? 4/10 Silver AMPS 209 PMPS 239 +2=292 +4=286 Ketones 3.5!

Discussion in 'Lantus / Levemir / Biosimilars' started by Juliet, Apr 10, 2018.

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  1. Juliet

    Juliet Guest

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    http://www.felinediabetes.com/FDMB/...279-4-311-9-239-pmps-268.193878/#post-2168313

    He came and woke me this morning so that's good. Two lots of poo in the floor beside the litter tray. Don't know which cat but I guess him given all the extra runny food he had yesterday.

    I've put down one full cat of fat that he is is eating now and when I walk out the door in half an hour I will put down another can. Likely he will eat it right away instead of saving it for later. Hope that won't make him sick but it's the only way to give him more food. I will try the popsicles tonight.

    Don't really want to go to work and leave him not he does seem his perky self again. Culture results came back but the emergency vet sent them to my regular vet and I need to call them today. Ketone meter arriving today and I will test him tonight.
     
  2. carfurby (GA)

    carfurby (GA) Well-Known Member

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    That's a good sign that he woke you up. I'm glad he is eating for you. It's hard to go to work when you want to stay home and keep an eye on the kitties. I'm sure he'll be fine today. Sending prayers.
     
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  3. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    I suspect you meant "one full can of food" but it gave me a chuckle -- which is not a bad way to start the morning.

    I'm glad to see that Silver is getting back to his normal behaviors.
     
  4. Juliet

    Juliet Guest

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    Oops yes I meant FF but I wrote it early before my coffee. He's very thin. Need to get some weight back on him. I can't seem to find the Recovery food in the stores. Is it only available through the vet?
     
  5. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Let us know later today how you and he made it through the day. Sometimes you just have to trust that it’ll be OK.
     
  6. Juliet

    Juliet Guest

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    I'll post when I get back from work. I'll need to give him his fluids again. @Marje and Gracie i watched your video. Very helpful. I did something wrong the first time and it was leaking on him. Think I forgot to close the thing at the needle. Would that do it? I know I didn't push right through the skin and out the other side. I hated doing it. Four more times to finish the bag.
     
  7. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    I am glad that Silver is home and eating.
     
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  8. Juliet

    Juliet Guest

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    Thanks. He crept onto my pillow this morning at 5am and purred. Nice way to wake up.
     
  9. Bellasmom

    Bellasmom Well-Known Member

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    So,glad,he’s,feeling much better and you are getting rest:bighug::bighug:
     
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  10. Stacy & Asia

    Stacy & Asia Well-Known Member

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    Recovery is probably a prescription food, which is one you'd have to buy from your vet or get a prescription to order it online.

    With the fluids, yes, you'd have to close the line (push the little wheel towards the needle to clamp it shut), you must have done when you stopped giving him fluids or else it would just keep spraying around everywhere. Once you get the needle under his skin, you push the wheel back away from the needle to unclamp it.

    I'm glad he woke you up and is eating enthusiastically. I hope your work day flys by fast so you can be home with him. :bighug::bighug::bighug:

    The cat popsicles should certainly slow him down. Question, you said Silver will get to the food before Sasha most times? If you had a timed feeder for during the day, do you think you'd try it out? You could set it to open automatically when you are home so you could see if he gets there first. I'm lucky in some ways, as Toki doesn't like Asia's food, so I don't have to worry about that bit.
     
  11. Juliet

    Juliet Guest

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    I looked into times feedersbit they're very expensive here. When I put the food down both cars were sleeping on my bed so didn't see me creep down with it. I think he'll get it first. I think he ate too much yesterday tho given the fact I had two large dumps of poo on the floor to clean up this morning. Usually him that uses the puppy pads. This morning he missed.
     
  12. Stacy & Asia

    Stacy & Asia Well-Known Member

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    It's good that he's eating that much, more in, more out. Hope the ketone meter says negative! :bighug::bighug::bighug::bighug:
     
  13. Juliet

    Juliet Guest

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    Just spoke to regular vet. Not a nice man. Talks over me. Doesn't listen. Anyway. I pushed him to get some info. Urine culture came back clear. No bacteria. So ketones should go now he is eating per vet. True? Or not?

    Tried to ask re dental. Guy is thick. Talks and talks but doesn't answer my questions. Anyways. Turns out he has to be regulated before I bring him for dental and they say they will need to run blood panel first. He just had a blood panel done. I feel they want to make as much money out of you as possible and don't care if the treatment is not needed so I am going to have to be firm I guess. What if the need for a dental is preventing regulation? Now his numbers today are back to what they were before the keytones BUT realistically those yellows are higher per lab readings. I really do wish Freestyle meters would read closer to the lab but not at the higher numbers they don't. A yellow is a lab pink.
    Going to let him recover and think about a dental in the next couple months. I have no more available vacation days so there poses another problem but perhaps a sickie will have to be in order for dental day.
     
