help needed: cat threw up after shot, what should I do?

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tiffmaxee said:
What I am wondering is whether he had a symptomatic hypo or you went to the vet because of a low bg reading. I know when I first saw a 60 nadir I was scared but my vet wasn’t. Max often dropped into the 40’s once regulated but never showed any symptoms of a hypo.
Do you have high carb foods and honey or karro syrup in case you get a reading under 50? If that happens someone here can help you get through it and not need to go to the vet.

if I were you would read the SLFS method and start with that. You will find it on the Lantus forum.
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I was writing when you posted. The first time, it was definitely a hypo; the second, I am not sure and wonder about. It was three a.m. and honey and high carb food didn't seem to be helping and I was terrified. When the emergency nurse told me to go, we bolted.

I have honey and syrup and some high carb foods.

That method is the one that seems more doable to me. I am lucky right now in that I am working from home due to the pandemic, but I will probably be heading back into the office in a few weeks. I am trying not to think about the yet, but I don't understand how I am supposed to shoot him and then waltz off to work and not know how he's doing until I get home. It makes me want to throw up. I am really anxious to get into a good groove before then.
 
Jenny Ellen said:
I was writing when you posted. The first time, it was definitely a hypo; the second, I am not sure and wonder about. It was three a.m. and honey and high carb food didn't seem to be helping and I was terrified. When the emergency nurse told me to go, we bolted.

I have honey and syrup and some high carb foods.

That method is the one that seems more doable to me. I am lucky right now in that I am working from home due to the pandemic, but I will probably be heading back into the office in a few weeks. I am trying not to think about the yet, but I don't understand how I am supposed to shoot him and then waltz off to work and not know how he's doing until I get home. It makes me want to throw up. I am really anxious to get into a good groove before then.
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I think it’s normal given the 2 scares you had. You will start to slowly feel better again and I think the libre was a great choice for you to help you feel safer about his levels.
 
Aleluia Grugru & Minnie said:
I’d be curious to know how low bg at the first ER visit. I think the second visit was more about yuh enigma cautious and I don’t blame you at all, but if that ever happened again, you’d post and ask for help and someone here would guide you with testing and feeding to get his numbers safely up. I assume also he didn’t have the libre a the time of the visits right? That should help you feel a bit safer.

I posted the link to the Lantus dosing protocols above. Check it out but I’m sure you don’t want to do TR, which is more aggressive. SLGS is the one for you.
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The first one, he didn't have anything, and they didn't tell me the number, or I was too upset to retain it. Actually, no, I know they didn't tell me. A vet came out to talk to me herself (we can't go into the clinic due to coronavirus) and told me and was just incredibly kind about it. (He's seen three different vets at this practice.) But she didn't give me a number. The second time he did have the libre, but it shows alarming signs when it goes anywhere under 70, which is the mark the vet wanted me to use, and seeing 50s was tremendously scary.

Thank you so much for all your help tonight. I really, really appreciate it. You have been so helpful.
 
We will help you figure it out. I know people do TR and work full time but I never could have done that. But we will help you get to a point that you can leave for work. One thing you will need is an auto feeder that you set to open and feed him while you are away. It works well at night so you can sleep without worrying when he’s in more normal numbers. We will coach you so you know what to do. .
 
tiffmaxee said:
We will help you figure it out. I know people do TR and work full time but I never could have done that. But we will help you get to a point that you can leave for work. One thing you will need is an auto feeder that you set to open and feed him while you are away. It works well at night so you can sleep without worrying when he’s in more normal numbers. We will coach you so you know what to do. .
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I can get one. I have another cat who doesn't have diabetes; they eat at the same times. Will it be able to hold meals big enough to feed them both? I have seen the notes about having icepacks for them, does that work well? I have never been able to get either cat able to eat food after it's been refrigerated/cold.
 
