New and have questions

My cat, Kiki, was diagnosed with diabetes on 4/19. Her blood sugar was 380 something at the vet and they put her on Novolin 70/30 1.6 units twice daily. I test her every morning and night at 8:30 and give her insulin after shes eaten at 9.

Three test have came back over 200 but very low 200s, highest has been 211 besides the day of the diagnosis. Saturday morning was the highest at 211 and I gave her, her insulin, but I noticed at 3:30pm she was unresponsive and when I went to pick her up she was limp. She came around after about 30-45 seconds of petting and rubbing her but wouldn't stay awake. I took her blood sugar and it was 59. I got her to eat and she started doing better. At 9pm it was 131. This morning it was 181 and I didn't feel comfortable giving the insulin. Tonight it was 204 and I am still just too afraid. I've had a prior horrible event about 17 years ago giving a cat to much insulin so now I'm terrified of it.

I'm wondering maybe if the dose for the insulin is maybe to high? She was on steroids from the beginning of December and we are now weaning her off of those. I am not sure if this is having an effect on the blood sugar as well? Saturday was her first day without steroids. For the rest of this week we are doing every other day with the steroids before we stop it completely.

Just a bit more information. She is very small. She weighs 6.4lbs not sure if that's important or not. I'm also not sure of her age. We found her under our deck and when we couldn't find the owners we took her in. She's at least 7 but this last year she has started to look like she's probably in her teens.

 

Hi and welcome to the forum. I’m writing this on my phone as I am not at home so bear with me if I make a typing error.
First of all please get a hypo kit set up immediately so you can treat a hypo which is what happened to Kiki. I will give you a link at the end. Next time this happens please rub honey on her gums and test the blood glucose 20 minutes later. Hypos are really serious and life threatening events.

You need to reduce the dose of insulin immediately. I would reduce it to 0.5 units. With Novolin you need to feed 1 hour before the dose. So you test the BG, feed wait 1 hour then give the dose if the BG is high enough. I would not give the dose if the BG is under 250. Post and ask for help if this happens.
Novolin is not a suitable insulin for cats at all. I would go back to the vet and tell him you want to swap to Lantus or Prozinc which are much more gentle and longer lasting insulins. I would never give my cat Novolin.
What type of meter are you using?
Steroids can make a difference to the BG levels. I’m not sure your vet know much about feline diabetes.
I am also going to give you a link to our spreadsheet and signature. If you can get those set up that will help us help you.
Please keep posting so we can help you keep Kiki safe
Bron

 

This link will
Give you information about the spreadsheet, the signature and the hypo kit.
I will ask @Bandit's Mom if she will
Look in and maybe help you with the spreadsheet
https://felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

 

Thank you for the reply and the information. I was definitely scared with her being limp but I figured the number wasn't extremely low either. I gave her some friskies lil gravies and thankfully that helped but if that ever happens again I will definitely get her some honey and to the vet. I have an appointment Tuesday to recheck her BG and will talk to the vet then. I'm using Relion Premier I'll add to the signature and work on the spreadsheet.

 

With a human meter which you are using you don’t want the BG to go under 90.
If it goes under 90, give some higher carb food and test again30 minutes later.
Any number under 50 is considered too low and you should give honey and or high carb food. Kiki was most likely lower than 59, especially as she was symptomatic with being unresponsive and limp. You were lucky she came out of it as quickly she did.
Make sure you reduce the dose now. Don’t wait until you see the vet.

 

I really can't thank you enough. I definitely was extremely lucky. If her BG doesn't go up anymore than it has been I may just keep her off the insulin until Tuesday. I know it will probably be higher at the vet than home at least from what I have read, so I'll give them all her BG tests I have done at home. From what I have read on here I also think the food I am giving her may be to high in carbs so I will switch at least to the classic pate...if she'll eat it.

 

@FrostD @Wendy&Neko @Bandit's Mom

tagging a few other folks due to the hypo event and at risk kitty

 

Well not stopped completely we are every other day with steroids. Saturday though was her first day with no steroids for the entire day. Sunday she got them but today she won't. She'll get them again on Tuesday and Thursday then we will be off them completely. I am with you though on stopping the insulin for now. I will definitely test her every morning and night around 8 and see where we are just to make sure she doesn't get to high but as of now I personally haven't seen very high numbers except on the day we left the vet and that day she got two dosages of steroids.

 

If you don’t give any insulin, you need to be testing for ketones the urine. For this you will need a bottle of Ketostix from Walmart or a pharmacy and follow the directions in the bottle. Please get a bottle today and test for ketones.
Diabetic cats can develop ketones in the urine if they don’t get insulin but need some. So I would be posting and asking for advice each time the shot is due. Don’t just stop the insulin until the vet visit unless you are advised to by an experienced person here on the forum
Also make sure you are testing around 4 hours after the dose as well.
I would also not change the food to a lower carb food at the moment without advice from here. That could lower the BGs further. Get the spreadsheet up and running first so we can help you with that.
Kitties that have had a symptomatic hypo can be very sensitive to insulin afterwards so please if you are unsure, ask for advice.

 

Kyle, it is not a good idea to suggest to someone to stop insulin completely and to see how things go after a week. I know you said if it was your kitty that’s what you would do but that does suggest it is meant as advice. I know this kitty had a hypo but if this kitty still needs some insulin and is not getting any, she could develop ketones and DKA if precautions are not being taken.
I have suggested she change insulins but in the meantime reduce the dose and to post and ask for advice if the Preshot is under 250. I have also suggested she buy some Ketostix to test for ketones in the urine.

