Discussion in 'Prozinc / PZI' started by srk4cats, Feb 17, 2018.
Are you not testing before giving insulin? I don't see preshot numbers on your spreadsheet.
Her cycle this morning looks good. If you can, get a +10 and that will be like a curve and with the preshot you'll see if she's rising or surfing at the end of her cycle.
Have you increased the amount of food or is she doing this good on the same amount?
Nice to see her in the blues! You're doing great with testing during the cycle!
I'm embarrassed to say that I ran out of test strips and couldn't find the ones for the Everpaw. I ran over to Walmart and picked them up as soon as the pickup counter opened (I had ordered them online yesterday).
Hey, it happens. I keep a hypo kit, battery for meter, bottle of 50 strips, high carb food, Karo syrup. I have run out of strips and used the hypo kit bottle, then I forgot to restock them. Ended up in a midnight Walmart run.
Now, once I start the second bottle of 50 strips, I order more right then. If I don't, I will forget or drag my feet and run out.
I'm worrying again. She didn't yowl for food at dinnertime, although she ate a couple bites after I put Chico and Cheddar in the garage. Now I set her food on the bed where she's been sleeping all day and I think she's starting to eat, but maybe its only when she sees me watching. She actually slept in my arm last night and I have a bad feeling.
Also, did you see she shot up to the 400's at her PM shot?
I haven't seen her pee.
If you think she's not feeling well get her to the vet sooner than later. If ketones are building early treatment is better. You mentioned that she's vomited a few times in the last day or two. I'd pay close attention to that.
I agree with Kris. If you can't get a ketone test done within the hour, I would take her to the vet. They can take off so fast.
She's eating now. At least she was when I was lying next to her and holding the bowl.
If she’s not showing her usual appetite be very vigilant. Vomiting, lethargy, coaxing her to eat are things you need to pay close attention to. She’s still in a very vulnerable post DKA state.
Try get her to drink some water too. Maybe you can get her to pee after some water. If you don't think you can get a test before the vet closes, I would take her in for a test. They should be willing to test her for you since she's post DKA.
How much money have you spent on your sugar babies in the past year? I just got her home from the hospital ($2,800). Isn't there anything I can do to help her at home? Since she was diagnosed a year ago, I've spent over $10,000 on her.
@StephG help. she's dying.
No where near that much. BUT Chuck hasn't had DKA. We are lucky that he isn't prone to Ketones.
If she has ketones, the best place for her is the vet.
Once she's sent home, what you can do is stay on top of her testing and test for ketones as often as possible. You could ask your vet about doing subQ fluids at home to help keep her hydrated. This might help keep Ketones at bay along with enough food and insulin.
It's NOT easy but it's worth it.
Did you get a ketone test?
There was a member that just lost her cat to DKA on Facebook. Vet have the cat fluids at the office. He went home and Ketones were 10x what they were at the vet later that night. He wasn't on insulin so they went up fast.
What is her BG?
What's the ****ing point of getting a ketone test when I already know she's DKA?
The only way to know for sure is testing.
Testing will tell you what the level is... Sometimes when they are Trace increasing fluids and getting BG down can help but I don't think it is likely in Chloe's case.
DKA is rarely treatable at home.
It hurts my heart to say this but if you don't want to or won't treat her DKA again, euthanasia is the more humane option. It makes me sick to my stomach even mentioning it but I don't want to give the idea that just letting her die from DKA at home is anywhere near ok.
She needs to go to the vet. Don't let her suffer at home.
@srk4cats what is your plan?
Please update when you can.
I had a restless night, but this morning, she is eating normally. She's been peeing out of the box in a couple different corners of the kitchen, so I got a sample. Negative for ketones. I think she either peed or vomited on my slippers. She is now sitting and licking her paw. BG is 134.
Why? Is DKA painful? Wouldn't you rather have your cat die in your arms at home, rather than in a cold hospital?
I don't think it's good way to go: https://en.wikipedia.org/wiki/Diabetic_ketoacidosis
Humane euthanasia by your vet is a better and kinder thing to do.
If you're going to let her go, there are mobile vets that can come and euthanize her at home so she doesn't have to suffer. You can call your regular or emergency vets for a recommendation.
