? 4/7 Hugo AMPS = 480 +6 = 438 PMPS = 489 +4 = 378 Worst his appetite has been - Q about bouncing?

We should be getting the test results from his vet visit today, thankfully. I need him to eat and even out.

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Looks like he is bouncing from yesterday. That could make him feel lousy. Hopefully he will start clearing that tonight.

 

I have a question about bouncing. Is the lowest part of the bounce where the cat usually ends up? Or do they end up somewhere between the highs and the lows?

 

Just got the call from the vet. His blood work is actually clear. Everything looked good and normal, except for his fructosamine, which was in the 600's!!!

He needs more insulin. I want to try 2.5 units and see what that does. He said the increase wouldn't do anything!? The vet had recommended either going up to 3 units and/or seeing an internist. The 600's are so dangerous, and he's never read at that high on our meter before. Could our meter be off?

I don't really understand the fructosamine test. I know it averages out glucose levels over 3 weeks or so. Can anyone help?

 

Elle,

Lantus dose needs to be consistent and builds up a depot. It is based the the lowest number of the cycle. Your doses are inconsistent. They have been from 1.75 to 2.5 units over a couple of days. The depot is what helps level them out and the depot is all jumbled up right now.

You need to keep the same dose minimum 3 days (unless he goes to low).

My thought is and hopefully others chime in. Is to raise to 2.25 and hold that at least 3 days.

There is a history of dka. You need to get enough calories and insulin in him.

 

+6 was 438.

Also, after days of barely being able to get blood from his ear, I'm pretty sure I went clean through the ear and vein, blood everywhere. I feel like the worst cat mom in the world.

 

Am I doing this? Is this my fault? We had him on 2 units in February for almost 2 weeks and he gave us a flat curve of 300s for his curve for the vet. Maybe all this testing is stressing him out. He's hiding under the chair in our livingroom right now. He never did that before.

His ear is gonna bruise so bad. I held it and put a cool washcloth on it, neosporin and everything.

 

@Bron and Sheba (GA)
@Wendy&Neko
@Nan & Amber (GA)

Anyone?

 

Oh, I'm so sorry. Trust me, we've all done that, hit a vein. It does make you feel terrible, but it looks a lot worse than it is, usually!

He's still bouncing from that green the other day, nothing you can do about it but wait it out and maybe he'll come back to nice numbers again once the bouncing has quieted down.

He might be picking up on your stress, too-- cats are very sensitive. Do you apply pressure to the poke site after getting the blood drop every time? That helps to speed healing and keep the ear in good shape overall. It doesn't always bruise when you hit the vein, especially if you apply pressure, sometimes even then that works to prevent it.

 

Hi Elle
Great news all the blood work was normal. that is a relief for you.
Are you still testing for ketones every day? That’s really important that we know the ketone status.

The fructosamine test is not an indication that the BGs are in the 600s. You are testing them and you can see they are not. The test shows that Hugo is not regulated yet but we already knew that by looking at his SS. The fructosamine numbers do not equate with the BG numbers.

You mention his appetite is bad. Is he still not eating? It’s really important that he eats well. That will help keep the ketones at bay. If he is not eating I would give him some antinausea medication.

As Nan says above, Hugo is still bouncing from the 98. I would wait to see what number he drops to after he comes off the bounce before increasing......providing there are no ketones.
Remember this dose brought him down to 98. He is only up high now because he dumped those hormones and glucose into his system.
See what Wendy thinks as well.

You are not doing anything wrong at all. Hang in there.

 

I don't understand really anything about the fructosamine other than my vet saying that he's badly unregulated. I am still testing them when I can, though it's for some reason getting harder to catch him at the litterbox. I'm worried he isn't getting enough fluids either, even though I see him drinking. When I add water to his food, he won't eat it. He's only been eating about half his food, even with the stimulant. I've been giving him a full 5.5 oz. can of food at mealtimes.

I would love to take him to a specialist like the vet said and run all the tests to find out what is going on, but I don't have the money for that, and I suspect the sustained high BG numbers are contributing to him feeling bad.

I still have a question about bouncing. Is the lowest part of the bounce where the cat usually ends up? Or do they end up somewhere between the highs and the lows? How much longer should I hold this 2 unit dose? We did 2 weeks on the 2 units before we did the first curve on my spreadsheet and got him into the 300's pretty consistently.

I feel like I'm talking in circles. I'm sorry.

 

Here is a post on References Ranges for the Fructosamine. Note that ranges have changed a bit for the UK.

If only it were that simple. Numbers wobble around during a bounce. Typically during a bounce the numbers are all higher than where they'd be without the bounce. In other words, things that go up, will come down once the bounce is over.

Can you tell me what time period you are talking about? You saw both low blues and greens on 2 units last time you were there.

How much does Hugo weigh? My 14 ish lb cat maintained her weight with 5.5 oz of canned, 4 oz of raw food per day. Of course, she didn't have ketones to worry about. And what is important is the calories per can. 5.5 oz can be anywhere from low 100's to over 200 calories per can. How much if the food you are giving?

 

Hi Elle,
No you are not talking in circles....you are just trying to understand FD which is good!
We know he’s not regulated. The fructosamine test has been used by vets for years as a diagnostic test for FD and still is... that’s the best way of seeing if a cat is diabetic at diagnosis, because it tells you what has been happening over the last couple of weeks and not just on the day, when the cat may be stressed and have a high BG.. Vets also use it after diagnosis to see if cats are regulated. But with home testing, fructosamoine tests are not needed as they don’t give as accurate a picture as home testing does.

