Unusual high readings

Buddy & Hillary

Buddy & Hillary

Member
Yesterday Buddy stopped eating on his regular schedule and his readings shot up. This is confusing me because I thought I would have to monitor him for low readings. He has also thrown up any little bit of food that I can get down him. please refer to my SS for details, thanks.
 
Looks like a bit of a bounce. Does he seem nauseous? Licking lips, hanging by food/water but not actually eating or drinking? Any signs of pain? Meatloaf position, ears down, etc
 
FrostD said:
Looks like a bit of a bounce. Does he seem nauseous? Licking lips, hanging by food/water but not actually eating or drinking? Any signs of pain? Meatloaf position, ears down, etc
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none of those side effects noted. with a bounce can he run high without eating any food? I expected that if he wasn't eating he would be low or crash, since I was still giving him the insulin even though he was not eating.
 
Buddy & Hillary said:
none of those side effects noted. with a bounce can he run high without eating any food? I expected that if he wasn't eating he would be low or crash, since I was still giving him the insulin even though he was not eating.
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Ok I'd check his mouth too if possible.

Pancreatitis common in diabetic cats, so if continues for another day or so if think about taking him in for a blood test.

Lots of things besides food affect BG - infection, pain, stress, time of day, etc. So even if they don't eat, it doesn't necessarily mean they'll crash - but always good to keep an eye!
 
FrostD said:
Ok I'd check his mouth too if possible.

Pancreatitis common in diabetic cats, so if continues for another day or so if think about taking him in for a blood test.

Lots of things besides food affect BG - infection, pain, stress, time of day, etc. So even if they don't eat, it doesn't necessarily mean they'll crash - but always good to keep an eye!
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Thank you, what should I look for in his mouth? He had several teeth pulled when we first rescued him 9 years ago. If this persists I will certainly have a blood test at the vet.
 
Buddy & Hillary said:
Thank you, what should I look for in his mouth? He had several teeth pulled when we first rescued him 9 years ago. If this persists I will certainly have a blood test at the vet.
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Any irritation, discoloration, teeth that look odd, etc.

Hopefully just temporary!
 
Buddy & Hillary said:
He was back eating his full breakfast this morning. strange blip. fingers crossed.
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Buddy is back to not eating. I can get some broth down him and tried making a thin "smoothie" with some of his food and chicken broth. He lapped up the broth but as the solids settled he did not even eat that. I have been monitoring his BS and giving insulin because it is called for. He has been licking his lips and slightly gagging when he trys to clean his mouth after eating. I tried brushing his teeth and rubbing his gums. could this be caused by a broken tooth?

he was 9.8 lbs before this started and now he is 9.4 lbs. So he is starting to lose weight. This started on Feb 7th. It has progressed from not eating his full meals to only a few ozs of food per day.

I made an appt for him with the vet for March 14th. they said if he got worse to call and they would fit him in earlier.
 
That's too far out, I'd get him in somewhere sooner. When they don't eat they're at risk for lots of things, including fatty liver.

In the meantime, would they prescribe you some ondansetron (better for generic nausea), and/or Cerenia (better for vomiting), and appetite stimulant?

I'd get a blood panel, urinalysis, and a test for pancreatitis.

Any vomiting? Diarrhea/constipation?
 
FrostD said:
That's too far out, I'd get him in somewhere sooner. When they don't eat they're at risk for lots of things, including fatty liver.

In the meantime, would they prescribe you some ondansetron (better for generic nausea), and/or Cerenia (better for vomiting), and appetite stimulant?

I'd get a blood panel, urinalysis, and a test for pancreatitis.

Any vomiting? Diarrhea/constipation?
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no vomiting or Diarrhea, his stools are firm. But it has been 1 1/2 days since I've seen one. I will call the vet in the morning and see if they can get me in for tests.
 
Buddy & Hillary said:
no vomiting or Diarrhea, his stools are firm. But it has been 1 1/2 days since I've seen one. I will call the vet in the morning and see if they can get me in for tests.
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Buddy went to the vet today and the blood panel showed weak kidney function. They took an xray and the kidneys looked enlarged. He will stay overnight and get some intravenous fluids. I will be dropping off his insulin in the morning if he has to stay multiple days (possibly up to 3)
 
Buddy & Hillary said:
Buddy went to the vet today and the blood panel showed weak kidney function. They took an xray and the kidneys looked enlarged. He will stay overnight and get some intravenous fluids. I will be dropping off his insulin in the morning if he has to stay multiple days (possibly up to 3)
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Oh I am sorry to hear this. I hope they can get him fixed up, is it kidney disease or something else? Did they give a prognosis?
 
