Mild to Moderate Hypo - Caesar, Violent Cat

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smellycat40

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Hi all,

I'm pulling this out from another thread because it's urgent. I have a cat I can't quite meter test due to violent behavior (not unruly but VIOLENT) and I finally got up to firing the pin from the lancet device to get a reading of 173 today at 3pm (first one ever). I'd been advised to increase to 3 units of Lantus twice daily and started Saturday morning, but the vet had based this off the physical symptoms I gave them of his extreme hunger. Long story short, I think he had an episode of mild to moderate hypoglycemia this evening based upon the fact his blood sugar was pretty decent before his 6pm feeding. His symptoms were:

ravenous hunger
twitching in the paws (hard to tell if this or neuropathy)
glassy eyed look
cold to the touch
climbing up into the easy chair and squishing up into the corner
irritability (he had growled at me when I put a food plate in front of him).

He normally gets 3/4 of a 5.5 ounce can of Evo at each meal. I ended up giving him at least another half can. May feed him again later in another hour (1/4 can). I've tried five times since the hypo to get blood and I can't. He won't bleed no matter how deep I put the lancet and hand lancing might cause me to lose a finger.

I believe he's coming around again. He's now stretched out on the ottoman instead of curled in the corner and flips his tail in agitation when I "tsk-tsk". My question now is, "what do I do tomorrow morning?" There is NO WAY I am giving this cat 3 units of Lantus and leaving for work. The ER vet won't advise on what to give without me getting a glucose count to them in the morning before feeding and I can't reach the regular vet during off hours (need to call the ER docs).

Can anyone out there advise me? I"ve heard it's not good to decrease suddenly either, but I am terrified to dose him now. Please help.
 
Also, to Julia-I'm sorry I haven't answered your last msg on the other thread. Hands are so full right now with this mess :cry:
 
Tried lancing again. Nothing. He is VERY upset. I need to stop or he won't let me administer any insulin if he does require it at some point (certainly not now!)
 
In my opinion, if you think this was hypo..and some of those symptoms certainly can indicate that, please drop the dose back. Especially since you're not able to test yet. It's better (for most cats) to be too high for a day than too low for a minute. 3 units is pretty high without really knowing what Caesar's numbers are doing. I know I read your first thread...I'm gonna go back and find it to remind myself of his background info...
 
Here is Caesar's previous thread
http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=49553

So he was started at 2u and increased to 3u bid just by observation? Or was he tested by the vet at that point? I think to be safe a drop back to 1 may not be a bad idea. It is recommended that on this board that Lantus is started around 1u bid and increased in no more than 1/2 unit from there. Have you tested him using keto-diastix yet? The main concern with dropping the dose back would be ketones. If you have the urine test strips, though, you can test for them. It's hard when you aren't testing. I'm not judging you at all--- you have to be concerned with your own safety. I'm impressed that you're even trying, and that's awesome!! It'll take a while to get him to trust you with this. Some kitties learn to accept it just because of the treats and the fact that the shot makes them feel better. But that doesn't always happen.

I'm glad that he is looking and acting more normally.
 
by the way- it took me about a week (poking a few times each day) to get enough blood to test my easy-going docile cat. Charlie would sit perfectly still in my lap while I did it, but it still took that long. That's pretty normal and no reason to get discouraged! :smile: I don't hand-poke either. Have you tried using the clear cap on your lancet? That may help you line it up better on his ear so you know that you're hitting the right spot.
 
Julie have you been able to test his urine for glucose yet just to see if the numbers there
are dropping any. It would help just to know that.
I know how scary it is being where you are right now. You gotta find out something.
He could be way down.
Don't cry.
 
I tried to respond so quickly that I didn't notice you had a successful test today! Awesome job! :twisted:

Now, we have what we call a "no-shoot number". This is generally around 200. If you ever see a bg number under 200 please do not shoot insulin. When you have more information and more tests that show you how he is actually responding to the insulin that number will come down. But for now, please no insulin if you test under 200!
 
