Since we were at the vet between 9-11, we only gave her first shot of the day at 11 after getting discussing it with the vet. That one was .5 units. We tested Charly at 10pm (1 hour earlier than her planned 11PM shot) and it came out at 14.2 (256 in US terms). She has not been eating a lot, but the vet told us to force feed her some hills prescription wet food this morning, and also at 6pm when we gave her a pain pill. We did so and worked it out, but it made me sad for that kitty as I felt like she really didn't want to be held in the kitty burrito towel and given food when her tummy likely hurt. She also ate a bit of the perle fish (1/2 bag?) on her own initiative a few hours ago. For a moment there, I thought it looked like a good sign, but then she returned back behind the couch and at last blood test, she seemed very out of it.

We will try to get her to eat a bit more soon but I'm not sure it will be so easy. The pupils of her eyes look extremely dilated and a bit white-ish (like cataracts). I hope she doesn't have that coming on! In general, she seems either in pain, or else spaced out from the medication.

Do you think we should give .5 if we can get her to eat? On the one hand, that sounds theoretically reasonable, but if you look at her numbers from today in the spreadsheet, I'm a tiny bit worried that it may still be too much.

Thoughts?

To answer your question, I do not see a link with the caninsulin specifically and the vomiting. That may not be the best type of insulin to give her, but if you look at her chart you can see that the times she vomited it was either:
A. Linked to increasing the insulin too high to 2.5
B. On a day when she ate veal (this could be just a theory but who knows)?
C. Likely tied to another variable (just a thought, as it happened randomly rather than at every interval of using caninsulin).

She also had 2 very good days (only 2 in a period of 1 month, but still). Let's hope for brighter pastures ahead. nailbite_smile
 
Re: Charlie - Help - 2 days of diarrhea & vomiting. Scared.

This is really out of my league, as I am relatively new myself, so I hope others pop in here soon with suggestions -- and please take what I am saying with a grain of salt: It just seems to me that, for 30 days, the traditional vets keep giving Charlie more and more "medication" ... from pain killers, to anti vomit shots, to the Caninsulin, and Hill's "prescription" food -- and she seems to be getting worse not better and now appears to be in pain and is hiding behind the couch.

With a preshot BG of 256, which is high, but not in a critical zone -- if it were my cat (and again, I am NOT expert here), I think I would just discontinue the Caninsulin for a day (keeping an eye on her BG levels) and let all the artificial medicines get out of her system. I would also consult immediately (first thing Monday morning) with the holistic vet and see about getting Charlie switched to a different insulin. If you tell them it is an emergency, perhaps they will work you into the schedule right away.

Looking at this realistically...If what the traditional vets have been suggesting was working for Charlie, I'd say keep following their advice and keep trying it their way -- but Charlie is not improving -- and at some point, you will have to try a different direction; and I would try the holistic vet (for a second opinion) who might be able to direct you to an insulin different than Caninsulin that Charlie could try.

I would also discontinue the Hill's prescription food (there is nothing magical about the ingredients in it) and see if Charlie will eat whatever food he has traditionally been comfortable with (prior to this month). Sometimes you have to GRADUALLY introduce new foods -- or it causes gastrointestinal upset (vomiting and tummy issues)... so if you introduced the new food this month, maybe Charlie is having a reaction to that as well.

I feel SOOOO BAD for you and Charlie and wish I could help more. I was devastated that the site went down last night -- but was sending you prayers for a positive outcome. Experts...please chime in. What approach might you take if this were your kitty??

For Charliesmom: My question about the history of vomiting..I meant, "Did Charlie vomit frequently prior to this last month (before he began treatment or had a food change)?
 
Re: Charlie - Help - 2 days of diarrhea & vomiting. Scared.

I think you're completely right. I don't know exactly if it's the right thing to do right now, but as there is so much in her little body at the moment, we have decided NOT to give her any shots for tonight. This is my thinking at the moment:

This morning the test came out at 26.3 at 9:30am. We gave .5 units at 11am, and within just a few hours there was something like a 19 point drop with just the .5 units. If we give .5 now and there's a 19 point drop again, she'll could have a hypo because she only has a total of 14.5 points to go down from.

It's possible we could try to give her .25 units, but trying to measure that out on the syringe would be seriously tricky, and not worth the risk.