FrostD said:
Oh I am sorry to hear this. I hope they can get him fixed up, is it kidney disease or something else? Did they give a prognosis?
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We will know more this morning when we take over his insulin. but his blood work showed that he was borderline kidney failure. the # was 14 if that means anything to you. He also had some broncheal restriction so he is on antibiotics for that. And he was dehydrated. That is why they kept him for the intravenous. they will do another blood panel today.
 
Buddy & Hillary said:
We will know more this morning when we take over his insulin. but his blood work showed that he was borderline kidney failure. the # was 14 if that means anything to you. He also had some broncheal restriction so he is on antibiotics for that. And he was dehydrated. That is why they kept him for the intravenous. they will do another blood panel today.
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Well, we took the insulin over in the morning and they did a test and he was 414 so they gave him 1 unit. We were able to talk to the vet and she said that the specialist who they sent the xray to said that his lungs and liver were also affected and that it was just a matter of time. They offered to do more tests and wanted to keep him for another day or two. But we decided if he was that close we would rather have him at home. So he is home. Did not have anything to eat yesterday except what they gave him intravenously and he has drunk water at home but not eaten anything. However, his reading when we got him home was 554. So I am not surprised that he has no interest and is just sleeping.

They did send us home with an antibiotic (amoxicillin and Clavulante potassium) to give twice a day and Elura Solution (capromorelin) for his kidney to give once a day.

Hopefully if his BS comes down he will be more alert and I will be able to get him to eat something. In any case, he is home with us and we will try and make him as comfortable as possible.
 
Buddy & Hillary said:
Well, we took the insulin over in the morning and they did a test and he was 414 so they gave him 1 unit. We were able to talk to the vet and she said that the specialist who they sent the xray to said that his lungs and liver were also affected and that it was just a matter of time. They offered to do more tests and wanted to keep him for another day or two. But we decided if he was that close we would rather have him at home. So he is home. Did not have anything to eat yesterday except what they gave him intravenously and he has drunk water at home but not eaten anything. However, his reading when we got him home was 554. So I am not surprised that he has no interest and is just sleeping.

They did send us home with an antibiotic (amoxicillin and Clavulante potassium) to give twice a day and Elura Solution (capromorelin) for his kidney to give once a day.

Hopefully if his BS comes down he will be more alert and I will be able to get him to eat something. In any case, he is home with us and we will try and make him as comfortable as possible.
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I am very sorry to hear this :bighug: I hope that he can be comfortable and you guys a quality time with what is left. Big hugs
 
I could use a little more insight into Buddy's readings. He has not eaten anything now for 6 days, but is drinking. His readings have been all over the map. We are still giving insulin twice a day at 5am and 5pm. We are just trying to keep him comfortable while he is slowly fading. I have increased the insulin to 1 full unit, his nader seems OK but then he shoots up again. I hesitate to give him much more insulin if it could cause him to crash. Today his nader was 98 at +5. But then at +8 it was 408, just 3 hours later?

Would you look at his SS and let me know if this is typical for a dying cat? I have been testing him 4-5 times a day. He still has enough strength to climb the stairs at night and get on the bed and is using the litter box (such a good boy).

Is it possible to keep him comfortable with the readings going so high? He was as low as 30 on one occasion and I would hate to relive that episode. So, have been watching for low dips, but they seem to all be high.
 
Buddy & Hillary said:
I could use a little more insight into Buddy's readings. He has not eaten anything now for 6 days, but is drinking. His readings have been all over the map. We are still giving insulin twice a day at 5am and 5pm. We are just trying to keep him comfortable while he is slowly fading. I have increased the insulin to 1 full unit, his nader seems OK but then he shoots up again. I hesitate to give him much more insulin if it could cause him to crash. Today his nader was 98 at +5. But then at +8 it was 408, just 3 hours later?

Would you look at his SS and let me know if this is typical for a dying cat? I have been testing him 4-5 times a day. He still has enough strength to climb the stairs at night and get on the bed and is using the litter box (such a good boy).

