Newly diagnosed and still at the vet

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Chris & Tucker

Chris & Tucker

Member Since 2012
Hello,
My 14yr old cat Tucker was diagnosed with diabetes last Tuesday, and he's still at the vets. They tell me they still can't regulate his levels. Yesterday they were 50 in the morning, and 350 at night. Although I know nothing about cat diabetes from personal experience, I want to bring him home now. I have a glucose meter and bought a variety of wet food recommended online. Do you think he'd be better off with me monitoring his BG, or should I wait for the vet to release him back to me? 8 days seems way too long.
I have another cat at home, who's 10 yrs old. She has been changed over to wet food already. I've been practicing by checking her BG levels. (They're averaging about 50)
I miss my friend!
 
Are there any complications? Have they mentioned DKA or ketones? There are some complications with high blood sugar that are not treatable at home.

But in general, we don't think cats can be regulated at the vet. They are stressed with all the strange noises and people and may not be eating well. Stress raises glucose levels. Have you asked your vet if you test at home, can you do the monitoring and call in his numbers to the office daily?
 
I'm not aware of any complications. They sent his blood sample for testing and said there were no other problems. I asked if I could bring him home and monitor his levels. They said I could bring him home, IF I would bring him back in to the vet 2x a day for testing. I mentioned Tucker is probably stressed and that could affect his BG levels. They responded with "he's fine, quietly laying in the back of the kennel".
I think Tucker would be better off at home. I think I will tell the vet I will pick him up in the morning.
 
It is hard to challenge a vet, but it makes no sense to me that they need to test twice daily. He's your cat; you're the customer. Maybe take in your meter and show them you can test - compare your meter to theirs on the same sample of blood. (what meter are you using? People have had concerns with the "True" meters. If he uses the AlphaTrak, it will most likely read lower than yours, that's okay. We are looking for trends and patterns; a difference of thirty points is not important)
 
I have the ReliOn Micro glucose meter. I think we will have a meeting tomorrow, the Vet and I.
I have no problem taking my own health decisions into my hands. I guess I'm just nervous with my cat and going into unchartered waters! Thanks for the pep talk!
 
I am confused. Are they wanting to keep your kitty at the clinic until they regulate him?
If that is the case and there is no other condition they are treating him for, then this makes no sense (to me).

It looks like you have prepared yourself for treating his diabetes. Great job!

Unless I am missing something, I would go get my cat and bring him home! I might ask for a very, very, VERY good explanation as to why they insisted to keep my cat in unfamiliar surroundings and away from home for something that could be treated at home. I would also ask for a refund and kitties medical records.

Can we help you find a vet in your area who supports hometesting?
 
ChrisJ said:
Hello,
My 14yr old cat Tucker was diagnosed with diabetes last Tuesday, and he's still at the vets. They tell me they still can't regulate his levels. Yesterday they were 50 in the morning, and 350 at night. Although I know nothing about cat diabetes from personal experience, I want to bring him home now. I have a glucose meter and bought a variety of wet food recommended online. Do you think he'd be better off with me monitoring his BG, or should I wait for the vet to release him back to me? 8 days seems way too long.
I have another cat at home, who's 10 yrs old. She has been changed over to wet food already. I've been practicing by checking her BG levels. (They're averaging about 50)
I miss my friend!
Click to expand...

There is no reason for your cat to be at the vet for 8days unless the cat has some serious life threatening condition, and feline diabetes is certainly not what I call life threatening.

No animal is going to be regulated at a vet office, none.

I would contact the vet and inform the vet that you are picking up your cat and bringing him home today.
What insulin is the vet using? What sorts of dosing has been done?

Seriously, Chris, there is no reason for Tucker to be at the vet for so long. Your vet should have advised you about Tucker being diabetic and told you about giving insulin shots and how to home test. Some cats take weeks and months to become regulated so your money is being wasted by your poor Tucker stuck at the vet, with both of you unhappy. Stress alone could be keeping Tucker's numbers high - the majority of cats test higher at the vet office then return to lower numbers when they get back home.

