Please help me through first hypo!!

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Jackie Devizes

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Please help me! Hobbes, my 11 year old male neutered cat, was recentlty diagnosed with diabetes. He has had his first hypo and seems to be getting worse, rather than better! He tested 2.6 (46.80 US) at 3pm. I rubbed honey into his gums, but he was quite coherent and managed to also have some wet cat food. By 3.30 his levels had come up to 4.8 (86.39), but he had become more restless, unsteady on his feet and panting, At 4.15 his levels had risen to 7.4 (133.20), but continued to be unsteady on legs, panting and very 'not with it', he is also 'looking around' moving his head from side to side a lot. At 5.15, his levels have gone right up to 18.3 (329.40), still panting, head turning, pacing and unsteady. I took him outside and he had the biggest wee ever and also passed a very small amount of faeces. I now have him confined to the cage, he has access to food and water. He layed down after a while but he is still panting, also keeps moving his head to look around all of the time, but movements are strange and he is not himself at all. He has also hissed a couple of times at absolutely nothing. He wasn't responding to insullin, so with vets knowledge and advice, I have taken off the dry diet he was on and he is now on a high meat content wet food. I have also given him some minced beef as he see's this as a treat. Is his behaviour normal for AFTER a hypo? I was out earlier and am worried that he could have been having seizures when I was away? I am worried that he now has some sort of brain damage. And I am terrified that my decision to change his diet has caused this and I am killing my boy! Please, please help me!
 
I have spoken to the vet! They said that I can monitor him better here, than they can in there!?! What would cause him to go blind?? Will he get his sight back? Oh my god, this is like some awful nightmare!!
 
Jackie there is just not enuf information. We might not know how low he actually went in his cycle. You said you tested him at 3, but how many hours was that after his shot? And is he being testing always, regularly?
 
Jackie do you see that red 911 above...put that on your ORIGINAL post ok...it will get you more eyes. Make sure it is on your very first post tho'
 
Jackie Devizes said:
Please help me! Hobbes, my 11 year old male neutered cat, was recentlty diagnosed with diabetes. He has had his first hypo and seems to be getting worse, rather than better! He tested 2.6 (46.80 US) at 3pm. I rubbed honey into his gums, but he was quite coherent and managed to also have some wet cat food. By 3.30 his levels had come up to 4.8 (86.39), but he had become more restless, unsteady on his feet and panting, At 4.15 his levels had risen to 7.4 (133.20), but continued to be unsteady on legs, panting and very 'not with it', he is also 'looking around' moving his head from side to side a lot. At 5.15, his levels have gone right up to 18.3 (329.40), still panting, head turning, pacing and unsteady. I took him outside and he had the biggest wee ever and also passed a very small amount of faeces. I now have him confined to the cage, he has access to food and water. He layed down after a while but he is still panting, also keeps moving his head to look around all of the time, but movements are strange and he is not himself at all. He has also hissed a couple of times at absolutely nothing. He wasn't responding to insullin, so with vets knowledge and advice, I have taken off the dry diet he was on and he is now on a high meat content wet food. I have also given him some minced beef as he see's this as a treat. Is his behaviour normal for AFTER a hypo? I was out earlier and am worried that he could have been having seizures when I was away? I am worried that he now has some sort of brain damage. And I am terrified that my decision to change his diet has caused this and I am killing my boy! Please, please help me!
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This happened to Simba in January, the same symptoms and he was low and I gave him lots of dextrose and then we rushed into ER, since he was breathing with his mouth open and not responding to me at all, just moved his head around and meowed at times. When it started he also staggered around the apartment, and by his food he was acting as if he was blind. I took him to ER because he had had hypos before ,but nothing like this, and since he couldn't breath, breathing with his mouth open, and of course I thought his pupils were diluted. They are a 24 hr hospital with everything you can wish for in care, so they kept him and put him into the oxygene box and gave him iv-fluids. He also vomitted a lot while there. The day after he had stopped breathing with his mouth open but wasn't eating, so they kept him there for a few days. When he came home he still didn't eat so I eventually had to take him back to ER for a feeding tube. It was the most strange hypo I've ever seen of the 3 he have had, and also the one it has taken the longest to recover from. It was as he lost his memory what food was. I am not sure I would have been able to do it on my own without the ER help we got.
 
lori and tom said:
Jackie there is just not enuf information. We might not know how low he actually went in his cycle. You said you tested him at 3, but how many hours was that after his shot? And is he being testing always, regularly?
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Hi Lori,

