Help advice for newly-diagnosed lethargic cat!

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SMATTLES

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Help, for 2 wks I've been treating "Smeegle" with .5 unit of insulin twice daily. Her sugar is slowly coming into "normal" levels -last I tested her which was an hr ago she was 13.5- lower than she's been in the last week. Everything would be fine but shes a little off her food -she was eating anything she could in the last week until now- and the last few days, she's been quite lethargic. I must admit, as we'll, I've had a bit of trouble adjusting to our new every 12-hourly feeding schedual, so Have been a few late or early periodically and we had a small setback where she got into some chocolate milk. I'm totally terrified she might have ketoacidosis but her blood suger lowering steadily but safely (as far as I can tell) makes me think otherwise. My big question is- while starting on insulin- is it possible for a "lowering" blood sugar level (not one too low but within normal-high range such as the 13.5 mentioned) cause lethargy? I'm hoping maybe she's just not used to having lower blood sugar and is causing her to feel tired? Can a few hrs difference in insulin injections cause major problems? I know I should be giving her meals and insulin more regularily (on the exact hr every day!)but had no idea a few hrs made a huge difference- please educate me if this is not the case!!! Figured since her blood sugar wasn't spiking and lowering into dangerous levels- and not for long periods if they ever were at those peaks of highs and lows- that I should avoid complications but again if a few hrs difference is known to cause issues-especially with ketoacidosis-please let me know-ANY ADVICE IS SO VERY APPRECIATED!!!! confused_cat
 
The timing of shots can make a difference. However, it also depends on which insulin you're using. With shorter acting insulin, it's less of an issue than with long-acting insulin.

Do you have Ketostix? If not, I would encourage you to purchase them. They are what's used to test for urinary ketones and it is the best $15 you will spend for prevention. You have to stalk your cat to the litter box and dip the end of the stick into the urine stream. After 15 sec., you compare the color on the strip to the key on the container. If there are more than trace ketones, you need to get your cat to the vet.

It's possible that your cat isn't used to being in lower blood glucose levels and that's what's causing the lethargy. However, whenever someone notes that their cat is lethargic, I encourage testing for ketones.
 
Sienne and Gabby said:
The timing of shots can make a difference. However, it also depends on which insulin you're using. With shorter acting insulin, it's less of an issue than with long-acting insulin.

Do you have Ketostix? If not, I would encourage you to purchase them. They are what's used to test for urinary ketones and it is the best $15 you will spend for prevention. You have to stalk your cat to the litter box and dip the end of the stick into the urine stream. After 15 sec., you compare the color on the strip to the key on the container. If there are more than trace ketones, you need to get your cat to the vet.

It's possible that your cat isn't used to being in lower blood glucose levels and that's what's causing the lethargy. However, whenever someone notes that their cat is lethargic, I encourage testing for ketones.

Thank u very much for your input, I'm lucky enough to have a vet who's open on Saturadays so will get her in if need be in the morning-I hope thats all thats wrong but am getting worrierd as her appetite has gone from day to night- last week as I said she was acting as though she hasn't eaten in days and was gobbling things up and tonite she is not very interested at all :( hope more advice keeps coming! Would giving electrolytes help at all? I don't have ketostix-yet- will prolly get some tomorrow a.m.- can u get them at any drugstore?
 
SMATTLES said:
Help, for 2 wks I've been treating "Smeegle" with .5 unit of insulin twice daily. Her sugar is slowly coming into "normal" levels -last I tested her which was an hr ago she was 13.5- lower than she's been in the last week. Everything would be fine but shes a little off her food -she was eating anything she could in the last week until now- and the last few days, she's been quite lethargic. I must admit, as we'll, I've had a bit of trouble adjusting to our new every 12-hourly feeding schedual, so Have been a few late or early periodically and we had a small setback where she got into some chocolate milk. I'm totally terrified she might have ketoacidosis but her blood suger lowering steadily but safely (as far as I can tell) makes me think otherwise. My big question is- while starting on insulin- is it possible for a "lowering" blood sugar level (not one too low but within normal-high range such as the 13.5 mentioned) cause lethargy? I'm hoping maybe she's just not used to having lower blood sugar and is causing her to feel tired? Can a few hrs difference in insulin injections cause major problems? I know I should be giving her meals and insulin more regularily (on the exact hr every day!)but had no idea a few hrs made a huge difference- please educate me if this is not the case!!! Figured since her blood sugar wasn't spiking and lowering into dangerous levels- and not for long periods if they ever were at those peaks of highs and lows- that I should avoid complications but again if a few hrs difference is known to cause issues-especially with ketoacidosis-please let me know-ANY ADVICE IS SO VERY APPRECIATED!!!! confused_cat

First, welcome to the site! Now that you are here, you can toss your fears out the window!

