Pls help Ozzie's numbers ...dropped really low!

Status
Not open for further replies.
lauren77

lauren77

Member Since 2010
I posted last night the update on Ozzie and that he was put on 2.5 by the ER clinic. She wanted me to shoot about 12ish before bed to see what is 8.20 shot of 2.5 did. Well, I have never been so scared in my life at 12.20 I had to do a bg on his little foot and finally I got it and it said 31! I got the karo on his gums to bring him back up and a little saucer of gravy food which he ate and I took it again and it rose to 57 then 92 but my god what is going on? He showed no signs of going down outwardly, this is so hard. He has not had anything to drink - I put water in his food and he hasn't gone to the bathroom to urinate - at least I don't believe so. And this morning nothing - usually he is the first one in there. I just took his bg reading upon waking up and it's 337. I have to call the doctor at 7.30 and tell her his numbers and she said she'll decide his dosage whether to lower it or keep it the same....Please help if you can. I can't believe he is all over the board. I have no idea what to do. She is not his regular doctor that got him out of DKA this past week but took over till Monday when I'll speak I guess a little to him but I can't figure if it's normal to be like this - terrified going up into the high numbers will bring on ketones again or maybe not after reading about Garland who was in the 200 range - Garland got ketones when he was in the 200's, so I guess anything is possible w/ this bloody disease. He's grooming himself on the chair right now, so he appears to be okay, but this falling so low you have to bring them up w/ syrup and they used the dextrose in the hospital, surely it's all messing him up. When he came out last time with his DKA he was fine, for a whole year - did not test all the time just once a week after he had his BG curve and 3.5 was his determined dose (the bg tests I do badly - I can't get blood straight away and end up squeezing his little ears till they're blue and bruised - terrible!) - but this I can see is going to be v. v. hard. Of course today we have the time change so really it's 6.29 now according to his schedule but 5.29 according to the correct time.
Any input, anything would be appreciated. There is so much to read, I start to read a post and then get so lost reading, I forgot the info I went on to read in the first place. My laptop is acting silly - crashing w/ new software I put on so I have to remove that. It's taking 10 times longer and harder to do things...isn't that always the way? But I'm thinking I cannot do this, I tried once again to give his bg by his ears but to no avail...wincing, pulling out. He is anemic so there isn't a whole lot to work with but I just stabbed the poor boy in his little pink pad on his foot and got it. Rubbed it w/ alcohol afterwards each time. He is on the antibiotic so that hopefully will prevent an infection in the foot - god forbid I kill him w/ a staph infection. This quite simply is one of the hardest things I've ever done - nobody gets it till you're put in this position. And I don't believe there's much room for error - I can't believe he has to go through all this....He's sleeping now on the chair, looks okay but definitely hasn't been to the loo this morning.
Any info or any advice is much appreciated it...I'm on/off the pc. Have 5 kittens (well they're older now so young cats were be more appropriate) to feed and keep away from poor Ozzie....my god this is HARD!
 
Good morning! Wow on the 31! You did the right thing with karo and gravy. That is definitely too much juice. Anything below 40 is an automatic reduction. I' m not sure what to tell you on dose, but protocol says to reduce by. 25U. The high number today is a bounce.

Tarragon had DKA a couple of months ago and his BGs were in the 200s so we are proof that that can happen. I know you are scared, but you are doing great.
 
Lauren you are handling this great. :YMHUG: Breathe....it will be okay. You are testing Ozzie and have proved you will keep him safe. I'm no expert...they will be along I'm sure. Just want you to know you are not alone and you are doing a great job.
 
Honestly I'm not you guys--- but thank you for the vote of confidence....I am calling the vet in 20 mins to give the numbers and she can let me know what she wants to do...I will update to see what she says and then give him the shot. No drinking or urinating...I've syringed a few times w/ fresh water in his mouth....
 
I would add extra water to Ozzie's food. When I think Harley needs extra water, I make his food a slushy mess, and he laps it up.

The real experts will be along, but don't be surprised if after this low, Ozzie throws you some high numbers.

Pattie
 
Hi Lauren! Great job last night. My cat was diagnosed about 2 1/2 months ago and I remeber those early days well- VERY scary. Try not to get overwhelmed, you really are doing great! Thank god you are testing, or who knows what might have happened!
 
Good Morning Lauren: Hang in there, you are doing fine. Please post the numbers you have gotten since Ozzie has been home. After you get your AMPS and talk to the vet post here. I know, hard to do but the sooner you get a spreadsheet up and running the better. That will provide the necessary insight into Ozzie's numbers.
 
((((Lauren)))) hang in there. This is the hardest part - once Ozzie is stable again things will become much more routine. Right now it's harder because you're having to be a nurse too. I've been there, it's really hard, but you can get through it.

