So Many Questions

[Spike's Mom]

I feel like I am messing up progress to heal for my Spike. We are on a emotional roller-coaster . Friday I was so happy to see his numbers in a normal range. My son called me at work worried because Spike was at 107. I was beyond thrilled. Then I came home for lunch and Spike was down to 82 within the hour down to 75. I start to panic realizing I have to go back to work and he is dropping fast. As some of you may know I can text my vet and he usually replies within about 15 minutes. SO I text the vet and he said to get Spike some food. I give him a small amount of food(about 1.5 oz). and we are back up to 94 within the next hour. As you can see by my chart we give him a break from testing and just watch his behavior for the next few hours. Pretest we are back up to 307.
We had a great day Saturday. Not much testing.

Sunday the vet said give Spike a break and do not pretest before his AM shot. Regretfully I agreed. I give him his food followed by a shot. Within 10 minutes my cat is throwing up everything he just ate. At his evening meal time I was out of his food so I gave him baby food again. Before I went to bed I left down a small amount of newly made homemade food. I was awakened by him violently vomiting at 4AM. I am out of baby food so I make a run for the 24 hour Wal-Mart. I decide to buy some baby food and some of the fancy feast classic food. He has been eating the fancy feast all day with no problems holding it down.
Here are all things I am wondering.
When do I start to worry about him becoming hypo?
When Spike's numbers are in the normal range he will not stop meowing while sitting at the empty food bowl. He seems to tolerate the higher numbers better...not as demanding hungry.
How do I keep him on his normal feeding schedule when this happens?
Has anyone following the recipe on http://catinfo.org had such a reaction with not being able to keep the food down?
Why is he so sick with his traditional food so suddenly?
Tonight I gave him some fancy feast classics as he is holding the food down with no problem. I am scared to give him his usual food. He has never thrown up the amount of food he has since yesterday.
And lastly I have to admit I have been taking the middle ground between the amount of insulin the vet is recommending and this board.
I have already bought the 100 IU needles but do not quite understand the conversion when looking at the needles. Is there someone that might explain it so I can understand vs the chart where I am totally lost.
Please help if you can. I am really getting scared. According to the vet Spike is just adjusting to his new insulin. I am not sure I agree.

 

[Larry and Kitties]

You need to transition a food change slowly by mixing the new food with the old slow over a weeks or two. An abrupt change can cause vomiting and other problems.
I myself and most others here test before each shot.

 

[bsmith]

I'm sorry that Spike is feeling so poorly. I'm not able to answer many of your questions, but I strongly feel that now is the time for more testing not less. You need to be able to see what is going on so you can know how to best help Spike. My cat also has issues with abrupt food changes so @Larry and Kitties suggestion is a good one.

This might help too https://docs.google.com/document/d/1oI_34_EgqeKdpyttFW0oLoG1mbw16IkATAWHhoQD2JU/pub . It's @BJM's Glucometer Notes and includes information on when to dose and not dose as well as what to do when your cat becomes hypoglycemic (many people print out the info from the hypoglycemic link).

 

[Spike's Mom]

You need to transition a food change slowly by mixing the new food with the old slow over a weeks or two. An abrupt change can cause vomiting and other problems.
I myself and most others here test before each shot.

I assure you I will NEVER again give a shot before I know exactly what his number is.
Yes I realize the food change should be done slowly. The problem is every time I give him his homemade food he vomits violently. I am not trying to change his food. I am just trying to keep some food in his system everything else is small amounts to keep his blood sugar from dropping so dramatically.

 

[Mogmom and Goofus]

It will take bit of time for Spikes body to learn what to do with the insulin, how to handle it. Food changes need to be gradual or there'll most likely be lots of vomitting. According to my vet, too many changes all at once will make it more difficult as the cat gets all stressed out which wreaks havoc with he numbers and can cause some behavior issues.

When Goof's numbers stayed with in the same range every am and pm for 2 weeks, I quit testing each time, but I always paid close attention to his behavior.

 

[BJM]

Are you using the same protein(s) in the raw home made food as are in the canned? He may have a food allergy.

 

[Spike's Mom]

[

Are you using the same protein(s) in the raw home made food as are in the canned? He may have a food allergy.

I was wondering about an allergy. By protein source do you mean the chicken and liver? I follow the recipe exactly as given on the site. I use 3lbs of chicken , 2 egg yolks, to 4oz of liver. All sourced from Whole Foods. Would the egg yolks also be a protein source?
I add the salt,fish oil, vitamin E,vitamin B, taurine,and bonemeal as I have not purchased a grinder yet. I am using a food processor. Which I have found dices quite nicely into the recommended die size bites. I bought all vitamins from the link provided to I-herb
His prior food was the Hills M/D.

 

[BJM]

Eggs, cheese, meat, poultry, fish are all animal source proteins.
Does the canned food you have been feeding have the same proteins, or different ones?