Call the vet and say you are coming to pick up Tucker and the prescription for insulin - you would do well with Lantus or Levemir - and you can hometest just fine so there is no reason for your vet to deny your taking YOUR cat home. You do NOT have to take your cat to the office to be tested 2x a day; that's ridiculous. I would not wait till tomorrow.
 
ChrisJ said:
Thanks everyone for the support and information. I will be off to pick Tucker up first thing in the morning!
Click to expand...

Great to hear you are picking Tucker up in the morning.
Be sure to get copies of all test results, and get a copy of their notes that contain all of the testing the vet has been doing on Tucker's BG.

I am sure that Tucker is going to be so very happy to see you and to come home where he belongs.
 
and if you do ask for a RX for lantus or levemir, ask for the pens, not the bottles. initial cost is more but these last a lot longer than the bottle. it is 5 pens
 
I've found it helps to show up to the vet armed with information; here are the American Animal Hospital Association guidelines that your vet should be referring to: http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf.
Note p. 218 (4), where it says "Precautions and Details." and explains that home testing is easier and more accurate, and should be strongly encouraged by the vet. It also gives insulin recommendations (Levemir (detemir) works about the same as Lantus (glargine) even though it's not mentioned here, so that is also a recommended insulin). And it also states that IF a vet decides to monitor a cat the first day of insulin (optional since numbers will be stress inflated anyway), after that one day the cat should be treated as an outpatient.

If your cat has been there for 8 days trying to get "regulated", then this shows that your vet does not understand how feline diabetes treatment works, and it actually makes me terrified for your cat that they are increasing the insulin dose there too much too quickly in an attempt to "regulate" him (which is NOT going to happen at the vets office--it usually takes weeks or months to regulate a cat, and you simply can't do it in a stressed environment feeding the wrong diet). It took two months to get Bandit regulated, and 4 months to get Sydney regulated. Also, they may have decided with their stress-inflated testing that your cat needs to be on a large dose of insulin--keep in mind that once you get home and feed Tucker the recommended low carb, canned diet, giving a large dose of insulin can cause a deadly hypoglycemic incident. You want to start with a low dose, around 1u. Do NOT accept a script for Humulin N (NPH) insulin. While good for dogs, this insulin is dangerous and mostly ineffective in cats.
 
Thanks everyone for all the helpful information. I have an appointment at 4 today to meet with my vet and discuss everything. Tucker is comming home with me today! I've printed up the "AAHA Diabetes Management Guidelines" to give to the vet.
 
If your vet is not receptive to this information, do not be intimidated or let him dictate to you. There are many vets who are in alignment with the views expressed on this board and willing to let you be a partner in your pet's care. If you tell us where you are from, members in your area can give you recommendations for vets, if you need them. Once you find a vet who specializes (or is fully knowledgeable in feline diabetes care), your vet expenses will be dramatically lower. I changed from my first vet (after racking up a lot of bills) and could not be happier.

Also...I would say that BEFORE you inject your cat with insulin at home, get the input from the experts on this board (not me) on the dosage. Many inexperienced vets start too high and this causes high fluctuations in the blood glucose numbers -- sending the blood glucose very low and then rebounding to high numbers. And that may be exactly what is happening at the vet based on what you describe above...very low numbers and then very high numbers. But the experts on this board will be able to guide you -- in conjunction with your current vet (if he/she is receptive) or your new vet in the event that he/she is not. Above all remember the motto of the board is "start LOW (related to the insulin dose) and go slow."

You will be fine. This is not as hard as it looks at first -- and the kind folks here will guide you every step of the way.