Jenny Ellen said:
I can get one. I have another cat who doesn't have diabetes; they eat at the same times. Will it be able to hold meals big enough to feed them both? I have seen the notes about having icepacks for them, does that work well? I have never been able to get either cat able to eat food after it's been refrigerated/cold.
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It would be best to get two, one for each. There’s one that I believe comes with ice packs. Susanne uses it and likes it. I’ll tag her for you to get the one. @JaxBenji
 
tiffmaxee said:
We will help you figure it out. I know people do TR and work full time but I never could have done that. But we will help you get to a point that you can leave for work. One thing you will need is an auto feeder that you set to open and feed him while you are away. It works well at night so you can sleep without worrying when he’s in more normal numbers. We will coach you so you know what to do. .
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Or you can train yourself to wake up at +6 and feed him like I do haha! A little humor for ya :D
 
Aleluia Grugru & Minnie said:
Or you can train yourself to wake up at +6 and feed him like I do haha! A little humor for ya :D
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I have to say I don't sleep very well these days, which is why I caught him for the second scare. If I had just slept maybe everything would have been fine. But I woke up and since I woke up I went over to him to check, and then it went on from there.
 
Aleluia Grugru & Minnie said:
Yes try to get him to eat again now. Still not a bad unsafe number at +5 since he should start going back up in an hour or so.

meant to say have you tried tuna? Sometimes the tuna water will entice them and they eat some and it’s food to get more liquids in him after vomiting
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He just had some more bites of the baby food.

Unfortunately I do not have plain tuna. I have a medium carb Wellness Signature select wet food that has tuna in it that he used to like in pre-diabetes days. But I shouldn't try that yet/now, right?
 
jt and trouble (GA) said:
Jenny your dedication is amazing! Youre doing GREAT!
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Jeanne, thanks for your encouragement. Many people to thank who helped me get get here, especially Ale. I am so grateful.

I finally felt like it was safe for me to try to sleep a little. Woke up at +10.5: 144. Just woke up again, time for the AMPS: 167.

I am absolutely bewildered by what happened last night and where we are now. He's never had this low a PS. The Lantus (1/4 unit) has never taken that long to reach a nadir, and then been so slow to come up again. I don't understand it at all. Was it just the vomiting that made everything go haywire? Is something wrong/different with the insulin (same bottle as early September; vet said it would be fine to use as it's been in the fridge since then)? Did I get the dose wrong?
167 is too low for me to shoot according to the vet. I am afraid it would hurt him if I tried to do less going by the SLGS method, which I would *NOT* do on my own due to the 167 -- I would wait for guidance, but I am kind of too petrified after last night to try.
 
Jenny Ellen said:
Thank you, Mogs. I am so tired and crying a little as I type this. No idea what to do now, but I am afraid that anything would be too much because I don't know enough and I don't understand what happened at all.
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Hi @Jenny Ellen :bighug:I was over here writing about the auto-feeder when I saw your post - @Critter Mom may be able to advise but generally with a lower pre-shot number (i.e. one that's safe to shoot but you may not be comfortable shooting), the advice is to NOT FEED and test again in 20 minutes. This way you can see if Comet is on the rise (i.e. last dose of insulin wearing off). Without input from someone with more experience than me, you also skip (or decide in 20 minutes).

I'll post about the auto-feeder too :bighug:
 
JaxBenji said:
Hi @Jenny Ellen :bighug:I was over here writing about the auto-feeder when I saw your post - @Critter Mom may be able to advise but generally with a lower pre-shot number (i.e. one that's safe to shoot but you may not be comfortable shooting), the advice is to NOT FEED and test again in 20 minutes. This way you can see if Comet is on the rise (i.e. last dose of insulin wearing off). Without input from someone with more experience than me, you also skip (or decide in 20 minutes).

I'll post about the auto-feeder too :bighug:
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Thanks, Jax. I just scanned again -- half an hour later, only up from 167 to 170. It makes no sense to me.
 
What I only have as a note in the spreadsheet is that he did not get any insulin between 9/26 PM to 10/17 PM because he was always what his vet said was too low to shoot. He was going up and down on his own, she liked what she was seeing -- he did not get into the 50-99 range on his own, but she thought he might get there.

