Should he be home after severe hypo event

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Lcrawford

Member Since 2012
Hello everyone.

Yankee is having a better day, he is standing frequently now, although he falls when he tries to go anywhere because he doesn't really know what to do with those legs right now.
His vision is still not there but he's responding to light by squinting. He ate with assistance, but is unable to eat by himself. He had a small seizure yesterday afternoon and some facial spasms today, which they gave him valium for. The vet at the emergency hospital feels he should remain there where he can get 24 hour care. When I expressed concern over the bill and how much time
there that we could afford she said if the choice were euthenasia or home, she would say home but she thinks it's too soon. I don't know if she thinks we must be incompetent since we OD'd our cat (though we did so becasue of a vets advice), especially since she told me she thinks we should allow the professionals to test and not do at home ourselves, or if in fact the care there is likely to help him recover more fully.

The old vet (the one that had us on the high dose of insulin) told me he thought I could manage his care at home at this point.
I have to consider though -is the most reliable source of info now given the bad recommendations I received about the insulin and dose.

He's been at the hospital for around 45 hours now, and since it's really a wait and see situation the vets there say they cannot advise me on when they would likely recommend he come home.
We worry would we be able to provide everything he needs (valium for face spasms?), get him to eat & drink enough etc. but also wonder if he would improve more at home, in a place he is familiar with, surrounded by people who love him.
 
sorry you are in a tough place with conflicting information. I would ask the ER vet about what treatments to provide, what to look for and how to respond (eg. when he might need valium, etc). If money is an issue and you feel confident in being able to monitor, I don't see why not IF he is relatively stable.
 
I'd be concerned about fall risk due to vision and mobility impairment, hence you need a crate or small room without levels (so he can't try to jump). If you have a moderately large dog crate (say 30 - 42" long) or a small room without heights in which he can be kept safely given his discoordination, then you have a suitable environment in which to keep him.

What are his current nursing care requirements?
If he needs IM Valium, can you do it?
If he needs subcutaneous fluids, can you do it?
Are you are able to do the nursing care he needs right now, even overnight (how much do you need to sleep? Can someone else help?), it might be OK to bring him home.
 
My vet overdosed Sebastian while trying to 'regulate' him. In 3 days he started at 0.5U of Lantus on the first shot--for a boney, just-recovered DKA cat who was only 6 lbs--by dose number 6 (3 days later)hehad him on 2.5U!!! So 5U a day! He was going hypo every single day because the vet overdosed him and they were not doing curves--only ONE midpoint blood test reading...and so they would miss it and get HI on themeter and then jack up the dose even more...when I realized this last December I insisted on taking him home and said I could regulate him. They got mad that I wanted to do this and I had to sign a waiver saying I was taking him 'against medical advice'...yeah, like I"M the one putting him in danger.

ONE HOUR after I brought hiim home he was 38 BG!!!! And since then, he's beeon on one shot of Lantus only 1/4 unit once a day.....and he is now DOUBLE THE BODY WEIGHT.

I think as long as he is not having ketones, or antyhing like that--you shoudl bring him home and go very very low and easy on the dose and home test, etc. Start with a 0.25U even and give it time. He will be very sensitive. If he's a little bit high in BG for a few days no biggie, but his body will need to recover from what he just went thru. I don't know about the seizures etc. but once he's out of that kind of thing...if it were my cat, I would def. bring him home. I simply do not trust vets anymore, most of them simply have no clue how to regulate insulin levels and their solution is always MORE MORE MORE. I think cats need so much less than we realize, and we just need to be a little more careful about timing our feeding to wait a couple of hours after a shot to feed IF they are high at preshot (on a slow acting insulin like Lantus)

good luck.
 
My vet overdosed Sebastian while trying to 'regulate' him. In 3 days he started at 0.5U of Lantus on the first shot--for a boney, just-recovered DKA cat who was only 6 lbs--by dose number 6 (3 days later)hehad him on 2.5U!!! So 5U a day! He was going hypo every single day because the vet overdosed him and they were not doing curves--only ONE midpoint blood test reading...and so they would miss it and get HI on themeter and then jack up the dose even more...when I realized this last December I insisted on taking him home and said I could regulate him. They got mad that I wanted to do this and I had to sign a waiver saying I was taking him 'against medical advice'...yeah, like I"M the one putting him in danger.

ONE HOUR after I brought hiim home he was 38 BG!!!! And since then, he's beeon on one shot of Lantus only 1/4 unit once a day.....and he is now DOUBLE THE BODY WEIGHT.

I think as long as he is not having ketones, or antyhing like that--you shoudl bring him home and go very very low and easy on the dose and home test, etc. Start with a 0.25U even and give it time. He will be very sensitive. If he's a little bit high in BG for a few days no biggie, but his body will need to recover from what he just went thru. I don't know about the seizures etc. but once he's out of that kind of thing...if it were my cat, I would def. bring him home. I simply do not trust vets anymore, most of them simply have no clue how to regulate insulin levels and their solution is always MORE MORE MORE. I think cats need so much less than we realize, and we just need to be a little more careful about timing our feeding to wait a couple of hours after a shot to feed IF they are high at preshot (on a slow acting insulin like Lantus)

good luck.
 