It sounds like 2.5 units is too much insulin for now. Is Ozzie eating ok? Do you have ketostix to test his urine for ketones?
 
It sounds like it was a tough night. Please read and/or print out these two posts. If no one is around, they will help you manage either low numbers or a low pre-shot.

PLEASE, do the following things and let us know if you did them or are not planning on doing so:
  • report back on how Ozzie is eating and on what the vet tells you about dose;
  • get Ketostix and start testing even if it means separating Ozzie and a litter box from your other cats. Alternatively, get a meter (e.g., Precision Xtra) that will test for blood ketones; and
  • get your spreadsheet running so we can help you;
  • let us know if you want help with learning to test. There are likely people in your area who can help;
  • stock up on high carb food and strips.

You may need to keep this dose of insulin despite Ozzie running low AND feed a higher carb food to offset the effect of the insulin. Ozzie may need the the amount of insulin to keep the ketones at bay.
 
Hi guys -

just got off the phone w/ the vet - she said it could be the rebound effect and to go ahead and shoot 2.5 units and check his bg in 2 hours and to get a ketone strip under him but he hasn't gone yet...that is exactly what she said about higher carb food but keep the dosage for the ketone possibility. She's calling the regular doctor they are sharing a number of patient updates but thinks it okay if he is responding to the insulin and trying now to get the right dose for him . She wasn't worried about the drinking b/c of the fluids he had in the hospital and eventually he will urinate she said...God it's the waiting game for sure.
I will test for sure in 2 hours but it's the pad on the foot and she's not sure how accurate that is...Thank you guys for all the comments and advice I'll watch him like a hawk for the next 2 hours...
 
Lauren,

"Honestly I'm not you guys". All of us guys were you. Not a one of us volunteered for this dance and we all came to it terrified. You are doing all the right things. Last night you almost certainly saved Ozzie's life. It will get easier as Ozzie becomes regulated and his care becomes more of a routine. Hang in there. You are not alone.
 
when you talk to the vet next, ask to get a bag of fluids to give at home. it is much much cheaper and super easy for you to give at home rather than have the inconvenience of leaving home and the kittens to take Ozzie back to the vet.

There are tons of people around who can help you if you need to give fluids and I would feel better if you have some on hand to give when needed.

if you search on Youtube, you will find lots of good videos about fluids; just search on "giving cat fluids" and sort by Rating..... the top couple are really great.... you are already using needles to give Ozzie his insulin, so fluids are really not that much different - insulin has a syringe on the needle, fluids has a plastic line on the needle.

The 2.5u may be a little high and after a big low number, some cats are more sensitive to insulin, so you may want to test more after that +2... even hourly may help you see exactly how he is doing and knowing will help you.
 
Testing on the paw pad is just as accurate as the ear. Blood is blood. Just remember to make sure that Ozzie's foot is clean and the poke has stopped bleeding. (You don't know where that foot is going!)

I would not just stock up on high carb food (i.e., over 18%). You may want to get medium carb food, as well. (This is food that falls in the 10 - 18% range.) You will need to experiment a bit as to which foods will help you to offset the effect of the insulin.

If your vet isn't giving you fluids, please add extra water to Ozzie's food. As we all keep saying, hydration is yet another way to help keep the ketones away.

Gayle -- I believe Lauren asked about squids and the vet felt it wasn't necessary. (FWIW, my vet didn't send me home with squids after Gabby's bout of DKA but I wasn't here and didn't know the first thing about squids or ketone testing at that time.)
 
Yes, I am worried about the fluids and Pattie mentioned to ask the vet about a bag - but she said he was buffed up and hydrated really well so unless something major happened he was okay - shouldn't need it. I added water to his food - but still no urine or going to drink any water. Does anyone know what causes this...dropping so low so fast. I will now test in an hour or so to see what his BG is and I'll post it here...thank you guys for being a life line of sage and sanity....
 
Fluids may just be necessary, and the cost plus inconvenience added to the stress for Ozzie should be a good enough reason to have fluids on hand. There is nothing wrong with being prepared. Souping food may not be enough.
 
There can be a variety of reasons that Ozzie's numbers dropped. One big factor may be that he's less stressed because he's home (vs. being at the vet hospital). Stress can elevate BG levels. I also don't know if it was a "fast" drop -- there are no numbers to look at in order to know where Ozzie's BG was pre-shot and how long it took for the numbers to drop.

