Kind of new and really scared

[Natalie]

Hello All,

My name is Natalie and my cats names are Jack and Boo. Jack was diagnosed w/diabetes in September 2011. It took a while but with a lot of work & teaching from my vet we got him stabilized. I was giving 4 units of insulin twice daily (Jack weighs about 15 lbs). His BG was on the high end of normal but the fructosomine test came back with reasonable scores and his clinical signs were gone, so we were in what I thought was "the new normal". I'm pretty confident in my ability to give the shots, and the new food (Science Diet R/D) was pricey but in my range.

In the last 48 hours though we've had a major crisis. Jack has had an URI, and he wasn't eating as much as I thought. Boo was eating some of his share I think, because there wasn't any change in the amount of food consumed by both cats. I woke up Saturday morning to find him in a major hypoglecemic episode. It was utterly horrifying. I put some honey on his gums and rushed to the vet. They stabilized him (BG was 37 when I brought him in - they got it up to 208) but since they aren't 24/7 they recommended that I bring him to a 24/7 hospital. He's been there since 5pm yesterday. They've run all the major bloodwork and done an abdominal ultrasound - everything was normal. The consensus is that he's not eating because of the URI. The awful part for me is that I have to take him home tomorrow even though he's not eating. This hospital is great but it's been $3000 over 2 days and I just can't afford it. So tomorrow I'm going home with a diabetic cat that won't eat and I'm terrified. Objectively I know that I have a great local vet backing me up, and I've read the articles on this board about syringe feeding and home glucose monitoring. I understand almost everything I've read and written down questions for the vet on the stuff I'm unsure of. But theory and practice are two different things and I am really scared of screwing this up.

These boards have so much information, and I'm going through it as quickly as I can - but it's overwhelming. I guess I'm just looking for some virtual reassurance, and maybe a bit of direction as to what posts/articles to read first. There's no way I can get through it all before he comes home tomorrow.

Thanks for listening,

Natalie (for Jack & Boo)

 

[Blue]

Hello All,

My name is Natalie and my cats names are Jack and Boo. Jack was diagnosed w/diabetes in September 2011. It took a while but with a lot of work & teaching from my vet we got him stabilized. I was giving 4 units of insulin twice daily (Jack weighs about 15 lbs). His BG was on the high end of normal but the fructosomine test came back with reasonable scores and his clinical signs were gone, so we were in what I thought was "the new normal". I'm pretty confident in my ability to give the shots, and the new food (Science Diet R/D) was pricey but in my range.

In the last 48 hours though we've had a major crisis. Jack has had an URI, and he wasn't eating as much as I thought. Boo was eating some of his share I think, because there wasn't any change in the amount of food consumed by both cats. I woke up Saturday morning to find him in a major hypoglecemic episode. It was utterly horrifying. I put some honey on his gums and rushed to the vet. They stabilized him (BG was 37 when I brought him in - they got it up to 208) but since they aren't 24/7 they recommended that I bring him to a 24/7 hospital. He's been there since 5pm yesterday. They've run all the major bloodwork and done an abdominal ultrasound - everything was normal. The consensus is that he's not eating because of the URI. The awful part for me is that I have to take him home tomorrow even though he's not eating. This hospital is great but it's been $3000 over 2 days and I just can't afford it. So tomorrow I'm going home with a diabetic cat that won't eat and I'm terrified. Objectively I know that I have a great local vet backing me up, and I've read the articles on this board about syringe feeding and home glucose monitoring. I understand almost everything I've read and written down questions for the vet on the stuff I'm unsure of. But theory and practice are two different things and I am really scared of screwing this up.

These boards have so much information, and I'm going through it as quickly as I can - but it's overwhelming. I guess I'm just looking for some virtual reassurance, and maybe a bit of direction as to what posts/articles to read first. There's no way I can get through it all before he comes home tomorrow.

