4/8 Silver Update NEW. PMPS 207

http://www.felinediabetes.com/FDMB/threads/4-7-silver-amps-202-update.193784/page-2#post-2167101

Silver had a good night and was eating. BG down to 234 in their pet meter so that's actually pretty good compared to usual as that is his usual number on the Freestyle. He still has ketones so they are keeping him today. They want to get rid of the ketones before I get him home.

Question - when they're gone and I get him home what's to stop them coming right back?

My civvie kept me up last night howling for her brother. I had to leave her to go to church just now and she gave me this mournful look. She's never been alone in her life and I feel so guilty but I had to leave her for a couple hours.

 

That is great that Silver is eating and had a good night!

From what I understand, enough food and insulin will keep the ketones from coming back.

 

Happy to hear Silver had a good night and ate well
I hope you got some rest too....sorry your civvie was howling for Silver

Sending more vines your way

 

Aw, poor civvie! That is so sweet, and so sad! Hopefully Silver will be home soon-- it sounds like he is doing really well so far.

Yep, food and insulin are the keys. There will be a period of convalescence, how intensive the home nursing will be depends on him. Others with more experience can walk you through the details when the time comes for that, but the fact that he's eating is the best sign. A lot of the really intensive home nursing comes in when they are free of ketones but still not really wanting to eat, so if he's eating now and continues to do so, that will be more than half the battle. Go Silver!!!

 

Be sure to ask about (continuing) the fluids at home. Keeping him hydrated will help. So glad he is eating and improving

Poor civvie .

 

Glad to hear silver is better, sending more vines your way and keeping you guys in my thoughts and prayers

 

What's to stop them from coming right back? You!

You'll have to make sure he is getting plenty of calories, feed more than his normal amount. If you can't get the calories, quantity wise, from low carb, feed a higher carb food while he is on the mend. Sandy told me 1.5-2 times the normal calories is the rule of thumb for fighting ketones. This may increase his insulin needs too, but so be it!

Hydration. Add as much water to his food as he will tolerate and if you are able to give sub q fluids at home, that too.

Insulin, you'll need to make sure he has enough insulin on board and you're not skipping shots. If he's too low to shoot, or not eating, ask for help, but he'd likely need at least a token dose if not the full amount.

What's your civvies name? Poor girl, she's worried for her brother. Hope Silver is feeling so much better by now and that he heals up quickly.

 

Awww, poor Sasha (right?). They are a bonded pair for sure.

Glad Silver is making progress and is recovering.

Sending large healing vines for Silver and hugs for you.


Sandy and Black Kitty may be a great resource for you. I have kept up on a couple of new members that joined after a DKA episode, she was great at guiding through those first few weeks of recovery.

 

He only stopped eating for one day tho. Can it happen that fast?

 

Sometimes yes. Some cats tend to be more easily prone than others. Hopefully when he back home you can find a way to do the ketone tests.

Im glad he is now eating at the hospital and I hope that they get those nasty ketones flushed out of him soon.

 

Thanks. He only stopped eating on Friday morning tho. Can it happen that fast? Hi hadn't skipped any shots and he wa on 4.25u.

Civvie is called Sasha. She's a gorgeous calico.

 

Sasha is beautiful. Sorry to hear she is missing Silver so much. I'm glad he had a good night and is eating. I'm not help with the ketones. I don't know anything about it. Sending prayers for all three of you.

 

I believe it can happen that fast. Also infection is also part of the recipe with DKA. The uti probably helped speed up the process.

It is a really good sign that Silver is already eating. I had to use a feeding tube for awhile after Osha's DKA episode.

 

I've ordered ketone meter and strips and found one that wasn't too expensive.

 

I have a sneaking suspicion that the UTI was brewing for a bit...may explain the dose increases that just didn't seem to affect anything. Which may have started the slide. Higher BG, not enough insulin and then not enough calories to compensate - we keep our kitties on low carb diet.

I have seen Sandy say to increase to carbs for the recovery period. You may want to PM her to get a head start on what you need to do when Silver comes home.

 

With the blood ketone meter you will need a large(r) blood sample than with the glucose meter. I just thought you might like to know. My ketone strips are almost $1 each and every time I received an error when testing it was because of too little blood.