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  14. Olive & Paula

    Olive & Paula Well-Known Member

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    Nice start this morning. Kitty doesn't need to be regulated first, actually the dental might help regulate if there are dental issues. Blood work is usually done immediately (hours) prior to dental. It's good to make sure liver and kidneys are in normal limits. Xrays before and after are also suggested (although mine only does after).
     
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  15. Stacy & Asia

    Stacy & Asia Well-Known Member

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    That is so frustrating! And I agree, I've heard lots of vets suggesting they need to be regulated before dental but I think it's more often the other way around, I just don't think they know enough about diabetes to realize that. The labs you just got should be good enough for a dental if you were going to do it soon. If not, they have to repeat it for safety of the anesthesia.

    There are no other vets in the area you could use? This guy doesn't sound like a good fit, he should answer your questions at the very least. Can the ER vet recommend some place for a dental if you call and ask? I would always get an X-ray pre dental. They will know if something is happening below the gum line that way, and it's the only way they would know for sure. Some do post dental too to make sure they got all the bits out, but it would depend how complicated the extractions are (if there are extractions). If I had to pick just one, it would be the pre dental X-ray. Sick day sounds like a plan, unless you luck out and find a practice that works on Saturdays.

    I'm glad the culture was unremarkable. That's one less complication to worry about (antibiotics and side effects).
     
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  16. Juliet

    Juliet Guest

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    Vet won't do the dental until he is regulated. Unfortunately it's only vet close to me. I just did blood work. If I have to do it again then I can't afford it. Blood work alone is $240 not counting X-rays and dental.
     
  17. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Good morning,
    certainly if there is no infection it is great! ALL 3 components are to be present - not enough eating+not enough insulin+ infection for ketone bodies presence to become DKA. If is out of the picture the chances for it to become DKA are lessened. Eating+drinking is key IMHO. Good news!!
    Needing dental is notorious to prevent remission but I think your vet meant that Silver is to be stabilized or leveled at somewhat lower numbers before dental procedure - regulated better than now but not necessarily only Green numbers in his BG.
    I might be wrong but that was impression. DUcia needs dental too, I think, but it is not happening this year :(.
     
  18. Juliet

    Juliet Guest

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    The only other vet close to me was worse!
     
  19. Juliet

    Juliet Guest

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    So sounds like he didn't have DKA then? He has no infection.
     
  20. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Your vet should tell you exactly what his Dx was - I do not think Silver had real DKA, thanks heaven, but I am no vet.
    If you can obtain a copy of his ER file you'll know exactly where he is - Ducia's file contained wonderful Dr notes, clinical signs observation and electrolyte's level and urine tests. Very informative.
    What was the level of ketones when you took him home?
    Negative or Trace?
    SQF should help flashing it all out. And eating well is a huge help.
     
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  21. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    My least favorite human, CONDESCENDING!!! Next time any doctor says "It's doctor actually" just respond with "Your last name is Actually? Is that Slavic?"
    See Juliet, you and Silver made it through the weekend and at least no UTI. :)
     
  22. Stacy & Asia

    Stacy & Asia Well-Known Member

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    Any of these options you haven't tried?

    Snelgrove Vet Services
    The cat hospital
    Kennedy rd vet hospital
    Heart lake vet hospital
    Fletcher's creek animal hospital
    Dixie road pet clinic
    North town vet hospital
    Brisdale animal hospital
    Brampton vet hospital
     
  23. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Since you liked one of the ER vets, would it be possible to call the clinic and find out if that vet is only at the emergency clinic or if he has a practice elsewhere? A couple of other thoughts:
    • The American Veterinary Dental College has a searchable directory and it includes Canada. There may be a dental specialist in your area.
    • Antibiotics may be indicated if Silver is having dental issues. The inflammation or infection can have an effect on regulation.
    • Post on the Health board asking about both vets in your general area and/or veterinary dental specialists. It's a good way to get recommendations even if it means a bit longer of a distance.
    Unless there is something specific that your vet requires as pre-dental lab work, you should not have to have to do labs over. That's ridiculous. The lab work should be good for at least 2 mos. If your vet wants to be sure that Silver is out of the woods regarding the DKA, that's a different issue. I would not rush to have a dental procedure done this soon after an episode of DKA. A surgical procedure is a source of stress and you want to have Silver back to normal before planning anything that's even remotely stressful.

    The diagnosis of DKA does not depend on whether or not there's an infection. Infection or inflammation is just one risk factor (and from what you're saying, Silver's teeth may be a source of inflammation.) The diagnosis is based on the lab work -- are the electrolytes causing an imbalance and whether ketone bodies are present. In Silver's case, you know that potassium levels were off and ketones were present so, he did have an episode of DKA.
     
  24. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Thanks for clarifying.
    I thought that an infection must be Dx AND treated w/ AB to make it DKA. If the ER vet did not Rx any AB, I thought, I was not full DKA.
     
