HELP! HELP! HELP!

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Matt & Maus

Matt & Maus

Member Since 2019
Maus' number went way high tonight - 338. She won't eat. Should I give her the shot now? Panic mode, please help!!!!
 
When did she stop eating? I know she has some other health issues-- does anything seem to be acting up? This is a rapid change from this afternoon....
 
OK, so the big worry here, especially given the skipped shots, is ketones. While they can come on really rapidly, I am hoping that that isn't the problem here-- she hasn't been ketone-prone in the past. But it is a worry.

Can you tempt her to eat something, anything? Carbs are fine at this point. I'd like to see her get some insulin tonight, but not on no food with Vetsulin.
 
Nan & Amber (GA) said:
OK, so the big worry here, especially given the skipped shots, is ketones. While they can come on really rapidly, I am hoping that that isn't the problem here-- she hasn't been ketone-prone in the past. But it is a worry.

Can you tempt her to eat something, anything? Carbs are fine at this point. I'd like to see her get some insulin tonight, but not on no food with Vetsulin.
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Just gave her 5 syringes of canned. Should I do more?
 
OK, that should be a decent base of food, enough to be able to give a shot. If it hasn't primed the pump to get her eating on her own, you can do another meal later, but hold off for now, don't want her throwing up what you just got into her.
 
Nan & Amber (GA) said:
OK, that should be a decent base of food, enough to be able to give a shot. If it hasn't primed the pump to get her eating on her own, you can do another meal later, but hold off for now, don't want her throwing up what you just got into her.
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How long until injection?
 
I think I'd wait a half hour, to make sure that meal stays down, and to see if the food has perked her up any.

Any idea what this could be? Lots of things can make them feel yucky and both cause a spike in BG and send them off their appetite, but it's just such a sudden flare-up. Has she ever been diagnosed with pancreatitis? Any chance she got into something she shouldn't have while you were away at work?
 
Nan & Amber (GA) said:
I think I'd wait a half hour, to make sure that meal stays down, and to see if the food has perked her up any.

Any idea what this could be? Lots of things can make them feel yucky and both cause a spike in BG and send them off their appetite, but it's just such a sudden flare-up. Has she ever been diagnosed with pancreatitis? Any chance she got into something she shouldn't have while you were away at work?
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No pancreas issues that I am aware of, and there is really nothing for her to get into. She has had some vomiting off and on for the past couple weeks, but not in the last two days. She had a UTI when I took her to the vet about the vomiting. Did antibiotics for UTI (went away), but she was still throwing up every couple days. Then they did xrays for kidney stones, but found none. Never did get to the bottom of that with vet. I don't know if that means anything. Vet didn't seem very worried, or say that it had anything to do with her diabetes. Maybe I should have mentioned this earlier, but I didn't think about it being relevant.
 
Hmmm. Have you been testing for ketones? It's a matter of getting a urine sample and dipping a little tester stick (available with other human diabetic supplies). I'd highly recommend getting some testers and testing regularly going forward, just to be safe. The "recipe" for ketones in a diabetic is, lack of food + lack of insulin + infection/inflammation/severe stressor.
 
Nan & Amber (GA) said:
Hmmm. Have you been testing for ketones? It's a matter of getting a urine sample and dipping a little tester stick (available with other human diabetic supplies). I'd highly recommend getting some testers and testing regularly going forward, just to be safe. The "recipe" for ketones in a diabetic is, lack of food + lack of insulin + infection/inflammation/severe stressor.
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Don't know anything about that, was never mentioned by vet.
 
Nan & Amber (GA) said:
Hmmm. Have you been testing for ketones? It's a matter of getting a urine sample and dipping a little tester stick (available with other human diabetic supplies). I'd highly recommend getting some testers and testing regularly going forward, just to be safe. The "recipe" for ketones in a diabetic is, lack of food + lack of insulin + infection/inflammation/severe stressor.
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She eats pretty regularly, and she was getting regular injections before the last couple days. She has had several UTI's in the past year or so.
 
Nan & Amber (GA) said:
Hopefully this flare-up of whatever it is (another UTI, maybe?) will pass as quickly as it came on.
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I gave her 1 unit about ten minutes ago, and just now she got up and stretched and went to the water bowl. Will get a few hours of sleep and check her again. I feel so helpless with her, the poor thing just can't catch a break. Thank you very much for your help, it means a lot to me. Talk to you soon!
 
OK, I have to head off to bed now, so I'm glad to hear that she perked up enough to stretch and get a drink of water! Those are good signs. The food may have helped, or she may just have something fleeting that is already starting to fade (fingers crossed!). Glad you'll be able to get a test in later too, to see where that 1U takes her and make sure she gets a bit more food in her.

I'd definitely get some ketostix tomorrow and try to test for ketones. If nothing else, that is something else you can do to remove at least one worry, even if you still can't fix what's wrong immediately. If only they could talk.

