Itty, 1st dose eatting problem...2

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cam don't be startled if you get an uber high # tomorow. it is likely for a couple of reasons that i won't bother you with now but don't let it rattle you.
 
Did your vet do any blood work on Itty? Some of the symptoms you noted could be indicative of ketones. If a blood panel was done that included electrolyte values, your vet would have noted and treated the problem.
 
Hi there-

I can add a little info about the hypo, since Harley decided months ago that I should be a hypo-pro, whether I wanted to or not! On her 2nd incident, after tons of food and syrup, she was still super unresponsive....still trying to stuff herself under furniture, trying to crawl on top of my sneakers. SUPER scary stuff. This was almost 2 hours after I got home and found her staggering around. Since she was still acting strange after all my attempts to bring her back (I wasn't testing at that time), I rushed her to the emergency vet. They tested her and her BG was right around 300. I think it just took her a little longer to get back to herself. By the time we left the animal hospital, she was sitting upright and meowing at me. Maybe your little one needs a little more time to sort it out. It's so great that you know that her BG is up. That's one less worry!! Maybe it is a reaction to the Lantus, or, maybe she just needs a little more time....it's so hard to know. The waiting is the worst!! I just wanted to share what happened with us and the fact that it took a really long time for it to 'look' like she was coming out of it, but her BG was responding to the intervention. Sending healing thoughts your way....

s
 
Sorry, haven't mastered the message board enough yet to have her info in my sigature... will work on that tomorrow if I am awake!

Itty is 4lb and estimated to be 5yrs old. She was dumped on my doorstep a while back (the dog let her in and she never left)... the plan was to get her fat and spayed then adopted. We see where that has gotten me!

she was free fed science diet indoor and given one pouch wiskas wet at night until I got the diabetis diagnosis. She was then given a choice of Science diet M/D kibble or blue buffalo high protein low carb kibble and M/D wet food morning and night.

She has eatten me out of house and home since she got here! If I don't watch her she will run the 80lb drooler off of her food and start eating it!

crud... now my internet is misbehaving :(
 
I really want to encourage you to talk to the ER vet about the possibility of diabetic ketoacidosis (DKA). If your vet did not do any blood work and didn't check for ketones, this could be a real possibility. Ketones can develop quickly. Their presence can be life threatening. If you notice a "funny" smell (like alcohol or nail polish remover/acetone) on Itty's breath, go to the ER. Wobbling or staggering is common with DKA as is lethargy.

How is Itty acting now?
 
july 24 her fructosamine was tested a 553 by a different vet (who put her on M/D but didn't tell me anything) her BG was 382

I don't have results from the testing they did today but you can bet I will have it when the vet opens in the AM!

Itty is still staggering but MUCH more alert and interacting more.

Still no call back from ER vet
 
breath smells like karo
can't find any ketones
think we may be about to puke (the cat, not me this time)
yep, just puked
puke has what little solid food she ate and smells like karo my guess is about 1 1/2-2 teaspoons of puke
 
ER vet "has 2 criticals and will call me when she can"
#1 for tomorrow... find ER vet that deals with diabetic kitties.
I need a yawning smilie!!!!
 
hi there, I am just tuning in... you are doing awesome, what a lot to deal with at once!!!

158 is good - quite a drop since the last hour, but still nothing to worry about... she may drop more again, so keep that Karo handy... you might find rubbing a little on her gums (if her #s drop down) helps it get absorbed quick, without irritating her stomach

going to go make sure the Lantus folks know you are here so people can help you through the night if those who have been helping you so far have to go to sleep or whatnot...
 
ok, don't force feed yet. we don't need her throwing up and no appetite. no need for any more karo. if you just leave food out in your bedroom and keep her in there with you could you sleep for a little while?
that was the karo wearing off.
if you leave the high carb gravey food out, maybe you can sleep for an hour or two.
 
I put a 911 on Lantus thinking that since it's long-acting, we can be sure peeps will continue to tune in overnight.... Lori (or anyone) do you think that's good? I'm not sure what the protocol is, I don't usually post over there... not sure if everyone who is helping now can stick around? if it's unneeded let me know & I can go delete it....
 