So he seems to be coming back around. He's eaten about twice what he's been getting lately, so I think I should stop for now. He is up and drinking, now lying in the dining room (head still up). Doesn't seem to be as bad off as before. Feeling a bit more warm.

I tested his urine Friday and it was off the charts brown (spilling glucose), but then today, I remembered that I use Nature's Miracle liquid cleaner to wipe out the box. I tested the cleaner and it came out dark brown! I also test the litter in water to be sure: no effect on the stix. I washed out the box with soap and water, refilled with litter, but moved it to the side and sure enough he peed right in his preferred spot and I was able to dip without problems. NO ketones and NO glucose. I dipped two to be sure and the strip was still near blue for glucose (not changing any darker colors at all, not even the green like you see with trace glucose in the urine!) <- if I'm interpreting right, but I have pics if you want to see.

I need to call the meter company and see if I can get a clear cap. There didn't seem to be one inside and this would be so helpful. I'm also wondering if I should work my way into a larger lancet (although I hear it hurts).

Charlie, he tested at 508 during our vet visit on July 27th. He was started on 2 u and I was worried about his diet, so I switched him to canned from a high protein dry not realizing that the dry is still a pretty high carb food. I called to say that he was extremely hungry and the vet said he probably needs more insulin. She said 3u, but I asked if we could do 2.5u based on Julia's input making me question the possibility that we're going in the wrong direction. Not long after, the ravenous hunger kicked in and I thought in my head "rebound", so I called the doc again and they said without meter testing, it's hard to tell where he's at. They suggested 3u, but to keep an eye on him. Good thing it happened tonight and not tomorrow while i'm at work (I cannot stay home tomorrow).

Just a little more background on Caesar that was not in the previous thread. It wasn't just the vet where he had a wild meltdown. He's done it in my own home twice to the point he didn't even recognize me. I had to shove my friend in the bedroom and follow her. I came out 5 minutes later and he was STILL in a frenzy. I returned again minutes later, crouched down, balled fist and let him sniff to see it was me, then s-l-o-w-l-y inched to the kitchen to give a treat and close the door while I got my friend out. The second was my niece. I saw it coming and was able to lure him into the kitchen for treats as he was backing her into a corner. This video shows what he's like when he has an episode of feeling threatened. It's hard to watch without crying and this cat is not as severe as Caesar when he's full tilt:

http://www.youtube.com/watch?v=MF88IYF2MHY

Again, he is very loving to me and it would be hard to guess given the information I've just shared. I have pictures of him nuzzling me while sitting in my lap and after tonight's hypo, he climbed into my lap and purred non-stop. It's just I have difficulties jabbing him knowing what he's done before. I feel sad that he had two previous owners that abused him. He is such a good kitty.
 
Charlie, thank you. I will never shoot again if he's under 200. This was something I'd not known about. I think he's been coming down for a while now. He's had more than one cranky episode where he felt "cool" to the touch (one sign I overlooked).
 
Can anyone tell me about how long this will last? He seems to be back wandering around again, drinking more and still feels a bit cool to the touch. I tried to give him more food just now, but he seemed only remotely interested. He is super touchy. I won't be able to get a reading.
 
Hi, I don't have info on how to deal with the hypo, but I have read both of your threads, and just watched the video.

My Hummer, who was originally named bummer, was a barn cat that had little to no real human affection. I was sick in bed for years, and asked a vet ifhe knew of a cat that needed to be adopted, Hummer's owner brought him to me the next day.

I wanted to share this with you, because I know all to well that violent insane cat rage reaction. Hummer was so surprised when he was brought to me. I knew he was coming and had a special feeding station, toys, catnip, all kinds of things that a friend had been kind enough to go get for his arrival. He was priceless, and I changed his name from bummer, (what a bad name) to Hummer immediately because when he came to me, he purred like I had never heard before! He knew he had found a real loving momma, and was in his glory.

