11/02/2019 PMPS=285,+2=75/35/66,+3=68,+3.5=69,+4=52

Good Morning
Salems has started at a low good number this morning ! YesterdayAMPS he was @428
Im trying to put myself on a schedule my schedule is all messed up . Still looking for some advise for a newbie , keton meters can anyone give me info on keton meters the best meters with an affordable strips , whats to be expected for the day will he start going in the l00s today ? these lower numbers are great but a bit scarey for me as he goes into possible the blue numbers Sandis gone over with me if hes to go too low shes given me what i call an emergency kit if he goes too low . I hope hes feeling wonderful this morning he sure is looking great more like my salem ! I wish he could talk so i know not only how he feels physically but mentally after all hes gone thru . They say animals dnt have souls ??! How can you believe that ? Salems got a personality how is someone with feelings and a personality not have a soul . Hes all heart and soul !
http://www.felinediabetes.com/FDMB/...ost-dka-amps-4-28-3-245-5-5-226-8-205.221145/

 

That is great to hear!!!

I would get a +2 today, to give you an early idea about what he has in mind. Blues would be very nice to see! There should be people around to help you during the day, but if you aren't getting responses, you can always change the title of your post to include a "Help!" message to get more eyes on you.

 

Ok thanks !!! I cnt believe some of the things you hear from vets ? I called salems vet to check on meters she tells me there is no such thing for ketons ? Im like what ?! Are vets old school are they so busy they are not staying updated ? I cnt believe she told me that ? And went an ordered me urinary strips a 100 for $80 no i didnt say order me those im looking to find keton meters ? Got an attitude too with me

 

Don't take those, that sounds like a crazy-high price! They must test everything!

I'm sorry I can't help on the blood ketone meter. Did you try posting in Feline Health about it? I know several people use them, but I don't know the details. As with the blood glucose meters, the key is figuring out cost of strips. The good news is that you don't use nearly as many of them, so that helps.

 

Yes i definetly told her cancel that order i was asking abt keton meters i didnt ask for strips i got urinary strips telling me i cnt break them up for you in lesser anounts . After i told her thats extremely high ! What a joke . Shes good but shes been making me shake my head at stuff like this i honestly think she must think im stupid !

 

I just bought a Keto-Mojo meter and strips from Amazon. The meter comes with 10 ketone strips (and some glucose strips and lancets). Replacements are $49.50 for 50, so 99 cents a strip. I haven't used it because Luna isn't home yet, but someone else here has. I imagine it's just like taking a BG reading since the meter can also do that.

Total cost for the meter and strips was around $110, but that's a heck of a lot cheaper than another vet bill like the one we have coming.

 

thanks hows luna i have been praying ! Salems surprised me i was so upset i couldnt stop crying !

 

http://www.novacares.com/nova-max-plus/
https://www.diabetescare.abbott/precision-xtra.html

I got those links of this info post written by Jill on DKA/and using meters and strips worth a read
http://www.felinediabetes.com/FDMB/...oacidosis-dka-and-blood-ketone-meters.135952/

 

How is Salem feeling? Eating?
I see he snuck some contraband yesterday? What time was that do you think? (in + hours in the cycle, would help if you pop that in the ss)

Nice to see him out of the reds and pinks.

 

There have been quite a few ketone meters coming on the market lately given how popular the ketogenic diet (for humans) has become. The two meters that Gill gave you links for, NovaMax and Precision Xtra, have been around for quite some time. The Precision Xtra is probably the the ketone meter that's been around the longest. The strips for most of the meters I've looked at run about $1.00 each. They are expensive but you aren't testing ketones as often as you test blood glucose.

A housekeeping note - could you change the color of your PM +6 cell on your spreadsheet. It should be yellow, not green.

 

Hes feeling good eating good hes finally starting to be hisself ! Hes reading 200 +4 Thanks

 

All great signs, and like how his BG is coming down.

