4/11 Silver AMPS 247 PMPS 221 +4=257

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Juliet

Member Since 2017
http://www.felinediabetes.com/FDMB/...-209-pmps-239-2-292-4-286-ketones-3-5.193930/

With ketones of 3.5 I would really like his numbers to come down. I did call the ER vet last night - she was very nice. She had heard of FDMB and I told her of SLGS. She says it sounds like a great approach. She'd rather I did a curve before any adjusting of dose given that she said it could take up to a week to stabilize having been off Lantus 36 hrs. Wish the numbers would come down faster though.

Little bit of illogic - yesterday 13.3 was 20.6 on the Accu-check - this morning 13.7 was 17.7 on the Accu-check. Not logical. Anyways, sorry, too early in the am for me to do the US calculation.
 
I'm not sure what the ketone numbers mean, but I hope they come down. It will take a little while for Silver to stabilize with everything he has been through. Just keep taking care of him like you have been. That's the best thing for him. You're doing a great job helping him get better. Sending prayers. :bighug::bighug::bighug:
 
Hope he starts coming down for you. This is cycle 5, so I hope you start to see some movement.

I don't know bupkes about keytones. Did the meter come with any instructions to it? Hope some one comes along with some info for you.

Is he still eating good?
 
Tracey&Jones said:
Hope he starts coming down for you. This is cycle 5, so I hope you start to see some movement.

I don't know bupkes about keytones. Did the meter come with any instructions to it? Hope some one comes along with some info for you.

Is he still eating good?
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Yes he's eating good. Meter works same as all meter. Stick in the strip and get a blood sample.
 
Kathy and TiTi said:
The catch 22 referred to you having no choice, at least as I read it. It is my belief that the vets are incorrect in saying that Silver must be regulated before having his teeth tended to. If your vets meant he must be ketone free, then yes that must happen first. But regulation often takes months, and waiting for that to happen can put Silver in further jeopardy. I think Stacy has mentioned an alternative. Putting a cat with bad teeth on a course of antibiotics can help alleviate the damage done by infected and/or inflamed teeth. @Stacy & Asia
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I have been advised by many experienced with DKA and dental issues to wait until Silver is stronger from his DKA episode before putting him under anesthetic. Makes sense to me. And no. That is not what I was mesnjnvvre catch 22. @Sean & Rufus was correct.
 
Kathy and TiTi said:
The catch 22 referred to you having no choice, at least as I read it. It is my belief that the vets are incorrect in saying that Silver must be regulated before having his teeth tended to. If your vets meant he must be ketone free, then yes that must happen first. But regulation often takes months, and waiting for that to happen can put Silver in further jeopardy. I think Stacy has mentioned an alternative. Putting a cat with bad teeth on a course of antibiotics can help alleviate the damage done by infected and/or inflamed teeth. @Stacy & Asia
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I completely agree with you. My point was some vets don't want to do the dental themselves if it's "high(er)" risk. My vet wouldn't, my old vet wouldn't, and I called another vet, and they wouldn't either. Had to go to a specialist. That was my point. Rufus was having issues where his numbers weren't moving after increased doses. I begged the vet to do dental, and she said she wasn't comfortable doing it until he was regulated. If this vet won't do the dental, she needs to find someone that will.
 
Sean & Rufus said:
I completely agree with you. My point was some vets don't want to do the dental themselves if it's "high(er)" risk. My vet wouldn't, my old vet wouldn't, and I called another vet, and they wouldn't either. Had to go to a specialist. That was my point. Rufus was having issues where his numbers weren't moving after increased doses. I begged the vet to do dental, and she said she wasn't comfortable doing it until he was regulated. If this vet won't do the dental, she needs to find someone that will.
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Don't worry. I can handle that if and when I need to.
 
I was just told that 3.5 on the meter is equivalent to “small “ on the ketostix , so it is above “trace”.

So make sure he is eating, he is hydrated.
 
OK I am a nervous wreck. Please someone calm me down. I just got home. His preshot is the lowest since he came out the hospital (except for the Sunday night when he got home it was 203. Now its 221. I am okay with that as its gradually coming down. I did just increase his insulin by 0.25 to 4.5 because I am horrified by the blood ketone reading of 4.7. The vet (both the nice emergency one and the regular one) are saying he is fine so long as he is eating ok. His five P's are fine - he went after my knitting last night, purrs fine, poo normal (I know his poo as he's the only one who does it on the puppy pad not in the tray). Still I am freaking out and wishing I hadn't bought the ketone meter. Help someone!
 
When is he next due for fluids?

Eating is good, 5Ps is wonderful-- all these are very positive signs that the ketones haven't started to make him feel yucky. I don't really know how to interpret that 4.7 properly (others will), but the increase in insulin will assist in fighting the ketones, and fluids will help flush them.

