Shadow 3 hypo crashes, 490 AMPS, not eating

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Quick question before update in case people don't read this all: DOES ANYONE HAVE ANY FOOD IDEAS FOR SHADOW TO GAIN WEIGHT? I have been trying to keep him on canned Hills (3 different flavors/types) due to kidneys not doing well with lots of protein, and at 25% carbs, that is better for him to put on weight than Wellness or tuna. I've tried about 3 types of Friskies canned, Fancy Feast, and he no longer has any interest in the Friskies kibble he has eaten for years...he does eat a little bit of Wellness kibble...but I don't want him getting full on low-carb kibble at this point. More food/eating info. below update:

I am happy to report that Shadow continues to improve! We had some delays in getting to the vet early in the week for blood testing to look at his kidney numbers and red blood cell counts. We finally took him in yesterday (Wed. 22nd) and got him tested! ALL HIS KIDNEY NUMBERS ARE NOW IN THE NORMAL RANGE! His red blood cell count went from a low about ten days ago of 18, last week up to 22.3 and the next day 22.9 Yesterday they were up to 25! That is still very low, but it's going in the right direction!

He is walking around much more, gone out on the porch for some fresh air a couple times, and most importantly, 2 days ago during a lap petting and chin scratching session he PURRED for the first time in 2 weeks!

His eating has slowed a bit and he is very skinny. I'm doing 3-4 varieties of canned at him, occasional Wellness kibbles, but he's not eating as much as he was. He did chow down on some tuna right out of the can last evening and before bed though. Mixing Tuna 50/50 with Salmon flavored Friskies patte this morning did not work. It has been since Sunday that he had the Rx appetite stimulants and we are out of it, so I am thinking of getting a re-fill. I am also strongly considering a baby scale today so we can more closely monitor his weight rather than the current eyeball/petting method that currently seems "he looks like he is dropping weight".

Thanks for the continued support,
Shadow, Nan & Matt
 
So lovely to see these positive updates. And to hear that he is purring again - wonderful!

I always had to look for lower calorie foods, not higher. :-D Here is a thread with food lists. I'd look for something with low carbs but high calories. (I think some kitten foods might be in that category.) Maybe buy a few cans of several kinds and try them out?

http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=115

Have you tried FortiFlora? It is a probiotic that has the flavor enhancer that makes kitties love dry food, so with some cats, it increases appetite. It is available on line and through your vet.
 
Nice update. I'm so glad he's doing so much better.

I was going to say Kitten food too, it's higher calorie. But look through the list Sue linked and see what you can find.
 
Sue and Oliver (GA) said:
So lovely to see these positive updates. And to hear that he is purring again - wonderful!

I always had to look for lower calorie foods, not higher. :-D Here is a thread with food lists. I'd look for something with low carbs but high calories. (I think some kitten foods might be in that category.) Maybe buy a few cans of several kinds and try them out?

http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=115

Have you tried FortiFlora? It is a probiotic that has the flavor enhancer that makes kitties love dry food, so with some cats, it increases appetite. It is available on line and through your vet.
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===========================

Sue, thank you for the link, tips and support! I have tears streaming down my cheeks right now as I type this. I saw the avatar pic, and PS that it wasn't Oliver. At first I clicked on the pic to hopefully see a bigger one of your Russian kitty, but that brought up your profile. Reading what you put there, and seeing that you have been "paying it forward" with over 11,000 posts on here, helping people an average of 9.5 postings per day when you no longer have a diabetic cat just touched me sooooo deeply that tears just started streaming! How wonderful, beautiful, touching, warm, kind, and great you are and the support you give other's like me! You are an inspiration and I intend to also "pay it forward" by participating on FDMB and writing and putting up my paper about "Aftercare for Hypoglycemic Event" for others to learn and use what I have gleaned.