I must admit that I love your smeegle already.... getting into the Chocolate milk? Awesome! My kinda naughty kitty!

OK now for some questions....

1. what insulin are you giving and what are your shot times.
2. it sounds like you are home testing (fantastic), what meter are you using?
3. what sort of other health issues does she have if any?
4. what kind of food are you feeding and why are you feeding only 2 times a day?

OK for food, it's best to be feeding low carb wet food, no dry at all. Here are some food links for you.
Look through binky's list and select some foods that are under 10% in carbs.
Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition


If you ask any human diabetic what would happen to their numbers if they ate only 2 times a day, they would let you know they would have problems. It is better to let Smeegle free feed because you will have better results by feeding several times through the day, small amounts. The majority of people home testing will say to pick up the food 2hours before your shot time because you want to have the pre shot test number not influenced by food.

Now your BG number of 13.5 is a fine number... it's not as the US people post, so I wanted to ask where you are located.
I recognize your test number OK, but to the US guys, that number is 243. And that is about where you want to keep Smeegles numbers, around 250 or lower, or in your numbers... under 13.9.
To convert, you can calculate or use the below tool.

To convert mmol/l of glucose to mg/dl, multiply by 18.
To convert mg/dl of glucose to mmol/l, divide by 18 or multiply by 0.055.
BG Conversion Calculator


It's best to test before giving any shots as you want to be sure Smeegle is not already at a low number, and that it's safe to give a shot. If Smeegle is going very low on the insulin, you may have some problems. Here are some links with info to prepare if you find yourself in a hypo situation.
List of Hypo symptoms
Jojo’s HYPO TOOLKIT
How to treat HYPOS-They can kill! Print this out!


And since you are testing, you will have many people asking you to set up a spreadsheet, so here's a link
Create your Spreadsheet
The spreadsheet is a great tool for recording all of your test results, and because it's accessible by others, you can have people here looking at the numbers and helping you understand what Smeegles numbers mean.

if you have not already been told, you can get strips from the pharmacy, KETOSTIX, and you can test her urine for ketones.
Ketones
Pet Diabetes Wiki: Ketoacidosis


I am sure there are many more questions you may have or info you need, so please ask and someone will help you out.
 
OMG thk u again for replying so quickly heres an update : so wasn't surprised that she didn't want her evening meal- she is obviously not feeling well- I thought maybe some "cat milk" might stimulate her appetite, and she did take some of it. Right after, I tried her faveorite food- chicken breast- but she turned that down as well. About a minute later I was horrified to see her vomit all her stomach contents everywhere!!!!!! She seemed relieved after, drank alot of water and actually ate a few morsels of chicken- she wanted more but i didn't want her to gorge herself so I only let her eat about 6 blueberry-sized pieces. She has drank since then quite a bit of water. I think im going to be up all night! She didn't eat a regular meal so I'm not going to give her insulin tonight-on request from the vet-n who also notified me she should have two meals-of wet "hills prescription diet" TYPE: M/D.-Low carb and fat food sold at the vets. I live in Canada, hence the difference inblood glucose testing-yes I bought and learned how to use a meter as soon as I found out she had diabetes. Its a contour USB model. I give her .5 a unit of human based insulin(NPH) twice a day. The vet tech did say I may want to give her small amounts of the dry version of "m/d in small amounts throughout the day and have been doing just that for the last few days. I'm so hoping shew might have found something bad and ate it...and so hope she was able to get it out of her system. If it was ketoacidosis, would she not have very elevated blood glucose levels? Any other ideas i can take before I (try) to go to bed?
 
SMATTLES said:
OMG thk u again for replying so quickly heres an update : so wasn't surprised that she didn't want her evening meal- she is obviously not feeling well- I thought maybe some "cat milk" might stimulate her appetite, and she did take some of it. Right after, I tried her faveorite food- chicken breast- but she turned that down as well. About a minute later I was horrified to see her vomit all her stomach contents everywhere!!!!!! She seemed relieved after, drank alot of water and actually ate a few morsels of chicken- she wanted more but i didn't want her to gorge herself so I only let her eat about 6 blueberry-sized pieces. She has drank since then quite a bit of water. I think im going to be up all night! She didn't eat a regular meal so I'm not going to give her insulin tonight-on request from the vet-n who also notified me she should have two meals-of wet "hills prescription diet" TYPE: M/D.-Low carb and fat food sold at the vets. I live in Canada, hence the difference inblood glucose testing-yes I bought and learned how to use a meter as soon as I found out she had diabetes. Its a contour USB model. I give her .5 a unit of human based insulin(NPH) twice a day. The vet tech did say I may want to give her small amounts of the dry version of "m/d in small amounts throughout the day and have been doing just that for the last few days. I'm so hoping shew might have found something bad and ate it...and so hope she was able to get it out of her system. If it was ketoacidosis, would she not have very elevated blood glucose levels? Any other ideas i can take before I (try) to go to bed?
 
