? 3/31 Ozzy Ketones 1.3

Dangit! Ozzy is at it again! Went to family's house for over nighter and Ozzy missed 2 shots (dinner yesterday and breakfast today). We came home and put down some food for pm meal and Ozzy wouldn't eat. His preshot number was 198 after missing 2 shots which was much lower than we expected given his missed shots and lately he has been running in the 250s preshot. I pulled out my Nova Max ketone meter and he tested at 1.3 on the meter. I think that after he hits 2 on the ketone meter is when we are in trouble. So we are close :-/

This happened 2 months ago when I was in hospital having my baby. The difference this time is that he started developing ketones quickly (in only 1 day), and more concerningly last time he was still eating. We gave him 1 unit at his PM shot time and I really wish we would've given him a little more (1+ - 1.25u) but i didnt know he wasnt going to eat or would have ketones already.

We put down meals in the auto feeder when we were gone and one meal was the young again zero carb, the rest were all low carb meat. We used the YA zero because its hot here in CA today and even a frozen food biscuit would have been a little funky left out for 24 hrs on hot day. We have a camera set up in the kitchen and I saw Ozzy eat both his portion of the YA and his brother Figgie's portion.

So what do we do now??? I tried to take him back to his food bowl an hour after his shot and he still didnt eat. I know the insulin hasnt kicked in yet. I know Ozzy ate yesterday and today but maybe just stopped eating during this last meal or two (they get 6 small meals a day). I know not eating with ketones and no insulin will lead my already super prone DKA kitty back into DKA so i want to be careful here. Do we need to syringe feed him? If so, when? Tonight? Tomorrow? He got his insulin 1 hr ago...can i top him off with .25U given the situation?

We.keep Ozzy's numbers on a notepad- I have been awful about updating the online SS due to just being pregnant and having a 7 week old baby. Here are his recent numbers below. I can't believe we are here again!!! I feel like I am never going to be able to leave my house without this happening!! Could stress be a factor? I think Ozzy has separation anxiety when I leave and we do have new baby.

3/17
730a 263, 1u+
730p 243 1u+

3/18
730a 265, 1u+
pm- hubby forgot to log numbers, 1u+

3/19
730a 273, 1u+
730p 254, 1u+

3/20
8a 253, 1u+
730p 246, 1u+

3/21
715a 248, 1u+
pm-hubby forgot to log number, 1u+

3/22
730a 248, 1u+
7p 234, 1u+

3/23
730a 102, 1u
942a 102
109p 187
639p 252, 1u+

3/24
7a 234, 1u+
630p 212, 1u

3/25
730a 240, 1u+
645p 268, 1u+

3/26
645a 297, 1u+
pm- forgot to log number

3/27
715a 218, 1u+
643p 257, 1u+

3/28
755a 217, 1u+
7p 247, 1u+

3/29
714a 212, 1u+
714p 266, 1u+

3/30
745a 242, 1u+
pm- SKIP OUT OF TOWN

3/31
am - SKIP OUT OF TOWN
733p 198, 1u
830p 238
830p- KETONES 1.3

 

I just looked at my last post on this from 2 months ago and see that @LizzieInTexas said ketones don't start forming until around 2.4+ on blood ketone meter so maybe we have a little more leeway here. Still concerned about him not eating? Appreciate any advice. I can't believe how sensitive my sugar kitty is to missing a shot or two. He is obviously badly diabetic!!

Last time this happened we were able to flush the ketones out by watering down his food, ensuring he was eating and giving a bit larger dose of insulin for a few cycles. Only he was not having issue eating then.

 

Jo, could you slowly syringe some food so he at least has some on his stomach ? That is always my go to in a case like this ... not a lot maybe 1-2 teaspoons slowly . Prayers that he straightens out easily tonight

 

I know he ate some food today so was wondering at what point do we need to assist? Are we there right now? In the morning? I don't want to traumatize my kitty by force feeding unless I have to (and I will if needed).

 

Bumping my own post. Hoping some more folks will chime in. Ozzy just went to kitchen and looked at his food but didn't eat. His insulin is kicking in. He went down from 238 at +1 to 200 at +2.5.

 

Did he lick his lips and turn away? Is it a food he normally likes? Do you have any Ondansetron or Cerenia for nausea?

 

I know nothing about DKA or answers to your questions. Sorry I can't help.
However, on the not eating front...have you tried a different flavor/open a fresh can? My cats can be real butts that way. Also, maybe try warming the food a bit. Just make sure you stir it well and test it on your knuckle or wrist like you would baby food.

