Discussion in 'Feline Health - (The Main Forum)' started by Critter Mom, Dec 25, 2016.
Please remind me when the next dose is due.
The next dose of insulin? 5:45 pm EST, just about exactly an hour from right now.
Oh, how did I get that wrong?
I don't know what you mean.
I thought I gave it to her at 9:45 my time, I thought next one was 5:45. I thought I had more time. I came to the laundromat cause we haven't had any time to, the washer is just about done though and I'll throw the clothes in the dryer and run home so I'm there on time.
Might have been a misunderstanding on my part. I'll check back through the thread to see. BRB ...
I checked back in the thread. AM dose was given at 9:45 AM. Next dose is due at 5:45 PM.
OK-- don't forget that she also needs food to go with the insulin!
For some reason, the time has really flown today-- I thought we were earlier in the cycle, too.
Mea culpa! (Mixed up the feed time with the dose time.)
To confirm: Next dose insulin due at 17:45 EST.
BG test and feed 30-40 mins before shot time.
Ok, I thought I got it wrong, I've been writing everything I do down here on my pc because the spreadsheet confuses me still. When I give her insulin I immediately write down all the time I'm going to have to test at and when the next shot should be so that I don't have to keep figuring it out with my tired brain, I just look at my list and know what time I'm waiting for. I thought maybe I wrote it down wrong. So next insulin is in 45 minutes, so I will test her right now and feed her too so she is ready.
question: i tried to read thru so I may have missed this info....
the recipe for ketones is not enough water + not enough insulin + infection ( present or brewing)
Has Mittens been checked for infection? I saw something about avoiding the er vet....
so I would say if antibiotics aren't on board yet..... save some of that pee sample ( when you get it - put it in the fridge)
so your regular vet can check it.
and if antibiotics are given, that will also hurt the appetite.
So if antibiotics are given, you might want to request ondansetron (for nausea) and cyprohetadine (for appy stimulation)
ondansetron is a human drug so you just want a prescription....
Next Potassium supplement dose due at: 18:45 EST.
Suggest giving this as close to the dose time as possible with a small amount of food (more likely to get the whole dose in); hopefully to help with the poop side of things.
I guess I'm not sure. She told me that the elevated number of white blood cells was probably because she's sick and her body is trying to fight it. She didn't suggest we check for anything else, like she didn't say there were more tests we should do. Maybe because she knew I had limited money to spend there? I guess since she didn't make it sound like a big deal I didn't think it was since she didn't say much specific about it.
When you say dose time are you referring to as close to the scheduled time for potassium or did you mean close to the insulin dose?
(Sorry for my typo confusing things. )
As long as you've got something you can follow which works right for you that is all that matters.
There's no rush on you getting to grips with the spreadsheet just now. Right now the great benefit of the spreadsheet is to let any members coming to assist you to see what's happening with Mittens' BG levels, etc., and they'll be able to offer better help.
As close as possible to the time when Mittens is due to be given the potassium supplement; i.e. 18:45 or as soon as she can manage after this time.
Ok, I will make sure she gets it on time.
Ok, she got her .5 shot of insulin at 5 minutes ago, 5:45 my time. I will make sure she gets a little bit of food and her potassium on time too.
I don't think I posted this on here, I tested her about 45 minutes ago +7.5 -320
Numbers are still higher than any of us would like, but this pre-shot is a bit lower than the morning's and this will be the second cycle at the higher dose, so let's hope the insulin can get to work at bringing the BGs down some.
Dan and Heather, have you tried baby food, pure chicken, or turkey, beef or ham? It might have been suggested prior and I missed it. What kind of meter do you use?
They have baby food and FF pate and gravy type. They have a ReliOn meter.
Which Relion? Thinking maybe there could be some peeps that have extra strips and could send to them to help out.
I don't know which one.
Thx, maybe someone will know and respond. Hope it's the Relion Prime because those strips are the cheapest.
Dan&Heather, any updates on Mittens? Feeding, BG, etc.
Relion Micro is what we're using.
She is scheduled to be tested in 20 minutes, so immediately after that I'm going to feed her the potassium with a litte bit of food. Besides that nothing new so far, she's just hanging out under the coffee table in the living room with us. She still hasn't used the liter box, I was hoping with those fluids we gave her she would so we can get a ketone test in. When I feed her I'm going to give her some more water too and hopefully it won't be too long.
