Pretty Foots diabetes out of control on vetsulin - diagnosed Aug 2008

[Pretty Foots]

UPDATED 8/8/15 - Great news Pretty Foots is still with us
After my post his BG went as high as 737 on 7/30 admitted in vet clinic until Monday 8/3. My vet suggested euthanisa. Pretty Foots let me know he wanted to live so I asked to take him home with the catherer left on to give him IV Cefalexon that I will learn to give Novilin R intramuscular every 4 hours. He maintained his weight and gain a little since then. Has URI added Guaifenesin today to get the junk out, ease his breathing. Lungs are clear and catherer rechecked every 3 days. I give him fluids 100 ml twice a day. Still on Arithromycin, Doxycycline and Cefalexon IV. I flush his catherer. He ate treats at the vet today and some later. No dry yet. Only food he is eating the Hills a/d and gravy from Fancy Feast gravy lovers. Vet never had anyone take a diabetic cat home like I have with catherer and giving intramuscular Novlin R insulin every 4 hours.

I won't consider long lasting insulin until URI clears, eating dry foot and gains more weight.
Pretty Foots mom
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Over the weekend he was hospitalized to get his blood sugar down. He lost another pound he couldn't afford and is battling a severe URI for more than two months off and on. At the hospital his BG was 700 when he arrived. They did two days of curves released him on Monday morning instructed me to do 2 units U100 Vetsulin and warned me they tried 3 units and his BG dropped too low. He was on 3 units earlier this year and w012ent down to 2 units a few months ago before the URI.
He gained a pound since release ate 2 cans Purina DM the 1st day he was released. I give him 75 ml fluids twice a day. He had energy to greet me at the door at 6pm (+10 hours) ate some Hills a/d. By 7:30 he was so tired he is sleeping in the sink curled up looking awful.
8pm HI >600 2 units U100 Vetsulin
10pm HI >600 retested 1 minute later 595
12am 507

Emergency vet said Lantus is best. I do my curves with Relion Confirm. He is on azithromycin, doxycycline and chlorpheniramine for URI. Mirtazapine every other day for appetite.
Pretty Foots is 15 years old never had diabetes out of control like since Vet saved him from ketoacidosis August 2008. Started on vetsulin until taken off market. Tried Humulin went hypo 3 times. Back on Vetsulin over a year ago.
Your advice greatly appreciated.
DJ and Pretty Foots

 

[Chris & China (GA)]

Welcome to the FDMB DJ and Pretty Foots!!

Lantus is actually a much better insulin for cats than Vetsulin or Humulin. It's longer lasting and more gentle. The biggest change you'll have to get used to is that Lantus is dosed totally different than the other insulin's you've been on. It's dosed based on how low it takes them, not what the BG is before shooting (the Pre-shot)

Infection, inflammation and pain can also raise the BG numbers, so hopefully as the URI gets under better control, that will help bring those numbers down!

The Hills A/D is higher carb than we suggest using. The D/M is OK, but it's awfully expensive considering there's no "magic" to it. Most of us here feed plain old Friskies Pate's or Fancy Feast Classics (all under 10% carbs) Controlling the carbs is one of the most important things you can do, BUT since you're giving insulin, it needs to be done slowly. There are lots of other foods listed on this Food Chart that are available at grocery stores and pet food stores....You want to pay attention to column C and choose foods under 10%

It's GREAT that you're home testing too! That's very important and will help you going forward. If you have your numbers written down, it'll really help if you'll start our spreadsheet and put some of those numbers in. If you have a week or two's worth, that's a great start! Here's "How to Create our Spreadsheet" instructions

Sorry I don't have time to give you a lot more details tonight, but I wanted to welcome you to the best place you never wanted to be and give you a little info! Hopefully you'll hear from others soon too!

 

[Sue and Oliver (GA)]

Glad you made it over here and hope we will be able to help. I agree with Chris that the infection is complicating the picture and is likely responsible for part of the higher levels.

Good job on testing! That will let you know what progress you are making. If you can get a test in around 4 hours and then 6 hours after the shot, that may help you see how low the insulin is taking him. Then you can see how the dose is working. How is his appetite? Lower carb food would be good to add to the picture, but for now, you want to be sure he continues to eat.

He is in very high numbers. Are you testing for ketones? I definitely would test for them too, especially if he has had them in 2008. DKA caused by high levels, poor appetite and infection and you have experience in how awful it can be. You buy the regular ketone strips that humans use. Stick them in his urine stream. If he won't let you do that, we have other ways. If the strip shows any more than a trace, you need to get him back to the vet.

Lantus is a better insulin. When you get things stabilized a little, it would be wonderful to change. For now, I'd suggest you concentrate on continuing to keep him hydrated and eating (wonderful that you are doing fluids). I think the DM is wet, right? If so, you might add a little warm water and make a gravy. It may be more appetizing for hum and it will help with his hydration.

If you can get some numbers later in the cycle to see if and when he drops, you'll know if you need to raise the dose. (They said 3 units was too much, right. It might be that adding 0.25 or 0.5 could lower the numbers without him going too low. Or your numbers midcycle might show you that he is really dropping too low on his current dose (you want him above 50) and bouncing back up.

I'd continue to test for blood glucose levels, test for ketones and make sure he continues to eat. Let us know how he is doing.

 

[BJM]

Check with your vet about adding some l-lysine; it can help some cats with feline herpes infections.

Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.