HELP - ANESTHISIA, GLUCOSE & BEHAVIOR

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MURPHYSMOM

MURPHYSMOM

Member Since 2014
Murphy was sedated for a heart ultrasound on sat morning. When I got him home he was very restless (which they said could happen) and kept crying (not like him at all!). I wasn't sure if he was in pain as they said they could tell his tummy was hurting him as they did another xray due to the green slime that continued (see my other message - Green Poop) so they gave him a shot. they also gave him shots for anxiety, nausea, diarehha and his allergies along with oral meds for the green slime if continued and for his allergies.
I kept trying to get him into the litter box, but it was a no go until finally at 2am sun I moved the litter box to a different local and he peed. :-) The crying subsided and all was silent and he seem pretty subdued most of the day and night, but ate, drank water and rolled around a bit.
I took his glucose at 10pm, just a couple hours after his insulin which was increased from 3 to 4 units on sat pm. It was 561.
This morning at 5:30 he woke me up and was trying to poop on me. A small hard piece came out and I directed him to the litter box where two reg pieces came out. :-)
I wrapped them and brought them to the cat clinic this morning. I also took his glucose at 6am and it was 340. Usually it has been almost 600 before testing in the pm.
He was acting so scared and strange and ran under the bed, that I couldn't give him his insulin or oral meds. He thought he was headed back to the vet and actually started digging for a safe place under my bed pillows as his reg place under the bed was gone as he had used the box spring padding as a place to hide and then poop the green slime last week so I had to tear it out. He was breathing fast, but I let him be to write a note to the vet.
He came out, rubbed against me a bit and then wen back under the bed where he looked a bit calmer.
Was all this strange behavior from the anesthetic? the insulin? the oral allergy meds? the diabetes? is he losing his mind?
I had to leave him to come to work and actually cancelled a 9am doc apt in case they said I must go home and get him.
I hope he will be ok. I have my 1pm cardio stress test, but will hopefully talk to the doc before then and also ask my neighbor to check on him around 12:30..
What is happening? I am calm, but frightened!
 
Zofran
diphenhydramine
midazolam
buprenex
reglan
**all injections

plus oral chlorpheniramine for allergies given only twice
 
There might be some interaction of diphenhydramine and chlorpheniramine since then both act the same.
Same for the diphenhydramine and buprenex since both are sedatives.
However, they should be be over such interaction by now.
 
Thanks Larry and Kittens!
I just got a call from the vet who said he should be better today.
she seemed pretty calm even tho I expressed my concern several times over the crazy behavior.
She told me his BP was high the 1st time they saw him, yet neglected to do a reading on sat before
his procedure, before his sedation??? I don't understand.
His liver enzymes are ok, but his liver is now misshapen since the 1st time they saw him on june 18th.
could be from the diabetes, the digestive issues. just not sure.
his calcium is high too and of course they want to do another blood test.
I cannot get to Murphy until 4 or 5 pm due to my stress test and work, so I sure hope he will be ok.
He has just gone thru so much in just over a month.
 
Just wondering how you and Murphy are doing today? Been thinking of you both.

I probably won't be online until tomorrow now, but wanted to send him a hug x
 
Hi Cassandra!
Thanks so much for checking on us!
Some people write a line or two....me a novel, huh?
Well, despite the fact that I fell off the treadmill, much to the amusement of my friend and several coworkers, I made it and the news is good although now I have a cold!
Anyway, I had just finished telling the tech that I hope I don't fall like those girls in the commercials run during the NHL hockey games this season. They are wearing rival jerseys and keep trying to outrun each other on the treadmill and go down one after another. I lost my grip and slipped when they jacked it up for the 3rd time, went backwards and down on my right side scraping my knee, arm, elbow and hip. I then got the "oh ok, lets inject you with the other stuff that jacks up your heart rate and tightens your chest for a few minutes cuz you didn't finish the treadmill test". WHAT?? Like I hadn't had enough already as I thought I was gonna hit my head on the machine behind me when I fell? The least they could have done was give me some Ninja Turtle band-aids for my scrapes! Then I tell the doctor what happened and he said didn't you know it was going to speed up? No, really? Duh!
Murphy seemed much more relaxed and hungry last night, so I was able to give him his allergy meds and insulin. He is that way usually in the evenings cuz once momma changes clothes, he knows he is most likely not going anywhere. Still a bit subdued, but much better. This morning all was calm and he only ran under the bed just before I left. I believe he is using the litter box and everything is ok so far, so good. The doc will call tomorrow night with the ultrasound results.
Thanks again to you and SweetAngel!
 
