New sugar momma with diabetic cat who has swollen face

Status
Not open for further replies.
Carl & Polly said:
If you are starting anew, it would be a fantastic idea if you would start a new thread on the Feline Health forum.
You could link this thread in the first post so that people can see the history.
And there would be more "eyes" to see it there.
Click to expand...


Yes I had planned to write a summary with what we now know about Skinky and her conditions and now various treatments underway, help write up a data informative profile signature, and move it over into Main Health Forum for every thing with the sub q's, how to set up log book spreadsheet and how and what to record in it, further bg testing, structure, practical e.t.c. But need Skinky's okay and approval for that.
 
Carl & Polly said:
I just want to make sure I understand before posting something inappropriate...

Is the plan to not give any insulin after the shot she gave tonight?

If so...
I would never suggest someone withhold insulin without discussing it with their vet FIRST.

NONE OF US are qualified to make that call, nor should we be advising that someone do so.
Click to expand...
Ann, please answer Carl's question. Have you made the suggestion (to Laura) to withhold insulin today and/or the next few days in order to establish what you're calling a base line?

Carl & Polly said:
@Critter Mom
I'm glad to see it wasn't just me that was worried. :)
My kitty Bob (GA), went through DKA and almost died. And cost me a big chunk of my savings account before he got his first shot of PZI. Any time i stumble across "stop insulin", especially in a case where kitty has lots of other things going on, all i picture is "ketones" and all that can lead to.
If you've never been to ketone hell, i hope you never come close. Anyone who has been there knows exactly what i'm talking about.
Click to expand...
Several of us have been worried and for that matter, remain worried for the very reasons Carl mentioned above.

Just a reminder. The recipe for developing ketones which can rapidly turn into diabetic ketoacidosis (DKA) is:

an inadequate supply of insulin + infection/inflammation/systemic stress + inappetance.

Withholding insulin is like sending an engraved invitation for ketones/DKA to walk right in the door. DKA is often fatal and can cost a caregiver thousands of dollars. I'm not so sure a cat in Skinky's condition could survive. Just my opinion.

Ann & Scatcats said:
4998c9e6-79bb-4cbd-8901-e021523e3fcc_zpsc501efd0.jpg
Click to expand...
Ann, have you become a doctor of medicine or a doctor of veterinary medicine in the last couple of years?
I find this picture with what appears to be a stethoscope around your neck unsettling and possibly misleading.

Critter Mom said:
I don't use Facebook. What happened? How is Skinky?.
Click to expand...
Ann & Scatcats said:
Dear Aine, we don't start that again -:)
Click to expand...
Pardon me, but oh yes we will certainly start that again!
Advice (especially dosing advice) is NOT to be given on the FDMB Facebook. You know it. Chris, the Moderator of that group knows it. All caregivers looking for advice are supposed to be directed to this message board. We are a peer-reviewed board. Going forward, please maintain the honor and spirit of this message board. Not everyone is on Facebook. Not everyone is a member of the FDMB Facebook group. Essentially, anything that goes on there is happening behind closed doors so-to-speak.


Getting back to the original question:

Have you made the suggestion (to Laura) to withhold insulin today and/or the next few days in order to establish what you're calling a base line?
 
Jill & Alex (GA) said:
Ann, please answer Carl's question. Have you made the suggestion (to Laura) to withhold insulin today and/or the next few days in order to establish what you're calling a base line?


Several of us have been worried and for that matter, remain worried for the very reasons Carl mentioned above.

Just a reminder. The recipe for developing ketones which can rapidly turn into diabetic ketoacidosis (DKA) is:

an inadequate supply of insulin + infection/inflammation/systemic stress + inappetance.

Withholding insulin is like sending an engraved invitation for ketones/DKA to walk right in the door. DKA is often fatal and can cost a caregiver thousands of dollars. I'm not so sure a cat in Skinky's condition could survive. Just my opinion.


Ann, have you become a doctor of medicine or a doctor of veterinary medicine in the last couple of years?
I find this picture with what appears to be a stethoscope around your neck unsettling and possibly misleading.



Pardon me, but oh yes we will certainly start that again!
Advice (especially dosing advice) is NOT to be given on the FDMB Facebook. You know it. Chris, the Moderator of that group knows it. All caregivers looking for advice are supposed to be directed to this message board. We are a peer-reviewed board. Going forward, please maintain the honor and spirit of this message board. Not everyone is on Facebook. Not everyone is a member of the FDMB Facebook group. Essentially, anything that goes on there is happening behind closed doors so-to-speak.


Getting back to the original question:

Have you made the suggestion (to Laura) to withhold insulin today and/or the next few days in order to establish what you're calling a base line?
Click to expand...


Laura had not really started on Lantus insulin. One vet had told her to give 1 U per 24 hours, on no weight reference on very thin and not eaten for a long while Skinky. As we understood, even Chris, Laura had taken a bg test showing 315, and then given Skinky the full 1 U.
I will copy the entire thread, since I first tried to get her to keep close bg tests on Skinky were that full 1 U was going to send Skinky to avoid a Hypo.
I also said for her to start a Thread in Main Health.