 

Thanks ! Didnt notice it ! Its fixed ! Lol

 

I use the same Keyto-Mojo meter. The thing that makes it different from BG testing (I use an AlphaTrak BG meter) is that it needs more blood to do a test and at first I messed up a few times and ruined some strips because I didn't have enough blood. Someone advised me to buy extra keytone test strips when I bought the meter and I'm very glad they did because I needed them sooner than I would have thought. Eventually, I got the hang of it, but it was a learning curve for me.

 

I use the nova max Gill linked above. I also used it for glucoses because strips are cheaper and requires small blood drop. HOWEVER, it very temperamental with glucose test. Waste a lot of strips, so I went back to my micro meter.. For the ketone test it was fine.. Expensive, only 10 stops to a bottle so good thing you don't test multiple times a day.

 

Salem was 200+4
+5 156 is he dropping too fast in an hour 45 mins ?! He has been eaten too twice today

 

BINGO!

Not a problem! He's looking great!! He should be getting close to nadir so just check again at +6. He's perfectly safe!

 

I agree, I like it too. And it is mostly a nice soft curve, so maybe Salem will end up not being very "bouncy" (knock on wood), reacting to any big drops. Time will tell.

You are still safe at 156, you are a long way from the "take action" number at 50. But what you can do is go ahead and encourage him to eat some more of his regular food -- first, because he needs to be encouraged to eat as much as he can anyway, and second because it should help slow down the drop a little.

Remember that graph that I drew for you of the different parts of a curve throughout the day -- we still don't have a good idea of when Salem's nadir (the lowest point in the cycle) is. He could almost be at his nadir already since you are about half way through the cycle. But we just need to keep an eye on him to figure it out.

He is SAFE right now. But give him some of his regular Friskies or Fancy Feast (NOT the gravy kind), and then maybe test at +6. If you shot at 7:30 this morning, then that would be in just 30 minutes from now at 1:30pm Eastern time, right? Then we just go from there. You are doing great, and I really like what we are seeing. But make sure he keeps eating, and still try to get urine if you can.

 

CHris and I posted at the same time. Great minds think alike

Feed regular food and test at +6

 

Ok great ! Thanks everyone ! Just got to breathe !!

 

Nice cycle so far today. Yeah Salem.

 

we just gave Salem 100 ml fluids (LRS) since Salem has not been drinking very much . Since his BG is
on the way up I will not test him again until PMPS. we are going to delay his evening shot by 30 mins so that we are back on schedule for day light savings time.

 

Good job keeping him hydrated.

FYI some folk have noted that their kitties BG can drop after IV fluids, I'm not suggesting he'll be anywhere dangerous.
But it might be worth getting a +10 /+11 that way if pmps is a litter lower than you are used to, you will have a good idea if his numbers are flat/rising or dropping.

 

That 306 at +11 could either be a bounce from the blue, or the result of us chasing him around the house and having to pull him out from under the recliner to give him fluids

 

+11 =306
Looking good still
Yeah thats what i remember you said he might do . Lol
He gave us a run for our money he he

 

Look at those eyes and fangs lol

 

Here is a thought. Set everything up when you give fluids so it's ready to go. Put some safe treats where you do the fluids (I give Ollie's in bathroom, put Ollie on old towel on counter). And give a treat every so often. Ollie gets 3 treats and loves the knuckles rubbing her chin. Sometimes she lays down but mostly just sits. Once 60 mls get in her she starts getting antsy. So I give 3 times a week because of her heart 60-70 mls each time. It more to keep her flushed and hydrated to help with p'titis and constipation.

 

salems doing really well Thanks to Sandi and all of your advise ! Yall saved my baby . Hes still eating really well. He dropped to 156 Sandi came over @ 2:30 gave him some fluids 100 ml (LRS)
Cnt wait to see a new day i will check him again at ten before i go to bed but looks like hes did a good job Salem mommies baby ! But he certainly Gave Sandi and me a run for our money . Back to my old salem full of energy ! Forgive me as i get these numbers in right instead of the time . Got to get them memorized . Im slowly learning lol i will get use to it the more i do it .

