Poncho diagnosed diabetic 1/15

Discussion in 'Feline Health - (The Main Forum)' started by christoph, Feb 5, 2015.

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  1. christoph

    christoph Member

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    Feb 2, 2015
    Hello. Poncho is 14 1/2 neutered male Tabby I've had since I rescued his litter at 3 weeks old. His food has been mostly premium dry food with a spoonful of wet x2 daily and he has been a grazing cat. I took Poncho in due to little appetite and rapid weight loss and the sniffles. I noticed this right after my oldest cat, who he was close to, died of old age Jan 1.....and like an idiot I thought he was grieving. He was diagnosed diabetic with possible pancreatitis. Since diagnosis his appetite was a problem but was immediately switched to canned food. Starting out he was put on IV fluids for 1 1/2 days and sent home with Prozinc @ 1 1/2 units x 2 daily. Unfortunately I was never made aware that a certain food he had a taste for was never sent home with him and I struggled to feed him for 4 days until I had to get him back in due to me not being able to get his appetite up and he was very lethargic. During those 4 days I talked to 2 other vets there who were on duty and they just advised warming his food or sprinkle cheese on it and either don't give him insulin or give him 1 unit depending on the BG reading (using Relion Confirm)......no mention of the food the original vet wanted him to go home with. During this time Poncho never vomited but they said his initial bloodwork before the IV treatment showed trace ketones. Anyway they did an ultrasound 1/20 and his pancreas was inflamed and he had some lipidosis so put him back on IV and 3 day pain injections for 4 days and I visited 3-5 hours per day to keep his stress down and he seemed to eat better with me feeding him. During this time mucous formed from his left eye and I was told it was probably due to stress. Saturday at 2:30 he was sent home. I still had to struggle with the appetite issue and his BG was always between 350 and high 400s with a couple @ 155 and 167 (before I found this site). This went on for 10 days with his appetite picking up well but then I noticed on the 7th day he would be hungry but walk away after sniffing his food. He also started to show some nasal stuffiness and the left eye was showing mucous and sensitivity. I figured he couldn't smell his food (Friskies chicken, turkey pate) so bought some seafood flavor......he sniffed and ate well. I had to wait 3 days to see the vet again for some antibiotics and glucose curve. The night before I took him for his 1st curve his BG was379. The next morning before I took him it was 60 so I rushed him in. They said he was hypo and had an upper respiratory infection and proceeded to do a curve after force feeding......no success. They said said my meter was way off up and down compared to theirs and they were stumped due to erratic and low readings. Sent him home again and said no insulin and would try the curve 1st thing the next morning. He ate fine that night and before I took him in next day. When I picked him up the vet said she had the same problems. His morning preshot BG was 379 and afterward next test was 166 then next it had dropped to 37. She said he needs to see a specialist or consider euthanasia. I said I'd prefer to let the antibiotic take out the upper resp. infection and then see what happens. She said no more insulin and to come back after the 10 days of antibiotics to try a curve again unless he crashes again then I guess that's it. I think his pancreas is trying a come back but the infection a a big monkey wrench. Anyway I might drive Poncho 250 miles back to his old vet in St Louis who treated his sister for diabetes successfully. I'm waiting for him to call me back. Does anyone here have any ideas on this.....it's stressful and confusing as heck. Thank you. Chris


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    Last edited by a moderator: Feb 11, 2015
    Reason for edit: Removed 911 icon. New thread started.
  2. dirtybirdsoaps

    dirtybirdsoaps Member

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    Welcome to FDMB,

    It seems your on the right track. Its always tough trying to treat different things because they all play there own part. First things first is to get rid of that infection, infection raises bg. Your vet is saying the numbers are off because they use a pet specific (most likely) meter. A lot of vets seem to be against human meters. This is a difficult thing because of the ketones. If it wasnt for the ketones, IMO i'd say give the antibotics a few days to do its thing and find a food that he'll eat thats low carb and no dry food. Stress, infection and diet can drastically raise bg. You may also want to try to do a curve at home, theres really no need to take him to the vet to do a curve. All it does is stress him out and raise his bg (especially if their trying to force feed him) not to mention cost you more money. As to the appetite, you can ask your vet for fortiflora (you can also buy it online as well), it can help or you can try something like bonito flakes or even tuna juice.