The vet called and said good news, while Murphy's heart size is on the high end of normal, all looks well.
Not 1/2 hour later after eating dinner, giving allergy med disguised in gel cap and before insulin does he throw up! Excuse me, but damn!
So I decided No insulin tonight. I only have the one test strip until my order comes to work hopefully tomorrow. He did get insulin today and I was home sort of watching him all day as I have a terrible cold and he was quiet, but ok. Definitely no where near 100 percent, but he did cuddle with me a bit while we were trying to nap, but my coughing kept it short. He is eating some dry now, so wish us luck! One step forward and two steps back. sigh
 
Yeah on the good news on Murphy's heart! So glad things are normal.

We call this the "Sugardance" for good reason. Sometimes you do make some forward progress, only to slip back a bit. Sometimes it's a waltz, sometimes a slow dance or even a Samba. Your kitty Murphy is leading this dance, and the best you can do is follow along with those constantly changing steps and keep plugging away.

Don't worry, you will regain that momentum and Murphy will get better.
 
hi Donna,

Great news on Murphy's heart, do they know what is causing the murmur? If not, I would have him re tested in a few months just to make sure it isn't hcm. Have they checked that the allergy meds are ok for diabetics?
Hope you're both doing better today and your cold has improved. Cat sick, ugh. Angel's pretty good, Cera's the worst as she seems to have a slightly delicate stomach, which was great fun when I started Angel on wet only and started giving the girls more wet! What with her and my LPR we were as bad as each other.

I think we all have these blips, once you've got the test strips then it's back to normal. Angel's on Prozinc now too :)
xx
 
[false assumptions removed by moderator]

Comparing a human glucometer to a pet-specific glucometer is like reading temperature in Celsius vs Fahrenheit. Both are correct. You just need to know the reference ranges to interpret what the numbers mean.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]


* * * * * * * * * * * * * * *​
Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
"'Sugardance" huh!. Thanks Deb and Cassandra for the encouragement. I was just reminiscing about how life was for Murphy and me just some 8 months back, before Sophie Mae and before his terrible allergies and of course, the dreaded "D". I was home sick again today..the clinic said it was a sinus infection, but last night my eyes were running so much and so swollen it had to be allergies. Anyway, even though it was a nice temp inside, I should have put on the air. With Murphy's allergies and his new diagnosis, he just seems to act a bit better with the air or even ceiling fans on. He still does not seem up to snuff. After last nights "tossing of his cookies" after the allergy med and no insulin, I opted not to give him the meds at all today. I wanted him to keep down his food and get his insulin, A coworker kindly dropped off the test strips I ordered this morning so I can test glucose freely..for awhile at least. I have heard it said that people and their pets can look similar after a time together, but how about having the same conditions? Murphy and I both have sensitive stomachs, bad allergies & now diabetes. We both just went for heart testing and also got meds for sinus and allergies and feel like crap. It seems when I feel bad, he does too. How weird is that?
I just feel so awful for him as I know he is not feeling well yet. I hope the PZI works. This morning after no insulin last night, his glucose was up to 669...really high. I will test again tonight and tomorrow am. The vet wants me to do a curve this weekend. I hope and pray he will be ok. He is my baby! I have had the honor of being his human mom since he was just a month old. I have no human children, so he (& yes, Sophie) are my kids. I worry about them, more him then her, of course all the time.
 
