Vetsulin adjustment and force feeding advice urgently needed

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Tanya and Ducia

Tanya and Ducia

Member Since 2017
Hello everybody,

my name is Tanya. I'm a newbie in this forum, and never heard about feline diabetes until now. I have human med background and hope to provide my girl with the best at home care possible.

I need help and advice for my beautiful 8 ½ YO girl named Ducia.

Yesterday Ducia was diagnosed with diabetes, DKA and possible pancreatitis. We give her 1st shut of 1unit Vetsulin earlier today without prior testing. We tested her about an hour after the shot and Relyon red 236. Four hours later tested again and it is up to 253. I just added 2 units shot.

We will monitor her blood sugar again in few hours. Ducia refuses to eat and I am afraid to overdose her. The syringe feeding Friskie diluted with Pediatric electrolyte was a fiasco twice today already. She hasn’t eaten in 2 or 3 days. Since Thu she received about 150 ml Ringer’s solution SC.

She is lethargic, motionless, refuses food and drink completely. She also avoids us petting her and turns her face away from food. Went to hiding in the closet.

Thank you for any advices and thoughts.
 
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Did your vet up the dose this evening or did you? It's dangerous to increase by whole units like that... And without eating vetsulin can really hit hard and fast. How long ago did you give the two units? Please recheck her 2 -3 hours past the shot to make sure she isn't dropping too fast. Vetsulin usually hits it's lowest point 4-6 hours post shot.

Other than the sub q's, is she getting any other medications? She needs something to get her eating like cerenia and possibly bupe pain meds.

Getting her to eat ANYTHING is super important to avoid fatty liver. Offer tuna, chicken, anything.
 
Tanya and Ducia said:
We give her 1st shut of 1unit Vetsulin earlier today without prior testing
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At what time did you give the first shot of Vetsulin? How many hours before the second shot?

Tanya and Ducia said:
We tested her about an hour after the shot and Relyon red 236. Four hours later tested again and it is up to 253.
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Meters are allowed to have up to 20% variance in readings so these are essentially the same number and not that high either.

Tanya and Ducia said:
I just added 2 units shot.
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This is a very large dose increase and if this second shot was only 5 hours after the first one (from what you described) your kitty might be in a situation of insulin overdose. This can be dangerous.

Tanya and Ducia said:
diagnosed with diabetes, DKA and possible pancreatitis.
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What treatment was given by the vet? DKA requires intensive care at the vet for a few days and pancreatitis needs to be treated with pain and anti nausea meds.

Tanya and Ducia said:
Ducia refuses to eat
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If she's has/had DKA she must eat. She might need an appetite stimulant along with anti nausea meds. She's at risk of going back into DKA or developing hepatic lipidosis if she doesn't eat.

My opinion is that your kitty is still very ill and needs vet attention. You also need to be very careful in how you dose insulin. Generally a starting dose is 1 unit twice a day 12 hours apart. This dose has to be given for several days to see how your kitty does on it before any changes are made. We recommend increasing in very small amounts of 0.25 u.
 
A cat that is not eating and in DKA really needs immediate vet care-- this is a situation that is life-threatening and very very difficult to treat at home. Once the DKA is resolved and she is eating we can offer lots of advice about dealing with the diabetes, but this is a life-threatening situation right now.

There is a page on syringe feeding here that gives some tips that might be helpful. She needs both food and insulin to deal with the DKA, if you are unable to syringe feed she absolutely cannot be treated successfully at home.
 
Tanya and Ducia said:
Thank you all for replies!
I have good news GB is 145 now, and 10 ml of Friskie w/ Pelialyte just went successfully down. I am here to post.
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How long has it been since the second shot. This is important because if you have a few hours to go until nadir it could go too low.
 
Tanya and Ducia said:
Thank you all for replies!
I have good news GB is 145 now, and 10 ml of Friskie w/ Pelialyte just went successfully down. I am here to post.
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If BG was 253 just before your first post 20 minutes ago and you had just given another 2 u of Vetsulin, a BG of 145 is a huge drop. That 2 u dose will not have its maximum effect until 4+ hours from now. Ducia's BG could very low by then.
 
The 1st shot was at 1pm, reading 236.
I increase the dose myself the vet's office is closed, and we cannot pay for the hospital, not until next week. The vet will see as for assessment on Tues. His recommendation was to hospitalize but, unfortunately, no money.
 