Hopefully more experienced folks will be by to give more specific guidance on this, but one more question: did anything come with the meter to test it (like the control solution with a regular blood glucose meter)? Obviously, you have to behave as if that 4.7 is "real", but I'm just wondering if there's any chance the meter is miscalibrated and it's an error.
 
Juliet said:
OK I am a nervous wreck. Please someone calm me down.
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:bighug::bighug:

I can completely relate. The only advise I can give is take deep breaths and take one test and one shot at a time. Getting through this is just one foot in front of the other. Do all you can and know that you are doing the best for Silver. Be sure to take care of yourself too.
 
LizzieInTexas said:
:bighug::bighug:

I can completely relate. The only advise I can give is take deep breaths and take one test and one shot at a time. Getting through this is just one foot in front of the other. Do all you can and know that you are doing the best for Silver. Be sure to take care of yourself too.
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Its the rising ketones that is scaring me.
 
Copying this from @Tracey&Jones's link so I can easily find it again:

The information that Christi received form the rep at novamax (who happened to have a diabetic dog) said "He said that 0.0 to 0.6 is negative, approx. 0.7 to 3 is trace (and would show up as trace on a urine ketone test also), 3.1 to 4.5 is small ,4.6 to 5.5 is moderate, 5.6-7.0 is large, 7.1 to 8 is very large and anything over 8 or HIGH is very life-threatening."

So looks like he has moderate ketones again. Same as when I took him in. Tagging folks that might know what to do....vet seems not worried.

@Sandy and Black Kitty
@Chris & China
@Jill & Alex (GA)
@Sienne and Gabby (GA)
@Tracey&Jones

Anyone else please pop in - I am a wreck and not slept since his hospital visit. I just need to know Silver is safe and vets not really worried. Well I am!
 
Juliet said:
I did just increase his insulin by 0.25 to 4.5 because I am horrified by the blood ketone reading of 4.7. The vet (both the nice emergency one and the regular one) are saying he is fine so long as he is eating ok.
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Did you call them to tell them blood ketones are now at 4.7 or is that something they said yesterday?
 
I know the price of the strips is awful, but it might be worth it to try it on yourself to make sure the meter is reading correctly.

Hopefully YOU don't have any ketones!
 
Jill & Alex (GA) said:
Did you call them to tell them blood ketones are now at 4.7 or is that something they said yesterday?
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I checked again and I got 3.4. So now I am more confused. They said as long as he was eating normally and I was adding water to the food and giving him subQ fluids then I don't need to bring him in. That was just now.
 
Chris & China said:
I know the price of the strips is awful, but it might be worth it to try it on yourself to make sure the meter is reading correctly.

Hopefully YOU don't have any ketones!
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Right now I just had a mini meltdown in my kitchen because the needle on the subq fluids thing got stuck and I couldnt put on the new needle. I am running out of my coping skills here. I am almost hyperventilating with fear while Silver preens beside me wondering what the heck the fuss is all about. :arghh::arghh::arghh:.

I'm going to replace the battery tomorrow as who knows how old that might be if it was sat in their warehouse.
 
Stacy & Asia said:
Did you leave food out for him while you were away today?
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No because he didnt eat all that I put down - I think I put down too much so yes, he would have had food left over when I was gone - but whether he or his sister got it is anyone's guess unfortunately.
 
Nan & Amber said:
When is he next due for fluids?

Eating is good, 5Ps is wonderful-- all these are very positive signs that the ketones haven't started to make him feel yucky. I don't really know how to interpret that 4.7 properly (others will), but the increase in insulin will assist in fighting the ketones, and fluids will help flush them.

Hopefully more experienced folks will be by to give more specific guidance on this, but one more question: did anything come with the meter to test it (like the control solution with a regular blood glucose meter)? Obviously, you have to behave as if that 4.7 is "real", but I'm just wondering if there's any chance the meter is miscalibrated and it's an error.
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Says it doesn't need calibrated. I did test again and got 3.4 so maybe I need a new battery. Will do that next. No control solution but we don't use that for regular meters either.
 
Juliet said:
Right now I just had a mini meltdown in my kitchen because the needle on the subq fluids thing got stuck and I couldnt put on the new needle.
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This has happened to me several times! Sometimes they come right off, sometimes they are stuck on there very tight. I use 2 sets of pliers, one to hold the rigid end of the line where the needle connects and another around the needle base and pull, more leverage that way, easy.

If you freeze the food, you’re guaranteed a certain length of time until it melts...hopefully, unless they would eat it frozen. I would continue to make sure he has access to food while you are away, I don’t know how quick the process is that his body would opt to consume its own fat for energy in the absence of enough food, but I wouldn’t want to tempt fate.
 