:)
 
Tucker is happily sitting in my lap purring and giving me kisses, BUT I'm a bit confused !!!!
The vet has him on 6 units of Humilin, at 8:30am and pm. He said his most recent highs and lows were 90 and 130.
I tested him when I got home at 5pm and his BG was 78. He ate some canned food, and spent an hour cleaning himself.
I tested him 2 hrs after eating and his BG was 51. Had me nervous, so I tested him again at 8:30 and his BG was 54.
I don't plan on giving him his 8:30pm dose....

I asked the vet why he was using Humulin and not pro zinc. He said there is a shortage of pro zinc and he can't get the proper amount of it that he needs. He didn't want to start Tucker on it, and then have to switch insulin types.

Should I skip this eves dose?
 
Yes, by all means! You do not want to give insulin to a cat when they have a BG of 51!

When is the last time they gave insulin?

Give them a call tomorrow and ask them for a prescription of Lantus.

Did you get an explanation for why they kept your cat?
 
I wanted to get that out fast.

But seriously, your vet is frightening. Why would he be giving 6 units of any insulin to a new diabetic whose numbers were in the near normal range? Much less a harsh insulin like Humulin. We suggest starting at .5 to one unit and increasing slowly by small amounts. 6 units of insulin is a huge amount!

If I were you, I would continue to test and record the numbers. Meanwhile, I would be looking for a new vet. This advice could have easily killed your cat, if you just had given the insulin and hadn't been testing. You may not need insulin if he stays in these ranges.
 
They gave him the last shot at 8:30 this morning.
The vet told me Tuckers levels went all over the board, going into the 400's and then fell into the 50s a few times. That worried him, and he wanted to keep him until it leveled out more.
 
That doesn't make sense to me. One, Humulin is not likely to give level cycles to any cat, at any dose. It is a harsh insulin that has a rapid onset and doesn't last long. And anytime a cat goes down into the 40-50 range with a harsh insulin, it is logical to lower the dose, not raise it. A vet should realize that the numbers he gets at his office will likely be unreliable. That's why FD specialist vets endorse home testing.

I'm just glad you are testing at home. Keep it up and if he goes above 200, then you'll need to explore a better insulin and I would say, a better vet. Truly, if you had given 6 units at 54, your cat would have hypoed.
 
Chris-
In all seriousness, it would be a really good idea to look for other vets in your area who use Lantus or PZI, and encourage (or at least approve of) hometesting. If you let us know what area you are in, we can probably find someone on the board with recommendations.

Were you able to get copies of the records so you know when they took tests, what the BG's were, insulin increase dates, type of food fed/when, etc. These are going to be important for you to have whether you treat at home on your own, or partner with another vet.

We don't mean to be harsh. So often we see vets with little knowledge of current diabetes research, protocols, and tx. On the flipside, there are just as many out there who will work with you to do what is best for your cat.

I am glad your cat is home. I'm sure you are both thrilled (I would be!). I think you will both sleep better by each others sides tonight.

I think Sue's idea to continue testing is a good idea. I would hold off on insulin a few cycles, depending on where the numbers go. Ask the vet for a lantus pen prescription. I definitely would reconsider shooting 6u no matter how high his BG until things get sorted out.
 
It didn't make sense to me for the BG levels to go down after eating either, especially almost 9 hours after he was injected at the vet.
Also, Tucker seems to be drinking a lot of water. I might be paranoid....
I live in Parkersburg, WV. Anyone know of a good vet?
 
If the numbers go down after eating, it can mean the pancreas is working. This is a good sign!

What larger town is it near or what section of WVA? I sent a pm to Barbara and Thumper in VA. Maybe they know someone in WVa...
 
The vet has him on 6 units of Humilin, at 8:30am and pm. He said his most recent highs and lows were 90 and 130.
I tested him when I got home from the Vet at 5pm and his BG was 78. He ate some canned food, and spent an hour cleaning himself.
I tested him 2 hrs after eating and his BG was 51. Had me nervous, so I tested him again at 8:30 and his BG was 54.
I don't plan on giving him his first home 8:30pm dose....
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Last night I checked Tuckers BG at 11:30PM and it was 68.
This morning at 7AM he tested at 219. Should I hold off on the 8:30AM injection ? Or do I give him a smaller dose?
 
