Trying to get the Pharaoh regulated

Status
Not open for further replies.
P

P_Eppinger

Member Since 2013
Greetings!

Ramses (the Pharaoh of Maple St.) was diagnosed 5 weeks ago, after laying around for 3 days with little movement and diminishing appetite. His BG levels tested at 409 in the vet's office, and 539 at the lab where the vet sent his blood for further testing. The vet (recommended by cat-loving friends) immediately put him on Novolin NPH (3 units 2x/day) and showed me how to give the injections. She suggested having his BG levels checked in a few weeks.

He showed immediate improvement. A couple of weeks later, he was back to eating with a ravenous appetite, drinking lots, and producing lots of urine. I called the vet who recommended increasing the insulin dosage to 4 units 2x/day.

This past Wednesday we went to the local vet to have BG levels checked; they measured 66. This vet recommended decreasing the dosage to 3.5 units 2x/day.
(Yes, different vet. I live in a very small, rural town. The local vet is a large-animal -- cow, horse -- vet, not so good with small animals. The good cat vet we went to is 75 miles away.)

Friday mid-day Ramses looked a little disoriented, walking drunkenly, symptoms the vet had said indicated low BG, and to give him food or a little glucose. He was tempted by Fancy Feast, and recovered quickly. Saturday mid-morning (about 2 hours after his insulin injection) he yowled and staggered, ate some Fancy Feast, then lay down looking paralyzed. I tried to give him some honey and called the vet's office. The vet at the small-animal clinic told me to give him Karo syrup, and skip the evening injection. (He also suggested bringing the cat in to the clinic next week so they can test his glucose curve.)

It took nearly 3 hours of smearing Karo on his tongue and gums (during which time he seemed to recover, then relapse and go into convulsions) before he seemed more normal and slept in my lap for a couple more hours. (Lap sleeping is very abnormal behavior for him.) He ate 2 or 3 more spoonfuls of Fancy Feast before I went to bed at midnight.

This morning he wasn't interested in eating and I was fearful of giving him insulin when I couldn't be around to watch his reaction, so I delayed his injection until early afternoon.

He's behaving fairly normally now: interested in eating, grooming himself.

I've bought canned cat food, and after reading several articles and postings on this site intend to switch both cats (diabetic and non-diabetic) to wet food. I plan to give him his regular insulin injection tomorrow morning and try to get back on schedule with that.

Quite frankly, I'm a bit overwhelmed by all of the information on this site. I see that nearly everyone on this site checks their cat's BG levels daily. I can't just pop down to Wal-Mart for diabetic supplies as the nearest Wal-Mart is 30 miles away. I guess I'm hoping that he'll be one of those who will stabilize with a change of diet, although the more posts I read, the more hesitant I am to adjust his food without regular trips to the vet for consultation.

Thanks for the information you've made available.
 
You could always order diabetes testing supplies by mail. Our shopping partner, ADW carries the Glucocard 01 and matching tests strips. You can also order online from Walmart. My closest Walmart is 25 miles away.

Please, do not switch your cat to a lower carb food until you are home testing. That food change can cause the blood glucose numbers to drop dramatically and result in another hypo.

Hypo tool kit
IN CASE OF EMERGENCY - YOUR HYPO KIT

Put together NOW the following items and put in an easily accessible place!

•Phone number of your vet
•Phone number, address and map/directions to your nearest emergency vet (or phone number of the cab company and some cash/credit card)
•Karo syrup, honey or corn syrup
•High carb canned food with gravy – 2-3 cans
•Some favorite treats
•Spare pack of 25 blood glucose strips
•Coffee for you ;)

How to deal with hypo instructions. http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887

It sounds like the insulin dose is too high if your cat has already hypoed twice.