    Hopefully someone with DKA experience will pop in soon to give some advice about dosing.
     
  3. phlika29

    phlika29 Well-Known Member

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    Sep 14, 2014
    Hi and welcome

    Have you seen the IDEXX article on managing pancreatitis.

    https://www.idexx.com/files/small-a...pec-fpl-treatment-for-feline-pancreatitis.pdf

    One of the supportive meds that I have found the most useful is not an appetite stimulant as mentioned in the article but an anti nausea medication such as ondansetron or cerenia. An appetite stimulant can also be given but you also need to address the nausea. Could you just phone and ask for the vet to prescribe it without having to go back in.

    I am not sure that leaving off the insulin is the best thing if he has ketones? But perhaps I misread that.

    When was his last insulin shot ? What is his reading now? Did the vet not suggest lowering the dose rather than just stopping?
     
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  4. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Hi Chris, and welcome to FDMB.

    It sounds like you and Poncho are having a tough time of it. (Big (((hug))) to you).

    Are you monitoring Poncho's pee for ketones at home? (Sorry if I missed that bit). You can get Ketostix or Ketodiastix (or equivalent) from a pharmacy. They are to be dipped into fresh pee. (Oh, what we do for our kitties....:rolleyes:)
    Here's a page of pics and info about how to do that:
    http://www.sugarpet.net/urine.html

    Regarding the steep blood glucose drops after insulin, it may just be that the insulin dose was too high for him. Some cats only need small doses.

    Keeping fingers and paws crossed that things improve soon for your boy. Please keep us updated.

    Best wishes,

    Eliz
     
  5. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    That low number post-shot automatically earns a dose reduction of at least 0.25 units. You'll have to eyeball it as no syringes measure quarter units.
     
  6. christoph

    christoph Member

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    Feb 2, 2015
    Thank you all for your prompt helpful replies. Before I took Poncho home last night he was given cerenia and a B12 shot. The last few days his appetite has been much better since I started giving him fish flavored pate instead of chicken (no dry food for 2 weeks now). I think the smell cut through his sinus issue. He hasn't had any issue with vomiting and his BMs have been normal (solid). The vet made no mention of home testing for ketones. I'll ask about that tomorrow. I did get a call back from my old vet and he said to continue with the antibiotics as prescribed and give sub cutaneous fluids (the other vet is going to have that ready to pick up tomorrow) and in a couple days test his BG again. He thinks he might be transient with the diabetes. This infection is complicating things and if need be my old vet said to make the drive and he'll check him out. He is sneezing less and his eye is better tonight. I'll update as we go. Thanks again......great site!
     
  7. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    You can test with urine test strips; you don't need the vet's permission. You get them at the pharmacy; they may be behind the counter.
    It is helpful to make sure there are no ketones. They form as a by-product of fat breakdown for calories. Too many ketones may indicate diabetic ketoacidosis (DKA), a potentially fatal, expensive to treat, complication of diabetes.
    See my signature link Secondary Monitoring Tools for other assessments which may be helpful too.
     
  8. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Glad to see that Poncho got a B12 injection. It is very much worth following the IDEXX recommendations to have a course of B12. They really help with pancreatitis.
     
  9. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Pancreatitis can interfere with normal GI absorption which results in less vitamin B-12 being absorbed. That is why a B-12 injection helps; it by-passes the GI tract and goes right into the body.
     