Shadow has eaten a bit better since I discovered a "trick for eating" of sorts for dry kibble. He was offered Wellness kibble that had been in the bowl several days (usually put up and not available until after canned) and would not eat it. I had an idea and got out the zip-locked bag of Wellness in front of him, put in "fresh food" from the bag, and he went right for it and ate! Now what I do is put any unfinished food away in the bag to stay "fresh and smelly" and zip-lock it. When it's time to eat I shake the bag, he runs over, I unzip it and he puts his nose in and gets a sniff, then I put some in the bowl and pet him while he eats. Since his first Hypo event 4 years ago and diabetes diagnosis, Shadow has always wanted and semi-needed some petting while he eats.

Our vet actually suggested FortiFlora yesterday, but they didn't have any and said it is stocked at Vitamin Cottage...where we will head tomorrow and get some! He actually suggested it for his diarrhea and IBD. I was already aware it can encourage them to eat when sprinkled on food. Also, we did get a re-fill on the Rx of the appetite stimulant, which we will start him on tomorrow morning.

In case other people may do searches and find/read this thread...I also want to mention some things I find key in his treatment besides home testing with a glycometer. PetSmart has a GNC Vitamin Supplement for cats that is wonderful. Even when Shadow was on syringe feeding he would lick it from the tube and it is indeed "yummy". I research vitamins and nutrients to support the liver, pancreas, and kidneys and the GNC product has basically 11 of 12 of them! Also, the vet gave us a Potassium gel supplement since we were doing home care over a weekend. He would not eat it, but smearing 1/2 inch of the gel on the roof of his mouth was quick and easy. Two doses a day and his Potassium was in normal range when tested on Monday after the weekend. It had been low and otherwise needed IV for it. They also make an "energy booster" that I got later. It is nearly identical, but has protein as well as a lot of vitamins and also some omega 3-6-9 the regular one doesn't. They are both high in corn syrup, molasses, etc. and primarily a sugar and vitamin gel. Interestingly, by BG testing we saw that it throws his BG up a lot, and fast! What is wonderful for us about this discovery is that when he was too low for us to give his AM shot, after giving his Vitamin and Energy booster...in 1.5 hrs. he shot up 150pts. So, it can make it easier to time a shot, or know that you can give a shot at a low BG...if you give these supplements right after and therefore know they aren't going to go hypoglycemic on you. This will help us stick more closely to 12hr. regimen on shots and sleep better overnight! The last thing is SmartWater (big bottles at Walmart for $1.85 and a fountain feeder! The SmartWater has electrolytes and potassium in it! When a cat is on an I.V. at the vet, they are usually getting water/saline, potassium, and electrolytes...maybe with dextrose (sugar) if needed. In summary, for home care, a combination of potassium gel, potassium in Smart Water, electrolytes in water, GNC Vitamins and Energy booster (sugar) if needed - you can fairly closely do the same thing as an I.V.!!!! Both our cats took right to the water fountain. We got a dog sized one at PetSmart and it works just great. Filling it with 7 liters of smart water, and with it's filter, means we can "set and forget" water until 3 weeks when we clean it and change the filter.

Thanks again Sue and best of health to all!

Matt and Shadow.
 
Thank you. I appreciate it :oops: My husband might argue that I am just a little obessed with diabetic cats. :lol:

Yes, you have learned a lot and should share it. It's true that you just have to try things and then hurray, something works.

Thanks for good Kitty report. It's so wonderful that Shadow is improving daily. :RAHCAT :RAHCAT
 
You are right about Sue, one of our members lovingly nicknamed her St. Sue for always being there when someone needed her.

Interesting about the vitamins from GNC, I'm going to go check it out for my seniors.

You should check out the post that Chuck and Susan posted today about her hypo experience in 2008, you and Susan have that nightmare in common.

I'm glad that Shadow continues to improve.
 
Rob and others,

I am glad you will check out the GNC Vitamins for your seniors...however, if any are diabetic...I have learned that while it can help boost their BG about 75 pts. in 1 hr., it is basically 3 kinds of sugar, including corn syrup and molasses...that "quick fix" is short lived (which in some cases may be good), but if a diabetic cat is already at 225+ at injection time I would not give vitamins...if when his numbers support it, I will only be giving Shadow Vitamins once a day right at his 6.5 Nadir and after testing...if not low enough I will be skipping the vitamins.