I also think he knew I needed him, more than he needed me.

Anyway, one night, while he was sleeping on me, (orange tabby, that always slept and cuddled with momma, go figure!) He went bizerk! He was growling and eyes completely dialated like the video, I wrapped the blanket around him instinctively, and in the calmest voice possible, kept saying, you're ok, you're ok, he bit me through the blanket, scratched me, and yet my gut told me not to let him go, I just kept telling him, you're ok.... it lasted about 5 minutes, and when he came back to himself he could see blood all over me, and was freaked! I could tell he didn't understand, who hurt you mommy???? I just held him, while wipping the blood with a nearby shirt, (hey it can be washed...) and started singing to him, and we fell asleep.

These incidents would happen occassionally, maybe 1 or 2x's a month, and every time, I did the same thing. After about 6 months, it never happened again. I didn't know much about his history, and I knew enough about cats to know he wasn't himself. But the more we bonded, the less he had those episodes.

I will tell you, he saved my life! He could tell how sick I was on any given day, if he layed at my feet, it was a normal day, if he was on my lap, it was a rough day, and if he was up by my chest or head, I would end up in a hospital!

No one will ever tell me he didn't respond to the love and gentle care and affection he found in his forever home.

I tell you about him, because it sounds like Caesar is very similar. I think the difference is that I would not let myself be scared. I learned to have an old leather jacket around, even leather gloves, and yet, to this day, I am convinced it was the calm, reassuring sound of my voice that would help him snap out of it.

I don't know your cat, and am not trying to advise you to do as I did, I applaud you with your love and care of Caesar, I just wanted to let you know, I do understand what it is like to have a cat with these terrifying episodes.

You and Caesar are in my prayers.
 
Just a quick update that Caesar pulled out of it, but not without consequences. He had an aggression episode. I grabbed the other cat and tossed her in the bedroom. I could see that "glassy" look in his eyes and thought perhaps it was another low and as I brought a few pieces of dry to him, he started stalking and growling. Again, I've been through this before, so I knew that a full on attack was up next. I went straight to the bedroom to endure the worst four hours of my life. I didn't know what was happening to him if he was okay, having a seizure, already in a coma, dead, etc. and I attempted to come out a few times, but he wasn't having it. I'm embarrassed to say it was so bad, that I couldn't even come out to use the bathroom and had to urinate in a litter box I already had in the bedroom. When I was finally able to come out, he seemed okay, but he was limping terribly due to his leg twisting out (this has been occurring a lot lately, I think it's the neuropathy).

I have come to think that maybe it's time to let Caesar go. This is not about diabetes, but instead, is about a violent diabetic cat who gets it in his mind that the ones who love him are trying to hurt him. I cannot successfully meter test him enough to monitor and I am NOT a fan of blind shooting. When I came here, it was in hopes that someone would have some method for being able to give insulin without harming their pet and not have to meter test, but I see now there is no such thing. If I undershoot, he goes hypo and risks seizure, coma or death and if it happens at work, then I can't help him. If I leave food out, then the blood sugars go high and he continues to self mutilate because he feels bad (as mentioned, he's got huge gashes in his back) and suffers from other ailments such as organ problems, neuropathy (it's already kicking up real bad from what I can see) and any other degenerative illness that comes from this. And even if I was able to pull it off, we still have the behavioral issue and I will have to stick a needle in him twice a day in hopes that he won't turn on me. It's incredibly hard and exhausting to keep treating a highly volatile animal that puts you and your other animals at risk. It breaks my heart as I have spent twelve years of his fifteen years with him and I love him, but I have now become frightened for my safety as well as the other cat in my house and even more distressing is knowing that he won't let me handle him if he has a life threatening medical incident.
 
I just wanted to post, how sorry I am, your thread is heartbreaking and I'm so sorry you are going thru this with your kitty.
(((((((hugs))))))
 
Has you tried giving him meds to calm his aggressive behavior? My cat Callie is very aggressive to one of my other cats. My vet prescribed Clomicalm and that helped significantly in calming down her behavior.
 