Hi, Chris. I'm from Athens WV. I'm a little too far away to give vet advice, but I thought I'd pop in and say "hi."

I'm glad you brought Tucker home. Sounds like you're on track with feeding and home testing. I don't know much about Humilin, but from what I've heard it's not really a good choice for kitties. It hits fast and hard, then wears out quickly. My boy, Cassie, is on Prozinc, and i haven't had trouble getting ahold of it (of course, one vial last 4-5 months, so maybe I've been lucky). 6u is probably too high. If you're going to be around to keep an eye on things, you may want to try a reduced dose of 1u to see what it does. Check every 3-4 hours and see how low Tucker has dropped. Once you have some sort of idea how he responds to that dose we can find one that works.
 
Thanks Bookw0rm. I need to go to work, so I think I'll NOT dose him this morning.
I hope to find a good local vet to change to a better insulin for Tucker soon.
 
Argggh. Your vet did exactly what I was afraid they were doing, which was use the wrong insulin, not understand how the cat's pancreas works, and then seriously overdose him. Giving 6u of Humulin N in the first week of treatment is insane, and you're lucky your vet didn't kill your cat. I would NOT go back to that vet or take any advice from them for anything concerning his diabetes. If you want, you can try and educate them if they are willing, but with someone that far behind you would be doing all the teaching.

When a cat drops into low blood sugar, their pancreas will release a hormone called glucagon--this is like the opposite of insulin. It tells the liver to release glucose into their blood stream to counteract the low blood sugar. So the more a cat is overdosed and dropping into low numbers, the more their numbers will bounce back up and hit very high numbers. This keeps happening until eventually the pancreas can no longer keep up with the low blood sugar, and you have a severe and potentially deadly hypo incident. That your vet does not know this and kept increasing the dose despite seeing very low numbers is simply unacceptable and very dangerous, in my opinion. You certainly did the right thing NOT giving him insulin once you got home. considering that those very low numbers at the vet were stress inflated already, giving a dose like that at home once your cat relaxed and his blood sugar had lowered some would not have ended well.

Here's the dosing protocol for Humulin N: http://www.uq.edu.au/ccah/docs/diabetesinfo/link2.pdf. Note where it says "Lente [Vetsulin] is the 3rd insulin of choice and NPH [Humulin N] the 4th of choice insulin for control of diabetes mellitus in cats, behind glargine [Lantus] or detemir [Levemir] (1st choice) and PZI (2nd choice), Lente and NPH result in lower remission rates compared to longer acting insulins." Also note that it states the dose is not to exceed 1u for the first week, and not raised by more than 1u every two weeks.

However, I would get a different insulin ASAP. Humulin N has a very low remission rate and is pretty ineffective in cats because of it's poor duration of action with cats' faster metabolisms. Call around to other vets in your area and ask if they prescribe Lantus, and/or say you have a diabetic cat that's already been diagnosed by another vet and you want to switch to Lantus. You should be able to find someone who'll be able to get you the script.

Here's an article that you can also bring to your or a new vet to get the prescription, if you encounter some resistance.


Here's a link to the dosing protocol for Lantus that's outlined in the article, which has the very high remission rate: http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf. This is very useful information to have because some vets can be great in most aspects of treatment, and then not know how to correctly dose the insulin in cats (many want to raise the dose too much to quickly, albeit not at the same insane rate your current vet did).