11/02/2019 263@AMPS+1 1.5 +2 259 +4 200 156@ +5.5 227@ +7 306 +11 PMPS 285 Remarks - @+7.5 gave 100 ml lactated ringers fluids

 

Thanks much, Paula. I agree totally. I should have clarified - it was more that I had just arrived at Tina's house, and I think when he heard me pull into the driveway and ring the doorbell, he got scared and did a disappearing act. If we do fluids again, I'll have Tina get Salem into the bathroom about 10 minutes before I am due to arrive and stay in there loving on him and giving some treats while I come in without ringing the bell -- then I think there won't be a problem at all. Once we caught him, he sat on Tina's lap on a towel and he did just fine just with almost no manual restraint at all. I used an 18g needle today to get it done more quickly since I didn't know how he would do, but he was alright. On our oldest girl I use (and love) 21g Terumo Ultra-thin wall needles for her kidney disease, but she is super chill, and she gets fluids daily so I want it to be as painless as possible. She's the one whose stash I stole the fluids from

My vet has always told us that in the absence of heart issues you could do 150mL on a one-off basis. Even though it's too far for me to get up to Tina's every day, I didn't want to give any more than 100mL since we don't know his heart status for certain.

You are welcome, Tina. He's looking good! Remember that you'll be shooting at 7am tomorrow (on a clock that has already been adjusted for daylight savings time).

Side note @Olive & Paula : In case it helps you or anyone else giving fluids, this most recent time one of the few places I actually found Terumo needles was at Cal-Vet Supply for a really good sale price (https://www.calvetsupply.com/terumo-utw-hypodermic-needle-ultra-thin-wall-box-of-100-5-sizes.html) as well as my line sets (https://www.calvetsupply.com/iv-administration-set-micro-drip-1-set.html ) super cheap, and unlike the vet supply website I ordered from last, I didn't have to get a prescription from my vet for the needles. Not that I couldn't have gotten an Rx again, just that it is so silly. Oh, and the best price I can find locally for fluids is at a Walgreens where I just paid $28 for a case of twelve 1000mL bags of Lactated Ringers with the coupon from https://rxsaver.retailmenot.com/ I was originally paying my vet $35 for an "at home fluid therapy kit" of one 1000mL bag, one line set and 10 needles...not at all sustainable long term when giving fluids on a regular basis.

 

@Sandi & Whisper @Tina and Salem ,

I get these lines. https://www.shopmedvet.com/product/i-v-burette-set/iv-administration. So I can give accurate amount. I use 19g terumo needles, I purchased 1 box of 100 needles. Since I give small amount of fluids 3x week, I get 500 cc bags from vet. I can't seem to find anyone else who sells the 500 cc bags.

 

Yall are so knowledgeable about this stuff its wonderful !

 

Not really. I do know I need to be very careful with fluids and I knew these lines existed from my newborn nursing days (long before the pumps they use now for accurate dosing). When Ollie had her bad p'titis episode vet wanted to give 300 ml subq. I'm like no way she has hcm. I didn't even like giving 100 ml. So then I talked to cardiologist and he put a limit no more than 200 ml a week and I could divide it how I wanted. Trial and error Ollie does the best with it 3x week. Once in awhile I can get 70 ml in her but not often.

 

Salems just a running all through the house tonight from one end to the other lol little sounds of his feet sounds good now hes climbing the counters mischief ! Super Kitty !

 

That line set is good to know, I've not had to worry much about accuracy but with 23 little fuzzy feets (edit: 6 CATS, 23 feet!) running around, I am sure the time will come when it will. I'll definitely bookmark it. I did see the 500cc bags in my quest for the lowest prices, but it was funny that they cost MORE than the 1000's

 

I am glad. I am sure the fluids make him feel better. I'll give them to any of our kids if they seem to feel off because it always helps (assuming there is no heart disease or anything else that contraindicates it, which there is not for us).

 

Wow. Just...wow. I can't believe he/she said that.

