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Info 12/08 Oldtimer Alex Update & Ketone Awareness

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Jill & Alex (GA), Dec 8, 2012.

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  1. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Hello LL! It's been forever and a day since I've posted an Alex update. However, I do skim posts & spreadsheets everyday and am also in touch with Sienne, Marje, and Dyana to provide an extra set of eyes when needed. I see lots of new faces in LL. Welcome to the group! :mrgreen:

    Alex WAS doing very, very well. So well that I thought she might even be trying to go OTJ for the third time in the last 6.5 years. I was able to take her dose down to 0.1u BID towards the end of October before she began to experience pancreatitis flares again. So, up went her dose!

    Things came to a head on Thanksgiving Day. She started out the morning in green and by evening her numbers had risen considerably. I'm pretty sure the stress of having a house full of family staying with us complicated matters. Over the next 5 days she saw more 400s than she had seen since being diagnosed and in DKA. Of course things always happen on the weekend... and a holiday weekend at that (my vet was out of town)! :roll:

    Luckily, I was able to get all the supplies I needed from my vet's office to get her through the weekend... sub-q fluids, cerenia, bupe, antibiotics, and cypro. By Monday morning she was doing very well, but took her in to get checked out and have an ultrasound done. DX was exactly as I thought: severe pancreatitis attack with probable liver involvement. Feeding raw food along with low carb canned food appears to have cleared up the diarrhea she was experiencing from the antibiotics. Incorporating the use of R insulin in combination with levemir helped to bring her number down considerably.

    She was doing pretty good with treatment and increased amounts of insulin up until the last couple of days... which brings me to the primary reason for opening a condo today... other than to say hi! Alex's appy was *off* the last two days and she bordered on what I would describe as almost lethargic. BG numbers weren't too terribly high (overall less than 200)... not high enough to be alarming. However, she was throwing trace ketones in her urine! Now that I'm aware I'm pushing fluids, both sub-q and orally. A second ketone test last night was negative for ketones in her urine. Alex seems back to normal this morning. Appetite has returned and the pep in her step is back, but I'll continue to stay on top of this. Looks like another vet visit is in our immediate future!



    The recipe for developing ketones is an inadequate supply of insulin + decreased appetite + infection OR other systemic stress. Ketones can develop quickly, can be very expensive to treat, and if left untreated can be fatal. If kitty is off in anyway (behavior, appetite, etc.) please, please, please take the time to check for ketones. Contrary to popular belief, BG numbers do NOT have to be high for ketones to develop! Alex's ss is a perfect example!



    Hope all is well with you and your kitties!
    Have a great weekend! :mrgreen:
     
    Juliet and Tanya and Ducia like this.
  2. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    Thanks for the update and the reminder about ketones.
    That's one of the reasons I am so concerned about J.D.'s eating while we are on vacation, because of the added stress, and all.

    I'm glad Alex is feeling better this morning. Sending keep feeling better vines to your girl. Please give her an extra pet from us.
     
  3. Hi Jill,
    Great to hear from you and that Alex is improving. Thank you for the reminder about ketones, and for pointing out that not only can a kitty go into remission, but can relapse. And not only that, but they can then go into remission again. It really drives home two points.

    Once a diabetic, always a diabetic.
    But more importantly, even with setbacks, remission is always a possibility.

    Let us know what the vet says.

    Hugs,
    Carl
     
  4. Michelle & Scrabble (GA)

    Michelle & Scrabble (GA) Well-Known Member

    Joined:
    Feb 10, 2010
    ((Jill)) thanks for the update on Alex! So sorry for what you had to go through with Alex that is horrible! Thanks for the info, that is good to know. Hope you are well and miss you around here!!!
     
  5. MelanieAndRacci

    MelanieAndRacci Well-Known Member

    Joined:
    May 19, 2010
    Hi Jill!