  25. Sean & Rufus

    Sean & Rufus Well-Known Member

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    That's why Rufus had to go to a dental specialist. 2 or 3 times the cost, but much more staff on board for the procedure. Dedicated people there to help if anything goes wrong during the procedure.
     
  26. Sean & Rufus

    Sean & Rufus Well-Known Member

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    My vet wouldn't do dental until rufus was regulated, that's why we had to go to a specialsist.
     
  27. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    Wow, lots of info coming your way today. I am glad he is back to eating and is handling the fluids ok. I have a CKD kitty...man she is a 6lb alligator. Takes two of us to give the fluids to her.

    My clinic requires blood work in the previous 3 months for a surgery. Not sure if your clinic is the same...but if the dental was done within that time frame you should be able to use the panel from the ER clinic. You can phone and ask for a copy just in case. My clinic knows just to email the results to me now. I ask every time.

    I hate those type of people that talk at you vs. to you.

    For the dental...if you had a vet well versed in FD, I am sure that they will know that the dental issues will most likely prevent regulation.

    You have time while Silver recovers from this episode to research in your area for a better vet. Can you go slightly outside your area?
     
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  28. Juliet

    Juliet Guest

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    Vet is absolutely an idiot. Could not answer my questions and knew nothing about Silver. He initially thought he was talking about Sasha. Trouble with me having gone to the emergency vet is that now they handed the file over to regular vet who hasn't seen Silver. Just reads off the file in complete ignorance. I knew what was in the filemore than him and I don't even have a copy. I will testfkr keytones myself. Seems I have to do everything myself. Hate vets. Only one I liked was the emergency vet who I can't have as my regular vet :arghh:
     
  29. Juliet

    Juliet Guest

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    Kennedy Road is close to me. I do not have the energy or finances to shop around. If silvervis in trouble I will take to emergency vet I liked. They open when the other vets close.
     
  30. Juliet

    Juliet Guest

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    I need to go to a vet five mins drive from the house. I'm a new driver. Don't go far at all and having a yelling cat in the car is unsafe for me. Must be close by.

    Thanks for all the tips everyone. Right now both Silver and I need to recover from this weekend. I am at work but suffering physically from it all.

    If I can afford it and that's a BIG if I will try and get him scheduled for a dental in a month. Within the 3 mths time frame of his labs. It would be better for me if it's just X-rays and dental. New blood work and the cost stacks up.

    On my second large coffee trying to get through the day.
     
  31. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    :bighug:
    A few ppl on this Forum can tell you that I was saying the exact same things one year ago, :joyful:.
    The only sensible and caring vet I have met was too, an ER one, a young fellow working nights mostly.
    It is not a bad thing to learn a lot for yourself - gives you some degree of control and definitely saves tons of money.

    Testing for ketones won't be too much trouble very quickly and it will give you piece of mind, priceless.

    Focus on much better Silver is doing now!
     
  32. Juliet

    Juliet Guest

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    Actually both vets were quite impressed with what I knew and what I was doing re testing. All of which I learned here.
     
  33. Stacy & Asia

    Stacy & Asia Well-Known Member

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    I gave you those suggestions as places to get a dental, not for emergency services. It should not cost any money to call and inquire about the cost of a dental and if they can use his labs from hospital, find out what their window is before labs need to be repeated.

    I second Sienne's thinking re: teeth and antibiotics. That could be the source of what's going on since UTI culture was negative. Maybe a call to the ER to inquire about antibiotics for his teeth until you can set up a dental.
     
  34. Juliet

    Juliet Guest

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    See my comment to Tracey. I can't drive far. I am a new driver. I only drive five to ten mins away from my house. Ever.

    I will do a dental when I have the money. I do not have it now. I do not have contact with the ER unless it is an emergency. He does not need antibiotics. Both vets said so.

    Vet did not say teeth were the issue.
    Okay. Need to sign off. I am at work.
     
  35. Juliet

    Juliet Guest

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    Last thing before I sign off. Is this correct for cats? 403FC065-8C0C-4B19-A5D5-B0F92B2A37C5.jpeg BAD06595-10CF-49EA-BFDC-07C69DFD25AF.jpeg
     
  36. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    It’s very possible you didn’t get the needle inserted far enough in since you are certainyou didn’t push through to the other side.

    I’m glad it helped you. Give yourself a pat on the back. It’s challenging and scary st first especially by yourself. You’ll get better at it. Let me know if you have any other questions. Best to PM me as you did earlier today as I’m not on the board every day.

    Vines for your sweet boy.
     
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  37. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Hi Juliet, glad to see things are better with Silver. I wouldn't follow that...Per attached link: http://www.felinediabetes.com/FDMB/...oacidosis-dka-and-blood-ketone-meters.135952/

    It shows some of the latest published research/studies for cats, you are looking for ketones of 2.4-2.55 or higher on a blood ketone meter. Less than that, I believe you just need to watch to make sure the readings don't continue to increase.
     