So this morning I tested his Glucose and it was down to 272. high, yes, but not as high as it has been. In fact, yesterday morning after not having insulin the night before due to tossing his cookies, it was 669.
I called the vet for help...do I give insulin, 1/2 the dose or skip? I had to leave for work in 15 minutes and did not want to have him go into a hypoglycemic episode.
The front desk people could not help and would not get a doc on the phone as they don't come in until 8:30 cst, so I had to bring him in for them to monitor.
I am sure they will check his glucose again, administer insulin, etc.
He still as not seemed quite up to snuff since Saturday.
I will ask the doc today for guidance as I cannot keep bringing murphy in...he is terrified on a daily basis.
Why do I have to be the one that keeps coming up with questions in regard to the diabetes, the insulin, the anesthesia? They are the experts and should give me guidelines
as to what to do when a newly diagnosed cats glucose is low. I cannot reach them after hours and the er would only say to bring him in.
A coworker this morning actually had the gall to suggest I give Murphy away as his illness has caused me so much distress.
Can't hit a girl and not a coworker or Id be in jail!!!
I am hoping that he will be ok and then I can take him back to his regular clinic, though not a strictly cats only place.
HELP!!
 
I can't find much to guide me. Have you given him the PZI before? At what preshot number and how much? And any numbers later that cycle? I see you gave 3 units but am not sure what that did. Be aware that 272 is not awfully high. We encourge new diabetics not to shoot under 200. So he is in decent numbers.

We need to get you set up with a spreadsheet so this info is all easily available. I'd be happy to do that for you. Check your private messages and we can get it done. "1 new message" at the top of the page.
 
Hi Sue!
I will try to send the spreadsheet I made up soon, maybe today if I can attach it. It is quite different than the ones I have seen here.
Are most of the people on this site going it alone or is it with advice of their vets?
I ask as the
spreadsheets show differing insulin for different glucose readings.
Murphy was put on 4 units as of last Saturday.
The vet just called and said we should stay on 4 units of pzi and that his glucose was just tested at 459 in the office.
she said that we should be shooting for readings of 150-250, but should be close to 300 at this point.
For any readings above 200, he will get his insulin.
They will be doing some sort of ionize-calcium test later today along with a retest of glucose and his blood pressure.
He ate breakfast and they need him to have an empty stomach for a bit.
I so want to get him regulated and not have all these vet trips for him.
 
I will send a blank spreadsheet and explain how to fill in the numbers. The one we use on Goggle is easy to allow access to everyone on the site, so we can see your numbers quickly and easily.

It varies. Some vets want the bean to feed a dry diet and discourage home testing and won't look at the spreadsheet. Those people either get a new vet or learn enough about the sugar dance that they can go it alone with the help of people here and use their vet for shots and emergencies. Your vet sounds pretty reasonable - okay with home testing, giving a decent insulin and diet. So you can give them access to the spreadsheet ( all they need is a Goggle log on) and have them guide you. At 2 am when they aren't available, we can help. The best thing about hometesting is that home numbers are more accurate (stress raises bg levels and Murphy sounds very stressed at the vet) and less expensive.

I agree he should have insulin over 200 , but I'd suggest the dose could be less at 200 than at 600. :-D 475 at the vet could be a much lower number once he's home and relaxes - some people report 100+ points lower. It sounds like you need your vet for Murphy's other issues, but if you want our help on dosing, we'd be glad to help.

Here's our ProZinc protocol with the basics

http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=109077
 
Thank you.
I will muse over the info and spreadsheet later.
I don't know if I can attach the ones I have already, but will try.
The 1st is with my comments or notes, the 2nd without.
 

Attachments

hi Donna,

Can you upload the spreadsheets direct to google docs?

Poor Murphy, I know how much he hates going to the vets! His bg may be extra high at the vets due to stress, have they done a fructosamine test? As for them being the experts, after my experience with the emergency vets when I thought Angel was having a hypo, I sometimes doubt that. My own vet is great, I have to do a curve for Angel for this trial he's on, and could either do it myself or get the vet to do it. He knows I haven't much money, he said do it yourself, the results will be more meaningful anyway as he will be stressed having it done there. He goes more by fructosamine levels anyway.

Hope he starts feeling much better soon xx
 
Cassandra & Sue,
I don't know what happened to my message. Its not on the board.