I agree that our vet is not working for us. That part is CRYSTAL clear. I already emailed the holistic vet yesterday (no reply yet but it's the weekend so I will try to call her tomorrow morning). We already have an appointment set up at our own vet for Tuesday at 11 as a backup plan. If the holistic vet is not available IN AMSTERDAM until Thursday, maybe we will try to get in with our own vet for Monday (instead of Tuesday) and then switch to the other vet as of Thursday? I need to think this over.

Today's bill was 270 euros. Ouch. If Charlie were feeling any better, I'd say it was all worth it, but I worry a bit that there is something more going on in her system (or that the pancreatitis is starting to make this more complex than we are able to manage. We'll have a good night sleep and take it step by step in the morning. Thanks for thinking of us and also for your prayers.

For the record: Charlie never vomited a day in her life before this last month so your theory may have some weight (or the pancreatitis flare up is causing it). Either way, bad news. :roll:

Thanks very much, and thank you also to Charlotte & Prop (who have been there for us today through their personal email address when this site crashed). No man is an island. Thanks to them for being there.
 
Re: Charlie - Help - 2 days of diarrhea & vomiting. Scared.

I agree. Personally, I would just let Charlie rest and not shoot any more Caninsulin for a day or so. Her numbers are in the 200's pre-shot which is not scary-high (so not much damage is likely being done to her in that short time); and the current method of treating her appears to be doing more harm than good - and costing you a lot of money. Did you provide the link to Charlie's spreadsheet when you emailed the holistic vet's office for an appointment? If not, you might want to include that. The vet may be able to look at the spreadsheet on Monday and, based on Charlie's numbers, advise if it is ok to discontinue the Caninsulin until she can see you on Thursday (so, provide guidance by phone). Make sure you tell them it is an emergency and that you have been to see the emergency vet over the weekend (sometimes if they know it is an emergency, they will bump you ahead of others).

If Charlie never vomited prior to this month, then logic would tell you that it is either the Caninsulin or the new food -- or a combination of both that are the likely culprits. If you read on the Caninsulin literature, it says that "in rare cases, allergic reactions to porcine insulin have been reported" and that this reaction can involve vomiting and loss of appetite. Not to say that this is true of Charlie, but it is a possibility. Maybe one you can explore with the new vet.

Lots of us out here pulling for Charlie!!!!!
 
Re: Charlie - Help - 2 days of diarrhea & vomiting. Scared.

I like Melanie's plan. She isn't super high and it seems safe to stop the insulin for a while. The important thing is to get her feeling better, eating and without diarrhea. Give her food she ate before, in small frequent amounts and see if the vomiting and diarrhea improves.

I am thinking she may have a sensitive system and the harsh drops the Canninsulin causes make her feel really crummy. Perhaps the vet can prescribe a probiotic to help her digestive issues.
 
Re: Charlie - Help - 2 days of diarrhea & vomiting. Scared.

Quick status update:

Charlie's numbers were high at pre-test this morning 22.4 (403 in US Measures) so we decided it was best to give .5 units (to keep the blood sugar in more balance) until we can find a new plan of attack. She ate a little bit during the night while we were sleeping, and we were able to force feed her a bit more of the specialist cat food from the ER vet. With this, we were able to give her a tramedol pill against the pain to hold her over for the time being.

Two positive developments:
- We are going to our normal vet now (without charlie) just to get some anti-diarrhea tablets. While we are there, I think I will also show them Charlie's chart (just as a last stitch effort to see if they have any thoughts). If not, fine. I have a backup plan. I will ask them if they can share with me copies of all her blood test full reports. Not sure they have them or will share but they should if they are professional. Then I can bring these as well to the new vet.

- I was able to get in for a 4:30pm appointment with the diabetes specialist at that holistic health center (seriously Melanie, thank you for that tip off!) I have already sent her the chart to take a look at and I hope she will have some ideas when I get there.

Charly is still hiding behind the couch. She still has diarrhea. Hopefully we can get that part under control today at minimum. I took the day off work and I will do what I can to get her feeling better.
 
Re: Charlie - Help - 2 days of diarrhea & vomiting. Scared.

That is great that you were able to get an appointment today with the diabetes specialist! Make sure you take all of Charlie's medications with you, and maybe even a list of the food you have been feeding, so the new vet is aware of what has been in Charlie's system recently. Please post again after your vet visit with an update on how Charlie is doing. Thoughts and prayers are with you today from all of us.

Melanie
 
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