Smellycat,

I'm very sorry you find yourself in this situation. No matter what you decide to do please know that you love him and that you've tried your best to help him.

Was Caesar this aggressive prior to being diagnosed with diabetes?

THe other two situations you mentioned - this was all recent?

I'm just wondering if there is another medical explanation. While each cat can certainly have different hypo symptoms - and there is a long list of possible symptoms, it just seems odd to me (i'm not a medical person) that he would recover from hypo symptoms without active intervention - food, karo syrup, etc. If he was in a hypo and wouldn't eat, let you give him sugar, etc., and you had to hide from him, it just seems odd to me that he would just go back to normal after a period of time. These are just some thoughts I had reading your post.

I used to have an aggressive cat - if he'd been diabetic - I would've had to toss the insulin at him from across the room.

I might suggest that you cut the dose down - 1/2 a unit - maybe 1 unit maximum - and just shoot him on a 12-hour schedule, and just feed him whatever he will eat. While testing blood glucose with the monitor is a great way to monitor, there is no rule in life that says you need to do this. If your cat won't tolerate it do what you can. He may improve - or not, but, there is no reason to make yourself sick over treating him. I've known several people who've given insulin without monitoring and they did fine.

Good luck to you whatever you do.

Best,
Pam & Layla
 
I agree with Pam & Layla. Do whatever you can. Cut the dose down. And if you can't hometest, you can't home test. You cannot risk your family's safety. Try the ketodiastix. Try this product from purina: http://www.petfooddirect.com/Product/3058/Purina-Glucotest-Feline-Urinary-Glucose-Detection-System I can't imagine how frightening it must be to have a cat go into a state of rage and panic. I feel awful for you and Caesar. We all know that he wants to be a sweet kitty, but since he was abused his trust is broken. That breaks my heart. You are an amazing mama bean for working so hard with him to gain his trust and I understand that all this testing feels like a step back. I really hope that you can figure something out. You know what is best and you have to follow your heart.

(((((Julie & Caesar)))))
 
Some people have been able to manage with urine testing--but it only can be successful if you do not start on too high a dose, because a high dose will make him throw very high numbers along with the very low. If the dose is started low and raised slowly and carefully, then it's possible you can manage things with the urine strips.

At this point, I think starting over at .5u would be a good idea since there are no ketones present, but I'd see what other people say, too. Normally I would say 1u is a good place, but I would rather be safe than sorry after a hypo incident. It'll be very important that you increase the dose slowly (hold for 5-7 days) and in small increments (.25u). You don't want to risk going above Caesar's ideal dose with urine testing since you can't catch low numbers like you can with blood testing.

Urine testing is definitely better than no monitoring at all, and you have to do what you are able in the confines of what Caesar will accept.

Here's some more info about times to urine test and dose adjustments: http://www.felinediabetes.com/bg-pstrip.htm

Yes, most people here bloodtest, but I know there are many people here who are always willing to give advice no matter what the situation. You are in a tough spot and no one can say you are not doing your best! Maybe we can help you at least get Caesar to a point where he is better regulated with the urine testing.
 
Julia-I'm waiting for a call back from the vet. I'd like to discuss starting over at .5 units. I am still contemplating letting him go, but I'm so very, very tired right now that I just need some rest and I'll think it through again. He frightened me last night and I once again find myself asking what will happen if he needs help and I can't give it to him because he won't let me near? Frankly, at this point, I don't even know if he'll let me give him insulin.