Novolin N and Humulin N are the same insulins, simply made by different manufacturers. Here is some basic info on the NPH type insulins for you to read. http://gorbzilla.com/nph_101.htm
 
N type insulins last roughly 6 to 8 hours in the cat. This leaves 4 to 6 hours without insulin when you dose every 12 hours. Of course, the next pre-shot test is going to be way high with the insulin worn off. And if you increase the dose based on that pre-shot without knowing how low the dose takes the glucose (the nadir), you can increase too much and send your cat into a hypoglycemic attack, as you've seen. You need to reduce the dose or that will likely happen again.

We strongly encourage you to consider a longer acting insulin in cats, such as Lantus, Levemir, or Prozinc.

Home glucose testing will keep your cat safer than shooting without knowing what his glucose is. You test before each shot. When you have a day to do it, you test around the insulin's nadir, roughly 6 hours after giving insulin, to see if the glucose is going just low enough, or the insulin dose needs adjusting. Some folks occassionally set an alarm to get them up at night to check for a nadir, especially since many cats go lower at night.

I've some learning tips in my signature link which you may find helpful.
 
P_Eppinger said:
Greetings!

Ramses (the Pharaoh of Maple St.) was diagnosed 5 weeks ago, after laying around for 3 days with little movement and diminishing appetite. His BG levels tested at 409 in the vet's office, and 539 at the lab where the vet sent his blood for further testing. The vet (recommended by cat-loving friends) immediately put him on Novolin NPH (3 units 2x/day) and showed me how to give the injections. She suggested having his BG levels checked in a few weeks.

He showed immediate improvement. A couple of weeks later, he was back to eating with a ravenous appetite, drinking lots, and producing lots of urine. I called the vet who recommended increasing the insulin dosage to 4 units 2x/day.

This past Wednesday we went to the local vet to have BG levels checked; they measured 66. This vet recommended decreasing the dosage to 3.5 units 2x/day.
(Yes, different vet. I live in a very small, rural town. The local vet is a large-animal -- cow, horse -- vet, not so good with small animals. The good cat vet we went to is 75 miles away.)

Friday mid-day Ramses looked a little disoriented, walking drunkenly, symptoms the vet had said indicated low BG, and to give him food or a little glucose. He was tempted by Fancy Feast, and recovered quickly. Saturday mid-morning (about 2 hours after his insulin injection) he yowled and staggered, ate some Fancy Feast, then lay down looking paralyzed. I tried to give him some honey and called the vet's office. The vet at the small-animal clinic told me to give him Karo syrup, and skip the evening injection. (He also suggested bringing the cat in to the clinic next week so they can test his glucose curve.)

It took nearly 3 hours of smearing Karo on his tongue and gums (during which time he seemed to recover, then relapse and go into convulsions) before he seemed more normal and slept in my lap for a couple more hours. (Lap sleeping is very abnormal behavior for him.) He ate 2 or 3 more spoonfuls of Fancy Feast before I went to bed at midnight.

This morning he wasn't interested in eating and I was fearful of giving him insulin when I couldn't be around to watch his reaction, so I delayed his injection until early afternoon.

He's behaving fairly normally now: interested in eating, grooming himself.

I've bought canned cat food, and after reading several articles and postings on this site intend to switch both cats (diabetic and non-diabetic) to wet food. I plan to give him his regular insulin injection tomorrow morning and try to get back on schedule with that.

Quite frankly, I'm a bit overwhelmed by all of the information on this site. I see that nearly everyone on this site checks their cat's BG levels daily. I can't just pop down to Wal-Mart for diabetic supplies as the nearest Wal-Mart is 30 miles away. I guess I'm hoping that he'll be one of those who will stabilize with a change of diet, although the more posts I read, the more hesitant I am to adjust his food without regular trips to the vet for consultation.

Thanks for the information you've made available.
Click to expand...

First off, welcome to the site.