 

Thanks for this. Yes. Hindsight is everything. I figure you're right. His numbers were higher. But I shouldn't have increased insulin faster than I did tho right? His numbers weren't horrible but they were creeping up. I think the UTI likely was developing for some time.

Thing is - what steps do I take to help prevent dehydration and the ketones returning? I can't increase insulin too fast. I can add water to the food - I didn't know to do that. I'll give him more food. I didn't know quantities and had been giving him 3/4 of a can of FF three ones a day. I'll increase that.

My concern is the care when I get him home. Looks like I won't get him home til either later today or tomorrow morning but I have to work. I'll feed as usual and then leave another can of food out. Chances are the civvie may get it but he is usually the one who pushes her out the way for the food.

I do have the bag of fluids they sent me home with on Friday night so I will ask about continuing that although that does scare me a little. Easy when there were two people when the vet showed me how to do it. I held silver while he led the bag. Harder on my own.

How do I do the home care when I have to leave him during the day? How do I know what insulin dose to start back on when he comes home - they will have given him short acting insulin to bring numbers right down but until I do a curve I won't know nadir in order to find out correct dose. What do I do?

 

Thank you. Good tip.
It says 0.3 micrometer. How big is that? I know accucheck needed more than freestyle.

 

I ordered a meter. Need easy solution.

https://www.diabetesexpress.ca/ketone-strips-meters-nova-meter-p-2517.html

https://www.diabetesexpress.ca/ketone-strips-meters-novamax-blood-ketone-strips-10bx-p-2472.html

Will only use it for the ketone testing.

 

That's the one I use. Only for ketones.

 

Easy to use? Set up?

 

Tagging @Sandy and Black Kitty. She knows this stuff Juliet. She can help. Trust me.

And you did nothing wrong! There was an invisible vortex going on...you caught it really early and took him where he needed to be at the first real signs of an issue.

 

Thanks. I'll need some help with how to tell my pet sitter in sept what to watch for.

And yes. I'm so aware of every little nuance of both cats as I live alone with them for the past 12 years so anything off and I am aware.

 

Yes. You set date and time. Use it just like the glucose meter. The meter automatically picks up the kind of strip inserted so you don't even have to worry about that. Reading of 2.44 is when to seek vet help.

 

Hi Juliet,
what an ordeal for both of you! Hang in there.
My Ducia recovered nicely from her DKA at home - and so will Silver!
If possible do arrange to run a blood work in a month or so - to keep an eye on electrolytes and infection.
I bet that UTI caused higher BG numbers.

Ever since DKA I feed Ducia stews - 1 teaspoon of hot boiled water per each teaspoon of pate/ meat mashed in. Makes her pee 3 times/ 24 hours - plenty of opportunity for me to catch that daily urine test. She is well hydrated.
I would double the FF amount you were feeding before - for now.
FF is very low in calories (average 80-90 Kcal/can) so you 'll have to feed more cans a day to add up to 250-300 Kcal/day.Ducia gained nicely on One and a Half 5.5oz can of Friskies.

He will definitely need SQf for a while. Doing it alone might be challenging for sure. My vet charged me $60 per bag w/ lines - and then I learnt that I could asked for Rx instead and buy it in human pharma for $18.
SQF: greatest tutorial video is HERE click.
Ducia was very weak when we got her home - it helped us to give her SQF in the beginning but a few days later she relaxed about it - learnt that she could not run anyway.
I held Ducia sitting between my knees from behind, gently poking the needle in at an angle - she would fidget a little for a sec. ETA: the LRS bag was pinned to the wall just above us.The most unpleasant moment for her was when the solution started to drip - but she could not run because I blocked her sideways with my knees. Give SQF at a room temp - cold might be irritating. Ducia received 100 ml/ 24 h in the beginning. We used gauge 18 needle - very large - it took about 30 min (if no running occurred) to get that much into her - and then another several hours to get all absorbed. She was underweight and sometimes the" water bag" of 100 ml fluids would hang on her scruff's side for hours almost tilting her over when she was walking. Not to get scared - it takes a while for the SQF to get absorbed. And of course hugs and treats afterwards.