About urine testing, yes, there were no ketones in the urine and I was surprised to find no glucose. I'd also noticed he was getting more and more hungry right after giving his shot (as if it were wearing off too soon). In the beginning, I would have to chase him down to finish his food because I was afraid of hypo when going to work, but as time went on he would wolf down the entire serving and look for more. After going from 2.5 u to 3u twice daily this past Saturday morning, he was off the charts hungry (looking at the trash can, seeing if there was anything under the stove, actually climbing on top of my back while I was on the kitchen floor digging in the cabinets). This morning I left the usual 3/4 can serving, but did NOT give any insulin. Maybe this was or wasn't a good idea, but after yesterday, I need more information before I start jabbing a needle in him again if I chose to go down this road. In retrospect, the vets probably shouldn't have said increase, but they have no data to go off of and they're basing decisions on what I tell them since I can't get any numbers to them. We started off at 2 u as his blood glucose registered at 508, then I kept telling them "look he's hungry all the time" not thinking to tell them about the pattern of hunger and that is was getting closer and closer to right after giving him the shot. So they took it to 2.5 for while, then the same pattern returned, so once again I said "look he's hungry all the time" and they agreed to 3u. Yesterday, he was fed at 6 am, but was in the kitchen again by 7:15 am (the fastest yet) looking for food. From there it was pacing in and out of the kitchen, to finally just lying in the kitchen and refusing to move until dinner. Of course I feel quite stupid in using the rationale, "Oh, 173 seems kind of normal to me. But maybe that's all the insulin doing this" not understanding that he didn't require any more at that point, so I shot.

I have a question for you (and others) about blood draws. I tried using luke warm water in the pill bottle and this was the closest I could get to heating him up, but he wouldn't tolerate it for too long. I had to go pretty deep on Sunday with the lancet to draw blood and I think he only "took it" because he wanted food so bad. I feel terrible because I "pierced" his ear. Wouldn't it seem easier to graduate to a larger gauge pin to increase the chances of getting something, but set it shallower? This way I don't have to try more than once and setting him off.

Pam-yes, he was this violent before diabetes. A lot of people think I'm crazy for even having kept Caesar after the first incident about 8 years ago at the vet. It took two techs and the doc to get him back in the carrier. He has to be knocked out each time he's examined. I've had him on Prozac and (for Lisa) -> he's now on Amitriptyline specifically for the mutilation behavior. There was a hiatus in the attacks, but definitely an increase in aggression since about the age of 12 (now fifteen years old) and it may have a lot to do with being older, feeling achy, fading eyesight. The last three attacks over the past year/year and a half took place in my home and two of them I witnessed (the one I did not see was toward a friend who had come by to use the internet since her computer was down). It was definitely the most horrifying thing I've ever witnessed to watch this beautiful, sweet old cat turn into the seething ball of terror and rage. I know I should not be afraid since he'll pick up on it, but the reality is that I am scared.

About the hypo, I did feed him. He'd already had 3/4 of a 5.5oz can as normal, then I fed 1/2 can more after I realized something was wrong and was on the phone with the ER docs, then 1/4 of a can about an hour later. At the two hour mark from shooting, he got that horrible glassy eyed look again and he was staring straight on at my other cat. I know this stare like the back of my hand, so I grabbed her and tossed her in the bedroom to avoid being mauled. I walked toward him and received deep long growl in return. Panicked that he might actually be dipping again, since I didn't know how low he actually was, I tossed some dry on the floor and ran to join my other cat. Now you'd asked me about the two other situations and were they recent, but I'm so tired right now that I can't find what I'd said so please let me know what this was in reference to.

Ronnie, Charliemeow and anyone else I've missed, thank you again for the kind words. My heart is heavy, body exhausted and my mind is struggling to sort through things to make the best (not always best feeling) decision.
 
My cat's been diabetic for 7 years, and she only gets half a unit of insulin. The original vet started her off at 4units - based on a number in his office.

I think your vet will support the lower starting dose when you discuss the hypos with him. He probably started at 2 units based on weight - which is sometimes how lantus is done (well, not those here..), but many cats do not need that type of starting dose.

Try the lower dose and feed what he will eat and see what happens. If it doesn't work you can change strategies.

I've had an aggressive cat and I know you don't love them less than the others. It just makes it harder to treat and take to the vet.