Lauren: could you please respond to ALL of the following:
PLEASE, do the following things and let us know if you did them or are not planning on doing so:

  • report back on how Ozzie is eating and on what the vet tells you about dose;
  • get Ketostix and start testing even if it means separating Ozzie and a litter box from your other cats. Alternatively, get a meter (e.g., Precision Xtra) that will test for blood ketones; and
  • get your spreadsheet running so we can help you;
  • let us know if you want help with learning to test. There are likely people in your area who can help;
  • stock up on high carb food and strips.
Click to expand...
 
like linda said, we were all just like you are! really.

you will learn what to do, you will get over being so scared, you will gain confidence about this. really. there are many people here ready to help you. don't be afraid - you're going through the training but i bet you've never had training before where there was a whole team of people standing next to you.

be confident. it's simply learning new things. and at some point you will be thankful for how close it has brought you and Ozzie. :YMHUG:

take it one step at a time. answer sienne's questions first, breathe and tackle each thing separately.
 
Good job catching that 31 and taking quick action to bring the numbers up.

please get the ss up - it will be an enormous help having all Ozzies data instantly available at a glance.
 
PLEASE, do the following things and let us know if you did them or are not planning on doing so:

report back on how Ozzie is eating and on what the vet tells you about dose;
get Ketostix and start testing even if it means separating Ozzie and a litter box from your other cats. Alternatively, get a meter (e.g., Precision Xtra) that will test for blood ketones; and
get your spreadsheet running so we can help you;
let us know if you want help with learning to test. There are likely people in your area who can help;
stock up on high carb food and strips.

Thank you so much for all pitching in with your advice. I just got off the phone w/ the doc. I gave the numbers:
got up at 6.14 337
i shot at 8.45 am 2.5 units
10:45am bg with the meter I've been using ultra was 398 /breeze meter bg was 468 quite a difference so I'll stick w/ the ultra.
Got a ketone strip when he urinated and still neg -- not as copious amount as usual but quite a bit. Still not drinking like he did - a sip here and then. Souped his food this am will add water again and tried a few syringes of water in mouth.
I will definitely get up the ss might need a little help though I tried once before to no avail.
The latest is and pls give me your thoughts. The doctor today is ER and spoke to his doctor at home re his numbers and it's strange but they are saying not to shoot at 8.30 tonight. They have seen him go down low in the evenings now 3 days and think either he doesn't need it or it might be the wrong insulin after all or something else is going on.
Please let me know what you think - any advice is much appreciated. I have to call in his bg reading at 4 pm which has been pure hell to get -- his paws are hard to squeeze and he is a little anaemic so it's a wee bit harder to do...I knew a year ago that it would all come down to this testing and getting it done correctly on his ears...oh god it's hard.
 
tell us what you have happen when you test his ears. is it that he fights you? or it doesn't bleed?

you really can do this. nobody wants to do it at first. i had to catch punkin and burrito him in a beach towel for the first couple of weeks, but then he gave up, his ears started to bleed better, and all around it got easier. now he asks to be tested. ozzie will adjust to it and you will get amazingly fast. i knew i'd made it when i managed to test punkin while i was talking on the phone without the person even knowing i was doing it. you'll get there.

a few tips:
- you can burrito him in a beach towel if he fights you while you're doing it.
- a warm ear bleeds better - warm with a pill bottle of warm water or an old cotton sock with 1/2 cup of rice that you nuke til warm
- aim for the outside 1/4" of the ear between the tip, down the outside edge to that little foldy part
- the ears grow more capillaries as they get poked, so while it can take multiple pokes to get blood when you're starting, eventually you get blood every single time. think of those pokes as investing in capillary growth!
- use neosporin ointment with pain relief - i slather it on at the end of the day and the ears are healed by morning.
- a thin slick of vaseline (very thin) on the ear first thing in the morning will help the blood not get soaked up in the hair or skin and bead up so you can test it easily
- apply pressure for a few seconds after testing to stop the bleeding and prevent bruising.

i'm sure others have more ideas, so just keep trying til something works for you.
 
ps, the anemia shouldn't have anything to do with getting blood. that just means he has fewer red blood cells, but the blood is still there. if he's not bleeding it's because you're new at it. he'll grow more capillaries.

i'll let others comment on the no evening shot. our standard here is 1 shot, same dose, every 12 hours per the international protocol we follow. perhaps somehow ozzie's case is different?
 
Many cats' numbers are lower during the PM cycle. This isn't unusual. With Lantus, you want to shoot the same dose at AM and PM. The vets sound like they aren't fully appreciative that this is a depot-type medication and there is overlap between shots. It may be that you need to lower his dose so you can shoot twice a day.

Lantus is also a twice a day dose. Once a day will make hash out of Ozzie's numbers.
 
Sienne, I know that Harley's vet was big on 1 dose AM, different dose PM. He never really got to where he is until I did a consistent dose AM & PM. Harley really was trash when I did 1 dose, once a day.

What can I do to help.


pattie
 
I think this is up to Lauren. I know how hard it is to not follow the vet's orders. I also understand the concern re. Ozzie's numbers dropping.

Some of the drop may be due to a shed that's been getting 4.5u of Lantus. It's going to take a couple of cycles for the shed to drain. I'm worried about skipping a dose given the recent ketones and I'm surprised that the vet isn't as concerned today as he was when he was suggesting 2.5u BID.
 
