2 Very High BG readings - risk of ketoacidosis?

I am so frustrated. Tisha's numbers started creeping lower again earlier this month. Every time they were below 200, she didn't get a shot, and we went for 4 days with beautiful numbers. Then, just like the last time we tried to take her OTJ, she started vomiting and refusing to eat. Another pancreatitis flare-up. We're getting better at coaxing her, so we managed to get her through this episode without going to the hospital again. She never completely stopped eating this time, but she was eating shockingly little food. So at the end of the last week, we finally got her to start eating again. She absolutely refuses to eat the normal FF food, and was only eating Meow Mix and tuna. (Yes, I know, neither is an ideal food, but when your cat is not eating, you will give her anything that gets her to eat.) We finally got her to eat some Wellness, grain-free canned food that appears to be okay for her diabetes and pulled the Meow Mix completely. So I get up this morning and I'm thinking that her numbers will finally start going down since she's back on an appropriate diet and that's what happened with her September pancreatitis flare-up. Surprise! Her meter read "HI" this morning. I gave her normal shot, and we will be rechecking in an hour to see if it's going down. If not, then we get to go back to the vet. I think I've talked to her every day the office has been open for the past two weeks.

Of course, to make matters worse, I had foot surgery last Friday and I am not supposed to bear any weight on my foot. DH has trouble picking Tisha up. You can just imagine how entertaining and effective it is to try to go get an uncooperative cat while either hopping around on one foot or using a walker with a seat like a scooter and pushing it with one foot. (It's okay. You can laugh. It's pretty funny.) :lol:

So if anyone has any advice, experience, or encouragement you can share, we could sure use some!

 

Re: Finally eating again, now BG is "HI"

Your SS does not show any insulin given yesterday or today? Is that true?
Just give give insulin when needed. Yo may have to increase to more that the old doe of 1/2 unit.

 

Re: Finally eating again, now BG is "HI"

Isn't this FD stuff fun? :roll:

I don't have a lot of advice for you... I still feel new to the dance myself... but I do have some experience with Wellness. Which flavor are you feeding? I use Wellness for Tink, but I can only use 3 flavors. The other flavors have more carbs, including some that are actually pretty high even in the GF varieties. The Chicken, Chicken & Beef, and Turkey flavors are around 4%. The rest are all higher - as high as I think 11% for Chicken/Lobster (I THINK that's the highest one in the GF, but I could be wrong). In Tink, ANYTHING over 4% affects his numbers. I use the 11% to control his dives because it usually brings him up quite a bit. So even though it's a good food, that could be a factor.

There's also been some talk on here about trying not to use their regular food while they're having nausea as it can create an aversion to that food. They associate it with the tummy troubles. So that might be why she wont eat her FF now. ??

One lc food that Tink really liked (he was REALLY picky when he was coming out of his DKA & hepatic lipidosis - PLUS had been a dry food addict his whole life) was the Paw Lickin' Chicken by Weruva. It's very low carb (but very expensive and hard to find).

 

Re: Finally eating again, now BG is "HI"

No, I updated her spreadsheet, but it must not be coming through correctly. She has been back on her .5 unit BID dose since Sunday. I haven't been doing a good job of writing shots down, but I know she got a shot for every reading, and that I gave her a shot anyway on at least one occasion when I couldn't get a good reading. There were two times that I didn't get readings, so I'm not confident she got both shots. I marked those with a ?.

I kind of feel like we're starting over with getting readings now - in part because it's harder with my restricted movement and in part because her ears just aren't bleeding very well.

We will be doing a curve today and I will update her SS as we go. The vet thinks we may need to increase her dose. I'm hesitant to do that because she kept rebounding at higher doses before this last pancreatitis attack.

Like I said, I'm really frustrated. It seems like there are no good answers. When her diabetes is doing well, it seems to trigger a pancreatitis flare-up, then the pancreatitis flare-up triggers a run of very high numbers. I wish we could figure out how to break this cycle.