Is it possible to keep him comfortable with the readings going so high? He was as low as 30 on one occasion and I would hate to relive that episode. So, have been watching for low dips, but they seem to all be high.
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Unfortunately I really can't say :( from the few end of life spreadsheets I've seen, yes it can go like this, though I've also seen some stay fairly regulated. With liver and kidneys failing I would assume this is pretty normal

All I can say is if it were me, I'd be ok with that 98. Id be trying to intervene less, and just trying to keep as decent range I can. I think so much is out of your control.

Is he on any other meds?
 
FrostD said:
Unfortunately I really can't say :( from the few end of life spreadsheets I've seen, yes it can go like this, though I've also seen some stay fairly regulated. With liver and kidneys failing I would assume this is pretty normal

All I can say is if it were me, I'd be ok with that 98. Id be trying to intervene less, and just trying to keep as decent range I can. I think so much is out of your control.

Is he on any other meds?
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Just an antibiotic (amoxicillin and Clavulante potassium). Which seems to have helped his breathing.
 
FrostD said:
Is it liquid? I've used liquid clavamox without issue, but it's always possible they put it in solution with sugar
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It is a liquid and it contains phenylalanine, which I googled and it says it can be in aspertaime. But isn't that a sugar substitute? would that affect blood sugar? He gets 1.4ml twice a day.
 
Buddy & Hillary said:
It is a liquid and it contains phenylalanine, which I googled and it says it can be in aspertaime. But isn't that a sugar substitute? would that affect blood sugar? He gets 1.4ml twice a day.
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Sortmry I don't know :/ you could just call and ask the vet to double check if you wanted, but how many days is he on it? The only thing they'd do is switch it out if it is sugar
 
Buddy & Hillary said:
It is a liquid and it contains phenylalanine, which I googled and it says it can be in aspertaime. But isn't that a sugar substitute? would that affect blood sugar? He gets 1.4ml twice a day.
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Buddy ate this morning!!!!!! He was 279 this morning and I gave him .75units at +4 he was 72, I put out some food as usual after testing and he ate about 1 tbsp dry and a few mouthfulls of wet food..
I thought I would test him before his meds and then again an hour later to see if it was causing the spike. He is very good about getting tested. He just lays in my lap and purrs. So that is not stressful for him. I will post the result of my test on his SS. This may tell us if there is sugar in the antibiotic solution.
 
One week after being given days to live Buddy has bounced back. He ate NOTHING for 6 days straight but then the antibiotic seemed to kick in and he was interested in food again. It took several days before he was eating close to his normal amount and I changed to FF classic wet food and gave him some dry food to nibble in between meals. These are higher carb foods than the FF naturals that he had been eating and his blood sugar was still high but has been treatable.

We don't know if he will continue to fade due to kidney issues. But we are glad to have him back for now. His rollercoaster ride can be viewed on his SS.
 
FrostD said:
I was scared to open this thread but SO GLAD to hear this!
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A follow up on Buddy. And a question. He has been doing well since early Feb when we nearly lost him. Eating 3 cans of food a day -(full can at 5am, 1/2 can at +6 full can at 5pm another 1/2 at +6 bedtime). He is going outdoors now that the springtime weather is here and I have changed his diet from the FFnaturals to FFclassic and his dosage to 1 unit.
He has been doing well on the 1 unit and the slightly higher carb food. But his readings are in the 200's at test time. would you recommend I up his dosage by .25 and see if it drops a little lower?
 
I would not. Nadir determines doses and based on that 95 yesterday 1U is good. Now, I actually wonder if he may need a reduction though...that 141 PMPS a few days ago tells me he went lower during the day, I just don't know how low. Additionally, you shot the full dose there - when you shoot a full dose at a lower than usual preshot you should always get another test in. I'd consider reducing by 0.2U.

I would also consider a switch to a depot insulin at this point. Hes been on ProZinc long enough and it's still dropping him too much and not giving enough duration - which is why you're still seeing the higher numbers. I really think you'd see better results with Lantus - there is a new generic ("insulin glargine") out that should be the same cost as if not cheaper than ProZinc.
 