She deserves that last gift of humane and painless euthanasia if its her time.
Since she seems better today and negative for ketones, I'm going to hold out for her regular vet visit this Thursday. I tried a mobile vet with Pogo and it was horrible. The vet had no empathy and wrapped his body up tightly in a blanket with duct tape. I had to loosen it before I buried him. He also didn't like the idea of my burying him in my yard. With Genghis, I took him to a vet's office to be euthanized after trying so many treatments unsuccessfully. That was a bit better. He had some sort of respiratory problem that was making him sneeze snot all over the place. I've had cats die from loose dogs and coyotes. I've done my best with Chloe and am ready to let her go. When she first got diagnosed, it was too soon after Pogo and Genghis passed.
Thanks, but that article was very medical and didn't say anything about whether it was painful. Many old cats die of natural causes.
https://www.medicinenet.com/diabetic_ketoacidosis_symptoms/views.htm. This article explains that there is dehydration, abdominal pain, vomiting, and many other symptoms. If it is Chloe's time, I find it unconscionable that you would allow her to suffer slowly and die while desperately thirsty, in pain, throwing up, and other things. Part of our job as caregivers is to give them an easy death to alleviate their suffering when it is time. Please let us know when Chloe is gone. We will certainly mourn her passing.
The article says, "Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing..." That sounds horrible to me. I cannot imagine allowing my kitty to suffer that way when it was within my power to let them go peacefully.
Yes, old pets die of natural causes. But letting a pet die because you're choosing to withhold treatment, and also making them suffer through that death....that just sounds like a terrible thing to stand by and do nothing while a pet is helplessly suffering. Cats are famously good at hiding their suffering from us, but that doesn't mean it's any less horrific for them.
Now from what you're saying, it sounds like she's doing fine right now and this isn't even an issue, but I really hope that if this becomes an issue at some point, you will have enough compassion to let her go peacefully through euthanasia and don't make her suffer in pain and gasping for breath.
@srk4cats My Aunt just had DKA a month ago. She had such horrible pain everywhere. When your blood is toxic it hurts everything. Cats hide their pain so by the time you see signs of it, it's beyond 10 out of 10 pain level.
On top of that pain, they're terrified and confused. Dying of natural causes, like a heart attack, is much different than suffering for hours until their body completely fails.
I would never let an animal suffer to death at home. If it comes down to it, I urge you to have her humanely euthanized. She's fought this long-- she deserves not to suffer.
Are you saying that you'll be putting her down at your next visit?
I'll wait til Thursday to see what the vet thinks before making a decision.
Aww they're precious!
Does she look like she's in pain?
It is inhumane to watch, or even let an animal die painfully---knowing you can help ease the suffering by offering euthanasia. Sure, some animals die of natural causes, but so do humans. It is normally done in their sleep, or you can get an autopsy report that states the patient died of natural causes. This is generally done after they have been at the hospital getting treatment, or walking into a loved ones home and realizing they are deceased. People generally want answers. In this case you know why she would die--lack of treatment, and likely DKA.
If this was a human how would you react? Would you let your loved one gasp for air, or suffer in pain knowing they need a breathing tube, or an O2 mask to help them? I'm sure the answer is no. I'm not saying you need to spend another 10k on Chloe. What I am saying is--when the time comes you need to do the right thing, and let her pass peacefully and not in pain. It will be less than DKA episode.
If you cant give Chloe the care she needs then at least have the compassion of letting her pass peacefully (when the time comes), but under no circumstance should you prolong her agony--especially if you plan on not treating.
Listen to your moral compass.
I'm not the cat whisperer. I can't know if she is in pain. She appears to be okay right now, but I don't know what is going on inside of her body. Cats show pain differently than humans.
I would monitor closely.
Like I said before, they hide their pain very well. It's a survival thing.
Keep testing for Ketones. It's good that she was negative.
Keep in mind, if she's lethargic and weak it could also be hypoglycemia. So it's best to test BG and for Ketones.
I just want to point that individuals who are depressed generally don't look depressed. They put on a cover. I'm not saying Chloe is depressed. It was an analogy.