That's difficult.
I am afraid I do not see any other solution but stay up late and sacrifice some sleep (temporarily).
But let's see first how he is when at home.

When you are picking him up can you ask the ER doctor to give you a feeding syringe?
After paying The DKA bill you may be entitled to some freebies, I hope.
You also need to have anti-nausea and appy stimulant for home care.

It's Sunday morning, Silver is in good hands and frankly, I do not know when is the next time that you have time to sleep so can you please try to sleep.? Have a nice hearty meal, a large one and try to sleep. Do all the shopping if needed before he gets home.

 

These are for you
So glad to hear that Silver is eating and doing well at the hospital.

 

I hope if you sacrificed sleeping this morning for church, that you were strengthened from the fellowship and blessings of your church family.

I understand they've been using R (fast acting) to get his numbers down, but they should be re-starting his basal insulin soon (if they already haven't).....You should ask

When he returns home, you're probably going to start at the same dose you were on before....with DKA in the picture, you don't want to skimp on the insulin, even if it means feeding a high carb food to keep him safe.

As the UTI clears, if that was keeping his numbers up, he'll start to earn reductions but until then, you'd start where you left off....at 4.25

 

Sasha is lovely, I hope she is doing okay without Silver and is elated when he returns.

Any time a cat stops eating, it’s quite serious and you should do whatever possible to get food in your cat, it can quickly become an emergency. Ketones or no, cats don’t have a great mechanism for handling starvation and are at risk for other life threatening conditions besides ketones like hepatic lipidosis (fatty liver). Ketones can develop rapidly, I believe Sandy said Black Kitty went from trace to large in 12 hours.

I know you haven’t skipped any shots, but whatever was brewing in the background caused a greater need for insulin and the not eating probably tipped the apple cart. It will be tricky to see signs of a UTI since they won’t use the LB in front of you. For Asia though, it was apparent outside of the LB, she would walk and squat her hind end down like it was hurting. She dribbled drops of pee when she did this, they were pink from blood for one UTI. Asia also sleeps in different places than normal when she isn’t feeling right, civvie Toki seems to know when she isn’t right and stays closer to her as well. I know Silver has been healthy thus far, but see if you can think of any subtle behavior difference before Friday and the growling stuff. Does he usually greet you at the door and it didn’t happen? Did it seem to take him a long time to get comfortable to lay down? Was he more clingy/needy than usual, wanting to be close to you, or being aloof and staying away? Can you looks back to before you knew he had diabetes and before the relapse, any things there that you saw last week too that could be general “I’m not right” behavior signs?

I would also ask the vet about his teeth, if any seem obviously infected or broken and how pressing an issue is the dental. Save up for it, get it done as soon as you possibly can. Asia almost died when she was 13, nothing to do with diabetes, it was bad teeth. I had no idea, my vet had no idea. Infected teeth can cause widespread infection too. I don’t know if you’ve visited @Sean & Rufus but Rufus has insulin requirements beyond Silver’s and after the dental, he is near OTJ!

I’m so glad you ordered a ketone meter, that should make it much easier to monitor.

You have so much good info on your condos the past couple days, save them somewhere so you can reference and absorb them later, it must all be a bit overwhelming at this moment. Eat and sleep and take care of you whilst the vets take care of Silver so that you have energy to give him when he returns.

 

Thank you this is so helpful!! When the vet gave the first 150ml fluids it went in so quickly - less than five mins and was absorbed before I got him home that Friday night. He must have been very dehydrated. Thanks loads for the tip re the Rx for the fluids. I will ask.

 

I just bought 24 cans plus 12 cans of. Gravy lovers in case he is reluctant to eat. Thanks. I will ask re the Lantus. Yes. Glad I went this morning. My Fitbit says I got 8 hrs sleep but it doesn't feel like it! Hoping I get Silver home tonight or then I have other issues re dealing with work tomorrow.

 

Rufus was on antibiotics 4 times between September and January. Never helped with his numbers or issues. Old vet, new vet, vet tech, and dental specialist said teeth were unremarkable. *maybe* need a cleaning, but nothing obvious. Finally talked them into just please xray and clean. 5 weeks after dental (1 extraction, 1 root tip exposed, cleaning), he is OTJ. His numbers are running a little higher again, but that is because of his new med, Atopica. So even an experienced dental specialist didn't think he needed dental. Even the antibiotics didn't help. Hopefully Silver is better regulated when his UTI resolves. Perhaps combination of teeth and high BG contributed towards UTI which in turn formed the ketones? Dental isn't cheap, but goes along way to helping kitty.

