Please Help!!!!

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Hello everyone! First off, I wrote in in February sometime, when my cat was first diagnosed with diabetes. I had alot of people respond to my concerns, and I would like to thank everyone for their advance and support. Since Feb, Clover has adjusted to life on insulin very well. I was giving him just about 3 units 2 time a day. I had him on a low carb diet, (innova evo). He started out liking all of the different 95% flavors, but eventually he would only eat the venison. I starting giving him a little bit of the Innova Evo hard food with his meals, (by a little i mean 1/2 tsp) because i was worried about his teeth and i thought the hard food would help to remove some of the tarter. I eventually added 2 treats, (a dental kind) a day (after his shots). Everything seemed fine and i didnt notice any change. Until a week ago....he stopped eating. I was able to get him to eat a little bit on sunday morning (10/24) but not alot so i only gave him half his dose of insulin. Then sunday night, he only ate about 2 bites, and wouldnt even touch his hard food or treat! So, i skipped his shot totally. Monday morning, he ate a little bit more than the night before, so i gave him a half a dose of insulin. Monday evening, only about 2 bites, so i skipped his shot again. Tuesday morning, wouldnt touch his soft food, hard food, or his treat! And he was beginning to act funny. I called the vet, and they had me bring him in. He was there from Tuesday through Friday. They ended up putting him on an IV bc he wouldnt eat or drink. They had to get his sugar back under control (which I dont really understand how it was all over the place since he hadnt been eating). When i went to get him on friday, the vet told me to up his insulin dosage to 5 units twice a day!!!!! (My first thought was Holy Crap!) He said that he had it up to 7 units, but that was too much and Clover sugar dropped to 67 at one point! He also said that he was walking around fine and drinking and that he should eat ok, but if not, to just force feed him. Ok- so i get him home, open the carrier, he walks out, and falls!!! He could not walk straight and his back legs kept giving out!! The first thing i thought was nerve damage from ketones!!! He eventually was walking better a little later on, still weak though. The vet told me that even if he doesnt eat, i should give him 5 units of insulin so his sugar stays regulated. Isn't that just crazy tho?? I was completely under the impression that if he doesnt eat, he shouldnt have that much insulin!! I had to force feed him Friday night. Therefore, he didnt end up eating much bc he wouldnt let me. I gave him 2.5 units, bc i was scared to give him the full dose of insulin. Throughout the night, he acted very strange. He wedged himself inbetween my radiator and wall in my bedroom and got stuck at one point! Luckily we get him out! (that was at 4am sat) For the rest of the early morning, he would lay in his little cat house in the living room, and get up once an hour and walk in a circle around the living room, back to his cat house, with his face about 3 inches from the floor, walking very slowly. He acted almost like he didnt know where he was or like he couldnt see. First thing Sat morning, i called the vet back, and they had me bring him back in. He is still there, they want to keep him another night. I dont think they are addressing the problem of why hes not eating. Which is why im asking for any advice/suggestions anyone may have. I just need him to start eating. He's sooo much worse than he was before i took him there last week! Has this ever happened to anyone else? I have no clue what to do! Like i said, any advice would be greatly appreciated!! Thank You! :)
 
I don't have any answers (I'll leave that to the more experienced) but, Shan, you and Clover will be in my thoughts and we're sending Healing vines to you both. Hang in there.
 
welcome back. so sorry you are going through this. first and you may not want to hear this BUT..............................
IT IS VERY HARD TO BE ABLE TO TELL YOU WHAT IS GOING ON IF YOU ARE NOT HOME TESTING. i KNOW, i KNOW. but we have no idea if the insulin he is getting is too much or not enough
second, dry food is not healthy whatsoever. myth that it helps clean the teeth. truth is, it is like eating a snickers bar and leaving the candy sit on your teeth all day and not brushing or washing it off. not only does it raise the BG but the sugars will cause tooth problems/gum disease
sorry I cannot be of more help. i am sure others will be here to give advise
 
PS

no way would I give that amount of insulin with out knowing what blood glucose is. dr lisa likens it to trying to drive a car with a paper bag over your head
 
This is a scary situation for you. I am so sorry.

I do not think you are getting very good advice from your vet. Giving 5 units of insulin to a cat who isn't eating is a disaster waiting to happen. I hope they are force feeding/syringe feeding him.

You can do both of these kinds of feeding at home, but if he also has ketones, he should be at the vet. I am just not sure he should be at your vet.....It isn't clear if he has been having ketones or going into hypo.

We can give you information on both types of feeding and lots of simple tricks to help him eat: http://www.felinecrf.org/persuading_cat_to_eat.htm

If I were you, I would call and find out exactly what they are doing to get him to eat. If they aren't force or syringe feeding or some other method of nourishment, I would start looking for other places to take him. If you want to give us your city and state, maybe someone will know a FD vet in your area.
 