 

just tuesday i was told he might not make it thru the night he was shutting down now he's super kitty !i cried so hard i couldnt breathe and my back cramped so bad none of meds helped it was a rough nite i got up saw no calls from the hospital called crossing my fingers he was still alive as soon as they got the intern she answered laughing said salems very talkative this morning hes eating wonderfully ! I was so relieved . I laughed hes talkative when hes hungry you got to fed him more he will climb the end tables and look at you meowing , he will take hes paw and slowly start pushing things off thats hes way of saying im hungry ! More ! Please ! Lol

 

She said since its absorbed it doesn't make a difference. If it was an IV no she wouldn't do that. Cardiologist says it's how fast it's absorbed no matter which way it's given. I'm just glad I knew to not let her give that much.

 

911, test of 75 retest of 32, I am on my way to Tina's but it takes 35min.

 

Eating gravy fancy fest acting fine but dropped

 

OK, well, that's a wakeup!

Re-test 20 minutes after the last test/feeding.

 

I'd test again to see which test is correct if the 32 was checking the 75. If 32 is correct or close, karo or honey immediately needed.

ETA did you add a bit of honey or karo to the gravy?

 

Ok

 

Actually, with that 32 reading, let's make it 15 minutes for the next test, and I agree about adding a bit of honey/karo. The carbs might not have had enough time to work in 15 minutes, but we want to keep an eagle eye on him for now.

Don't feed too much at a time, Tina, just a tablespoon of food or a few drops of honey at a time. We want to keep him hungry so we can get him to eat.

 

66

 

Great. Retest in 20 minutes to make sure Salem is staying up.

 

Ok thanks !

 

OK, either that 32 was a bad strip, or else the carbs popped him right back up again. We still want to keep a close eye on him, so I'm glad Sandi is on her way!

You don't have to feed more carbs before the next re-test, let's see what he's doing on his own for a little bit.

 

Ok boy what a scared he was just running and climbing but settled down laying with my son in bed

 

Heh. Well, at least someone's having a fun evening! You're doing great, Tina, this is always scary the first few times, but you are on top of things and keeping him safe

 

Trying lol on my second bottle of strips lol

 

Hang in there! You're doing a great job.

 

Hoping Sandi is there or will be soon... It's also just about time for another test. Please keep us updated here, too, even if everything is under control there-- we worry!

 

I was just wondering about an updated test too. Gotta make sure all the kitties are safe and sound!

 

It's Sandi, I am here. We just retested at +3 with Whispy's Confirm meter that I brought with me and got 68. I am worried that we are still only 3 hours in. I am concerned that he has already gotten a good part of 2 cans of FF gravy and the second can had honey on it too. It is unclear how much of that Salem actually got, but I am afraid that his tummy is way more full than I would like it to be.

I need to take care of something here, can you all please advise what kind of food you would give now? I know how Whispy reacts but we have no idea how Salem will react or how much we can get him to eat.

 

If he's been eating the meat in the food then I'd try using just the gravy now as he may be kind of full at the moment and honey only if he starts dropping again as it can sometimes upset the tummy.

 

Hi Sandi!

OK, let's game this out. My first instinct would be to follow normal procedures and back off of food entirely-- the 68 is safe, he's got a bunch of carbs under his belt, and chances are he's going to (eventually) bounce from this low at some point. If we hold off of food for a bit longer and start to see him rise, we can be fairly certain that the rise is "him" and not carb effects, and that he'll be safe. If we feed now, we can't be sure.

 

I agree with Nan. I didn't mean to feed him now but if a boost is needed I'd stick with just the gravy sans meat.

 

It looks like everything is under control here, correct?

We reserve the “911” header for emergencies that are life threatening. If that’s not the case please remove the 911. Thanks in advance.

Lots of action over here tonight

 

I get it Nan, although that worries me, but I'll play for a bit. Will retest in 15 min which will be 30 min from the 68 on my meter. But then we might have to hit gravy pretty quickly after that depending on what we see. And yes the 911 was put up when I was running out the door when Tina got a 32. I'll remove it. Thx -Sandi

 

You bet! We really don't know what he's going to do-- still too new at this to predict, but with the frequent testing (and you on-site-- you are a hero, Sandi!), he should be safe.

