Help needed in NYC - will pay

Thanks to everyone who has steered me in the right direction with my cats' new diabetes diagnosis. I want to take him home now instead of leaving him at the vet all week. So many people seem to think it isn't helpful to keep him there and add stress.

What I really need is an experienced person in the NYC area to visit us at shot time for the first two days that he's home and show me the ropes with insulin and blood draws/metering.

I will pay for your time.

I live in the east village if anyone has any suggestions.

thanks!!!
sara

 

What are you doing now?
Do you have a meter?
Do you know how to home test?
What are the Bg's?
What insulin are you using?
What kind of food are feeding?

We do have NY folks.

I will contact one to see if she may be able to stop by, I think she works downtown somewhere (she lives in Queens). But keep in mind, typically when someone comes to help, it's to help you get set up and feel comfortable about testing and shooting. Not many people will be able to come by twice a day and for several days.

I've helped out several people and it's one visit and stay as long as needed to get the person set up.

 

Thank you so much - we're actually doing well over here under the guidance of Dr. Lisa Pierson. I am testing several times a day in an attempt to learn how he is metabolizing the insulin and determining nadir. We are on lantus and have been shooting a "skinny 2" for the past three cycles. And for the past two cycles, I've been spacing out 250 calories daily - mostly Merrick wet with a bit of Weruva wet.

If you can suggest anything I could be doing or looking out for, I would be grateful.

Unfortunately I tested with ketostix and it detects "trace." I don't know exactly what this means but I don't like it. I will find out more about this later today when I chat with Dr. P...

Thank you Hillary.

Kindly,
Sara and Stinky

 

That is good news that you are working with Dr. Lisa. She's great!

The trace ketones is something to watch for to make sure it doesn't become more serious and lead to DKA - what you can do for now, is add a lot of water to his food. You want to flush them out and fluids (sub q) is one way - but I am not qualified to advise on that, in the meantime, you can do it the old fashioned way, but making him drink - syringing water or adding extra to the food.

And making sure he eats/laps it all.

If you need any further help - I work in midtown (live in NJ). I'm sorta local. ;-)

 

Hillary...

Thanks again! Glad to know that I have some support in the 'hood. I think I will try some water in a syringe now, since he hasn't been drinking much... although I know the juice in his canned food may be reducing his need to drink from the bowl... I gotta get rid of those ketones traces though! Should I be testing with ketostix as often as possible?

thanks,
Sara

 

Yes you need to test often because you don't want it to escalate. Otherwise you may have to take him to vet or er vet for treatment.

Syringe water him and add extra water to the canned food. What I do is add anywhere from 1/2 - 1/3 can of water per can of food.

A cat I took care of really liked it so I used 1 can of water to 1 can of food. It may sound extreme but if he will est it so what.

When they esat primarily wet food they do tend to drink less water. And if u add the mounts I add, mine rarely drink from the water bowl anymore. They still pee a storm .

Also go back to your original message in this post and change the subject to trace ketones to get more eyes and advice. Or start a new post with that subject. You need to get more input from others with this experience. To guide you. .

 

So what numbers are you getting on the Lantus?

How is his appetite? Is he eating well?

I wonder if he is battling an infection which could be contributing to the trace ketones.

Nice that you are consulting with Dr. Lisa. She has been such a help on this board for the last five years.

 

Hi Sara,

Nice to meet you.

I have the world's most ketone prone cat, Alex. I'm petty used to testing for ketones and reading the ketostix and what I've learned..and this is big, is that often a negative and a trace reading can be confused depending on the light that you read it in. Your kitty's numbers are pretty good today. Very good as a matter of fact. You have a few high ones mixed in, but normally (and I say that emphatically because Each Cat Is Different) a kitty has to have pretty high numbers for at least a few hours in a row to have any ketones going on. I see no reason why your kitty should even have any ketone activity unless there is some strange residual from 3 cycles ago(at THAT time I wouldn't have been surprised to see trace ketones).
When a cat has had trace ketones and is back to low numbers, you CAN sometimes see them when you get a urine sample because it takes hours after the cat is no longer producing them for them to actually leave the body("lag time" is what I was trying to say before and just thought of it. Excuse me but I've had a bad headache all day)!. So you can still see them on a ketostick even if the cat really doesn't "have" them anymore. That's also something to remember. ....although 2 or 3 cycles later would be unusual :?
I've only been using 'trace' ketones in my post to you because if you ever see anything that looks like it's above that, you shouldn't try to handle it yourself, you should get to a vet as soon as possible. The only treatment for trace ketones is insulin, food and water. Your kitty needs all 3. That's why this is tricky stuff and if anything seems out of whack(appetite or anything), you still should go to a vet. If your kitty is getting all 3 of those things, he should be fine. And as Hillary said, it can't hurt to soup up his food with some extra water.

Hope I've helped at all and if you have any questions other than those that Dr. Lisa is far better equipped to answer...please feel free to shoot me a message :razz:

Caryl

 

Thanks for chiming in Caryl - I knew you would be able to answer this question easily.

Sara - what Caryl said regarding ketones and treatment. ;-)

 

AND.................... you need to read at exactly the times stated. longer and you could have a false positive. good way to check if it is actually a trace after read the correct number if seconds, is too dip on in a glass of water. sometimes trace can be very hard to read in the lighting

 

Thank you all very much. Are ketones something that come and go all the time with diabetes? How often should I be testing for this? Frustratingly, by the time I know he's urinating, he's done by the time I get there.