My father died a couple years ago. He was ill and used a walker. He was ready to die and he told me so. Chloe is not ready yet. In fact, I think we finally found the right dose.
Exactly the point we tried to make originally.
As for your father, I know how that feels. When my father passed, he was ready and had BEEN ready, and he said so. If it had been legal, I would have helped him die earlier when he was ready and still had his dignity. I would have done anything to spare him the suffering I watched him go through. What he went through still haunts me. I'm grateful that I am able to spare my cats that and show them how much I love them by sparing them intense suffering that they cannot understand.
I really hope that Chloe has turned a corner. If you make it your mission to up your testing game and stick to it I think you can avoid another costly and stressful DKA. On work days aim for:
AM/PM pre shots - always
one right when you get in the door after work
one before bed every night.
On days off, get at least 2 mid cycle tests in addition to AM/PM pre shots and the before bed test. Once you have a denser scatter of data on your SS and she's well past these crises you can ease off on testing periodically but not all the time. This should be workable for you and would help Chloe a lot. It'll become a habit for you over time and won't feel so burdensome.
I also recommend getting a blood ketone meter so you can track that without having to follow her to the litter box.
Just info: Always ask your vet too if anything that can be done without bringing her in. I was afraid Baby had another UTI & they were willing to test if I could bring a sample. I know it’s not always easy to get that. I’ve been there so much & spent $$$ that they were kind to help me. It never hurts to ask I hope she’s ok & bless you!
I like the fact that your vet was willing to do that. It shows they are trying to work with you.
@Teenuh -Yes I have a great, really 2 lady vets that both are good with Baby! Dr. Kline is impressive with her knowledge on diabetes! The techs I’ve dealt with so far are most knowledgeable- they’re experienced & have the correct training. Night & day from my old one! Sooo thankful
I like Kris's routine suggestion.
I just bought at blood ketone test. It will be worth it, as it is cheaper than an episode of DKA! I'm really encouraging you to do the same.
That 292 preshot makes me wonder if she went a little lower last night.
How's she doing? I would still be getting ketone tests done. She got them before in 200s... I think the tests this weekend were great, minus that red of course.
Some cats need for insulin is little lower at night so a before bed test will let you know if she needs an extra snack before you go to bed. Could make the difference of a blue preshot and anything higher.
I mean . . . I guess this makes sense in a way. There are great-knowledgeable doctors/specialists and there are some not so great, lack the knowledge.
Anyway, I'm glad you found a vet who is on board with you!
That's a lovely dark green last night. I see you gave the full dose on an AMPS of 113 this AM. Did you leave out some carby food for her? Are you off to test her mid cycle?
^^ what Kris said.
Good job on getting the number dialed in on your SS.
I’m not saying she’s as experienced as the people here by any means.? She seemed open & pleased to the info that this board has given me.
I personally think many of these crazy cat ladies know more about FD than many vets.
At least your vet is open to the board to the board. Mine doesn't know about the board. Although she did see me buy a bunch of FF and Friskies at Target over the weekend. I wonder if she put two and two together.
@srk4cats how's Chloe?
doin' swell. how's chuck?
He's not very happy with me. I've been testing every hour for for the first half of the cycle the last few nights. We added another insulin to our game plan to try to bring his numbers down without having to increase his lantus dose. So he's hiding under the chair.
I see that 46 on your SS, Roberta. This dive might have been brewing since the 2.5 u dose on your AMPS yesterday of 113. I strongly encourage you to get a before bed test every night. She might have signalled her intention to drop then. The night before she dropped to low dark green when you gave 2.5 u on a PMPS of 149.
Just saw your negative ketones test - hurray! Skipping insulin after a DKA isn't ideal but I don't know what else you can do on a work day. She's far too low to give her shot.
Post DKA she needs enough insulin to keep ketones at bay. That means you might have to feed her higher carb food to support that higher dose. I don't know the carb level of the 9 Lives she eats but you might need to switch it up for now until she's well past the DKA crisis.
I agree with Kris.
It looks like you'll have to increase the carb level of her food. When she gets down to under 50 it will cause a bounce and she'll be in dangerous numbers again risking ketones.