  38. Kathy and TiTi

    Kathy and TiTi Well-Known Member

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    Yes
     
  39. Juliet

    Juliet Guest

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    Okay just had an interesting call with the vet receptionist. More helpful than the vet. Got a dental quote for the basics and also asked her to read me his ER file over the phone. This got me a little worried. From what she read in the file the last time they tested his keytones was Sunday morning and it said +3!!! Surely that is bad and I should not have been sent home with him???

    This is the dental quote - is this reasonable?

    Blood work - full geriatric panel - $170
    X-rays and cleaning with no extractions involved $500
    Extractions - $170 per 15 mins of time.

    I have booked him in for a free exam and estimate for this Saturday. Can't hurt to get that done.

    Then if he is stronger and recovered from the DKA episode (and the notes confirmed he did have DKA) then I will take him in a month for his dental. I want to be sure he is fully recover d before I do anything else.

    Does this sound like a good plan? @Tracey&Jones @carfurby @Stacy & Asia @Sienne and Gabby (GA) @Marje and Gracie
     
  40. Beenie (GA)

    Beenie (GA) Well-Known Member

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    Glad there isn’t a UTI. Sorry you’re not happy with your local vet. Maybe things will change and he can work with you.
    One day at a time. It’ll all sort itself out Juliet :bighug:

    I just saw your post on dental costs. Glad you can bring Silver in to get a better idea of price. I honestly can’t remember what my civvies dental cost was:rolleyes: maybe I erased it from my brain :joyful:

    Please do take care of yourself and rest up:)
     
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  41. Juliet

    Juliet Guest

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    Thanks. I'll take care of me once Silver safe. My baby is too thin.
     
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  42. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    That’s looks reasonable to me. The last dental I had for civvie Tobey was last Nov and it was $1600 with no extractions and that didn’t include labs which we had already done. Granted $600 was for the anesthesiologist we have to use due to his heart.

    IMHO, soon as he’s been stable with negative ketones a few weeks, irs eating well, and has put on weight, then it’s a good time to discuss with your vet getting him in for the dental. I wonder if they should consider antibiotics u til then if they feel he has an infection. I’m glad you’ve got a blood ketone meter. It seems odd to me that they were not checking his ketones daily and they released him without a ketone reading. Perhaps they were just seeing his electrolytes were back in balance and thought he’d do better at home. He can have ketones and not DKA but 3+ on the ketones would certainly concern me. I’d ask to see what his labs looked like when they released him.
     
  43. Juliet

    Juliet Guest

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    The difficulty I have is that the vet who did the treatment is the emergency vet who has now handed off to regular vet who is thick and can't seem to read a file. The receptionist read the file to me and they were testing ketones daily and they were 3+ on Sunday morning. I took him home Sunday night and they had no retested. I will test tonight. Pray it's zero.

    I am going to stop by the regular vet on my way home and get some more Recovery food (how much should I feed at each sitting). I will see if the receptionist will give me copies of his file and notes and I'll post here.
     
  44. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    My civvie was just done - dental, x-rays, and 3 extractions - $1200 with pain meds and metacam to come home with. Which would be in-line with your quote if 3 extractions are needed (hopefully none are needed)/

    Don't use the metacam - ask for the alternative. The last thing Silver needs is an upset stomach and diarrhea. Canada does have a metacam that is formulated at such a strength for use for cats...but it is a 50/50 proposition if your cat will react to it. If he gets extractions make sure he gets a liquid meds for the pain.


    I would not expect a +3 for keytones and sent home. I realize they are an after hours vet but I would of thought they would suggest a transfer to another 24 hour facility.


    .
     
  45. Shawna & Davidson (GA)

    Shawna & Davidson (GA) Well-Known Member

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    Too bad your vet won't do the dental, most likely there won't be a regulation with the DX as the dental is causing the BG's to be higher. I was happy my vet did Davidson's dental knowing his diabetes was back.. Hopefully you can find a vet that is open to your needs.
     
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  46. Amanda & Shmee

    Amanda & Shmee Well-Known Member

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    I am happy to hear your update that Silver is feeling more perky :bighug:
     
  47. Juliet

    Juliet Guest

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    Well we don't know if the teeth had any thing to do with the DKA. I am just being preemtive and ruling it out.

    Just had a crappy call with the vet. Talk about thick. First he calls me as his receptionist said I wanted a call. Clearly he had not read the file. He said he had ketones levels of 4 and a hospital stay was recommended. Duh. I told him to hang up and call me back when he's rhome as the WHOLE file. He's k St been released from hospital. And we pay these guys thousands of bucks. Seriously.

    So. 15 mins later he calls me back. Says they didn't re-check the ketones. When I know they did. He told me to call the emergency vet for those results. I told him I did and they said to call him!

    So I said I was coming in tonight anf I wanted a copy of the whole file. Now he's acting weird saying he needs to check their policy on that. Scared I'm going to move vets. Tempted as I am!

    Rant over.
     
  48. Juliet

    Juliet Guest

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    Unfortunately Silver won't take liquid meds. I always have to ask for them in pill form.