Tested again at 7:15 pm my time, almost half an hour ago +1.5 -230 I fed her about 5mL of fancy feast with potassium mixed in and then 10mL of water from the syringe too. That went down quite a bit. Too much? I was going to test her again in an hour, would that be ok?
Well, we want her numbers to go down, so that's good, but that is a considerable drop. Is it possible to test in a half hour? We may need to slow down her descent with some higher-carb food.
@Dyana, if you are online now, could you take a quick peek at the situation? I need some more experienced eyes.
Mittens has been running in the mid-300's all day, pre-shot was 320, 0.5U of Novalin administered, +1.5 was 230 so it looks like an active cycle.
I've recommended another test in a half hour at +2 to see if the drop continues.
The last ketone test was yesterday around midday, with a reading of "small". We have been unable to catch her for another test since then. She has had fluids today, plus potassium.
That's a nice drop and I would give a little LC food to slow her down some. I wouldn't pull out the HC food with numbers in the 200's. And like Nan said, another test 1/2 hour after the last one to see what is happening.
@Dan&Heather , was 5 mL food and 10 mL water all Mittens consumed prior to her shot tonight?
If so, you'll want to get more food into her now... about 10 - 15 mL of food if at all possible.
Edited to add: You'll want to try to get a total of 20 mL food into her prior to her shot. When you're giving potassium make that 5 mL food mixed w/potassium plus 15 mL food.
Are you around a while tonight?
I tested her again at 8:15 +2.5 -199 I'm worried about how quickly it's going down. I'm going to feed her again, should it be the regular stuff or the higher carb gravy stuff.
Thank you so much for checking in.
If you look at the top of Mittens' spreadsheet on the right hand side of the TID Dosing banner you'll see details of the foods they have and their carb ranges.
I'm not sure of the time frame your talking about. I'm sure you don't mean was that she ate all day. She ate 7.5mL half an hour before her shot and has had the 5mL with potassium and water since.
Actually, the drop has slowed a bit-- she's not crashing at the moment, but let's see what the experts have to say.
Have you been giving her food between the +1.5 and +2.5 readings, and if so, what?
Mittens is in a safe range so breathe a little!
I suggest following @Bobbie And Bubba's recommendation to feed a little low carb now to slow the drop a little.
I think I would just try to get 2 syringes of her regular food into her and test again in 1 hour.
I think Jill suggested giving the potassium in a small bit of food (like 5ml), and then giving her the rest of her food without potassium (like 15ml).
Ok, thank you for clarifying.
I'd try to get about 15 - 20 mL low carb into her.
What you're seeing is what you want to see... the lower numbers you're working so hard to see.
Edited to add:
Try to feed 20 mL prior to her shot plus at least another 20 mL in each of the three cycles.
Ok, I just got done feeding her. I got her to sit thru two syringes of her regular food. Because we all know I cannot feed her without spilling some on my hands, I get about 7.5mL at a time with the syringe. So she just had 15mL of fancy feast classic. I guess I'm just so used to seeing her number way up that when they go into the better range it makes me nervous. I will test her again in one hour and see where she is at.
Between these two this time she got 5mL fancy feast mixed with potassium
You're doing great! I think you two are awesome care takers for your girl You have learned so much so well and so quickly.
I hope she is starting to appreciate all that you are doing for her.
I'm just trying to make sure I understand the above properly. Is the following correct, Jill?
Preshot Feeding: Test, then feed 20ml meal 30 mins before giving Novolin N.
Mid-cycle Feeding: Feed a total of 20ml over the course of the cycle.
Total food needed for cycle: 40ml
Total Daily Amount of Food (TID Dosing - 3 cycles): 40 x 3 = 120ml food per day.
I'm going to let you in on a little syringe feeding trick... if you have a blender or food processor.
Whenever anyone talks about syringe feeding, they immediately tell you to blend some water and food into a slurry. That's fine, but when I do it that way, kitty and I end up wearing some of the food... and worse yet... sometimes it ends up shaken onto my walls, counters, or floors... oh, and always in my hair. I don't like it and being the normally fastidious creatures they are, kitty isn't happy either!
The solution: I stopped adding water when blending the food. Instead, I syringe water separately. Adding water while blending had a tendency to make the food mixture too runny and it was hard to keep it in her mouth. She'd shake her head and I'd end up wearing most of it. When blending without water, the mixture is almost fluffy and a thick pudding like consistency. When you gently squirt a little in the side of kitty's mouth it pretty much stays there instead of running out.