 

Re: Finally eating again, now BG is "HI"

I couldn't find a lot of info on the Wellness food. I actually sent DH to the store to buy FF flaked tuna, since that's not too bad and it's similar to what she was willingly eating, but he brought back the Wellness food instead. The vet suggested that we consider a novel protein in case food is contributing to her p'itis flare-ups, so I think he brought back everything with duck or lamb in it that he could find. Not many of the Wellness foods are on Dr. Pierson's chart. Where did you find carb info? Here's what we have for Wellness: sliced salmon, shredded white meat chicken with chicken liver in sauce, shredded white meat chicken and turkey in sauce, chunky turkey and white meat chicken in sauce, shredded white meat chicken and beef in sauce, flaked skipjack tuna with shrimp in broth, beef and chicken formula, beef and salmon formula. NutroMax Cat: Savory duck chunks in sauce, lamb and turkey cutlets chunks in sauce. Blue Wilderness Grain Free duck. Natural Choice chunky loaf salmon and duck dinner.

[quote="JenM"There's also been some talk on here about trying not to use their regular food while they're having nausea as it can create an aversion to that food. They associate it with the tummy troubles. So that might be why she wont eat her FF now. ?? [/quote]
]I suspect that's exactly what happened, although we didn't really push the FF while she was sick. Just kept it available in case she felt like eating - but gave her tuna, catsip and Meow Mix because I knew she would actually eat those. If only I could pick the foods she would develop aversions too....

 

Re: Finally eating again, now BG is "HI"

Those sound like the new Wellness flavors which I believe are all high or at least medium carb. Generally speaking, anything with "sauce" or "gravy" is higher carb, though there may be exceptions. Not all Wellness foods are grain free either - only the ones marked as such. THIS is the list I keep in my purse, though I've heard it's not necessarily current. The Merrick formulas have changed dramatically - Cowboy Cookout is now a high carb food (18 or 19%), so I'd get new info before using any of those. But I think the others are still correct. I'm pretty confident that at least the Wellness ones are right - as my guy is pretty carb sensitive. We only feed the 3 flavors that are listed as 4%.

viewtopic.php?f=28&t=94685

I also asked Wellness themselves and got the following list - which has different values than any of the lists we use here... but still at least somewhat helpful. And it does contain all (or at least most) of the new flavors.

Thank you for taking the time to call about Wellness® Wet Cat Food.

Here are the nutritional values you have requested:

Wellness® Dry and Wet Cat Foods: Carbohydrates

Wellness® Dry Cat
Complete Health Deboned Chicken, Chicken Meal and Rice Recipe
As Fed: 29.51%
Dry Matter: 32.08%
Complete Health Salmon, Salmon Meal & Deboned Turkey Recipe
As Fed: 29.60%
Dry Matter: 32.17%
Complete Health Healthy Weight
As Fed: 41.62%
Dry Matter: 30.95%
Complete Health Indoor Health Deboned Chicken & Chicken Meal Recipe
As Fed: 37.95%
Dry Matter: 41.25%
Complete Health Indoor Health Salmon & Whitefish Meal Recipe
As Fed: 34.18%
Dry Matter: 37.15%
Complete Health Kitten
As Fed: 28.48%
Dry Matter: 30.95%
Complete Health Senior Deboned Chicken & Chicken Meal Recipe
As Fed: 33.78%
Dry Matter: 36.72%

Wellness® Core® Dry Cat
CORE® Original
As Fed: 17.90%
Dry Matter: 19.46%
CORE® Turkey, Turkey Meal & Duck
As Fed: 24.43%
Dry Matter: 26.55%
CORE® Indoor
As Fed: 27.70%
Dry Matter: 30.11%
CORE® Kitten
As Fed: 18.01%
Dry Matter: 19.58%

Wellness® Complete Health Wet Cat Foods
Complete Health Chicken Recipe
As Fed: 1.74%
Dry Matter: 6.48%
Complete Health Chicken & Herring Recipe
As Fed: 2.10%
Dry Matter: 8.40%
Complete Health Beef & Chicken Recipe
As Fed: 1.42%
Dry Matter: 5.91%
Complete Health Turkey Recipe
As Fed: 1.67%
Dry Matter: 6.22%
Complete Health Turkey & Salmon Recipe
As Fed: 1.79%
Dry Matter: 7.35%
Complete Health Salmon & Trout Recipe
As Fed: 2.89%
Dry Matter: 11.17%
Complete Health Chicken & Lobster Recipe
As Fed: 3.81%
Dry Matter: 15.16%
Complete Health Kitten Recipe
As Fed: 1.99%
Dry Matter: 7.40%
Complete Health Beef & Salmon Recipe
As Fed: 2.12%
Dry Matter: 8.66%
Complete Health Salmon, Shrimp & Crab Recipe
As fed: 3.87%
Dry Matter: 13.52%