 

I noticed something wrong on Friday morning went he didn't come wake me at 5am. He does need a dental. One bad tooth but vet said he needs to be stable first. It will be a priority. Scares me tho as then we have issues re anesthesia, pain meds etc which will mess with his diabetes right?

Heading home now. And yes @Chris & China i have bought some chocolate and some vodka ice cream and plan to veg in front of a good movie until the vet calls me back.

 

Can I ask you - how expensive was that dental? Good to have a ball park idea.

 

If the regular vet would have done it, it would have been about $500 I think. Rufus had so many issues going on we had to go to a specialist. It ended up being $2100 for dental and an ultrasound, so probably $1500 ish. I know, I know. It's crazy rediculous. Even the $500 is expensive.

 

BTW, diabetes was steroid induced or influenced. Not that he didnt have all the prerequites, he did.

 

When I had Gordys teeth cleaned, it was in the range of $300 to $500 USD. (I can't remember the exact dollar amounts.)

Sometimes the cost will vary due to the severity of his teeth. His first cleaning, Gordy didn't actually need any extrations, so it ended up being less than what I was quoted. The 2nd time, he had one extraction but the cleaning took less time, so it ended up being close to what I was quoted.

Your vet should be able to give you a quote so you can plan. If they feel too expensive, you always try a different vet. (But in that case, you'll have to bring him in to be examined, so work that into cost.)

 

I believe it was Wendy (@Wendy&Neko ) who recommends Royal Canin Recovery for it's high caloric content. https://www.royalcanin.com/products/vet/recovery-support It is surely more expensive than Fancy Feast, but might be worth it.
Sending lots and lots of vines for Silver. And scritches for Sasha (beautiful girl). And hugs for you.

p.s. Marje (@Marje and Gracie ) did a great video on administering fluids.
http://www.felinediabetes.com/FDMB/threads/how-to-give-subcutaneous-fluids-video.75933/#p821247

 

Same here. Silver lost his remission due to prednisolone.

 

That's do-able. I was thinking it would run into thousands given how much this hospital stay is. I think he will need at least one extraction.

 

Do high calories mean high carbs?

 

Rufus was in and out in a couple hours at dental. Hopefully with dental and UTI cleaned up, you can get Silver in remission again!

 

Sasha wont leave my side.

 

no, it does not.
Total caloric value is listed on each can.
For instance my favorite Tiki Cat is 107 Kcal per 2.8 oz can with zero carbs (as per Dr. Pierson chart). It means that all of the calories come from protein and fat, no carbs calories whatsoever.
Ducia ate 2 cans/24h, very low activity indoor only girl of 9 YO - she gained too much on it.
I cut her portions to 160 - 180 Kcal a day. She maintains. Will make further cuts as needed.

Try feeding Silver 250 - 300 Kcal per day to start with.If he lost a lot of weight lately - start with 350 Kcal per dayl and watch his weight and appy.

 

AD food for whatever reason is very tasty to cats who are not eating. You can get just a couple of cans and mix 1/2 his regular food with enough AD food to make up for his regular amount of food.

 

Poor Sasha, brother is missing and momma is upset.


AD is what I had Jones on when he was first diagnosed and used again after his ER visit. Always have a can handy. Hopefully they throw in a can or two for you to take home.

Keep hanging in there.

 

Not sure what AD food is?
@Tanya and Ducia i couldn't find where to read the calories on the FF? Silver is quite fussy so would like to try and keep him on same food. He is a bit of a horse tho and if I doubled his food he would normally eat it right up. I also got some gravy lovers to mix in if he was hesitant to eat but so far the vet says he is eating. I'll mix in water too as someone suggested.

 

What is AD?

 

a/d is the canned food by science diet. Critical care cat food. High calories and it mushy enough that you can thin it with water to syringe feed.

ETA Royal Canin also has one. Jones didn't like that one as much.

 

Me too.