Since the mixture is creamy and thick, it'll also stay put if you squirt about a quarter-sized dollop on the back of your hand. Kitty can lick it off your hand instead of suffering the indignity of having a syringe put in their mouth. Alex much preferred licking it off my hand to putting a syringe in her mouth. I could get 30 mL into her in less than 15 minutes!
This method is so neat & clean that eventually I would feed Alex a little bit wherever she was in the house... including when she was laying on furniture or my bed.
Might be worth a try!
Edited to add: Alternate feeding 10 mL food with 5 mL water. Repeat after every 10 mL food fed.
We know that feeling!
All the BG testing will gradually build up a picture of Mittens patterns of response to her insulin and it will act as a guide to keeping her safe and improving her BG regulation (hence the spreadsheet).
Correct. This is approximately the equivalent of 5.5 - 6 oz of food.
This is a guesstimate when you don't have any idea of how many calories you're feeding. Although, if kitty will eat more... go for it! Feed them a little more. It'll help.
Thanks, Jill. Making a note of this for future reference. (I've been able to manage with finger/hand feeding; no experience with syringing food.)
More info here: Syringe/Assisted Feeding (Video and Tips)
I used to add the calories of the cans of food I put into the blender and then divide the total number of calories by the number of syringes I was able to fill up. I was using some pretty high calorie food, and pretty much got about 16 calories per syringe. I was trying for 220 calories per day for J.D., and Mittens probably needs more right now. When I was giving 16 calorie syringes, I needed to get about 14 syringes per day into J.D. to get him to the 220.
This is how I figured J.D.'s calories for the day: First I figured out how many calories the batch of food had in it, then I divided by how many syringes.
1/2 can MaxCal (333 per can) is 166.5 calories and 1/2 can Friskies Liver & Chicken (171 per can) is 85.5 calories and 1/2 can Natures Logic Feline Chicken Fare (241 per can) is 120.5 calories and 7.5 teaspoons of canned pumpkin (2 calories per teaspoon) is 15 calories equals a total of 387.5 calories. 387.5 divided by 24 syringes equals 16.15 per syringe.
Then, I counted the syringes I fed during the day and multiplied by the calories per syringe:
7 syringes at 16.15 per syringe equals a Total Of 113 Calories For AM, plus the few bites of FF he ate at 6:00am.
7 syringes at 16.15 per syringe equals a Total Of 113 Calories For PM.
TOTAL CALORIES FOR DAY IS 226, plus the LC he ate in the AM.
Dyana, did you use water when blending food for syringe feeding?
Tested her again +4 -180
Glory hallelujah! Just what we wanted to see. Doing happy dance!
Sorry Dan & Heather, just trying to catch up here. When did you last feed Mittens? 9:00pm ? It would be good to get some more food into her now in case she is still dropping and while she can go a little lower we don't want her to go too low too fast.
Ok I fed her again, only one syringe this time, got done about 10 minutes ago. Is that enough? It was about 7.5mL of the same fancy feast. When should I check her BG again? The schedule we were following before at this point would have us check at +6 which would be in about 45 minutes.
Fantastic job Heather or Dan. That should be fine for now. Not sure whose on duty now!
I think you can stick with the schedule and check in 45 minutes. The food should slow or stabilize any drop and she's still well within a safe range and well into our goal range for her right now.
LoL still Heather for a little while longer, I feel like I can't sleep until she pee's. I'm going to keep giving her a syringe of water with each feeding.
Ok, I will get her checked in just a little bit.
I just checked her again, +6 -228
Thank you Heather. That's fine. You're doing great. The next shot will be due at 01:45am. So here is a little schedule for you to follow so we don't have any major lag time due to posting timing and getting alerts etc.
Test Mittens again at 00:45am.
Post reading on the board immediately after so if there is any issue giving shot or dose needs to be adjusted we'll have time to decide.
Feed Mittens 15ml from 00:50 to 01:15am
Give insulin 0.5u at 01:45am
Any questions, just holler!
According to her spreadsheet, Mittens has consumed 7.5 + 5 + 15 + 7.5 = 35 mL food plus 10 mL water this cycle. Nice! Very close to the 40 mL food plus 20 mL water we're aiming for during each cycle (at this time).
Nice work, Heather and Dan!
Now if only Miss Mittens would oblige with a pee sample for a ketone test!