Stinky's appetite is really good. I've got him on a 250 cal/day diet of Merrick and Weruva wet food and he has adjusted to this change immediately. He's eating it all in the form of many small meals. Hillary - that's a super idea to add water to the food. I'm gonna try that. Pamela - the lantus numbers, duration, time and number of nadir are all over the place with each cycle. If you want to take a look at his chart below the sig line, feel free - I can use all the advice and explanation I can get : ) And Caryl - thanks for your input on the nature of ketones and reading the result. I hope Alex is ketone-free at the moment.

Thanks again.

 

Sara,

This is a good meter to have to test blood ketones - so you will know before they show up in the urine and become troublesome.
http://www.abbottdiabetescare.com/adc_d ... 000078.htm

The strips are very expensive, so, look for them on ebay or on the canadian pharmacy sites for best deals. If you buy them, make sure you are buying the blood ketone strips and not the glucose strips - because the meter will work both ways, but takes different strips/calibration sticks for each function.

It really should be in your toolbox for a ketone-prone kitty.

Best,
Pam & Layla

 

I'm on the UWS so a little out of the way, but would be happy to talk if you still need. Just send me a private message.

best
martica

 

I just ordered this on Amazon - great tip

 

Sara - check out e-bay for the Precision Xtra ketone strips. They are WAY too expensive retail (and generally have to be ordered).

 

Hi again Sara,

Ketones really aren't that random and the good news is that you're home testing! you'll start recognizing when to be looking for them. On a day like today you really have no need to test Stinky at all. A cat that is staying at under 300 usually won't develop ketones (I'll say 275 to be very very safe even though I wouldn't test at that number). If at the beginning you feel like testing once a day go ahead, it can't hurt, but don't go nuts with numbers like this. It's a waste of money.

Ketones don't develop 'just because'. There has to be something that's causing an insulin deficiency (such as a fur shot, an incorrect dose, an infection, cortisone interference..things like that) that are making a cat's bg go higher as well. You'll know this is happening when you see his numbers start to go up. I have one of those meters you ordered as well and I very rarely use it. I go through a box of 10 strips in about 3 months because of 1)the expense 2) it's not as accurate as the urine strips. The meter is very accurate for telling you IF ketones are present..but for knowing the degree (trace, small, moderate, large), the ketodiastix- which also give you the glucose count are the best. I have had discrepancies between the two(meter and urine) side by side several times which isn't a good thing...so I RELY on the stix for accuracy. But looking at Stinky's chart, it doesn't look like he has ketone tendencies? At least not now, although with any diabetic it's a good habit to get into testing for ketones so this is good! Good for you :razz: Has he had them before? Is there a reason for your concern? His response to Lantus seems really positive, even though he is all over the place...he's all over the place with decent numbers for the most part.
I predict wonderful numbers for stinky within a short time..by he looks of things

Thanks for asking about Alex. He doesn't have any ketones right now...but if I look at him the wrong way, that could change. That's my boy :lol: :lol: :lol:

Caryl

 

Great 411 Caryl. Thanks. I don't really have any sense of whether or not to be concerned for ketones - I am just being overly-proactive right now and trying to nip as much as I can in the proverbial bud. The sooner I get diligent, the faster Stinky will get well.

 

you are doing just fine and I see you are now on lantus board too. You will get lots of help with the dose and bg's there.

it's always good to be over-cautious, and if you want to test daily with the ketostix, they are cheap enough and it's easy enough to test that way.

Since you ordered the keto meter - since the strips are $$, you may want to reserve its use for when you have reason to be concerned.

Caryl knows what she's talking about with ketones, as Alex gets them and Caryl can smell it before he shows signs on the ketostix.

So, just take a deep breath and try to relax, there is a lot to learn and you have come a very long way in a very short time.

 

my vet said that not everyone can smell ketones. Some people can never smell it, and others can only smell the acetone-ish odor when it's strong. Apparently it's a physical capability to distinguish those particular molecules. Fortunately she is extremely sensitive and can smell ketones very early on.

laur

 

No, it is not something you have to be constantly testing for but in the beginning when your kitty is unregulated it is a good idea. I rarely test Tigger but if he were acting like he didn't feel well and his numbers were higher than usual, I would be testing his urine to see if there was any buildup. It is hard to say. Some people prefer to test more often than others if their cats have been known to get ketones building up in the past.

Great that his appetite is so good. That is important.

As far as his numbers, yes, they are rather up and down which says to me that maybe, possibly, he has a low grade infection. Of course Dr. Lisa has his bloodwork so she would have noticed something here I am sure. Maybe his teeth? How old is Stinky?

You might want to do a profile so everyone can see a history on Stinky. The instructions are in the Tech forum.

BTW ketones in most cases develop because of a lack of insulin which can be brought about because of an infection driving up the numbers, a lack of food because the cat feels lousy so just doesn't want to eat, gets dehydrated, stressed out and so on. A trace doesn't always mean anything or it can mean something. But he is eating so that is good and he is responding to the insulin and coming down at times which is good.

Try not to worry. You will get the hang of all of this. Nice that you are going to be home the next few days to monitor.

 

Thank you Pamela. I actually did try that profile thing, but failed both times to figure out how to link the info to my signature. Oh well.
Alternatively, I put pertinent info in the upper-right quadrant of the spreadsheet.... Hopefully this will be good info for anyone who I ask for
opinions and assistance on Stinky. Thank you for taking the time for your thoughtful reply.