Juliet, attatched is the info for a/d. It was the only food Gizmo would eat last panc flare and possible kidney infection.

 

Anesthesia and pain meds should not mess with his diabetes. The morning of the surgery vets typically suggest a 1/2 dose of insulin, but other than that, should be no change with his insulin routine. Neko was on pain meds long term due to her arthritis. Addressing pain improved her BG. The cost of a dental typically varies depending on how many extractions they have to do.

No, Royal Canin Recovery is low carb. Another alternative is A/D. It's a bit higher carb, but given Silver's current condition, that's OK. Higher (not high) carb food will allow you to get enough insulin in him and keep him safe. The higher proportion of fat in the food, the higher the calories. That doesn't impact the carbs. The nice things about Recovery and A/D, is that some cats really like them. The other thing is that if you have to syringe feed, they are very easy to do so with.

Sandy has in the past said her BK went from trace to large ketones in 24 hours. Glad you've ordered a ketone meter.

Regarding fluids - I often gave fluids in the bathroom. The bag was placed on a hanger which hung on the shower rod or a hook on the door. The height makes the fluids go in faster and is one less thing for me to hang onto. Ask your vet if they have 20 or 21 gauge needles, easier to stick the cat with than the 18 they usually send you home with. I found fluids costs varied quite a bit. Much cheaper at the regular vet than the ER vet.

 

On the FF cans the calorie content is at the very end of the "Manufactured by Nestle Purina" paragraph on the can. This is the paragraph directly under the "guaranteed analysis". I'm looking at a can of FF Turkey & Giblets Classic and it says:
94 kcal per can (1110 kcal per kilogram). This is pretty good for a 3 oz. can, but over 100 kcal would be better.

 

Thanks. That's a good idea re the shower. I was wondering where I could hang the bag. I already have a bag of fluids they sent home with me in Friday. Will see what they tell me when I pick him up if I'm to give it to him.

 

Awesome. Thanks. I'll take another look.

 

I just looked - our cans are nothing like that - in Canada they do not list the calorie content at all. Went through it line by line. Bummer but there it is.

I am at such a loose end waiting for Silver to come home. Can't seem to focus on anything else. Three and a half more hours before I expect the next call from the vet. I really want him home tonight.

 

I'd rely on Dr. Lisa's list. They have to put everything in French and English on Canadian labels so stuff gets left off.

 

Darn..I forgot you were Canada....
Perhaps @Wendy&Neko , @Kris & Teasel or @Tracey&Jones can help with it?...

Can pursuade you to go to sleep, a short nap at least now?
Think that Silver is in the best place to be at the moment and try to relax. It is important that you got some rest.

If yo ucheck Ducia SS for March 2017 you'll see that I wasn't sleeping at all - too scared.
Now, a year later, I am telling you with all of the confidence - that exhaustion helped nothing. I could barely understand what was said to me - really.

 

Sorry, never fed Fancy Feast, and never will.

 

I copied this from somewhere else on FDMB (I think) and it might be useful, Juliet:
________________________________________________________________________________________________

Canned LC Foods - Canada

............................................................................................................................................


In Canada, we actually have a good selection of grocery store brands that are low carb. Compliments (Sobeys/IGA) and President's Choice (SuperStore, LobLaws) foods are good choices. One big bonus is that the PC and Compliments cost less than FF, and several of them have better ingredients! There are several PC flavours that are low carb- like duck - which FF doesn't even carry. The WalMart and PC ones are in Janet's international charts, and the FF ones are in her old charts. Regardless, stick with pate ones - no gravies. The gravy ones are full of corn starch. If it's used, wheat gluten is listed on the labels in the ingredients, so it's easy to avoid those if you like.


The Compliments ones (Sobeys) also have really good pates. The ones you buy in a box (turkey and giblets, beef dinner, and mixed grill) are all pates and good to use.


Friskies also has some really good low carb pates, and it says "Pate" clearly on the label. My guys like turkey & giblets, chef's dinner, chicken dinner and - as a once a week treat only!- the salmon dinner or whitefish and tuna.


If they are not in Janet's list, the next best thing is to label read- avoid obvious grains (wheat, rice, corn) and other carbs (potatoes, peas), fruit & vegetables, and things called "food starch".. which I assume is cornstarch, but the "starch" part says "stay away" to a sugarcat.