I know it's not ideal but it would be a very good idea to bring the litter box into the room where you and Mittens spend most of your time together and keep her isolated from your other cat so that you can .
(If you don't have another litter tray you could try lining a suitably sized, shallow cardboard box with some bin liners and putting litter into that as a temporary box for your other kitty to use. If you do this put another bin bag underneath it just in case your kitty tears the bag used as a liner and there's any seepage.)
If you have the litter box where your other cat can't access it and you can keep an eye on it you'll be able to observe Mittens' litter box behaviour (e.g. straining to poop) and catch urine samples more easily. It will provide valuable diagnostic information to you.
Nan and myself need to get some kip. Can someone provide cover for the next cycle?
I can do the one after that.
@Dan&Heather, whenever you have a moment - how are you on supplies (e.g.. test strips and lancets, cat food, ketone strips)?
I believe I read that DCIN is sending some supplies (?), but if it hasn't arrived and you urgently need either and can get it at Walmart, it might be faster/easier for me to email a walmart e-gift card to you. I can't promise enough for everything, but I think that I can send enough for 100 strips and a box of lancets.
If this is something that would help you:
1. Do you have a Walmart close by?
2. If so, confirm either what meter you use or that you can actually buy the strips you need at a Walmart? I think you are using ReliOn Micro or Conform but not positive.
3. Do you have a printer?
If yes to all, click the picture of my orange kitty and select "Start a conversation". I would need your actual email address and the answer to those questions, and in the morning I will get a gift card to you by email. Not sure if it will come directly from Walmart, or if I have to email it to myself and then foward it to you. But one way or the other I believe you will be able to print it out and take it to Walmart with you to buy your supplies.
I cannot offer advice, but Whisper and I can try to help out with supplies. You both, and Mittens' aunts and uncles here on the board, are doing an *absolutely* stellar job. Mittens is very lucky to have you.
I wish I could, but I have house guests til after the 1st. I'm doing my best to check in when I can.
I'm so glad you've been able to check in, Jill; it is making a world of difference. Thank you very, very much!
And please thank your guests, too!
Mogs, I'll keep an eye on things for a few hours and if need be longer. You and Nan definitely need some kip! I'll catch a few cat naps as I did the other night if no one else is around to take a shift.
Linda, you are a topper!
Ok, Dan checking in. Just checked her BG and its 229 about to feed her now. Sorry ill update this better in a minute, im not sure what hour were on for BG test and Heather is sleeping. Gonna get caught up on the thread after feeding.
Please can you post quick updates on litter box activity and behaviours.
Also to help monitor Mittens better it is advisable to make a note of the time of any pees and poops. (The delay between poops will give info on whether constipation is an issue, as will their consistency: stool quantity, hardness, size/shape, colour, smell.)
8/8/8 dosing is very challenging and the job you're doing is amazing. Try to grab rest as best you both can manage. I wish I was round the corner from you and could help out a bit with the practical stuff.
I am glad to see Mittens' BGs in a better range.
Ok Dan. No problem. That will be your PMPS and you need to get 15ml of food into Mittens. Please see post #261 for schedule.
Please let me know when you are finished feeding Mittens and we will decide exactly when shot can be given. We need to make sure we leave enough time between the food and the shot. Also exactly what time did you take the reading of 229.
Donnalea replied to Kris' shout-out and said that she would try to check in for moral support.
Ok i will try to find a suitable box for a makeshift litterbox, should be able to find one.
That is very kind of you and thank you very much but i think we can make it to payday.
Heres just a quick inventory of stuff we have for Mittens,
1 jar of Turkey and turkey broth baby food(Beach Nut Classics)
2 jars of chicken and chicken broth baby food(Beach Nut Classiics)
1 opened jar of Beef and beef broth baby food(Beach Nut Classics) - In the middle of feeding this to her now
2 cans of Fancy Feast Classic Tender beef and liver feast
2 cans of Fancy Feast Classic tender liver and chicken feast
2 cans of Fancy feast classic savory salmon feast
1 can each of Fancy feast classic seafood feast, tender beef feast, turkey & giblets feast
1 can of Fancy Feast Gravy lovers Beef feast in roasted beef flavor gravy, and 1 can of salmon & sole feast in seared salmon flavored gravy(both we will only use if her BG drops real low) Also have honey in stock for the same reason.
fresh 100 pack of Relion ultra thin lancets
fresh 50 pack of Relion confirm plus glucose test strips
Still have a good amout of Potassium pills
Still have some of the appetite stimulants(i believe we only gave her 1/8 of a pill so far)
Our meter were using is a Relion Micro
Sorry Dan. Don't mean to rush you but have you finished feeding Mittens? Just trying to keep the schedule as much as possible.