Feel better soon Maus, and goodnight to you Matt!
 
Nan & Amber (GA) said:
OK, I have to head off to bed now, so I'm glad to hear that she perked up enough to stretch and get a drink of water! Those are good signs. The food may have helped, or she may just have something fleeting that is already starting to fade (fingers crossed!). Glad you'll be able to get a test in later too, to see where that 1U takes her and make sure she gets a bit more food in her.

I'd definitely get some ketostix tomorrow and try to test for ketones. If nothing else, that is something else you can do to remove at least one worry, even if you still can't fix what's wrong immediately. If only they could talk.

Feel better soon Maus, and goodnight to you Matt!
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The test from 3 hours after insulin is 153. Seems much better. Will get those test strips ASAP. Thanks again!
 
Nan & Amber (GA) said:
OK, I have to head off to bed now, so I'm glad to hear that she perked up enough to stretch and get a drink of water! Those are good signs. The food may have helped, or she may just have something fleeting that is already starting to fade (fingers crossed!). Glad you'll be able to get a test in later too, to see where that 1U takes her and make sure she gets a bit more food in her.

I'd definitely get some ketostix tomorrow and try to test for ketones. If nothing else, that is something else you can do to remove at least one worry, even if you still can't fix what's wrong immediately. If only they could talk.

Feel better soon Maus, and goodnight to you Matt!
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She ate over 1/16 cup of Dr. Elsey's after the +3 test. Tested again at +7 and it is at 129. She also ate a fair amount of canned on her own after test.
 
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Can you monitor today, or are you working? She did well on the 1U last night, but I'm sort of thinking of trying a half dose of 0.5U, just because she was doing so well and keeping low-ish numbers for a few days on nothing? I hope Linda (@MrWorfMen's Mom ) or someone else who has used vetsulin will be able to weigh in on this, though.

If she's eating, that's a fantastic sign re: ketones.

The thing about ketones is that they are much easier (and much less $$$) to treat if you catch them early, so regular urine testing is a good idea, even when she isn't showing outward signs. I'm glad you have the strips now!
 
From your other thread:

MrWorfMen's Mom said:
I agree with Chris that if you get a pre-shot of 200 or more, I'd try 0.5u. If pre-shot is between 150 and 200, and you can monitor Maus, then I think you could try 0.25u. Your aim is to get her numbers down to around 90 and you don't want her dropping much below that. I'd try this on a day when you can get a couple of tests in during the +2 to +6 hours post shot period which is generally when Vetsulin reaches peak action. If Maus drops below 90, then she earns another reduction in dose.
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So the other option is to follow this and do 0.25U.

I just wish we knew why she spiked so high last night....
 
If Linda doesn't respond within 30 minutes (she just ate some canned), would you personally do 1/4 or 1/2? And yes, I will do my best to check for ketones regularly now that I am aware of the issue. Thanks, as always!
 
Matt & Maus said:
If Linda doesn't respond within 30 minutes (she just ate some canned), would you personally do 1/4 or 1/2? And yes, I will do my best to check for ketones regularly now that I am aware of the issue. Thanks, as always!
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Since she's currently eating on her own, if she's otherwise 'back to normal' I think I'd go conservative and just do 0.25U. That gives her some insulin on the off-chance that she's on the edge of ketone development, but not so much that you are likely to get into a lot of trouble today if she's feeling better and her numbers are dropping on their own anyway.

Once you have a ketone test under your belt, we'll have some more information to deal with.

Ah, I see you came to the same place on dose! Great!
 
Nan & Amber (GA) said:
Since she's currently eating on her own, if she's otherwise 'back to normal' I think I'd go conservative and just do 0.25U. That gives her some insulin on the off-chance that she's on the edge of ketone development, but not so much that you are likely to get into a lot of trouble today if she's feeling better and her numbers are dropping on their own anyway.

Once you have a ketone test under your belt, we'll have some more information to deal with.

Ah, I see you came to the same place on dose! Great!
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OK, will do a re-check two hours after giving 1/4 unit. :banghead: (lol)
 
Matt & Maus said:
OK, will do a re-check two hours after giving 1/4 unit. :banghead: (lol)
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Nan & Amber (GA) said:
Since she's currently eating on her own, if she's otherwise 'back to normal' I think I'd go conservative and just do 0.25U. That gives her some insulin on the off-chance that she's on the edge of ketone development, but not so much that you are likely to get into a lot of trouble today if she's feeling better and her numbers are dropping on their own anyway.

Once you have a ketone test under your belt, we'll have some more information to deal with.

Ah, I see you came to the same place on dose! Great!
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The +2 number is 144. I gave her some food, as is normal at this time. Will check again in 3 hours.
**edit** - I was just able to get a ketone test, and it appears to be negative to my eyes (tried 3 times). That is good, no?
 