Juliet said:
They said as long as he was eating normally and I was adding water to the food and giving him subQ fluids then I don't need to bring him in. That was just now.
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FWIW, here's what I think...
  • You've called. The vets know what's going on and aren't concerned.
  • Silver appears to be eating well and feeling fine. <----- This fact is HUGE when we're talking ketones.
  • You have fluids to give tonight.
  • You've increased the dose.
  • You'll make sure he eats as much as he wants.
Bobbie's Bubba was another one of those cats who could throw ketones at 5.0 on a blood ketone meter, but he was acting fine and eating well. As long as Silver continues to eat well, gets fluids and insulin... I'm less concerned than I would be if he wasn't eating and/or lethargic. I'd remain watchful and vigilant, but I wouldn't be ready to jump off a bridge.

Just my thoughts...
 
Just like a glucometer, you can get a bad test or a bad reading. This may be even more the case with the ketone meter since I believe it needs a bit more blood than your glucometer. Give yourself the benefit of the doubt that a new meter will take a bit of getting used to.

I would encourage you to leave food out regardless of whether Silver has cleaned his plate before you leave for work. Just add water (plus an ice cube or two) to the food so it doesn't get crusty.

And, BREATHE!! Hyperventilating won't help and will probably cause you to have a panic attack. One step at a time. Give yourself a chance to think. You can always ask questions here.

I get worried about a ketone-prone cat if the caregiver says the cat is lethargic, not eating, etc. if Silver has been eating and his behavior seems pretty normal, I'm not overly concerned. You do need to monitor carefully, just like you're doing.

Remind me -- doesn't Silver need a dental? If so, you might ask the vet about an antibiotic to help get any inflammation under control there's less of a risk for ketones developing.
 
Jill & Alex (GA) said:
FWIW, here's what I think...
  • You've called. The vets know what's going on and aren't concerned.
  • Silver appears to be eating well and feeling fine. <----- This fact is HUGE when we're talking ketones.
  • You have fluids to give tonight.
  • You've increased the dose.
  • You'll make sure he eats as much as he wants.
Bobbie's Bubba was another one of those cats who could throw ketones at 5.0 on a blood ketone meter, but he was acting fine and eating well. As long as Silver continues to eat well, gets fluids and insulin... I'm less concerned than I would be if he wasn't eating and/or lethargic. I'd remain watchful and vigilant, but I wouldn't be ready to jump off a bridge.

Just my thoughts...
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Thanks. The only thing I just noticed is that I think he is peeing more - due to the fact I changed the litter recently and it looks like it needs changed again. Possibly due to all the exta fluids he is getting? His meals are more like soggy stews but he laps it up.

Ok. Gonna go TRY and relax for a couple hrs.
 
Sienne and Gabby (GA) said:
Just like a glucometer, you can get a bad test or a bad reading. This may be even more the case with the ketone meter since I believe it needs a bit more blood than your glucometer. Give yourself the benefit of the doubt that a new meter will take a bit of getting used to.

I would encourage you to leave food out regardless of whether Silver has cleaned his plate before you leave for work. Just add water (plus an ice cube or two) to the food so it doesn't get crusty.

And, BREATHE!! Hyperventilating won't help and will probably cause you to have a panic attack. One step at a time. Give yourself a chance to think. You can always ask questions here.

I get worried about a ketone-prone cat if the caregiver says the cat is lethargic, not eating, etc. if Silver has been eating and his behavior seems pretty normal, I'm not overly concerned. You do need to monitor carefully, just like you're doing.

Remind me -- doesn't Silver need a dental? If so, you might ask the vet about an antibiotic to help get any inflammation under control there's less of a risk for ketones developing.
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I did ask about antibiotic when he as in the hospital. They said he didn't need one as they found no infection. Hmm.

Yes he's never had a dental and I have some money coming to me for my birthday so am setting that aside for that. Folks here say I should let him get stronger after this weekend's DKA incident first tho. Am thinking next month? I dunno
 
What's all the fuss about momma bean? I feel fine. I'll just steal your cushion.
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If I had to guess, I bet the ER docs thought you were referring to the UTI they thought he had. If the issue of a dental never came up, they probably weren't thinking in those terms.
 
Juliet said:
The only thing I just noticed is that I think he is peeing more
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Gizmo does the same thing when he is feeling better after a bout of pancreatitis. When they don't feel well they don't clean themselves and then make up for it once they are better.
Eta-^^^ I read preening :banghead::banghead: Just ignore. :)
I have issues with the sub-q needles too. There must be a trick to it but I haven't figured it out :confused:
 
Sienne and Gabby (GA) said:
If I had to guess, I bet the ER docs thought you were referring to the UTI they thought he had. If the issue of a dental never came up, they probably weren't thinking in those terms.
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We did discuss dental. They looked in his mouth. Said I should book him in. Doubt they could tell infection by looking? I do want to take him for one. Would like to get his numbers a little more stable first tho.
 
Chris & China said:
Maybe make yourself a shake!! I hear red wine and chocolate go good together!

As long as he's acting so good, PLEASE try to relax....if he was in trouble, he'd tell you.
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Urgh. I think I'll pass on the shake.

I've noticed he sneezes a lot. Anyone else's cat do that? It was my first indicator his diabetes had returned.
 
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