Please Help our Dcat

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tbennett

Member Since 2013
His name is Darren, a sweet loving tuxedo who gives nothing playful joy. Recently he showed symptoms of a UTI. We took him in and the VCA vet, more on the signifigance of that in a bit, said his sugar was 530. In 6 minutes time she presented us with an estimate for $1900. We paid. We used a Care Credit card, but we paid. Sub fluids, flushing, the whole bit. Also, Zenequin. Zenequin can raise blood sugar. So fast forward a few days we bring him home on 1 unit 2x per day. He is still high. Way high. We up it to 2 on a new Vet's advice. Now he is starting to come down, between 150 and 300, where we were aiming. In this time frame he managed in one day to read as high as 448 and as low as 76 after the Vet said 2.5 units. We tried that, did not like his lethargy/nadir, went back to 2. (You find some Vets are not worth the paper their degree is printed on.) Funny thing though, we stopped the Zenequin. And each day as we moved from the Zenequin we have found lower lows on the 2 units. He is eating wet and dry diabetic food, and I curve him. So last night at about 9pm, I check and he is at 297. Still high, but a good number for his 12 hour frame without it. I give him his 2 units and go to bed. Except kitty is restless.

Thanks to my lurking here, which I have found to be the single biggest guide with this whole process, I know that restlessness means the sugar is off. High or low, but off. We test at about 2:50a.m. 35. I am floored and upset, but we immediately give him some Welch's jelly and wet food. He stabilizes, we nap, at this point the whole process is so hard on us we cannot sleep, and when he is ready time wise for his insulin, we check and he is at 80. We do not give him insulin. 2 hrs later he goes to 155. I am going to run him a full 24 without it because he is too low to give it.

Complicating matters is our booked vacation. We hired a pet sitter, who is very experienced, but now we can't give him insulin in a schedule because he is reacting so inconsistently. But I suspect something, one, he is not diabetic but had a bad infection. About half of vets consider this possible. Two, VCA ran scam. Took one reading way too seriously and gave him a sugar maintaining antibiotic. 3, it is possible on the diabetic food he is self regulating. To that end I am going to give him 1 unit later if he is high, and move him to one unit once per day while we are away. The way I figure it, this will be enough to prevent acidotic state, but not so much he would go hypo. I don't know what to do. Please help. Trip is pre booked and much much needed. Thank you.
 
It sounds like you and Darren have had quite a ride! How wonderful you were testing at home and were able to catch the low number and give him some carbs.

Yes, infections can cause high blood glucose levels. Also, being at the vet can be stressful and stress raises levels.

I think your idea of starting over at one unit (or even .5 units) is a good plan if he is over 200 at preshot. Be sure you can monitor if you give insulin since you can't be sure how he will react. Here are our general guidelines:

A cat is generally considered regulated if they range from mid 200s at preshot to double digits at nadir, but not under 40, on insulin. We consider a cat in remission if they range from 40 -120, off insulin, with the majority of the time in double digits, for 2 weeks.
 
I unit once per day may be too low, but the 2 units 16 hrs later and he is still under 200. Very afraid to go that high. 1 unit once per day may be too low, but should avert hypo, hyper, just don't know. Can't expect pet sitter to do blood curve.
 
.5 (half a unit) should be fairly easy to measure on your syringe. You could also eyeball .25. But yes, I wouldn't give any insulin under 200.


What insulin are you using?
 
Novalin Human N. Getting ready for cheaper reli on. My concern is that as the Zenequin left his system, he is going lower and lower, actually I guess a good thing, and that we were scammed, looking back on it, it was a melodramatic presentation saying he was dead in a matter of days unless we coughed it up. Also, the girl there says she has been seeing a HUGE spike in diabetic cats. Wondering if VCA is finding diabetes every chance they get.
 
Sure sounds fishy... I'm confident my Baloo was diabetic for more than "a matter of days" with blood sugar off the charts before diagnosis, and he's still alive!

Have you been to this particular vet before? Are there other possible options available to you?

Glad both of you made it out okay!
 
tbennett said:
Novalin Human N...

That's a problem right there. N type insulins only last about 6 to 8 hours in the cat. The lowest point, nadir, is about 3 to 4 hours after the shot. This may be managed by either picking up all food 6 hours after the shot, or giving insulin every 8 hours.

