Emergency - lantus help and other

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Susan & Sheba

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Hi and please help,

Sheba has been having problems for a week and a half. The vet thought it might be diabetic neuropathy, and we have been working on her foods and BG levels. I had her in today for a pancreatitis test, as she is also having nausea and abdominal pain.

This afternoon she made a serious decline and couldn't make her jumps, fell down, lays down, seeming hard to stand up. She was a bit better but now is even worse with me taking her to the litter box, and she fell over while peeing and I carried her back to the couch.

Since I don't currently know if she has pancreatitis, my main focus is to get her BG levels down.

This week her BG levels have been really good in the day and horrible at night. At night her BG levels raise after her shot, and go to the very high ranges.

I need to start getting the BG levels at night to be better, and do not have time to play around with things right now, as I am watching her decline!

Does anyone know why this would be happening if she is getting everything the same in the morning as the evening???

Does anyone know anything about giving a different insulin in the morning than the evening???

At this point I need a positive change now and if I may have better results giving her Lantus in the morning and caninsulin at night, I need to do so! Any info from those with experience on this would be greatly appreciated!!!

Also any info on diabetic neuropathy versus pancreatitis, or what else I should be doing!!!

(Yes I have read up on this, my vet doesn't seem to know either - both times today and last week I saw the newer vet, and not one of the senior vets, and really probably should have seen one of the senior vets, but both times were last minute appointments!)

If there is anyone with experience that I could call that would also be greatly appreciated, please PM me your number or I can Pm you mine!

Please, please help,
Susan & Sheba & Jason, Mika, Kano and Zowie
 
Now breath is fruity - first time I ever smelled it fruity, called the vet and woke him up, but he didn't think it was an emergency if there are no other signs (well there are other signs but nothing different than earlier when BG's were good).
 
Ok, please read this http://www.felinediabetes.com/ketones.htm as it sounds like your kitty may have ketones. I never had to deal with that and since no one else has responded to you and I recalled something about the breath smelling a certain way from reading posts about ketones, I found tha link. Ketones are serious and your kitty needs to see a vet.
 
Susan, do you think the breath smells like acetone (nail polish remover)? This is how it always presented with Layla - like nail polish remover, but, some have reported a fruity scent.

If Sheba has ketones that might account for the wobbly walking and lack of jumping abilities, or, it might make any neuropathy issues appear worse.

If you know something isn't right you should take her in as soon as you can. Ketones need immediate intervention.

If you don't go to an ER tonight I would urge you to see the vet when they open in the morning.

I hope things improve soon.
Pam & Layla
 
Hi,

Well I will be staying up with her I think, she is walking around a bit now, and though I have moved water/food/litter closer she is still going to the other dishes (tough little cat ). Her breath smells fruity - almost exactly like a strawberry fruit roll-up (it's probably been 10 years since I had one...but that is what it smells like). The vet said he didn't think it was an emergency if no other signs are currently present, so I feel a bit better about watching her, then I can get my husband to take a turn in a few hours, then we can call the vet in the morning.

One of my main concerns is that I am worried that I will get the newer vet again, so I feel I should know the next step and inquire. I really need to get her BG levels to be lower at night (the way they are in the day). Why are they raising every night, but lowering in the day? What do you do? Two different types of insulins, one for am and one for pm? Raise or reduce her pm dose? What is the best sure fire way to go about this?

Today the vet suggested a different food and I tried it tonight (however her BG levels have been this way at night all week, so I don't think it is due to that.

Any thoughts?

Susan & Sheba
 
Susan,

If you read the link Carol provided it will help you understand the (possible) ketone issue a little better. I would suggest that you go to the pharmacy in the morning and buy ketodiastix - they measure sugar in the urine as well as ketones.

I would urge you to consider using only the lantus insulin - and not shoot lantus in the morning and caninsulin in the evening. If you've been testing Sheba before each shot and some midpoint numbers, would you mind posting them to give us an idea what is going on?

Lantus works on a consistent dosing schedule and a consistent dosing regime. Have you read the Tilly's protocol?

http://www.tillydiabetes.net/en_index.htm
If you haven't yet, do read over it before changing doses, etc.

If Sheba appears stable to you - get some rest.