Hi guys -- I'm just reading over the last few posts since I updated and I think that's the problem - I spoke about the shed but I don't know if they agree - definitely agree w/ the rebound effect though which is good!
I got his bg at 4pm 207
running late i got home at 6:45 my sister babysat but can't prick just like me but I have to force myself b/c it's life or death.
so I pricked his little tootsie again and bingo 401. called vet expecting the call and she said she thinks half a unit. going to confer w/ Dr Erikkson if she can reach him - he takes over the data and numbers tomorrow - and is thinking b/c he goes so low in the evening that might even him out. He just ate and is due in the next 15 mins or so.
Re the baytril liquid the stuff smells so bad for love or money I could not get it down him and even sprinkling on his food I had to throw that away in case the other critters found their way into it.
he's looking good and is better 100% than he was before when he got home...but i won't jinx him - he's holding his own.
Thanx for giving advice about his ears - well if it wasn't so serious it would be hysterical -
this is what happened last night when it got the low reading. I have a microwave and I have left the rice sock in there b/c we very rarely use it...so i go and it's not there so i find it the kittens have chewed it around playing w/ it and the rice is spilling out. I put it in and it's popping around making a noise...all this the little guy is so low i'm rubbing karo on and the rice is sticking to my fingers...so i grab a sock and throw it in the microwave and i look over and i see flames --- the socks have glitter thread in them and they are lighting up the bloody microwave. I thought the fire trucks are going to come out for the sock on fire...honestly it's been on helluva of a week...here's hoping the new one is better.
I think I might need to study the ear test and really get hands on ...my nemesis that bloody bg testing on the ears...
Many thanks to you guys for all your kindness and wealth of knowledge. I'm hoping it gets easier...fires in the microwaves ad sticky rice fingers elimated....
 
I'd encourage you to talk to your regular vet. You probably don't want to use the term, "shed" -- that's Lantus Land speak for the technical term -- depot. I suspect that if you describe the yo-yo effect that you've observed, asking if it would make more sense to lower the dose so you can shoot the same amount twice a day may make sense to your vet.

If you are only going to give a token dose tonight, please do whatever you can to stalk Ozzie to the litter box and test ketones as often as you can. The ketone test is the best prevention you can possibly do especially since your vet is wanting you to give less insulin.

Baytril -- ask the vet if you can get this compounded. There are pharmaceutical companies that will custom blend a medication so it doesn't smell or taste horrible. You could probably get chicken or tuna flavored Baytril that will be more palatable. You may want to make sure they don't add sweetener to the the formulation, though. Alternatively, are you able to pill Ozzie? If the vet will give you pills, you can also put them in an allergy formula Pill Pocket. The allergy formula doesn't contain corn syrup so it's fine for diabetic cats.

If you want help with the ear pokes, you can ask here and/or on Health. It's very likely there's someone in your vicinity that would be able to help you. Paw pokes are fine. Several people here routinely poke paws. Blood is blood, no matter where it comes from.
 
Thanx Sienne and Linda -- I shot half unit and I have the pills from the first visit to ER last week but I'll check w/ the dr tomorrow about them - I will stalk him but he's pretty obvious when he goes to the litter box - will only use the big one and usually a lot water so I have chance to jump right in there.
I guess you have to slow down and breathe but it's hard. I will after the next few days - sort out time w/ his local vet but he didn't have one b/c I moved to NYC and for a whole year he hasn't had one day of illness or problem with him. Till the critters came, then I took my eye off the ball w/ him...I'm so sorry and feel so guilty I still cry when I think how unaware I was...
Anyway, I will work on the SS tomorrow and post his numbers that I get tonite..I have to try and get one at 2 am so it will be interesting to see what happens here...
Thanks again girls -every single one of you you're all awesome!
 
*snort* i loved your sock microwave sticky rice story. sometimes you have to laugh or you'll throw something through a window! it really does get better. you're doing fine.

punkin had the liquid baytril from the compounding pharmacy - it was supposed to taste like chicken. the poor guy acted like it was the most repulsive thing ever. he walked around foaming at the mouth and vomiting all over the place. someone told me baytril liquid is just really really bad. the flavoring can't cover it up.

the pill pockets are a Godsend! even if ozzie doesn't snarf them up, because they cover the pill they make it much easier to push it down their throats. punkin will eat them on the floor. trying throwing a couple of 'blanks' without pills first to get the pump primed!
 
Zener LOVES the pill pockets (duck & pea). He starts trembling with excitement when he hears us opening the bag. :-D Definitely the way to go with pilling our guy. You're doing great, Lauren. It takes a while to learn this stuff and you are making great progress.
Liz
 
Status
Not open for further replies.
Back
Top