Good for you, getting a +4!!! You're gonna be a pro at testing at the end of all of this!! Wow....talk about trial by fire. You are doing a fantastic job. I'm by no means an expert here (I'm learning on a daily basis), but I am a night owl, so if you need an ear after some folks call it a night, I'll be around.

s
 
you know what joann, i did the same thing about an hour ago. i figured we needed all the lantus help we could get. another 911 or a bump would'nt hurt.
funny we posted at the same time with opposite advise. about the karo :lol: i just thought long lasting gravey would give cam more of a break for the night.
 
oh no, I think we are on the same page - I didn't mean give Karo now, I meant if she does need to give it later (or HC gravy is good too), rubbing on gums instead of force feeding might be the way to go if Itty is feeling barfy.... if she will eat the gravy on her own, even better! gravy should keep the #s up for longer, right? but if she goes limp & stuff again, I would rub Karo on her gums I think...
 
Cameron,

Let me get this straight, there was no BG number taken when you gave 1u tonight?

Did the vet give you a BG reading this morning before he shot 1u?



Recap:

+1 130
+2 153
+3 225
+4 158
 
OK! got one vet to call me back... her advice

make wet food available
no more insulin
no more BG testing
go to sleep and if it gets worse call

OK... Newbie moment... If I go to sleep and I am not tracking BG how will I know if it gets worse????
 
sorry, trying to keep up...
9am BG I think (and counting on me thinking at this hour is dangerous...) was a 268 I will see if I can find it
Vet wanted to give me a chance to get used to giving insulin before doing at home BG monitoring :lol: ... the tech was going to teach me how to do a BG in a week or so after they did her next curve. Glad I got a meter and supplies anyway!
 
Is this the same vet from this morning?
Sorry, but if that were me, I'd stay up until you see a rise back up. In my honest opinion.

I'm adding the following info for you:

This might help, if you can print this up Cameron, as a guideline.
For further reading, the highlights in bold blue with more info.
Plus you can chart your numbers along.
This is what we pretty much suggest in the Lantus forum when dealing with dropping numbers - since things are uncertain with how Itty will respond:

You may have to test a couple more times, and if Itty goes under 100 you'll want to offer small bits of food to steer the numbers.
This can help keep her surfing ( hanging around the same numbers)

If you get any 50's, add a bit of gravy, re-test in 30 minutes...
if you hit 40's, offer a higher carb choice (HC), like something with gravy - re-test every 15 minutes till you see a rising number.
Anything below that, karo or honey. Re-test every 15 minutes till you see a safe rise back up.



Learn how YOUR kitty is responding to insulin:
Onset ---> the length of time before insulin reaches the bloodstream & begins lowering blood glucose
Peak/Nadir ---> the lowest point in the cycle
Duration ---> the length of time insulin continues to lower blood glucose

Example of a typical curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower. <---- this is where Itty is hanging around right now, more or less
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

Carryover ---> insulin effects lasting past the insulin's official duration
Overlap---> the period of time when the effect of one insulin shot is diminishing & the next insulin shot is taking effect
Insulin Depot ---> (aka "storage shed" in Lantus Land) "spare tank" of insulin, which has yet to be used by the body
More on the Shed ---> Lantus & Levemir Insulin Depot AKA Storage Shed
 
I agree with make food available and hold off on any more insulin for the moment, but personally I would continue testing periodically. Lantus is longer-acting - I don't use it so I don't know the details - but from what I understand the "danger zone" where their BG may still drop lower can be several hours. Given her symptoms were quite scary earlier, I would want to test a while longer if it's at all possible. Lantus folks can give you a better idea of how long until you know she is out of the woods.... at some point if you get #s that are in a safe zone and are rising, you will know the risk is minimal, but I doubt you are at that point yet. The #s may only be good now b/c of the karo, which means once that wears off she may go back to where she was. Hopefully the vet is right and it's not actually needed, but personally I would keep monitoring...

wow, yeah, glad you got the meter today... yikes!!!
 
vansplic said:
OK... Newbie moment... If I go to sleep and I am not tracking BG how will I know if it gets worse????
Click to expand...

