New member - help needed

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Patti A

Patti A

Member Since 2021
I have posted on the FB page a bit already but this is the first time in the forum. My Buffy was diagnosed the other week with diabetes and I am trying to deal with it as best I can. At the moment, Buffy is in the ER because she was so lethargic today and she could barely keep her eyes open. She was also smacking her lips as if she was was nauseous. I am waiting to hear back the ER but I can't help but wonder if anyone here has had this issue. I scanned some threads and saw a reference to lethargy but I don't think it was completely answered.

Buffy has other health issues like pancreatitis, an autoimmune disorder that causes pain in her legs for which she is taking gabapentin and dexamethasone and she has elevated liver enzymes to name a few. So I am not sure if it is the diabetes, her medications or one of her other conditions that have made her so lethargic.

Thanks for any input.

Patti and Buffy
 
Hi Patti and Buffi and welcome.
I am so sorry Buffy is unwell. Hopefully the ER will find out what is causing the lethargy.
It does sound as if she is nauseated with the smacking of the lips.
Has she been eating OK until now?
It is possible she could have ketones in her urine or it has progressed to DKA which is a serious illness. This will cause lethargy and nausea, but she is definitely in the right place if this is the case.
It could also be pancreatitis.
She could also be dehydrated, or have a UTI.
All these conditions can be treated.
Are you hometesting the blood glucose yet? I see you have a spreadsheet set up.
Please let us know when you hear back from the ER.
Bron
 
Hi, have heard from the ER vet and Buffy is staying overnight. A recheck of the ultrasound showed that her pancreas is inflamed and may explain the lip smacking. They are planning an evening of IV fluids, blood tests, testing the ketones (although they don't think there is a worry there as BG measured at 7.6). I tested it this morning and she was at 15.9. They are going to monitor her glucose while there. The vet didn't come right out and say it but I think she is a little perplexed at the extent of Buffy's lethargy. It was to the point where she could not keep her eyes open. We are going to try and decrease the gabapentin from 3 a day back to 2 a day to see if that helps. If anything crops up in the night, they will call.
Poor little girl has been at the specialist and hospital 3 times in the past week and a half. Last Wednesday she had joint tap biopsies done and before that the ultrasound. She can not catch a break!
 
Poor Buffy.
I’m glad it is not DKA though.
How much gabapentin is she on? I don’t like gabapentin at all. Three times a day is a lot. That can make them very drowsy.
Is there not another pain medication she could take?
 
Bron, Buffy has been on Gabapentin for years but usually just 2 a day. Why do you not like it? My vet said cats tolerate it well. Lately she has been taking 50 mg three times a day but I think we are cutting back to only twice a day again.
 
Patti A said:
Bron, Buffy has been on Gabapentin for years but usually just 2 a day. Why do you not like it? My vet said cats tolerate it well. Lately she has been taking 50 mg three times a day but I think we are cutting back to only twice a day again.
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I don’t like it because I have seen cats here on higher doses and they get drowsy and wobbly and we had a cat here that died last year from being prescribed too much.
I think going back to 50 mg twice a day is a good idea. If Buffy has been on it for years she is probably used to it but the lethargy she had could have been from the higher dose. Just my opinion. You need to speak to your vet about the best dose for Buffy that doesn’t cause drowsiness but keeps her painfree.
I used tramadol 10 mg twice a day for Sheba and it did not sedate her at all.
How is Buffy now? Is she still in the ER?.
 
The advantage of gabapentin may be if Buffy had neuropathic pain. However, it is likely to do very little for the pain from pancreatitis. If she's in pain from the latter, and pancreatitis is quite painful, it may be contributing to her lethargy. I would also ask about getting her blood pressure checked. Have they re-checked her liver enzymes?
 
Other than fluids, are they giving your cat anything for pain and nausea. (I have chronic pancreatitis and let me tell you, the pain and nausea is over the top.)
The pancreatitis primer will tell you what meds your cat should be getting. Speak out if you have to.
 