With fluids, if he won’t eat the food with water in it, then you may have to leave it out.
Have you tried cooking some chicken bones in water...nothing else added...cook for a few hours, then drain the bones and throw them away. Put the liquid into the fridge to cool and skim off the fat. Then use the juice for Hugo. Freeze in IceCube trays and use as needed.

Do you think he is nauseated? He may need an antinausea medication again. It is really important he eats well.
Are you feeding him during the day and night as well as before shots.?
A full can of 5.5oz in one go is a lot of food......is that what you are doing? how much would you estimate he eats over the period of a day?

With bouncing a cat can wobbly up and down a bit ....say in the 400s then down a bit to the 300s then up again to the 400s. Some cats only bounce into the 200s.. every cat is different (ECID). Eventually they will drop down to lower numbers again. Hugo might drop down to the blues or he might not...we just have to wait and see. There is no definite number they will drop to,.

I think you need to wait until Hugo comes off the bounce before increasing PROVIDING there are no ketones in the urine. But lets wait to hear what @Wendy&Neko thinks as well.

ETA. I see Wendy posted at the same time I did.

 

I guess I mean if his numbers would settle around those greens and blues, or they would stabilize somewhere in the middle of those and the 400s he's been getting.

The 1st two week period isn't on the spreadsheet. We did 2 weeks on 2 units on insulin, then I started the spreadsheet with the curve that I had done for the vet after that time period. So that 1st day is him being on 2 units 2x a day for 2 weeks. That's when the vet told us to go up a whole unit.

Hugo weighs 16lbs. He was 18 before things broke bad. Then he got down to almost 14. I give him a full can of Friskies pate in the morning and 1 at night. I know that diabetic cats need 1.5 times the food that non-diabetics need, so like 3/4 of a can. I always just give the full can because our other cat inevitably steals some of Hugo's food, and I want to make sure he has enough left to get his full amount. He's around the same weight he was the last time he was in for a checkup after he was first diagnosed, about a month ago.

 

I don't think I have any chicken with bones at the moment, but I might have tuna water? I will get some and freeze it. That's a great idea.

He gets 2 cans a day, one in the morning, and one in the evening. Our other cat Meowmar likes to steal food, so Hugo usually only gets about 3/4 of the can. We've tried separating them, but then neither of them eat anything. There's usually a little left over in the dish that he finishes a little while later. Right now he isn't even eating half. I have no idea if he's nauseated. He isn't hovering and licking his lips. He eats for a little bit then leaves.

I will do my best to watch ketones. He was neg last night, neg this morning, and he was apparently neg when our normal vet tested him as well.

 

What does the vet say his idea weight should be? I was surprised one time when Neko lost some weight and the vet told me it was too low. Neko was happy of course. She got more food! Diabetics don't need 1.5 times the food of non diabetics. I fed Neko and her civvie the same amount. Cats recovering from DKA however, do need more. Are you feeding him all at once or spread out over several meals?

 

All at once. I asked the vet if he needed to lose weight and the vet told me very sternly no. I told him many times how much I was feeding him and what and asked if it was too much or too little and he said no.

Doesn't he need more because he isn't regulated yet?

 

Feed Kitty As Much As They Want?

 

Do I really want to mess with that when him eating less caused ketones and acidic blood?

I'm ok with spreading it out more, but I don't feel comfortable with feeding him less at all.

 

Look instead at what his weight is, and what it should be. Recovering DKA kitties need more. He may eat more if spread out, most people here give more smaller meals. It's easier on their pancreas.

 

PMPS was 489. I want to cry.

I gave him half a can to see how much he was actually eating and he didn't even finish that. I will give him half a FF can later and see if he eats that.

Every bad reading makes me think he got a furshot and we're messing up.

 

Elle I know how hard it is to see him in high numbers but try and remember those high numbers are from a bounce that will resolve, not because he is not getting insulin. I doubt you gave a fur shot unless you thought you did at the time.
When Sheba bounced earlier on I’m her journey she would stay ‘hi’ during the whole cycle.
The really important thing is he is testing negative for ketones.
I’m glad you are offering food at times other than shot time. I feed my cats 4 times a day.

 

How long should I wait to feed him again? I can tell he feels like crap. He's lying by the water bowl again.

I also worry that it isn't sustainable. I can do it now because we're all having to stay home, but eventually I'll have to go back to work and I wont be able to feed him during the day.

 

Most of us get automated feeders. The Petsafe 5 is a common model. There is a spot under the tray you can put a cool pack to keep the wet food fresh. The feeder allows us to make sure there is fresh food available around the time of the cycle when they might be going lower.

Finding the best time to feed depends on the cat. You want to feed ideally in the first part of the cycle, before nadir, when the insulin effect is stronger. Feeding after that can shorten duration and give them higher preshots. For a cat that likes to dive at onset, a small meal 1/2 hour before onset can slow the dive. Fast dives can also cause bounces. But not all cats do that. Playing food timing is an experiment. You need to try each experiment for a week or two to see if it makes a difference. You could start by trying to feed before onset, so maybe +2 to +3. If I look at AM cycle of March 23rd, he did a 140+ drop in two hours from +2 to +4 so a small meal in between might have helped. Not certain yet whether he does that all the time, but it's a place to start.

Sorry Hugo isn't feeling well. My girl was very fond of black in the beginning. I feel your pain.

 

+4 378