I did get the spreadsheet and will check it out later. Thanks much.

I hope SweetAngel handles the glucose testing well. Its always easier and cheaper and calmer when done at home.
It sound like you have a great vet.

I am so glad to know all of you and thanks for your wisdom and guidance.

off to go pick up Murphy and then home. I hope his day wasn't too bad at the vet.
:-)
 
Hey Murphysmom,

Don't be so hard on yourself! I have been feeling that for the past 3 weeks I've been the most obsessive-compulsive person on the board! I have been apologizing every day for asking for help (hey, no comments from the peanut gallery!). I've also probably broken every single rule or recommendation already posted because I can be such a nut case. :lol: I finally realized that we all have gone through this stage at one point or another.

I too have some fairly serious medical issues. And because this is where we want to focus on our sugar babies and what is best for them, we generally do not like to talk about our own issues, but they exist nonetheless. Sometimes it can just be harder if we can't move to respond to our babies right away, or we have to be at our own docs, or whatever the reason. People here understand but they won't focus on it because they know, we don't want them to do so. But sometimes we just like to let folks know that we might have some limitations once in awhile. And that is the good and humane thing. I try to keep in mind, everyone has their own challenges - financial, personal, medical...but here we balance each other because of the love of our babies. On a downside, I am on disability but on the up side I can be home to watch my 'kids' all day for the most part. On the downside, I might not be able to run out and get the best food or meds at the most opportune time for my babies but on the upside, I am lucky enough to afford (because of hubby) Amazon Prime so I can usually have stuff delivered within 2 days with no shipping costs!

I know I am over-simplifying everything but that's the best I can do right now...but my whole point is that I really feel for you. The people here have been there and reassured me many times over and they don't seem to be losing patience with me. Not yet anyway. nailbite_smile Ha!

Simmie has made leaps and bounds since I found this place. It is a godsend. I absolutely believe that if I had continued down the road I had been going on, with my limited knowledge and total dependence on my wonderful vet, Simmie would be going downhill. I completely believe that and for good reason. I have always lots of cats, 95% indoor, with hyperthyroid, renal failure, diabetes, heart disease, blood clots, pancreatitis, etc etc. I have never known a place that I have felt safer than right here. I know downhill and my heart breaks with every rememberance but if I can believe I have done the right thing, it gets better. You are doing all the right things.

Sleep tight and don't let the kitties bite!
 
Thank you. As sad and tired as I am right now, I really appreciate your kind words.
I just stated a new topic as I had to take Murphy to the ER due to low glucose and leave him there for now. so, so hard. I think its time to go back to his old doc if they will have us as the cat clinic does not seem to be getting things sorted or is this how it is in the beginning...dangerous highs and lows before getting settled?

I don't know whats worse, being there with them every step of the way or having to leave them once again when you just brought them back from the vet.
 
Hi Donna,

We know how you feel. Really. I hope you got some sleep or are sleeping now.

Right now the best thing you can do, while Murph is at the vet, is to work on your spreadsheet if you haven't already. I waited too long, IMHO, and I just experienced what others on this site must have been experiencing with me before I did my own ss for Simmie. Based on your message I immediately went looking for your ss. It will give you so much peace of mind as well, you'd be surprised.

Try and have a good day and think positive thoughts.

Hugs, Lydette and Simmie
 
I will work on it soon. mine is very different than everyone else's. I just had a very taxing weekend with Murphys highs n lows. Last night at this time he was n the er with a glucose of 82. right now it is 465. I just don't understand. well, we did halve his pzi insulin with the pm dose.
do you work with a vet to know how much insulin to give or do you play it by ear?
 
I'd suggest your trying to work with your vet because Murphy has other issues. Once your spreadsheet is up to date, you can send it to them and they can see how he is doing. The problem is when they are unavailable or when you suddenly get a low number and wonder about redcuing the dose and they can't get back to you by shot time. Most people here adjust doses as needed and keep the vet in the loop.

Here is a protocol we put together for ProZinc. Maybe it will give you the basics.

http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=109077
 
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