? NEED HELP FOR MEMBER WITH DKA KITTY TOLD TO SKIP SHOT

A newer member with a kitty just out of DKA has lower readings...no spreadsheet and was told by vet to skip the shot. Need some people with DKA experience to advise her:

http://www.felinediabetes.com/FDMB/threads/missed-dose.164078/

@Sienne and Gabby (GA) @rhiannon and shadow (GA)

Member is on FDMB FB page looking for advice. Vet has also said not to bother testing for ketones at home

 

Thank you!!!

 

You are welcome. I asked if you could post some of your numbers on your other thread. http://www.felinediabetes.com/FDMB/threads/missed-dose.164078/

This would be very helpful to help with dosing advice,

 

BUMP

 

@Doodles & Karen do you have any experience with DKA?? @Bobbie And Bubba

 

Telling us to skip another shot......I'm arguing, but they're telling me not to shoot that low........I don't know what to do :'( :'( You guys are telling me not to miss a dose, and they're saying miss another.....so upset :'(

 

Can you post some numbers Becky?? What was the preshot last night? What is the current number...make sure your kitty has not eaten for at least hours to give an accurate preshot. How long is it since the last shot? A vet who says to skip 2 shots with a kitty who has just recovered from DKA is risking another DKA episode happening. We really need more information to give you some advice.

 

You could check back with your vet and ask about a small token dose. Ask them if they will cover the expenses if your kitty has another DKA episode because of not having insulin.

 

I don't have experience with DKA but do know that "some" insulin is much better than "no" insulin and kitty also needs to be eating. Sorry I can't really help on advise.

 

Vet wants to see him....of course.......another 25 mile trip one way down a windy mountain road.....so stressful for him.......she said to test him again tonight, if under 200? don't shoot.........now I'm getting mad.........who do I listen to? What do I do? This is a roller coaster ride that I'm not liking much It's a really good thing that I love our animals like I do.........but I can see why some people give up.......so many opinions and advice from so many different directions.....I'm totally lost right now because of it...

 

The normal no shoot number would be 200 on a human meter. However with having just recovered from a DKA episode that changes the usual protocol. If you have been giving 3.0 units that would definitely be too much. However a small dose...trying to see what would be best...would have some insulin on board at least.

Can you please let us know...what type of meter you are using and some of the other glucose readings you have been able to get as I asked on your original thread. Also do you have lots of strips for testing and how long are you able to monitor and some high carb food and syrup on hand?
Thanks

 

We are using Alpha Trac II........we were using Freestyle Lite, which failed, and is why we had the DKA episode to begin with......he was in the mid 300's since we brought him home...Thursday, Friday, Saturday, Sunday.....then Monday night he was 250....we still gave 3 units.....then last night he was 150.....called the vets office and they gave us instructions to test again in 30 minutes, and call back......he was 178......she said to skip the dose for last night, and test again this morning.....he was 142 this morning.......he is eating less than normal, but he is eating....he's drinking......more or less? seems pretty normal to us, but we also work all day and he's home with the other fur babies.......

Always have gravy food on board, and always have karo syrup........

 

I did ask that question, when I was on the phone with them.....that's when they decided that we needed to make an appointment....

 

Just to summarize..

PMPS 150
Retest 3o minutes later 178
AMPS 142

Did you fed him since the preshot test and have you done another retest?

 

posted the #'s below.......he is eating, he is drinking.....we can actually see an improvement every day that's he's coming back......It's been 24 hours since he's had any insulin....

 

What is needed is to continue monitoring his numbers which you are able to do at home. Also the numbers at home will not be affected by stress the way they are at the vet.

 

We did feed, but have not retested........we are all at work now, and can't test again until lunch

 

How long after the morning test will it be at lunch time?

 

Also how long has Ruckus been on Prozinc and what was the starting dose?

 

Since you are at work and couldn't give the shot anyway, my suggestion would be to test about an hour before your usual shot time, without feeding Ruckus and post your number. There should be more people on at that time and we can try to figure out a dose if it is safe to give. As far as taking him to the vet tomorrow, you can do your own testing at home. You said on FB that you had ordered ketone testing strips. That is definitely something you should be checking after a DKA episode.

 

The morning test was at 6:30, and we'll test again at 12:00.......

 

Strips will be here tomorrow...

 

It will be 3 years in November.....original dose was 2 units twice a day.......but there were so many things no one ever told us.....we weren't testing at home....we almost killed him by not testing and shooting blindly....so we don't do that anymore.......he was in remission once for 6 months.....this was his first bout with DKA......only spent 1 night in the hospital and then he's been home a week tomorrow....

 

Thank you for the information. First it is great that you decided to home test. That is one of the most important things anyone can do for their kitty. Once a kitty has had a DKA episode it is more important to test for ketones since they are more prone to a reoccurrence if they are not eating well... if they are not getting enough insulin..if there is an infection...any combination of those three puts a kitty at greater risk.

There are a few people who are very experienced with Prozinc and there are different dosing options that can be used with Prozinc, because it is an "in and out" type of insulin. If you have time when you are home setting up a spreadsheet to show your test results would give a much clearer picture on how Ruckus is responding to the insulin. Prozinc can also be given on a sliding scale, which depends on both the preshot number and the nadir (lowest number of the cycle), but you would need to have more data available for the experienced Prozinc people to advise on that.