Good luck to you.

Pam & Layla
 
I am so sorry for your terrible situation. I watched the video -- that is a cat who is terribly, terribly scared and who feels like he has to defend himself. The way the person keeps coming at him is so scary for him that it's traumatizing. I think this is just the sort of thing that happened to my abused rescue cat, who couldn't take it and bit the hell out of his people several times. (He's now a lovebug.) It also sounds like Caesar finally will attack when he gets over stressed. Of course your problem is that you can't simply back off and give the cat plenty of space.

Why not call on Jackson Galaxy? They are now casting and even if not for the show, he may try to help you since this is so time critical. It can't hurt to ask. http://jacksongalaxy.com/my-cat-from-hell/

In the meantime, I think you should buy some cat gloves. I work with feral TNR and these are invaluable when the cat is biting and clawing like crazy. Won't stop every bite completely but all I've gotten is little nicks -- from cats intent on ripping me to shreds. Like Theresa says, a calm voice is very important. And yes, medication could be really helpful in the short term. Not just calming meds --- pain meds! If his back is torn up, he must be in real pain. A big towel will also be helpful.

I would recommend considering crating him as well, especially now that he has wounds to be cared for. This will protect your other cat too. Get a multi-tier cat tower crate so you do not have to chase Caesar to get him for his shots or testing. Any chasing/cornering is extremely scary for him. Be sure to put hiding box or something similar in the crate; put a towel over the top of the crate so he has secure-feeling areas. Put the crate near a window and get a bird feeder outside for him. Train him that when your hand comes in the crate, when your hand comes near him, it means a hand bringing a good thing (chicken breast treat or a bit of tuna). Do this many times a day at first -- he will soon get the idea. Before attempting anything, sit by the crate for several minutes and simply talk or read to him (be non-threatening, do not stare at him, just dart a glance now and then).

You might even consider a muzzle. Normally I wouldn't advocate it, and it depends on the cat, but I have had some luck when the alternative was getting bitten while providing medical treatments several times a day, treatments which required a lot of manual dexterity. Having their eyes covered can be calming.

Cat & Wildlife gloves -- https://www.animal-care.com/index.cfm/i ... 309/Gloves?
sizing chart -- https://www.animal-care.com/files/anima ... _chart.pdf

muzzles -- http://www.amazon.com/Pack-Muzzles-Smal ... dpp_ttl_ex

great cat tower -- http://www.amazon.com/Tower-Small-Anima ... 000YG65XQ/
 
I agree, you should start at a lower dose. It is very possible that the dose you started at was too high to begin with. There is a condition called Somogyi rebound that is caused when the insulin dose is too high. In order to protect itself from hypoglycemia when too much insulin is given, the body produces extra glucose. So if you had been successful in hometesting, you would find the BG readings very high. Your cat would also exhibit the symptoms you had been seeing that is similar to an unregulated cat: excessive hunger, thirst and peeing.

By starting over at a low dose, you will increase the insulin by 1/2 unit increments, giving at least one week between changes to give the body time to adjust to the new dose. Once you find the optimal dose, you will see a significant improvement in your cat's health. Hopefully as your cat begins to feel better, he will also begin to let you hometesting.

I had mentioned in an earlier post about asking your vet for a prescription to help calm your cat down. One of my cats is very aggressive towards another one of my cats. My vet prescribed Clomicalm and it helped significantly in calming her behavior down.
 
smellycat40 said:
I have a question for you (and others) about blood draws. I tried using luke warm water in the pill bottle and this was the closest I could get to heating him up, but he wouldn't tolerate it for too long. I had to go pretty deep on Sunday with the lancet to draw blood and I think he only "took it" because he wanted food so bad. I feel terrible because I "pierced" his ear. Wouldn't it seem easier to graduate to a larger gauge pin to increase the chances of getting something, but set it shallower? This way I don't have to try more than once and setting him off.
Click to expand...