Thanks for your comment,
Matt

Rob & Harley (GA) said:
You are right about Sue, one of our members lovingly nicknamed her St. Sue for always being there when someone needed her.

Interesting about the vitamins from GNC, I'm going to go check it out for my seniors.

You should check out the post that Chuck and Susan posted today about her hypo experience in 2008, you and Susan have that nightmare in common.

I'm glad that Shadow continues to improve.
Click to expand...
 
Shadow Rides high again UPDATE: Rocky few days with Shadow apparently overcoming his insulin sensitivity after Hypo crashes...his numbers started soaring and we had to move from the tiny 1U (100U scale) that he had been on for 10 days to 4U to deal with 536 BG, then that was not enough and at +9 hrs. had to do 3.5U, and that helped, but not enough still, and at +9 hrs. we had to move up to 7.5U !!! Wow, I guess his Nadir numbers were creeping the past few days and we noticed eating had declined. Due to high numbers he went back to refusing to eat, started syringe feeding...finally got him down to 143 at +6hrs. after those 3 doses. It is not all that odd I supposed, because prior to this hypo incident, he had been stable for 2.5 yrs. on 7U doses every 12 hrs....it just snuck up on us!

We are going to keep feeding, injecting, and keep him LOW! Today was hard tightrope and nervous of giving the 7.5U and another hypo crash...but seems we made it. He was syringe fed at the +6hrs. so I think we are out of the woods, going to test now for the +7hrs.

IF ANYONE HAS ANY ADVICE ON WHAT I MAY LOOK FOR IN THE NEXT FEW DAYS FOLLOWING A RETURN TO PRE-HYPO DOSAGES, AS WELL AS AFTER GOING TO 536 AND STAYING HIGH FOR 3 CYCLES...I WOULD SOOOO APPRECIATE IT!! IS HE GOING TO BOUNCE NOW? GET A BIT STABLE AT THE 7U?? THANK YOU!

PS I made a wonderful spreadsheet calculator that you simply enter BG and it tells you EXACT dosage to give (based on standard tables (ranges) internal mathematics, and also you can enter a specific factor for YOUR cat based on his previous few days data of what he actually does, as well as a feed/no-feed factor you can use if you do/don't do a lunch feeding. I WILL PUT SOME POLISHING TOUCHES ON IT, INSTRUCTIONS, INFO. ON HOW IT IS ALL CALCULATED, AND SUBMIT IT TO THE GROUP. (Excel Spreadsheet, can easily be added as a new "Tab" on your existing spreadsheet!
 
OK, I just tested at +7.25 hrs., got 152, which is a nice little, slow increase of 9 pts over 1.25 hrs...from the +6hr. of 143 (usually 6.5 Nadir on him). I timed his 2 syringes force feed (10mL total) at +6.25hrs. and it slowed the insulin and also prevented spike back up high. I am currently thinking of injecting again at +9 hrs. since that is what we had to do twice to finally get him even below 200 from that nasty 536! (umm, which I had tested early at +11 hrs...good thing I didn't wait until +12).

My thoughts in general (please point out where I may be ignorant or wrong!)

- Slight overlapping of 9hr injection cycle (3 so far) has worked well
- Basically at +8 or +9 his BG number are on the rise and so I don't think 10-14hr.
normal duration of Prozinc is what is occuring (maybe 9-10hrs). When he was
post-hypo and insulin sensitive...there were still drops at +12, & even +14
hrs... but not the past 4-5 days.
- Since I need to syringe feed 10mL every 2-3hrs. for probably another day,
the overlapping 9 hr. dosage will both keep him low AND will be offset by
continual feeding.

WHERE I THINK I MIGHT BE WRONG AND 9HR. INJECTION CYCLE MAY BE WRONG APPROACH: Maybe it was just required to do 3 9hr. injections to finally get him down from 536 because we weren't giving enough insulin seeing as he just recovered and returned to his normal 7U dosage. Maybe now that we finally got him below 150, I should instead look to inject at perhaps +9 hrs, or +10 hrs. before he gets to high, and then consider the next day going to 11hrs. or 12hrs....following at night with a return to normal 7U 12hr. injection cycle? Opinions/suggesting on this???

