HHS Experiences | Feline Diabetes Management Board

HHS Experiences

T

thaurermellon

Member
Good morning all. I'm just looking for some support and I'm just curious if anyone has had a cat who has survived HHS?

My brave Paco was able to fight through it when I read there's only a 12% chance of survival, but unfortunately 6 weeks after now all signs point to him starting to develop it again and his kidneys are no longer filtering anything.

I have put him on palliative care and I am just struggling with knowing the end is near. I know I did everything I could for him, but I want to also hear from anyone else who has experience with hhs. Do any of these poor babies survive it? It just seems so horrible :(

Here's a pic of him. He's happily laying in his favorite spot right now and I'm so glad I am a teacher and have the rest of July with him before it's his time to go.


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Why do you think Paco has hyperglycemic hyperosmolar syndrome? His numbers are high at times but he's not getting much insulin. It also looks like there's a response to insulin. There's a far better chance that what you're seeing is bouncing versus HHS. I would also suspect that high dose conditions would need to be ruled out but Paco isn't at a place with regard to dose that would warrant getting those tests run.
 
Sienne & Gabby (GA) said:
Why do you think Paco has hyperglycemic hyperosmolar syndrome? His numbers are high at times but he's not getting much insulin. It also looks like there's a response to insulin. There's a far better chance that what you're seeing is bouncing versus HHS. I would also suspect that high dose conditions would need to be ruled out but Paco isn't at a place with regard to dose that would warrant getting those tests run.
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He had HHS a few weeks ago and my vet is just suspecting he is headed towards it based on the calculation they can with his electrolytes etc. The biggest issue for him is his kidneys are not filtering anything and his numbers are rising rapidly. I had him in for fluid therapy in hospital and it did not help him.
 
How did the vet make the diagnosis? The presence of ketones is a rule out for the condition. Do you have more recent labs? The labs you have are from June and there's nothing there that suggests anything problematic.

I think Paco needs more insulin. Would you consider switching over to Tight Regulation vs SLGS?
 
Sienne & Gabby (GA) said:
How did the vet make the diagnosis? The presence of ketones is a rule out for the condition. Do you have more recent labs? The labs you have are from June and there's nothing there that suggests anything problematic.

I think Paco needs more insulin. Would you consider switching over to Tight Regulation vs SLGS?
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I am increasing his inuslin and trying to get him a bit lower. My biggest concern is his quality of life. Right now he is needing a lot of meds to just act semi-normal. I am waiting until his quality of life gets to a certain point where I need to do it. I mostly just don't want to bother taking him to the vet anymore because that is very stressful for him and I'm just managing him at home.
 
Can you list the meds he's getting now, and what they are for?

To me Paco's spreadsheet doesn't look hyperglycemic, just bouncy which is normal for recently diagnosed diabetics. My girl Neko was much more hyperglycemic in the beginning and she needed a much higher insulin dose.

I agree that it looks like he could use more insulin.
 
Wendy&Neko said:
Can you list the meds he's getting now, and what they are for?

To me Paco's spreadsheet doesn't look hyperglycemic, just bouncy which is normal for recently diagnosed diabetics. My girl Neko was much more hyperglycemic in the beginning and she needed a much higher insulin dose.

I agree that it looks like he could use more insulin.
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I'm honestly at this point not really concerned about the hhs (if he has it-- I was a bit uncertain) because his kidney values have taken such a dive and I just can't afford to hospitalize anymore. THat's why I said he is on palliative care. I was just curious if anyone has had a cat survive hhs since he did have it 6 weeks ago and has been struggling with his kidneys and appetite ever since.

He was just getting phosbind (for phosphorous removal), insulin, and some kidney gold (just supplements essentially). The specialist had taken him off of his blood pressure med, but we put him back on it and then he is also starting some potassium. It gave him diarhea last time so I am being careful with it and not giving a full dose. I would have to check what other supplements he gets.

He also has ondansentron for naseau and he just started entyce instead of miratazapine for an appetite stimulant.
 
Entyce isn't the greatest product for diabetics, as it can cause excess growth hormone to be excreted, and thus insulin resistance. Did you try Mirataz?

My Neko had really bad kidneys. Have his kidney values gotten worse since the 6/11 numbers on the spreadsheet? Has a USG (urine specific gravity) test been done? What does need to be addressed is Paco's phosphorus numbers. High phosphorus will impact his appetite. I'm glad he's on a phosphorus binder but his P might need to be retested to change the binder dose. Did you change diet to a lower phosphorus food? This food chart has a list of diabetes CKD foods that are low carb and low phosphorus Andrew Hall, Feline CKD Facebook Group food chart In addition to CKD when it advanced suddenly, Neko also had a heart condition and small cell lymphoma on top of the diabetes. Battling inappetance was almost daily for me. But I found a good balance which included getting her blood sugar values in a good range that was mostly under renal threshold and easier on her kidneys.

Not sure I'd bother with the kidney gold.

Honestly, have not seen much in the way of HHS here. Maybe once or twice?
 
Wendy&Neko said:
Entyce isn't the greatest product for diabetics, as it can cause excess growth hormone to be excreted, and thus insulin resistance. Did you try Mirataz?

My Neko had really bad kidneys. Have his kidney values gotten worse since the 6/11 numbers on the spreadsheet? Has a USG (urine specific gravity) test been done? What does need to be addressed is Paco's phosphorus numbers. High phosphorus will impact his appetite. I'm glad he's on a phosphorus binder but his P might need to be retested to change the binder dose. Did you change diet to a lower phosphorus food? This food chart has a list of diabetes CKD foods that are low carb and low phosphorus Andrew Hall, Feline CKD Facebook Group food chart In addition to CKD when it advanced suddenly, Neko also had a heart condition and small cell lymphoma on top of the diabetes. Battling inappetance was almost daily for me. But I found a good balance which included getting her blood sugar values in a good range that was mostly under renal threshold and easier on her kidneys.

Not sure I'd bother with the kidney gold.

Honestly, have not seen much in the way of HHS here. Maybe once or twice?
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I did try mirataz and it didn't seem to help with the ear kind. I think it also comes in another form which I could ask for. The entyce is working really nicely for the appteite, but that sucks about the diabetes I didn't know that. Would you say that happens often?

Is it common for a phosphorous binder to stop working? It had been working for him for 4 years and now all of a sudden his numbers were through the roof. That's why I'm worried. I also have spent more than I can on him. He was hospitalized probably about 7 times now since March. I'd love to have infinite funds, but I just don't. Just feeding him and medicating him alone is a big expense when I have 3 other cats too.

I've tried to get him on lower phosphorous foods but he is so dang picky, and especially now with his inappetite. If he can recover from that, I'd have more hope for the switch to a lower phosphorus but I've been battling with him with this since March probably. I have his initial blood work but they did 2-3 times when he was there and they haven't sent it yet. His phosphorous got worse initially to 15 when I went in this weekend, and then did drop to 12 before he came home. Still high though obviously. I'm out of funds to keep testing his blood work and I am just trying to manage him at home. I'd be willing to take him in for some IV fluids but that's probalby the most I can afford right now.
 
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