Need dosing help

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totallybeachin

totallybeachin

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This is copied/pasted directly from my thread over in PZI, to save me from having to type to much.
My internet is going in and out and right now, I am juiced through someone in the neighborhood's wireless network, but the signal is weak! :lol:

It was suggested I post over here to get some feedback.

Hello everyone.
I am hoping to get a little guidance.
I have an elderly person close to me who is going through a rough patch right now and had to move in with their daughter, who also has her own children and 1 grandchild living in the home. My elderly friend was not allowed to take her kitty with her. I decided to take the cat in until my friend is able to get back on her own feet. His name is Rocky.
I have known Rocky would be coming for about 2 weeks now, and as a condition of me bringing him here, I told my friend she needed to switch Rocky to an all wet diet, as I wouldn't be putting any dry out in fear that Callie Mae would get into it. She made the switch with no problems and Rocky couldn't be happier with his new diet.
Prior to the switch, she had mentioned on occasion that Rocky had been drinking a lot of water and had lost some weight and just seemed a little *off*. She told me since she switched his food he didn't seem to be drinking as much water and he appeared to have put back on a little weight. I have known Rocky since he was rescued as a kitten. My friend had been living out of state for about the last year or so, and I knew he had also been a little on the chunky side, so I didn't realize exactly what she meant by *weight loss*.
Well, Rocky came to my house today, and I knew right away something was wrong.
Please remember, Rocky's owner is an elderly person, Rocky is all she has, and she lives on a VERY limited fixed income. Unless something serious happened, vet visits were out of the picture. She can't even afford a yearly checkup.
If she thinks this cat has gained weight, I hate to see what he looked like 2 weeks ago. This cat is so skinny, I can feel his bones. :sad:
I decided to test him around 9:30 this am, he had already had his breakfast around 8:30, and his bg was 389!
I tested him again at 7:20 pm, right before dinner, and he was 275.
I want to monitor him for a couple of days to collect some data on him, but I have a sneaking suspicion that he had diabetes.
I can not afford to take this guy into the vet to have him checked out. I just went through all that with Callie Mae.
I am wondering if it would be safe to start him on some PZI, without a diagnoses, if his numbers continue to be above a "shootable" number?
I am fortunate that I actually have the know how and supplies to be able to help this guy, but I would like to get some input on how you guys feel about giving a kitty insulin without a dx from a vet.
I tested his ketones also, which came back neg! At least that's good.
I started a spreadsheet for rocky, even though the only numbers I have so far are the 2 I got from today.

Before I write a book, I'll stop here.
Your thoughts?



BTW, Callie Mae is still doing GREAT!! :thumbup
 
Wow, that's a tough one. I guess the other avenue I would use are some glucose urine strips - there could be no doubt then that Rocky is diabetic. We don't think vets should go by glucose tests alone either.

Not that I or anyone here are condoning treating a cat without veterinary diagnosis, but the future does not look good for Rocky if those levels aren't brought down. With the weight loss, he could become ketonic and that would be very bad. In fact, get some glucose/ketone type strips so you can test for ketones too.

Have you spoken with the owner about this? Surely they or their family have some resources, is she giving you money for food or has she completely turned his care over to you until such time as she could take him back? I hate to tell you this, but the chances are she may not be able to do that. But because he's technically not your cat, I think you should discuss all this with his owner and at the very least get her permission to help him.

Would your vet be willing to do a visit and bloodwork on a payment basis instead of all at once, that way maybe the owner could give you a little money each month to off-set your cost. I'm guessing but you should be able to get that done for around $100-$120 if they do simple bloodwork to check for glucose and other anomalies. The problem would be if he is showing ketones or other infection, it would end up being more.

There are resources available to help people with vet costs. IMOM is one and maybe Venita will check in and offer some advice. I would just hate for you to try the insulin but Rocky has other issues complicating the FD and making him worse.

Bless you for helping Rocky and your friend!
 
