Need STAT help with dosage - please!

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Buffy has my Heart

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I'm taking Buffy to emergency vet to see if they'll administer subcutaneous fluids with electrolytes but need help with insulin dose before I leave.

She's still having small amounts of diarrhea, some vomiting. She had mirtazapine about 9:00 p.m. and vomited an hour or so later so don't know if it took effect. Does not appear to have done so.

Anyway, I've forced some broth and she voluntarily ate some freeze-dried chicken. I don't want to hurt her further but don't know what to do about dosing a 360 bg. Should I dose as normal even though she's not eating normally? This number is high for her as her normal high lately is around 320. Normally has 1.0 unit twice daily but lately 0.5 unit.

Should I dose her normal 1.0 unit?
 
That is an excellent question and I don't know the best answer. Are you using Lantus? Do you normally post in the Lantus group? I see you just joined a few days ago -- have you posted Buffy's history anywhere here yet?

Rule of thumb when the kitty is not eating is to wait on the insulin -- since you are going to the ER vet -- I would leave it to them -- take along your insulin and syringe and if they say go ahead -- then you're ready.

Giving SubQ fluids affects the insulin / blood sugar too.

Or it might be best to have the ER vet monitor and give a little bit of R insulin which is a fast acting insulin that only lasts 4 hours. Is Buffy going to stay overnight?
 
Want to add, I've been giving the lower dosage of 0.5 unit because it's been keeping her under 200 and emergency vet had told me not to dose her if under 200, but I was afraid not to give something.
 
Phoebe_Tiggy_NortonGA said:
That is an excellent question and I don't know the best answer. Are you using Lantus? Do you normally post in the Lantus group? I see you just joined a few days ago -- have you posted Buffy's history anywhere here yet?

Giving SubQ fluids affects the insulin / blood sugar too.

It might be best to have the ER vet monitor and give a little bit of R insulin which is a fast acting insulin that only lasts 4 hours.
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Hi. She's on ProZinc.

No, haven't had time to post much, just ask questions. I work full-time, take care of my elderly mom, and I'm getting my first grandbaby this week so I'm completely stressed and can't think!
 
If your kitty is newly diagnosed, then not giving insulin when under 200 is a good recommendation.

If you've been treating a long time, and you've done many curves to know how Buffy is using the insulin -- then you may have proof that it is safe to give insulin at a lower blood sugar.
 
Dear Buffy has my Heart, and, of course, you too, sweet Buffy,

Since you're taking her to the ER vet, I'd let them decide dosage while treating her.

I don't know what insulin Buffy is getting, so I'm hesitant to suggest dosing. That said, and since she voluntarily ate some freeze-dried chicken, if she's keeping it down, I'd tend to give her a bit of juice. 360 isn't wonderful; but, it isn't that bad. Trust me.

I'll be looking for your updates whilst praying she's going to be okay. Cats are very resilient and baffling creatures...

So are parents of aforementioned cats...

Love and countless hopeful and encouraging hugs,
Deb and Nikki -- and, Giz, who taught me volumes about being reslient...

PS: Do you have Keto-Stix? Are you catching pee? You need to consider doing that.
 
Hi everyone. Thank you for your thoughts and prayers. Just now got in from the vet. She got subcutaneous fluids with electrolytes, a shot for nausea, and a sulfa antibiotic that she's to begin tonight after 8:00pm. From her history, emergency vet believes she's had a bad reaction to antibiotics, especially metronidazole, as I began it again on Friday and that's when the vomiting and anorexia began again. Since I had been through it I knew not to dose her again. Then the Zofran her vet called in did not help matters at all. She also suggested some other tests such as for pancreatitis - which is next. But she's been getting fluids for a week now so maybe I've gotten a jump-start by doing that.

I do have ketostix and that has been negative, was negative at the vet as well last week. I've spent over $1200 and every test has been negative so far, with exception of bacteria in urine - we're still awaiting the culture results. Before the really bad stuff, she was found to have a mild UTI and was given Convenia, ugh :( When I took her in the following week, her urine had blood and her UTI was worse, started on clavamox, on top of metronidazole for the diarrhea, and everything got worse.

Anyway she was scheduled for pancreatitis screening test but I was sick and could not drive so had to cancel. Will try again Tuesday. Emergency vet suggested she may need vitamin B12. Her vet has never mentioned that so I'm not sure if they even have it. Does anyone know if this is something I buy somewhere myself? I was asking the E-vet so many questions but that slipped my mind. I'm really worried because I changed meters and I believe this new meter may be wrong and I've been dosing wrong. I hope I haven't caused damage, but I'm sick about it. Now I know that it's about 50 points off from the one the vet uses.

Sorry I didn't post her insulin - it's ProZinc, 1 unit twice/day, has been diagnosed diabetic for a year and I've done several curves. Here lately though 1 unit drops her 200 points and since she wasn't eating but very small amounts, and was hovering just above 200, I was frantic about what to do so I've been doing 0.5 unit.