Editing to clarify that last sentence. Her goal for him wasn't to get him as low as 50, she wants him no lower than 70 and said it was hard to get that safely with cats on insulin. She was pleased because he was getting to 125 or 150 under his own steam and only getting up to 250 or so. She and another vet at the practice thought he was beginning to regulate.
 
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Critter Mom said:
Hi Jenny,

Some questions:

1. Is Comet eating properly now?

2. Does Comet have any history of producing ketones or diabetic ketoacidosis?

3. Is Comet underweight?


Mogs
.
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1. Mostly? He hasn't had anything for a few hours. I fed him some FF at around 3:00, nothing since then.
2. No. He has always tested negative for ketones when I test his pee.
3. Yes. The vet didn't seem that worried about it and said some of it could just be age-related (he is sixteen). He is 9.4 now. He was 10.8 before diagnosis, but was last weighed a few years prior to that.So maybe age? But one of the reasons I brought him in to get checked out was in addition to the drinking/peeing, he felt lighter to me.
 
Jenny Ellen said:
1. Mostly? He hasn't had anything for a few hours. I fed him some FF at around 3:00, nothing since then.
2. No. He has always tested negative for ketones when I test his pee.
3. Yes. The vet didn't seem that worried about it and said some of it could just be age-related (he is sixteen). He is 9.4 now. He was 10.8 before diagnosis, but was last weighed a few years prior to that.So maybe age? But one of the reasons I brought him in to get checked out was in addition to the drinking/peeing, he felt lighter to me.
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Further additions to the above:
1. I should note that I didn't give him very much as I did not want it to come up. I just wanted to make sure he had something before I tried sleeping.

3. I don't know if this helps, but his brother, who does not have diabetes, also weighed less than he had a few years ago. So maybe age-related? But the diabetes diagnosis did not not make think that was the only reason.
 
Thanks for the info, Jenny.

Considerations:

1. Appetite uncertain.
2. Not much recent BG data.
3. AMPS - first test under 200, also second test after stalling 30 minutes didn't show any rise.
4. No history of throwing ketones.
5. Previous strong response to 1/4 unit with depot only partly full (3rd dose at 1/4 unit), and today's PS BG level is lower than on that occasion.

Based on the above considerations, my suggestion would be to skip the dose this morning. I'd also suggest seeing whether Comet can eat properly and giving your vet a ring for advice/treatment.

What do you think, Jenny?


Mogs
.
 
Critter Mom said:
Thanks for the info, Jenny.

Considerations:

1. Appetite uncertain.
2. Not much recent BG data.
3. AMPS - first test under 200, also second test after stalling 30 minutes didn't show any rise.
4. No history of throwing ketones.
5. Previous strong response to 1/4 unit with depot only partly full (3rd dose at 1/4 unit), and today's PS BG level is lower than on that occasion.

Based on the above considerations, my suggestion would be to skip the dose this morning. I'd also suggest seeing whether Comet can eat properly and giving your vet a ring for advice/treatment.

What do you think, Jenny?


Mogs
.
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I am very willing to take this advice! Thank you so much, Mogs. I am really scared of shooting now. I will offer some food and see where we go, then contact the vet.
 
I can understand your worry completely. By way of a little reassurance, last night Comet was in really, really safe numbers and you did a sterling job of watching over him last night. :bighug:

By way of general information, it can be completely safe to give Lantus insulin to a kitty when the preshot is lower than 200 BUT first you need to gather enough data to determine how the individual kitty responds. You're only at the data gathering stage at the moment, Jenny, but as you record more and more readings for Comet and build up the picture, you'll start to feel much more reassured of his safety on a given dose and gradually move him into a better BG range. All is good. :)

Be sure to let us know how you get on with the vet, and post for any help you need.

Treat yourself to something nice today after all your good work last night. And have another one of these: ---> :bighug:


Mogs
.
 
