? 7/15 Post DKA Millie Home; AMPS 321, +2 215, +4 62 Concerned about HYPO

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Sylvia & Millie

Sylvia & Millie

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Millie is home from the hospital after another bout of DKA. She is currently on 2.5 U of Lantus, down from her 3U before being in the hospital I was going a curve today and her AMPS 321, +2 215 , +4 62. I gave her some higher calorie food. Never experienced this so looking for guidance.
 
Sylvia, please know I know where u are coming from...I experienced both hypo and DKA with Elmo. Don't feel qualified enuf to give much advice but would encourage you to read Sticky on hypos and test her every 30 minutes (be sure to write it down)...
 
Hi there! Giving her some food was the right thing to do. How long ago did you test? and eat? You want to re-test about 20-30 minutes after eating.
 
Beth 73 said:
Sylvia, please know I know where u are coming from...I experienced both hypo and DKA with Elmo. Don't feel qualified enuf to give much advice but would encourage you to read Sticky on hypos and test her every 30 minutes (be sure to write it down)...
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Yes, reading over & over!
 
Sylvia & Millie said:
How do I put in 20 minute increments on the SS?
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Cram them all into the +4 cell, Sylvia. It'll expand to hold more numbers. You'll have to manually colour it by going to the little paint bucket icon up in the SS tool bar. No need to say +20 min, etc. Then move to the +5 cell when it's time. You can put notes in the comments section about the 20 minutes between tests, how much food you gave and whether it was LC, etc.
 
When I spoke to Millie's ER vet she thought a .5 decrease might be warranted because Millie had a bg of 98. I tried calling today but the doctors that treated her DKA were not there.
 
Sylvia & Millie said:
When I spoke to Millie's ER vet she thought a .5 decrease might be warranted because Millie had a bg of 98. I tried calling today but the doctors that treated her DKA were not there.
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The 62 on an AT meter has earned you a dose reduction of 0.25 u if you're following Lantus guidelines. I think that could work and getting Millie's numbers down (safely) is definitely what you want after her ketone episodes. If it was my kitty I'd do that and be prepared to do some food steering. I really like the touches of blue and green recently. It's stressful but it's what she needs. What do you think?
 
Kris & Teasel said:
The 62 on an AT meter has earned you a dose reduction of 0.25 u if you're following Lantus guidelines. I think that could work and getting Millie's numbers down (safely) is definitely what you want after her ketone episodes. If it was my kitty I'd do that and be prepared to do some food steering. I really like the touches of blue and green recently. It's stressful but it's what she needs. What do you think?
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I thought she would probably need a reduction, just didn't know whether to give a .25 or .5 . Your suggestion sounds better. We are around tomorrow as well and I can do another curve before I head out of town on Monday. This way it was be established for the vet tech staying here.

Thank you, Kris!
 
Kris & Teasel said:
What food is Millie eating right now, Sylvia? Post-ketones is a dicey time. I wonder if Millie would benefit from MC or even HC food to allow a higher insulin dose (ie., the 2.5 u) for the next few days/weeks?
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She's been on LC- MC food (to help her slowly gain back some weight).
 
Sylvia & Millie said:
I thought she would probably need a reduction, just didn't know whether to give a .25 or .5 . Your suggestion sounds better. We are around tomorrow as well and I can do another curve before I head out of town on Monday. This way it was be established for the vet tech staying here.

Thank you, Kris!
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There's always experimenting involved with FD, Sylvia. :)
 
The vet actually said that
Kris & Teasel said:
I wonder how she'd do with mostly MC? I know that being underweight can increase the risk of DKA.
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That's what I was giving her before. The vets wanted her on DM diet. I asked about her needing to gain weight and there was no response! I can always mix the HC saucy food with her MC CORE Wellness, I'm sure she won't complain!
 
Sylvia & Millie said:
The vet actually said that
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Do you mean the correlation between weight and DKA? The DM pate is around 6% carbs and the "Savory Selects" chunks is around 10% carbs. What did they feed her in hospital?

The whole diet/BG level/DKA situation is complex. You're going away on Monday so there isn't a lot of time to experiment and you don't want to change too many things or any one thing by too much.
 
Kris & Teasel said:
Do you mean the correlation between weight and DKA? The DM pate is around 6% carbs and the "Savory Selects" chunks is around 10% carbs. What did they feed her in hospital?

The whole diet/BG level/DKA situation is complex. You're going away on Monday so there isn't a lot of time to experiment and you don't want to change too many things or any one thing by too much.
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Sorry, didn't finish my sentence. They were giving her Tiki cat, 0 carbs. That's all she would eat. They gave me some DM to bring home. As mentioned, I'll continue the MC food with just a touch of HC.
 
You know, it's possible that Millie might be a kitty who would do better on a slightly higher carb diet. She's underweight, has had several bouts of DKA/elevated ketones, etc. I'm sure you've covered this in past posts but how is her appetite generally when she's feeling well? Is she a finicky eater? It would be worth researching some articles on pros and cons of (very) low carb diets for FD cats. Lower carb levels are best but I don't think they all do well on very low carb foods.
 
Kris & Teasel said:
Lower carb levels are best but I don't think they all do well on very low carb foods.
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I agree. Especially so soon after the DKA episode. Ducia had hers 4 months ago and she eats Tiki Cat, too. However, when Ducia breaks her constant bounces I fed her Friskies - Classic Pates 4-5%, lowest phosphorous count possible like Poultry Platter in the early parts of the cycle. It allows me to keep her dose on. DKA is no fun and must be confronted aggressively. Perhaps a combination of Tiki - it's good quality good caloric value and Friskie?
 
Kris & Teasel said:
You know, it's possible that Millie might be a kitty who would do better on a slightly higher carb diet. She's underweight, has had several bouts of DKA/elevated ketones, etc. I'm sure you've covered this in past posts but how is her appetite generally when she's feeling well? Is she a finicky eater? It would be worth researching some articles on pros and cons of (very) low carb diets for FD cats. Lower carb levels are best but I don't think they all do well on very low carb foods.
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I did get some feedback after her first DKA episode. I remember correctly, it was suggested that she get MC food with higher calories. The CORE Wellness fit that. She did gain weight after her 1st hospitalization so I was going to do the same thing. Millie can be quite finicky and tires easily of the same flavors so topping off with a little gravy is up her alley.
 
Tanya and Ducia said:
I agree. Especially so soon after the DKA episode. Ducia had hers 4 months ago and she eats Tiki Cat, too. However, when Ducia breaks her constant bounces I fed her Friskies - Classic Pates 4-5%, lowest phosphorous count possible like Poultry Platter in the early parts of the cycle. It allows me to keep her dose on. DKA is no fun and must be confronted aggressively. Perhaps a combination of Tiki - it's good quality good caloric value and Friskie?
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She loves the Tiki cat but the one they were giving her I think is LC (plain salmon). I could look into that as well to add to the CORE Wellness MC, high calorie. We were topping it off with FF Gravy Lovers.
 
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