New Member - Keesha and Alton - Feeling pretty lost and overwhelmed

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Keesha

Keesha

Member Since 2020
Alton is an 8.5-year-old neutered male cat recently diagnosed with diabetes. He was acting very weird at the start of February and was hungry all the time. In June, he got very sick, and I took him to the emergency vet hospital near me; and they thought he had a virus and gave him antibiotics and fluids. And he seemed good after that until our yearly checkup in October when he was finally diagnosed as diabetic. The first few weeks were a little rough. But then we got into a routine, and things seemed to be going pretty well. His pre-shot numbers were a bit high (400s), but he was peaking around 80-100 and still eating consistently. He was on Novolin insulin until 11/25/2020 when the vet had me switch to ProZinc; all went downhill. On Thanksgiving Day, he ate well that morning. He was super lethargic in the afternoon, and BG was at 560, and he was refusing to eat anything. It was a very scary night, but we could get him to eat some treats and pull through. From Friday until Sunday night, he has had numbers all over the place and has very little appetite. I'm lucky if I get him to eat his full serving during the day. He seems more hungry at night, and last night I got hopeful (stupid me) as his eating returned to normal. But this morning, he ate a super small handful of food, and then that's been it. I've been checking BG every 2 hours, and his lowest was 97, so everything seems fine, but he just won't eat. I talked to my vet, and they just went, yeah, this is how it is. Somedays he will eat and some he won't. I just feel so lost when he was so consistent on the novolin, and now I feel like I can't leave his side for a moment because I spend the day trying to get him to eat and make sure his BG stays normal. Any advice or tips would be much appreciated. I am just so scared - this is my baby, I've had him since I was 25, and he's been with me through a lot of stuff. I just want him to be happy and not jumping from near-death to near-death all the time.

Thanks
 
Hello--

I'm so sorry you're going through this with your little guy... I have a couple questions for you:

1) What dose(s) of Novalin and now Prozinc?
2) (related, and very important) Did the vet have you switch the type of syringe (U-100 to U-40) when you switched insulins?
3) Has Alton ever been tested for pancreatitis?
4) Are you testing for ketones at home?

Sorry for the barrage of questions, but inappetance in a cat (particularly a diabetic cat) needs to be addressed asap!
 
Nan & Amber (GA) said:
Hello--

I'm so sorry you're going through this with your little guy... I have a couple questions for you:

1) What dose(s) of Novalin and now Prozinc?
2) (related, and very important) Did the vet have you switch the type of syringe (U-100 to U-40) when you switched insulins?
3) Has Alton ever been tested for pancreatitis?
4) Are you testing for ketones at home?

Sorry for the barrage of questions, but inappetance in a cat (particularly a diabetic cat) needs to be addressed asap!
Click to expand...

Thanks - I am good with a barrage of questions I thought the same about him not having an appetite and I'm feeling crazy but alas here are the answers to your questions:
1) Novalin for 2.5 U and Prozinc 1.5
2) Yes she had be switch needles to the U-40 after Thrusday I have been using the conversion chart found on here as he fights super hard with the U-40s and doesn't feel the U-100 plus the half notches make it a lot easy to get the right dose.
3) Not that I am aware of - at his check up they run a full bloodwork panel but I'm assuming that might not be a routine thing to check
4) Yes and so far all the strips have been "No Trace"

Again Thank you
 
OK, great! Couple of observations:

-- the dose decrease when switching to Prozinc may be part of the problem. Usually when switching insulins, we do a much more equitable dose-to-dose transfer. That said, hitting 97 on the curve suggests he's doing well-- it's hard to say for sure without more data. Would you be willing to set up one of our spreadsheets (FDMB SPREADSHEET INSTRUCTIONS) and input at least the last couple weeks of your BG data? That way, some of our Prozinc people could take a look and interpret how he's doing on the 1.5U.

-- I ask about pancreatitis because that's a pretty common chronic condition with diabetic cats, and a flare can definitely cause them to not want to eat. So it's worth checking if you can bring him in to your vet. You can do a SNAP fPL in-office (usually) for a quick yes/no, or else the SPEC fPL (has to be sent out) for a more detailed assessement of the severity of the flare. There's no treatment per se, but managing the symptoms (pain and nausea, principally) can go a long way towards getting him feel better and start eating again.

