Treating Ziggy (Thread #3)

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Natalie and Ziggy

Member Since 2018
Hi again, everyone. This is a continuation of this thread.

I'm continuing to test Ziggy and administer 2.25 U of Vetsulin every twelve hours. We had a very successful Sunday, in which we got a full curve. Since then, I've been testing Ziggy three times a day. The past few tests have shown an increase in his levels (Monday's AM spike was particularly nasty) and he's been a little less willing to sit down for blood testing.

I think this might have to do with the fact that the Friskies Seafood pack comes with four different flavors, and the Mariner's Catch was by far his favorite. He would eat all of it until he was full. Now that we're out and on the three other flavors, he's not eating as much because he doesn't seem to like them in comparison. So every time I take a test, he's begging for food.

His litterbox behavior has gotten a little worse, too, and he's peeing very frequently compared to last week. Nothing too bad, though. No poop tracks, at least!

Other than that, things are going well. He continues to be tricky to test in the AM because I can't get him to sit still (he keeps trying to lure me into the kitchen for feedy times, and my roommates walking around gets him a bit alarmed).

I will keep you all posted should anything out of the ordinary occur!
 
I gave him 2.25 U before I posted this thread, but I can definitely try 2.50 U tomorrow.

I'll have to pick up some more test strips for the weekend, as I'm running out. Money is very tight for me at the moment. All the things I bought for Ziggy, plus his vet visit (which was inexpensive but I needed syringes) more or less wiped out my paycheck. But I can try to do a curve for sure.

Just gave him a before-bed test. Very high numbers again. I'm a little discouraged after his numbers were so (relatively) good this past weekend, but nobody said it would be easy, right?
 
Takes a lot of patience and time!!!! I’ve learned that from here, gotta have patient pants on all the time, it will be easier and better as time slowly drags by, seems like forever but it does happen, your doing a great and job and so super proud of you for taking on this responsibility
 
Woke up at 5:00 AM to the sound of Ziggy sneezing and, eventually, vomiting in the living room. He only vomited a tiny amount of a white substance that may have been his 2:00 AM snack. He vomited again at 6:00 AM, this time a clear yellow liquid in a very small amount. He seemed fine after that and is very eager for breakfast.

Lots and lots of pee in his litter box!

He used to vomit a lot when he was in my parents’ care. Like, everywhere and in huge amounts.

I’m only feeding him half of his usual portion this morning, so as not to upset his tummy too much.
 
I gave him 2.25 U before I posted this thread, but I can definitely try 2.50 U tomorrow.

I'll have to pick up some more test strips for the weekend, as I'm running out. Money is very tight for me at the moment. All the things I bought for Ziggy, plus his vet visit (which was inexpensive but I needed syringes) more or less wiped out my paycheck. But I can try to do a curve for sure.

Just gave him a before-bed test. Very high numbers again. I'm a little discouraged after his numbers were so (relatively) good this past weekend, but nobody said it would be easy, right?

I want you to look at both of bellas spreadsheets, there is 2 of them, look back at feb and look at current, BIG difference and feb is when I found this sight, it might make you feel better as to whether it will get better or not, I followed exacted what people advised.
 
You'll get there. Give some thought to bumping him up to 2.5 u so you can get a curve at that dose on the weekend. The peeing should reduce when he's in lower numbers much of the time. The problem with staying high too long (among other things) is that they can get stuck there. They become less responsive to insulin because of the effects of glucose toxicity. The way through is regular, small dose increases to get to a dose that breaks through the toxicity. It's not unusual for the dose to drop after that.
 
@Bellasmom Looking at other spreadsheets has been calming for me, yes. And they can be pretty encouraging, too. :)

I upped his dose to 2.5 tonight and took at test +3.5 hours after the PM shot. 248. That's on the lower end of Ziggy's usual range, though he's probably coming out of his nadir.
 
More vomiting throughout the night. This time it was all food. I’m wondering if his automatic feeder giving him snacks at night has anything to do with it? He threw up an hour after both of the programmed feeding times. But he didn’t have a problem with this before, so I’m not really sure.

Edit: I think it might have to do with his food. He doesn’t like the salmon and whitefish flavors very much, and he only started throwing up a couple days after he moved on to that food.
 
