Help! Can't control his BG!

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Tuxedo Mom said:
@Bobbie And Bubba can you add some help with DKA and R isnulin since you have been through his before

ETA Or if you know other member with experience with this any help would be appreciated
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Bubba had moderate ketones and we did use the R however, he did not go into DKA. I had help from Jill and Libby with the R dosing and I am not qualified to guide some one using it. I do know that I was started a very small dose.10 unit and was increased as it was monitored how he would react. Jill mentioned she is leaving town this weekend but perhaps @Marje and Gracie could help guide lisam and Arthur with the use. Or even maybe @Doodles & Karen as she has used R.

Unfortunately, am heading out of town for the weekend tomorrow and won't be around much. If @lisam could get the Novolin R from her Vet or Walmart, she could start posting on Lantus Forum tomorrow and ask for help with shooting R. But as mentioned, the SS needs to get up and going so dose advisor have a clear idea of what has been given.
 
lisam said:
I don't generally have a problem syringe feeding the food. A shot with the hand blender after some added water makes it pretty smooth.

Novolin R is the fast-acting insulin, correct? I'm guessing I would only give .25u at a time, and then check again how long after?
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I know this probably doesn't help, but I understand the stress of being unable to afford another vet visit. I know you mentioned Novolin R, and that you live in MA...and like I said, this probably won't help, but I live in Rhode Island and I have a bit of Novolin N left over as well as Humulin N, so if f it turns out you need to switch insulin to either of those, you're more than welcome to have them. I've kept them in hopes that I can help someone else in need.
I'll leave the rest of this discussion to the folks who know best. Good luck with Arthur.
 
I will try to get hold of her later or tomorrow. I appreciate the intervention, but without knowing how much help they are able to give, I can't bring him to a hospital and commit myself to an amount I can't cover myself.

I will continue to test, feed, and get fluids into him tonight. I will contact the vet in the morning and get him in to see them as soon as I get home from work. I desperately wish I could just take him first thing, but I just started a new job two days ago, and I cannot take off this soon without jeopardizing it. And if I don't have a job, I certainly can't afford to take care of Arthur.

I'll hold off on the R and discuss it with the vet tomorrow.
 
lisam said:
I will try to get hold of her later or tomorrow. I appreciate the intervention, but without knowing how much help they are able to give, I can't bring him to a hospital and commit myself to an amount I can't cover myself.
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Once DCIN commits to caring for a cat, they pay the entire bill.....That's what Jenna has done by telling you to take him to the vet
 
@lisam - Trust DCIN's word - they've done the same for me. I'm REALLY terrified that if you don't, you're going to lose Arthur tonight or tomorrow. Reading back thru all this, he's headed into bad territory and I don't think you can chase it hard enough at home. NOT that you can't do it, it's all just so far ahead of you right now like a runaway freight train.

Are you sure your insulin is good?

He's likely fallen into hypo numbers and shot back up because of the liver dumping sugars but you've not caught it.

Don't worry about answering me if you can head to the vet with him....
 
Please keep us posted when you can. And the very best of luck and all the fingers and paws that are crossed here for Arthur. :bighug::bighug::bighug::bighug::bighug:
 
No word yet. I should have gotten an update by now but haven't. I called but the doc isn't available at the moment. Either way I will go there after work to see him and hear what is up. Thank you all for the support and concern, I will post when I know anything.
 
image.jpg
This is my sweet boy taking a nap and apparently having happy dreams.
 
BG is coming down but they are very concerned about his persistent anemia (one of the things I brought him to the vet for a week and a half ago). They did tests and are doing an ultrasound this afternoon.
 
Update: Arthur has chronuc pancreatitis (which I'd already figured out), which flared up and also caused a bleeding ulcer, which caused his anemia. The pancreatitis caused the insulin resistance and DKA. He is responding well to treatment and should be home in a day or two. He doesn't have cancer, which was our biggest fear. I will have the vet train me to give rapid acting insulin, since that's the only thing I haven't done to head off what are and will always be occasional serious flare ups.