Hi all, Buffy is still in the hospital as we are awaiting the test results for the pancreas. All other tests that came in were normal and good. The did check her liver enzymes and they are within acceptable range. The ER doctor said she would call around 6 pm and if the results were not back yet, Buffy could either remain until the next day or if I felt comfortable enough to bring her home we could discuss that.
Thanks for the primer on pancreatitis. I am not sure if they put her on Buprenorphine or not but I assume they would have for the pain.
 
Thank you all so much. My baby is home with me and so happy to see me. And she no longer looks like she can't stay awake. All values were good today so she was sent home with Bupe and Cerenia for 4 days. Will continue to search for an appropriate low fat low carb canned food but she has to like it and eat it. I hate pancreatitis as it seems to come on quickly and be so hard on the babies.
 
I'm glad she's home with you ,did they say why they thought she was lethargic
I'm glad they sent you home with meds
Are you home testing yet?
 
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Might be a good idea to set up your signature, it's at the end of everyone's post in gray

Click on your name upper right hand corner , a drop down will appear , tap in signature , fill out info
  • On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback. There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.
 
So glad to hear Buffy is home again with you and more alert. I’m sure she’ll feel better with the cerenia and bupe. Ondansetron is also very good for nausea.
I hope she will eat for you. Keep us posted!
 
Thanks Diane, I updated my signature hopefully including everything on the list. I am home testing and the did a curve yesterday in hospital. Today Buffy is at 12.1 so no insulin given.
They are not really sure why she was so lethargic but perhaps a combination of things such as the pancreatitis, some dehydration (although I mix her canned food with water to give her more fluids), and the start of insulin. I personally think that
the 3rd Gabapentin that was added about 3 weeks ago also factored in and we are now going back to her usual 2 a day.
I do have a copy of the food chart and will be reexamining it to find a palatable low fat low carb canned food that she will enjoy. After being with a nutritionist from January - May and have her on various vet foods and hating them, I am just glad she is back to eating consistently from what I had her on before.

Thanks all for your help and advice. I will keep updates especially as I am sure I will need further guidance
 
How much (mg) is each dose of gabapentin and how much does Buffy weigh?
My civi Moxie who weighs 8-9lbs has been on 50mg twice daily for years for joint degradation (in addition to Adequan and Dasuquin). It does not make her lethargic.
 
@Patti A
The fancy feast pates are fine low carb
Is the Royal Canin kibble?
Are you using syringes with half unit markings?
So how many units of Lantus is she on?
I see your SS is set up and you said you are home testing can you start entering Buffy's BG on it :cat:
 
@Diane Tyler's Mom
Fancy Feast does have low carbs but the fat is higher than she should have. I have also read somewhere recently that FF have changed some of their formulation and that the old 2017 info chart may not be quite accurate anymore.
The Royal Canin is canned. She hasn't seen kibble for over 2 years now as she struggles with her weight.
My syringes have half units and she does take .5 units only if she registers over 13 in the morning however the ER doc said her specialist notes said that Buffy should only have insulin if she is over 15. That seems rather high.
 
Patti A said:
@Diane Tyler's Mom
Fancy Feast does have low carbs but the fat is higher than she should have. I have also read somewhere recently that FF have changed some of their formulation and that the old 2017 info chart may not be quite accurate anymore.
The Royal Canin is canned. She hasn't seen kibble for over 2 years now as she struggles with her weight.
My syringes have half units and she does take .5 units only if she registers over 13 in the morning however the ER doc said her specialist notes said that Buffy should only have insulin if she is over 15. That seems rather high.
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@Patti A
I am going to tag
@Wendy&Neko to see if she might know of any foods you can feed that are low carb and low fat or might know other members from Canada who might be able to give you some suggestions since she has other medical issues

Do you have any BG numbers to add to your spreadsheet since you said you are using the Alpha Trak,?
 
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Why is the fat an issue? Fatty foods is an issue for dogs and pancreatitis, not as much for cats. I don’t know much about low fat low carb foods in Canada. I fed primarily raw food. A lot of the foods in the Catinfo food chart are available in Canada.
 