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You'll need to be very patient this is a marathon and is hard at the beginning but it will get better hang in there

Usually giving them snacks helps avoiding stomach acid vomiting just liquid is usually a sign of stomach acid, but you could try and see if it has to do with one special flavor when he vomits more maybe is that particular type of food that is upsetting his stomach

Are you testing for ketones already? If not as soon as you can you could buy some urine ketones testing strips at the pharmacy and while he's in high numbers it would be good to be monitoring him about them
 
I'm not testing for ketones yet, but I will pick up some strips as soon as I am able.

I came home to find vomit around the apartment and Ziggy had lost all of the weight he'd gained over the past week. His blood sugars are the highest I've seen yet. I think I'm going to slightly adjust his feeding: I'm moving his AM and PM shots an hour earlier, and giving him a meal right before I go to bed. That way, he won't have to go so long after I wake up (AM) or get home (PM) before his pre-shot test. Hopefully that'll reduce his hunger-related stress a little bit.
 
Bought him some more of the Friskies he likes, but he’s barely touching it. Gave him his shot, but he doesn’t seem very happy with his food.

What a rollercoaster! :nailbiting:

Looks like he’s going to throw up. Uh oh!

Edit: Okay, he didn’t, but he’s hiding under my bed now after turning his nose up at his new dinner. I feel so bad for him. It feels like we’re back to square one again.
 
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Try one more dose of 2.5 u tonight and increase to 2.75 u tomorrow AM. His numbers are high and likely making him feel awful. Ketone testing is important at these high numbers. Would an auto feeder help so he can have more meals in a day and overnight?
 
Oh no, I panicked and called the vet and they want me to bring Ziggy in for an examination right now.

I can’t afford a big procedure or anything. I’m wondering if I should just take a deep breath and cancel it?

The auto feeder has been working well, and he likes it, but right now all it’s doing is making him vomit more.

@Kris & Teasel Do you mean give him a second shot tonight, after I already gave him one at his PM shot time? Edit: Oh wait, I see what you mean, I think. I forgot to update his spreadsheet -- I did give him a PM shot of 2.5 tonight.
 
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Ziggy made it through most of the night fine, but he vomited bile just as I was getting up. Hardly touched his food and didn’t want his insulin shot — he pulled away as I was injecting. I still had 2.25 U left in the syringe, so I shot the rest in after distracting him.
 
Ziggy made it through most of the night fine, but he vomited bile just as I was getting up. Hardly touched his food and didn’t want his insulin shot — he pulled away as I was injecting. I still had 2.25 U left in the syringe, so I shot the rest in after distracting him.
Seems that Ziggy might need some antinausea/antivomiting meds like Cerenia to get him feeling better. High numbers + dehydration from vomiting + possibly too low an insulin dose is a bad mixture. I strongly recommend urine ketone testing ASAP.
 
Ziggy started to eat a little more as the morning went on. He wasn’t devouring it like he usually does, but it was encouraging. I wonder if he’s just pacing himself due to his upset tummy? Still, chances are I’ll come home to a lot of puke like last night. I wouldn’t be so upset if he wasn’t doing it on the rugs.

Ironically, his litter box behavior has greatly improved. One problem solved, another pops up in its place. :nailbiting:

Seems that Ziggy might need some antinausea/antivomiting meds like Cerenia to get him feeling better. High numbers + dehydration from vomiting + possibly too low an insulin dose is a bad mixture. I strongly recommend urine ketone testing ASAP.

I will pick up some ketone test strips tonight and try to get started this evening. And he was on anti-nausea medication when he lived with my parents (not sure what it was) but they forgot to bring it when they brought Ziggy to me.

This might seem like a silly question, but do I have to see the vet about getting Cerenia? I assume that I do, but I’m almost broke for this month, and I don’t think I can afford a vet visit until June. :(

I’ve started to mix a little water into Ziggy’s wet food. That seems to get him to eat more.

Maybe try some baby food (no onions or garlic) to get him eating. You don't want an aversion to his normal food.

I can try some baby food, sure.
 
You have to get cerenia from the vet. Some plain pepcid a.c. original strength might work. 10 mg tabs give 1/4 tab. Give 2 hrs before or after food.

Are you giving small meals or snacks spread out every couple of hours through day and night?
 
You could try can give him some omeprazole 5mg (not sure what presentation you can get over there ) every 12 hours, wouldn't use it long term but I think is ok for a few days to help his tummy while you can get something better and a little bit more permanent.