Thanks everyone for your thoughts. I have decided that as soon as I get him home, and get him eating again, I am going to home test. I didn't think there were any affordable testers and test strips available, but I found the Relion brand at Walmart. I also found a general scale on a website that tell approx how much insulin will be required based on what the sugar level is at. I'm hoping that will work. I didn't do this from the beginning bc Clover hated it....but I know now that his life literally depends on it! I'm just kicking myself for waiting this long to realize that!! As far as what my vet has done, I have no clue! I don't know if he's checked for ketones or any thing else! The main reason I've continued taking Clover there is, he is affordable. He actually isn't charging me for Clover being there this weekend. (Is that bc he's not really helping tho?) With my $300 bill from Clover being there from Tues-Friday, I can't really afford to take him somewhere else. I'll have to think of something tho if nothing changes. He's only 8 years old and could have a normal healthy life if we can just get this figured out. Thanks again for your thoughts.
 
Unless they are a 24/7 facility and this vet says to shoot insulin even if he isn't eating, I would bring Clover home ASAP, test him yourself, check his urine for ketones (buy some Ketostix) and go from there. I am afraid of them hypoing him and no one there if/when it happens. Also, have you asked them about using an appetitie stimulant for him?
 
I'm glad you've decided to home test. If Clover just isn't going to let you take a blood drop from his ear, you can always use a paw pad.

Although I can't say with certainty, what you describe after Clover returned home from the vet the first time sounds like hypoglycemia (i.e., BG is too low). Also, in my opinion, you were directed to give a VERY large dose of insulin. Does Clover have any other issues that might be the cause for such a high dose?

In the end, Clover must eat. You've been given great suggestions as to how to sweet-talk him into eating. However, you might want to talk to the vet about an appetite stimulant. I'd also suggest you talk to the vet about how long you should wait - if Clover won't eat - before you consider a feeding tube. I know that sounds drastic, but feeding tubes are not painful for the kitty and assure proper feeding and nutrition, such that you can administer insulin.
 
Did your vet ever speculate about why he is developing ketones? They usually take a combination of factors including I>ufficient insulin, insufficient food and / or infection. Has he been tested for infection, does he have bad teeth...??

My blunt suggestion is to get him away from that vet who keeps overdosing him, but those ketones make me very nervous. He needs some insulin, needs food and water and his urine tested for ketones

Jen
 
Shan, you stated: I also found a general scale on a website that tell approx how much insulin will be required based on what the sugar level is at. I'm hoping that will work." What is this website? I really do not think there is any such reliable dosing scale. Each cat is different.
 
I might have missed it but what insulin are you using. that could be a problem also. I would test and post here or the ISG of the insulin you are using to get dosing advise. I would not trust a website you found for a sliding scale cause ECID and your cat may respond quite differently. also with the less carb diet, insulin needs should be a lot less. you did good regarding relion meter. that is one of the cheapest strip wise to use
 
Dian, in it earlier posts she said it was PZI. Please let us know if this is a PZI that the vet just has some local compounding pharmacy doing it for him or if it is Prozinc or discontinued IDEXX.....we need to know if this is a manufactured PZI and the name and if the bottle says it is a U-40 insulin.
 
Ok, the insulin is Prozinc. And I'm actually not sure if the vet has checked for ketones...I only know symptoms from doing some research. The vet told me that Clover's white cells were ok, so that ruled out any sign of infection. Idk, in a way, I don't even trust that! As far as I'm aware, he doesn't have any other issues that would cause his sugar to be high. I originally thought a low carb diet would help, and I was hoping he would go into remission. As far as the scale that i found, I'll have to try to find the web-site and let you know (I bookmarked it on my work computer). And I wasn't planning on just basing how much insulin to give on that, but just to use it as a guide line. Here's what it said:

Blood Glucose Units of Insulin
151-170 .5 units
171-185 1 unit
186-200 1.5 units
201-220 2 units
221-250 2.5 units
251-290 3 units
291-350 3.5 units
351-410 4 units

So, according to this general scale, Clover's blood glucose must have been pretty far over 410 for the vet to up the dosage to 5 units! And how could that be if he wasn't eating? I'm bringing him home tomorrow regardless and if anything, I'll force feed him, test his levels, possibly skip the insulin, and probably find a new vet on Wednesday. Thank you all again for your advice.
 
Hope + (((Baby)))GA said:
The first thing i thought was nerve damage from ketones!!!
Okay, you thought but did the vet say he had ketones?

No, I'm sorry I wasn't very clear with that situation, the vet did not say he had ketones, and I didn't check either. (Along with a new meter, I'll be picking up some of those strips too)
 
fwiw that scale probably came from one of two sites, either yourdiabeticcat.com or diabeticcatcare.com

that scale is part of a treatment protocol that my old vet came up with and is not universally known among vets or known much at all in the vet world actually based on what i've seen over the years. sooooooo, i doubt that your vet used such a thing to base his dosing on.

i just want to say that if you plan on using a scale, you really should read and study and learn how the protocol that goes along with it works. personally i think a couple/few weeks at consistent dosing, with a lot of data gathering via hometesting, will help you get a good baseline of knowledge about how your cat is going to react and then you'll know if more aggressive dosing is called for.
 
