Please Help Me Understand

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aritae

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Hello all,

This is my first post here, and unfortunately a sad one.

My cat, Louis, was diagnosed with diabetes 3 weeks ago and put on 1 unit insulin twice a day. At the time, I was devastated because I wasn't sure where I'd come up with the money to purchase his supplies, and I was worried he wouldn't have a great quality of life because I work from 7 am to 9 pm most nights and have to travel on weekends. The vet assured me I could make it work--that they would help me to plan and make expenses on the supplies and if his insulin wasn't dosed out like clockwork, or if I couldn't find a cat sitter on the weekends that missing a couple shots wouldn't kill him. They'd even teach me how to do my own glucose testing in a couple weeks so I could be totally in charge of his care and so I wouldn't accrue vet fees every month.

Well, it appeared it killed him.

Louis did fantastic for the majority of the three weeks since his diagnosis; he started putting on weight, ate like a champ, got bright eyed and curious again, began grooming, and was even chasing the other cat up and down the stairs like his usual self. Every so often after a shot he'd look glassy eyed and woozy, but I'd get him to eat and he'd ostensibly be fine again. He even missed a dose of insulin over a weekend and rebounded with no problems. This weekend, though, I returned home from a Sunday out and he was wobbly, glassy-eyed, anorexic, and barely moving. I gave him insulin, and he didn't eat so I put honey on his gums hoping he was hypoglycemic. He didn't get better through the night, so I took him into the vet first thing yesterday morning. The last time I talked to them they said he was stabilizing and doing okay with IV fluids, and that I should be able to take him home this week and would just have to plan to board him on weekends I couldn't find a cat sitter. This morning I got a call from the vet that Louis had died overnight from untreated diabetes. :(

I guess my question is, what did I do wrong that killed him? I worried so much about him missing doses, but the vet assured me it wouldn't be fatal, and I was absolutely consistent with his insulin when I was home. I dropped the insulin bottle once on the floor, so is it possible I ruined the suspension and it just wasn't working? Could his diabetes have been far worse than the vet realized and his dosage just wasn't going to make things better? Why did he get so much healthier if it wasn't working, though?

I have this intense mix of guilt but also relief that he isn't slowly suffering (if I wasn't helping him after all), but I also want to make sure I use this as a lesson to make sure my other cat is healthy and happy and well cared for. Has anyone else been through similar circumstances and gotten answers? I'd appreciate any advice or perspective. I'm glad this forum is here.
 
Oh, I am so sorry this happened to you and your sweet Louis.

Feline diabetes is a complicated disease, one that most vets don't have much experience with and caregivers, none at all. It is incredibly hard to learn all about it in just a few days or weeks. You followed your vet's advice and were diligent about the shots and monitoring him.

There is no way to know whether he died from too much insulin or too little, or something else. Both too much and too little insulin can sometimes be fatal. We support testing at home from day one. It looks like your vet wanted to wait a while to get that started. It is understandable. Often his customers are overwhelmed with just the insulin shots and throwing daily glucose testing into the mix might just be too much. So their experience probably told them to wait.

No one's fault, just sad. I hope you can remember your wonderful times with Louis and realize that he is the rare cat - one who had a safe, warm place to live with someone who deeply cared about him, fed him wonderful food and gave him lots of love. There are so many cats out there who have so much less - who never have a loving home, who never have full bellies.
 
Sue and Oliver, thank you for your reassuring words. That helped a lot to read.

squeem3, I can discern between a 1 and a 10, so I'm confident I was giving him the correct dosage. I also practiced twice with the vet tech before taking him home. I gave him insulin because the vet said to dispense the insulin no matter what, so I was following what I thought was the correct course. When he wasn't eating, but also wasn't responding to the honey, I realized it was more likely ketoacidosis (which the vet confirmed after checking him out) and rushed him in.

My question wasn't whether I was giving him his insulin incorrectly or made a bad call when he got sick again; it was why he was doing so much better for three weeks and then suddenly got incredibly ill with no warning signs.
 
If the vet said he died of untreated diabetes, he must have been talking about hyperglycemia not hypo! One unit of insulin many hours before he passed away can not have caused a deadly hypo!
In other words your cat's BG was probably too high during the night he stayed at the vet. How old was he? Did he have any other disease?

Please dont blame yourself for what happened. you gave him 3 extra week of well being! You did care about him all that time, and dont worry he knew that!
wings_cat
 
I am sorry for the loss of your kitty .. I am also sorry to read that your vet said to dispense insulin no matter what, when you were not home testing. I am sure a doctor would never tell the parent of a child with diabetes to shoot blindly. It could kill their child. Fly Free Louis ...
 
So sorry for the loss of your sweet kitty!! Also, PLEASE don't feel insulted if anyone questions what dosage you were shooting-there are quite a few different sizes of syringes, and that can make it VERY confusing as to what you're shooting. I have one diabetic cat who is currently OTJ (diet-controlled only, no insulin) and one who is getting insulin, and I have 3 different sizes of syringes in the house. Unfortunately, it's very difficult to tell what happened w/your boy-he may have had something else going on that caused his diabetes to be out of control. Know that you loved him & tried to do everything right for him, which is more than many people do when their kitties are diagnosed.
 
aritae said:
My question wasn't whether I was giving him his insulin incorrectly or made a bad call when he got sick again; it was why he was doing so much better for three weeks and then suddenly got incredibly ill with no warning signs.
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Here is some info on ketoacidosis: http://petdiabetes.wikia.com/wiki/Ketoacidosis. It is difficult to diagnose, even for people who are monitoring blood glucose levels. And it can come on and worsen suddenly. Cats tend to hide symptoms of not feeling well so that makes it more complicated.
 
{{hugs}}

May your good memories of him help lessen grief.

There are many other conditions which may occur along with diabetes which can make management of it very difficult. Pancreatitis, hepatic lipidosis, and inflammatory bowel disease are just a few of them. These may affect appetite, digestion, and energy expenditure which all go into regulating the glucose level.

You did the best you could with what you knew to do.
 
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