Sorry if this post sounds a little rant-ish. Most vets don't know every single detail of diabetes treatment with cats, so it's very common for diabetic cat owners to stray from their vet's advice once they've educated themselves. Vets are general practitioners that must know many general things about many different diseases for many different animals, so it's unrealistic to expect every vet to get feline diabetes treatment perfect. As long as the vet is fine with you taking charge of your own cat's treatment a bit (and many vets welcome and encourage this), then getting something wrong is not necessarily a reason to leave your vet. However, given the dangerous nature of your vet's treatment, I would not only leave, I would make them very aware of exactly why I was leaving, because it might just save the life of the next diabetic cat that shows up at their office. I'd also put up a huge stink about the bill for keeping your cat and subjecting it to their "treatment" for eight entire days. If you've paid the bill already, I would demand at least a partial refund--what they did is ridiculous.
 

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The vet has him on 6 units of Humilin, at 8:30am and pm. He said his most recent highs and lows were 90 and 130.
I tested him when I got home from the Vet at 5pm and his BG was 78. He ate some canned food, and spent an hour cleaning himself.
I tested him 2 hrs after eating and his BG was 51. Had me nervous, so I tested him again at 8:30 and his BG was 54.
I don't plan on giving him his first home 8:30pm dose....

Last night I checked Tuckers BG at 11:30PM and it was 68.
This morning at 7AM he tested at 219. Should I hold off on the 8:30AM injection ? Or do I give him a smaller dose?
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When I checked his BG at 8:30am it was 235. I decided to stay home and give Tucker a 1 unit dose.
He was very active and ate well. I checked his BG at noon and it was 24 ! Quickly gave him a gravy pouch of food and retested an hour later at 56. He's very alert, tail wagging and walks without a problem. Just pooped in his litter pan too! (found out he didn't last night, and pooped on the carpet twice) Not sure where he's peeing. Sophie the 10yr old maine coon is growling and hissing at Tucker anytime he gets near her. I guess she liked being #1 cat for a week.

The vet is out of the office till tonight. I talked with the assistant and explained I want to switch Tuckers insulin to Lantus, and for the vet to call me back.
Should I have them order the vial or pens? Are they very expensive? ..or should I ask for Pro Zinc from another vet? (mine can't get enough )
Thanks Julia and Bandit, Sue and Oliver, Carolyn and Latte, MelanieP and Ninja.... and everyone else.
I keep rereading the info, hoping it sinks into my head!
 
Chris: The BG of 24 you got today is an EMERGENCY! You need some expert eyes on the insulin and dose moving forward. I would tell you that you never give insulin or increase the dosage based on one BG test (though it is hard not to have that knee-jerk reaction to give insulin when you see a high number). It just doesn't work like that. Tucker's BG of 235 this morning could have been high because his BG fell low yesterday (sometimes their body releases glucose to combat the low BG due to insulin) and had you not stayed home to watch Tucker, it would have been a hypo situation (with a BG of 24!). Julia explained this nicely in her post from earlier today.

Experts: Should Chris discontinue the Humulin and wait to see what Tucker's numbers look like for a day or two before starting Lantus (this is assuming his vet will give him a prescription for Lantus)? I ask that because he got some pretty low numbers last night and dangerous numbers today (24 on 1 unit); and if Chris is planning to switch insulins, would you not want to get a feel for what Tucker's BG is going naturally (since he is swinging so wildly on just 1 unit of this Humulin)?

Chris, this is not a recommendation, it is a question for the experts here. They need to guide you on what to do today, tomorrow, and how to safely switch to the Lantus or other insulin. I would advise you to do NOTHING with the insulin until someone here provides guidance, and continue to check Tucker's BG levels.

As to the cost of Lantus, I use it and it is expensive -- something like $120 for a vial + the syringes (you have to use U100 syringes with this insulin) -- but the good news is that the vial can last up to 6 months if properly refrigerated and handled -- so over time, the cost is not that much.

PS: You might want to attach the 911 icon above to your post, as numbers like you got today are an emergency. You will get more responses that way. PS: You handled the hypo numbers like a pro!
 