    After my rant above - vet called me again and told me NOT to check for ketones and focus only on the BG. Right. Will ignore that piece of advice. You'd think they'd be happy I was taking precautionary measures to keep him safe. I'm glad I can ignore him.

    I really liked the emergency vet and asked him about hospital transfer but he said the fact Silver was eating and no longer dehydrated he was happy for me to take him home.
     
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  49. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    I don't know what to say about this guy. I think watching for keytone's is imperative after an episode like this. It allows you to know if what you are doing is working - food, hydration, insulin....I have a word in my head but I will keep it to myself.

    Keep doing what you are doing. You received your keytone meter right? Can't remember if it was today or tomorrow.


    Too bad on the pills...I found it easier to get into the cheek pocket and squirt vs trying to open up a sore mouth with sutures in it.
     
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  50. Juliet

    Juliet Guest

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    I'm on the train heading home but yes. On checking the tracking - package containing the ketone meter and strips was delivered. I don't have to open his mouth for the pills. He takes them in his food as if it were candy.

    Question - will he still eat if his mouth is sore? If he won't eat then we are right back where we landed up on Friday. DKA.

    I still don't know the cause of the DKA. No UTI. Vet didn't say it was teeth. I am just getting them done to be sure.
     
  51. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Mar 19, 2016
    Can't ever say for sure what any individual cat will do :rolleyes:, but all the cats I have ever brought in for a dental charged directly for the food bowls as soon as they got home, despite the after-care instructions that said to gingerly "offer small amounts of food" at first. So that wasn't a problem, at least for them. They do have to be fasted overnight for the anesthesia, so you will want to work closely with the vet to make sure that the fasting time is kept to the absolute minimum, and figure out how to dose insulin on the day (when the time gets closer, lots of folks here have done this with their diabetic cats).

    That is frustrating, dealing with your vet! I'm really glad you are getting the ketone meter and will be able to test. Silver is doing great so far, so hopefully he won't have any recurrences, but if he does that meter will help make sure that any problems are caught quickly. Makes a world of difference in terms of treatment.

    Would be nice to know what the trigger was for this last episode, though.
     
  52. Juliet

    Juliet Guest

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    Silver usually doesn't eat after 10:30pm until his breakfast at 6am so am guessing he just misses breakfast. Is that safe? Would missing one meal cause DKA again? I would have to drop him off at the vet at 8am on a work day and pick him up on my way home at 6:30pm. So that would be 20 hrs without food. Scary.
     
  53. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    All my kitties and dogs have gone straight the bowl after a dental. They are starved after fasting. I would assume that if he is stable from the DKA, that that one fast will not bring on a DKA episode but I am not an expert. Plus, I have read here that they will still get a half dose before surgery.

    If the dental is the issue...you need that inflammation/infection removed. That is the one hidden thing that can drive up BG and is one of the ingredients for DKA. To me, that is the bigger risk over the long term then fasting for a day.

    My Civvie was sore but she had some big extractions right at the front of her mouth. That said she ate about half her normal food that night and by the next day was eating normally until the metacam set her off. Even then, shot of cerenia and she was eating normally within 24 hours. I gave her 2 bupe shots. She went CRAAAZZZY on it. That was the end of that. So the two days she got it.

    Don't panic about the details of a dental till you get there. I know you like to have things all firm in your mind...but just focus on Silver and your rest for now.
     
    Last edited: Apr 10, 2018
  54. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Yeah, that's why I think you should work with the vet to try to shorten that time (have them offer a little food midafternoon before you pick him up, for example). But in any case, you aren't going to do the dental for a while, when he's fully recovered from the DKA and put on some weight too (the skinniness might have been a contributing factor here, he'll be more robust when he's back up closer to his normal weight). Lots of time to get a plan in place.
     
  55. Juliet

    Juliet Guest

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    Sounds good. But if it is a tooth problem then the dental needs to be a priority right? I have an appointment for the dental exam on Saturday. Metacam is the pain meds right? I can't even say I don't want it because it has a bad effect as Silver hasn't had it before.
     
  56. carfurby (GA)

    carfurby (GA) Well-Known Member

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    Feb 19, 2012
    That does sound like a reasonable cost for the dental. I'm sorry your vet is being so ridiculous. I hope Silver will continue to get his strength back and you'll be able to get the dental done soon. Sending prayers.
     
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  57. Juliet

    Juliet Guest

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    Trouble is I don't know what caused the DKA and if it's the teeth then dental must be a priority. I could take a sick day I guess but I'd prefer not to.
     
  58. Juliet

    Juliet Guest

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    How much Recovery should I be feeding him? I'm off to get some more cans from the vet. Was given three. Gave him a full can yesterday as well as two cans of FF. He did have a bit of runny poo this am.
     
  59. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

    Joined:
    Dec 12, 2016
    After he recovers from the DKA. That is going to take him a few of weeks.