 

[Spike's Mom]

I don't see liver or eggs in the fancy feast chicken feast classic food. I suppose it could be either of those. I no longer have a can of the Hills to compare as we transitioned off it completely a few weeks ago. Since Dr. Lisa doesn't include the eggs I will make a new batch without eggs and give it a try. I am just so puzzled why he wouldn't have gotten sick earlier. Do food allergies usually happen so quickly?
Thank you for your reply. You have been very helpful in so this issue and many other posts I have had concerns.

 

[bsmith]

The Hill's website should have the ingredient information: http://www.hillspet.com/index.html

I don't know what version of Hill's you were feeding so I can't give you a more specific page.

Oops, it was in a previous post here Hill's m/d http://www.hillspet.com/products/pd...w-carbohydrate-glucose-management-canned.html

Pork liver listed, but no eggs.

 

[BJM]

So chicken eggs, or other eggs?

In allergy, sometimes the initial exposure causes sensitization, then a later exposure triggers allergic symptoms.

 

[bsmith]

What type of liver are you using, i.e., beef, pork, alligator ( ), etc.? If it doesn't turn out to be the eggs maybe try to use pork liver since that's what's used in the Hill's m/d. I've seen allergies come on very fast in humans who previously had no issue with the allergen. It happened to my father with wasp stings and with my grandmother with lobster. Fine with it in the past and then all of a sudden an anaphylactic type reaction.

Also, what type of insulin are you using? You mentioned something about U-100 syringes, but not understanding the conversion. Are you trying to use U-100 syringes with U-40 insulin? If so, @BJM's conversion is as follows:

You can use a conversion chart and use U-100 syringes
U-100 means 100 units per mL
U-40 means. 40 units per mL, or 40% of the concentration of U-100
Multiply the tick marks by 0.4 to adjust the number to 40% of what is indicated, and that is the U-40 dose
Ex
0.4 * 0.5 tick = 0.2 units of U-40
0.4 * 1.0 tick = 0.4 units of U-40
0.4 * 1.5 tick = 0.6 units of U-40
0.4 * 2.0 tick = 0.8 units of U-40
0.4 * 2.5 tick = 1.0 units of U-40

I hope this is not the conversion chart that is already confusing you. I also hope tonight goes better for you. There's nothing worse than a sick kitty in the middle of the night.

 

[Spike's Mom]

We are using chicken liver. Meds are prozinc. As far as the needles it is still not clicking in my brain. May be the serious lack of sleep for the past couple of weeks. I just keep looking at the lines on the u-100 trying to figure this out.

 

[Mitzelplik's Mom]

Is the homemade food raw? If so and he's not used to raw, that could be what's causing the vomiting and you'll need to transition very gradually from the fancy feast.
Hope Spike will feel better soon!

 

[Spike's Mom]

Yes raw. We transitioned from the expensive Hills m/d wet food to the raw a few weeks ago. Oh what fun because every time I put his food down he would pick out the raw food and refuse to eat any of the Hills food. Then Sunday he suddenly started throwing up every time I fed him. Even this morning same results. The fancy feast is a replacement food otherwise he would have no food in his system. Not a good thing with insulin.

 

[Meya14]

I was looking at the labs that you have posted, and it appeared at the time that there was elevated WBC with elevated eosinophils. These can be elevated with allergies, but are also related to intestinal parasite infestations. I would ask your vet to check for worms, as well as other intestinal parasites such as giardia. Usually you'd see diarrhea with with these.

Also, on those labs his potassium was low, was this rechecked? This can cause ileus (weakness of the bowel muscles) and can lead to vomiting/constipation. If your cat is anything like mine before he was regulated, he was so hungry that he would eat too much too fast and vomit. Perhaps this is why certain foods are triggering, he's wolfing them down too quickly? Combined with low potassium the GI tract can't handle a lot of food all at once.

 

[bsmith]

Tanya's CKD site has a page that offers a lot of good information on nausea and vomiting including its symptoms and possible causes: http://www.felinecrf.org/nausea_vomiting_stomach_acid.htm

One good thing to know is whether Spike is vomiting or regurgitating. Tanya's site defines the two as such:

There is a difference between vomiting and regurgitation. Vomiting is usually accompanied by a lot of abdominal movement, whereas regurgitation happens suddenly and with less warning. Vomiting means the cat is emptying the stomach, whereas regurgitation is where food has not yet reached the stomach but is being ejected from the oesophagus more or less intact, often because of eating too fast or hairballs. Regurgitation is often sausage-shaped.
​

 

[Spike's Mom]

I was looking at the labs that you have posted, and it appeared at the time that there was elevated WBC with elevated eosinophils. These can be elevated with allergies, but are also related to intestinal parasite infestations. I would ask your vet to check for worms, as well as other intestinal parasites such as giardia. Usually you'd see diarrhea with with these.

Also, on those labs his potassium was low, was this rechecked? This can cause ileus (weakness of the bowel muscles) and can lead to vomiting/constipation. If your cat is anything like mine before he was regulated, he was so hungry that he would eat too much too fast and vomit. Perhaps this is why certain foods are triggering, he's wolfing them down too quickly? Combined with low potassium the GI tract can't handle a lot of food all at once.