Pam & Layla
 
Hi All,

Thanks for your help. Well the B complex drops that my vet gave me today have fructose listed as the second non-medicinal ingredient! Ughhh!!! So NOT impressed right now, wouldn't a vet think of that? Could that be why although she has been this high before (most nights lately), her breath never smelled fruity, but it does tonight?

I'm not so sure her numbers would be that helpful, as we have been trying different foods. I think I might just try once more to get her to eat the old food, maybe if I put little bits of another food on top. At least I know how much insulin she should be on with that food - even if she doesn't eat as much - now just doesn't seem like the right time to be figuring this out. Hopefully with some luck we can work this out, at least until she is better enough to try different foods.

Thanks everyone, I think I will try to get some sleep Pam.

I will review that info also. Still haven't figured out the correct way to do my profile, maybe I can get Jay to help me tomorrow.

Thanks,
Susan & Sheba
 
how were her recent blood test results? are her kidneys okay? i've seen that falling over thing with kidney issues as well. have you had an abdominal ultrasound done? that may show you more re the kidneys and pancreas. cleo had chronic pancreatitis and it is very painful.

is the B complex you're talking about methylB12 or methylcobalamin? that's the kind of B vitamin we suggest for neuropathy.

i would not mix insulins (give different ones morn and nite). just give one type of insulin. it would just be too hard to figure out which was causing which result.

how high was her blood glucose level? do you know how to home test? not everyone can discern that acetone (nail polish remover) smell. i think i have heard of fruity breath during ketones. is she staggering or lethargic? drinking more than normal? is the vet open in the morning for you to bring her in? otherwise i'd suggest getting ketone test strips at the pharmacy. do you have an all-night one nearby? walmart would carry it, and i know there are some 24-hr walmarts. it's pretty easy to check. you just dip the test strip in the litter immediately after she pees and before she has a chance to cover it up. it's rare for litter nowadays to give a false positive for ketones. to check whether your type of litter does, you put a little fresh litter in a container with a little bit of water, then dip a fresh ketone test strip in to see if you get a positive reading. if you don't, you're free to test her pee right after she uses the box. if you do get a false positive, you'd have to catch the pee and dip the stick into it. i waited til my cat started peeing, then stuck a ladle in there. if she started peeing, she was unlikely to stop, so i could get a sample pretty easily.

let us know how your kitty is doing now, okay?
 
The B-complex drops usually provided by a vet could be "Pet-Tabs". or used to
be called "Pet-Tinic". Brown liquid ? Just B-Complex, not Methyl B12

I found that with Smokey, it was better to give ordinary B-Complex in his Sub-Q fluids.

If not giving fluids, you can take a regular B-Complex vitamin tablet for people, crush it
up, and put a little bit into food each day....not the whole pill, but maybe 10% of a pill.
You have to figure out the dose.

B-vitamins are water soluble and get peed out with excessive peeing. It's hard to over-dose,
but I would still try to figure out an appropriate dose if using a people-pill.

B-vitamins are essential to nerve health. Diabetic neuropathy is a problem with the
nerves in the extremities (legs).


It's possible she has keytones (serious).

I would get to the best vet you can, soon.
 
Hi All,

I have spoken to my vet, he said that the drops they gave me have such a small amount of fructose that it shouldn't be the reason. He thinks she is fine for now and I am going to get some keto-diastix today so I can judge for myself (it has never been an issue with her before last night). I asked about sub-q's, but I think we are going to wait for the pancreatitis results to come in on Monday.

She is doing better today, BG levels have dropped and are doing well, and no fruity breath (the fruity smell started going away this morning before I fell asleep), I went to sleep, knowing that Jay would be up 1.5 hours later, so I felt it was okay. I am really hoping that tonight her BG levels will be better.

I got her methyl B12 pills - that have no sugar, but the B complex drops the vet had ordered in do (well actually it's fructose), so I was planning on giving her both, however I don't think I will give the drops tonight even though they said it should be okay.

The drops say Rx Vitamins (underneath it says for pets, Professional veterinary formulas) AMINO B-PLEX (liquid nutritive formula, 2 Fl. Oz (60 ml) Formulated by Robert J. Silver, D.V.M., M.S.

I think sub-q's may go a long way.

Thanks for all the great advice, help, and caring, a special Thanks to Sandi and Pam and Karen, who seem to have taken me on in a special way and help, as they probably know I have no-one else. Thanks for taking us under your wings. :-)

Susan & Sheba
 
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