Thanks for listening,

Natalie (for Jack & Boo)

Sorry you are having such a rough go of things, but you are in a good place now.
A couple questions will be asked but a big one is what insulin are you using and what if any meds did the vet send you home with?

if you don't have copies already, get copies of ALL the blood work and test results, including the ultrasound.
get some appetite stimulant from the vet as it will help.
you can pick up a meter for testing blood at the pharmacy; Relion is good and the strips are cheap, but do not get a free style meter as they are bad for readings. So get the meter, some test strips and lancets, then any of the people on the board here can help you to home test.... just a poke on the tip of the ear with the meter's lancet device, then sip the drop of blood up the test strip in the meter and you will have a number.

You don't need to feed expensive vet food; you can feed any of the pates with fancy feast or friskies; the prices are better and the food is decent low carb.

what meds did you get for the URI? I was thinking that if you cat is nauseous, you can pick up some pepcid AC at the pharmacy as well, and you can give 1/4 tab of the 10mg tabs am and pm. it will help if there is any gas or nausea.

keep posting and ask all the questions you like; someone will be here to give you answers and support.

 

[Karen & Pearl]

My advice is to watch the home testing videos and learn to test as soon as he gets home. I don't think, considering he has had a major hypo, that until you can test and be sure of where his numbers are that I would, if it was my cat, give insulin right now. Cats are often MORE sensitive after a hypo incident for a while. Very occasionally it may throw them into a kind of temporary remission. I think that if you focus on that, that will be something you can handle and give you a sense of peace (because you KNOW if he is high enough to get insulin). Even when you start up again, I would back down to a beginning does (most of us believe in start low, go slow, starting at 1 unit- dosing should not be based on weight. There are 18lb cats who need only a touch of insulin. There are some guidelines that go by weight but VERY often it is misread, yes, even by vets and they dose by *CURRENT* weight, when the dosage is suggested to dose at *IDEAL* weight for the body frame. Even vets miss this very often.). With testing, you will then be able to make some informed decisions about dosing. 4 units is a lot of insulin, usually.

If it was my cat, I would give him whatever he wants to eat to get him eating for right now. I wouldn't give insulin until I know for sure he is needing it. I'd learn to test and see what numbers are before I would consider giving a shot again. When I did, I would start back at a 1 unit dose so I could gauge what is going on. Once I have testing down and a little handle on the situation, at that time, I would consider *what* he is eating.

 

[blakismom]

Hi, I just wanted to offer my support. I am new here on this board and new to feline diabetes. It is so scary, I know. The people here are a Godsend! You will find much comfort and support here. I know the horrible feeling of not being able to afford thousands of more dollars, as I have also spent thousands of dollars in one week since diagnosis, between hospital stays and all the supplies and meds. We all love our kitties and would do anything in the world to keep them well. We do the very best we can. We all do and our kitties know that. My heart feels deeply for you. I hope you and your kitty are okay. I'll keep you guys in my prayers. God Bless.
Nora & Blaki

 

[akbahsMum]

Hi, I just wanted to offer my support. I am new here on this board and new to feline diabetes. It is so scary, I know. The people here are a Godsend! You will find much comfort and support here. I know the horrible feeling of not being able to afford thousands of more dollars, as I have also spent thousands of dollars in one week since diagnosis, between hospital stays and all the supplies and meds. We all love our kitties and would do anything in the world to keep them well. We do the very best we can. We all do and our kitties know that. My heart feels deeply for you. I hope you and your kitty are okay. I'll keep you guys in my prayers.

Yes, what she said: I agree.
I've only just learned home testing this month, I did it through sheer determination to work out what what happening with my cat. It is well worth the learning curve (for me it has been one heck of a learning curve).
big hugs
Nat and Akbah

 

[akbahsMum]

I've only just learned home testing this month

well to be accurate,I started trying in December and mainly just upset everybody involved. I turned a new page in January so it feels like that's when I learned. But actually I did get some successful tests done at home in December. mumble. I'm going to stop procrastinating on FDMB now and write this essay I'm meant to be working on.

 

[ohbell]

Welcome and dont feel bad for being overwhelmed! It is sooo natural, but you will become a natural with a little practice.

I have a sugar girl, Bean that is in remission now. She would not be here with me today if I had shot as much as the vet wanted me to and without this forum encouraging me to test. You can well see in her spreadsheet that the first test was only 27! and she was acting fine. If I had not tested, eeeks, hate to think about it.