  10. christoph

    christoph Member

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    Feb 2, 2015
    Tomorrow I'll pick up the test strips for ketones and get started on that. When I pick up the fluid bags/needles I'll get the BG numbers from the curve attempts and comparison numbers with their meter and my Relion so I can start testing again with some reference as a guide. I hope I didn't buy a "lemon" meter. I don't like the idea of stopping the insulin if it's needed and if I get a high BG reading the vet will have to ok at least .25 unit I would think. Unfortunately she wont be there so one of the other vets will have to ok resuming insulin. Seems like a "catch 22". For 2 weeks I've been giving 1 1/2 units and only until Tues and Wed was there a sharp post shot BG drop. I hope his next BG is in the normal or low/safe range. Thanks BJM for the very informative links.
     
  11. christoph

    christoph Member

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    Feb 2, 2015
    First thing this morning I noticed Poncho straining in the litter box to go so I called the vet clinic and they said to come get the fluids right away and after fluids and syringe feeding ad critical care he should loosen up. I don't think it is urinary since he went last night a good amount but last BM was Wed night. I'm having them fax all lab work and vet notes to my old vet in St Louis and asked his office to have him review it all and if he thinks he can work with Poncho I'll get him there Monday am. I just have to get him out of the current mess and I want to still test his BG but they said his BG on my meter was up to 100 points higher AND lower than the reading on their meter, so I guess I can still test but will have to consider that the reading could be 100 pts either way and if its lets say 400 I could safely give him .25 - .5 units? I still have to get the ketone test strips later today. Any thoughts? 5pm: Ok got the test strips. My old vet asked me to have the clinic do a BG on Poncho to see where his level is after 2 days and they seemed not to want to do anything else for him.....see a specialist or euthanize him is their view. Probably has a little to do with the fact I'm low income on a disability pension and they don't think they'll ever get paid.....which is wrong. I syringe fed earlier and gave fluids. He did leave a marble sized piece of poop but threw up a little of the ad food I had just given him. I got some MiraLax so will put some in his syringe feeding food. I called the clinic again and they'll do a BG in the morning (reluctantly) and then call my old vet's clinic and hopefully another vet will be able to guide me since Sat is his day off.....great timing! Starting to feel hopeless about this.
     
    Last edited: Feb 6, 2015
  12. phlika29

    phlika29 Well-Known Member

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    You are doing fine. Don't lose hope. We can help you also.

    Were they using an alphatrak meter? These are feline specific ones and do read different from the human ones we use here but that isn't a problem. I think they have gotten a little confused or confused you

    You are using a relion confirm aren't you? They are usually fine. Perhaps others using it can comment on whether they have found their readings off but I haven't heard mention of it. Meters are only meant to be a guide rather than complete accuracy but you did the right thing, a quick drop is entirely possible if the dose is too high.

    If you want to take a reading in the morning when you would normally give a shot or whenever you want then post here asking for advice on dosage. I am sure we can help. I do think that if he high then a small dose might be advisable as long as you are able to monitor and have the high carb gravy, honey or karo to cope with a low. The trouble with taking him to the vet is that his blood glucose will go up anyway. What is he reading now?

    Have you read the prozinc protocol? Their suggested starting dose is 0.5 to 1 unit. I just wonder if your starting dose was too high.
    http://www.felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.109077/

    If you want advise once you take a reading then I think you should change the title of your original post by going back to the top and editing the thread. Change it to prozinc dose advice now required or something similar but I agree with you if in the 400 or even lower then I would give the 0.5 dose.

    The miralax should help him go. It might take a day or two. I used to give 1/8 teaspoon per day or even twice a day in food or water.
     
  13. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    You are questioning your meter, so you may find my signature link Glucometer Notes enlightening. It includes feline-specific reference numbers for human glucometers. You may want to share it with your vet.
     