 

How come? Its all my cats will eat and I am thankful it is low carb and suitable for diabetics. I thought it was recommended on here along with Friskies for being low carb and okay?

 

Thanks for this. Actually I have bought the gravy kind as well - I need to persuade Silver to eat and if it means his numbers run a little high then so be it. I have tried the compliments brands when $ was really tight and both Silver and Sasha turned their noses up at it. I have tried many varieties over the past 12 years and FF seafood varieties are the only kinds my fussy pair will eat. Right now I need Silver to eat so that is my main focus. I will give him more than his usual food and go from there.

 

I like spending money on cat food. Seriously though, FF is too high in phosphorus for cats with kidney conditions. At the time I had Neko, my second cat had cystitis, which also meant low phosphorus for him too. On the west coast, I can get over half the foods listed in Dr. Lisa's list so there are several alternative low carb/low phosphorus options. Most of the time I fed raw on the civvie's vet's recommendation. Home made raw is even cheaper.

 

On the dental, the other factor that adds to expense is getting x-rays (not all practices do). Unfortunately for the wallet, it really is advisable to get the x-rays-- lots of problems can lurk under the gumline where a visual inspection won't find them.

 

hear! hear!

And it is also so much better for them!

But when "the finances sing "romances" you don't have MUCH choice.

 

Tiz , which is a pain in the bum where I live here in NZ as it is mostly all that is on offer. Shelves are stacked high with the stuff so I wish it was otherwise.

 

More a time thing for me. I don't even cook for myself let alone the kitties.

 

I'm so glad Silver is making progress.

If Wellness is available in Canada, it is higher in calories than FF or most of the other low carb foods. The chicken or turkey flavors are 4 - 5% carb. As others noted, carbs and calories can be unrelated. It depends on whether they are adding things like potatoes, rice, etc. which would affect the % of carbs vs fat, which will not affect the carbs.

Fluids: When Gabby came home from the hospital after DKA (plus pancreatitis and hepatic lipidosis),I didn't have to continue with fluids. A lot will depend on what the vet thinks is necessary. Adding water to Silver's food will help. Even with Gizmo not being diabetic, I add warm water to his food. It's good for the kidneys!

Unfortunately, some cats become prone to developing ketones after an episode of DKA. Because their electrolyte (e.g., potassium, phosphorus) levels have been out of whack and the underlying infection may not have fully cleared, there is a possibility that ketones can reoccur. When Gabby came home after several days at the kitty ICU, she was prescribed an antibiotic, anti-nausea medication, an appetite stimulant, pain medication and I'm not sure if there was anything else. (It was some time ago!!) I do remember making a guide for myself as to what meds were given when so I didn't miss any doses. She did not have any problems after that one episode of DKA. I also watched her like a hawk.

I am concerned that this is going to be tough on you. Like you, I work full time. I was willing to sacrifice sleep and test into the evening because I was completely frantic about Gabby but I didn't have the health complications you're dealing with. Once you're back on your routine with Silver and your sure he's doing better, keep a close eye on him. Monitor his BG and ketones regularly. (You should check ketones at least once a day.) Any indication that Silver is "off" means a trip to or a talk with the vet. Any time someone mentions a post-DKA cat is acting lethargic, my antenna go up. As Stacy said, you are the best one to know how Silver is doing.

 

Thank you. I will keep an eye on him. Doubt I will be sleeping much any time soon. Wish I had some vacation days available. The ketone meter and strips should be arriving soon. They'll ship tomorrow and I should have it Tuesday.

 

I see... time IS money...

Here is another thought that occurred to me: make a list of what you want( need) from the ER (paying their astronomical DKA bill gives you an opportunity to ask for freebies: (ask other members here what would they ask for for their kitties). Most meds/ supplements are OK if kept in the Fridge for several months.
I'd start writing the list like that:

LRS+lines and needles
Anti nausea med
Appy stimulant
Pain management - pills
Probiotic - to offset harsh AB action on all of the bacteria.
FEEDING SYRINGES - TRY TO GET AT LEAST ONE FOR FREE.









