? 2/21 Arya: AMPS 383 +2 302, 2.5 U, PMPS 319 +2 265 +4 296, trace ketones, post DKA/HL

KatieBDZ

KatieBDZ

Member Since 2020
Yesterday's post: http://www.felinediabetes.com/FDMB/...ositive-ketones-test-pos.225924/#post-2530336

I had a bit of scare last night with Arya having a postive ketones test that was at the "small" level and then on a re-test seemed to darken and be more in the "moderate" level - called emergency vet twice but they said not to bring her in as long as she continued to eat and drink and act otherwise normal which she has been - still drinking a lot and ate a half cup of food this morning as well as more last night post ketones test. Her stool was a little loose this morning but not full on diarrhea. Gave her 2.5 units this morning, up from the 2 units. I did get a fur shot yesterday too in the morning so thinking that may have contributed to increased ketones. Will try to get another ketones test this morning but so far no luck.

I need to go into work for at least a half a day but planning on leaving out food for her. I should be back in time for a +5 or a +6 after work and will be able to get a +2 before leaving.

I'm concerned about the ketones but the emergency vet did not seem to be and she is presenting well, affectionate, purring, alert and eating and drinking...following up with my regular vet once he is in the office this morning and will ask about giving her subcutaneous fluids at home.
 
Hi Katie
Well done giving the 2.5 units this morning. I’ve been waiting for your post.
Try and get a ketone test in before you leave if you can. It would be good to know how many ketones are there this morning.
Can anyone come in to check on her today while you are gone?
I’m really glad Ayra is eating well and drinking and seems ok. I hope the loose poop clears up.
Let us know what your regular vet says about the subcutaneous fluids.
I’ll watch for the +2
 
Bron and Sheba (GA) said:
Hi Katie
Well done giving the 2.5 units this morning. I’ve been waiting for your post.
Try and get a ketone test in before you leave if you can. It would be good to know how many ketones are there this morning.
Can anyone come in to check on her today while you are gone?
I’m really glad Ayra is eating well and drinking and seems ok. I hope the loose poop clears up.
Let us know what your regular vet says about the subcutaneous fluids.
I’ll watch for the +2
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I was just able to get a ketones test in and it is the same as last night - I'd say darker than the small range so closer to moderate. She continues to eat and drink well though. Hoping that this level of insulin coupled with the food/water will get that level down :(
 
KatieBDZ said:
I was just able to get a ketones test in and it is the same as last night - I'd say darker than the small range so closer to moderate. She continues to eat and drink well though. Hoping that this level of insulin coupled with the food/water will get that level down :(
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Yes hopefully the increase in insulin dose will help bring that ketone level down. Well done getting another test in.
Can you document those ketone tests in the SS remarks column please with the time? Thanks.

So to get those ketones down we have increased the insulin dose, and are encouraging Ayra to eat as much as possible and encouraging fluids. And you are going to ask the vet about subQ fluids today.

Is she still having the antibiotic? Can you tell me again what the infection was, that she is having the antibiotic for?

How are you managing? You are doing a mighty job looking after Ayra. Tell her she is being a super good girl eating so well and drinking. Please give her a cuddle from me.
 
Bron and Sheba (GA) said:
Yes hopefully the increase in insulin dose will help bring that ketone level down. Well done getting another test in.
Can you document those ketone tests in the SS remarks column please with the time? Thanks.

So to get those ketones down we have increased the insulin dose, and are encouraging Ayra to eat as much as possible and encouraging fluids. And you are going to ask the vet about subQ fluids today.

Is she still having the antibiotic? Can you tell me again what the infection was, that she is having the antibiotic for?

How are you managing? You are doing a mighty job looking after Ayra. Tell her she is being a super good girl eating so well and drinking. Please give her a cuddle from me.
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Yes she is still on the antibiotic but having a difficult time getting her to take it today but will continue to try (actually just watched a video on pilling)..she seems to have figured out the pill pockets and won't eat them now. They didn't tell me what the infection was just that she should be on the antibiotic for a few days to help resolve the ketones.

I'm definitely anxious and exhausted - barely slept I just kept waking up and staring at her to make sure she was ok but thank you for all of your help and support! Gave her extra cuddles ❤️ she is laying against me purring right now
 
I’m sure you must be exhausted.
It’s good that the ketones have not got worse overnight so that’s encouraging. We just need them to reduce now, which they hopefully will with the increase in insulin.

Its really important she gets her antibiotic as infection/ inflammation plays a part in DKA and we need to make sure that it has been treated. When you have time it would be an idea to ring whoever prescribed the antibiotic and ask them what the problem was so it can be checked again to see it has been successfully treated.

Ayra sounds a real sweety. Maybe you could post a photo of her sometime. We love our kitties!’
 
Bron and Sheba (GA) said:
I’m sure you must be exhausted.
It’s good that the ketones have not got worse overnight so that’s encouraging. We just need them to reduce now, which they hopefully will with the increase in insulin.

Its really important she gets her antibiotic as infection/ inflammation plays a part in DKA and we need to make sure that it has been treated. When you have time it would be an idea to ring whoever prescribed the antibiotic and ask them what the problem was so it can be checked again to see it has been successfully treated.