There are better insulins for cats - Lantus, ProZinc, and Levemir all last longer than 8 hours.

If you are feeding prescription diabetes food, especially dry, changing the food to low carb canned or raw will reduce the glucose levels as much as 100 points.

For a printable food list, plus more nutrition info written by a vet, go to Cat Info
 
If he was diagnosed in diabetic ketoacidosis, that is fatal if untreated. And if so, you'll want to pick up some urine ketone test strips to check for them. Tips for doing that are in my signature link Secondary Monitoring Tools.
 
A diet change to all wet low carb would most likely bring the numbers down - what are you feeding? But those are diabetic numbers. We like to see cats in and below the 250- 280 range which is generally considered the renal threshold. And no, N is not a popular insulin here. Instead of being mild and long lasting like Lantus, Levemir or ProZinc, it tends to have a sharp curve downward early in the cycle and then not last more than 8 hours or so. It is more difficult to regulate with than the other three insulins.

Your kitty did have a long cycle with N. Sometimes when cats hypo, they do stay in lower numbers for quite a while before going back up.
 
Honestly we have seen more evidence of Somogyi's than diabetes itself. I think that my cat may mave been manipulated to get VCA paid. I am going to call AG's office about it. Remember they made this diagnosis off of the reading of one test, in the middle of a bad UTI. And they came out with a 25 line item estimate in 6 minutes, and told me he will die in days and I should pay if did not want him to suffer. Cannot say enough bad things about VCA. And he had no ketones, which later research shows brings into serious question about whether the condition is chronic.
 
I have never heard of Zeniquin raising BG. Zenequin is in the same class of antibiotics as Barytril. I have used both and have not seen any effect on BG. Maybe the Zeniquin beat the infection that was raising the BG and it is just a coincidence you stopped the Zeniquin.
 
Up to 407. So what we know is 1 unit per day will not get him to the good range, but 2 units given too low could be dangerous. This. is. A. Nightmare.
 
Part of the problem is the insulin. N is likely to not last long enough and take the bg level down in the first 3-4 hours of the cycle, then bounce back up. It isn't necessarily that one unit of insulin wouldn't be enough; it is likely that one unit of N isn't going to get the results you need.

Any chance you can get another insulin? What are you feeding? Is higher carb food part of the problem?
 
Would you please tell us specifically which 'diabetic' cat foods you are feeding?

How much of these are you feeding?

When do you feed in relation to the shot of Novolin N?
 
Purina DM wet food, 2x daily, free graze DM dry. Vet preferred. Whatever that means. Personally I think we are being taken for a ride. 1 is not enough, 2 is too much, going to store to buy U100 1/2 unit cc measurement syringes and try 1.5 if 1 does not work.
 
Again, it may not be about finding a good dose. It may be about finding a better insulin. It's worth a try to try 1.5. - if you get a number in the first 2-3 hours after the shot and then 5-6 hours after, it should show you how long it is lasting.

Eliminating the dry food should bring down the levels. It is different for each cat; our Oliver went down 100 points when we eliminated the dry.
 
2 units last him just fine, even the N, it is too good, because 12 hrs after he was at 80. So obviously I can't give him more then.
 
When using the NPH type insulins, like Novolin N or Humulin N, it is important to make sure your cat has eaten 30- 45 minutes before you shoot the insulin. This is because this insulin has a quick onset and drops the blood glucose number very rapidly, anywhere from 150-350 points in an hour or so.

Because of this rapid onset, it is imperative that you test before every shot but after your cat has eaten.

If your cat has not eaten enough before you give the insulin, there is a much greater risk of the cat dropping to a life threatening low number, hypoglycemia.

ETA: Please read this link on making sure your cat really is diabetic. http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=94948
 
Thank you for your support. I am willing to give him insulin if he needs it, but evidence says he is coming down off a rebound. Want more numbers before I fire up the juice.
 
You have done some great things here but I think there are some things you can do to fix all this... but when do you go on vacation?

The main issue is you need a better insulin as mentioned above. Also you need to work on getting rid of that dry food. Removing dry alone could cause a need for less insulin so be ready to reduce the dose.

To help us really get a good idea of whats going on though can you create a spreadsheet for us? http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207


Wendy
 
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