@Wendy&Neko , Buffy has pancreatitis issues often and she needs to lose weight. The vets are pushing for low fat diets but theirs always seem to have carbs even in the wet food because they are often slices with gravies. This is the reason that the fat content has to be lower. I tried raw (vets not fans) but with 5 cats, I had 3 who refused and the other 2 were not happy with it.

@Diane Tyler's Mom , I have 2 readings with the Alpha Trak. One on June 21 and then she went into the ER and the one from today. Not sure why updates of spreadsheet not coming through. I thought with the link that they did.
 
Then look for a food that's higher in protein and lower in fats. I just can't give you examples of what ones to use in Canada, because I fed raw. Feeding lower carbs will help her lose weight too.
 
Patti A said:
Not sure why updates of spreadsheet not coming through. I thought with the link that they did.
Click to expand...

One thing on your spreadsheet....you're entering your test numbers on the "US" side. Since you're in Canada, you should enter your test numbers on the "World" tab. That way the spreadsheet will automatically convert the numbers on the US tab for those of us that are used to using the US numbers. Since you just started, I'd probably just delete those 3 lines and start over on the World tab side. Also, are you only giving insulin once per day?
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Chris & China (GA) said:
One thing on your spreadsheet....you're entering your test numbers on the "US" side. Since you're in Canada, you should enter your test numbers on the "World" tab. That way the spreadsheet will automatically convert the numbers on the US tab for those of us that are used to using the US numbers. Since you just started, I'd probably just delete those 3 lines and start over on the World tab side. Also, are you only giving insulin once per day?
View attachment 61348
Click to expand...
Thank you @Chris & China (GA) :cat:
 
@Patti A
I see Chris asked you if you are only giving insulin once per day?
Insulin should be given once every 12 hours
Plus you need to be testing during each 12 hour cycle to see how the insulin is working and how low Buffy is dropping
At least get a test @+3, @+6, and @+9 for both cycles
Vary the test times
Example test @+2, @+5, @+8
Like filling in pieces of a puzzle
Of course if Buffy has dropped really low you will have to be testing more to get her up to safe numbers

We increase or decrease by 0.25 units
We also base how many units to give by how low Buffy has dropped
We don't base how many units by her AMPS or PMPS
If you are not sure if you should shoot or get a low pre shot you can post
? Need help with dose or
Help! Low Pre Shot
 
Part of that process is getting a feel for basic concepts:
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
 
Patti A said:
My syringes have half units and she does take .5 units only if she registers over 13 in the morning however the ER doc said her specialist notes said that Buffy should only have insulin if she is over 15. That seems rather high.
Click to expand...
That 15 is rather high
Since you don't have much data yet, and are quite new to the process, we suggest you don't shoot if you get a preshot number under 200, stall (don't feed) and post for help.

On a pet meter your take action number is 68 which means you have to start feeding to start to bring her BG up. Always post for help

You should also have some medium and high carb food and honey in the house
15% medium carbs
20 % high carbs
 
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@Chris & China (GA) , thanks for the correction on the spreadsheet. I have adjusted and am now on the World Tab. Usually I am not this dense but I must confess that Buffy being diagnosed with diabetes, all this information and then her being in the ER has my mind somewhat rattled.

@Diane Tyler's Mom, Buffy will be seeing her specialist on Wednesday and I will ask about the once a day insulin. She specifically said once a day and so did the ER doc. Not sure if that is because she has just recently been on the cusp of being diabetic and then moved over. I haven't done a curve yet mostly because they did one in the hospital on Tuesday and they did one last Wednesday when she was in for her joint taps. I do plan on doing it.
I do have corn syrup in the house and of course kibble and other higher carb canned foods for my other cats in case Buffy does go hypo and I will try to get into the routine of testing more frequently. I would just like to find out from my vet what her rationale is for the once a day. I do trust her as she finally diagnosed Buffy's autoimmune disorder when no one else could. Everyone including the orthopedic groups was sure it was some kind of muscle or bone issue and it took a year until she went into internal medicine to have this figured out. They still do not have a name for it.

I am so glad for this group and the wealth of information here. I will keep you updated. And thank you all
 
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