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Great news! That means that whatever was causing her inappetance and lethargy last night, at least it wasn't that, which is a huge relief.

So, for right now, it's just back to managing her insulin needs, and figuring out why they spiked so suddenly and why she was feeling yucky last night.

Next time you have to take her to a vet for one of these episodes, one of the things they can test for is pancreatitis (using either the SNAP fPL, which gives an instant yes/no, or the Spec fPL test, which gives a quantitative read on severity of a flare but has to be sent out usually). The symptoms are usually pretty non-specific (like inappetence) but I'm mentioning it as a possibility because it's fairly common in diabetic cats. More info here: A Primer On Pancreatitis
 
Nan & Amber (GA) said:
Great news! That means that whatever was causing her inappetance and lethargy last night, at least it wasn't that, which is a huge relief.

So, for right now, it's just back to managing her insulin needs, and figuring out why they spiked so suddenly and why she was feeling yucky last night.

Next time you have to take her to a vet for one of these episodes, one of the things they can test for is pancreatitis (using either the SNAP fPL, which gives an instant yes/no, or the Spec fPL test, which gives a quantitative read on severity of a flare but has to be sent out usually). The symptoms are usually pretty non-specific (like inappetence) but I'm mentioning it as a possibility because it's fairly common in diabetic cats. More info here: A Primer On Pancreatitis
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One of the biggest problems I have had with her is that she has been a mess for most of the 2 years that I've had her and she was already 7 when I got her, so I have no idea what her "normal" state is. She is not much like what I call "normal", but maybe that is normal for her. Sometimes she shows flashes of what I call "regular cat" behavior, but she usually acts as a paper weight. No matter how many things we have taken care of medically, there still always seems to be something lurking in the background that is holding her back. That page on pancreatitis looks promising though.

"Kitty might seem lethargic, the blood glucose (BG) may have increased, he/she might be sitting in a meatloaf position, hiding, and/or generally does not seem “right”. Perhaps Kitty also vomits."

That largely describes her most of the time she has been here. The vomiting has always been there, but it was much more rare until recently. I will definitely have her checked for that, it is worth a try. I live to see the "regular cat" that lives inside her, or whatever kind of cat she would be. I don't believe I have ever seen much of the "Real" Maus, but I sure hope to. I hope you aren't getting tired of hearing it, but I can't thank you and Linda enough for all the help and support that you have given us in such a short time.
 
Nice handling of Maus Matt. You're doing fine. Great that there were no ketones but sorry to hear Maus went off her food. Your decision making on the dosing was spot on. Being conservative with the dose until you determine her reaction and figure out what is going on with her is the best way to proceed.

I think checking Maus for pancreatitis would be a good idea. It's one of those underlying conditions that quite often occurs in diabetic cats and will rear it's head every so often. If Maus was perhaps a bit nauseated it could explain that suddenly higher BG.

Glad to see numbers coming down again and anxious to see where she's at today.
 
MrWorfMen's Mom said:
Nice handling of Maus Matt. You're doing fine. Great that there were no ketones but sorry to hear Maus went off her food. Your decision making on the dosing was spot on. Being conservative with the dose until you determine her reaction and figure out what is going on with her is the best way to proceed.

I think checking Maus for pancreatitis would be a good idea. It's one of those underlying conditions that quite often occurs in diabetic cats and will rear it's head every so often. If Maus was perhaps a bit nauseated it could explain that suddenly higher BG.

Glad to see numbers coming down again and anxious to see where she's at today.
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Her pre-shot number is today 140. I don't know if you will respond in time, but I'm not sure if I should shoot or not. Her numbers have been going up in the afternoon, so that has me a bit worried. I am feeding her now, so if I give insulin it would be around 12:00 (45 minutes from now.)
 
What is your availability to monitor today? Is it a work day? Could you monitor to +6 post shot? If you can monitor her, then I'd suggest trying a 0.25u dose and see where that takes her. She didn't drop a lot yesterday on the quarter unit dose but pre-shot is lower today and we're not sure what's been going on with those suddenly elevated numbers of late.
 
MrWorfMen's Mom said:
What is your availability to monitor today? Is it a work day? Could you monitor to +6 post shot? If you can monitor her, then I'd suggest trying a 0.25u dose and see where that takes her. She didn't drop a lot yesterday on the quarter unit dose but pre-shot is lower today and we're not sure what's been going on with those suddenly elevated numbers of late.
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Yes, I am off work today and can keep an eye on things. I will do 1/4 and monitor her. (+6 or every 2 hours until +6?) As always, thank you!
 
I'd check Maus at +2 and see what she's doing. If she's dropping a lot, you can steer her with food. Wouldn't wait till +6 as Vetsulin starts working early and some cats hit lowest point by +3.
 
