Hypoglycaemic shock last night :(

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Red'sMomHeather

Red'sMomHeather

Member Since 2015
Red, 8.5 y/o, diagnosed just shy of two weeks ago. Also has concurrent liver problems.
Woke up at 4 am, couldn't find him. Don't know where he was hiding but when I did find him he was ataxic, pupils very dilated. Ran to get corn syrup with no idea how much to feed him but rubbed it in his mouth. All in all about one hour until we got to a vet. Through this my baby was seizing, crying out. This is the worst pain I've ever experienced. I thought he was going to die.
Talked to vet just now who has done more blood work. Liver values in general are better, but hepatitis is worse? Also dehydrated yet not concentration his urine. Has a UTI.
I'm not sure if I can handle this. I'm not sure if this is even something that can be handled. Am I torturing him? Am I being selfish keeping him around?
 
(((Heather))),

First off take a very deep breath... And now take another one.....
You must be exhausted after last night, and that will exacerbate how you're feeling now.

You poor love; you and your kitty have been through a lot in a very short time.
You're not torturing Red. You are being a wonderful loving caregiver. And you may well have saved his life. :bighug:

Has the vet prescribed antibiotics for Red's UTI?

Hugs,

Eliz
 
Hang in there. You're dealing with an acute situation right now; there is intervention possible to help him stabilize and then determine what you think is best.

Hepatitis means inflammation of the liver. This may happen to a diabetic when a lot of fat has broken down for calories, because there wasn't enough insulin. The fat goes to the liver and causes it to swell. It can be tricky to treat, however improving test values are a good sign.

Dehydration is common in an unregulated diabetic because the glucose is sent out via the urine. It can be treated with IV or subcutaneous fluids, in addition to getting insulin on board to regulate the levels.

Once the acute problems have stabilized, you'll be able to get a management plan for his care.

This can be pretty stressful, so take time to breathe!
 
A couple of years before my cat was diagnosed with diabetes he became very jaundiced and sick. He was very poorly and it took a while to get thing under control but he was diagnosed with cholanghepatits and pancreatitis. He was prescribed both an antibiotic (clavomax) as well as a steroid. He was also getting destolite for his liver. This got the condition under control but it seemed hit and miss for quite a while.

With regards the caninsulin dose I hope this will be reviewed by the vet. 3 units twice a day is pretty high. My 5 kg cat was first prescribed caninsulin and he went low on just one unit twice a day. As cats can be more sensitive to insulin after a hypoglycaemic episode it would be best to discussing with your vet about whether a dose reduction is necessary. If you are managing to get some readings at home this will also keep him safer as you can monitor what is happening and react before they actually get too low.
 
Thank you everyone for your responses. Today has been super emotional and stressful and I have no idea how I'm going to sleep tonight.

Due to work I had to have a family member pick him up this afternoon so much of on info is second hand and I won't be able to confirm until they re-open Monday.

WBC count is high due to the infection but as stated his liver values, specifically bilirubin are lower. He's been prescribed a "hepato support" (looks like a vitamin supplement. Has milk thistle, B vitamins, etc) as well as an antibiotic (orbax) for the UTI.

According to the vet the biggest problem was that he hasn't been getting nearly enough food. Given that, she had yet to suggest a lower insulin dose. I'm to bring him in Monday or a recheck to discuss lowering the dose but right now ok terrified of giving him that much.

As far as the dilute urine she believes he's been drinking too much water. No idea how to regulate that other than putting down a smaller amount but no idea what the right amount would be...
 
Red seems to be doing well now. We're trying another wet food from the vet. It's a medi-cal recovery. Although not a diabetic specific food she said the higher calorie (and fat?) content would be good for the moment. He seems to be eating it like candy so far.

I actually find it very strange that she didn't tell me to give him a lower dose tonight/tomorrow.

I'm working on getting a glucometer. The one the vet has is $140... A member on here (sorry don't remember the name!) suggested a relion micro that can be found at US walmart for roughly $15 and as I live in a border city I'm able to go there and pick one up, just need to call and make sure it's there. Wishing I could skip work tomorrow since this is much more important in my mind right now.

Also sorry for the disjointed replies. Trying to make sore I've said all I need/answered all Qs on a tiny iPhone screen. Thank you all again for your help and hugs/thoughts/prayers. I really appreciate it and I'm sure Red does too. :)
 
Hi.
sounds like you've had lots of stress and worries...
I would definitely advise that you go with a human glucometer.
those alphatraks are way too expensive and you can only get strips from the vet.... also ridiculously high.
You can do a comparison test at the vet with your human glucometer vs his alpha trak.
it's pretty consistent with the lower numbers..... usually around a difference of 30.


as time goes by, we can help with all the issues... don't want to overwhelm you all at once. It's a lot to learn and take in all at once.
The dilute urine could also be kidney disease.... you can check that later by getting a urine specific gravity.
We have a great website that helps with that issue.


Adding my prayers for Red.... and you....
 