The last shot was at 7 pm. How soon should we test her?
Definetely going to give her food again later on.
I never posted/replied on boards such as that one. Still figuring out how to.
 
Wait.... So you shot 1 u at 1 pm, then 2 more uNits like 7 hours later? That was an hour ago your second shot?

Shots are to be given 12 hours apart... And that is way too much. I think you better get some honey ready. Not to scare you, but You may be in for a hypoglycemic event.
 
Vetsulin is supposed to be dosed 12 hours apart, and a 2 units starting dose (esp with the reading only in the 200's) is a lot!
 
Tanya and Ducia said:
The 1st shot was at 1pm, reading 236.
I increase the dose myself the vet's office is closed, and we cannot pay for the hospital, not until next week. The vet will see as for assessment on Tues. His recommendation was to hospitalize but, unfortunately, no money.
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Then you'll have to do the best you can at home:
  1. syringe feeding of plain meat/broth baby food (without seasonings, onion, etc.) or pureed canned cat food
  2. syringing of water/pedialyte
  3. regular dosing of 1 unit insulin AM and PM 12 hours apart
  4. test BG before feeding and giving insulin AM and PM (no food at least 2 hours before)
  5. test BG again around 3, 5, 7 hours after AM insulin shot
  6. post BG results here for advice.
Until you start a routine, you need to post BG numbers here tonight. Your kitty is in danger of hypoglycemia because of the large amount of insulin given.
 
JanetNJ said:
Wait.... So you shot 1 u at 1 pm, then 2 more uNits like 7 hours later? That was an hour ago your second shot?

Shots are to be given 12 hours apart... And that is way too much. I think you better get some honey ready. Not to scare you, but You may be in for a hypoglycemic event.[/QUOT
after 1st shot BG was 236, she was to too bad, not responsive at all, GB went up to 253. That's why increase the dose and gave 2nd shot at 5pm, 4 hours after the 1st.
Hypo is main concern now. How soon should we check GB?
What are the symptoms of hypo?
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Hypo symptoms:

The symptoms to be concerned about include but are not limited to:
  • staggering, uncoordinated movements, 'drunken' walk, wobbling, balance problems
  • ataxia - usually lack of muscular coordination, but maybe changes in head and neck movements
  • disorientation (yowling, walking in circles, etc.)
  • twitching
  • stupor
  • convulsions or seizures
  • coma
 
Kris & Teasel said:
Then you'll have to do the best you can at home:
  1. syringe feeding of plain meat/broth baby food (without seasonings, onion, etc.) or pureed canned cat food
  2. syringing of water/pedialyte
  3. regular dosing of 1 unit insulin AM and PM 12 hours apart
  4. test BG before feeding and giving insulin AM and PM (no food at least 2 hours before)
  5. test BG again around 3, 5, 7 hours after AM insulin shot
  6. post BG results here for advice.
Until you start a routine, you need to post BG numbers here tonight. Your kitty is in danger of hypoglycemia because of the large amount of insulin given.
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Thank you for your response . I will check BG in a few hours again I hope she will get better. Her ACT and ALT on blood test over 400. It may look like pancreatitis. Food is really dangerous to buy.
 
Tanya and Ducia said:
Thank you for your response . I will check BG in a few hours again I hope she will get better. Her ACT and ALT on blood test over 400. It may look like pancreatitis. Food is really dangerous to buy.
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Please check her now.... Don't wait a few hours. The insulin had not yet reached its lowest point. If it goes too low she could be in danger. Numbers too low are MUCH MORE dangerous them high numbers.
 
She was most likely behaving the way she was because of the pancratitis, not the elevated bg.
 
JanetNJ said:
She was most likely behaving the way she was because of the pancratitis, not the elevated bg.
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the vet did not tell us about pancreatitis- I picked up copy of her tests and got it from there AST 484 ALT 384 norm 15-95, her bellyrubin 1.5 norm is 0.4
What to expect?
 
Tanya and Ducia said:
the vet did not tell us about pancreatitis- I picked up copy of her tests and got it from there AST 484 ALT 384 norm 15-95, her bellyrubin 1.5 norm is 0.4
What to expect?
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Why is your vet not telling you what you need to know?! The ast and alt are saying she's got liver problems. She probably has fatty liver er from not eating. What did the dr say about why she's not eating? it's not the diabeties. Her numbers aren't sky high.... And numbers often go up when a cat is sick out stressed. So they may cone down once her other issues are resolved.