Here is a link to setting up a spreadsheet:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

If you need any help getting it started ( I sure did), just let us know and there are a couple of "spreadsheet gurus" that can get it set up for you in no time at all.

Once you have the S/S set up and filled in the picture will become clearer as to what the best approach will be to keep Ruckus safe from both DKA and hypos.

 

Becky...I know it's hard to trust a bunch of crazy internet cat ladies, especially when your vet is telling you something different, but please listen to the crazy cat ladies in this instance

When there's a DKA in the picture, it's vital that Ruckus get insulin....maybe not 3u but he must have some.....even if that means feeding a higher carb food to keep him safe

Vets only get 5 hours of "formal" education on diabetes when they're in school....and that covers all species of animal, not just cats....unless your vet just happens to have a special interest in feline diabetes, they probably don't get much in the way of continuing education on the latest treatments. The people here do nothing but deal with FD and the complications that come with it....and you'll see people here who've had many years of real life experience with treating their sugarcat

The people here are so dedicated to helping others that many of them remain on the message board even after their own cats have "Gone Ahead"....If you see GA next to a name here, that doesn't mean they're from Georgia...it means their kitties are waiting for them at the Rainbow Bridge, but they are still here, trying to help another

I've posted in the ProZinc forum and hopefully some of the people using your insulin will come along to help guide you, but I can assure you, it IS important that Ruckus get insulin

Sending lots of virtual hugs for you and your extra sweet Ruckus

 

Thank you I said the same thing to my son about giving him extra carbs to get the #'s higher to give insulin.....

 

My son is going home now to test him again......and depending on the #, we will either feed him a gravy food to raise the #'s, so we can give a little insulin, or we will feed regular food, and give him something.......maybe 1/2 unit....or 1 unit...depending on the read.....I will post on here I can't tell you how much I appreciate the feed back....and my son and I both agree that we will listen to the crazy cat ladies in this instance, because we do agree with you...it's what we've been saying all along.....but not what the vet is saying...

 

Replied here on this thread: http://www.felinediabetes.com/FDMB/threads/missed-dose.164078/#post-1765992

 

Becky...if you decide to shoot insulin at lunch time, how will that affect your schedule for shooting? You should be spacing the shots about 12 hours apart and if you shoot at say noon time then you would need to shoot at midnite and still do some monitoring. It might be best to wait until the normal evening time to give a shot. You can test before shot time and post on the forum to get some feedback.

 

I agree. Unless kitty is really acting off, not eating normally, lethargic, sky-high BG numbers, etc... I'm not seeing an urgency to shoot at lunch time.

 

just tested.....he's 150....not going to shoot at lunch.......will test again at lunch, but we'll wait until his pm testing and feeding to decide if we need to shoot.....trying to combine all of the help with the circumstances......he is acting so much better than he was a week ago...he's not lethargic....he's eating, he's drinking...he's purring...he's attentive.....a pest not at all like he was last week when he was so sick.......

 

We are only going to test at lunch....not shoot......will wait till normal PM time to make that decision.....I will post his #'s tonight thank you!!

 

No need to give insulin right now...his numbers are OK and it would put you on an impossible shooting schedule...it's OK to wait for this evening

Can your son usually come over during the day and get a mid-cycle test? That would be so helpful!

 

From your other thread: http://www.felinediabetes.com/FDMB/threads/missed-dose.164078/

Your plan makes sense.
In the mean time, if there are any changes (won't eat, acting sickly, hiding, sky-high numbers, etc) grab some ketone sticks from any pharmacy to test for ketones. They run about $10 - $15 and are worth their weight in gold!

 

Chris asked me to come look at your thread as you use ProZinc. We put a protocol together that is in my signature in blue; it may be helpful. The cycle today is in good levels especially as you are using a pet meter and I agree there is no need to consider a shot.. I would guess he will slowly rise and hopefully be high enough to give a little insulin tonight. Clearly 3 units was too high a dose.

 

Not usually, but sometimes......it depends on where he's working....sometimes it's easier for me to get away......I'm usually the one that goes and feeds at lunch, and I can test then....we're done with work by 4, and we can check then also.....

 

You won't regret it, Becky! These crazy internet cat ladies know their stuff .

 

We have some crazy internet cat guys also.

 

Ruckus is back to 297.....giving 2 units instead of 3......and we'll test keytones as soon as the strips get here tomorrow......not taking to the vet, unless keytones are high...planning on doing curve Saturday....our first one.....

 

@Becky Smith ...now that things are a little calmer, it would really help if you'd go ahead and get our spreadsheet started ....Here are the Instructions for setting up the FDMB spreadsheet again....if you have any trouble, let me know....I can set it up for you in about 30 seconds. You'll need a Google account or an email addy registered with a Google account

It'll also help for "next time" if you'll go ahead and fill out your signature. Just go to the top right and click on your sign on name and choose "signature"...a new box will pop up for you to enter some information in so we don't have to keep asking the same questions over and over again.

Important info to put into the signature is Your name/cats name, age, sex, date of diagnosis, type of insulin, type of meter, type of food, any other health issues? and maybe a general location

When you get your spreadsheet set up, the link to it will also go in your signature so if you need help from us, we can take a look at how he's been doing.