Thanks everyone for sharing your experiences and advice.
The evening wasn't as good for Yankee as we hoped. He stopped urinating on his own so they attempted to express him.
He wouldn't express so they had to catheterize him. He has an IV w/ fluids and a little glucose because he is not eating and they now have him on 1 unit lantus twice a day and are happy with his bg numbers in the 100s yesterday. It's hard to tell if that 1 unit is where he ought to be because of the glucose drip and him not eating. He had a reaction to the Valium so they can't give him that anymore. With the need for the catheter now we don't feel comfortable bringing him home today and are just praying for small improvements at this point. We are going to wait and see what today holds.
A few friends and family have told us he's suffering and we should let him go but as long as the er vets say there is hope I cannot fathom making that choice.
 
Take in a shirt that smells like you to help comfort him. If they'll let you visit, some gentle kitty massage or brushing may help him feel better.
 
We took a fresh smells like home tshirt last night, glad we did, the one we took the day before was gone. We'll take another today. He loves to be brushed, I'm so glad you suggested that BJ, We will be sure to take his favorite brush.
 
Your "friends and family" have NO CLUE what your cat is feeling. Only you and the vet can determine this. Do not let them dictate to you what treatment should be. Most people put their pets to sleep the minute they have diarrhea or miss the litter box. Visit him and give him love and hopefully he will stabilize again and you can take him home. Maybe you can even bring a kitty donut bed for his cage? One of my vet hospitals allowed this...they get dirty obviously so you have to switch but if you have those flat light ones that are cheap at Petco maybe you can get a few and switch them daily...
 
just as with people, there is a time to fight and a time to say enough. you, your vets, and your boy will be able to tell when its time. meanwhile, if you can afford it, fight as hard as you can :)

hugs to you

Jen
 
Poor sweet boy, he's really having a rough time.
Vet called while we were on the way to see him and reported his bg was 28. Although he is
essentially in an ic unit, they only test him every four hours which I was upset to hear,
especially since he came in severe hypo Wed night and they just started him on 1 unit twice a day of the Lantus on Friday I expected they would be monitoring him much more closely. For him to be at 28 w/ an IV of basically sugar water! How? Then the vet says that really they can't say coming home on Sunday could happen as we had discussed now that he's had this setback. That he needs at least 48 more hours there so they can try to get him regulated. He's still blind and can't hold himself properly even while sitting. They said his case is pretty severe but still to just give him time.

I'm pretty irritated that any time I mention info I've learned from FDMB, like AAHA guidelines and Lantus tight regulation protocol they talk down to me about the hazards of online information and say things like you can't know what those other cats levels were and then I respond that actually you do because most people post a spreadsheet. Then she says well there are other factors professionals know to look for.
At which point I want to scream that a professional Is the one that caused my cats OD, and if I'd made it to the site sooner or been able to Interpret and act on what I read here sooner my cat and my family might not be going through this nightmare. It was just so much info, and I was overwhelmed and not able to grasp it all initially. They might do a better job if they checked it out themselves.

Yankee isn't at all himself but my daughter and I both felt like he was comforted by the brushing and afterwards he sort of wiggled like a worm to press himself into her neck as far as he could. She's his all time favorite person so we thought it was intentional, though they said it was a reaction to the stimulation. We'll go to visit again in an hour or so.
 
I'm so sorry about your boy. It is really good you and your daughter are going to see him as it sounds like he is comforted by your visits and touch. He went down really hard and it is no wonder it is tough for him to get back up but it sounds like he is trying. Keep an eye on those vets and being an advocate of Yankee. Love, love, love him and sending prayers that he'll be good enough to be home with you soon. This bond is between you and him and family and friends often don't get it.
 
Grieving for our handsome sweet boy

Thank you for the advice, hugs and prayers. You're an amazing group. Sadly we had to say goodbye to our Yankee an hour ago. We appreciate all of the info, assistance and support offered at FDMB. Wishing you all the best!

~L
 
I'm so sorry for your loss of your handsome kitty Yankee ((((((((Hugs)))))))).
Vets just don't understand how much we know here on the board.

Fly Free and Land Softly, Sweet Yankee :cry:
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You will be missed much by your family.

He will be waiting for you at the Rainbow Bridge to join him one day.
 
Damn, I felt so sure he would recover and be able to come back home to his loving family.
I'm so,so very sad for your loss. You did everything you could for him.

Peace to you and your family. Fly free Yankee,
Carl
 
So sorry you lost your sweet Yankee boy :YMHUG: I was really hoping he could pull out of that. It's nice he got some brushes from his favorite bean - I'm sure he knew you were with him all the way.
 
My deepest sympathy to you and all who loved Yankee. You did everything you could to help him and you did everything your vet told you to. This never should have happened if your vet had updated himself on feline diabetes knowledge. He was the professional as was the ER vet and you were given wrong info and totally wrong comments from that ER vet. Yankee paid with his life for carelessness and you are left with heartbreak and my heart goes out to you. You are the ones who loved him and will miss him.......your vet won't! Makes me so mad and I just want to scream at that vet and the ER one with all the comments about the internet, regulating before going home, etc. My heartfelt sympathy wings_cat
 
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