Hypo kitty to Emergency vet

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Lcrawford

Member Since 2012
Planned to switch Yankee to Lantus tonight, instead we returned home to find him under the bed breathing but stiffened and not responsive. We pulled him out rubbed honey on his gums and raced to the emergency clinic. He was seizing in my daughters arms along the way. His Bg reading was 40 and they said it appears he may have been that way for awhile. We are supposed to call in the morning for an update. The emergency vet didn't give me any idea how likely it is that he will be okay neurologically. I guess they can't say, she said it could take 3 days to know for sure. She did say she was concerned because he didn't respond well , didn't look around and start eating etc. We were able to see him and he didn't seem to recognize us, or anything really, although he was somewhat alert.
I'm just devastated at this point and feeling so horribly about giving him that am shot and leaving him by himself, poor furry sweet boy. Praying somehow he will be ok.
 
L,
Praying for your boy. How much insulin (humulin?) did he get, and how long before you found him was his shot?
Do you know if they have him on a glucose drip? He may have been lower than 40 before you found him, but I have "seen" cats here recover fully from this.
Please let us know as soon as you have more news,
Carl
 
Carl,
Thank you for the prayers.
I gave him 7 units this morning at 645, then didn't return home until 6 tonight. He didn't use his litter box at all today, so I'm scared that means he dipped low right after that morning shot.
They do have him on a glucose drip, and they were warming him with warm water bottles and a warming towel. His temp was 94.
 
Sending healing thoughts to Yankee and you both. Please don't blame yourself - diabetes is an illness and you're doing the best you can. You've already shown such great care for Yankee in showing up here and talking to your vet about changing to Lantus. ((hugs))
 
7 units of Humulin? Yikes, he had been on 3u not too long ago, hadn't he?
When he comes home, you're switching to Lantus, right? Keep the faith.

Carl
 
Many healing vibes being sent to Yankee. I hope he bounces back quickly for you. Don't feel guilty. I'm gone 11.5 hours after the AM shot and I stress out too. All we can do is our best.
 
Just spoke with the emergency hospital. They said he still can't see, has improved a little neurologically but not much so they need more time. Temp is now normal and they've removed his glucose drip. I've not had to go to er before with a pet so I'm not sure if their rates are standard but geez. 700 for 6:30 pm last night to this morning, then 500 more for today? I feel like we have to at least give him today there, I don't really want to move him to our vet who is not familiar with feline diabetes and doesn't have 24 hour care. Wondering though about the likelihood of him recovering fully given that he's only sitting halfway up now and not eating etc...

We started Yank at 3 units Humulin N twice a day Oct 15 then up steadily since then. I lowered to 7 units that last dose, After reading everything on here I was really concerned about our dosing. But our vet had suggested 9 at our last visit, we had already lowered that to 8 and I felt like I couldn't go too far from that. Carl here on the board said those doses scared the heck out of him, you could probably see this coming. Ahk! Hindsight!

So much respect for all of you managing this disease! Praying we have another chance with of our handsome boy. Our home will never be the same.
 
so sorry this has happened. just wanted to say in the many years i've been on this board we have seen a few kitties have severe hypos and suffer some pretty serious neurological effects. often they do recover, maybe not completely, but they can. so don't give up hope if it doesn't happen overnight. i'll send out a message to one couple i know who's kitty had a real bad one.
 
Sorry to hear about Yankee - hoping he starts to show improvement today and makes a full recovery.
Don't kick yourself about the dosage - it could have happened to anyone of us if we hadn't found this forum. We follow the experts advice and trust they know what they are doing - unfortunately, its not always the case.

Sending healing vines...
 
Oh, my...I'm sorry to hear about Yankee. I bet you guys were really shaken up! Poor little thing. I'm glad he is slowing improving. That is good news. Yes, unfortunately, that is a common amount to pay for and ER vet, but they are are babies and we will do whatever we can to help them out.
Have you seen him yet? I would call and see if you can visit him to see for yourself how he is. Sometimes being in a strange place w/o anyone they know or a voice they recognize will reflect in their behavior. I wonder if he heard your or your daughters voice if he would liven up a bit.
My Spot was up to 7 units of N. It wasn't doing him any good, so I switched to Levemir and he did so much better. Have you given any thought about switching insulins? I'm not pressuring you to do so, I was just wondering if you gave it any thought.