LOL!! good dang question!

if you gave the shot at 9pm your time, it's almost 2 am your time now right? which means it's been nearly 5 hours since the shot was given right? theoretically you should be coming to the end of this. if the next number is up, go to bed. if the next number is down, make a pot of coffee :)

no matter what though, i'd talk to your vet early tomorrow because this continued staggering and stuff bothers me. she shouldn't be having those symptoms with her BG's where they are now. if it were tied to BG's, the only thing i can think of is that her BG was way too low earlier, for an extended period of time, causing neurological damage that is taking her body a while to recover from. that would mean that the low long BG probably occurred at the vet's office and i doubt that happened since they let her come home. she was normal after coming home right? and this all started after the shot right?
 
I thought I sad no more quizzes tonight! ;-)
OK, the chart make a LOT more sense now than it did 8 hours ago.
this was a different vet (ER vet) than this morning
after 5 ER vets I guess the tech wasn't kidding when she said FDMB had already taught me more than most vets know.

+5 216

my couch looks like a war zone!

I know that we are by no means in the clear but what kind of risk am I taking if I sleep for the hour until her next BG? Now I am starting to get woozy and disoriented ;-)
 
Recap:
AMPS 268 at the vets

no PMPS
+1 130
+2 153
+3 225
+4 158
+5 216


Can you make it for one more test?
How is Itty doing? What is she doing?
 
i myself think you're good to go to bed at this point but see what at least one or two others think. a consensus is always good :-) (that and i've been on painkillers for a week now so my brain is kinda mushy at 11pm :lol: )
 
looks like I get a nap!
we left the vet around 7:30/8pm... It is an hour+ drive home. I let Itty out of her crate, got my son into bed, fed and shot... honestly she could have been acting funny... I don't know.

Off to a nap until +6
 
When you get up, if you need this, remember:


You may have to test a couple more times, and if Itty goes under 100 you'll want to offer small bits of food to steer the numbers.
This can help keep her surfing ( hanging around the same numbers)

If you get any 50's, add a bit of gravy, re-test in 30 minutes...
if you hit 40's, offer a higher carb choice (HC), like something with gravy - re-test every 15 minutes till you see a rising number.
Anything below that, karo or honey. Re-test every 15 minutes till you see a safe rise back up.



it's 2am over here and my time is up.
There may be late niters around, post if you need help ok?
 
Itty is sleeping laying "up" as opposed to our earlier wet noodle.
Nap 'till 3am

If someone thinks the nap is too dangerous or I don't repost around three my phone number is ....
 
Actually, in the case of a symptomatic hypo, if that's what is going on, the rules about nadir don't apply. While the typical duration of Lantus is around 12 hours, with a hypo situation, numbers can drop well past 12 hours -- sometimes 16 hrs or longer.

Unless number drop, I don't think you can definitively conclude this is hypoglycemia. The gait disturbance and lethargy could be caused by any number of things, some of which are totally unrelated to FD. That Itty is disinterested in food is not typical of a cat with low numbers -- usually they will eat everything in sight. In addition, Cameron noted that Itty has typically been a hungry kitty. The inappetance is not typical of this cat.

I can't hang around. I've got to get some sleep. I'd really encourage you to talk to your vet in the AM and/or get Itty seen.
 
the #s are high enough napping seems like a good idea to me :-D I don't know Lantus though, but the others posting do, so if they say nap, then nap it is!!!! :-D I am off myself for the night, but I will leave the 911 post on Lantus so hopefully others will check in as they come on the board... it's morning already somewhere, right? and sounds like a few night owls will still be around.... at this point you know as much as I do anyhow about treating hypos... you are already in diabetes grad school!!! :mrgreen:
 
just for recap/clarity, she vomited earlier so her lack of appetite could be due to upset stomach (unknown whether it's cause or effect of other problems)

also some karo/HC has been given - in the #s recap for tonight (for the next recap), if you remember, you may want to note in there when you gave Karo, so it's clear where #s may be elevated from Karo, vs. #s stand on their own.. if I recall, the +3 looked like a Karo spike, but then she barfed up some Karo later so I guess it's unclear anyhow... oh well :YMSIGH:
 
Up... so much for a nap... got in bed, started shaking from the stress hitting, got up, puked (me this time, not the cat) and the alarm went off...

But... Itty woke up and "met" my eyes with a better gaze than I have seen in a while...

Onto +6
 
sorry puter decided it had it for the night ;-) had to restart.