Hi MelanieP,
I was worried about not giving his 1st home dose last night, and really questioned not giving a dose again this morning. I can't believe it dropped that low with only 1 unit. I called the gluco-meter company to send me a "control" sample, just to make sure it is working properly.
What would you have done with a BG of 235 ? Is there a reference chart I could study as to levels?
Yesterday I felt good making the decision not to give the evening dose of 6 units, which probably would have killed him.
Yet today, with 1 unit, I could have killed him. I'm a wreck.... he had no symptoms at a BG of 24.

He's eating wet canned food only now. No dry at all. Not the DM food the vet was. Maybe that's causing the swings?
The cost of Lantus would be doable for me. Are pens better value overall?
How often should I be checking Tuckers BG levels? He's patient with me not always getting it right and having to redo it. Poor thing will have sore ears!
I normally work 8:30-5, plus a lot of evenings and weekends. This will be tough.....
 
I did a google search and it looks like there's a VCA hospital near you:http://www.vcahospitals.com/dudley-avenue. Your first exam is free, and I'm pretty sure that VCA requires that their vets remain currrent, and I know that all vets at VCA near me (in Syracuse, NY) prescribes Lantus, and recommends hometesting (they may try to sell you an alphatrak pet meter, but you just say no thank you. We all use human meters and they work just fine since all the dosing protocols are written for human meters anyway). I could be mistaken, but I believe that treatment guidelines are the same for VCAs throughout the country, but I would call or make an appt. (since it's free anyway), and talk to them about Lantus. Go armed with information, as well as your cat's records.

If that doesn't work, I would just start calling Parkersburg vets near you and ask them if they prescribe Lantus or Levemir to any of their diabetic cats, and if they support home testing (If they say yes, but we want you to buy the Alpha trak, that's fine--you can just tell them once you get theere you're already home testing with your human meter. Vets make $ off the Alphatrak so some vets push them). When you get a vet that says yes and yes, make an appointment. Parkersburg is big enough that I am sure there is a good vet somewhere in town. It just may take several phone calls to find them.

Lantus and Levemir have the best remission rates in cats, so I would start with one of those. Get a script for the pens, because even though they are more expensive up front, they save you a ton in the long run because you use almost every last drop of insulin. They'll last you at least 6 months, but more likely a year or more. A 10 ml vial will go bad before you can use it all up. Do not get the needle tips that come with the pens, get script from the vet for .3cc, 5/16", 31-33g syringes with half unit markings. You can get a box of 100 at Walmart for about $13 bucks. Walmart or Costco pharmacies usually have the cheapest prices on insulin, too.

Here's the link to $25 off coupons for Lantus or Levemir pens, whatever you get: http://felinediabetes.com/FDMB/viewtopic.php?f=15&t=36964. Lantus makes you fill out a questionnaire now before you can print the coupon, just fill it out in your name but you can answer with your cat's info (for example, feline diabetes is close to type II) and use it anyway. There's nothing that restricts it from being used with veterinary scripts.
 
ChrisJ said:
Hi MelanieP,
I was worried about not giving his 1st home dose last night, and really questioned not giving a dose again this morning. I can't believe it dropped that low with only 1 unit. I called the gluco-meter company to send me a "control" sample, just to make sure it is working properly.
What would you have done with a BG of 235 ? Is there a reference chart I could study as to levels?
Yesterday I felt good making the decision not to give the evening dose of 6 units, which probably would have killed him.
Yet today, with 1 unit, I could have killed him. I'm a wreck.... he had no symptoms at a BG of 24.

He's eating wet canned food only now. No dry at all. Not the DM food the vet was. Maybe that's causing the swings?
The cost of Lantus would be doable for me. Are pens better value overall?
How often should I be checking Tuckers BG levels? He's patient with me not always getting it right and having to redo it. Poor thing will have sore ears!
I normally work 8:30-5, plus a lot of evenings and weekends. This will be tough.....
Click to expand...