Hi Vickie, thanks for your response.
I do have some keto-diastix already that I used on him yesterday. The ketone test was negative, the glucose was off the chart! Well, not technically. It was brown, which is the farthest color on the chart for this brand, and it registers 2000 or more mg/dl, which is obviously high.
My friend does not have a problem what so ever in me doing whatever is necessary to treat her boy. She just don't have the resources. At least not right now. She has "offered" to buy his food, but as soon as she arrived with him, she asked if I could give him something to eat "until she got to the store to buy some".
That was Friday night when he arrived. He is here, she is gone!!! I am not going to worry about it right now.
I did *chastise* her a little about Rocky and his weight when I saw him for the first time Friday night. I'll admit I was a little upset and it angered me and when I confronted her, I asked when was a good time to try and get him to the vet, when he was dead?!
That was mean, I know it, and it made her a little teary eyed. I know she don't have the money. It just upsets me when I see people who can't even take care of themselves and they go out and get a pet. Like that is going to solve all their problems. Although, I have to say, she didn't go out and just get Rocky. He is 9, and it was just recently that her situation has changed. I should not have acted out like that to her. But, I was angry. No excuse.

My vet doesn't do payment plans. Not even for long term customers like myself. I have brought him patients since he first opened his practice in 1998. He wants payment in full at the counter, before you leave.
And I really can't afford to shell that out right now. My job has me scaled WAY back. I am only working 2 days this week, and that's the first I've had any work in more than 3 weeks! Money is TIGHT!!!

I just almost feel like, everything happens for a reason.
Callie Mae was dx, I got all the supplies needed to treat her, I found this board and all these wonderful people and this wealth of knowledge. Managed to get Callie Mae OTJ, and no longer need all those supplies, only to turn around and take in a cat that I suspect has FD.
Coincidence? Perhaps.
God working his magic through his own way? Could be.
I just know that this is what's going on, and if there is a way to possibly help this kitty, I want to do what I can.

I just don't want to wait to long, because if he is having any activity with his pancreas, now is the time to help it out. I just need to gather some more data. Way couldn't it be later in the week and I have more #'s!!!

ETA: Just got a +4 reading. 411... :o
Granted, +4 really doesn't mean anything, as I have not given him any insulin, but if I were, that would be where we are at!... ;-)
I think I am just going to go ahead and give him a dose tonight, as there doesn't seem to be much input here. I can understand people not wanting to say to much with no dx and all, but I really feel there is no other choice right now. I guess I will just have to figure out if I should start him on a full unit or just a half.
It's really just a guessing game for me, because I did not have to learn a whole lot about dosing. As soon as I made the switch to wet with Callie Mae, we were barely dosing at all before she went OTJ.

Any suggestions????
Anyone???
 
It is a really tough situation, and maybe I have a little different perspective.

It seems to me that you have pretty good eyes, and have tested his bg high. Yes, it could be a bit of stress moving to a new home. It could be a uti. It could be dental. But the fact remains that the cat has high bg. And despite all the other 'coulds', insulin is one of the tools for treating high bg.

You might want to consider liability issues - have the cat signed over to you temporarily? Then if he were your cat, you can think about whether or not you would go ahead and give insulin without seeing the vet. Maybe a little decision tree to assess the options will help.

Its hard to say what I would do in your situation, but atm I'm inclined to think that I would start insulin. Let's be clear though - I'm not advising or even suggesting that is what you should do. Good luck.

Edit - I don't and haven't used PZI so am not avoiding the dose question.
 
Sad to read your prediciment, and not sure what I would do either. Pehaps IMOM could help. Perhaps your friend's family could spot you for the vet visit so you could get a dx? I'd like to see what a vet says - perhaps there is another vet nearby that could help you with lower rates for Rocky? Hope you can help him, and bless you for your efforts. Good to hear about Callie Mae!!
 
Well, sadly, I have decided to not give any insulin, as I don't know what would happen if he is not diabetic.
I can not afford to take him for a vet visit, and I know that is an expense that is out of the question for the owner. At least until she is on her feet.
So, for Rocky, the best I can do is try and keep him as comfortable as I can.
He doesn't seem like himself. He wants to stay under the bed all day and sleep. I have to coax him out just to get him to eat. So far, he still hasn't eaten the half a can that was given to him for breakfast.
Keep him in your prayers.
 
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