Alrighty, you are feeding a good food, fancy feast.... be sure it's just the pate flavors as lots more carbs in the other ones like gravy, grilled, and marinated. There are lots of other low carb wet foods you can feed, just stay under 10% carbs... refer to a list and other info on Dr. Lisa Pierson's site:
catinfo.org/docs/FoodChartPublic9-22-12.pdf

Now, the insulin you are using is far from the greatest... sure, it can be used, but this insulin gives the cat a hard and fast drop in numbers in a couple hrs, then wears off in the next 4hrs.... It's like being tossed into a tub of cold water if you have a fever, then yanked out again. It does NOT feel good. I suppose you could use it until you can get a decent insulin, but maybe drop the dose more and give shots every 8hrs.... nah, I think going with maybe 2u twice a day until you can get Levemir or Lantus, then switch to the new insulin right away.

Maybe you can make one trip where you can see the vet for a prescription for Levemir or Lantus, then stop at a pharmacy to fill it, and pick up a human blood glucose meter, test strips and lancets, plus a container of KETOSTIX to measure for ketones in urine.

Home testing quite easy and both my cats slept through having their ear tip poked to get a drop of blood for testing. With the insulin you are using, there's too big a risk of hypo with the fast and sudden drops, and you are not all that close to a vet who can help alot with cats, like you said.
Most people here home test because you want to be sure it's safe to give your cat insulin or not.
Your goal, ultimately, is to attempt to help your cat's pancreas heal and be able to function on its own without more help of insulin.... and the only way you will know your cat is getting better is by testing before shots. Cats are not going to wait until the next curve at the vet office, right? Curves at the vet are not great anyway because most cats are stressed and will just register higher numbers than they would if tested at home.

So I hope you can arrange to visit the vet and any pharmacy to get a new rx for better insulin plus some testing supplies, and then you and Ramses (the Pharaoh of Maple St.) will be good to go!
For sure you can try to switch to just low carb wet food and see if Ramses can be ok with no insulin, but you will need the meter to know if the food is working or not. I would not bother with arranging for supplies to be mailed; it would be better for Ramses if you can have them sooner.

Plenty of people are here who can help you with any sort of issues you have, with testing and other problems.

Gayle
 
Thanks, Deb & Wink, BJM, and Blue, for the encouragement.

We'll try to get in to the vet this week, ask about other insulins, and learn how to test Ramses' BG at home.

I'll let you know how things go.

Priscilla
 
4 units of insulin is a lot, and it is evident from the Pharaoh's two hypo incidents that he needs a dose reduction.

We recommend starting at 1 unit every 12 hours, so your vet really started him at a pretty high dose.

Please reduce dose and learn to test blood sugar at home since the good vet is so far away.

Welcome to FDMB!!!
 
Ramses is more stable now.

Thanks, all, for the concern and suggestions.

We went to the vet on Wednesday; Ramses' BG level tested very low. He now gets 1unit of insulin 2x/day and is acting more like his old self.

Based on the information on Lisa Pierson's site I'm feeding Friskies Salmon dinner -- one of the lowest carbohydrate listings. Our vet recommended always feeding the same food in order to maintain consistency in BG levels, so the cats will be eating salmon from here on out.

Priscilla & Ramses (and Osiris, who doesn't like being left out!)
 
That's great he is doing better.

Two things though

1. If he is testing low at the vet he will be lower at home.. Who knows with the food change he could even be possibly going into remission and this is where issues can occur (hypo or bouncing) if you are shooting blind.. So I would strongly recommend home testing.. What do you think?

2. I understand the vets point about only feeding one food to keep BG stable but unfortunately , like with humans, fish isn't good to eat every day because of toxins etc. so maybe add a meaty friskies to the mix and alternate? The 8% pâtés like turkey and giblets dinner are close enough that shouldn't make a difference to his BG plus it means he won't get sick of the same flavour every day.. "!fish again...??" Lol.

Wendy
 
How are things going? Are you interested in home-testing?

As Wendy said, it's not recommended to feed fish more than once or twice a week. Dr. Lisa's website has some great options, as you've seen. The Friskies Special Diet are even lower in carbs (~5%) than the Friskies Pates if you wanted to go that route.
 
Status
Not open for further replies.
Back
Top