Yes 24 is a hypo situation! Keep checking his BG. Do you have any higher carb (gravy) canned foods at your house? Can you run out very quickly and get some? What about karo syrup or honey, or perhaps some high carb treats? You want to boost his blood sugar and get it back into a normal range. Luckily, Humulin N wears off quickly (within 4-6 hours).

You may want to test him for a few days on the low carb diet before giving any insulin at all. About 25% of cats go into remission from diet change alone. Also, I'm pretty sure your cat had several hypo incidents at the vet--after a hypo incident cats are often very, very sensitive to insulin.
 
What would I have done? Based on Tucker's numbers last night of 78 and 51, when I saw the the spike this morning of 235, I would probably have given him nothing (particularly since the Humulin driven numbers are kind of meaningless anyway). Tucker's numbers have been fluctuating so wildly -- even on 1 unit, and as Julia pointed out, Humulin is not a good insulin for cats anyway. Julia is an expert so I hope she will read this and post again to give you guidance. There are many other experts who will probably check the board throughout the afternoon or maybe this evening (after work). If it were my cat, I would give no insulin for a day or two just to see where the real BG numbers are. If you were switching from any other insulin than the Humulin, you might be able to estimate this -- but it seems to me that the Humulin fuled BG numbers are worse than NO numbers on which to base a starting dose. Do you think your vet will prescribe Lantus for you? If so, that will be a very positive step forward.

Until you hear from the experts on this though...do not give more insulin. Honestly Chris, I have seen, just in the last month when someone's cat goes into hypo BG numbers -- like Tucker did today -- that assuming the cat doesn't die from this, sometimes they come out the other end not needing any insulin at all. Strange but I have seen it happen here recently. NOT something anyone would want to risk intentionally; but what I am telling you is that Tucker's insulin needs may have been greatly diminished by what happened today -- so give NOTHING until you hear from experts like Julia or others.
 
Chris: Based on what Julia is saying above, assuming you gave the Humulin this morning at 8:30 EST, you should be out of the danger zone so you would not need to keep feeding high carb foods. Is that right Julia?

J
 
Excellent....Julia posted while I was still writing! Chris, as you see she recommends trying Tucker on a low carb diet with no insulin for a few days and checking his BG levels. That way you can see if he still needs insulin at all...and if so, what level will work best for him. I agree with Julia about getting in to see a vet who routinely prescribes Lantus and is supportive of hometesting. You might want to delay picking up your prescription of Lantus for a day or two -- on the off chance that Tucker may not (paws crossed) need it anymore. Might save you a few bucks.

Julia, you are the BEST!!!!!!!!
 
Sorry, I guess I am confused--he does not have a BG of 24 right now, but it was 24 earlier today? How long ago?

I would wait 5-7 days and keep testing a few times a day before giving any more insulin. As I mentioned, about 25% of cats go into spontaneous remission from diet alone, and on top of that your cat is probably sensitive to insulin from the probable hypoglycemia at the vet.

If you see numbers start to creep up into mostly the 200+ range, then you might want to start insulin (I would get that script for Lantus, but wait to fill it until you're sure he needs it).

You don't want to give insulin based on one higher number; when a cat goes to low, their blood glucose will spike afterwards. You need to get several tests throughout the day, and see what the overall picture is.

How is Tucker's weight? Is he overweight/underweight at all? That can make a difference in how long you try diet change before starting insulin.
 
OK, the 24 was about 3.5 hours after the 1u dose, and an hour later (after feeding) he was at 56? You do need to check again to make sure he isn't dropping back down. Humulin usually peaks by +4 after the shot, but you don't have a long enough history with Humulin to know that for sure. If you see a lower number than 56, feed him some more. If he'll be satisfied with just the gravy you can give him that (that's where most of the carbs are) so that his belly doesn't fill up too much.

