Diabetic cat BG dropped without insulin suddenly

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compendious

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Hi, my diabetic cat Dean, who is not on tight regulation, usually has bg around high 300 or low 400 and requires 3 to 4 units of NPH. He gets canned Friskies Special Diet food twice daily and eats some cat chow. His appetite has not been the best for the past week. He has a cut on his chin that he saw the vet for Monday. He got a low dose steroid shot, an antibiotic ointment called muprocin, and an oral antibiotic called cefpoxodime. I applied the ointment all week and I started the oral med today after he ate a little canned food. His bg tested at 217 so I skipped his shot. He refused food tonight and acts sleepy. His bg tested 195. I don't know how or why it decreased. It has not ever happened before. I am concerned.

Has that happened to anyone else? confused_cat

Renee
 
Hi Renee!

Are you testing his urine for ketones? You can get ketostix at most any pharmacy for fairly cheap. My worry would be that due to a possible infection and a lack of eating, he might have ketone develop. Otherwise, the low number is probably corresponding with the lack of appetite (which means a decrease in carbs) is working to keep his BGs lower. You want to make sure he keeps eating and test his urine for ketones as you wait for him to recover. And give insulin if his numbers warrant it (i.e. over 200), although you may need to give a reduced dose (probably half of it).
 
I thought ketones only build up in cats and people with chronically high blood sugar left untreated or not responsive to treatment.
 
The breeding ground for ketones is infection + not enough food + not enough insulin. It's not necessarily high BGs but too little insulin that can cause ketones, which is why it's wise to monitor for it whenever either of the other two symptoms are present.
 
I can't give NPH to him unless his bg is over 250 because his bg isn't rising as fast as it usually does and it is a fast acting insulin. He hasn't had insulin in over 24 hours now and isn't getting much increase. Under normal circumstances he would be over 500 after 24 hours. He is at 224 last I checked. I don't know if he will pee for me to check ketones. He is sleepy since the first dose of oral antibiotic.

A year ago He went hypoglycemic on NPH and had to be hospitalized for seizures. The vets dosed him with 2 units of Lantus and gave him more seizures and he went blind. He regained his sight when they stopped the insulin
 
If your vet is using Lantus, then may I ask why don't you change to Lantus. It's an excellent insulin and you will have an easier time managing the diabetes with it.

Of course, if the cat is in hypo and having seizures, I have to question why the vet dosed him with insulin at all. This doesn't make sense. Instead of trying to figure out what happened, I'll focus on what now.

There are any number of reasons why BG levels drop. Using steroids and dry food can actually cause the BG to elevate rather than drop. However, when a cat is sick, anything is possible and ketone testing as KPassa pointed out is very important.

Can you smell his breath? Does it smell at all like acetone - you know the smell of nail polish remover.
That is another sign of ketones.
 
Not using Lantus glargine because it is expensive. I don't know if he now has an inflamed pancreas
now. He has symptoms that point ti nausea and too much stomach acid. He stopped eating.
 
You certainly need to get him to eat, weather giving insulin or not.

How about some of these ideas?

Food suggestions for poor appetite
sprinkle food with :
- forta flora -- a probiotic you can get at vets or online. is very smelly and cats love the taste of it.
- parm. cheese
- smashed crumbles of dry food
- bonito tuna flakes
- halo chicken treats -- crumble into dust over food
- poor a little water from tuna in water over food ( I use low sodium/no sodium added as other kinds in water has veg. broth in it and I assume that means onions, which are toxic to cats-- check labels)
-powdered oregano. yep sounds weird . but some cats like it and it will entice them to eat.

other ideas of foods to offer your kitty to stim appy:
- trader joe tuna for cats
-baby food -- beechnut turkey and broth or chicken and broth. they have no onions or other additives. some babyfoods have onions . please read labels if you can't find beechnut.
- kentucky fried chicken
- deli turkey /chicken
- plain cooked ( boiled or baked ) chicken breast
-canned chicken for people (watch the label that their are no onions)
- chicken broth -- low sodium
Click to expand...

You could also try giving 1/4 or a tab of plain Pepcid, not the complete version, not the extra strength version. This can help with stomach acid sometimes and get your cat to eat.
 
How is he doing now?

A vial of lantus will last you six months if you keep it in the fridge. Plus some pharmacies sell individual pens for $25 that last the same amount of time. Something to consider.
 
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