This was 7 hours after his first shot. He's given his shots at 8.00am and pm each day.
He has settled down and his levels are now 20.6. He has stopped panting and seems steadier on his legs. I think that his eyes may have been affected, but am leaving him quietly in his cage and wil continue with the testing each hour. He gets VERY stressed in car and at the vets, so now that he is a bit more settled, I will keep him here. I am in Wiltshire in the UK and my vet is some way away. I have been with them for 11 years, but will probably move to a different vet, one that is closer. I have lost a bit of faith in my vet over the way that they have been dealing with things. I have had more help, understanding and advice from online. My vet told me that you couldn't glucose test cats at home as blood has to come from a vein in the leg. Utter nonsense!! Am still very worried about Hobbes, but he does seem to be improving!
 
good that he is at 20.8 now

a +7 2.6 is a hypo, especially since each cat is different --- good catch there in testing him before he dropped even lower.

I am not sure, but I think if he has suffered any brain damages, they too can heal, the brain and nerves takes up to 2 years to heal, Simba has some brain injuries left, but besides that is back to his normal self even if it have taken time. I am also not sure if they sort of get a hang over from it, going from so low up to high, like when one been out drinking ones head into pieces and try to wake up in the morning after that, and the brain just hurt if trying to move. Like a concussion. So he is probably in a good place in soft light and solitude in the carrier. Keep monitoring because people will be up here so there will be people at hand if need.
 
Ann & Scatcats said:
Any news about Hobbes?
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Hobbes not interested in food, water or anything, advice from vet is to keep him here tonight and take him in first thing. Don't give him any insulin and keep him quiet, which is what I am doing. His breathing is normal, no more panting and he is no longer restless and staggering. Unfortunately I believe that he may have sustained some damage to his brain as he is still behaving very strangely. I also don't think that he can see and that his eyes have been affected. I feel totally useless and that I have failed my lovely boy. We will have to see what the morning brings and what the vet has to say tomorrow. I can only hope that what has happened to him is reversible and that he will get better. At the moment though things are not looking great. Thanks for your help and advice, will keep you all posted. x
 
I'll be thinking of you tonight and tomorrow and hope for good luck and that Hobbes starts feeling a little better. If he is not eating tomorrow, regardless of he has gone blind permanently or temporarirly, or because his brain has taken acute injury (that will become better eventually), but regardless why if he isn't eating tomorrow, remember to talk to the vet about an nose attached feeding tube into his tummy. It is okay if he doesn't eat for a day, but after that cats very easily develops hepatitis and liver damage if not getting any food, and then the best way for recovery again is a feeding tube.

Linda's Bear Man was blind I think, and he handled life fine, and then Sampson, on of the seniors here, have recently gone blind too, and then there is one more blind I think. So they can handle themselves and life well if blind. They just need training in learning their way around again and a bit of handicap adaptions at home.

The same with brain injuries. The worst with brain injuries, are the loss of the senses, and loss of the motoric, like paralysed. Simba fought his way back once after becoming paralysed, with my help of course, and we trained several times a day. I tickled him to awake the sensoric nerves again, made the bicycle leg exercises, sitting up exercises, walking exercises, balance exercises and other exercises I could think of. I am a brain injury and car accident person myself having undergone lots of physiotherapy and learning how to read and write again, and remember, recognise and cognition and such. That's why I was so good in training Simba. I did it, Simba recovered, and I am sure as long as Hobbes are fine, that he will recover too.


And last, don't blame yourself. All of Simba's 3 hypos have been my own fault too, that is part of being the diabetes responsible person, but what really counts is how quick we respons with the testing and filling them up with the dextrose. You are taking good care of him now and I hope he doesn't worsen during the night but instead stabilizes, and then you get the vets help tomorrow.

Hugs to you and Hobbes.
 
Hobbes update: Hobbes went into a very deep sleep for a number of hours last night. I woke him up at 11.45 and his 'head turning' and twitching behaviour had stopped. He also got his vision back and he went out to the kitchen and jumped up onto the dresser, where his food is and demanded something to eat! Fed him but didn't do his bloods as didn't want to stress him in any way (although he doesn't really mind the whole tesing thing) and waited to see what this morning would bring. This morning, he is back to his usual self and hassling me for his breakfast and generally having the 'what's the matter with you, everything's cool' kind of catitude. So releived!!! His sugars are quite high this morning, but only gave him 1 untit of insulin as I can't risk another hypo, he obviously is not a cat that handles hypo's very well! Will keep an eye on him to see how he reacts to the single unit and take each day as it comes. I knew that by removing carbs from his diet that he would react differently to the insulin, but was not prepared for the dramatic drop that we got (AND NEITHER WAS MY VET?!?!). From now on I will look at bringing his levels down slowly as it is now obvious that the 7 units that the vet was advising was far too much. As for the vet, well, I think that I need to find a new vet and my decision will rest on the potential new vets answers to my question, which will be: 'what do you see as the best way to handle and control feline diabetes and what do you think about 'home testing?' I need a vet that realises that cats are CARNIVORS! Not one that wants me to keep buying their very expensive high carb prescription dry food and doesn't believe in 'home testing' glucose levels! Thanks for all of your help and concern and I will keep you informed of how things go with my boy. Hobbes says to say hi to everyone and to thank you for keeping an eye on his mum and helping her when she was having the worst day ever! xxx from me and Hobbes.
 