That 32, though-- wow! A heart-stopper of a number, for sure!

 

6 mins until retest, I will work on keeping SS and title up to date but I am used to my own laptop so I am struggling on a tablet!

But know that he is acting just fine. Good news.

 

I wonder why he dropped so far and so fast tonight? Can it be just that he's feeling better all of a sudden? Did anything else change recently for him (food, meds) that you can think of? It could just be that the 1.5U dose is too high for him right now, and we're seeing the effects of a filled depot, but what a sudden change!

Normally, that drop into the 30's calls for an automatic 0.25U reduction, but there are some different rules for DKA recovery, it will need eyes more expert than mine to decide whether or not to reduce, and if so by how much.

 

I'm wondering if it was the fluids. Being well hydrated helps keep BG down.

 

Just the fluids that I gave earlier today, that's all that knowingly changed, but that was 5 hours before PMPS, and I've never seen the result be so dramatic.

+3.5 = 69 holding and I haven't given anything since Tiina did at +2.5 Will retest at +4.

-Sandi

 

Even after all those carbs at +2.5, my goodness. Either he isn't very carb-sensitive, or he is determined to stay in these good numbers now that he's there!

 

The meat in the food would take a bit more time than the gravy to get processed so that might hold him for awhile. The question is how long.

 

We've dropped to 52. I am thinking whatever gravy is left in the bowl with a little bit of honey? -Sandi

 

Agreed!

 

Ooooof.....

 

Correction, he isn't wanting to eat gravy, we may have to go to dry food or whatever he'll eat, if anything, and if not then we'll have to get more forceful... I'll find out shortly... -Sandi

 

How about rubbing some honey on his gums until you figure out what he will eat. Dry food will take longer to hit his bloodstream.

 

Full recap:
PMPS=285
+2=75/35/66 Then gave two cans FF Gravy + honey

(+3 and beyond with Sandi's ReliOn Confirm meter)
+3=68 (no food given)
+3.5=69 (no food given)
+4=52 Honey on gums

 

When was last test? Feed small amount you don't want to fill him up. Need to keep eating.

I'll stay with you til Sandi gets there.

 

Double, triple check with Tina the amount of insulin given. Get her to show you on a syringe.

Just trying to look for a reason why the 32 and difficulty maintaining.

 

@Olive & Paula Sandi is there Paula. Salem doesn't want to even lick gravy at this point. I think he's full from previous "rescue feeding".

 

We are at +4.5 now
Will try to confirm insulin later, she is trying to feed now.

Full recap:
PMPS=285
+2=75/35/66 Then gave two cans FF Gravy + honey

(+3 and beyond with Sandi's ReliOn Confirm meter)
+3=68 (no food given)
+3.5=69 (no food given)
+4=52 Honey on gums around +4.25
+4.5=48 Found out he'll eat better when I leave the room, so Tina is trying gravy again now, not sure how much honey got in before. I didn't bring a feeding syringe with me and she doesn't have one here. Maybe whatever got in at +4.25 hasn't hit his bloodstream yet...? Still behaving fine.​

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Does she have a plastic baster? Might work in a pinch.

 

Ok. Thats good. I'll just follow.

 

Thanks Paula, I appreciate it, I know this thread got messy when we thought he was ok earlier today.

Yes, tried turkey baster before and got more on the cat than in the cat

Full recap:

PMPS=285

+2=75/35/66 Then gave two cans FF Gravy + honey



(+3 and beyond with Sandi's ReliOn Confirm meter)

+3=68 (no food given)

+3.5=69 (no food given)

+4=52 Honey on gums around +4.25

+4.5=48 He did lick a little bit of gravy/honey. Next test in about 10 minutes. Giving up editing the title, instead will just keep this recap going, too hard to edit the title on this tablet.