  14. christoph

    christoph Member

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    Feb 2, 2015
    Yes, phlika29, I'm using the Relion Confirm. He hasn't had insulin since Wed when they tried the 2nd curve with no success. When I took him home that night the vet said no more insulin.....she had given him 1 unit when the drop occurred. They started him off with 1 1/2 units twice daily, which he's been getting for over 2 weeks until last Monday night when Tues morning BG was 60 on the Relion after 379 the night before pre-shot @ 1 1/2 units. I'll post the chart on his BG and injections since his stay in ICU. I just syringe fed him with the ad and 1/8 tsp Miralax and 1/4 tsp or less olive oil. Right now I'm waiting for him to pee so I can test for keytones. Should I do a BG test tonight or wait for morning here....I agree taking him to the clinic will be too stressful, hence inaccurate even with their meter (don't know what brand) and not feeling that welcomed since they threw the towel in. He's had a stressful day and I still have to syringe feed him again, unless he eats enough on his own, so his BG will probably be elevated due to that, however I would like to get a reading and insulin in him if needed. I'll edit my title after I test BG and keytones. Thanks for your help and encouragement.
     
  15. christoph

    christoph Member

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    Feb 2, 2015
    Thanks, BJM. Looks very useful. I'll see if I can email it to my old vet.
     
  16. phlika29

    phlika29 Well-Known Member

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    Sep 14, 2014
    I would do a test tonight and one tomorrow. The more info the better at this point. Just make a note of when he last ate in relation to the reading. If you could list them all out that would be useful. List the tests, the dose and whether he was at home or at the vets.

    You want a dose that just helps support his pancreas without it dropping too low. He needs to be eating and drinking as well. If you have to assist him with that so be it. My one concern is that the cerenia injection will wear off soon and if he is still feeling sick he may stop eating. Carefully syringing water into him will help a little (or sub q's) and help ward off ketones but you ideally want to continue with an anti nausea medication. Can you get so e tablets off the vet to see you over the weekend without having to take him back in?

    If the ketones show anything over trace amounts you will need to take him back to the vets as it can become dangerous very quickly. As I mentioned before to help ward ketones off you need to ensure a cat has enough water, food and if required insulin (hence the need to continue to monitor blood glucose).

    Just be careful with the olive oil. Some cats with pancreatitis can be fat sensitive. I would just stick to miralax from now on.
     
  17. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    If your vet has internet access, just send the link.
     
  18. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Hi Christoph,

    I am so sorry that these particular vets are behaving that way towards you. I've been in a similar predicament and it's horrible for you and Poncho to be treated like that. I think it's awful the way some people automatically assume the wrong thing, and where they are so focused on dollar signs they lose sight of compassion.

    (((Christoph)))

    Thankfully you've found FDMB, and there are some very knowledgeable people here who will help you and also there is so much you can learn here to help your kitty. In spite of the questionable response you're getting from your current vets, you're not alone with this, OK? :)

    Re anti-nausea support, Sarah's advice is spot on.
    .
     
  19. christoph

    christoph Member

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    Feb 2, 2015
    His keytones are very high -80- so I'm taking him to the er.....I'll have to say good bye to him since I don't have the funds anymore esp with the er prices. Any other suggestions before we take off? I'm at a loss.
     
  20. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    I have so little experience that I have no direct advice to give you. My heart aches for you in such a predicament. (((Christoph and Poncho)))

    I do have one bit of advice, though. Post a new thread and choose the prefix 911. Put a title like "Ketones High and Worried about ER Tx Costs - Please Help". Maybe some of the members with experience of ketone problems might be able to offer valuable advice.
     
    Last edited: Feb 6, 2015
  21. Critter Mom

    Critter Mom Well-Known Member

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    I've posted on one of the other boards asking for help, Christoph. I hope that you'll get replies here (or on a 911 thread if you create one). I'm so sorry that I can't do anything more to help you both.

    (((Christoph and Poncho)))
    .
     
  22. Linda and Scooter & Jack

    Linda and Scooter & Jack Well-Known Member

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    Nov 9, 2012
    He does not need to be euthanized because of ketones!!!
    Do not let them euthanize him. Bring him home and folks here will help.
     
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  23. christoph

    christoph Member

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    Feb 2, 2015
    I'll keep him here for more advice.I had just given him fluids and he urinated in the box on top of a sheet of plastic wrap so I dipped a strip and it immediately turned to a high dark color. Bg test was 378
     
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  24. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    What insulin do you have available?
    Looked up near top - you use ProZinc. Good. That is more flexible.