Good work mum and Hobbes! Now that was a scare but so happy it went well! Good work.


And yes, better do with the insulin as we generally say - start low, go slow - now when you are trying to find a new dosage for Hobbes. What insulin do you use, so those using it can help you? ( I myself use Lantus)

And what is his menue now? I mean what are you feeding him now after the dry switch? And how much a day?


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I am glad he is doing better.

Where are you located? City and state only. We may have a member in your area that can recommend a good vet.
 
Oh my goodness, yes, 7u is a dangerously high dose for your vet to have kept him on with a diet change. I'm so glad Hobbes made it through, you are very lucky!

Most cats on a wet diet do not need more than 1u of insulin. If you can tell what kind of insulin you're using, there are many experienced people here who can help you with dosing, and possibly even help bring Hobbes into remission.
 
Lisa and Witn (GA) said:
I am glad he is doing better.

Where are you located? City and state only. We may have a member in your area that can recommend a good vet.
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Hi Lisa, I am in the UK, near Devizes in Wiltshire, but I have a new vet in mind. If you do happen to have a recommendation for the Devizes area in Wiltshire I would be happy to hear from you. :smile:
 
Ann & Scatcats said:
Good work mum and Hobbes! Now that was a scare but so happy it went well! Good work.


And yes, better do with the insulin as we generally say - start low, go slow - now when you are trying to find a new dosage for Hobbes. What insulin do you use, so those using it can help you? ( I myself use Lantus)

And what is his menue now? I mean what are you feeding him now after the dry switch? And how much a day?


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Hi Ann & Scatcats, I intend to do exactly that. Low and slow is the way to go!
He is having two 70 gram pouches or equivalent in tins each day, and a bit of raw minced beef as well. Today he has had Applaws, which is a high meat content and no grains etc, but I have a few different kinds and makes, so that he has plenty of variation to keep him interested. All the foods that I have chosen have a high muscle meat content and no cereals etc. High protein, low carbs. I also have some chopped raw rabbit and beef mince in the freezer, as he seems to really like raw meat too. I feed him in the morning at the same time that he gets his shots and in the evening at injection time as well. He never eats the whole pouch of food in one sitting and then when he has finnished I add some more as his sister Hilly, always eats after Hobbes. I am also popping home at lunchtime, to check that he's ok and test him (that is if I can find the little devil). He supliments his own diet with the occcasional mouse or vole, but he won't let me weigh them! I just hope that hes not eating mice that have been scoffing corn or wheat!
 
Julia & Bandit said:
Oh my goodness, yes, 7u is a dangerously high dose for your vet to have kept him on with a diet change. I'm so glad Hobbes made it through, you are very lucky!

Most cats on a wet diet do not need more than 1u of insulin. If you can tell what kind of insulin you're using, there are many experienced people here who can help you with dosing, and possibly even help bring Hobbes into remission.
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Hi Julia and Bandit,

I am using 'Caninsulin'. His levels were 20 mmol (360 mg/dl) this morning and I gave him 1 unit.
He was off being a cat somewhere at lunchtime, so I couldn't test him then.
At 4.39 he was 20.8 (374.4) and vet told me to inject 2.5 units for his next injection, which I did.
Tested him again at 11.22pm and he was 12.7 (228.6) and after I tested him he has had a little bit of minced beef (about 2 tablespoons) but he did not eat all of it.
My vet said to give him 2.5 in the morning as well, and to keep him on that......
Obviously I will wait and see what his levels are in the morning, but the way that she was saying it was like give him 2.5 anyway?!? Man, I have to get a new vet tomorrow.
 
Hi Hobbes and his mum,
So glad that you are feeling better. And I'll bet that your mum is too. I'm thinking that we should all start over at the beginning - what do you think? I'll give your mum my favourite fd basics notes if you don't mind.

There are 3 keys to managing diabetes - and you already know all the pieces. But let's just review.
1. Diet: wet, lo carb, canned food is best for all cats, not just diabetics. No dry food pushed by the vet - just take it back. Somewhere on this board there is a list of foods available in UK that are suitable for diabetics. If you don't find it, ask and someone will know exactly where it is.