 

I was just reading about those and can get some today. I definitely think 1.6 units is way to high so I may just give her the .5 if shes showing up in the 180-190s like usual and see where we go. Thankfully there is only 3 more dosages until the next visit but I haven't given her any since the she got so low. We were snowed in until last night and I didn't want to risk anything happening. I'm most worried about the evening dosages. We do have an emergency vet but I've had a lot of bad experiences with them so if I can help it I'd like to stay away from them if at all possible.

 

fair enough, i am definitely not giving advice here should not have posted that

 

Is the spreadsheet not working? I don't know how to change it from it giving a url to just the name of the document I saved it under? Sorry I really never use forums so I am not that great at understanding all of this.

 

I can view your spreadsheet, the way you have it is fine. If you really want to condense the URL, then you have to put URL in brackets around it like this, with the name of the spreadsheet in between the brackets and then end it with a /URL in brackets

 

Yes your SS is working. Sorry I am on my iPhone and it’s hard to see sometimes. I would not give the dose if the BG is under 250 with Novolin at the moment. Novolin hits hard and fast. Make sure you get those tests in around the +3 to +7 range to see how low the dose is taking the BG.

 

Thank you Hendrick think I got it condensed. Also will do Bron and no problems I easily could have messed it up I will also talk to the vet about changing her to Lantus. I was pretty leery of getting insulin over the counter at walmart anyway lol.

 

Her reading was 132 this morning, so again won't be giving insulin. I called the vet and let them know about the drop on Saturday and the number this morning. Unfortunately its my vets surgery day so I'll have to wait for a call back. I just wonder if I changed to the pate and stopped the insulin maybe that would keep the glucose low enough that I wouldn't need the insulin at least until the steroids finish or her numbers get about 250? Sorry all, I know I don't have hardly any data so there probably isn't much to go on. I just feel like if I do nothing I am harming her and maybe if I do, do something I am harming her.

 

If you are not giving any Novolin insulin, it is ok to give a low carb diet. I just wouldnt like to see you try and swap to a lower carb food while you were giving the Novolin and the BGs were not all that high. You could try it while the preshots are this low. Just make sure you are testing for ketones daily.
If you had a better insulin like Lantus you could give a tiny dose of it.
You can give smaller doses than you are giving at the moment but I don’t think anyone would advise you to give any Novolin with a preshot of 132.
Unfortunately we don’t have anyone much who uses Novolin to help you. I would ask the vet about swapping to a better insulin.
Looking at the SS she still needs some insulin….She is not in remission
Let us know what the vet says.

 

You should always have these for your hypo kit
For your hypo kit you want some
Med and High Carb food and some honey



Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Look for some 23 percent carbs also

Or any on the food chart.
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
On your spreadsheet when you don't give insulin can you put NS ( no shot) in the units column

 

Thankfully it seems I have all I need for the hypo kit and will get that all put in container together so everyone knows what needs to be done if we have another episode.

I was able to talk with the vet today and she is taking her off insulin until Wednesday to see how she does, unless her numbers jump back up, and we are going to a low carb diet. I have a case of the fancy feast classic pate so will get her on that right away. I also will get the ketostix tonight and begin testing her urine as well. I'll still ask them to change to Prozinc or Lantus, I think I would just feel more comfortable with something like that.

I really don't know much about diabetes but I am guessing you want them numbers to be pretty close day and night and slowly get them down to normal range?

 

Yes please test daily for ketones. If any appear, that indicates that insulin is needed. Also make sure Kiki is eating well.
can you put what food you are feeding in the remarks column of the Ss please so we can see. Thank you.

The normal range of BG for a cat is 50-120. And to get a strong remission you need to keep supporting the pancreas for as long as possible so it can heal. Stopping insulin too soon….which many vets do, means the cat is likely to fall out of remission

 

I am waiting for her to go to the bathroom now. She is eating well, when she was on the full dosage of steroids she was eating a ton but now it seems she's back to what she was eating before we started them. I am not sure what the vets plan is but hopefully I will know more tomorrow. I won't be able to get a different insulin until Thursday unfortunately.

 

Steroids makes you want to eat more ….happens in humans too.
Encourage her to eat as much as possible…that helps fight ketones as well. Hopefully she won’t get them but it’s always good to monitor for them. Prevention is better than cure!

 

I agree, is there a time of day that is best to test?

 

Whenever you can catch a urine sample is fine.

 

Ok thank you for all the help again. It definitely has helped me understand a lot more and especially the things I need to keep an eye on.

 

Happy to help and to help you understand it all. Knowledge is power. We all started off knowing nothing aboutFD

 

hi there, I was just thinking about this thread and looked at Kiki's SS. Sorry to see the note about lymphoma.

I hope she is as comfortable as she can be.

 

Thank you so much. She is doing really well so far. I do wonder about the diabetes just because I have noticed her eyesight going and coming, which was what had the vet test her for diabetes in the first place. We have been misdiagnosed since January but they did see the tumors in the ultrasound a few weeks ago. I'm just more confused than ever I guess. I really want to thank everyone here. You all helped so much with the the fear I had of insulin. You are awesome and I can't thank you enough.