Wellness® CORE® Wet Cat Foods
CORE® Grain Free Chicken, Turkey, & Chicken Liver
As Fed: 3.09%
Dry Matter: 11.12%
CORE® Grain Free Salmon, Whitefish, & Herring
As Fed: 4.65%
Dry Matter: 16.93%
CORE® Grain Free Beef, Venison & Lamb
As Fed: 1.95%
Dry Matter: 7.24%
CORE® Grain Free Turkey & Duck
As Fed: 1.89%
Dry Matter: 7.55%
CORE® Indoor
As Fed: 3.27%
Dry Matter: 14.17%
CORE® Kitten
As Fed: 2.03%
Dry Matter: 7.79%

Wellness® Cubed, Sliced and Minced Wet Cat Recipes
Cubed Chicken Entrée
As Fed: 2.81%
Dry Matter: 12.51%
Sliced Chicken Entrée
As Fed: 2.85%
Dry Matter: 12.74%
Minced Chicken Entrée
As Fed: 2.94%
Dry Matter: 13.15%
Cubed Turkey Entrée
As Fed: 3.48%
Dry Matter: 15.25%
Sliced Turkey Entrée
As Fed: 3.58%
Dry Matter: 15.98%
Minced Turkey Entree
As Fed: 3.72%
Dry Matter: 16.47%
Cubed Turkey and Salmon Entrée
As Fed: 3.33%
Dry Matter: 14.73%
Sliced Turkey and Salmon Dinner
As Fed: 3.47%
Dry Matter: 15.57%
Minced Turkey and Salmon Entrée
As Fed: 3.60%
Dry Matter: 15.90%
Minced Salmon Entrée
As Fed: 2.49%
Dry Matter: 11.37%
Cubed Salmon Dinner
As Fed: 2.72%
Dry Matter: 12.36%
Sliced Salmon Entrée
As Fed: 2.71%
Dry Matter: 12.36%
Cubed Tuna Entrée
As Fed: 3.52%
Dry Matter: 15.51%
Minced Tuna Dinner
As Fed: 3.32%
Dry Matter: 14.70%

Wellness® Signature Selects
Signature Selects Shredded White Meat Chicken with Chicken Liver Entrée in Sauce
As Fed: 6.63%
Dry Matter: 32.89%
Signature Selects Shredded White Meat Chicken & Beef Entrée in Sauce
As Fed: 6.40%
Dry Matter: 31.79%
Signature Selects Shredded White Meat Chicken & Turkey Entrée in Sauce
As Fed: 6.52%
Dry Matter: 32.82%
Signature Selects Chunky Beef & White Meat Chicken Entrée in Sauce
As Fed: 6.47%
Dry Matter: 36.74%
Signature Selects Chunky White Meat Chicken & Wild Salmon Entrée in Sauce
As Fed: 6.16%
Dry Matter: 32.04%
Signature Selects Chunky Turkey & White Meat Chicken Entrée in Sauce
As Fed: 6.10%
Dry Matter: 34.09%
Signature Selects Flaked Skipjack Tuna with Wild Salmon Entrée in Broth
As Fed: 3.43%
Dry Matter: 15.75%
Signature Selects Flaked Skipjack Tuna with Shrimp Entrée in Broth
As Fed: 3.64%
Dry Matter: 17.01%

Thanks again for contacting us.

Maryann
Consumer Affairs Representative
WellPet

000374202A

 

Re: Finally eating again, now BG is "HI"

Okay, now I've gone from frustrated to worried. BG is 493 at PMPS. Never got below 294 today. We did increase her dose to 1 unit to try to get the BG down, but I'm worried that she's still high. What do I need to be watching for? We have never been successful at locating ketone test strips locally, so I can't just check her urine. What else can I do?

 

See my signature link Secondary Monitoring Tools and use the water drunk, urine output, hunger, food consumption, dehydration checks, weight checks, and anything else that helps you identify problems or improvement.

Also, if you've stopped the Meow Mix, you may have actually dropped the glucose levels and those black numbers could be bouncing. Be careful.

 

Thanks, BJ. Her water intake has been high for several days. She is eating like she's starving to death today. She really needs the food, but I'm concerned that she's so hungry because her body just isn't processing it. (When she was diagnosed, there was so much fat in her blood that they couldn't even run it through the machine to test it.)