At first, before we got our routine down, the testing wasnt the easiest thing to do, but I just kept telling myself 'i must do this, her life depends on it'. WE finally got down the routine of testing - and lots will offer tips and support and advice - even a hands on class if you would want to share what part of the world you are in..... You both will get the hang of it - promise promise.....

The food issue, I have a civvie - Slappy - that would not eat.... I got hands on experience from here, Ms. Patricia, came over and showed me how to burrito ms. Slappy in a towel (I tried watching the youtube videos) and I dropper fed her. We used meat babyfood mixed with tuna water. I also used some a/d from the vet. I would puree it in my magic bullet with tuna water and again dropper feed her.... She finally got to where we didnt even need the towel/burrito anymore.... I would have bet you my last dollar that would never ever happen....She is 16 and still with me today.... and I know I would have lost her if it were not for Patricia teaching me how to dropper feed...

Hang in there - sending paw hugs to ya both

 

[Hope + (((Baby)))GA]

Please tell us what insulin he is on. Dose is normally not decided based on weight. R/D is usually only used as a reducing diet and loaded with carbs. As others have stated, you need to learn to hometest ASAP. Back off on the insulin dose because not eating and giving insulin is contributing to another possible hypo happening. Walmart has the ReliOn meter.....cheap but good. Fancy Feast and Friskies, without gravy, is what majority of cats are eating. Try getting some and see if he'll eat for you. He needs food ASAP because he runs the risk of going into fatty liver (Hepatic Lipidosis). Also, if the antibiotic he is on is Clavamox, talk to you vet about a different one. A lot of cats cannot tolerate that drug and get sick on it.

 

[Hope + (((Baby)))GA]

Forgot to mention you need to buy some Ketostix or KetoDiastix at the pharmacy. They test the urine for ketones and if he starts throwing ketones, he needs to go to the vet ASAP. Hypo's can kill but so can Ketones.

 

[nwnews]

HI Nat, ask your vet for a pill popper syringe (its a big syringe with the end cut off) then get either Hills A/D or Royal Canin Recovery. They are very mushy food - put the syringe in so food mushes into it and then put it up to your kitties mouth and slowly put the food in. Usually their reaction will be to swallow it and as they get the food taste it will stimulate the appetite. A 1/4 tablet of Pepcid AC can also help with nausea or if that doesn't work ask the vet for a compounded RX for prilosec. As everyone else said - hometest your cats blood sugar and don't give insulin unless its over 200. Hometesting is your best defense with diabetes. I'm sorry to hear you've had such a difficult time but hopefully with the wonderful folks here you can get past this and get your kitty to feeling better. Jan

 

[monkeykisses]

Hi Natalie,

So sorry you had this scare. Don't worry you are doing the right thing. Glad you found these boards - they are so truly helpful. I do agree with many posts here that the first thing you want to do is learn to do testing at home. Here is a page I like that has lots of step by step instructions, pictures and links
http://www.catinfo.org/?link=felinediabetes#In-Home_Blood_Glucose_Monitoring

Here is a good video if you prefer to see someone testing: http://youtu.be/cZ6iXetR398

Many here talk about a rice sock which is something I just learned. I had a little toddler sock I bought at the dollar store, filled it with some rice (from the toe to the heel) and then just tied a knot at the top. I throw it in the microwave for about 15 to 20 seconds and it really helps in warming the ear and getting a good sample.

You will also want to download the tracking spreadsheet and then follow directions on how to add to your signature so you can share with everyone here for advice:
http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207


~Monica

 

[Karrie and Maverick]

There is a great Yahoo group dedicated on helping with assist feeding - Yahoo Feline Assisted Feeding. When you join you get an autofile on how to assist feed safely and efficiently. It gives great tips on some ideas - every cat is different. Some need to be burritoed, some no constraint. Wellness Chicken has 200 calories a can and is low carb. Syringe feed food you don't feed normally. There is a video on the feline assisted feeding home page.

You will get amazing advice on managing diabetes here and you will save a fortune on vet care in the process. Doing your own curves, not feeding veterinary food, etc. Maverick was on a single tiny drop of insulin (0.10 units) when I lost him suddenly - due to undetected heart issues.

