Stroke or hypoglycemic episode?

Status
Not open for further replies.
A

Aelise & Sushi

Member Since 2022
Hi all. This forum has always had the answers I needed while stabilizing Sushi after diagnosis. She was diagnosed in July and after some diet changes and lots of home monitoring, we reached a good stasis.

Yesterday, I gave Sushi her 1 unit of insulin at 9:30am and went to work. I had not tested beforehand as I got out of the habit after a month or so of stable numbers. (I have been testing before evening shots a couple times a week to ensure no remission.) At 2:30pm, my daughter came home and found sushi seemingly stuck under the litter box. After being pulled out, she seemed to be walking stiffly and continued to try to put her head in any crevice she could find. But she would eat when offered food, drank, and even peed when she was placed near the litter box and walked in.
I figured out she had gone blind and was distressed from that, so off to the vet we went. I didn’t even think to test for glucose at this point because she wasn’t lethargic. When the vet tested her at 5pm her glucose level was 176 and so the vet said it wasn’t a hypoglycemic event and we all suspected stroke.
We went home with no treatment and she was recovered by 9pm.

My question for you guys: is it possible this really was a hypoglycemic event, even though her blood sugar wasn’t low at the vet/time of symptoms? Previous blood curves indicate her lowest to be around 1pm. Could it have dropped low to the point of blindness and then come back up on its own? I don’t think she found her food once she went blind, but was given a small amount of kibble before we left for the vet.

I will be doing a curve today to test the theory, but appreciate the feedback. Most of what I have found on hypoglycemic events, the cat is usually treated for it, not recovering on their own.
 
Hi Aelise, yes it is possible Sushi had a hypo episode by the description of what happened. Cats can go blind during an episode. Some cats remain blind, depending on the severity of the hypo. I don’t think a cat would recover from a stroke that quickly.
If you gave her food before you took her to the vet, it is certainly possible for the BG to rise to 176 by the time the vet checked the BG which was 3 and a half hours after your daughter found her.
I can’t stress enough how important it is to test before every dose of insulin to see it is safe to give the dose.
It is probably that Sushi is needing less insulin now and you will not know unless you are testing. Just testing a couple of times a week is no guarantee.
I would reduce the dose now……most cats are very sensitive to insulin after a symptomatic hypo so I would be very careful and test the BGs frequently.
Cats BGs change every day and it is possible you can test on a day when her BG is higher then on other days and not realise she is getting low BGs.
Also you need to be checking the BGs during the cycles to see how low the insulin is taking Sushi.
Complacency is dangerous when treating a diabetic cat. Hypos can kill.

Can you tell us what type of insulin and dose you are giving please?
And what type of glucose meter?
Have you considered setting up a spreadsheet to document the BGs?
I would strongly recommend it after what has happened.
Here is a link to the spreadsheet, signature, and hypo kit and other useful information HELP US HELP YOU
Please make sure you have a hypo kit set up and ready to use always.
Please keep us updated on how Sushi is:)
 
I think it's entirely possible that your cat had a hypoglycemic event. It may help to always keep in mind that insulin dosing is not like giving an antibiotic. Absorption can vary and as a result, you don't get the same response to the identical dose from shot to shot. If you had been keeping a spreadsheet, you likely saw variability over each cycle -- cycles were not identical. This is why it is critical to test. You may have no idea if you gave a shot when Sushi's BG was at 200 or if it was at 40 or what the mid-cycle numbers have been and if you have been needing to reduce the dose. FWIW, recovery from a stroke generally takes more than a few hours.
 
Thank you both. The vet (not our regular) was relieved she was better and again suggested a stroke, but it was sitting right with me with the quick recovery, which is why I ended up posting here at 1am, my time! He was so happy with her BG, it took me awhile to think through.
I did lower the dose to 0.5 unit and she’s been eating kibble instead of her wet food, mostly because we kept her close and didn’t want the other cats into it.
I know I have lapsed. I do keep a notebook with her numbers. She’s on novolin, 1unit. I use an alphatrak to monitor and actually do have a hypo kit on hand, but that behavior was not on my list.
thank you for your help.
 
My aneurysm caused a brain bleed and several TIA's and I had some temporary vision problems. Diagnosing between a stroke and a hypo after the event is almost impossible, more so because strokes can have such different outcomes.
At that time I had my first diabetic cat and the second followed soon after. My own misadventures taught me how fragile the brain is and how important testing was. One unit doesn't sound like a lot but so many other things have to be factored in. I'm not laying on guilt, I've made my own horrendous mistakes. Just wanted you to think back to when not testing would have seemed unthinkable.
 
My cat had two symptomatic hypos and both times his only treament was food. One was worse than the other. He was walking in a circle and would not stop, he was totally out of it and disorientated and would not respond to voice or touch and I have no idea if he could see or not. Then he sort of just plopped to the floor when I gave him a gentle shake. I put some corn syrup in his mouth and that "activated" him enough that I could get him to eat. After he ate I took him to the emergency vet and they monitored him for a couple hours and then let him go without any treatment, no glucose or even any additional food.

The same thing happened to my cat with the hypo seemingly out of nowhere. He was stable on 4 units for months and I had stopped testing him so much cause he seemed to be really solid. Then he had the bad hypo and his dose went from 4 units to 2 units in less than 2 weeks with another (less bad) hypo in middle. It happened that fast. Lesson learned for me. If you can, get her low point BG number as much as you can. That's what is going to tell you if she is getting too low, especially if she is going to go through a period of her dose needs dropping.
 
Novolin N insulin is a harsh insulin and hits hard and fast.
Are you testing the BG, then feeding Sushi 1 hour prior to giving the insulin? This is what you need to do when giving Novolin N.
I would seriously look at changing to a more suitable insulin for cats. Novolin N insulin is not a suitable insulin for cats.
Here is a BEGINNERS GUIDE TO NOVOLIN N. Click on the blue type for link.

Please think about setting up a spreadsheet…we can help you set it up and most importantly test before every shot and during the cycle.
 
Your spreadsheet is not an invasion of privacy, it's simply a tool shared between you, your vet (if they're on board) and the members here.
 
Status
Not open for further replies.
Back
Top