Paying several thousands at the ER puts you into a rare opportunity to Demand what you want - other times you vet might want to brush you off (like mine does). Seize the opportunity!

Plus - all of the medications they think you'll need - antibiotics, liver supplements. Potassium replacement , etc.

If they offer you a recovery canned food - take it all.
Even if it is higher in carbs you might need it for a while and then donate unused rest to a local shelter (as I did w/ Ducia).

ETA: almost forgot the MOST Important : have the entire ER file for Silver copied and take it home!

 

Totally agree with Tanya and Ducia.
Ask for freebies with a winsome smile of deep gratitude on your visage and grab anything they offer.

 

I like that analogy. " Invisible Vortex" It's so true.

 

Fluids and admin kits are cheaper online than from the vet - half the price. Prescription not needed in Canada. If fluids are deemed necessary, just get enough to get you through until you can place an order.
https://www.petsdrugmart.ca/Product/Lactated-Ringer-Injection-6602705/3287
https://www.petsdrugmart.ca/Product/Saline-Solution-0-9-Sodium-Chloride-6602715/3501
https://www.petsdrugmart.ca/Product/Terumo-Needles-3230700/3525 (though terumo ultra thin are preferred)
https://www.petsdrugmart.ca/Product/IV-20DR-Set-J400-Jorvet-1870358/3278

My vet once charged me $40 CDN for a kit which consisted of 1 bag fluids, 1 admin line, 10 needles all thrown together in a grocery bag and called a "kit."

 

Feeding syringes can usually be found at TSC stores or a pet store.

 

Sorry guys. This is the weekend emergency hosptial. They have none of this stuff there. As I am NOT paying the bill I do not feel comfortable asking for freebies anyway. And quite honestly I don't know if I will be needing any of it. I won't force feed him. I tried and he won't have it. The ER file will be sent to my regular vet. It's safe there.

This is my plan moving forward:

Increase his food as much as he will eat
Add water to the food to keep him getting dehydrated
Check for ketones daily
Check BG more often when I can (with work restrictions)
Keep him on his regular FF food (that is all he will eat anyways)
Give the bag of fluids I have here at home (complete with line and needles) IF and only if the vet says he needs it.
If he acts off or is hesitant to eat I will take him right to the vet as I did on Friday night. That is the safest place for him. I trust these vets more than I do my regular vet. However they only open when the regular vets close and are not for regular appointments. Emergencies only.

I am not worried about his eating right now as the vet said he started eating almost immediately. They did not need to give him either pain meds or appetite stimulant. They will have him on antibiotics so I am presuming they will send me home with the rest of the prescription. I will ask a lot of questions before I take him home. I am quite good at doing that.

 

I won't use those. I will take him back to the vet. Will not force him to eat if he is unwell.

 

Not comfortable doing that. I am grateful for what I have been given already.

 

I won't do anything like this without vet direction.

 

So happy to hear Silver is doing better

 

I paid 42.00 last Wednesday for the same thing for Bella’s sister, Abby, I just about fell over

 

I’m so glad silver is feeling better, hope for a soon return home
Lots of
Get some rest tonight and sleep

 

Well it's hard to know what's happening re tomorrow. Am stressing out a little. I'm supposed to be at my desk for 8am. On the 6:39am train. If Silver comes home tonight that works bit if he comes home tomorrow morning I don't want to pick him up and leave for work right away but my work will be really upset if I don't come in. Also if I have to transfer him from one hospital to the regular vet hospital then I will be very late. I'm not very good with uncertainty and not knowing what's happening. Not conducive for good sleep.

 

If he doesn't get food (calories) Silver runs the risk of developing DKA again. You may have to force feed until he is eating enough on his own. Most times it isn't something that lasts that long but cats are notorious for not eating and having diffiulty starting again. This can also lead to hepatic lipidosis which can be deadly also.

 

Like I said. If he shows ANY signs of not eating I will take him to the vet.

 

Heading to pick him up. He's had a very good day. Not lethargic. Fully hydrated and eating well. They are happy for me to take him home.
I've to give the bag of fluids I have here to keep him hydrated in the next few days. 150ml a day x 4 days.

They said they will call me when they get the results of the urine culture. They tested for ketones 10hrs ago and still a trace but happy for me to continue at home.