2. Insulin: You already know more about this than you were hoping to ever find out! However, I will just say that managing diabetes is a delicate job of balancing food intake with insulin. The body has an efficient self-defense mechanism for dealing with a little too much insulin for a short term. When the bg goes a bit low, you will often see a bg spike. This is called a bounce, and is the body's response to that too low number. However, eventually the reserves are used up and a crash happens - this is a hypoglycemic event. Having a hypo kit prepared is important, even now after you have had a hypo.

3. Home testing. With Caninsulin, which I think you are using, it is especially important to test before every shot and to be sure that Hobbes has eaten some food b4 he gets a shot. Caninsulin brings the bg down quite quickly, usually over about 5 to 7 hours, and then it runs out and the bg rises again. It is also useful to get tests in the 5 to 7 hour range when you can as well. We can help you later with the finer points of testing and how to react to unusual numbers. There are a few people who are using Caninsulin, and a few of us who have used it in the past. We'd all offer suggestions if you need them.

The package insert with Caninsulin actually has good information on it about the action of the insulin (at least the Canadian version does). Check it out and the information on the insulin support groups about the action of the insulin.

I also want to say that cats are often quite sensitive to insulin after a hypo. Cutting the dose is a good idea. Perhaps you can leave food out for him when you are away as well. Then he can eat to bring his bg up if he needs to.

So glad that he is better.
 
Hi Just - As - Appy.
I must say that I have become quite dissillusioned with my vet over the whole 'changing food and dosage' thing.
I am going to meet a new vet this afternoon, that I have had very good things about and who is much closer to where I live.
Thank you for your advice and guidance, it is such a life saver for me to know that all of you guys on here are so helpful, you have all been fantastic!
As for Hobbes, well, he is such a tollerant boy and so trusting of his mum, but it is a strain knowing that someones life depends on you getting things right.
I know that I am doing what is best for him, but still quite horrible having to put the poor little bloke through it.
At the same time that my lovely boy was diagnosed with diabetes, he was also diagnosed with feline AIDS, so this is an added complication.
Fortunately, we now live on a farm, so there are no other cats around for him to pose a threat to as far as passing on the AIDS is concerned.
My husband says that Hobbes is going to end up with ears like teabags, with little perforations in them from all of the testing! But it is something that has to be done, so there's not a lot I can do about that one!
The other thing is that just before Christmas, my Mum died. She had a heart attack whilst she was staying with us for the Christmas holidays and didn't recover. Mum had been an insulin depenant diabetic for about 15 years and although I was taking her backwards and forwards to the doctor, they missed the signs that it was her heart, because they were looking only at the problem with her sugar levels and putting it down to 'badly controlled diabetes'. So diabetes has been an enemy of mine for a long time. One that I thought I had seen the back of when my darling Mum was taken from me. It feels so unfair that once again my life seems to be revolving around this awful illness! Even writing this now the tears are falling fast and my heart aches both for what I have already lost and for what is yet to come.
Diabetes, I hate you! But I will fight you and this time I will win!
Thanks to everyone for all of your help, you guys are fantastic! x
 
Drat - you've had a few rough spots in the last while. I really think that we can help you with Hobbes though. We all live with diabetic cats (yes, some have more than one!) and many with complications. If one of the members doesn't have the experience to offer, I'm sure that she/he will know where to look.

Regarding the 'tea-bag' ears - makes me laugh! If you look at my spreadsheet at the bottom of this message, you will see how often I poke Tony's ear (one bleeds better than the other, so I nearly always use his left ear) and I assure you and hubby that it looks just as good as the other one that never gets poked.

B/c of the time difference, I'm guessing that you have already seen the new vet. Did she/he seem to be knowledgeable and open to working with you on Hobbes care? Hope so. Look forward to hearing about it.
 
Jackie Devizes said:
Hi Just - As - Appy.
I must say that I have become quite dissillusioned with my vet over the whole 'changing food and dosage' thing.
I am going to meet a new vet this afternoon, that I have had very good things about and who is much closer to where I live.
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As you should be--I would not trust them again after this incident. I hope your new vet works out well for you!

One thing that I would recommend you discuss with your new vet is a possible switch to a slower acting insulin, like Lantus or Levemir. Here's a link to an article citation that speaks of the efficacy of Lantus and home testing. I think it will be much safer and more effective. 80+% of newly diagnosed cats go into remission with this treatment. http://www.ncbi.nlm.nih.gov/pubmed/19592286
 
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