Gayle Shadoe & Oliver said:
SMATTLES said:
Help, for 2 wks I've been treating "Smeegle" with .5 unit of insulin twice daily. Her sugar is slowly coming into "normal" levels -last I tested her which was an hr ago she was 13.5- lower than she's been in the last week. Everything would be fine but shes a little off her food -she was eating anything she could in the last week until now- and the last few days, she's been quite lethargic. I must admit, as we'll, I've had a bit of trouble adjusting to our new every 12-hourly feeding schedual, so Have been a few late or early periodically and we had a small setback where she got into some chocolate milk. I'm totally terrified she might have ketoacidosis but her blood suger lowering steadily but safely (as far as I can tell) makes me think otherwise. My big question is- while starting on insulin- is it possible for a "lowering" blood sugar level (not one too low but within normal-high range such as the 13.5 mentioned) cause lethargy? I'm hoping maybe she's just not used to having lower blood sugar and is causing her to feel tired? Can a few hrs difference in insulin injections cause major problems? I know I should be giving her meals and insulin more regularily (on the exact hr every day!)but had no idea a few hrs made a huge difference- please educate me if this is not the case!!! Figured since her blood sugar wasn't spiking and lowering into dangerous levels- and not for long periods if they ever were at those peaks of highs and lows- that I should avoid complications but again if a few hrs difference is known to cause issues-especially with ketoacidosis-please let me know-ANY ADVICE IS SO VERY APPRECIATED!!!! confused_cat

First, welcome to the site! Now that you are here, you can toss your fears out the window!

I must admit that I love your smeegle already.... getting into the Chocolate milk? Awesome! My kinda naughty kitty!

OK now for some questions....

1. what insulin are you giving and what are your shot times.
2. it sounds like you are home testing (fantastic), what meter are you using?
3. what sort of other health issues does she have if any?
4. what kind of food are you feeding and why are you feeding only 2 times a day?

OK for food, it's best to be feeding low carb wet food, no dry at all. Here are some food links for you.
Look through binky's list and select some foods that are under 10% in carbs.
Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition


If you ask any human diabetic what would happen to their numbers if they ate only 2 times a day, they would let you know they would have problems. It is better to let Smeegle free feed because you will have better results by feeding several times through the day, small amounts. The majority of people home testing will say to pick up the food 2hours before your shot time because you want to have the pre shot test number not influenced by food.

Now your BG number of 13.5 is a fine number... it's not as the US people post, so I wanted to ask where you are located.
I recognize your test number OK, but to the US guys, that number is 243. And that is about where you want to keep Smeegles numbers, around 250 or lower, or in your numbers... under 13.9.
To convert, you can calculate or use the below tool.

To convert mmol/l of glucose to mg/dl, multiply by 18.
To convert mg/dl of glucose to mmol/l, divide by 18 or multiply by 0.055.
BG Conversion Calculator


It's best to test before giving any shots as you want to be sure Smeegle is not already at a low number, and that it's safe to give a shot. If Smeegle is going very low on the insulin, you may have some problems. Here are some links with info to prepare if you find yourself in a hypo situation.
List of Hypo symptoms
Jojo’s HYPO TOOLKIT
How to treat HYPOS-They can kill! Print this out!


And since you are testing, you will have many people asking you to set up a spreadsheet, so here's a link
Create your Spreadsheet
The spreadsheet is a great tool for recording all of your test results, and because it's accessible by others, you can have people here looking at the numbers and helping you understand what Smeegles numbers mean.

if you have not already been told, you can get strips from the pharmacy, KETOSTIX, and you can test her urine for ketones.
Ketones
Pet Diabetes Wiki: Ketoacidosis


I am sure there are many more questions you may have or info you need, so please ask and someone will help you out.


Did send a reply but wasnt sure if you d get it unless i "quoted " or what-im new to thius whole 'msg board thing' sorry bout that! This is a reply after she already had a few pieces of chicken and a vomit b4 that. I checked her glucose-only have 1 friggen strip left- gonna use it a bit later- and it was 15.7 after giving her a few more pieces of chicken. She wants nothing to do with her wet canned food yet so thought it might put something in her stomach-did say was not gonna give her insulin w/o her reg. meal but decided to anyway after seeing the 15.7. Figure if it is ketoacidosis she should have her insulin if her sugar is that high. Will be observing her behaviour throughout the night. Any help is still being seeked!
 
What's the chance she might be constipated?
Some canned food doesn't provide the fiber need for some cats. So it's easy for them to become constipated. I give Baxter Miralax daily 1/8 tsp added to water. I started doing this after Baxter became severely constipated. He was throwing up a lot & acted very lethargic. He had to have a manul clean out. :o
Are you adding water to the canned food meals?
 