Something that I don't know how easily you can get but is not very expensive either and has worked very well with my civies is slippery elm bark
 
Natalie, I’d check out slippery elm bark ( aka SEB).... I give Elmo 1/8 t mixed with a little water then gently syringed right before bed to keep his stomach settled overnight. Different members do it different ways but this is how it works for us . You can get it in capsule form at any Wal Mart so it’s handy and not expensive , is natural and it works . I take it for myself
 
Thank you for the suggestions, everyone. Ziggy's stopped vomiting since my last post and his appetite is 100% back. I think the salmon and whitefish flavors of Friskies might have just made him sick for a few days. Hope I'm not jinxing it by saying it.

I started using some U-40 syringes I got from the new vet, but I noticed that they dose up to 40 units (the previous set of syringes dosed up to 12 and were also labeled U-40). I was still able to give Ziggy his 2.75 U tonight, and I made absolutely sure I wasn't misreading the units so I wouldn't overdose him.

I didn't get to do a curve today, but I can try to do one tomorrow. His numbers have been consistently high for the past few days.

Oh, and I wasn't able to get any ketone strips for Ziggy. There aren't any available anywhere! I ordered some online.
 
Got a full 12-hour curve yesterday on 2.75 U. The main thing I’ve noticed since his last curve is that his glucose levels are, on average, higher than they used to be. I am beginning to think that changing his food from Friskies Seafood to Friskies Poultry Favourites has something to do with it (though Poultry Favourites doesn’t seem to have much more carbs than the Seafood).

Unlike the Seafood, he loves all four flavors of the Poultry, so no vomiting or loss of appetite!

No ketone strips yet. :(
 
The poultry food shouldn't be a problem and if he likes it and eats it with no tummy issues I'd feed it. The curve gave you really good information:
  • his nadir is around +4 which is fairly typical of Vetsulin (+4 to +6)
  • he dropped only a bit more than 50% from PS to nadir which is in the ball park of what you want
  • he started rising again around +8 which is also typical of Vetsulin but he was still below AMPS at PMPS - possibly getting close to 12 hours duration
  • he needs a bump up in dose to 3 u either tonight or tomorrow AM - shouldn't drop him too low while you're at work but do get a before bed test every evening and plan on another curve next weekend.
When judging BGs we tend to look closely at the most recent numbers, say, the last week or a bit longer. Anything further back is history because their response can change for any number of reasons.

Re ketone strips: any human pharmacy should stock human urine ketone test strips - very common item. Bayer Ketostix is one brand. Ask the pharmacist. What they won't necessarily stock is blood ketone test strips for a blood ketone meter.
 
Is very good that he's not vomiting so I also think you should stik the poultry food for now.

Considering he's been on the actual treatment just for a few days I think he's looking good that curve you got looks pretty decent, the fact that you are seeing some yellows and no blacks is very good
 
I’ve upped his dose to 3.0 U. :)

Kitty really hates the new syringes I bought at the vet. They must be bigger or something, because now he reacts when I stick the needle in and squirms as I’m trying to give the shot. He’s even taking to backing up against the wall as he eats so I can’t get to him (have to bring the food bowl out to the center of the kitchen).
 
It’s the U-40, but it holds up to 40 units instead of 12. The gauge is 29 1/2. His old syringes were just 29.

No stomach problems with kitty since changing his food! He’s peeing way more than he was, though, and he’s back to meowing at 4-5AM for food, even though he eats all the food in the automatic feeder. I feed him a full can at breakfast and dinner, but he’s always like “more, please!” I would, but money is so tight right now (I’m now broke and my parents are helping me) and I’m trying to make his food last while still making sure he’s fed.

He’s finally cleaned off his paws and he’s got his old energy back. He’s chasing his toys around the house, which he hasn’t done in such a long time. The sheer amount of pee in his box means he’s tracking lots of litter around, though.

And finally, blood testing is so easy now. I never thought we’d master it so quickly. Now if I could only teach Ziggy to stay still for his shots.

Still trying to get a hold of ketone strips.
 
It’s the U-40, but it holds up to 40 units instead of 12. The gauge is 29 1/2. His old syringes were just 29.
That means the syringe holds 1 mL of liquid and the marks will be very close together - makes it hard to see between them and I guarantee you'll want to be able to do that.