Anyone with hands-on knowledge of 8hr (3cycle) or 9hr. injections with ProZinc would be soooo helpful to me now!

Thanks,
Matt, Nan & Shadow
 
Whoa!

Diabetes management takes time, please slow down! Keep a consistent dose, every 12 hours (or every 8 hours) with consistent feeding, and get him stable. Change 1 thing at a time so you know what effect the change has. If you give too much insulin or drop the glucose too fast, you may trigger counter regulatory hormones which pop the glucose right back up, making you think more insulin is needed when it isn't. Better too high for a day than too low for a moment! You can't get the insulin out once it is in.

ProZinc does have fairly steep onset and offset while the cat is getting used to it.

Low carb kitten food (higher fat and protein) is good for increasing weight; carbs will just make it more difficult to manage the diabetes.

While the calculator might be nice, cats' glucose homeostasis is multifactorial and includes activity levels, endocrine balances, and more. What works for one cat may not work for another. And I am a numbers person, OK?
 
BJM,

Thank you for the reply and your thoughts and counsel. I especially appreciate what you wrote about the counter-regulatory hormones and "artificial highs" tricking me into thinking he needs more than he does! That is PRECISELY the advice/tip I needed and what to watch out for next. THANK YOU SO MUCH! Shadow has been on ProZinc since 2010, so at this point he and I are just getting used to a new dosage after his Hypo traumas, rebounding, insulin sensitivity.

GOOD NEWS UPDATE: +7.25hrs 152, (syringe fed), +9hrs 186, +9.7hrs 161 ...So, it looks like with some food and only a few hours to go now he will be ready for a shot at 12 hrs. I will do my best on dosage and hope to get him back to 12hr. cycle again in morning. Food has been as consistent as possible. 2 Syringes force fed every 2 hrs...excepting when he 400+

[Part of what follows is for the "historical archive" of his case and hopefully of benefit to others who may search the forum boards]

I do know and planned to take insulin dose increases LOW & SLOW. Unfortunately, I was apparently caught with my pants down and failed to notice for about 4 days that he was ready for gradual increasing after going to a micro dose (.4U on 40U scale) after his 3 hypoglycemic incidents in 6 days. He was so insulin sensitive. After 10 days that apparently started going away, and I was slow on the uptake (pun intended). If I had a "do-over" I would have started .25-.5 increases 4 days ago and kept pace with his needs in a gradual manner. My problem was him running too high for days, the huge 536 combined with not eating for 25 hrs. and very low eating the previous 2 days. His eating had been much better, but apparently dropped off when he was running too high a BG and I wasn't doing the slow dose increases I should have been doing. Running high numbers for too long can obviously cause the hyper stuff, ketones, etc. and I feel was making him also not eat. Bottom line I guess is that I did get him down...and will try more SLOW adjustments now and try for 12hr cycle. After his episode it too like 7 days to even get him to handle two shots a day!

I feel like a tightrope walker!! Peril on either side...it does not help that I am new to it and have been drinking (not really)! Oh life was easy when Shadow was well regulated and we didn't home test. 7U every 12 hours and never worried about anything :) Ahhh the good old days and decent nights sleep!

BJM said:
Whoa!

Diabetes management takes time, please slow down! Keep a consistent dose, every 12 hours (or every 8 hours) with consistent feeding, and get him stable. Change 1 thing at a time so you know what effect t
​
he change has. If you give too much insulin or drop the glucose too fast, you may trigger counter regulatory hormones which pop the glucose right back up, making you think more insulin is needed when it isn't. Better too high for a day than too low for a moment! You can't get the insulin out once it is in.

ProZinc does have fairly steep onset and offset while the cat is getting used to it.

Low carb kitten food (higher fat and protein) is good for increasing weight; carbs will just make it more difficult to manage the diabetes.

