weakness, staggering, displaying signs of hypoglycemia

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patNJ

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Hi, I'm new here and really need help with my newly diagnosed cat Diablo. He's been on Lantus 1 unit 2x daily since 12/11. Several weeks ago began having signs of hypoglycemia at 12- 1 am. I would immediately check his sugar & it would be in the 230-270 range. He usually eats & gets his insulin about 10 pm so it seemed like it was related to the insulin. I would feed him more not knowing what else to do. After that happened 2 nights in a row I took him to our local vet who wanted to increase his insulin. Vet # 1 thought it was the Somogyi effect & wanted to hold his insulin for a night & start at a little less than a unit 2x/day. Vet #2 said hold the insulin for the weekend and start fresh on Monday. Saturday night Diablo was exhibiting symptoms, I has able to get urine , it was positive for ketones so off we went to the hospital were he stayed for a couple of days. I was able to show the Vet #1 a video recording of a more minor incident of him staggering and now they think he has a brain tumor which I'm just not buying yet.
Today I'm trying to get him on 2 meals a day, cutting out the afternoon meal. He was just acting poorly, weak on legs decided to feed him a little early, didn't eat much but right now looks a little better. Blood sugar an hour ago was 274.
I have been searching the internet trying to get all the info I can in order to save him. One thing I was wondering is if anyones cat has ever had side effects from Lantus. Everyone including vets has told me no, but I have found plenty of humans at a website related to Lantus who have a variety of side effects.
It seems like the past few weeks all my time is spent doing internet searches and observing him, but not really getting anywhere.
 
Several weeks ago began having signs of hypoglycemia at 12- 1 am. I would immediately check his sugar & it would be in the 230-270 range. He usually eats & gets his insulin about 10 pm so it seemed like it was related to the insulin.
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Saturday night Diablo was exhibiting symptoms, I has able to get urine , it was positive for ketones so off we went to the hospital were he stayed for a couple of days.
Click to expand...

It sounds to me like there is something else going on with Diablo. It just doesn't seem like hypo symptoms should go with what you posted. With BG in the mid-200's, he shouldn't demonstrate hypo. If I read the other thing right, the vet told you to hold off on the insulin, on Friday, but the next night he showed the same symptoms, and tested positive for ketones....did you check his BG on Saturday night? Do you know if he showed any strange symptoms while he was at the vet for those 2 days?

I'm not ready to buy "brain tumor" either, but I have no idea what it could be. I don't think he's been hypoglycemic however.

Carl
 
Thanx Carl, the first night without insulin (Friday) he did ok, it was the next night he showed symptoms & we took him to the hospital. They didn't see any symptoms there but he was kept in a cage. Both vets believe something else is going on but don"t know what. I've already invested 4-5ooo and can't go another 1800 for an MRI. He's had a chest xray_ negative ; abdominal ultrasound x2 negative except for liver which is seen in diabetic cats (not a major problem)
vet # 1 wants to decrease insulin, vet # 2 says increase as the cat is not getting enough sugar to the organs. I didn't mention previously that I did increase to a little over 1 unit (probably not even 1.25) several days before he started having these symptoms (which were 12-1 am; lately they are around 7-8pm) and instead of his readings going down they started going over 300.!!!
Its sad because you don't really have a vet to give you any answers - their only available 8a-5p after that the hospital is an hour away.
 
Hello and Welcome!

Those numbers are not causing what you are observing.
Your kitty may be experiencing neuropathy. Check symptoms here Neuropathy

Please test kittys urine for ketones. They can quickly develop into DKA which is life threatening . Anything higher than trace warrants a trip to the ER.
For your peace of mind check asap and check frequently.

Was vet #2 aware of the ketones?
 
vet # 2 is aware. You have no idea how I've camped out by his litter box waiting with my spoon without luck...he sees me move & jumps right out. Don't really know what I would do if he went into ketosis again & so soon, last week ran about 2000. I'm determined to try to help him but am getting frustrated. When you have 2 different vets telling you to increase & decrease the decision suddenly becomes yours & its really hard to give insulin to a cat who is unsteady, staggering, looking like hes ready to pass out. These incidents are fairly short lived, he rebounds quickly. But I still end up observing him for hours.
As for the neuropathy he doesn't fit the picture. One thing he does frequently which he didn't do prior to being diagnosed is lay on the floor near a door or baseboard with his feet touching the door or baseboard which seems to indicate dizziness.
 
so the episodes are brief? but you've seen a couple of them and then in between he seems fairly normal?

i wonder if there's any possibility of it being a seizure. i don't know anything about seizures in cats, so i may be way off base, but i've been around some children & teens that have them and it can be anything from a momentary brain blink - like they mentally checked out for a minute, to a full-blown fall down & seizing on the floor. do you think it could be anything like that?

to check for ketones, one option is to put out a box of something non-absorbent. people use aquarium gravel and lentils. another option is to put some pieces of plastic wrap in the box, or some little cups that you might be able to catch some. some people make little foil cups and put them in the litter.
 
If you have kept the records of Diablo's blood tests it would be really helpful if you could put them into a spreadsheet and post that in your signature, here is the link for how to do it: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=50130 But it does sound like this problem may be unrelated to the diabetes or even causing the diabetes - often it is an underlying problem that brings the diabetes on.

Based on what you have said there are no signs to decrease the insulin and it is definitely not hypoglycemia. You mentioned that his BG went up after you increased the dose slightly - this is quite common and okay we call it NDW (new dose wonkiness) and it will settle in a few cycles when the new dose has a chance to take full effect.

I'm not sure why you want to decrease Diablo's meals to twice per day. With long acting insulin like lantus it is usually better to feed more smaller meals throughout the day but not in the 2 hours prior to giving the lantus so you can be sure that the blood test you take is unaffected by any food spike.

I'm so sorry that you and Diablo are going through this right now
 
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