Thanks again for your help - very grateful. I'll check back for any advice after I eat a bite and rest up from a long and sleepless night :)
 
Hi - I would suggest that you edit your first post title to say you're back from the ER Vet with an update and questions, OK?

Regarding vitamin B12, you can get human vitamin B12 at health food stores or pharmacies -- I'll see if I have a link -- it can be crushed up and mixed into food. No worries about giving too much - it does not build up in the body -- which also means that you need to give it every day for a long time for best results.

Can't find the link -- someone else will come along and post it --

There are two types of Vitamin B12 - Methyl B12 is the one you need to get.

Here is a link to more info about it:
http://felinediabetes.com/weak-back-rear-legs.htm
 
Typically, cats that are insufficient in B12 need B12 injections vice oral B12 since they likely have problem absorbing B12 from the GI tract. The standard dose is 0.25 grams (250 mcg) weekly then less often. You can get your vet to write you a script and use your insulin syringes to inject it.
 
Phoebe_Tiggy_NortonGA said:
Hi - I would suggest that you edit your first post title to say you're back from the ER Vet with an update and questions, OK?

Regarding vitamin B12, you can get human vitamin B12 at health food stores or pharmacies -- I'll see if I have a link -- it can be crushed up and mixed into food. No worries about giving too much - it does not build up in the body -- which also means that you need to give it every day for a long time for best results.

Can't find the link -- someone else will come along and post it --

There are two types of Vitamin B12 - Methyl B12 is the one you need to get.

Here is a link to more info about it:
http://felinediabetes.com/weak-back-rear-legs.htm
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Thanks! I'll edit title. I'll ask vet about the B12 today.
 
Re: Need STAT help with dosage - back from vet, some questio

Larry and Kitties said:
Typically, cats that are insufficient in B12 need B12 injections vice oral B12 since they likely have problem absorbing B12 from the GI tract. The standard dose is 0.25 grams (250 mcg) weekly then less often. You can get your vet to write you a script and use your insulin syringes to inject it.
Click to expand...

I'm going to call as soon as GI vet is open and re-schedule the pancreatitis test. Hopefully they can see her today, and if pancreatitis, start treatment. From what I can tell, most of the treatment would be what I'm doing now.....subcutaneous fluids, supportive measures, keep her eating. I did read something about IV fluids and nutrition in order to rest her pancreas, so that might be necessary, but I agonize over leaving her at the vet.

In the meantime I'll call her regular vet and ask if they checked her B12 in all the b/w they've done lately. It seems like they would have told me if she had been deficient; although I was told by her regular vet that she had done all she could do. Didn't like that. The emergency vet gave her a sulfa antibiotic that the regular vet never offered, even though I specifically requested a different antibiotic and something in liquid form that she could tolerate. E-vet gave her Albon. It hasn't caused worsened symptoms and she doesn't balk about it. I do understand that some medications are better at treating some ailments, but there's no benefit to any drug that makes her vomit.

I'll be asking about the B12 injections. She doesn't mind injections at all. Thanks.
 
Someone else may have already pointed this out, but you want a kind of methyl B12 (methylcobalamin) that does not have any xylitol or other sweeteners/flavoring ingredients in it. These can be poisonous to cats. I personally did not have any luck finding it at regular drugstores/grocery stores with pharmacies. Some people on here recommended this kind: http://www.ilifelink.com/zobaline-for_d ... blets.html

Unfortunately I never got to try it because my cat had to be put to sleep for other health problems. But anyhow, I've seen the recommendation here before. I'm sure there are others that would work, though.
 
saimasmom said:
Someone else may have already pointed this out, but you want a kind of methyl B12 (methylcobalamin) that does not have any xylitol or other sweeteners/flavoring ingredients in it. These can be poisonous to cats. I personally did not have any luck finding it at regular drugstores/grocery stores with pharmacies. Some people on here recommended this kind: http://www.ilifelink.com/zobaline-for_d ... blets.html

Unfortunately I never got to try it because my cat had to be put to sleep for other health problems. But anyhow, I've seen the recommendation here before. I'm sure there are others that would work, though.
Click to expand...

saimasmom - thank you for your reply. I'm so sorry to hear about your Saima. My heart goes out to you. I recently had to put my Yoyo to sleep [she and her brother and sister were carriers of feline leukemia from their mother]. She made it to 15 and was healthy and happy up to that point. She then went downhill very quickly and we knew we couldn't let her suffer any longer - but it is one of the most heart wrenching decisions there could be. Please take extra care of yourself and cry when you need to ((((hugs))))

Just like you, I've done a lot of research trying to find answers and was not sure who to trust, but I trust the folks here to lead me straight, even more so than her regular vet - which is sad. So I come here and arm myself with info and knowledge in order to help my furkid.
 
Thank you so much, and in turn I am so sorry about your Yoyo. I'm glad you were able to give her such a wonderful life. Hugs to you as well, and best of luck with your Buffy! It sounds like you are on the right track.
 
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