While the calculator might be nice, cats' glucose homeostasis is multifactorial and includes activity levels, endocrine balances, and more. What works for one cat may not work for another. And I am a numbers person, OK?
Click to expand...
 
I have to admit that I wasn't around much when you started posting so I'm not as familiar with Shadow's history as I should be. But I don't really understand your dosing strategy.

Also if you could set up our spreadsheet it will be easier for us to track your bg history and help out where we can. Personally I'm uncomfortable giving any advise without a spreadsheet and notes in the comments, it's a quick refresher of your journey for you and us.
 
Thank you Rob. I am days behind on updating my spreadsheet, but I will and I will attach it in the next day or two. Right now it's 5 hrs. sleep and notes/log on the backs of envelopes all over the counter. But, they are very detailed with times, food, etc. and I have my Glucometer history to double-check with.

I am taking a lot of your advice to heart. We were at 12 hr. cycles before this 536+ crap. We are back on it now and will stay on it. I will use my spreadsheet to calculate my best dosage for tonight, dose again in 12 hrs. exactly, and if I need to make any change it will be a small one! Thanks!

Also, I meant to say about the dosage calculator spreadsheet...contrary to what you said about different cats, diet, etc. making it not work, the beauty of it's premise is something I call a "BG Point Drop Factor" that IS SPECIFIC TO YOUR CAT, CURVES, AND READINGS! You can start with a baseline from a chart, avg. that with your cat, or enter your cats last day number, 3 day avg. etc. So it is specific to your cat and timely/updated based on food consumption, type, exercise, etc. My findings were that my actual numbers were darn close to the avg. of 2 charts (within 1 point!). So, I was able to use the previous day's Factor averaged with 2 charts and get dead on!

Rob & Harley (GA) said:
I have to admit that I wasn't around much when you started posting so I'm not as familiar with Shadow's history as I should be. But I don't really understand your dosing strategy.

Also if you could set up our spreadsheet it will be easier for us to track your bg history and help out where we can. Personally I'm uncomfortable giving any advise without a spreadsheet and notes in the comments, it's a quick refresher of your journey for you and us.
Click to expand...
 
Shadow passed away on Memorial Day at 6:31am. He had been into the E.R. and was on an I.V. for 14 hrs. but was getting worse and unable to urinate. We brought him home and he spent 12.5 hrs. with us. He spent his last 9 hrs. on his mommy's lap...where he has spent about 6-8 hrs. a day for the past 10 years and was his favorite place in the world. He passed on her lap quickly without suffering. We have come up to our cabin in the mountains and buried him beneath a 6ft. tall Colorado Spruce tree at the edge of the meadow.

Apparently he had an undiagnosed/untreated UTI (established by the E.R. urinalysis), despite the primary vet conducting urinalysis test(s) and finding crystals present. They did not start him on antibiotics and could have about 12 days prior. The E.R. started him on antibiotics immediately. Since his kidneys had fully recovered, had he been given antibiotics 12 days prior (it is usually a 10 day treatment), his drinking and urination system would have continued to flush his healed kidneys and Shadow would have lived. The same vets administered more insulin than required on two occasions which resulted in his 2nd and 3rd hypoglycemic events that made his kidneys so damaged in the first place and his recovery so long and difficult. I advise everyone to be cautious with veterinary care, ALWAYS approve any insulin dosage given to your cat by someone else!!! Do you best to care for your cat at home once it no longer required an I.V. Or do I.V.'s during the day and bring the cat home overnight. We could have given oral antibiotics to Shadow at home had it been diagnosed and recommended.

Thank you to everyone here who tried their best to help us and Shadow.

Matt, Nan and Shadow R.I.P.
 
Oh, Matt and Nan, I am so sorry to hear about Shadow. You tried so hard to get him well. I'm glad you had some good time with him and you can always know he felt loved and treasured.
 
Matt and Nan,

So sorry to hear of Shadow's passing. I hope those last hours at home, in his momma's lap, give him and you much comfort.

Fly free little Shadow. You have earned your wings wings_cat but will be sorely missed.
 

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