Research data show that human glucometers tend to read, on the average, about 30-40% of what a per meter reads. You can skip the math, though, because we have feline-specific reference numbers listed in my signature link Glucometer Notes.
 
I'll definitely pick one up as soon as I can and compare it to the vet's numbers using that chart. Thank you.

As for tonight, I've fed him about as much in the last four hours as I was all day (only a bit more than half a can total of some wet purina DM and some wet royal canin recovery).

I gave him his insulin 3 hours ago. I probably only gave 2.5 units as I was trying to draw it up a little shy.
At the moment he's resting and seems ok but I have corn syrup drawn up in a syringe and I'm pretty ready to pull an all nighter. Rest is no good to me if he's ill.
 
I personally wouldn't worry about giving the reduced dose until Monday. It is you that has to deal with the consequences and I am sure you want to avoid another hypo situation at all costs, especially if you aren't able to monitor his blood glucose or stay with him all of the time. If it were me I might even be a little more conservative.

Are you leaving food down for red, especially when you go out or go to sleep. Again until you are able to monitor this will may help avoid emergency situations.
 
BJM said:
Research data show that human glucometers tend to read, on the average, about 30-40% of what a per meter reads. You can skip the math, though, because we have feline-specific reference numbers listed in my signature link Glucometer Notes.
Click to expand...

9-14-2014

I just did two tests with my original AlphaTrak and my human Easy Gluco Plus meter. Both comparisons used same drop of blood from two different cats


Dulce OTJ
AT = 72

Easy Gluco Plus = 54
The AT is 133% of the EGP value

Badgar
AT = 377
Easy Gluco Plus = 331

The AT is only 113% of the EGP value
 
The statistics, as I've noted before, are based on paired comparisons of more than 2 or so tests, more like hundreds of paired tests. Plus, for any test, the meter may read +/- 20% from what the number actually is.

Home glucometers are NOT intended to give you exact numbers, only a general clue to what the glucose level is. Many folks keep assuming that its like measuring with lab equipment and it most definitely is not!
 
The data are in the reports Rand did, Larry.

Do you really want me to give an introduction to statistics and measurement theory on the board?
 
phlika29 said:
I personally wouldn't worry about giving the reduced dose until Monday. It is you that has to deal with the consequences and I am sure you want to avoid another hypo situation at all costs, especially if you aren't able to monitor his blood glucose or stay with him all of the time. If it were me I might even be a little more conservative.

Are you leaving food down for red, especially when you go out or go to sleep. Again until you are able to monitor this will may help avoid emergency situations.
Click to expand...

If no one's home I have him in a large room by himself with both dry and wet down. Otherwise I've been leaving the dry down and putting out the wet as needed/at mealtimes. If I leave wet down one of the other two cats will eat it all up. He eats everything - but isn't overweight. Go figure.

I ended up staying awake for 6 hours after the shot last night. All is well. I skipped this mornings's dose as a precaution since I would be at work all day. Will most likely give the insulin again tonight and then watch him, but I think you're saying he'd be ok if I didn't give his insulin today at all?

He goes in to the vets again tomorrow afternoon.
 
BJM said:
The data are in the reports Rand did, Larry.
Click to expand...
It is not complete.
The blood glucose values were based on using portable glucose meters (Ascensia Contour, Bayer,Leverkusen, Germany; Accu-Chek Aviva, Roche Diagnos
tics, Basel, Switzerland) which use≤0.6 μL of blood per test. These meters measure blood glucose concentration in whole blood and are calibrated for
use with human blood. Measurements from meters calibrated for human blood which provide plasma-equivalent values are approximately 10% higher.
NB. It is very important to note that blood glucose concentrations measured using a whole blood glucose meter calibrated for human blood may measure 30-40% lower in the low end of the range than glucose concentrations measured using a serum chemistry analyser or a plasma-equivalent meter calibrated for feline use.
Therefore, if using a meter calibrated for feline use (eg. AlphaTRAK, Abbott Laboratories, CA, USA), or a serum chemistry analyzer, add approximately 30 mg/dL (1.7 mmol/L) to the target glucose concentrations (see Table 3B)
. For example, a target > 50 mg/dL (2.8 mmol/L) becomes > 80 mg/dL (4.4 mmo/L) when using a meter calibrated for feline use.
Instead of aiming for 50-100mg/dL (2.8-5.6 mmol/L) , aim for 80-130 mg/dL (4.4-7.2 mmol/L [round numbers 4.5-7.0 mmol/L). Meters calibrated for feline use may read higher or lower than the actual value, in contrast to consistently lower readings for meters validated for human blood.

They only test a with a very few brands of meters and did not really give all the data I see no statistical analysis. Did not say how many different meters (one of each brand?) and how many different lots of strips were tested.
 
But the meters they uses are not typically used in the USA. Do the the inherent errors in the point-of-use meters all that really can be said is that human meters read lower than the AT ( I have not seen any data comparing the AT to other per point-of-use meters). How much lower is not really know because of the inherent errors.
 
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