Another thing on the URI - if it is suspected herpes flare up there is new research on 1000mg of lysine. The old dose is 500mg a day. Susan had Lanky in the ER twice for breathing difficulties and within three days of upping lysine to 1000 mg he was clearing up. It has to be given in bolus doses twice a day. So 500mg in the AM and 500mg in the PM - syringe fed with tuna water for example. Not sprinkled on food over the day. It has to be consumed at one time. I got our lysine Now brand from iherb.com and a 5$ off coupon code for first time customers. Looks like its on sale now also: http://www.iherb.com/Now-Foods-L-Lysine-Powder-1-lb-454-g/653?at=0

Coupon code - check and see if it still works: http://www.iherbcouponcode.org/ You may be in a big city and can get it locally. Being up in Canada I couldn't find the pure powder.

Sending hugs. You will get through this. Stay strong. Its just a temporary blip - things will settle.

 

[Natalie]

Thank you all for your wonderful replies. We got a reprieve today in that the hospital worked with me on financial aid so that I could afford another 24 hours. The doctors felt strongly about sending Jack home with a feeding tube because he wasn't eating and his bg was having major swings every two hours. They didn't want him to leave until they got a full meal into him and figured out if he needed insulin when he had food. They lowered the fees considerably - first time I ever heard of that happening. That coupled with a really understanding boyfriend (who paid the rest) made the extra day possible.

I just got home from the hospital now. Jack was still sleepy from the feeding tube insert when I saw him but he did recognize me. (or he thought I was just another one of his groupies - the old flirt) BF and I will be picking him up tomorrow afternoon. I'm exhausted but I wanted to answer a few of the bunch of questions/comments my post received.

- The insulin is Lantus. I just read about using the cartridges instead of the bottle so I will be switching asap.
- They want me to continue him on the Clavimox when I bring him home. I'll ask about alternatives that might be easier on his stomach.
- The hospital vet also mentioned that the Science Diet R/D was high in carbs. For now I'll be using the food for the feeding tube but will move him over to a specifically diabetic diet. I'm hoping that the feeding tube will only be in for a few days.
- I bought two glucometers - the Walgreens TrueGo (cheap) and the AccuCheck (not so cheap). The vet offered to do some research on how to calibrate them for cats and then I will return one based on her recomendations. (and what I read here).
- Last week I was laid off. Next week (I hope) unemployment kicks in. Then I'll buy a true animal glucometer if neither of the ones I bought are ideal. Ironically, if I *wasn't* laid off last week I wouldn't have the time to take care of him properly. Silver linings and all that. :YMSIGH:
- I just called the hospital. After 4 hours w/o dextrose and a feeding his bg is 129. It's only the beginning of the curve but we'll see if it holds. I'm really hoping that he doesn't have to keep taking the dextrose to keep his bg up.

I'm feeling a bit better today, partially because Jack has 24 hours more care, and partially because I have tomorrow morning to cram on what I need to know to bring him home. It's just so hard to see the same cat who would eat anything not tied down, just stop eating completely. :sad:

Also, I got a giggle over how many of you who replied have black cats. I've attached a picture of Jack for comparison. (with his new pet goldfish)

More tomorrow.

 

[Jen & Squeak]

oh Sh*t! clavamox is what made my nondiabetic cat stop eating. I had to syringe feed her after stopping the clavamox. I'll never use it again just in case. Honestly, any chance you can insist on them stopping it? Did they do a culture and sensitivity test to determine that clavamox is needed? I'm assuming that it is a UTI not a URI that he has? (upper urinary vs upper respiratory?)

Jen

 

[Karen & Pearl]

Truly, a meter does not have to be calibrated for a cat. AccuCheks are excellent. Once you get going you can buy strips off eBay for way less (or at least you used to be able to) but it's a good meter. Should measure quite closely to any in house testing. Remember ALL meters have a 20% variation, and that is normal and not to worry about. It's the trends that you really watch and you will have a "floor' that you decide on (ours was like 90) where I didn't want her sinking past. I really wonder about the dosage they had him on. I would want to be very cautious *especially* if he is not on dry. What they determine at the vets *could* change when you get home and are feeding different food. Just be cautious.