You can blame me without all the facts.
I will get the full fb threads copy.


Plus perhaps translate my entire certified CV and copy paste it where you see I am actually National Medical Trained.
 
Ann & Scatcats said:
Laura had not really started on Lantus insulin. One vet had told her to give 1 U per 24 hours, on no weight reference on very thin and not eaten for a long while Skinky. As we understood, even Chris, Laura had taken a bg test showing 315, and then given Skinky the full 1 U.
I will copy the entire thread, since I first tried to get her to keep close bg tests on Skinky were that full 1 U was going to send Skinky to avoid a Hypo.
Click to expand...
Ann, you've yet to answer the question:
Have you made the suggestion (to Laura) to withhold insulin today and/or the next few days in order to establish what you're calling a base line?
 
Here is letter for letter from the fb post she had made
I am not even a part of that fb group








Kim Edmonsson
What type of insulin are you using?

Laura Cowan
hi, lantus

Jamie Minear
What is she eating?

Laura Cowan
Hills Science AD mixed with a little cat sure

Robyn Hooven Wilson
Oy...what kind of infection Laura Cowan? I know when Penny was OTJ and she had a UTI that her numbers shot up into the 300s and by Day 3 on Clavamox, she was back down in the 60-90 range...

Laura Cowan
Robyn Hooven Wilson: Well, it's a LONG story! She might have cancer, she might have a fungus issue. She is very old and weak, dehydrated. The diabetes is secondary to whatever else might be going on. What is OTJ?

Karen Pattersson Nilesn
OTJ = OFF the juice (insulin)

Robyn Hooven Wilson
"Off The Juice"...off insulin and diet controlled. What's Science AD? The higher numbers are def bc of an underlying issue and maybe not so much diabetes. I'm inclined to not be as aggressive as I would be with a cat who didn't have underlying conditions.

Chris Ronkonski
OTJ=Off The Juice...In remission....I think that since you're feeding the A/D, that's probably why her BG is higher

Mary Madeco-Smith
Off topic on this but did she have an x-ray or ultrasound to confirm possible issues? Just throwing the thought out there. hugs....

Laura Cowan
Oh. So when the kitties are back on insulin do we say that they are "hitting the sauce" again? :) OTJ - good to know!

Karen Patterson Nilsen
LOL!!! Hitting the sauce!!! Bwahaha!!!

Robyn Hooven Wilson
Chris Ronkoski..wouldn't them giving her Lantus just for when a number is over 250 not even effective since Lantus is a depot insulin?

Robyn Hooven Wilson
Can you switch her to low carb food like Fancy Feast or Friskies pates? Most likely her numbers will do down.

Chris Ronkonski
Correct...you can't give Lantus based ONLY on a Pre-shot number

Laura Cowan
REALLY?? Argh.

Laura Cowen
Robyn Hooven Wilson: She's extremely fragile, emaciated and dehydrated. Of the foods I've given her via syringe, this has been the one that she fights/gags least with. I don't think the vets believe she is going to make it. This AD, which is a critical care food, has been decent, so I don't really want to try anything else, even if means something lower carb. for now I'm thrilled that i was able to get a half can into her today and yesterday. Mary Madeco-Smith: long story, finances, questionable vets, her frailness. I was initially directed to a specialized hospital for a CT scan, which would've been 2k. By the time I found a more affordable place for an xray, she was very weak and the vets don't really want to anesthetize her. Right now I"m primarily focusing on getting food into her, keeping her hydrated with sub Q's and seeing if the new medicine will have a positive impact on the swelling around her nose. If I can get her stronger, we'll see what we can do. She doesn't have the best prospects..but she does keep fighting!

Chris Ronkonski
Right now she's having to syringe feed Robyn...the A/D is made for that. She has lots of other health problems right now that are more important than the possible diabetes

Karen Patterson Nilsen
Poor little girl


Ann Pettersson
Laura, fructosamine 500 + and bg 300 +
Start Low, Go Slow
with the insulin
You have given 1 U, test that frequent now spot checks like every 2 hour, like a bg curve
Time of insulin amount
+ 2 hours after, a bg test
+ 4 hrs after
+ 6 hrs
+ 8 hrs
+ 10 hrs
+ 12 hrs

Lantus has a 12 hour duration but can go steep dip fast low if 1 U was to much for first time, so keep very high carb as dextrose sugar, karo syrup, high carb food at hand if hypo low for instant feed

Otherwise I feel 1/2 U every morning and night with 12 hrs apart is the better
Even 0.25 U twice a day 12 hr apart actually to start with
We start very safe

Laura Cowen
But must be done DAILY, regardless of this 250 threshold?

