Official introduction, advice needed? (hypo epidsode)

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Drea

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Hello! It appears that I've registered here before, but am unsure if I've posted. My father's cat was diabetic, but now my cat has been diagnosed diabetic. Hence why I'm here. :)

My name is Drea, and it's nice to "meet" everyone! Thanks in advance for any and all advice you might have!

So here's my question.

This afternoon, Zoe Asha had a mild hypoglycemic episode. I took care of it immediately with karo syrup. I'm unsure of her numbers-I can't test her, she really won't allow it. I pray every time I give her a shot she'll let me do it, lol. She's a twice a day girl, so her episode was at about noon. It was a result of being under the bed. She was hiding there from the vacuum cleaner, so she didn't get out to get something to eat, I think her sugar dropped too low there. At least, I suspect.

Should I give her the 3 units that I'm supposed to give her at around 7 or 8? She's recovered nicely at this point, I've been watching her. Just worried.

Thanks!
:)
 
If she had a hypo, the normal thing to do is to reduce the dose.

And without hometesting you are really flying in the dark, both when it comes to the 3 U and hypos.
 
Can you tell us about your attempts to test her? It is hard at first, but we all have ideas that helped us.
We used the kitty burrito at first. We wrapped Oliver up in a towel with only his head showing. We could poke his ear and give him his treat and then undo the towel.


The only way to keep her safe is to test. Otherwise, you are guessing and shooting blind.

What kind of insulin?
What do you feed?
 
I wonder what it is about the vacuum cleaner they find so terrifying? Even my brave cat freaks out if she so much as sees it lurking in the closet. :( Sorry you're having problems testing and dosing Zoe Asha. I understand how difficult cats can be even when it's for their own good. Still, if she had a hypo, it would be great if you could give home testing another try. I used extreme bribery with Tuna Flakes and a firm hand to test Scout, but then she's a really easygoing cat.

I would definitely reduce the dose. They have to be pretty hypo to have noticeable symptoms. Have you changed her diet recently or was today's not eating just a one-of?

Lori
 
Haven't attempted testing yet, I'm almost afraid to, to be honest with you. You ought to see shots! I'm the only person that she'll let get near her, period, especially with a needle. It's getting better, maybe because I'm getting better with the needle, but she's a special cat, period. I have to give her time to acclamate to one thing before I start another.

She's on Humulin N, and we feed her Prescription MD, prior to that, EVO. Low carb. She's eating well. I just talked to the doc, and he said to back off the insulin until tomorrow. In the mornings, she gets 6 units. We go to the vet again in a month, for another check up. It's literally been about 2 weeks that she's been diagnosed, if that long.

Apparently, when they get upset by neighbors, vacuuming, etc the blood sugar can take a dive. Found out the hard way. She's such a sensitive individual, I can't even express it. I wish I could.

But we went to the vet on Saturday, and her levels were in the 500's after a night of fasting, and no insulin for 24 hours. This is when he added the 3 units in the evening.

I asked my pharmacist about a home testing kit, but they said that the stuff that they had doesn't work for cats? My vet said essentially the same thing, but adding that there is a large curve, and that it isn't quite exact. Also, how do you determine how much insuline to give your cats from the BG tests? See, newbie, right here. My dad just went by what the vet said for all the years he lived with Chandler, and it was fine.
 
Lori, today's not eating was a one off. She's usually a great eater. As soon as I gave her the karo syrup, and she was steady, I gave her some wet food, and she ate that dutifully. And then all was right in Zoe world once again. :-D
 
Darn. We have a protocol that has worked for thousands of cats (14 years worth). It includes a long lasting mild insulin. People here use Lantus, Levemir or ProZinc. Humulin is a harsher insulin, doesn't last as long and is harder to regulate with. Here is some info in it

viewtopic.php?f=19&t=303

We have had people who were able to work with it, but only with hometesting. You really have to stay on top of the numbers because it tends to be harsh.