 

Gave him his favorite fancy feast watered down. I just tried rubbing a little on his gums and he went on to eat a few bites but not much. When would we need to syringe feed him? As mentioned earlier, he did eat a lot of YA zero carb food this morning.

 

Let me check in his box and see if we have any left over from last yr when he was in dka. what is expiration on these?

 

I am concerned that he is not eating because he is nauseous. If you syringe feed him and he throws up, we'll be back to square one. I wouldn't worry about expiration dates. In my experience, most meds continue working long after they "expire". If you've got some, it's better than nothing. How does he do with pilling?

 

@Tricia Cinco(GA) & Harvey Found bottle of metoclopramide that vet gave us for nausea support. Expiration was 2/18. I will give him some now. Why do sugar kitties get nauseated?

 

Forgot to mention we came home to kitty vomit in 3 places. Maybe he is nauseated.

 

Ketones can cause nausea.

I would try giving it to him, but it's possible he might throw it back up. I'm not familiar with it, so I don't know how long it takes to work, but if he doesn't throw it up, I'd try offering food after 30 minutes. If he doesn't eat then, try after 60 minutes. If he hasn't thrown up at that point but still doesn't eat, you might try syringe feeding at that point, but not too much at a time. Sometimes when you syringe a small amount, they realize it doesn't make them feel worse and begin eating on their own. Be sure you test his BG every 30-45 minutes as long as he isn't eating.

 

Jsut have him 1.5ml of the anti nausea med. How long till it works?

 

Thanks. Hope the meds make him feel better. My poor kitty! Fun dealing with this with my sugar kitty and nursing my 7week old infant every two hours!!! Geez!!

 

I'm not sure. See my last post above.

 

Saw that . We cross posted. Thanks again!!

 

I know you've got a lot on your hands, but keep me posted as you can. I'll be watching.

 

Thank you again. If he doesn't eat more by the am we will most definately syringe feed him. Think he will be ok tonight? As mentioned above, he did eat today and he got a dose of insulin tonight and he was drinking some water. Are we in an emergent situation that requires closer monitoring and testing tonight? We just returned from out of town and are exhausted from car ride and our infant. I was planning to turn in for the night in next 30-45 mins with my baby. Do I need to reconsider ?

 

Since he is dropping, and hasn't eaten since he got insulin, I think he needs to be monitored for a little bit longer. Can you get a +4? If he's not significantly lower, I'd leave food out for him. If it's possible for one of you to get up a couple hours later to check him, that would be ideal. But if he has dropped by more than 50 points, I'd set an alarm for one hour to check him again.

 

We have food out on floor for him it's almost +4 so I can grab a check on him then. He just vomited a HUGE pile of cat food and liquid on floor so he did have food in him before. He obviously didn't like that medicine. Poor kitty! He has gone by his food again so he is interested.

 

Unfortunately, that's not good, since he has insulin onboard. He may need monitoring for a while. Why do they always do this on a holiday?

 

Just got a +4 and he went back up to 238. I don't see him having a hypo event tonight with those numbers. His nadir is usually around 5-6 hours in. I'm more worried about him developing ketones.

 

I agree. He really needs food. Any sign he's feeling better?

 

How quickly can they develop considering he has insulin in him now? I really can't believe how he turned down hill that quickly? We only were gone for 29 hours and he missed 2 shots!!

 

Ketones can develop very quickly. The recipe for ketones is not enough insulin + not enough calories + infection or inflammation. Any cat with a history of DKA is at risk if they miss a shot and/or don't eat.

 

miss a shot? so we can never skip a shot for him or he is at risk of DKA again? We rarely ever skip shots but we were out of town over night.

 

Unfortunately, with a history of DKA, that's the way it works. I'm not criticizing you, Jo. You just need to be aware of the risks. Next time maybe you can find someone to give him a reduced shot? Any insulin is better than none.

 

No worries i didnt take offense. I just see a lot of ppl skipping shots and thought going away overnight was ok to miss one or two shots every once in awhile.

I just gave him some fresh food and he is eating it and looks like he has a good appetite. Ya! Thanks @Tricia Cinco(GA) & Harvey!

 

I'm so relieved to hear that!!!

Yeah, most of those people have cats with no DKA history. It stinks, but that's the way it is.

Go to bed, Jo, and sleep well!