Relieved and a little scared. Hope I can keep him safe and well.

 

Sending prayers that everything will work out. Like you ... I hate uncertainty and always like to have a plan in place.

ETA - just saw you are bringing him home tonight.

 

Hooray!!!!

I totally understand the stress and concern, this is a scary situation. But: he's eating, he's hydrated, he's got that nasty UTI on the run, and he's coming home!!!!!!! Absolutely everything is pointing in the right direction, and he'll be so much less stressed at home, and be getting the very best TLC from both you and Sasha. You've got this!

 

I am glad to hear that Silver is doing better. It's hard when they get down. You are on a good path to help Silver recover, and stay recovered. In a month, this will just be a distant memory as Silver lays in your lap and helps you read or watch TV.

 

You can and you will. It’s going to be a process and no doubt stressful and exhausting, but you will manage for your boy. We can’t do any of the heavy lifting, but we are all here to support you.

So glad Silver is doing well enough to come home!

 

Funny that's one thing neither he nor his sister have ever done is lie in my lap. On my head, in my bed and just about everywhere else tho. Until tonight when his lonely sister crept into my lap. Surprise surprise. First time ever in 12 years.

 

Thanks. Don't think I've slept since Thursday night. Will be a little frazzled at work tomorrow wanting to be home and doubt I'll be going to bed soon. I've to give him half his dose tonight says the vet. Is that ok? It's three hours late for his usual shot time. They have not given any Lantus. Just humulin.

 

Happy to hear Silver is coming home. I felt so weird when he was at the vet for a curve and gone for 10 hours. I know how thrilled you are to have him home!

 

Felt the same way on his first curve. Hated him being missing.

 

Welcome Home, Silver!

 

Did they start him on antibiotics for the UTI or are they waiting for the culture to come back before addressing that?

I haven’t dealt with ketones and DKA personally, so I’m not comfortable giving my thoughts on dose here. I wonder what his number is and if he is willing to eat, I think that will assist in deciding how much insulin to give. He may be more sensitive as well. Let’s get some thoughts @Sienne and Gabby (GA) @Sandy and Black Kitty @Wendy&Neko @Tanya and Ducia

 

I'm so excited for you that Silver is going home. Sounds like you have a clear plan which is good for the both of you.


and TBH I'm no cop at all for asking for freebies or for a 'best price' in a shop. I'm a wimp & so is husband. lol

 

Not got antibiotics until culture comes back. Either tomorrow or Tuesday. He's not even sure it's an UTI now he said. So wants to wait.

Silver is now chomping down on a full can of FF. Was given three cans of Royal Canin Recovery and told to leave dry food down for tomorrow when I am out 12 hrs. Should I?

I gave him 2u just now and tested him on both freestyle and accucheck. Very pleased to see the numbers quite close.

203 on freestyle and 270 on accucheck. Both yellow but not horrible.

 

I do think leaving food out is necessary. I know Sasha may eat it too, but you can always cut her calories back a smidge later if she gains weight, it will just be a mess for Silver if he doesn’t get enough calories right now in the meantime. Also, if he is eating more calories and higher carbs (dry food), you will have to increase his insulin accordingly to compensate. It’s going to be a process, but I there are many people here that can help you see it through.

I’ve seen clever food contraptions that they have to work at it to get bits of food out, like a game, but it also keeps them from inhaling the food as well as exercising them a bit and keeping them stimulated. Might be a good option for leaving food out, not tomorrow, but just in the future going forward. I don’t even think you’d need to buy something, it could be something you could get creative and DIY.

 

This is all they did and instructions at the bottom. I'll post here if I encounter a low number. Glad to see he encouraged home testing. I really like this vet. The other one I saw yesterday talked to the wall not me! Shame he's just the emergency vet. Would rather he was my regular vet. He said I'd done everything right and was pleased I'm going home testing and will be testing for keytones.

 

Ok I'll do that. The vet tech said rules go out the window in these situations but wasn't high numbers part of the cause of all this? Dry will push him right up no?

 

I have a vacation day booked for April 20th. I'm very tempted to call in and ask to switch it to tomorrow but I know tomorrow is supposed to be a busy work day. Hmmm