I am so grateful to DCIN and you guys for connecting us and providing support. It's hard when your pet is so sick, but there's no money in the bank.
 
lisam said:
........ I will have the vet train me to give rapid acting insulin, since that's the only thing I haven't done to head off what are and will always be occasional serious flare ups..........
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WOOHOO!! Not cancer and you know what it is! I was SO very worried about him last night.

We have several members that have lots of experience using R insulin along with base insulin - you'll have lots of support here on an hour by hour basis if needed!

HUGS!
 
Good news it's not cancer. Make sure you get anti nausea and pain meds or scripts so you can order and keep on hand. Those two are key in pancreatitis treatment. They can be compounded to flavored suspension (sugar free) so you can syringe in if needed.

When he is back home, if you check in here daily, as already said there are many who can help with the R. It is tricky. You have many here to help you with all kinds of things.
 
lisam said:
Update: Arthur has chronuc pancreatitis (which I'd already figured out), which flared up and also caused a bleeding ulcer, which caused his anemia. The pancreatitis caused the insulin resistance and DKA. He is responding well to treatment and should be home in a day or two. He doesn't have cancer, which was our biggest fear. I will have the vet train me to give rapid acting insulin, since that's the only thing I haven't done to head off what are and will always be occasional serious flare ups.

I am so grateful to DCIN and you guys for connecting us and providing support. It's hard when your pet is so sick, but there's no money in the bank
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Wonderful news that Arthur is doing better, you have a firm diagnosis (and it's not the "C" word) and he's responding well to treatment!! I'm not sure you really want to take a lot of advice from the vet regarding using R considering vets seem not to know a whole lot when it comes to treating diabetes. We have lots of people here that have cats with chronic pancreatitis (as well as occasionally acute) that can help you control that...You shouldn't need to use R except in very specific circumstances and it can be dangerous if not used properly. At least when they're at the vets, if they mis-use it, they have access to IV glucose....at home you're not going to have that.

Isn't DCIN wonderful?? They are one of the greatest organizations I've ever come into contact with!!
 
The docs at Tufts were all fantastic, and they were thorough and respectful. The doc discussed the R with me at my request and vetted me (no pun intended) pretty carefully before agreeing I could handle it. We discussed the very specific circumstances. It's basically the only thing we didn't do that could have helped keep him out of the hospital (to do it earlier, not after ketones show).

DCIN was really awesome. I'm exhausted, but I'm about to text Jenna now. So, so glad my kitty is coming home! And I feel blessed - another cat in DKA was there too, but not responding well to treatment and having seizures. There but for the grace of God... :(
 
I am SO glad to hear that Arthur is recovering well, and that he doesn't have cancer! We were all so worried about him. DCIN is indeed a wonderful organization. I know you must be incredibly relieved. :bighug::bighug::bighug:

He certainly is a handsome fella! :)
 
How wonderful is that, I have a kitty who loves shoes. Hope you get to bring him home. It's a good idea to get copies of his treatment.

Did you ever find his log book?
 
I can't find the book, I suspect someone was too thorough in his cleaning.

But Arthur is off the iv today and hopefully coming home tomorrow :)
 
Good news, glad he is doing well. Guess you have to start a new book. Maybe you can get your ss up before he comes home.
 
@lisam -

I'm so glad that Arthur is feeling better and that the oh-so-wonderful DCIN was able to help you both.

My Saoirse also has chronic pancreatitis. I strongly recommend that you ask your regular vet to give you a supply of ondansetron (for nausea) and an appetite stimulant (e.g. cyproheptadine) so that you'll have the ability to respond at home to any signs of nausea or inappetence without any unnecessary delay. It could make a world of difference to management of Arthur's chronic pancreatitis issues, reduce his risk of going into DKA or developing complications with fat deposits in the liver. Saoirse gets ondansetron twice a day now as a matter of course. It is a marvellous medication and it has saved her life. Twice.

Here are some links to resources that I found invaluable in learning how to manage Saoirse's pancreatitis. I hope you'll find them helpful, too.

IDEXX Pancreatitis Treatment Guidelines

Nausea and Appetite Problems - Symptoms and Treatments

If you can stretch to it, a course of B12 injections can be a great help. Even one or two doses can give a boost when a flare is at its worst.

I wish Arthur a very speedy recovery.


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