Sending fast recovery vines to your boy. I hope he is home with you soon.
 
PJ and I had a radical hypo experience with our Cagney after our now ex-vet overdosed her. PJ took her to the ER vet. Cagney's temp was very low as was her BG and she was in a coma. She probably had seizures but we're not sure. The vet wrote in Cagney's records that she was "essentially a dead kitty."

Within a few days (memory's a bit hazy, but I believe it was 3 days with the ER vet) after coming out of the coma blind and unable or unwilling to move, the vet sat on the floor of the exam room with us marveling at Cagney's tentative walking and obvious return of some vision.

While we know her vision isn't what it used to be (it's still pretty darned good) and she's now hypersensitive to insulin (she's on 0.6 units of Lantus twice daily), she's in good health and recovered from her neurological difficulties. The experience changed her a little, but not much. Your mileage may vary, but there is hope.

Forgot to mention, this happened over 6 years ago shortly after Cagney's 10th birthday. Cagney is still a happy and reasonably healthy kitty today.

Oh, and yes, the ER vets are damned expensive, but they do save lives.
 
Like Steve said, charges at the ER are higher than your usual vet. The same is true for humans -- ER services are more costly than at your doctor's office.

I hope this all turns out well. You might want to bring a smelly t-shirt with you to put in Yankee's cage. It will be a familiar smell in the midst of a lot of strange smells and noised and be a source of comfort.
 
Happy to hear that Yankee is doing a little better. He may not fully recover quickly, but he can improve enough so that you can bring him home soon.
Unfortunately, that cost sounds about right. Roughly $1000/day.
Do try to visit him, and let him hear and smell you. And leave a shirt or towel that smells like you so he feels you're nearby.

When he does come home, and you switch to lantus, keep in mind what Steve said about Cagney's hypersensitivity to insulin following his hypo. And most definitely post in the Lantus Tight Regulation forum before determining a starting dose.
Continuing to pray for your baby,
Carl
 
Ugh! Poor Yankee! My kitty went hypo a few months ago and we had to rush him to ER. I don't think he was "out" for that long. I shot him up at 6:30am and found him at about 11:30am - he was completely limp and twitching, unable to eat. Honey on the gums and off to ER! Fortunately, he bounced back rather quickly. After about 30 minutes at ER we were able to visit with him and he was able to recognize us and just seemed kinda groggy (and sticky from the honey - hehe). Buster was there for approximately 24hrs and our bill was about $600 so I think you're about right there.

Try not to beat yourself up too much - we're not born with a handbook on how to treat FD. Stick with this board and continue to be diligent. You ARE helping Yankee! I hope he makes a full recovery quickly. Big hugs to you and Yankee! :YMHUG:
 
{{{hugs}} So sorry this happened to you and your kitty.



I'd be very inclined to give your current vet a huge piece of my mind, plus the articles on using Lantus. There's no excuse for not getting current on treatment when you have a case type you haven't seen in a while. It may be called due diligence!

If and when you feel comfortable doing so, here are 2 articles for your current vet to help him become up to date.

AAHA Feline Diabetes Treatment Guidelines

Dosing protocol for cats on glargine or detemir using daily home monitoring of blood glucose concentrations to adjust insulin dose
 