I used a damp washcloth that I heated in the microwave and put in a plastic baggy, and I know many people here use "rice socks" that they heat in the microwave, also. I would do whatever Caesar seems the most ok with. As for lancets, absolutely it's easier to use a larger gauge lancet. I started using 30-31g lancets and they were pretty useless. I now use 26g lancets, and set my device to the setting before the deepest setting.

After a month or so of testing, the ears "learn" to bleed, and you don't need to heat them up anymore unless they're super cold, which I do by rubbing Bandit's ear until it warms up a little. And don't feel bad about "piercing" their ears--they really don't feel it after week or so and especially if you dab a little neosporin + pain relief on their ears. If you put pressure on the area until the bleeding stops (about 10-20 seconds) there should be no bruising or scabbing.

I really hope Caesar cooperates with you. To give you some hope, many people have had some really difficult cats that came around and completely tolerate blood testing. Here's a video of how Bonnie's cat Junior used to behave: http://www.youtube.com/watch?v=kXyrKSJTlYA. He came around and Bonnie has no problem testing him anymore, but it took some time. Bandit used to bite and scratch at me (not as bad as Caesar, I'm sure) and I had to put him in a basket and wrap him in a blanket for each test so he wouldn't take my hand off. Now he couldn't care less if I test him, and I don't even have to hold him. He just sits there and patiently waits for his treat. Treats/food are key--the more the cat associates the testing with yummy things, the better they comply.

I would also pick up a few bottles of wine as treats for you! It's just as important.
 
Hi everyone,

Just spoke with the vet and she did not even realize the other doctor had told me to raise it up a half unit the day to 3u total the day I called the office (good reason to stick with ONE vet at a practice). She said he was definitely hypoglycemic and has suggested we drop back to 1 unit twice daily with 3/4 of a 5.5 ounce can of food at each meal. She stressed NOT to feed him in between meals no matter how much he begs for it, since extra feeding will affect his blood sugar.

I have much to think about in the coming days about this situation. I am on four hours of sleep and need rest terribly. Will come back again to answer any questions anyone had and thank you again for the support, thoughts and suggestions about Caesar.

Julie
 
smellycat40 said:
Hi everyone,

Just spoke with the vet and she did not even realize the other doctor had told me to raise it up a half unit the day to 3u total the day I called the office (good reason to stick with ONE vet at a practice). She said he was definitely hypoglycemic and has suggested we drop back to 1 unit twice daily with 3/4 of a 5.5 ounce can of food at each meal. She stressed NOT to feed him in between meals no matter how much he begs for it, since extra feeding will affect his blood sugar.

I have much to think about in the coming days about this situation. I am on four hours of sleep and need rest terribly. Will come back again to answer any questions anyone had and thank you again for the support, thoughts and suggestions about Caesar.

Julie
Click to expand...

Dropping to 1u is a good idea. However, I definitely disagree with feeding in between shots. I feed Bandit four times a day, at each shot time and 6 hours after each shot. He's in remission now--and I fed him up to 6 times a day when he was insulin last year. Diabetic cats do very well on small, frequent meals. Plus, Caesar is an uncontrolled diabetic and you don't want to restrict food right now or you risk diabetic ketoacidosis. If he is acting like he is starving, feed him.

When Bandit's blood sugar is getting low, he begs for food and acts hungry. Eating boosts his BG a little bit. A low carb food is not going to raise him up enough to have a negative effect on his insulin therapy, but not feeding him if he is getting low could cause another hypo incident. If you were able to bloodtest I would say that feeding only twice a day wouldn't be a big deal as long as you got a test 4 hours and 6 hours in, but since you're only able to urine test I would not restrict his food.
 