    The runny poo can be from the new food and stress over the last few days. Hopefully that clears up over the next couple of days.

    I thought I saw a post to give 1.5 normal calories. So with the FF how much more calories does he need. FF is around 85-90 calories per 3 oz can. Recovery has been 183 for a 5.5oz can. What is his ideal weight?
     
  60. Juliet

    Juliet Guest

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    Ok just back from vet. Told to give 1/2 a can of the recovery along with his regular food at normal amounts.

    Seeing vet on Saturday re dental exam and will see what he says. If he sees them bad enough then he may say do dental now. The vet I am seeing Saturday is not the same as the ones I have talked to so far and apparently he has experience doing dentals for diabetic cats. Let's hope he is nicer when I talk to him. He is on duty tomorrow and I have asked if they will have him read Silver's file and see if he can tell me what caused the DKA and be up-to-date with his conditions before we see him on Saturday.

    Had to worm my way around getting a copy of his file. They told me to get it from the emergency vet. I told them they said to get from them. Little white necessary lie. I got the file. Will go over with fine tooth comb tonight.

    How would I know his idea weight? I have no clue.
     
  61. PussCatPrince - GA

    PussCatPrince - GA Well-Known Member

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    Nov 25, 2017
    Morning Juliet.
    Haven't yet properly caught up but it sounds like Silver is recuperating well.
    Glad he is eating well & after snuggles.
    That regular local vet sounds like he came out of the ark. Maybe the ER vet can suggest someone although I know transport is an issue.
    You need a vet who can listen as well as be able to explain well & fully.
    With regards to Silver's notes , records, lab results. They belong to you & you have a right to them.
    I do know what it's like to have an intransigent vet though, as we started with that before a swapped to the vet I now solely see. Same teaching vet hospital as that is the only place really with the mod cons just younger model of vet.

    M
     
  62. Juliet

    Juliet Guest

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    Well let's hope the one I see on Saturday is better. I think sometimes the less they know of what I am doing the better.
     
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  63. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    Dec 12, 2016
    What does he weight now? The vet notes should have a weight. I know you said he is a little thin...but we can add some grams to it.

    I am glad you got the notes.
     
  64. Juliet

    Juliet Guest

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    Sep 8, 2017
    I'll check the notes shortly and post.

    Just got home, feeding him his Recovery/FF - he is lapping up like there is no tomorrow so appetite back to normal.

    Not happy with the BG at all....I hope this is still the depot filling up?? Unfortunately I now know that the Accu-check is more in line with the lab.
     
  65. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    :D:cool::D:cool:
    wise words!
    I do just like that - worked perfectly so far.
    (I did not come up to this idea of behavior by myself - my vet's acting suggested it!, honestly!)

    I, too would be curious to learn what caused the DKA episode but if the treatment is the same - I care not.

    I'd try to beef up my cat's immune system in general - but not against any particular problem - as yo u said - "was it UTI that caused DKA? - well, try cranberries or vitamin C)" -no, not like that, but rather as a whole organism, strong enough to fight whatever infection, or other, is thrown at it.
    I hope that Silver's good eating and hydrating will help him to regain enough of his natural strength to fight anything.
    (And yes - vit C and cranberries are the huge help for the immune s., benefits the whole body - not the ur tract alone!)
     
  66. Juliet

    Juliet Guest

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    Sep 8, 2017
    Yup, the hydrating comes once Silver and I have both eaten and relaxed for an hour, then I will go and attempt second try at these fluids. I hate hate doing it and glad I only have to do it four more times.
     
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  67. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    Dec 12, 2016
    That will take a few days for sure to refill. Usually 6-8 cycles you hope to see some movement.

    Glad he is enjoying his food!
     
  68. Juliet

    Juliet Guest

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    Sep 8, 2017
    He will be after mine shortly - sweet and sour duck (NOT cat food!)
     
  69. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    This might help. It doesn't give weights but helps you judge where kitty is presently.
    http://meowaum.com/602-cat-body-condition-score-chart/
    My two boy cats are decent sized and look good at 13-14 lb.
     
  70. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    :bighug: yeah..
    When you do try to remember that Silver desperately needs this therapy and, unfortunately, you are the only one to do it for him.
     
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  71. Juliet

    Juliet Guest

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    Sep 8, 2017
    I managed. Its done. Didn't drip it all over him...I do think I got it too far up his scruff though and may should have aimed lower? I was getting a little worried when the ball of fluids was almost on his head. Oh dear. Maybe I will get it right third time.

    @Tracey&Jones the notes say his weight is 5.47 kg (which is 12lb). Sounds like a big cat? But I can feel his spine and bones. However, he was always a very chunky cat before diabetes.

    I would scan the notes from the vet but there are 15 pages and my scanner only does one page at a time.