We feed wet low carb food. See this website by a vet: www.catinfo.org. But we wouldn't want you to change food until you are testing. It can mean a huge downward trend in the blood glucose levels, overnight.

That's a lot of things that conflict with your vet, and I know that is hard to hear. We're crazy cat people on the Internet. But the vast majority of us have cats that are regulated or in remission, using
our protocol. And most of the regulated cats are on around one unit twice daily. If I were you, I would read some of the info on the site and see what you think.

If you have questions, ask, if you want help, we can help.
 
Hi Sue and oliver,
We've been feeding low carb wet food for a while now-so no big change there. I'll keep reading and reading and reading. All of this is brand new to me, like I said.

I cannot thank you enough for your help and advice. Endless gratitude.
 
Drea said:
Haven't attempted testing yet, I'm almost afraid to, to be honest with you. You ought to see shots! I'm the only person that she'll let get near her, period, especially with a needle. It's getting better, maybe because I'm getting better with the needle, but she's a special cat, period. I have to give her time to acclamate to one thing before I start another.

She's on Humulin N, and we feed her Prescription MD, prior to that, EVO. Low carb. She's eating well. I just talked to the doc, and he said to back off the insulin until tomorrow. In the mornings, she gets 6 units. We go to the vet again in a month, for another check up. It's literally been about 2 weeks that she's been diagnosed, if that long.

Apparently, when they get upset by neighbors, vacuuming, etc the blood sugar can take a dive. Found out the hard way. She's such a sensitive individual, I can't even express it. I wish I could.

But we went to the vet on Saturday, and her levels were in the 500's after a night of fasting, and no insulin for 24 hours. This is when he added the 3 units in the evening.

I asked my pharmacist about a home testing kit, but they said that the stuff that they had doesn't work for cats? My vet said essentially the same thing, but adding that there is a large curve, and that it isn't quite exact. Also, how do you determine how much insuline to give your cats from the BG tests? See, newbie, right here. My dad just went by what the vet said for all the years he lived with Chandler, and it was fine.
Click to expand...

hi Drea,

My first question is about the dose you are giving ..... did you say 6units in the morning, in one shot?
if yes, that's TOO MUCH.

Home testing is easy, does not hurt the cat, and it will keep your cat alive if you are testing.
My cats pretty much sleep through the pokes to their ears for testing.

Here's some info on the insulin you are using, but I would suggest you change insulin and start home testing right away.... 6units is more than most cats ever need in an entire day, nevermind in a single shot.
Humulin Primer Info

Humulin N insulin does not last the full 12 hours so your cat's BG is falling off a cliff heading to hypo with that 6units shot, then is zooming up after about 8hrs, staying high till the pm shot and then drops down a bit for around 6hrs and then spends the 2nd half of the nite in high numbers again.
To keep your cat safe, it may be an idea to give 3units am and 3units pm.
Once you are testing at home, you will see how the insulin is working, and how quickly it wears off.

When you speak with the vet, have a discussion about switching to a longer lasting insulin like Lantus or Levemir, and you will start to see great improvements.

Be sure to post every question you have and someone will help you out.
 
Hello and welcome!

I will concur w/ those who've already posted. Testing is key to giving your cat the right dose. If the numbers are too low, you either skip the dose, or reduce it significantly. My cat had longer cycles. The insulin was supposed to go away in 10-12 hours... several times it hung around for 20-24, so when I went to give my evening shot, he was too low to even consider shooting. Testing saved him from being shot when he was at 138 or 125 instead of the 450 he was usually at! No tellin if he'd even be around had I not seen his numbers first.

Just out of curiosity, what size needles are you using? Every now and then we hear someone say they're giving their cat, say 6 units of insulin. And for those of us on the U40 insulin/needles, that's HUGE!!! And we all think they are WAY overdosing and it needs to be reduced. In many cases it does... however if your insulin is labeled U100, that would make a difference. 6 units in a U100 = 2.4u of U40. Still a lot for a new cat, but not as large a dose as it sounds!