Here's what you need: https://www.adwdiabetes.com/product/18570/bd-pet-syringes-u40-29g-3-10cc-1-2in-half-unit
https://www.adwdiabetes.com/product/1640/bayer-ketostix-reagent-strips

Many people order from this company successfully.
 
I have been watching your thread , Natalie. I have no expertise and very little experience, so no advice. I just want to say how amazing you are, how much you have learned and accomplished in such a short time. As Churchill used to say "Keep buggering on", this you are doing. So proud of you!
 
Thank you @Kris & Teasel for the links. I really don’t have a lot of money to spare until the end of the month, but I will order new syringes and ketone strips from there. Another problem I have with these syringes I have is that there’s always a small air bubble that I just can’t get rid of.

Ziggy’s been doing great, but this morning was a headache. After his 4 AM snack he started meowing like crazy and wouldn’t stop for the next two hours. He wanted nothing to do with blood tests (got it anyway — 515, one of his highest numbers yet) and had tracked poop all over the living room. He devoured his food (1 full can) and got his insulin, though he squirmed like crazy. Now he’s begging for more breakfast.

I think I’m going to have to give him a full can for the automatic feeder both day and night, instead of half. Right now his portions don’t seem to be enough.
 
I’d be happy to give him all the food he wants if it weren’t so expensive. But if that’s what he wants, that’s what he’ll get. He’ll get better eventually, I know — it just sucks to see a 500!

Now he’s goofing off and playing with his toys. :p
 
there’s always a small air bubble that I just can’t get rid of.
That's a common problem. Do what you can to flick it out and then don't worry. A tiny air bubble at the dose volume you're drawing up shouldn't be an issue. :)

I’d be happy to give him all the food he wants if it weren’t so expensive.
Friskies is economical and you can probably find sales at Walmart, etc. He'll be ravenous until he's better regulated.

He wanted nothing to do with blood tests (got it anyway — 515, one of his highest numbers yet)
Are you giving him a low carb treat with every test and shot? More if needed. One economical way to make treats is to roast or poach a plain chicken breast and cut it into very small pieces. Keep out a day's supply in the fridge as treats and freeze the rest.

I do all my testing and injecting in the bathroom with door closed. My guy is very cooperative but it's better for me to have a small area he can't leave, all my stuff laid out at the ready, no distractions from my other two kitties, etc. The less restraint you can use the better - none is ideal.
 
Ziggy’s PM pre-shot test number is 579. I’m starting to get really worried. His numbers are just climbing and climbing, even though his dose is increasing. I know it’s supposed to take time, but it sucks to see his numbers get worse and worse every day. :(

Maybe his nadir is really low, though? I’ll do a curve on Sunday. No time to do one tomorrow.

@Kris & Teasel Normally he’s very cooperative and just lays down in my room when it’s test time. It’s just that he’s so desperate for food in the morning that he has no patience for testing (he just meows like crazy and runs all over the house trying to wake us all up). I do give him a low carb treat after every test, though.
 
Ziggy’s PM pre-shot test number is 579. I’m starting to get really worried. His numbers are just climbing and climbing, even though his dose is increasing. I know it’s supposed to take time, but it sucks to see his numbers get worse and worse every day. :(

Maybe his nadir is really low, though? I’ll do a curve on Sunday. No time to do one tomorrow.

@Kris & Teasel Normally he’s very cooperative and just lays down in my room when it’s test time. It’s just that he’s so desperate for food in the morning that he has no patience for testing (he just meows like crazy and runs all over the house trying to wake us all up). I do give him a low carb treat after every test, though.
Try not to panic. Those blacks are ugly but won't kill him. You need to do a curve at the 3 u dose tomorrow or Sunday. It's impossible to assess the dose with no mid cycle data.

Re hunger before pre shot in the AM: give him a teaspoon or two of his breakfast just before it's test time to take the edge off. It would take 15-20 minutes for that food to affect his AMPS so you have a little window to get a non food influenced test.
 
Thank you, Kris! Ziggy’s doing great in all other respects (though his litterbox behavior has fallen off recently) so I’m not panicking just yet. I just hate to see those high numbers.

I will try giving him a little breakfast before test time.

Oh, I had another question, @Kris & Teasel. I currently have the automatic feeder set to give him 1/3 can of wet food at 4:00 AM/PM — it switches to an empty tray at 4:30 AM/PM. I test him at 6:40 AM/PM. Do you think that allows for enough time for the food to wear off so that it doesn’t affect his numbers?
 