Ayra sounds a real sweety. Maybe you could post a photo of her sometime. We love our kitties!’
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+2 is 302 getting her to eat and drink a little more then off to work for a bit, she is very sweet will post a picture soon
 
KatieBDZ said:
+2 is 302 getting her to eat and drink a little more then off to work for a bit, she is very sweet will post a picture soon
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That’s a good drop at +2..
Make sure you leave a good amount of food out for her. Will she eat on her own if you are not there?
Are you going to separate her from your other kitty?
 
Bron and Sheba (GA) said:
That’s a good drop at +2..
Make sure you leave a good amount of food out for her. Will she eat on her own if you are not there?
Are you going to separate her from your other kitty?
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Yes she will eat on her own and I'll leave out a cup of food? Will keep her separated from my other kitty. She's eating right now and I successfully "pilled" her for the first time ever (after many tries) so she got her antibiotic at 7:15 am
 
Bron and Sheba (GA) said:
That’s a good drop at +2..
Make sure you leave a good amount of food out for her. Will she eat on her own if you are not there?
Are you going to separate her from your other kitty?
Click to expand...

Got in another ketones test too just now and it seemed to be lower (it's hard to fully tell with the colors) but to me it seemed closer to "small" and was less dark. She had more loose stool but again not full diarrhea..could just be new food (I've been switching her around a bit to find something she'd eat a lot of for now)
 
I’m heading to bed now but there are others who will be able to help you if needed. You can tag Wendy, Sienne or Chris all know you and Arya.
Try and get home to get a +5 if you can.
Have a good day.


KatieBDZ said:
Got in another ketones test too just now and it seemed to be lower (it's hard to fully tell with the colors) but to me it seemed closer to "small" and was less dark. She had more loose stool but again not full diarrhea..could just be new food (I've been switching her around a bit to find something she'd eat a lot of for now)
Click to expand...
That’s great the ketones are decreasing. Hurrah!
Is the new food you are feeding the same carb content as the dry?
We don’t want you swapping over to low carb food just yet until we get the ketones under control as we would have to reduce the insulin dose as the BG would fall lower with low carb food. Does that make sense?
 
Bron and Sheba (GA) said:
I’m heading to bed now but there are others who will be able to help you if needed. You can tag Wendy, Sienne or Chris all know you and Arya.
Try and get home to get a +5 if you can.
Have a good day.



That’s great the ketones are decreasing. Hurrah!
Is the new food you are feeding the same carb content as the dry?
We don’t want you swapping over to low carb food just yet until we get the ketones under control as we would have to reduce the insulin dose as the BG would fall lower with low carb food. Does that make sense?
Click to expand...

Thank you for all of your help have a good night! The new food is still a dry food with slightly lower carb content (it's 15%) but still around the same as what she's been getting. It's orijen fit and trim dry food. But yes that makes sense..I obviously want to get her on lowest carb/wet food asap but understand it's just about getting her to eat enough/getting her regulated and ketone free for now.
 
Can you get Fancy Feast Savory Centers wet food? It's lc but saucey. Might be able to use that to hide pill in so she will eat it.
 
Just to update spoke to my regular vet he didn't like that the ketones were there but thinks it's just because she's not regulated yet and recommended to up the insulin dose from the 2 to 3 and to do a curve. Going to stick with the 2.5 for now and try to get some more numbers since it'll be the weekend now to be more conservative before moving her up to 3. He said as long as she is eating and drinking well she's ok to stay home and just continue with this plan of getting her regulated.

I also ended up having to work a full day so couldn't get any in between numbers today but a friend checked in on her and she was ok - going to get more numbers tomorrow.
 
KatieBDZ said:
PMPS 319 +2 265 do you think I need to do a +4? Going to try for a +3 and +5 or +6 tomorrow to get more data
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Yes I would get another test in to see if it drops lower. It is good data for us especially as we may have to raise the dose again sooner than we normally would..the rules change when DKA/ketones are in the picture..
+5 would be good but if you need to go to sleep, get a +4
 
That’s a good drop to +2, so yes on another test. We have been increasing you faster/more than the dosing methods suggest because of the ketones. With that comes more vigilance. Hopefully once we know what this dose is doing, we can slow down the testing and be more strategic. Still trying to figure out the nadir, onset seems to be +2, so that’s one piece of data.
 
Wendy&Neko said:
That’s a good drop to +2, so yes on another test. We have been increasing you faster/more than the dosing methods suggest because of the ketones. With that comes more vigilance. Hopefully once we know what this dose is doing, we can slow down the testing and be more strategic. Still trying to figure out the nadir, onset seems to be +2, so that’s one piece of data.
Click to expand...

+4 was 296 she has been eating in between I've been letting her free feed basically for now so thinking that might be messing with the numbers? Think she's good for the night though going to catch some sleep only got a few hours last night because of worry
 
Bron and Sheba (GA) said:
Yes I would get another test in to see if it drops lower. It is good data for us especially as we may have to raise the dose again sooner than we normally would..the rules change when DKA/ketones are in the picture..
+5 would be good but if you need to go to sleep, get a +4
Click to expand...
Wendy&Neko said:
Sleep well! I agree, she should be fine.
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New post: http://www.felinediabetes.com/FDMB/...h-number-increase-insulin-post-hka-dl.226012/ - help her AMPS was 572 :(
 
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