MrWorfMen's Mom said:
I'd check Maus at +2 and see what she's doing. If she's dropping a lot, you can steer her with food. Wouldn't wait till +6 as Vetsulin starts working early and some cats hit lowest point by +3.
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The +2 number was 93! That is our first green number so far, yeah! I am giving her some food this hour, as it it the normal hour before I leave for work. (I try to keep her on the same schedule on the weekend.) Will check again at +5.
 
Yeah for green. Check again anytime now just to be sure she isn't dropping much more. Please don't wait till +5. You need to monitor closely right now to be sure she stays in safe numbers.
 
You only need to wait the 2 hours after food for the pre-shot tests. Those are the ones that you don't want food influenced. Other testing can be done at any time regardless of when kitty ate. If you are on the same meal schedule daily, you'll know. It would however be helpful to make a note in the remarks column on the spreadsheet for anyone helping to reference.
 
MrWorfMen's Mom said:
You only need to wait the 2 hours after food for the pre-shot tests. Those are the ones that you don't want food influenced. Other testing can be done at any time regardless of when kitty ate. If you are on the same meal schedule daily, you'll know. It would however be helpful to make a note in the remarks column on the spreadsheet for anyone helping to reference.
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If you get the chance to peek at my chart to see if this is what you mean? I did another check and it is up to 109.
 
That's fine but you can type "109 @ +3.5" into the +3 cell on the SS but you 'll have to manually colour it blue. I'd retest her again about +5 and if she is still in the greens or blues then maybe around +8 as there is another little hit from the Vetsulin which may or not be evident for Maus. Might as well gather some data while you have the opportunity. If BG is up considerably (I hope not!), then don't bother with the +8.

Looks like she might be a very early nadir kitty but that could just be an fluke given the past few days of ups and downs. All considered though it's good. She is maintaining decent numbers well below renal threshold again now which is great.

You don't want Maus going much below 90 at this point so when you get a reading like 93, best to give her some low carb food as you did and retest in no more than 30 minutes to an hour depending on how far below 90 she is. If BG happens to drop to the 60s or 70s higher carb food like Fancy Feast gravy lovers or a bit of honey or karo added to low carb can be used to bring numbers up but a little more testing needs to be done to make sure she stays in safe numbers.
 
MrWorfMen's Mom said:
That's fine but you can type "109 @ +3.5" into the +3 cell on the SS but you 'll have to manually colour it blue. I'd retest her again about +5 and if she is still in the greens or blues then maybe around +8 as there is another little hit from the Vetsulin which may or not be evident for Maus. Might as well gather some data while you have the opportunity. If BG is up considerably (I hope not!), then don't bother with the +8.

Looks like she might be a very early nadir kitty but that could just be an fluke given the past few days of ups and downs. All considered though it's good. She is maintaining decent numbers well below renal threshold again now which is great.

You don't want Maus going much below 90 at this point so when you get a reading like 93, best to give her some low carb food as you did and retest in no more than 30 minutes to an hour depending on how far below 90 she is. If BG happens to drop to the 60s or 70s higher carb food like Fancy Feast gravy lovers or a bit of honey or karo added to low carb can be used to bring numbers up but a little more testing needs to be done to make sure she stays in safe numbers.
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At +5 it is 132, so it is still climbing. This is what is scaring me, because the numbers have been going up the past couple days during the time when I would be at work during the week. I wouldn't be able to monitor her and do anything about it. Should I try to begin moving her towards a later injection time? Also what are your thoughts on the shelf life of Vetsulin? It says stop after 42 days from 1st use. I asked my vet about this, and she said it was good for a couple months after that. Is my vial getting old? I am at 91 days right now. Lastly, I figured out how to fix the chart.
 
Don't panic over individual numbers. Maus isn't regulated but her BG has not been that high aside from the one pink reading the other night and goodness knows what caused that. Even those yellows weren't that high. There are a lot of folks who would be very jealous of Maus' SS. Maus will be fine.

As for shot time, that is really up to you. Best to schedule shot times to allow yourself as much time to test at critical times which could mean as an example, getting up an hour earlier and leaving enough time to test before heading out the door. Being able to get a +2 test post shot will give you a better idea where she is headed and you can leave out some higher carb food for her to eat in your absence if she is dropping faster than usual. I have to admit that with Vetsulin, it's a bit harder to deal with the lower pre-shots you've been getting but it can be done. The longer lasting insulins like Lantus are better at holding low numbers than pulling BG down so a little easier to work with in lower BG range.

The insulin should be fine for at least 3 if not 4 months or a little more if stored properly. The 42 days is simply the amount of time the manufacturer tested the insulin to comply with FDA regulations. Usually if the insulin has gone off it will look cloudy or have little particles in it even after the customary rolling before withdrawing insulin.
 
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