ShanNClover said:
I also found a general scale on a website that tell approx how much insulin will be required based on what the sugar level is at. I'm hoping that will work.

Just an important note, you do not want to continuously change the insulin dose based on one reading. There are many things that can affect an individual reading and readings can fluctuate from day to day. With most insulins you want to keep giving the same dose (unless you start getting a lot of very low readings) for at least one week. It takes at least a week for the body to adjust to any new dose. You may want to consider starting over at 1 unit twice a day and gradually over a period of weeks, increase it until you find your optimal dose. 5 units is extremely high unless your cat has other medical issues. Most likely you have missed your optimal dose.
 
ShanN - tomorrow when you pick Clover up, ask for copies of all labs. The experts here can help you decipher, plus, another vet, if you change, will need as much info as you can give. I'm sure you've told us his weight, but make sure the experts know that tomorrow when you get him home. do lots of testing, if you need help with that, just ask. post ALL your data, don't give insulin without asking here for expert advice. make sure you have canned food that he likes, ketostix and a hypo kit, a meter and plenty of test strips. I've never used PZI but tons of folks here have and they will help you any way they can. I'm confident these knowledgeable folks here can help you. you don't have to do this alone. the advice about moving your questions to the PZI forum is gold. These people here are so smart and experienced, so kind and helpful, they will help you any way they can and in a couple of days, you and Clover could be moving him closer to wellness. take a deep breath. with the help you will receive here, you can do this.
 
Again, thank you everyone for all your wonderful help! I'm waiting to hear from the vet's office. Can anyone tell me how to set up a spreadsheet like I see many of you have?
 
gosh how scary ... You received a lot of great advice here and I don't have much more to add so I'll just keep you and clover in our thoughts and prayers ...
 
Ok another question. I'm getting ready to start home testing once I get Clover back home...when i test in the morning before his shot, is that supposed to be before or after he eats? The feeding/shot schedule I had him on was, 6:30am- Half a can or so of canned Evo Venison 95% and 1 tsp. of hard Evo, his shot was always at 7:00am, and he would get one treat after. Then, 6:15-6:30pm- Half a can or so of canned Evo Venison 95%, and his evening shot at 7:00pm, with one treat after. Then he would get another half a can or so at about 10:30pm and 1 tsp. of hard food, just to hold him over for the night. (Other wise he was waking me up at 4:00am to eat!!) I'd like to come up with a schedule for testing. (I'm very organized) I'm just a little unclear about when exactly I need to test. Thanks again!! :)
 
with all insulins, you always test before feeding. that is all I know since I am not familiar with PZI anymore.I used to use it but wheezer is a very different kitty and has his own rather distorted schedule and times we use lev now
 
When we used PZI, we would test, feed and shoot. We would give him a few treats for the test at first. After a while, he knew his breakfast/dinner was coming, so he would sit still for the test. Once we got a number, we gave him the food and shot while his face was deep into it.

PZI is not so picky about when you feed. You don't need to have food on board because it is a milder insulin. Food may impact the numbers but not for 30 minutes or so. We fed him again at noon. He was never a grazer, but demolished food as soon as it was down. We stayed away from food a few hours before the PM shot so we wouldn't have a number influenced by food. You are just gathering data at first, so set up a pattern that works for you and stick to it.

Have you read the sticky on the PZI forum: viewtopic.php?f=24&t=1979
 
UPDATE...we spoke with the vet, and he wants to keep Clover there for a little longer as he is still not eating on his own. He said that he is drinking, and using the litter box and he is more alert. We are going to visit him to see for ourselves how he is doing. I'll let you know. :-|
 
How mich insulin are they giving? Are they giving him an appetite stimulant? Fluids? Force feeding???


Will he be there again overnight, unsupervised?

My cat wasn't eating either; I took him home, gave him appetite stimulants and force fed him...

Jen
 
Perhaps it is time to speak with the vet about a feeding tube? Because of "vet stress," not only do BG levels rise (my cat B.K. can go up 300+, and even mellow Chester is always 100+), but the high BG levels result in cats feeling awful and vets suggesting too much insulin. If Clover got a feeding tube, you would be taught how to use it and be able to bring him home. Just something to consider...
 
My Clancey was at the vet for 2 days 2 wks ago with high Blood sugars and low potassium. He was not eating and not doing well. We brought him home. Had to force feed for a little while but he started to eat on his own within 24 hours. I don't think he would have eaten if he did not come home. He was very weak and seemed disoriented as well , maybe because of low potassium. We gave the potassium at home and it was back to normal in a few days.

Did they do any electrolyte testing to see if the potassium is within the normal range?
 
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