It was 1:15am my time, almost an hour ago when BG was tested, then she ate 10mL of baby food right after she was tested, got done feeding around 1:30am. We gave her the .5u insulin about 10 minutes ago, right at 2:00 my time.
We finally got a urine sample from her a few minutes ago, we tested it with a strip and it came back pretty much the same as last time, It was between trace and small. But we feel like the color is closer match to trace.
First off Hallelujah on the ketone test being trace. Secondly you rock!
Now because Mittens PMPS was lower, I would suggest we test her at +1, a half hour sooner than usual.
You may need to do a bit of steering with food this cycle but this is all good because we need to get her BG down and try to keep her running in a good range for as long as possible. This is an excellent start. Please post the +1 reading. I'll check back then.
Sorry, i get lost in the replies, theres so many people willing to help Yes i fed her at 1:15 about 1 hour 10 minutes ago, 10ml of beef and broth baby food.
Ok, i will test her at +1. Does that apply to the rest of the times too? For example instead of +2.5 should i test at +2 instead or just the first test after insulin?
I will post the +1 result in approximately a half hour.
Dan, because of that lower starting BG, we are going to have to play it by ear tonight. The reading at +1 will dictate when you next need to test. Im not goona lie....it may mean more testing tonight but believe me this is good for Mittens....just not so much for you! But it is progress.
I got no problem with that, thanks for the help! I will post her +1 in 25 minutes.
PMPS - 229
+1 - 249
I've done many a poop dance in my time, but this is my very first pee dance!
I can sleep now.
Ok Dan. No worries. That higher number is just food influence so let's do another test at +1.5 at which time I expect we'll start to see some drop.
Linda, when is the next dose due?
Ok, should i feed her again you think? I got some food warming up in a syringe but can wait til after the +1.5 if you think that would be best?
Next dose will be due at 10:00 am EST.
Dan, I'd wait till we do the +1.5 test. If we have to steer her, we can try to combine the feedings with the steering as much as possible to try to make your life a little easier. Feed after +1.5 test.
PMPS - 229 1:15am EST
+1 - 249 3:00am EST
+1.5 -247 3:30am EST
HMMMMM! I really thought we'd see more movement by now. When you post can you also provide the time you took the reading too please. Hard to figure out with just board info. Go ahead and feed Mittens. What are you feeding this time? If you can get 15 -20 ml into her that would be great. Let's test again at +2. Wish these cats would read the rule book!
Ok i will go back and edit the post, i was gonna feed her more of the beef and broth baby food, can swap it out for some Fancy feast tho?
I don't think you need to. I might have suggested that if her BG had dropped but it hasn't. Save the FF for steering right now because she still might drop.
PMPS - 229 1:15am EST
+1 - 249 3:00am EST
+1.5 -247 3:30am EST
+2 -301 4:00am EST
Ok I am totally gobsmacked. Please try to syringe about 10ml of water into Mittens in the next hour and retest @ +4 unless Mittens displays any odd behaviour in which case test immediately. 99% sure this will not happen as she has a long way to drop so no panic but better to be forewarned just in case. Can you check the label on the baby food and provide the ingredient list please? I'm gonna grab a catnap and will check back in at +4 around 06:00 EST.
Ok will get the water into her now, just fed her 10ml of the beef and broth baby food(only ingredients listed are beef and beef broth, same for the chicken and turkey).
Will post back at +4, i will keep an eye on her just incase and if i notice anything i will test immediately. Thanks again, yes get some sleep i think we should be good here for a few hours.
The baby food I get here in Canada has rice starch in it. I wondered if yours might too and that it might be having some influence but obviously that theory just went out the window. be back about 0600. It's also possible Mittens is doing a little bounce from that lower number earlier today. I won't try to explain bounces now. We'll keep that for a bit later. You get some rest too.
Ok, the Gerber brand baby food we got has cornstarch in it, but we havent gave her any of that. Bought it by mistake, the little jars look nearly identical.
PMPS - 229 1:15am EST
+1 - 249 3:00am EST
+1.5 -247 3:30am EST
+2 -301 4:00am EST
+4 -304 6:00am EST
Separate names with a comma.