I was really hoping for a dramatic drop when we completely dropped the dry food again, but we're obviously not going there. Then again, she was in the 400-500+ range for almost 2 weeks after her last flare-up. I guess I just need to take a deep breath and remember that it takes her a LONG time to get regulated again when she's been sick. Poor kitty. She clearly doesn't feel well. :YMSIGH: I would really like it if we could have a few weeks of not being worried about Tisha. The vet said that we really need to be thinking about her quality of life since she seems to spend more time sick than well.

 

Hi

You can monitor for ketones by testing her urine with ketostix test strips. When remi had high blood glucose I did it at least once a day and sometimes twice.

If she is struggling to eat you could ask you vet to give you some ondansetron as this helps with nasuea. If she is being sick then cerenia may also help. These drugs have really helped to overcome remi's pancreatitis over the last couple of years with regards eating and I keep ondansetron going regardles.

If Tisha is dehydrated that can make nausea worse and you might find syringe feeding her a little helps. I use a 5 ml syringe and gently and solely give remi water into the side of his mouth. I aim the water from one side of the mouth to the other. Not down the throat.

 

I'm surprised that you can't find ketone strips - they should be sold at any pharmacy, box store, etc that has diabetes supplies. I get mine at Walmart because that's where I get my strips (can't beat $9 for 50 strips). They're under $5. Given that Tink was in DKA when he was diagnosed, I always have them on hand and test whenever he's seeing higher numbers (as well as sometimes "just because"). Especially if she's not feeling well - I'd try to find some, or have a vet check for them. Tink crashed FAST when he was in DKA. Of course we didn't know he was diabetic - or anything about DKA, etc at the time, so I'm sure that didn't help. Still, he went from normal day 1, to no appetite / a little lethargic day 2, to death's door and nearly comatose the morning of day 3. For what it's worth, he eventually made a full recovery from the DKA and hepatic lipidosis and while we're still struggling to regulate, his quality of life is great. Sending healing thoughts to your Tisha.

 

We actually have a standing prescription for ondansetron (Zofran), Pepcid, and Cyproheptadine for the pancreatitis. We give the ondansetron with subQ fluids at the first sign on nausea, and she was on it for about 10 days for this bout. Now we're at the other extreme - she was acting like she's starving. So much so that our cat who is normally REALLY good about not getting on the kitchen counters climbed up on the counter, picked up a wrapped taco from Taco Bell in her mouth, and carried it down to the floor to help herself. It was incredibly funny to watch, and I wish I had gotten a picture, but I was busy taking it away from her before she got sick. :lol:

BG is still high this morning, but not quite as high. She seems to be slowly working her way down to a more normal range. She also seems to be feeling a bit better again this morning. I was alarmed that she was hiding like she does when she's sick last night and that she was moving very slowly. Today, she's purring and sitting with me. She's also eating, but not acting like she's completely starving. Definite improvement.

I don't know what the deal with ketodiastix is here. They don't have them at the pharmacy or at WalMart. I even tried to order them on-line to pick up at Wal-Mart and when I got there they said my order was cancelled because they don't sell them here. I wonder if there's some weird regulatory issue?

 

Hi LIsa,

So sorry to hear that Tisha's in the wars again, and relieved to hear that she stopped hiding and started purring again. (I remember so well what you went through a little while back ... ) It must be very tricky while you're convalescing as well. I wish you both a speedy recovery. (Sorry for the brevity - getting ready to move house next week.)

FIngers and paws crossed for you both in the Shire.

:YMHUG: cat_pet_icon

 

Uh oh. I think her and Tink have been secretly messaging each other!! Better start keeping tabs on their social media! :lol:

 

Does Tink like Taco Bell too? It really was funny.

Aine, it's good to hear from you. It sounds like Saoirse is doing well, which I am glad to hear.

Good news! Tisha was being finicky about the Wellness food, so I offered her some FF to see if she would eat it, and she did! So maybe, just maybe, we can get her back to food that is both healthy and a little bit less expensive!

 

Tink has snuck into a covered pan containing couscous, taken pizza from a box on the counter (and eaten an entire slice), gnawed on a very large zucchini sitting on the stove, taken a beefsteak tomato off the counter and consumed over half of it, and stolen 3 macaroons from the counter, never to be seen again. Those are just the adventures I am aware of. :roll:

Do NOT let Tisha have any unsupervised communication with him! He'll RUIN her!!!! :lol: