? Chronic hypo? Please advise!

[Sebastian’s mom (Lauren)]

I don’t want to speak too soon, Sebastian still is very unwell, however I feel like he’s having slightly better days now that I put him down from 3 units to 1 unit of Lantus. I can’t even begin to describe the intense guilt I feel for thinking this could be my fault. That Sebastian could have been receiving too much insulin and having seizures for a MONTH because I took the advice of a vet, a vet I already had so little faith in. That this could easily be fatal.
I really need advice on where we go from here. If it was too much insulin, how do I help him recover?
Is the damage done permanent?
Do I try to wean him off the anticonvulsants?
I haven’t noticed them helping, just him getting lethargic and wobbly.
What does this mean for the vet?
For more context incase you missed it, Sebastian started having seizures and was constipated, lethargic, overall not himself, so I took him to the vet and at first it was written off as REM sleep. After I returned a second day in a row she told me it could be seizures and she was very concerned, he was very unwell. After looking at his blood work and seeing high BG she told me her biggest concern was his diabetes management and getting his numbers lower and until we did that, we couldn’t get anticonvulsants and it wasn’t advised that we move forward with his dental surgery. She told me she wanted to see his insulin increased to 3 units right away. I was hesitant making that jump in one day so i went slower than she’d like, but faster than I’d like. She and another vet there told me high BG can cause seizures over time so I thought I was doing right by lowering his numbers to get him cleared for anticonvulsants.
This whole ordeal has been very traumatic and stressful to say the least.
I still don’t know what any of this means for us. Please advise if you are able. I trust this group a million times more than any vet and I can’t lose my boy.

 

[Sienne and Gabby (GA)]

Lauren -

Do you live anywhere near a vet school? If not, do a search in your community for an Internal Medicine vet. Just like human doctors, not all vets are created equal. I think you may need a second opinion.

What medications is Sebastian prescribed? What is the gabapentin for?

To be honest, with your early numbers, there's no way to have an idea of what was going on without some mid-cycle tests.

Generally, high numbers causing seizures would likely be numbers over 500 or 600. I've seen members post their cat's being in that range and not seizing. Very low numbers -- symptomatic hypoglycemia -- can also cause seizures. There's no indication from your more recent numbers that Sebastian was dropping that low.

If you're concerned about food allergies, read the FF labels closely. They mix different proteins into their ingredients even if it's not labeled. In other words. FF chicken has fish in it.

 

[Sebastian’s mom (Lauren)]

I agree that I need a second opinion, but this is more like a 4th since he’s seen 3 different vets during all of this already (one being ER) and funds are exhausted. I wish I would’ve taken him somewhere else to begin with.

The gabapentin was originally for dental disease, anxiety and stress, then they told me I could use it for seizures at a higher dose. However he already gets phenobarbital and Keppra and has an emergency rescue so I didn’t want to also give him this. He’s also on clindamycin for possible toxo and miralax, lactulose for constipation. But the clindamycin is giving him sprayinggg diarrhea when the laxatives wouldn’t even work.

that was suggested because I didn’t hold a dose long enough before increasing.

I’m concerned with everything simply because I don’t know what it is and I need to rule everything out asap to give him the best possible chance.

 

[Sienne and Gabby (GA)]

I would suggest a probiotic, S. boulardii for the diarrhea. It is very effective. ReNew or Jarrows are good options.You start with about 1/4 - 1/3 of a capsule mixed into food.

I would be hesitant to add gabapentin if your cat is prescribed phenobarb and Keppra. I'm also not clear why it would be prescribed for dental concerns.

Please don't beat yourself up. You're doing the best you can.

 

[Wendy&Neko]

Clindamycin is a very strong antibiotic, but good for dental issues. However, it can really go a number on your GI (she says with personal experience). I would strongly recommend a probiotic also be given, though a couple hours apart from the antibiotic.

Not sure why you reduced the dose to 1 unit. There doesn't seem to be any evidence in his numbers that he was going hypo. Did you test him when either during or shortly after the seizure episodes? Was he seizure free when on 2.5 units?

Keep testing him daily for ketones with such a large dose reduction.