Thank you so much for your advice. Chloe is eating again. I'll have to call in at work to say I'll be late. I won't leave until she is above 100. When do you think I can give her a reduced dose, maybe .5?
How long do you have before you have to leave for work? You could give 0.5 u just so she has some insulin in her. My guess is she'll bounce after this lime green so that tiny dose should be OK. If you give it, test her before you leave to see what's happening.
If you don't have any higher carb food at home I suggest you get some. You can mix gravy style food (high) with low carb pate to create a medium carb food so you only need low carb and high carb in your pantry to give you lots of options.
I agree. She needs insulin but was obviously too low at 46. I think we suggested higher carb food so she can get a higher dose before...with the DKA on her past it’s super important.
Based on 1/26, 1/27, and 2/9 AM cycles I think 0.5 units would be ok and I agree with testing before leaving the house after the dose.
If you test again before the insulin and she's over 150, I think 1 unit would be ok too.
If you're feeling braver you could go as high as 1 u, Roberta. If you've already given 0.5 u don't give more though. Just trying to figure out what's best for Chloe right now.
Good point, Steph.
Yep I think 0.5 would be fine too. And I’d be sure to test before leaving today.
Oh I missed the 1 unit if over 150 comment! I agree with that too. I’d want that higher dose if a higher number is present.
Any decision yet, Roberta?
She is at 58 and I've put some honey in her mouth at 6:30 and again just now. Her BC is not moving much. Do you think it's safe to go to work or should I wait another hour?
I just opened a can of generic wet food and poured out all the gravy into Chloe's bowl. She is eating and all the other cats came running, too, so it must be a cheap hi-carb. Moisture is 78%, protein 10%, so that would make it 12% carbs, right?
She's not budging much. You can't surmise the %carbs from that analysis on the label unfortunately. You just have to assume that because it's a gravy style food it's high carb (usually starch in the gravy).
Trying to balance the need for insulin against the low BG is really tricky. Maybe wait an hour, retest and if she's high enough from that food give 0.5 u. Leave out more of that food while you're at work. That seems the best of less than ideal solutions.
I just emailed work that I will be late, but after reading the new email from my principal, I don't feel like going in at all. I emailed back that I would be late, but that also, I was feeling harrassed. Maybe I won't go in at all today. He was supposed to do my observation yesterday and didn't and I'm sure he's going to claim that it was scheduled for today. Prick.
If you decide to stay home, try the 0.5 u dose. Test 2 hours after and keep high carb food out of the picture if you can.
Side note: Do you have in writing (email or text) that the principal was supposed to do your observation yesterday? If so--I'd try not to worry. Did he just no show up yesterday? I'm sure that is frustrating-especially if you planned for it.
Wishing you and Chloe a good day.
No, it wasn't on my calendar. The union rep is the other special ed teacher and she's part of the problem. I called the union, even though I'm not a member. I'm going to have to take a xanax now.
If you decided to give 0.5 u you can enter it in one of the BG cells on your SS at the appropriate time. We need to see it.
I just tested her at +4 and she's at 121. I'm going to give her .5 now and go to work. Somehow I screwed up my SS and the colors don't show. I'll ask tech to fix it.
You can manually colour it by using the little paint can icon in the SS tool bar. Please put in the dose in the appropriate time cell.
every time? I don't think so. I'm in the middle of a bunch of stuff and getting very frazzled. I put the time in the comments section, but that's not working either. It's 10:25 my time and I'm going to give her 1 unit. after I test one more time.
She's at 248 at 10:25 am and I just gave her 2.5 units. Now I can breath again.
When you are less frazzled we can help you adjust your spreadsheet to reflect accurately.
I'm not an expert, but did d you just tell us you're going to give your kitty a second dose of insulin in less than eight hours?
That's not safe to do.
Yes, you'll have to adjust Chloe's dose time or else give a tiny fraction.
No, when I saw she was over 200 in the morning, I gave her the full dose (2.5u). Problem is, I didn't know when to give her the PM dose. She's been eating for quite a while on and off, so I gave her the 2.5 at 7:45 pm, which is only about 9 hours after her AM dose. It may have been a bit of a fur shot because I was so hesitant. I'll test her again in a couple hours.
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