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Well if there was any question about a dose reduction with that 32 being questionable, you got your answer now. Reduction earned.

 

KFC (or rotisserie chicken )with the skin removed has been known to entice many kitties.

It’s generally 20 minutes from mouth to bloodstream.

 

Another thing to try. Tiny bit Pure maple syrup/honey on top the food. So he licks the syrup and might eat the food.

 

Managing the numbers this cycle has been like trying to rein in wild horses.

Reduction earned. New dose is 1.25u

Don’t forget to breathe.

 

Full recap:
PMPS=285
+2=75/35/66 Then gave two cans FF Gravy + honey

(+3 and beyond with Sandi's ReliOn Confirm meter)
+3=68 (no food given)
+3.5=69 (no food given)
+4=52 Honey on gums around +4.25
+4.5=48 He did lick a little bit of gravy/honey.
+5=86 Hallelujah! He ate better with me out of the room at +4.5. Will test again at +5.5 (1:30am Eastern for reference...will get squirrely with times in 30 min when the clock changes!)

**sorry for crappy formatting and multiple edits, this tablet is giving me fits! We are going to wait until 1:30am (about 24 minutes) without feeding again and then test​

 

Phew! Much better there, Salem!

I'm afraid I'm going to have to call it a night at this point, this is very late for me and I can't stay awake. I hope Salem behaves himself from here, and lets you guys get some rest tonight, too. My goodness...

 

Thanks, I appreciate it, check in on the adventure when you wake up! ;-)

 

I'm watching this thread but won't add anything as you have great help at hand. But I'm here if others need to go to bed.

 

Full recap:​

I don't know what is going on with the formatting so I'll just start here at +4.5

+4.5=48 He did lick a little bit of gravy/honey.

+5=86 Hallelujah! He ate better with me out of the room at +4.5.

+5.5=91 with no food since +4.5, so that is good. I am going to still withhold food and check at +6
​

 

Bron, here in about 21 minutes, I might have to drive home if his numbers are holding or rising, but I need to be able to drive home without falling asleep, and I might need you to keep an eye on Tina if that is ok with you? It is normally about a 35 minute drive, but it is deer mating season and we are in the country, so it make take a little longer so that I can be more careful to not hit one on the way home. I drove up here like a bat out of hell, probably only took me 25! -Sandi

 

Also watching this thread in case Bron or anyone else can’t.

Hi Salem and Tina! Quite a day today for you both and Sandi!

 

Ok. I’ll be around

 

Thx, ladies! Will be testing in about 5.

 

I’m tuned in but not for long

 

I am about to hit the sack. Fingers crossed the rest of the night is uneventful!

 

@Bron and Sheba (GA) So glad you are here. Sarah and Blaze are having a PJ party so can you just keep an eye out periodically there too. Blaze is still in the 60s but he seems dead set on not coming up despite HC so no telling what he might do. Thx.

 

Ok will do.
Sleep well. A busy night on the board by the look of things!

 

Full recap:

I don't know what is going on with the formatting so I'll just start here at +4.5

+4.5=48 He did lick a little bit of gravy/honey.
+5=86 Hallelujah! He ate better with me out of the room at +4.5.
+5.5=91 with no food since +4.5, so that is good. I am going to still withhold food and check at +6
+6=99 Still no food since +4.5

So we are in the home stretch. I am going to have to drive home now. I think that he is going to be ok since he hasn't had food in 1.5 hours, but when do you think that Tina should check again tonight?

And then in the morning...I am asking her to test at PMPS+11. I am suspicious, with as much trouble as we have been having getting him to eat and to come up even when he DID eat, that he may still be somewhat low. Tina knows that even if he is over 200 that her new dose will be 1.25units. However, I am worried he may not even be up to 200 (if that is even the valid threshold with DKA and everything we have seen tonight)=??), so I want her to post an hour before AMPS to gather opinions. Does that sound reasonable too? Because of my own health issues and medication that I am going to have to take when I get home, I will NOT be able to be even barely awake 5 hours from now at PMPS+11.

-Sandi


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