It COULD be pancratitis..... But he should have given you treatments IF. that's what it is.... Cerenia, sub q's, pain killers.

He also didn't give you enough instruction on dosing. What's up with this vet? THANK GOODNESS you are at least testing at home.

Listen, no more insulin before 5 am tomorrow, ok? And test before you shoot. And no more then 1 unit 12 hours apart.

Over the next few days we can help you set up a spreadsheet like the one you see in our signatures below. It will help you to track her progress and help others with dosing advice.
 
It would be very helpful if you could make a list of dose times and BG test times like this:
  • 1 PM - 1 unit Vetsulin
  • 2 PM (1 hour later) - BG: 236
  • 6 PM - BG: 253
  • 7 PM - 2 units Vetsulin
  • __ PM - BG: 145
  • 8 PM - BG: 114
 
JanetNJ said:
If you could get her to eat a bit, food is longer lasting. Just keep the honey on hand just in case. I am glad to hear she's not under 100 yet. I would test again in 20-30 min to see if she's dropping more.[/QUOT
JanetNJ said:
She was most likely behaving the way she was because of the pancratitis, not the elevated bg.
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The vet didn't mentioned pancrea
JanetNJ said:
Why is your vet not telling you what you need to know?! The ast and alt are saying she's got liver problems. She probably has fatty liver er from not eating. What did the dr say about why she's not eating? it's not the diabeties. Her numbers aren't sky high.... And numbers often go up when a cat is sick out stressed. So they may cone down once her other issues are resolved.

It COULD be pancratitis..... But he should have given you treatments IF. that's what it is.... Cerenia, sub q's, pain killers.

He also didn't give you enough instruction on dosing. What's up with this vet? THANK GOODNESS you are at least testing at home.

Listen, no more insulin before 5 am tomorrow, ok? And test before you shoot. And no more then 1 unit 12 hours apart.

Over the next few days we can help you set up a spreadsheet like the one you see in our signatures below. It will help you to track her progress and help others with dosing advice.
Click to expand...
JanetNJ said:
Why is your vet not telling you what you need to know?! The ast and alt are saying she's got liver problems. She probably has fatty liver er from not eating. What did the dr say about why she's not eating? it's not the diabeties. Her numbers aren't sky high.... And numbers often go up when a cat is sick out stressed. So they may cone down once her other issues are resolved.

It COULD be pancratitis..... But he should have given you treatments IF. that's what it is.... Cerenia, sub q's, pain killers.

He also didn't give you enough instruction on dosing. What's up with this vet? THANK GOODNESS you are at least testing at home.

Listen, no more insulin before 5 am tomorrow, ok? And test before you shoot. And no more then 1 unit 12 hours apart.

Over the next few days we can help you set up a spreadsheet like the one you see in our signatures below. It will help you to track her progress and help others with dosing advice.
Click to expand...
Thank you so much!
I will post new BG in 20 min
She received 150 ml SC ringer's solution at 12:20 pm. The water bulge under her skin is still hanging on her side thou much reduced. Yesterday's dissolved much much faster. ANy thoughts on that?
The vet is general practitioner, waited to hear from specialist until late on Fr.
Sent us home without any word about pancreatitis at all, or painkillers. Said needs hospitalization , we could not afford.
I thought of fatty liver too.
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How much does she weigh? My cat (not the diabetic one, a different cat) who is 16 lbs had pancratitis a few months ago. He is normally a big eater so when he was barely nibbling for three days we brought him in. They did a snap test to diagnose. He was already on sub q's because he has kidney disease, but was still dehydrated so we went from 100 ml twice a week to every day for a few days. He also got cerenia for nausea and a plain killer as pancratitis is very painful. After a day in that he started eating more on his own. We were fortunate that he was basically fully recovered in a week. Some cats do need to be hospitalized.

The fluid bump is going down slower this time because she's not as dehydrated as she was yesterday.

The best thing is to keep getting as much food into her as possible. Really important.
 