--Excellent news on the ketones!!!!
 
-- I was concerned about the dose as well but the vet said it was better to start low. I have added a few weeks worth of data here https://docs.google.com/spreadsheets/d/1-zW2GQoiCHi4CtrDPwkAWuMzFBWozFq_v9Rxsw2pS3E/edit?usp=sharing

-- My vet is a mobile vet and she is out until tomorrow but I can call her then and see if she can come out to run that test for pancreatitis.

He seems perfectly fine other than the not eating. He's been playful and his urination has decreased on the new insulin a lot so it's just the not eating that is super concerning - especially since he has always been such a good eater.
 
Hi Keesha,

Great job getting the spreadsheet up and running. I'm very sorry to hear that Alton's having difficulty eating at the moment. It's hard on both kitty and human. :bighug:

It seems to have been a good call on your vet's part to start at the lower dose because on the evening of 26 November the 1.5IU dose took Alton too low: the lower limit of the normal feline BG on an Alphatrak is 68, and that night he dropped down to 65.

I've not used Prozinc myself so I'm tagging some members with experience to ask them to help you with dosing when they come online.

@Deb & Wink
@JanetNJ

If you don't hear from anyone before your next dose is due then I suggest you consider reducing the dose by 0.25IU down to 1.25IU Prozinc. This is the standard dose reduction advised in the FDMB Prozinc guidelines. If your vet is still open then perhaps give them a call about the dose as well as soon as they're available.

I think some of the black numbers you've been seeing might be due to blood sugar levels 'bouncing' up to high levels as the body responds to a BG nadir that's a lot lower than it has been used to.


Mogs
.
 
Critter Mom said:
Hi Keesha,

Great job getting the spreadsheet up and running. I'm very sorry to hear that Alton's having difficulty eating at the moment. It's hard on both kitty and human. :bighug:

It seems to have been a good call on your vet's part to start at the lower dose because on the evening of 26 November the 1.5IU dose took Alton too low: the lower limit of the normal feline BG on an Alphatrak is 68, and that night he dropped down to 65.

I've not used Prozinc myself so I'm tagging some members with experience to ask them to help you with dosing when they come online.

@Deb & Wink
@JanetNJ

If you don't hear from anyone before your next dose is due then I suggest you consider reducing the dose by 0.25IU down to 1.25IU Prozinc. This is the standard dose reduction advised in the FDMB Prozinc guidelines. If your vet is still open then perhaps give them a call about the dose as well as soon as they're available.

I think some of the black numbers you've been seeing might be due to blood sugar levels 'bouncing' up to high levels as the body responds to a BG nadir that's a lot lower than it has been used to.


Mogs
.
Click to expand...
Thanks Mogs
Yeah the Nov. 26 episode was the first night he refused to eat anything at all and my Vet told me still give the insulin and just watch and test him. When he dipped to the 65 we gave him Karo syrup on the lips and he seemed to pull out quickly after that and resumed eating the next morning(a little bit here and there but still better than nothing). I want to avoid a repeat of that incident it was super scary for me and I'm sure it wasn't a picnic for him either.
 
Keesha said:
the first night he refused to eat anything at all and my Vet told me still give the insulin and just watch and test him.
Click to expand...
:banghead:

With a kitty off its food, a token dose would have been more appropriate, not the full dose. I'm sorry you had such a scare but you handled it well.


Mogs
.
 
I ended up following my gut and just taking him to the Animal ER nearby instead of trying to get my vet to respond. He ended up need to be hospitalized for two days, luckily it wasn't anything major like Pancreatitis or DKA - they believe it was some GI upset that was not resolving on it's own. I got him home last night and things seem to be going well he is on an anti-nausea medication and I was also given an appetite stimulant. His BG was 254 last night PMPS and he ate well (yay!). This morning his BG was 155 so I was told to hold the insulin and let him go about his day checking his BG later in the day. The ER vet's have been amazing and gave me suggestions to where to take him as my current vet gave the bad advice on how to treat him initially when he presented with nausea and not eating. I have an appointment next week so fingers-crossed things start going well. Thank you all so much I might be have convinced myself to believe not eating in a diabetic cat was normal had it not been for all of you.

Again - thank you.
 
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