Carl
 
fwiw, i wouldn't do anything for the next couple days. don't contact the vet, don't order any other insulin, and don't give any insulin. kitty has been overdosed now for at least 8 days. their body is freaking out. that is what is causing the swings in the numbers. i would just feed and spot check for a couple days and let kitty's body calm down, readjust, and go from there. if let's say, you do nothing with insulin for the rest of today and tomorrow and late saturday/sunday he's sky high (300+) then i might contact the vet about getting a prescription for lantus and then start on a miniscule dose, probably 0.25 to 0.5 unit twice a day.

you're probably gonna see higher numbers again today but that is to be expected from dropping way too low today. the body will try to save itself. whatever you do, don't react by shooting more insulin.

if by chance the diet change was enough and the numbers don't climb back up over the weekend, you won't have to get any insulin at all :-)
 
Great advice from Julia and Cindy. And if you do end up needing insulin, I would agree - go with Lantus or Levemir. Get tje 'scrip now so you can pick it up quickly if you end up needing it.
There is a current shortage of Prozinc and you would probably have a hard time finding it.

Carl
 
Julia & Bandit said:
Sorry, I guess I am confused--he does not have a BG of 24 right now, but it was 24 earlier today? How long ago?
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Julia: Chris said it was 24 around noon EST; he fed gravy meal and got it up to 56 at 1pm. Original shot was 8:30 am. So I think he weathered the hypo ok, but was concerned that he needed expert guidance about discontinuing the Humulin and how to get started on the Lantus. As I told Chris, if it were my cat I would just stop the Humulin immediately...but wanted to get expert opinions on that since I don't really know. But I think the recommendation to stop insulin for a few days and see what the levels look like naturally makes sense. Thanks again!
 
Here's a link that tells you how to set up a spreadsheet to keep track of his numbers (like you see in many of our signatures): http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

When you get a chance, set one up and post it in your signature. It's incredibly helpful not only in letting you visualize your data, but also in putting in a form that makes it easy for people here on the boards to give you dosing advice.

All I have to say, thank goodness you were so proactive in educating yourself while Tucker was at the vet.
 
Chris: Make note of these names -- the diabetes cavalry, so to speak -- Julia & Bandit, Carl & Bob in SC, Cindy + Mousie, and many others -- are all experts at this and can give you good solid advice moving forward. You can send them a private message if you need to (the PM button to the right of the name) or if you have an emergency, just post here using the 911 icon and they will swoop in to help you. Just like the cavalry. Thanks guys!!!!!!!!!!!!!!
 
I just checked Tuckers BG and it's 110.
Earlier with the 24BG at noon, I gave him a foil package of a gravy food. He has eaten some Classic FF that I put out since then too. My Maine coon was hungry.....

It helps not feeling totally alone in this situation... Thanks all
 
Good. The 110 indicates the worst is over and he's back into safer numbers.

Carl

And now that you joined the board, "alone" isn't going to happen again. :smile:
 
you're definitely out of the woods today so no need for more gravy or karo

that number may be up due to the gravy so it might drop back down a little as the effects of the gravy wears off. it very well could continue up a bit though due to the body kicking out it's reserves to protect itself. just tell Tucker it's ok, you guys are taking the day off, take a deep breath and enjoy the rest of the day.
 
Don't forget to check BG readings over the next few days and update your post daily to provide Tucker's BG readings without any insulin. That way the experts can guide you on next steps. I can help you set up a spreadsheet if you'd like. Just send me a PM.

Melanie
 
I will keep Tucker off the insulin until further notice. I will try and get to the spreadsheet to fill in numbers. I have a big work project to work on, so I might just post his BG numbers.
I will call the VCA Animal Hospital as suggested, just to check about the Lantus availability. They're pretty close.
Thanks again to ALL !! I think I need a nap....
 
OK.... Tuckers BG at 6PM was 223. At 9PM tonight it's 406. I tried to put together the SS, so I hope that helps.
From what you guys taught me, this high spike is expected after the very low BG this morning.
Tomorrow morning hopefully it's a bit down?
 
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