 

[kim and simon]

Hi, welcome! I've learned the ropes pretty quickly since my Simon's diagnosis a couple of weeks ago. You will figure testing out quickly! I have one picky eater and fancy feast classics do the trick every time! :YMHUG: hugs

 

[Lori&Scout]

Hi Natalie! Welcome to you and Jack and Boo! I just joined last week for my cat Scout... this is a great community. I don't know how I would have managed without it, but here I am a week in and my vet has said she doesn't even need to see Scout since she's doing so well!

I also have a black cat, Nipper, but thankfully she's not the diabetic one as she really strong, stubborn, a royal pain in the ass to pill, and hates all wet food. :roll: But yeah I also noticed all the black cats on here! I'm sure they are all jealous of Scout with her pink ears and white fur - its soooo much easier to get a drop of blood from pink ears than black... or at least easier to see what the heck you are doing.

Good luck with Jack's homecoming tomorrow and keep us posted! One piece of advice: you might want to try the blood sugar test on Boo in the meantime to get the hang of it.

Lori

 

[akbahsMum]

Hi Natalie

- Last week I was laid off. Next week (I hope) unemployment kicks in. Then I'll buy a true animal glucometer if neither of the ones I bought are ideal. Ironically, if I *wasn't* laid off last week I wouldn't have the time to take care of him properly. Silver linings and all that. :YMSIGH:

ohmygod_smile You are one strong lady to find that silver lining.
There's plenty of good advice here, so I'll just offer this:

and these pics of my pair of felines

xNatalya

 

[Karrie and Maverick]

Please join the Yahoo Feline Assisted Feeding group for advice on your tube. You will learn a ton of things - including pictures on how to change bandages. A lot of vets don't tell you that you need to do this. Especially in diabetic cats prone to infection and DKA.

Crash course for you:
1. Do not do a preflush. That takes up space that food can and isn't needed. Do a good preflush of 8mls of water after feeding and medication.
2. Go slowly - 1/2 to 1cc at a time and give a break of 30 seconds or more in between.
3. Use warmed up food. You can prefill syringes in advance and put them tip down in warm water before each feeding to warm them up. Cold food can make vomiting and nausea worse.
4. If kitty bolts while being tube fed drop the syringe! You won't be able to hold kitty back by holding the syringe and can pull out the tube.
5. Most cats can only handle up to 40ccs of volume. You will most likely need to fit in a night time feeding or two the first week. Food is medicine here along with insulin. And you need a lot more food than a healthy cat would.
6. Ditch the high carb food! Wellness Chicken is 2-4% carbs and 200 calories a can. There are other foods higher than this. Blend the heck out of it, add some warm water and then strain in a fine metal sieve to get any gritty bits out. You need 1.5xs the amount of calories normally eaten.
7. Have coca-cola on hand - not diet or pepsi - to clear tube blockages. Instructions on the FAF site for doing this if you need it.
8. Don't put sticky meds down the tube.
9. Buy a kittykollar from www.kittykollar.com. Much more comfortable and easy to change dressings. Until you get a kitty kollar you can put the elastic end of a mens tube/sport sock around the bandages to give kitty something to scratch and reduce the risk of them catching a nail on the tube and pulling it out.
10. Most important - - don't race kitty to eating on its own. You have the tube, use it. Kitty will eat when he is feeling better. And don't race to remove the tube. Too many people do this. Relapses are common in an unregulated cat and the tube is a safety net. Your cat will adjust so well to the tube he won't even know he has one. Wait at least one week, preferably two before removing.

 

[Karrie and Maverick]

Actually the biggest most important thing is to not give an appetite stimulant to a tube fed cat. No mirtzipine or cypro. You can cause long term food aversion issues. Watch for signs of nausea - lip licking, lip smacking, teeth grinding, showing interest in food but licking or sniffing and walking away. Most cats with feeding tubes have underlying issues like DKA, pancreatitis or feline hepatic lipidosis and need an antinausea medication - ondansetron, dolasetron, anzemet and cerenia (used for acute vomiting). Reglan/metoclopromide and pepcid AC are not antinausea medications. Pepcid can help with excess stomach acid though.