For those of us who have cats sipping their insulin rather than guzzling it, the U100 syringes make it easier to get the right dose... if the needles have 1/2 unit markings, we can actually go to a .2 increment... whereas my U40 syringes I had to eyeball to find a half unit.

Drea said:
Haven't attempted testing yet, I'm almost afraid to, to be honest with you. You ought to see shots! I'm the only person that she'll let get near her, period, especially with a needle. It's getting better, maybe because I'm getting better with the needle, but she's a special cat, period. I have to give her time to acclamate to one thing before I start another
Click to expand...

My Grayson is very tolerant - it's a good thing HE was the one diagnosed, and not one of the others! We have a routine we follow. I pull out the chair, he gets up on his little table. I scratch him a little, put my arm around him, and he lays down. After he licks my hand for a while, L arm still around him, my hand is near his scruff if I need to grab him. I use my thumb to roll the ear back, and I poke him. He didn't bleed well, and I don't use the rice sock (which would probably would have helped) but now I can get just enough for my Relion meter. Someone suggested getting the little blob of blood on your finger nail instead of sticking the meter on his ear. Initially he hated the contact w/ the strip - now, not so much. But when he's wiggly, I use my nail and then he can wiggle all he wants. I draw the blood up from my nail. The reward of freeze-dried chicken treats makes him forget all about the poking. He would rip my arm off to get them, if need be. So don't forget to reward him!

Good luck and feel free to post questions as you learn "the dance".

Lu-Ann
 
Hi,
If I understand what you've said so far, Zoe gets 6 units in the morning, and your vet wants you to shoot another three units in the evening? And then bring her back to the vet in a month for another checkup?

Drea, I don't really like saying this sort of stuff to people who just posted for the first time, but seriously, if you continue to give her 6 units in the morning, and 3 more at night of Humulin without testing her BG every day, before every shot you even think about giving her, and checking her sometime in between shots every day.... there's a really really high probability that she won't make it until that next appointment.

There is a lady who posts on PZI every day who is currently treating two diabetic cats and one diabetic dog. The dog is on Humulin, and I'm guessing she weighs three or four times as much as your kitty does. Her dog has high BG numbers too. And he gets 11 units a day. That is more or less "normal" apparently for a mid to big sized dog. And dogs use isnulin up only half as fast as cats do. 9 units of Humulin is insanely high for a cat. She can't handle that much for long.
When she was hiding under the bed today? It might have been the vacuum. But when cats go hypoglycemic, that is one thing they do. They hide or seclude themselves. She could slip into a coma and you would never know it unless you saw it happen. Please listen to the people who are telling you that the dose is completely unsafe and dangerous unless you can monitor her BG at home every day, and that you have to know it is safe to inject the insulin before you do so.

Once the insulin is in her body, you can't get it back out. It will do what it is supposed to do which is to push down her BG until it is done working. Her body might be able to fight it off a couple or a few times, but it can't do so for a month.

I have seen an animal die from hypoglycemia. It was horrifying.

Carl
 
Just a quick clarification of something I said...
"Just out of curiosity, what size needles are you using? Every now and then we hear someone say they're giving their cat, say 6 units of insulin. And for those of us on the U40 insulin/needles, that's HUGE!!! And we all think they are WAY overdosing and it needs to be reduced. In many cases it does... however if your insulin is labeled U100, that would make a difference. 6 units in a U100 = 2.4u of U40. Still a lot for a new cat, but not as large a dose as it sounds!"

What I meant was...
If you had U40 insulin and were shooting in a U100 syringe, it's not apples & apples. I couldn't eyeball the small dose I needed on the U40 syringe for my U40 insulin. So I shoot U40 insulin on a U100 syringe. When you do this, you have to follow a conversion chart to keep the doses accurate.