    How many blood glucose test strips have you got?

    Financial Help links
     
    Last edited: Feb 6, 2015
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  25. christoph

    christoph Member

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    Feb 2, 2015
    Prozinc 15 BG test strips
     
  26. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    What is his current glucose level? - 378 mg/dL about 11 pm Ohio Time
    When did you last give insulin and how much?


    Depending on his glucose level, you may need to give him some more insulin, along with the fluids you have to help flush out the ketones.


    Also, have you got a spreadsheet of his numbers in any format you can share?
     
    Last edited: Feb 6, 2015
  27. christoph

    christoph Member

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    Feb 2, 2015
    I just gave sub q. BG was 378 on Relion Confirm Last insulin was Wed afternoon @ 1 unit which caused a drop to 37. What dose .5?
     
  28. BJM

    BJM Well-Known Member

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    What did it drop from - the total drop for the dose is what I need.

    Ah - I snipped that into Notepad
    "preshot BG was 379 and afterward next test was 166 then next it had dropped to 37"
    - that was a drop of 342 points, if the testing equipment was lab equipment. If it was a hand held glucometer - human or pet - they are allowed to read +/- 20 % from what a lab would get.

    Yes, I would give 0.5 units of insulin now.
     
    Last edited: Feb 6, 2015
  29. BJM

    BJM Well-Known Member

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    How is he behaving? Eating, drinking, peeing, pooping, playing, purring, preening/grooming? He is more than a glucose or ketone number.
     
  30. christoph

    christoph Member

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    Feb 2, 2015
    The vet said curve preshot was 379, next BG was 166, 3rd BG was 37 He's lethargic....more than usual.....sleeping.
     
  31. BJM

    BJM Well-Known Member

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    Do you know if it was a lab machine that did the determination, or a form of hand held meter?

    That was a drop of 342 points, BUT:
    If the testing equipment was lab equipment, I'd think it accurate.
    If it was a hand held glucometer - human or pet - they are allowed to read +/-20 % from what a lab would get.
     
  32. christoph

    christoph Member

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    Feb 2, 2015
    I don't know, but when he was in ICU the techs used a hand held meter. They might use lab machine for curves
     
  33. christoph

    christoph Member

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    Feb 2, 2015
    Going to give him .5 injection. I'll be up all night of course to monitor. Shot given 10:45
     
    Last edited: Feb 6, 2015
  34. BJM

    BJM Well-Known Member

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    These are all the tests you've reported. Without specific times, it is a tough to see what is happening.

    "his BG was always between 350 and high 400s with a couple @ 155 and 167"
    - using glucometer

    "The night before I took him for his 1st curve his BG was 379."
    - using glucometer

    "The next morning before I took him it was 60"
    - using glucometer

    "His morning pre-shot BG was 379 and afterward next test was 166, then next it had dropped to 37"
    - could have been a lab machine OR a glucometer
    - This seems to be a curve, and if so, the tests would likely have been 2 hours apart. If so, we can list it like this:
    AMPS ~ 379; 1.5 units ProZinc
    +2 ~ 166
    +4 ~ 37


    Tonight: 378 mg/dL about 11 pm, No insulin on board
    - using glucometer
     
  35. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    If the curve they did was based on 1.5 units of ProZinc and that dropped him about 342 mg/dL, 0.5 may drop him in the ballpark of 100 mg/dL, although it doesn't follow the math that exactly.
    If you can test about every 2 hours just to see what it does, we'll get a feel for how he responds.
    This should help with the glucose and ketones a bit, and may perk him up. Recall how you may have felt after eating way too many carbs, if you every did that - lethargic is a common after effect.
     