    Have read the notes - some of it blatantly wrong. They said they discussed syringe feeding with me - they did not.
    They said ketones remained unchanged overnight and was 4mmoL - this was written on Sunday morning. No further comment was made about keytones - wow...crazy. If they sent me home with him at 4mmoL - what was the point of hospitalisation? just to get him to eat? They said his BG had been down as low as 144 but that is on THEIR pet meter so must have been much lower than that on our human meters. Most of the time he hovered around 234 - again on their Alph-Trak.

    So I don't think they lowered blood sugar, don't think they removed ketones - what the heck DID they do??

    Am going to eat, then test him for ketones on the meter. A bit worried about what I might see. However, he is bright, perky and back to his normal self.
     
  72. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    THIS is what's important.....stop trying to overthink it and enjoy your Sweet & Sour duck!

    There isn't always a clear reason for DKA.....even a cat with totally normal blood glucose numbers can develop ketones.

    As long as Silver is eating well, acting good and being a normal cat, be happy!!
     
  73. Tanya and Ducia

    Tanya and Ducia Well-Known Member

    Joined:
    Feb 25, 2017
    what was done can only be answered if you compare the pre-admition and the at-the release blood work, IMHO. (one of the reasons I always suggest to get the whole file). I understand you were hesitant to put any kind of claim on freebies I've suggested on the other thread, but a copy of the file is your property, even if it's been paid for by the DCIN - they paid for in your behalf, so it is yours! (and theirs of course, should they've ever wished for it, which I doubt)
    My vets in ER were successful in bringing Ducia's BG down whilst she was there - but it's not like fixing thing forever.
    Ducia was in Pink and Reds right after - and yet, I am telling you honestly, that "stabilization at the ER" that cost DCIN more than my car 's worth - it's saved Ducia's life.
    I am sure that the ER staff did something good for Silver, something that helped him being here.
    Btw, one cannot "remove" ketones as such - but rather create conditions under which ketones would not like to reappear/expand.
    That's means no infections, enough food and water and insulin in proper dose. All of which you are already doing.
     
    Last edited: Apr 10, 2018
    Reason for edit: gram err
  74. PussCatPrince - GA

    PussCatPrince - GA Well-Known Member

    Joined:
    Nov 25, 2017
    Woobie.jpg

    :arghh:
     
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  75. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    Dec 12, 2016
    Not really. Jones was around 5.75Kgs before all his issues. And he was a pleasantly plumb old man. Depends on their bone structure etc. My Fat Momma civvie is slim at 6kgs.

    So let us aim for 5.75kgs for Silver. Adding some extra grams in to that 5.47kg, Jones IM vet told me a few extra grams is not a big deal and when dealing with a chronic condition would rather see a "plump" cat vs an ideal cat.

    Calorie Calc = ideal weight in lbs x 13.5 +70

    So calories 5.75*2.2*13.5+70=241 - So 250 calories a day roughly.

    FF is around 90 calories per 3oz can - so two of those get you to 180.

    Recovery is 183 calories per 5.5oz can - so 1/2 of that gives you another 90 calories.

    There you go 270 calories plus any treats he gets.

    This may be too much once his numbers come down but for now I think a little more than less is ok.

    I am getting off the computer tonight as doing taxes after work and working on month end all day has my eyes very dry and sore. I hope you and Silver have a good night.
     
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  76. Juliet

    Juliet Guest

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    Sep 8, 2017
    OK. Agreed. I just checked his ketone levels with the new ketone meter I just got - and it said 3.5! How can that be good. It was 4 while he was in the hospital so obviously not much improvement in the ketone numbers. Am going to call the emergency vet back and ask how this can be okay.
     
  77. Juliet

    Juliet Guest

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    Sep 8, 2017
    I have the file. It does not help much. According to them he has no infection but we don't know that. We only know there is no UTI. He is eating and I am following SLGS so I can't increase insulin any faster than I am. He is getting the fluids from the bag they sent me home with and I am mixing water in with his food. HOWEVER he still has ketones of 3.5. This isnt good and I am upset.
     
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  78. PussCatPrince - GA

    PussCatPrince - GA Well-Known Member

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    Nov 25, 2017
    Before I run as am late but want to place this note before I forget.

    I believe some kitten foods may be OK for a diabetic cat and will help weight gain in the right way.

    Perhaps the more experienced members can comment on that for Juliet.
     
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  79. Juliet

    Juliet Guest

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    Sep 8, 2017
    Just bought 10 cans of Recovery. That should do the trick.
     
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  80. Juliet

    Juliet Guest

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    Sep 8, 2017
    Thanks. This is really helpful. Two cans of FF plus 1/2 can Recovery. I can do that.
     
  81. Juliet

    Juliet Guest

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    Ketones number is worrying me.
     
  82. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    Hey, :bighug::bighug:
    please try to ratio your upset.
    Can you take a pic/ photo of the test results you are looking on?
    And post them here?

    ETA: Frankly, I 'd prefer that you post it in the Lab Tab - just underneath the SS.
    Is that ok?
     
  83. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    The ER vet should be open. I'd give them a call.
     