Thank you, Kris! Ziggy’s doing great in all other respects (though his litterbox behavior has fallen off recently) so I’m not panicking just yet. I just hate to see those high numbers.

I will try giving him a little breakfast before test time.

Oh, I had another question, @Kris & Teasel. I currently have the automatic feeder set to give him 1/3 can of wet food at 4:00 AM/PM — it switches to an empty tray at 4:30 AM/PM. I test him at 6:40 AM/PM. Do you think that allows for enough time for the food to wear off so that it doesn’t affect his numbers?
Yes, that's enough time.
 
I just took a pre-bed test (6 hours after his PM shot) and he's still up in the 500s... I'm wondering if maybe there's something about his syringes that I'm not catching?

His previous syringes were the UltiCare VetRX U-40 syringes, which held up to 12 units. Right now he's using the Exel Comfort Point U-40 syringes, which hold up to 40. I'm wondering if 3 units measured in the UltiCare syringes equals 3 units measured in the Exel Comfort Point syringes? I know they're both U-40, but I don't know. I'm starting to worry that the 3 units I'm giving him isn't actually 3 units.

Then again, he was in the 200's for his pre-bed shots on these new syringes. He only rocketed up to the 500s yesterday. Which was also when I got him new kitty litter (World's Best Cat Litter)... Maybe he's eating it!! I'll check to make sure tomorrow.
 
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Sorry for the double-post, but I just caught Ziggy munching on his kitty litter. That's got to be a factor in his high levels lately! :nailbiting:

Going to buy some new litter first thing in the morning!
 
His previous syringes were the UltiCare VetRX U-40 syringes, which held up to 12 units. Right now he's using the Exel Comfort Point U-40 syringes, which hold up to 40. I'm wondering if 3 units measured in the UltiCare syringes equals 3 units measured in the Exel Comfort Point syringes? I know they're both U-40, but I don't know. I'm starting to worry that the 3 units I'm giving him isn't actually 3 units.
A unit is a unit on any proper insulin syringe. (important thing to know! :)) What can differ from one type to another is the total capacity/volume of liquid the syringe holds and that can affect the spacing between the marks. The Ulticare Vet Rx syringes hold a total volume of 0.3 cc (3/10 cc = 0.3 cc =0.3 mL) which is a little less than what the Excel Comforts hold (1/2 cc = 0.5 cc = 0.5 mL). Cats usually need tiny insulin doses so it's best to have syringes that hold a smaller volume (0.3 cc). That way the marks on the barrel will usually be a little further apart making it easier for you to read them. Half unit marks are really good to have because they make fractional doses so much easier to measure out or eyeball in between as needed. For now, you can use the Excel syringes but I suggest you try to get others with 0.3 cc capacity and half unit marks when you can afford them.

Try hard to get a test or two today between +4 and +6. you need to know how low he goes at this dose in the daytime. If that test gives you a high BG, I suggest a dose increase this weekend (if you can be around to keep an eye on him). You can try a 0.5 u increase instead of the usual 0.25 u increase because his numbers are high.

Eating non-food things is called "pica" and can be related to a dietary deficiency or some other health issue.
 
Thank you for the information about the syringes, @Kris & Teasel !

Ziggy's +4 test was 212, which is among his lower numbers, and his +6 1/2 was 380. I don't think I want to increase his dose by .5u because that's not bad for him. Maybe I can try 0.25 u?
 
This weekend's curve is done. :)

I ultimately ended up going with the 3.5 u dose. There didn't seem to be much of a change in his levels to start out with, but the last test I took +4 after his PM shot showed him with a 178 nadir. I think I might reduce the dose to 3.25 u, just to be safe? He whined and squirmed when I gave him his shot -- he really doesn't like these needles.

Kitty's developed a little bit of cement paws again! My landlord understands that Ziggy makes a bit of a mess with his litter, though. I still do my best to clean up after him.
 
Hi congratulations on your curve during the weekend, his numbers are starting to look slightly better, I don't know much about vetsulin hopefully some of the vetsulin experts will take a look at your results soon but actually that 178 doesn't look bad actually is a very nice number your first blue that is good news.

The whole litter problem does get better so hang in there when you can maybe you could get one of those litter rugs they help a little
 
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