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

Discussion in 'Lantus / Levemir / Biosimilars' started by Juliet, Apr 11, 2018.

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  1. Juliet

    Juliet Guest

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    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.
     
  2. carfurby (GA)

    carfurby (GA) Well-Known Member

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    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:
     
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  3. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Good luck today.
     
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  4. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    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?
     
  5. Juliet

    Juliet Guest

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    Yes he's eating good. Meter works same as all meter. Stick in the strip and get a blood sample.
     
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  6. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Very important! :)
     
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  7. Juliet

    Juliet Guest

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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.
     
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  8. Sean & Rufus

    Sean & Rufus Well-Known Member

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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.
     
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  9. Juliet

    Juliet Guest

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    Don't worry. I can handle that if and when I need to.
     
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  10. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    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.
     
  11. Juliet

    Juliet Guest

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    Oh really? Oh thank goodness. I've been worried sick!
     
  12. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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  13. Juliet

    Juliet Guest

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  14. Juliet

    Juliet Guest

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    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!
     
  15. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    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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  16. LizzieInTexas

    LizzieInTexas Well-Known Member

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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.
     
  17. Juliet

    Juliet Guest

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    Its the rising ketones that is scaring me.
     
  18. Juliet

    Juliet Guest

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    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!
     
  19. Stacy & Asia

    Stacy & Asia Well-Known Member

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    Did you leave food out for him while you were away today?
     
  20. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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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?
     
  21. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    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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  22. Chubba (GA)

    Chubba (GA) Well-Known Member

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    I know nothing about ketones, but sending prayers! :bighug:
     
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  23. Juliet

    Juliet Guest

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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.
     
  24. Juliet

    Juliet Guest

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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.
     
  25. Juliet

    Juliet Guest

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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.
     
  26. Juliet

    Juliet Guest

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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.
     
  27. Stacy & Asia

    Stacy & Asia Well-Known Member

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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.
     
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  28. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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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...
     
  29. Stacy & Asia

    Stacy & Asia Well-Known Member

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    Which brand ketone meter do you have?
     
  30. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    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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  31. Juliet

    Juliet Guest

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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.
     
  32. Juliet

    Juliet Guest

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    Nova max
     
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  33. PussCatPrince - GA

    PussCatPrince - GA Well-Known Member

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    Tiz Novomax.

    :bighug: Please , please. :bighug:
    Hugs , cuppa and tv or book.
     
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  34. Juliet

    Juliet Guest

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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
     
  35. Juliet

    Juliet Guest

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    A good cry is more likely what's gonna happen!
     
  36. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Absolutely. What goes in will come out! :D
    Good idea! Taking care of our kitties is exhausting. Relax and enjoy both of your cute little kitties!

     
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  37. Juliet

    Juliet Guest

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    What's all the fuss about momma bean? I feel fine. I'll just steal your cushion. A255CC57-88D0-4A7E-A504-AAC954B934D6.jpeg
     
  38. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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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.
     
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  39. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Go pet that handsome guy! :)
     
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  40. LizzieInTexas

    LizzieInTexas Well-Known Member

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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:
     
  41. Juliet

    Juliet Guest

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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.
     
  42. Juliet

    Juliet Guest

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    I am. He's purring like there's no tomorrow. Me - I need chocolate; ice cream and a glass of wine. In no particular order.
     
  43. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Go for it and enjoy!
     
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  44. carfurby (GA)

    carfurby (GA) Well-Known Member

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  45. Kris & Teasel

    Kris & Teasel Well-Known Member

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    FWIW this guide mentions ketone control solution on page 27:
    https://novacares.com/downloads/NovaMaxPlus_english.pdf
     
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  46. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    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.
     
  47. Juliet

    Juliet Guest

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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.
     
  48. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

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    He looks great in that photo. Try to calm yourself down and get some sleep.
    :bighug::bighug::bighug:
     
  49. Olive & Paula

    Olive & Paula Well-Known Member

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    Long bubble bath with that wine and chocolate ice cream. :):):)
     
  50. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

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    Hang in there Lady...you are doing all you can...food, insulin, water and loves.
     
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  51. Juliet

    Juliet Guest

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    Just had loooong call with vet from my regular practice as I had asked one of them to at least call me back and see if they knew the cause of the DKA. And what do you know - this vet has two diabetic cats and knows his stuff. He reiterated all you guys have said.

    We are doing a dental exam on Saturday as well as a test for pancreatitis. He says he is very surprised a cat on 4u of insulin went into DKA. I told him of SLGS. He says we might have to tweak dose to see if we can get him better regulated. I hope he really IS on the same page as this board. He said he had had one of his own cats go into remission three times so I do hope so.
     
    Last edited: Apr 11, 2018
  52. Juliet

    Juliet Guest

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    Wish I could. Basement apartments unfortunately don't have baths!
     
  53. Olive & Paula

    Olive & Paula Well-Known Member

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    At least the wine and chocolate ice cream then.
     
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  54. PussCatPrince - GA

    PussCatPrince - GA Well-Known Member

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    OK. Cries - and be good and loud about it as tiz cathartic - then dries the eyes. Slurps some wine & eat some choc.


    Stick yer feet in a bowl of hot water and pretend. I am assuming here said feet cannot reach the sink unless you sit on your draining board. Not quite the same cosiness. For added spa feel drop something in. In the absence of petals , any old thing will do. Weeds, peelings but not an onion.

    Looks like you may have found your vet *fingers crossed*. Silver is looking lovely and bright which is lovely to see.
     
  55. Juliet

    Juliet Guest

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    :D:D Thanks for making me laugh!

    Yes I hope so.
     
  56. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

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    Silver is a cutie-pie :cool:
    Looks like he is feeling well.

    It was a good investment. Knowledge is power; forewarned is forearmed. :cool:
     
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  57. Juliet

    Juliet Guest

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    Got two very different readings though - 4.7 and 3.4 within minutes of each other. I thought there should be NO ketones?
     
  58. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

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    Why do you think there should be NO ketones?
    (Don't get me wrong, that would be lovely.... )
     
  59. Juliet

    Juliet Guest

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    Dunno. Thought ketones were bad. Everyone says to test for them.
     
  60. Bellasmom

    Bellasmom Well-Known Member

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  61. Bellasmom

    Bellasmom Well-Known Member

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