Ann Pettersson
Well Laura, what clock time did you give her the 1 U today? We better set up an high alert watch with spot checks as per the hrs,
First we get through this day, and see what we got
Make an evaluation after this critical 1 U day, then we see

Chris Ronkinski
Laura Cowan...Best to stick to the message board for dosing advice...But in my opinion, you have enough to worry about right now ....Her numbers don't seem to be THAT bad considering everything going on with her

Laura Cowan
Well I have given her two injections before, but i was using the "if over 250" guideline...I gave the shot before I posted this question, so about 45 minutes ago.

Ann Pettersson
Chris, we have to take her through this first high critical day, and Laura knows I have many years and milage down the roads in this, from the Board. I am not gonna send Laura around in a critical movement but work right with bringing her safe through this first high 1 U critical day and night right here.

Ann Pettersson
Laura, do an 1 hr - 1 1/2 hr bg test ... I base that on Skinky's thin state, it goes faster for the insulin then in when it starts its onset action time downwards. You ward off all steep lowerings with giving small amounts fast acting dextrose sugar mixed with water or karo syrup, as first, and then you support fill up with extra high carb food which has longer uptake that's why kicking in slower
I've had to hypo rescue Simba god many times, they start to flick around the eyes, whiskers, then if waiting too long, in entire front body and front legs

Ann Pettersson
Are you okay, Laura??

Ld Squeaky
Laura, I agree with Chris, those numbers aren't THAT bad for all she has going on. Feed her whatever you can get into her - YOU'RE DOING WONDERFUL for her! Heck, PAST wonderful! Yes, stick to the message board for dosing but right now, continue to focus on getting food into her. Her body isn't used to food the last week so hearing all those things should be expected. HUGS and HUGS...

Laura Cowan
Ann Pettersson: Little overwhelmed. :) Just put Skinks in the kitty sauna and gave her some more food and cleared her drainage. So, why I don't PM you and you an walk me through a few things?

Ld Squeaky
Laura, check your 'other' email folder please. :)

Laura Cowan
Oh Robyn Hooven Wilson: that is great! i've been worried if my skink has developed liver issues from not eating. but one CATastrophe at a time. It's encouraging that Tabby eventually ate on her own. I'm sticking with the AD for now...this past weekend I tried some baby food, she gagged. I tried organic boxed chicken broth, she spat it out at me. or on me. the only thing she would eat/drink is cat sure. and this Hills AD is much easier/less messy than the catsure

Ann Pettersson
I have you in stereo now, Laura -:) reading your posts in on FDMB too, saw you didn't get any replies adressing the insulin give questions and only having one test strip left. Tell me if you want to move into under Main Feline Health with new thread title Possible Hypo Alert - Emergency - Skinky and Laura, test strips out too ???

Ann Pettersson
You can add location NYC in that new bright Hypo Alert thread title too, Laura. I am hoping any fellow New Yorkers run to you with test strips then!
Laura??

Ann Pettersson
I go were you and Skinky go, Laura,

Laura Cowan
Hi Ann Pettersson - I don't think she is in emergency or hypo alert? I just administered according to what one vet stated - only if over 250...which I guess his direction was wrong? but she seems ok...I just took her out of the sauna so I can keep an eye on her...

Ann Pettersson
Laura, Rhiannon in under your thread in FDMB has sent you a close by pharmacy pm for test strips check there. Hope you have gotten it.
I am not stereo stalking you -:) Just keeping a close stereo eye, I'm logged in there too and just said Great! to Rhiannon and a thank you

Ann Pettersson
Laura Cowan and Skinky Cowan dears, about 5 hours have now passed, if I have calculated right, since the 1 U insulin give. How are the two of you doing?

Laura Cowan
Hi Ann, we are doing good. She is ok! :) Thank you!! :) :) :) going to step away from the computer for a little bit. I appreciate your strong support and guidance! :)

Ann Pettersson
Okay. As you see I have made a rounding off of tonight's escapads in under the FDMB thread, so for next round with finding out the right bgs and if insulin on that, we set up the test business e.t.c in there. So I am also rounding off here if the two of you are okay and will be okay.

Ann Pettersson
I am going to bed now then, If something, hollow in on the FDMB site.




I actually I need an apology from Jill.
 
You have to be a part of the group in order to post there.

Really, it was a "yes or no" question that Jill asked. It didn't require that you copy/paste from FB. And this is just one of three FB posts that are all being posted in.

I'm not sure what you want an apology for, but if someone said something you have an issue with, report it so that the moderators and Robert can address it.

Can we start a new thread now?
 
I have to agree with Carl that I see no reason for Jill to apologize.....her questions and statements were spot on.

Ann....these long posts on FB stuff are not helping Laura. They are only cluttering this thread and not contributing anything at all. Whatever happened on FB matters not with the exception that no dosing advice is allowed there.

If it were me in this situation, the thing that would help me most would be short, concise posts with support or valuable info/links. Long posts that ramble on about nothing are not helpful and could cause a person to leave the forum.

We need to be respectful of Laura's time.

 
Status
Not open for further replies.
Back
Top