    I'm so sorry poor Alex was so sick but glad she's on the mend again. Thank goodness you knew what to do and were able to get supplies! I hope she continues to improve. Please keep us updated on her progress.

    Thanks for the update and the reminder to check ketones. It's easy to become complacent. Especially with a cat like Racci, who has never had a ketone problem.

    Hugs,
    Melanie & Racci
     
  6. CD and BigMac

    CD and BigMac Well-Known Member

    Joined:
    Dec 28, 2009
    Great info and an important reminder about ketones.

    I hope Alex is feeling better already and soon is completely recovered from her Thanksgiving episode. Pancreatitis is tough on a kitty... and on the momma-bean too. She's a trooper and so are you!
     
  7. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    And wouldn't you know it? On only the third cycle of the increased dose Alex dropped to 38 @+5.5! :roll:

    Under normal circumstances I would take a reduction, but because there were ketones in the picture less than 24 hours ago I'll probably maintain the same dose unless I have to fight to keep her numbers up today. Remember the recipe for ketones = inadequate supply of insulin + inappetence + infection or other systemic stresses. I want to keep as much insulin in her as safely possible... even if I have to feed the curve to keep her from bottoming out. Since it's the weekend, I have the luxury to monitor her carefully.

    Fed her the usual low carb (4%) mini-meal she would normally get for lunch. Alex is extremely carb sensitive so I can usually get away with feeding foods 5% (or less) kcal from carbs even when she drops into the 30s. We'll see where she's at in a little while.


    Dyana: Thank you! I haven't had time to post yet, but I see JD s having a few difficulties of his own. Sending feeling better vines to him, too.

    Carl: Yep. Once a diabetic always a diabetic. That's for sure! Alex was in remission for almost 3 years the first time. Only 5 months the second. Unfortunately, her health issues get in the way of remission these days, but anything is possible!

    Michelle: So good to see you! Thanks for stopping by.

    Melanie: It IS easy to become complacent... especially when you've been "doing this" for awhile!

    CD: Thank you! Alex is a trooper. I can't believe how much she's had to overcome the last few years!


    Ahhh... much better. She's 82 @+6.25. A nice 44 point rise from her regular food. I'll continue monitoring this afternoon...
     
  8. Anne&Muffin (GA)

    Anne&Muffin (GA) Well-Known Member

    Joined:
    Jul 11, 2010
    Hi Jill! Great to see an Alex update, although I'm sorry she is going thru all this. Important reminder about ketones, too, thank you. Nice catch on the 38, and glad she's already back up to 82. You rock! :lol:
     
  9. Anne & Zener GA

    Anne & Zener GA Well-Known Member

    Joined:
    May 26, 2011
    So great to see a condo from you Jill. Poor Alex has been on the drama-rama wagon lately. You are such a pro and Alex is one lucky feline to have such a bean! We always learn something from your condos and it is an excellent reminder to stay diligent on checking ketones. It's been a few days since we checked Zener so I will be on "pee patrol" today.
     
  10. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Anne and Anne: Hi there! Good to see you both.
    Alex has definitely been on the drama-rama wagon lately! :lol:


    Good news... I was able to catch some urine this afternoon. Ketones = Negative. BG numbers are holding steady. Yay!
     
  11. Deb & Spot

    Deb & Spot Well-Known Member

    Joined:
    Dec 28, 2009
    Hi Jill! Glad that you dropped in with an Alex update and glad that she is doing better...and wow!!! She decided to give you a nice little surprise too!
     
  12. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Thanks, Deb!
    Hope all is well with you and yours...
     
  13. Hillary & Maui (GA)

    Hillary & Maui (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Alex is in such good hands with you. You SOOOOOOOOOOOOOOOO know what you are doing and how best to care for her. That's one lucky girlie.

    It also shows how important it is to test for ketones and how to keep it from becoming DKA. This board is very lucky to have you on it!

    Thanks from the bottom of Maui's paws to the tip of her nose! And she is doing great, still in remission and no looking back for her.
     