The eating too fast could be possible. How did you resolve this problem? We have checked for worms and given the all clear. I just sent the vet his readings and have asked him to give me a call tomorrow. He is a pretty dedicated guy always wanting daily readings a couple of times daily. Mainly the preshot values. The part I am most concerned about with his vet is worry he is using my kitty as the guinea pig, researching how to treat diabetic cats through research on mine.
Which labs are you looking at we have 3 posted? Two are on the spreadsheet and the last is a separate attachment at the bottom of my signature. It was a little different than the preloaded information on the original spreadsheet.

 

[BJM]

Look at your U-40 syringe.

Look at your U-100 syringe.

Each is marked for the concentration of insulin normally used with that syringe.

Line them up next to each other.

Notice how much bigger the U-40 syringe allows for 1 unit vs the U-100 syringe.

This is because the U-100 insulins are more concentrated (100 units in 1 milliliter) than the U-40 insulins (40 units in 1 milliliter).

If it is less concentrated, then you need a large volume to get the right number of units.

 

[Meya14]

When he was eating too fast, I had to put just a little food out at a time, then wait like 20 minutes and put more out. Honest to god, I'd put the food down, and turn around, and it was gone. He would scream for food a lot too. Once I started increasing the insulin dose the behavior started to get better. He still has his moments if he's really hungry, so I have to push him away from the bowl sometimes if I see him inhaling the food. High calorie food would probably help significantly if overeating is your problem, as he won't have to eat so much volume. We use innova cat and kitten. Other foods with higher calories are nature's variety instinct - all varieties, wellness grain free kitten, Iams max cal (has a lot of fat). The calories are sometimes listed on the cans. We still can't and probably never will free feed - he's a fatty at heart.

For the labs, I was looking at the 2nd tab (the undated labs). On these labs there is elevate WBC, and elevated eosinophils. Eosinophils can be allergy or parasite. Also the urinalysis on this one showed a UTI. Was that treated? The labs date 1/22 (the first tab) also showed elevated eosinophils. The labs that are attached to your sig I can't get into cause they aren't public. Also, ask your vet to recheck the potassium if he hasn't recently.

Sometimes intestinal parasites can be missed on a sample, especially protozoan, or if he had fleas recently or goes outside. How are his stools/BM patterns? http://www.vet.cornell.edu/FHC/health_resources/Parasite.cfm

As for your vet "experimenting", trust me, that is much much better than having a vet unwilling to take time to learn or work with you. Your vet sounds like he is open to new information, wanting to learn and help you, and will take time to do some research if you give him information you found. This is a good thing. There are some very good resources that others can link for you that he might find helpful/interesting.

 

[Spike's Mom]

When he was eating too fast, I had to put just a little food out at a time, then wait like 20 minutes and put more out. Honest to god, I'd put the food down, and turn around, and it was gone. He would scream for food a lot too. Once I started increasing the insulin dose the behavior started to get better. He still has his moments if he's really hungry, so I have to push him away from the bowl sometimes if I see him inhaling the food. High calorie food would probably help significantly if overeating is your problem, as he won't have to eat so much volume. We use innova cat and kitten. Other foods with higher calories are nature's variety instinct - all varieties, wellness grain free kitten, Iams max cal (has a lot of fat). The calories are sometimes listed on the cans. We still can't and probably never will free feed - he's a fatty at heart.

For the labs, I was looking at the 2nd tab (the undated labs). On these labs there is elevate WBC, and elevated eosinophils. Eosinophils can be allergy or parasite. Also the urinalysis on this one showed a UTI. Was that treated? The labs date 1/22 (the first tab) also showed elevated eosinophils. The labs that are attached to your sig I can't get into cause they aren't public. Also, ask your vet to recheck the potassium if he hasn't recently.

Sometimes intestinal parasites can be missed on a sample, especially protozoan, or if he had fleas recently or goes outside. How are his stools/BM patterns? http://www.vet.cornell.edu/FHC/health_resources/Parasite.cfm

As for your vet "experimenting", trust me, that is much much better than having a vet unwilling to take time to learn or work with you. Your vet sounds like he is open to new information, wanting to learn and help you, and will take time to do some research if you give him information you found. This is a good thing. There are some very good resources that others can link for you that he might find helpful/interesting.

Yes we had a follow up with his vet on regular vet on the 16th. The 2nd tab without the date was from last week at the emergency vet.I will have to figure out how I can attach the latest results so they can be seen. I now have the correct syringes so the conversion chart makes a lot more sense. Unfortunately when I came home I noticed Spike has an infection in his eye now. Good thing I am expecting a call from the vet in the morning. Looks like another trip to the vet is in the works for tomorrow. I am going to get my list of questions together tonight so I don't forget anything. Thank you for all the information you have shared it was very helpful.
Spike has not been outdoors unless he is going to the vet since 2009. He disappeared for a week and I had given up hope he would return. Apparently that week was quite traumatic for him. We found out through x-rays the night of the emergency vet he had been shot and a BB has been inside him all this time and we did not know. He is a former fatty so he doesn't miss many meals. Well unless you count how sick he has been since January.