FrostD said:
I'd consider reducing by 0.2U.
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I have two bottles of the prozinc. So, rather than switch insulin now after his very recent close call I would rather try with your lower dose suggestion. If I switch to using the U-100 syringe the conversion would be .8 units. I could begin this dosage tonight and run it for a week and see what happens.
Test him at +4-5 every day as this seems to be when he hits the nadar. And run a curve at the end of the week. Then re-post for your input. Is this a good plan?
Thanks again
Hillary
 
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Buddy & Hillary said:
I have two bottles of the prozinc. So, rather than switch insulin now after his very recent close call I would rather try with your lower dose suggestion. If I switch to using the U-100 syringe the conversion would be .8 units. I could begin this dosage tonight and run it for a week and see what happens.
Test him at +4-5 every day as this seems to be when he hits the nadar. And run a curve at the end of the week. Then re-post for your input. Is this a good plan?
Thanks again
Hillary
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Yep, sounds good!
 
this thread had me on pins and needles, what a rollercoaster of emotions reading through this and seeing that he was given days to live, not eating....what a turn around! Yay for Buddy, warms my heart through and through.
 
Since I got a notification I opened his spreadsheet - as long as ketones stay negative and he doesn't earn any reductions, I would give this dose 2-3 weeks. See if his preshots and other numbers start to come down a bit. You don't have any more room to increase.

If not, I would recommend switching to Lantus (or it's generics/biosimilars, there's a lot more cost effective/cheap options now!).
 
FrostD said:
Since I got a notification I opened his spreadsheet - as long as ketones stay negative and he doesn't earn any reductions, I would give this dose 2-3 weeks. See if his preshots and other numbers start to come down a bit. You don't have any more room to increase.

If not, I would recommend switching to Lantus (or it's generics/biosimilars, there's a lot more cost effective/cheap options now!).
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I just saw your Friday reply. Yesterday (Tues) I completed a week at .8 and ran the curve if you would like to check his spreadsheet again.
My concerns are for the summer when we will be traveling and our cat sitter will be taking over for weekends and one 10 day trip that we make each August. She is familiar with Buddy and is diabetic herself but has trouble with the testing. Last fall I would just leave the # of syringes needed for two shots a day already filled in the fridge. We have a 2 day trip in the end of May and this will be our first "test run" with no testing, just shot giving.
 
So what we usually do is a "vacation dose" that's basically dictated by his numbers and patterns at the time. He's pretty reliable, so in his case it would probably just be a 0.2U reduction while you're gone. And/or you can always leave slightly higher carb food than he normally eats.

We don't recommend prefilling syringes because there's a lubricant in there for the plunger that comes out into solution when it sits. Most of us just leave an example syringe filled with colored water taped to an index card with a warning not to use it.
 
FrostD said:
So what we usually do is a "vacation dose" that's basically dictated by his numbers and patterns at the time. He's pretty reliable, so in his case it would probably just be a 0.2U reduction while you're gone. And/or you can always leave slightly higher carb food than he normally eats.

We don't recommend prefilling syringes because there's a lubricant in there for the plunger that comes out into solution when it sits. Most of us just leave an example syringe filled with colored water taped to an index card with a warning not to use it.
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Again, really great advice!
the .8 dose on the U-100 syringe already requires some very good eyesight. The plus is that it is 2 units on the syringe no guessing for a dose "between the lines". the vacation dose would be .6? That would be 1.5 on the U-100 and I don't know if my 75 year old sitter would feel confident drawing the 1/2 measure.
For a weekend trip of two nights that would be a 5-6 doses. Would it be safe to leave filled syringes for that length of time?
 
Buddy & Hillary said:
Again, really great advice!
the .8 dose on the U-100 syringe already requires some very good eyesight. The plus is that it is 2 units on the syringe no guessing for a dose "between the lines". the vacation dose would be .6? That would be 1.5 on the U-100 and I don't know if my 75 year old sitter would feel confident drawing the 1/2 measure.
For a weekend trip of two nights that would be a 5-6 doses. Would it be safe to leave filled syringes for that length of time?
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I suppose 0.4U for 2 days wouldn't be that bad, that's on a line right?

All I can say is everything I can find here on the forum says not to do it (and links to scientific papers etc confirming). I know that's not exactly helpful!
 
FrostD said:
I suppose 0.4U for 2 days wouldn't be that bad, that's on a line right?

All I can say is everything I can find here on the forum says not to do it (and links to scientific papers etc confirming). I know that's not exactly helpful!
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Will try that. It is on the 1st line. Actually, it will be bringing him back to what he was for many months before he had his "close call"
 
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