I understand your insulin is a U100 - which is a stronger insulin than the Prozinc I use. So 6 units in a u100 syringe is a much stronger dose than mine - by far. I won't recommend a dose, but my vet initially told me they usually start Prozinc at 2 units 2x/day. We agreed on 1 unit instead. For a while it was reduced as low as .2 (yes, 2/10 of one unit!). So you can see why 6 units sounds like a lot to me!

It might be REALLY helpful to go on the Humulin Board and look over some of the spreadsheets of users to see what their doses are. Keep in mind that every cat is different, but you can learn a LOT from reviewing these! Good luck!

Lu-Ann
 
I know some folks who go by what the vet says, take the cat in for periodic curves, etc, and the cats live many years on insulin... but I also know a lot of folks on here with cats who (including my own) were regulated by a few weeks of insulin and a change in diet, and either no longer need insulin or only need a tiny amount. If you look for the threads marked OTJ you will see some of the success stories. My vet prescribed 3 units twice a day, which I immediately lowered and began home testing to determine the best dose. (The folks here helped with the details and specific advice.) Scout now has normal blood sugar on no insulin. If I hadn't been testing at home, I could have killed her.

As others have mentioned, 6 units is a really really high dose. I don't know of any cats on anywhere near that high a dose here except those with other severe medical conditions. Cats can hypo on one unit. What happens when the cat goes hypo is the liver dumps a bunch of sugar into the blood to protect the body (because if blood sugar goes too low, brain stops functioning and seizures, coma, and death follow). Once the liver dumps sugar, blood sugar values are often really high and not responsive to insulin for several days. This is called a bounce and is really stressful to the cat's body. If that's what's happening with Zoe, then you might take her back to the vet, get another high reading, and the vet says to up the dose. Now you are in a vicious cycle which hopefully does not end in giving Zoe more insulin than her liver can protect her from. I would recommend learning to home test asap and lowering the dose until you figure out what's going on.

We are really glad to have you on here and hope we can help you get Zoe regulated and back to her normal (crazy?) self. Please continue to ask questions and ask for advice. There's some really good links on here with info you can read to arm yourself with knowledge and even provide your vet with more info.

Scritches to Zoe!

Lori
 
Drea said:
Hi Sue and oliver,
We've been feeding low carb wet food for a while now-so no big change there. I'll keep reading and reading and reading. All of this is brand new to me, like I said. .
Click to expand...

You mentioned that you're feeding Hills M/D--the canned M/D is not low enough in carbs for a diabetic cat. The only prescription food that is under 10% carbs is Purina DM--however, it's pretty much the same thing as the cheaper grocery store brand cat foods, of which there are may low carb options.

If you were feeding EVO canned before, I would go back to that food. All of the EVO canned varietys are under 10% carbs.

However I 100% agree with the others that shooting 9 units of Humulin a day without home testing is a recipe for disaster. Most cats on a low carb canned diet don't need much more than 1u of insulin. As others have mentioned, Humulin N is not a good insulin for cats.

I would urge you to lower that dose and try home testing. It's really not as hard as you think. Bandit fought me tooth and claw in the beginning, and I used to have to bundle him in a blanket to do it. A month later, he would come running when he heard the meter beep on, jump into his testing basket and start purring. Eventually even fractious cats come around once they realize a treat is coming after each poke!

As for the cat fighting the shot--it very could well be Drea has realized the high dose of insulin is making her feel bad, so she fights it. I few months ago I started helping a friend of mine with her diabetic cat. He was in the same boat as Drea--he was getting 4 units of Humulin N twice a day without testing. He was chronically hypoing--and after 6 months of him getting worse with severe neuropathy she finally decided to take my advice over her vets, started testing and switched to Lantus. He used to fight her with the shot of Humulin N also--but after the change (and the home testing so no more hypos), he no longer cared about getting the shot. Now she does it while he eats and he ignores it.

One very important thing to realize is that the majority of the time when a cat has a hypo incident it does not have symptoms. The symptoms only present themselves once the incident is severe--which is why it's very important to home test.
 
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