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Thanks, Mogs :bighug:

@Jenny Ellen - there is so much to learn but you may be interested in reading about some basics of lantus - check out this sticky - it has some info on the terms of Carryover/Overlap/Depot/Bounce that you may find helpful.

Below is info on my auto-feeder - I agree with Elise that you'd probably want one for each cat or separate them at night. I have two cats and we keep them separate at night; I also transitioned my non-diabetic to the same food as Jax so that if Jax happened to get in his food, it wouldn't be a big deal.

I got the Cate Mate C500 - It has 5 compartments (1 open and 4 hidden) and ice packs. I ordered right from the manufacturer (link here) - I also ordered 2 extra ice packs in case I wanted to use it for AM and PM (so I'd just have to wash it out, reset the times, and put in new ice packs). I also have mine rotate to an empty spot 2 hours before shot time (though I'm sure Jax would not let any food go uneaten ;)). It's definitely an investment but I personally have felt it's worth it.

Hope that helps and hope you can get some rest today :bighug:
 
Critter Mom said:
By way of a little reassurance, last night Comet was in really, really safe numbers and you did a sterling job of watching over him last night. :bighug:

I can understand your worry completely.

By way of general information, it can be completely safe to give Lantus insulin to a kitty when the preshot is lower than 200 BUT first you need to gather enough data to determine how the individual kitty responds. You're only at the data gathering stage at the moment, Jenny, but as you record more and more readings for Comet and build up the picture, you'll start to feel much more reassured of his safety on a given dose and gradually move him into a better BG range. All is good. :)

Be sure to let us know how you get on with the vet, and post for any help you need.

Treat yourself to something nice today after all your good work last night. And have another one of these: ---> :bighug:


Mogs
.
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Thank you, Mogs. Trying to feel reassured! I think previous scares make me see rapidly dropping (to me) numbers feel dangerous and when they don't seem like they're stopping... ugh. Especially at night.
 
JaxBenji said:
Thanks, Mogs :bighug:

@Jenny Ellen - there is so much to learn but you may be interested in reading about some basics of lantus - check out this sticky - it has some info on the terms of Carryover/Overlap/Depot/Bounce that you may find helpful.

Below is info on my auto-feeder - I agree with Elise that you'd probably want one for each cat or separate them at night. I have two cats and we keep them separate at night; I also transitioned my non-diabetic to the same food as Jax so that if Jax happened to get in his food, it wouldn't be a big deal.

I got the Cate Mate C500 - It has 5 compartments (1 open and 4 hidden) and ice packs. I ordered right from the manufacturer (link here) - I also ordered 2 extra ice packs in case I wanted to use it for AM and PM (so I'd just have to wash it out, reset the times, and put in new ice packs). I also have mine rotate to an empty spot 2 hours before shot time (though I'm sure Jax would not let any food go uneaten ;)). It's definitely an investment but I personally have felt it's worth it.

Hope that helps and hope you can get some rest today :bighug:
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Thanks, Susanne. I will check out those stickies. I am so thankful for them; I feel like my brain has become a lot less sticky since this started and I have a harder time retaining/remembering stuff. Will also look at the CateMate.

Unfortunately, I can't really separate them -- I live in a studio apartment. Even if I had another room, they would probably cry all night about not being able to get to each other. :) They are both on the same diet as it would be hard to manage different ones for both.
 
Jenny Ellen said:
Thanks, Susanne. I will check out those stickies. I am so thankful for them; I feel like my brain has become a lot less sticky since this started and I have a harder time retaining/remembering stuff. Will also look at the CateMate.

Unfortunately, I can't really separate them -- I live in a studio apartment. Even if I had another room, they would probably cry all night about not being able to get to each other. :) They are both on the same diet as it would be hard to manage different ones for both.
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Oh it's overwhelming! Hang in there! Keep asking questions and read stickies as you have the time :bighug:

And gotcha on your kitties & your studio - that's sweet they love each other! Mine are brothers but have always just tolerated one another...we have always said each would have been happier as a "single" cat lol.
 
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