Thank you everyone for all of your prayers, support and positive thoughts.
The emergency clinic reported that he didnt have many changes during the day today, he's not eating still and he had a small seizure at 415 pm.
That being said, this vet was much more optimistic then the overnight vet. She said she is hopeful that he will recover. She said he was sitting up this morning, that it was obvious that although he couldnt actually see because he didnt respond when she put her hand in front of his eyes, when she shines a light at him he squints a lot so she felt he did have some vision. she said he cant stand at all but can feel his legs because he reacts when she pinches him. (Poor kitty might tell her how he really feels about that if he were his usual self). She said he needs more time.
She also said its clear to her that it was an insulin overdose that caused it. That he never should have had it continuously upped. She said she felt certain that the high numbers we would see at each vet visit were what's referred to as a somogyi response. That it was misinterpreted as a need for more insulin when he was actually on too high of a dose. That a curve should have been done 10-14 days after we began insulin.
She also urged me to not home test - to have a knowledgable professional that can truly give me guidance do this in their office. She said she is going to try to start him on slow acting insulin tonight, do a curve and try to find his correct dose in preparation for when he will be able to come home (no word on when this could happen). I'm cringing as I see the bill continuing to rack up.

Once (if) we are able to have him home with us, I'll need to find a knowledgeable vet that will be supportive of us doing the curve and home testing.

Just returned from a visit with our dapper fellow. He was able to lift his head, and responded to my voice and initial head kisses with a jerky lick lick lick for about 30 seconds does he not have control of his tongue? this is not something he would do except when grooming in the past and he was doing this to the air.His eyes did not have the scary vacant look that so terrified us last night. He looked like one seriously sick kitty though. When I stroked him he did not stretch as he normally would, but did close his eyes slowly, repeatedly, as he always does when I scritch him in his favorite spots.

It's still a waiting game.

I felt like we were treating incorrectly and I was scared to trust my gut, should have reacted more quickly taken him somewhere for a second opinion immediately, home tested sooner and more thoroughly.

He has been a fantastic furr baby. 12 years ago he came to us as a foster a week old and we bottle fed and ended up adopting him. So sad I didn't do a better job at interpreting and managing his diabetes.

We are grateful for your continued positive vibes and prayers!
Will be calling the hospital again before bed and the daytime vet said she would call me in the morning when she comes in.
Will keep you updated.

~L
 
I am so glad to hear your cat is doing better; I believe there have been other cats whose vision returned but slowly, and the reaction to light sounds like a very good sign.

She also urged me to not home test - to have a knowledgable professional that can truly give me guidance do this in their office. She said she is going to try to start him on slow acting insulin tonight, do a curve and try to find his correct dose in preparation for when he will be able to come home (no word on when this could happen). I'm cringing as I see the bill continuing to rack up.

I can't believe the vet urged you to refrain from home testing! Ask that vet if a human dr would say that about a parent testing a diabetic child! Sadly, I am not shocked. I am puzzled how these vets who discourage testing think.

Can you find out what 'slow acting insulin' this vet is giving? Also, tell the vet you want all of the curve numbers and the times, plus the doses given. Please do not let the vet keep your cat if stable, in some attempt to find his correct dose..... the correct dose will be found but slowly, and certainly not at the vet office.
 
She also urged me to not home test - to have a knowledgable professional that can truly give me guidance do this in their office. She said she is going to try to start him on slow acting insulin tonight, do a curve and try to find his correct dose in preparation for when he will be able to come home (no word on when this could happen). I'm cringing as I see the bill continuing to rack up.

Urging you not to home test is bad advice. And if this long-lasting insulin is Lantus or Levemir, then there are already published studies and protocols that will tell you exactly what to dose, when to adjust the dose, and how much to adjust the dose. With proven results. The same protocols we follow here. Tell your vet that by following the Tight Regulation protocol for Lantus/Levemir, cats go into remission "here" on a weekly basis. Hundreds have. You've already been given the links to the literature. Please share them with your vet, because if she doesn't know them already, she needs to. If it turns out that those are what she goes by, then you don't really gain anything from her "professional knowledgeable advice".

If Yankee is well enough to come home (like he's eating fine and has gained mobility for instance), even if he isn't 100%, and even if he can't see well, tell them to release him to your care.

Your vet is NOT going to find his correct dose in the matter of a few days. The correct starting dose is found in the AAHA guidelines that hopefully she is planning on using to determine the initial dose. After that, the "correct dose" is different for every cat going forward. It is totally dependent upon how he reacts to the starting dose, and every cat will react differently and on a different timeline. You can do this at home, without "vet stress" and vet costs. And we will help you do that.

Carl
 
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