SMATTLES said:
OMG thk u again for replying so quickly heres an update : so wasn't surprised that she didn't want her evening meal- she is obviously not feeling well- I thought maybe some "cat milk" might stimulate her appetite, and she did take some of it. Right after, I tried her faveorite food- chicken breast- but she turned that down as well. About a minute later I was horrified to see her vomit all her stomach contents everywhere!!!!!! She seemed relieved after, drank alot of water and actually ate a few morsels of chicken- she wanted more but i didn't want her to gorge herself so I only let her eat about 6 blueberry-sized pieces. She has drank since then quite a bit of water. I think im going to be up all night! She didn't eat a regular meal so I'm not going to give her insulin tonight-on request from the vet-n who also notified me she should have two meals-of wet "hills prescription diet" TYPE: M/D.-Low carb and fat food sold at the vets. I live in Canada, hence the difference inblood glucose testing-yes I bought and learned how to use a meter as soon as I found out she had diabetes. Its a contour USB model. I give her .5 a unit of human based insulin(NPH) twice a day. The vet tech did say I may want to give her small amounts of the dry version of "m/d in small amounts throughout the day and have been doing just that for the last few days. I'm so hoping shew might have found something bad and ate it...and so hope she was able to get it out of her system. If it was ketoacidosis, would she not have very elevated blood glucose levels? Any other ideas i can take before I (try) to go to bed?

Great, I like the meter you are using; it's my favorite.
Where are you located in Canada? There are several members and some may be near you. I am in Winnipeg right now but was in Toronto and there are a few people there that I know.

I am not familiar with your insulin NPH (seen called N or Humulin N by some people); it's not an insulin that I have seen others using, and it seems to be more old school and harsh on the cat, plus it does no last the entire 12hours.
Since you are in Canada, you are lucky because we don't need to have any prescription for insulins. You can go to any Shoppers Drugmart or any other pharmacy and buy whatever you like. I would suggest you use Lantus or even Levemir; you puchase a package of 5 cartridges and you are set for months. It's pricey at the purchase of the box, but when you think of how long it lasts, over half a year or more, it's not that expensive.
I would definitely switch insulins as you will have a much higher chance of getting her off insulin, in remission by giving her Lantus or one of the other long lasting insulins rather than using N.

Here in Canada, it's much easier to just go to the pharmacy for Lantus or Levemir and also your Bayer test strips and your U100 syringes than find a vet who will get you one of the PZI type vet insulins... many vets are still selling owners caninsulin which is poor for cats.

In the meantime, here is some info on N insulin:
Humulin Primer Info


The vet food is not great, and most cats won't eat it, as it's likely just crap to them. no wonder your girl won't eat it. Just pick up some friskies or fancy feast pates, no gravies, and see how she likes those foods.
Here is some food info:
Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition

Being in Canada, I don't think we can get miralax but go to the laxative section at the pharmacy and pick up a container of RestoraLax and add it to her food.... you will need to add lots of water to her food because the Restoralax works by drawing water from the cat's body and into the stool to soften it. If you do not add water to her food, she may end up dehydrated and get sick.

It could be that she is nauseous, so you can try some pepcid. Pick up a box of Pepcid AC regular strength 10mg and cut the tabs into quarters, 2.5mg in each quarter. The max dose for cats per day is 5mg so you can give her 1/4 tab of pepcid twice a day, maybe at shot times.

If she keeps vomiting, contact your vet as she may be sick.

let her drink all the water she wants, and for food, let her eat the chicken or wet cat food as much as she wants, but keep the dry food away from her because the dry food and even that vet food are contributing to her high numbers. Let her eat when she wants and 2 meals a day is NOT the safe way to feed a diabetic. In order to level off the blood sugars, you will need to feed many smaller meals or just leave the wet food available at all times except 2hrs before her shots. You do NOT want to feed any dry food, and there are healthy snacks ....
List of Low Carb Healthy Treats

if you have more questions, please ask.
 
SMATTLES said:
the vet-n who also notified me she should have two meals-of wet "hills prescription diet" TYPE: M/D.-Low carb and fat food sold at the vets.


You don't ned to feed the prescription food at all. It's poor quality expensive junk :-Q Commerical canned foods like fancyfeast and Friskies and Wellness are better choices.


I give her .5 a unit of human based insulin(NPH) twice a day.

0.5 units of Humulin N, correct? Just making sure :smile: Are you using half unit marked insulin syringes?

Humulin N isn't the greatest insulin to use. It tends to drop blood glucose levels quicky and the effect wears off just as fast so for most of a 12 ours cycle your cat is still in the higher blood glucose levels. It's better to use an insulin that lasts longer and is more gentler, such as Lantus or Levemir. Even ProZinc, a pet insulin, would be a better choice.
 
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