9pm - BG 146
10pm - next test
10:30 pm - next syringe
Planning on to give next shot around 5am
Ducia went to litter box to bury poop after 2 days interval and her walk was "drunken" a little on the way there but straight on the way ba
Will keep honey at hand
Thank you all so much!
If you can please stay in I want to post something and hear your feedback
 
JanetNJ said:
How much does she weigh? My cat (not the diabetic one, a different cat) who is 16 lbs had pancratitis a few months ago. He is normally a big eater so when he was barely nibbling for three days we brought him in. They did a snap test to diagnose. He was already on sub q's because he has kidney disease, but was still dehydrated so we went from 100 ml twice a week to every day for a few days. He also got cerenia for nausea and a plain killer as pancratitis is very painful. After a day in that he started eating more on his own. We were fortunate that he was basically fully recovered in a week. Some cats do need to be hospitalized.

The fluid bump is going down slower this time because she's not as dehydrated as she was yesterday.

The best thing is to keep getting as much food into her as possible. Really important.
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Thank for the info, will definitely read thru. Ducia's weight om Thu was 7.2
 
Tanya and Ducia said:
9pm - BG 146
10pm - next test
10:30 pm - next syringe
Planning on to give next shot around 5am
Ducia went to litter box to bury poop after 2 days interval and her walk was "drunken" a little on the way there but straight on the way ba
Will keep honey at hand
Thank you all so much!
If you can please stay in I want to post something and hear your feedback
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Good
 
Have you gotten any food in her? Check out the assist feeding video I posted. It's essential that she eat. I fostered a fatty liver kitty and got him through it, but I had to keep helping him eat for a couple of weeks.

If you think she had/has pancreatitis, this primer on pancreatitis may help, including meds to help her nausea and get her eating.

142 is a good number.
 
Wendy&Neko said:
Have you gotten any food in her? Check out the assist feeding video I posted. It's essential that she eat. I fostered a fatty liver kitty and got him through it, but I had to keep helping him eat for a couple of weeks.

If you think she had/has pancreatitis, this primer on pancreatitis may help, including meds to help her nausea and get her eating.

142 is a good number.
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WE were just talking about pancreatitis. Thinking to give her another 150 ml SC Ringer's. The water bump from morning iv dissolved just recently late at night. Thank you for the info so much. The 142 BG is good but it i s lower than 146 an hour earlier, so there is downward tendency. I will check BG later on but love to hear your thought as to watering fpor pancreatitis. We do not have any pain killers.
 
Tanya and Ducia said:
WE were just talking about pancreatitis. Thinking to give her another 150 ml SC Ringer's. The water bump from morning iv dissolved just recently late at night. Thank you for the info so much. The 142 BG is good but it i s lower than 146 an hour earlier, so there is downward tendency. I will check BG later on but love to hear your thought as to watering fpor pancreatitis. We do not have any pain killers.
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She had 2 syringes Friskies+Pedialyte at 8pm
 
Tanya and Ducia said:
The 142 BG is good but it i s lower than 146 an hour earlier, so there is downward tendency.
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Given that meters are allowed a certain variability, the 146 and 142 are really the same number. Her numbers aren't really changing.

How big are the syringes you fed her? When I had the fatty liver kitty, each of his meals were 12 syringes, but that's because I was using the 3 ml syringes at the time. He got 6 meals a day. You want to try to get the equivalent of close to a can of food a day into her.
 
Wendy&Neko said:
Given that meters are allowed a certain variability, the 146 and 142 are really the same number. Her numbers aren't really changing.

How big are the syringes you fed her? When I had the fatty liver kitty, each of his meals were 12 syringes, but that's because I was using the 3 ml syringes at the time. He got 6 meals a day. You want to try to get the equivalent of close to a can of food a day into her.
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Thank you. We use 10 mp syringe but it hard to say how much exactly went in. She resists aggressively. At list 1 1/4 at 8 pm, and closer to 1 at 7pm.
We just gave another 150 ml SC.
Her condition regardless of BG's level is bad. She lays motionless on the bed, covered with blankets. I watch my girl going maybe in pain and its nothing I can do. Vet never mentioned any complications on top of DKA. We guessed it from the test results and dr. google.
What can we do help her?
 
Chris & China said:
does her breath smell like fingernail polish remover? If that's it, that's due to the DKA and she really needs to be at the vets office
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No, non acetonic smell. Rather unpleasant nor her own usual one. As somebody else dirt. There were also some spills done while feeding diluted Ocean White Fish Friskies which I cleaned but maybe some stuck under her chin
 
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