  84. Juliet

    Juliet Guest

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    Sep 8, 2017
    It's 15 pages and I have no scanner so I don't know how I can.
     
  85. Juliet

    Juliet Guest

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    Sep 8, 2017
    Thanks. Am waiting for them to call me back. Nothing is changed from his hospital visit in terms of ketones or high BG. Only difference is he is eating. So I am nervous this DKA is not over.
     
  86. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    it is over in term that you are prepared better to guard it off.
    and him eating good for you is a sign, and an important one, too.
     
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  87. Juliet

    Juliet Guest

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    So what about the 3.5 reading? I'm so scar d he's not safe.
     
  88. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    there is no real reason to believe him unwell unless he stopped eating - and in combination with "off" behavior.
    The 3.5 ketones reading is a bit questionable - was a sample taken under the stress or after Silver was stabilized in the ER? Who sampled it? Was urin that they've tested - a Urinalysis? Big difference ....
    :bighug::bighug::bighug: let's hope it is over....:)
     
  89. Juliet

    Juliet Guest

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    Sep 8, 2017
    This was my test on the blood ketone meter I bought. Why would it be questionable?
     
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  90. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    Juliet, Bubba threw Ketones while he was in the 200 range. He went as high as 5.5 on the ketone meter. His ketone episode was after a dental with 2 extractions and then 6 weeks later his right eye was removed due to cancer. Surgery can throw a cat into ketones just from stress. Bubba had no infection at the time of the ketones. Like Sienne said, infection is just one possible component to a DKA scenario. We were lucky that Bubba did not stop eating through this and I had the guidance here to get more insulin in him safely to help bring him down. He did not have lethargy or vomiting. He was thin as he was starving to death and he ate like a horse through all of this. We were lucky that his ketone event did not go into a DKA event.

    I was able to manage his ketones at home with lots of water in his food, enough insulin, but as I said Bubba always ate through all this which was our saving grace.

    I would agree with the others and get him stable before taking him into a dental surgery setting.
     
  91. Juliet

    Juliet Guest

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    Sep 8, 2017
    Okay that makes sense. I'll keep adding water to food bit not sure what I do re insulin as I can't ever catch nadir until Saturdays. Hence me following SLGS. His numbers are not good but @Tracey&Jones said his depot needs replenished and it can take 6-8 cycles. I'm just scared I guess.
     
  92. Juliet

    Juliet Guest

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    Sep 8, 2017
    What if it's the teeth that caused the DKA?

    I'm trying to figure out why the numbers went into yellows (from mostly blues) from the increase 3:50 to 4:25. Each increase has not had any affect. So if I don't do the dental and the teeth are the issue - won't the numbers stay high and therefore not get rid of the ketones? Ketones is a new unfamiliar area for me and I don't know what to do. I'm not convinced he is safe. I don't do TR so I am restricted with insulin increases. What do I do?
     
  93. Juliet

    Juliet Guest

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    Ok the day is done and I am heading to bed. The ER vet did not call me back so I do not know if Silver is safe at 3.5 ketones in his blood. Thankfully he is eating. His BG numbers are the highest they have been in weeks and I am going to bed scared. Tomorrow is another day. I need those blue numbers back to feel he is safe. Should I wait for the curve at the weekend or increase now given the DKA situation??
     
  94. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    The presence of ketones does not necessarily mean the cat is in DKA

    DKA is the presence of ketones, electrolyte imbalances and blood gas results.

    As long as he's eating well and acting fine, just keep an eye on them.....it takes time for them to completely clear out of the body.
     
  95. Juliet

    Juliet Guest

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    Ok thanks. Maybe I'll sleep a little easier. I'm jumping at every sound from him.
     
  96. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    Didn't they find he had a UTI? If so it takes about 72 hours for the AB to squash the bacteria.

    Get some sleep. As long as he is eating and getting lots of water in his food and you're giving sub Q fluids try not to worry too much. The ketones can come and go. That's what happened with Bubba.
     
  97. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    Thank you. That's what I was trying to express with my log winded post.
     
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  98. Stacy & Asia

    Stacy & Asia Well-Known Member

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    Oct 2, 2017
    Like others have said, he needs to stabilize from the bout of DKA before you want to give him anesthesia and surgery. It’s good that you are keeping the teeth issue on your radar and intend to address it, I know first hand what bad teeth can do to a cat. My thought with teeth in the meantime, I would inquire about a course of antibiotics that would be good at addressing common oral infections. It’s a bandaid but should be good enough to keep things at bay until you can get the dental.
     
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  99. Juliet

    Juliet Guest

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    The culture came back clear. No UTI
     
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  100. Juliet

    Juliet Guest

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    Sep 8, 2017
    Well both vets said no infection so didn't give any AB. I wish I knew what caused this because if I don't know the cause I won't know how to stop it happening again. All I am doing differeny is adding water to his food. His numbers are not good. I am so scared for him I feel I am having a panic attack at times. Silly I know.
     
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