  14. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Thanks, Hillary! It's so good to hear how well Maui is doing!
    Tell her Alex is hoping to get back to the Falls at some point. She'd love to reunite with her old friends!
     
  15. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    You are so vigilant about Alex's wellbeing. Your condo from today is not just a reminder about ketones but also about how important it is to know your cat.
     
  16. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Hello Sienne!
    Yep. Once we truly "know our cats" treating them becomes so much easier. :mrgreen:
     
  17. Camille and Cyclone

    Camille and Cyclone Member

    Joined:
    Dec 29, 2009
    Hi! Nice to see an update, but not so nice that Alex hasn't been feeling well. Good that you caught this before things could get worse, and that you knew what to do! I hope Alex continues to improve quickly - poor baby; I know pancreatitis is no fun. :( But she couldn't be in better hands. :)
     
  18. ecurie

    ecurie Well-Known Member

    Joined:
    Sep 27, 2012
    Hi Jill,
    I'm so sorry Alex had such a hard time. He's one lucky kitteh to have you for a bean! I'm sure that works both ways tho. We have learned so very much on this board and have gotten more knowledge from your condo today.. like, know your cat and pay attention!
    I'm just sorry that poor Alex had to have a difficult time. I'm glad you caught it early and he's feeling better.
    take good care and thank you
    mary and oliver
     
  19. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Camille: Good to see you. Thanks for the vote of confidence!

    Mary: Alex has already used up quite a few of her 9 lives, but as long as she wants to keep fighting... I'm with her all the way.



    PMPS 103 (1.25u Lev)
    +1 50ml squids
    +2.25 159
    +3 Ketones = Negative
    +4 49 fed small 4% snack
    +5 50 fed small 4% snack

    Looks like we'll be up for awhile yet...
     
  20. tortie58

    tortie58 Well-Known Member

    Joined:
    Jan 3, 2012
    Yes, Ketone awareness . Thanks for the reminder esp to those of us who have never experienced it. Alex is lucky to have you who really close monitor on her daily behavior. I wish I can do better, but with 21 I can only try my best. ;-)
    Wish Alex work the juice, get btter & no need to have vetty vistis!
     
  21. Pumbaa

    Pumbaa Well-Known Member

    Joined:
    Apr 7, 2012
    Glad to hear that Alex is doing better! And thank you for the above information...it's an excellent reminder for all of us.

    Suze
     
  22. Frosty

    Frosty Well-Known Member

    Joined:
    Aug 27, 2012
    Hello Jill. I'm glad that Alex is beginning to get back to his normal routine and feeling better. I hope her numbers are in the safe range by now. Thank you for the info on Ketone awareness.

    Have a great day.
     
  23. Chris & Tucker

    Chris & Tucker Member

    Joined:
    Jul 24, 2012
    Jill, Alex is one lucky kittie to have you as his bean!
    Glad to hear he's doing better. I hope he continues on a speedy recovery. Happy Holidays!
     
  24. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

    Joined:
    Jan 11, 2010
    Hi Jill,
    We are sorry to hear that Alex has not been in perfect health in recent weeks, but you sure are on top of it all! It's great that she is feeling better. Thank you so much for the valuable reminders. And thank you for being here for all of us.

    Have a good evening and a very happy holiday season,

    Ella & Rusty
     
  25. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

    Joined:
    Dec 28, 2009
  26. Tanya and Ducia

    Tanya and Ducia Well-Known Member

    Joined:
    Feb 25, 2017
  27. Juliet

    Juliet Guest

    Joined:
    Sep 8, 2017
    I thought Alex had GA. Was this a different kitty in your signature?
     
  28. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    @Juliet
    This is an "Info" post written in 2012. Alex was very much alive at that time.
     
  29. Juliet

    Juliet Guest

    Joined:
    Sep 8, 2017
    Oh I didn't realize the first post was 6 years ago.
     
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