I have to agree with the drop back to 1u, but also disagree with restricting food. Feeding small frequent meals will help keep the sugars more stable and help stave off hypos. Most human diabetics only require one shot of insulin per day. Could you imagine if their doctors suggested that they only eat once a day at the shot time? I know that it's hard to get advice from total strangers that conflicts with what your vet suggests. Most vets don't know much about diabetes. They are generalists. They deal with so many different species, and so many different health issues that they simply cannot be experts at everything. Most of the folks on FDMB are treating their kitties with great success, and are just passing on info that they found works best for their cat. We all deal with diabetes all day, every day. A vet may only see a few cases in his practice, and all he has to do is charge them an arm and a leg to run a curve and adjust a dose, and send them home. Often with doses that are too high. We want the very best for you and Caesar, and we have combined decades of experience in treating diabetes. I wish we could offer more help on testing Caesar, but, while it may not be ideal, many people have cats who are perfectly healthy diabetics without hometesting. It says a lot that you want to, but you can only do as much as Caesar will let you do. No one faults you for that! Don't fault yourself, either.

Me for example...I feed Charlie 5 times a day (1/2 can of 9-lives each time), plus at least one snack of chicken treats. I feed at 7am with his morning shot, at noon, at 4pm, he gets a snack at 7pm with his evening shot, and a feeding at 1am (using the petsafe automatic feeder). He is 10 years old and weighs 15-16 pounds.

I'm glad it looks like you have a temporary plan of action. Please let us know if there is anything we can do to help you.

~Claudia
 
I too have a cat who has a history of being violent - I won't go into details, but extremely cruel treatment for her drove her over the edge and she put a person in hospital with wounds. She is 4 and I've had her for about 2 years.

I will share my observations and thoughts in case they help.

It seemed that intense sniffing of a new person or new smells (if I had been shopping) was a trigger. She would do open mouth breathing (I know there is a term for this - I think there are receptors of some kind at the back of the throat) and go glassy eyed. Any movement usually resulted in an attack. I started a 'no sniffing' rule. When she would approach to sniff, I would move away or tell her firmly 'no sniffing'. If someone new were coming to visit that I knew had animals, I would put her in the laundry room to begin.

I also found that prey seemed to stimulate her. I took away toys that looked like prey. I played a lot with her with wads of paper (she is a 'fetcher'), string, foam balls - nothing that looked like a mouse or a bird.

When she was in attack mode, I tried to confine her as opposed to letting her corner me. Maybe it is too anthropocentric, but I felt like if she cornered me she had somehow accomplished her objective. I also found that she was better shut in 'her' room and then I would just go about my activities as though nothing were wrong. At first she would growl and yowl for an hour, and gradually over a few months it got to be about 10 minutes b4 she was begging at the door to be let out. I would just open the door and walk away - I tried not to react to the agressive behaviour at all. And let me tell you - it took a lot to stand and watch a cat chew on my leg and do nothing. She left 5 full sets of teeth marks - deep. Fortunately, no infection.

It seems that there is a food sensitivity in there as well. I feed her the same food all the time - no variety. I tried a few different ones, and noticed that she seemed a little more on edge, so have stayed with one that works for her.

She is generally now quite a love bug - on her terms. She does not like being confined, but will tolerate it to have her nails trimmed. Sometimes she can only stand 2 feet and sometimes will let me do all 4 at one sitting. I have learned how far to push her and she has learned that I won't hurt and will let her go when the job is done.

I have taught her to leave a situation if she does not like it. Sometimes, for example, she doesn't want to be petted. Rather than biting, she leaves and I never pursue her. I want her to feel that leaving is better than biting.

Vet visits are a challenge, but since the vet gave her to me to care for (with a long agreement about her care and what to do if I can't keep her), the clinic is very understanding and she is never gassed or otherwise sedated or roughly treated. And she never leaves my sight - no back room ever.

I don't know if any of these ideas will help you. I can say with fair certainty that I know how you feel. Speaking of feeling, I always felt that she did not feel well after one of these agressive spells - the adrenaline low makes some people feel quite sick, and I wondred if she felt like that too.

Anyway, I have rambled a bit here. Best get going.
 
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