New to this and emotionally raw already

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MamaP

MamaP

Member Since 2012
My 15 year old girl was diagnosed just a couple weeks ago. We came back from vacation to her skin and bones. She is taking ProZinc insulin and right now the only issue is regulation. I woke Saturday morning to her not begging me for breakfast like normal and after a thorough search found her in a closet laying on her back with drool all over and she had pooped herself. Rushed her to the vet and they didn't know what happened. Good news though that her liver function was normal as compared to high when I first brought her in. Went home with instructions to increase her insulin as her levels were 370 in office. Saturday night I made sure that the closet doors were tightly shut and she sleeps at my head usually. She woke me up in the middle of the night seizing. I immediately took a test and her levels were 262. Repeated just to make sure and got 264, so it couldn't be because of too low levels. So, now we know what happened in the closet. Sunday afternoon she seized again but this time her sugar level was too low to register on the meter. I gave her syrup and some dry food to bring her levels back up. Retested Sunday evening and skipped the injection because her levels were at 180. I have since lowered her dosage to prevent another hypo. (I am using a RelionMicro I found by using your spreadsheet)

I don't really need any advice. I am testing frequently and have been reading this board and the suggestions since diagnosis. I guess what I'm really looking for is some emotional support. I was feeling down already and wasn't feeling well this weekend and the seizure episodes have put me on an emotional roller coaster. Ginger seems to be fine. She is running, jumping, vocal, and cuddly like normal. She is even playing like a kitten again and she hasn't been that way in years. She is having a little difficulty putting on weight which I was told to expect until we get her sugar levels normalized. She is 5.8 pounds right now, up from 5.4 when we originally took her in. Not much, I know, but every little bit right now counts. Vet says to continue what I'm doing, testing and adjusting insulin levels by 1/2 unit until we get it right. He says to stay at a dosage for at least two days before further adjustment (pending testing before injection of couse). Nothing more than he could do in the office himself.

I'm thankful for this board and the information immediately available. It has really helped me inform myself and become educated.
 
hi,
So she has had three episodes of seizing? And one of them at least, due to a low reading? What doses were given each time, and what is her dose right now?
Carl
 
Yes, three episodes.
She came home on 3 units and I was told to test and increase by .5 units until we could get her as close to 200 as we could.
So I increased her to 3.5 and was unable to get her under 350 before injection but she was down to the 100's about four hours after.
Moved to 4 for two days by vet suggestion (only checked here before injection in the mid 300's), and the second night was when she apparently had the first episode in the closet.
Vet said it was from high glucose because in the office she read 370. However, she had not had her morning shot yet so it could have just been because her sugar was rising again. I was afraid to give her anything until seeing the vet.
Vet was insistent that it was from extended high glucose. He said give her 5 as soon as we got home and continue to give 5. So, I did. That night she seized and her level was 262 (at time of seizure). So, I did not give her any syrup or anything just kept an eye on her. Tested her in the morning and level was 364, gave her the next injection of 5, but this time I decided to test every two hours to see what was happening.
At 9 am before her shot: 364
2 hours after shot: 324
4 hours after shot: 80 (I got concerned and gave her 2 Tbs of dry food)
6 hours after shot: seizure, Lo reading on glucometer. Gave her about 1/2 Tbs Karo syrup, and 2 Tbs dry food
12 hours after shot (time for next shot) 180 Decided to skip shot

Last night there were no seizures at all, but she seemed kind of hyperactive. She was very vocal and wide awake. When she did try to sleep she did so directly on top of my face. :roll:

At 9 am this morning her sugar level was 345. I am at work, but hubby gave her 3.5 units. We decided to go back low for a few days.
He has not retested her yet, but no problems so far.
I was only testing just before injection and four hours after because we had no problems. Now I am trying to be a little more diligent.
 
OMG a LO :shock:

J.D., my diabetic sleeps at my head and across my face sometimes, too. :razz: His little sister is Ginger.

I don't know that much about the insulin you are using, but it definitely sounds like the dose needs to be lowered. I'm glad you are testing more often, now. Also, I have heard many times that once a cat has a systematic hypo, they are often super sensitive to insulin afterwards. Can your hubby keep testing her, today?

You might want to try posting in the PZI forum to get more specific help regarding the dose, as they know that insulin.

Good luck. Post whenever you want, whether you need support, or help, or just need to write out your frustrations.

Hugs.
 
Holy crap, no matter what her BG numbers were when she was diagnosed, that 3u starting dose was way too high!

Please share this information with your vet. It is the AAHA guidelines for dosing insulin in cats. Don't tell them that you got it from a bunch of crazy internet cat people. It's a document he should be familiar with already. You might ask what led him to determine your cat needed six times the recommended starting dose?
http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf. Scroll down to page 218 for details on dose, and dose adjustments.

The panel recommends a starting dose of 0.25 U/kg q 12 hours, based on an estimate of the cat’s lean body weight. This equates to 1 U q
12 hours in an average cat. Even in a very large cat, the starting dose of insulin should not exceed 2 U per cat q 12 hours
Click to expand...

Your cat weighs less than six pounds. At MOST, the dose should have been .75u every 12 hours. We would have suggested starting at no more than .5u every twelve hours. And in two weeks, he had you up to 5u? That's way too much too soon. Those guidelines recommend a reevaluation after 7 days, and increases no more than .5u at a time. My opinion, your vet is being far too aggressive, and is putting your cat's life at risk. You've seen the scary low numbers already. They came from too much insulin. This isn't a "race". It is good to get the numbers down as quickly as safely possible, because the sooner the numbers are under control, the more likely a cat can go into remission. Prozinc is a good insulin, and you can see that kitty is responding to it very well (too well at the moment). The number one concern, especially at first, is safety. You did well by deciding to hold off on shooting when you saw that 180 reading. And the 345 this morning really wasn't too high considering it had been 24 hours since the last shot, and considering that she went all the way down to 80 yesterday. Going from high 300s to double digits is a huge drop in BG, and it usually causes much higher numbers at the next shot time. You only saw a 180 then.

Please talk to the vet and try to get his logic and some answers before thinking about continuing on these high doses. If your vet says anything higher than "1u" going forward, I would ask for another vet's opinion.

Carl
 
One other thing from reading your posts again. Seizing from high BG numbers? I've never seen anyone here say that has happened. My cat and many others spent weeks in the 300-400 ranges, and I can't recall anyone ever saying they saw seizures caused by high numbers. High numbers cause damage and can kill slowly. Low numbers can kill very quickly once they result in a hypoglycemic seizure. The seizures could also be caused by something outside of diabetes that has nothing to do with BG levels.
Carl
 
When we initially took her in he started her on 2u and hospitalized her. She had very high liver function and was severely dehydrated. They gave her a bag of fluids and the discharging doctor the next day sent her home on 3u on Purina DM dry food (which I now know isn't the best food). I'm honestly not sure why they kept her on 3u. Her initial blood sugar when we took her in was 501. On release the next morning it was 401. We don't know how long she had high blood sugar. My only guess is he was being aggressive because of the critical condition she was in. Luckily her kidneys tested fine.

Her liver test came back normal Saturday, so those seem to be better. I asked a question about food transition in my spreadsheet thread. Perhaps they sent her home on 3 because they had her on the Purina DM dry?

I will call him to see what he says.
 
Poor little darling! And you too! I don't have advice, but I'll be thinking about you both and checking in here and there. If you want to vent and/or chat for moral support, some of us here are new like me and don't have a lot of answers, but we're good listeners!
 
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