It looks like she may have licked at her food but one of the civies got out... Emma tends to be an eater tho not a licker so my guess is that it was Itty.

5 more hours until the vet opens!
 
Haha....I have the same problem with my internet connection....silly computers! I should have asked, when was the last time she ate anything? I'm definitely not a veteran here...others have WAY more knowledge, but I can say that my girl usually peaks (lowest #s) at +5, sometimes +6, and then sometimes she dips a little again at around +10. It's been hours since any syrup, right? Poor thing....it's so late for you! And by late, I mean EARLY!! If this were a 'normal' cycle, I'd say she's probably in the clear for now, but to be on the safe side, maybe 1 more test? Hopefully there are still a couple of expert eyes still lingering around to give you a definite answer. What a night for you!!

s
 
she had a few bites at 9pm but threw those back up

at 6:30 am she ate about 1/3 can of ff
at 9:00 am she inhaled a whole can of ff at the vets
 
Gosh, Cameron....I just don't know. I was just looking back over the numbers and there are such big swings in the last 4 tests. She's gone up and down now a few times. If I'm reading your last post correctly, she hasn't had much food today at all, and definitely not much tonight. Is that right? A little more than a can? Or did I miss something? Do you think she'd eat a little now? When you say 9pm, is that your time? Sometimes it's easier to post event times in +1, +2, +3, etc. relative to shot time. That way people in different time zones can be sure when you mean. You might want to edit your subject line to include a big HELP PLEASE to get additional attention. Those swings make me a little nervous. I'm sorry...that's probably the last thing you want to hear. If this were a normal cycle, her #s should linger a bit and then start to rise after +6 or so...

Let me see if I can get someone's attention for you...

s


(haha....I'm rereading this before posting and SORRY for all the questions!)
 
Can you check her gums to see if they are red and inflamed? Are her teeth sensitive to the touch? If she is having a tooth issue, then she mightnot want to chew anything and will only lick up gravy. The "low-carb" blue buffalo you have makes good gravy, take 1/4cup of the dry and add 1/4 cup of hot/warm water. Let it sit for 5-10 minutes and stir. You can also make a "slurry" by mixing some water into some pate style wet food. Podo did not want to eat when she was first diagnosed and threw up often. You just have to keep trying. I would rub a small amount of food on her mouth. When she was stronger, she would eat small amounts from my hand, but nothing larger than a pea sized piece at a time.

For the morning, get a BG test around 15-30 minutes before 9am (shot time), and post in the Lantus group for recommendations. In case I'm not up at that time, just looking at this one evening, I would guess that a better starting dose would be 0.5U or even 0.25 being such a small kitty.
 
I know I am late to the game here, but I did notice your area code. I live really close to you, so if you ever need someone to come by ... or anything at all - please let me know!!

I know it is early - shot time for us, but how is Itty doing this morning?
 
Please help. the emergency vets were useless!
Itty's +9 is 119 BUT she is VERY lethargic and when I make her get up she is walking on her haunches.
 
OK, up off her haunches when she is on solid ground rather than my bed.
staggering so badly she can hardly walk.
We are financially beyond our limit and terrified.
 
you HAVE to bring her in. the ER vet is open, right? they will not know anything over the phone. they have to see her to do a physical exam and run some tests. she may need fluids at the very least.
that staggering worries me, especially when it was at higher numbers. low potassium and other things can cause that.
sorry, i know it's not my money but this really seems to count as an emergency.

do they take care credit? it's a short term loan with no extra charges. i think it's good for at least 6 months before you have to pay it back and if you can't pay back in full the interest charge is high.
 
119 is a great number. The lethargic behavior isn't going to go away overnight. It wasn't until 2-3 months into treatment that Podo started getting her old energy back. At first she didn't have the energy to do much more than lay on the ground.

Staggering isn't good. Ideally getting her looked at by the vet would be great. But, you are the one there looking at your kitty, so you will have to judge for yourself. If you just had a full blood workup at the vet when you got the diagnosis, then they should have already seen low potassium or most other things that can cause disorientation.
 
brian, she said "staggering so badly she can hardly walk."
that, IMO, is grounds for bringing her in. they cannot diagnose and treat over the phone.

sending good vibes that kitty will be okay. (((HUGS)))
 
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