  36. Marje and Gracie

    Marje and Gracie Well-Known Member

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    May 30, 2010
    Chris

    A couple things to consider:

    • If he's not eating and he gets insulin, his BG will drop. It doesn't necessarily mean the dose is too high. However, I have never used PZI and would not begin to offer dosing advice. It's critical to get food into him but you have to treat the nausea first.
    • Diabetic ketoacidosis is very serious and can be a fatal condition. It occurs when there is not enough insulin + infection + not enough food/water. If he's throwing ketones that high, he really needs to be in a good hospital that understands how to diagnose and treat high ketones and possibly DKA.
    • If he also potentially has hepatic lipidosis from a decreased amount of calories, it would be best to also discuss with the vets the possibility of a feeding tube. These cats need lots of fluids, lots of calories, and the right amount of insulin.
    Have you ever applied for Care Credit?

    I know funds are limited but if you can get some assistance through Care Credit, you could get him to an ER....which is where he needst to be. We've had many cats here survive high ketones, DKA, and hepatic lipodosis. With ketones that high, I'd want him in the hospital getting IV fluids.
     
  37. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Dec 28, 2009
    Treating any more than TRACE ketones at home is not recommended and is highly discouraged. Amongst other things, Poncho needs an IV treatment that includes electrolytes.
    Is there any way you can get him into an ER tonight?

    Sometimes a vet will work together with an ER by allowing the caregiver to hospitalize kitty over night at the ER and then releasing kitty to the vet for daytime care... returning again to the ER for treatment over night. This arrangement will help reduce costs.

    Tomorrow you could try organizations listed in our Financial Help Links.


    KETOACIDOSIS:
    DKA cannot be treated at home. Veterinary care for DKA involves intravenous (IV) fluids to flush the animal's system of the ketones and when necessary, to replace depleted electrolytes[19][20][21], such as bicarbonate; intravenous or intramuscular fast-acting insulin to bring the blood glucose levels down[22][23]; measured amounts of glucose or force feeding, sometimes by feeding tube, to force the metabolism back from fat-burning to glucose-burning.

    Dehydration becomes involved with ketoacidosis, which can mean that subcutaneous insulin injections are not properly absorbed; when this occurs, intravenous treatment with soluble, short-acting insulin is needed[24],along with rehydrating intravenous fluids[25].

    Veterinary care for DKA may involve a hospital stay of five days or more and cost, in the U.S., $2,000 or more. Some animals are DKA prone, and may have multiple episodes of the condition.

    Veterinarians have sometimes been known to send pets home from a DKA episode while still displaying ketones in the urine due to owner financial constraints -- this can turn into a fatal mistake. Your chances of fixing the problem yourself are slim. If your cat or dog comes back from the hospital and still has ketones showing on urine testing stix, it's usually best to find the financial means to go right back to the vet's as your pet may need to stay in hospital longer.



    Just thinking out loud...
     
  38. Marje and Gracie

    Marje and Gracie Well-Known Member

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    May 30, 2010
    And to Jill's and my posts, I'll add one other thing. The vets can give him the appropriate dose of a short acting insulin and they can give it more often than the PZI to help bring and keep the BG down.
     
  39. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Ketosis does not automatically mean diabetic ketoacidosis; you will need a vet to determine that with some blood work.

    Does his breath smell like vinegar or fruit? Two of 3 types of ketones may be detected by smell.
     
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  40. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Dec 28, 2009
    KETOSTIX.JPG

    When kitty is throwing "Large" ketones... noted by the caregiver as "high dark color", a vet should be consulted immediately if at all possible, no?


    EDITED TO ADD:
    In a diabetic, any urinary ketones above trace, or any increase in urinary ketone level, or trace urinary ketones plus some of the symptoms above, are cause to call an emergency vet immediately, at any hour of the day.
     
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  41. BJM

    BJM Well-Known Member

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    And I said you will need a vet to determine it by blood work.

    And previously stated on a different thread (there were about 4 of them) that having the vet determine what the condition was, was the 1st step.
     
  42. christoph

    christoph Member

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    Feb 2, 2015
    Can't do Credit Care. I have no established credit and my disability pension is only $1072 per month before rent etc. My SPCA vet bill so far is over $900 although they are letting me pay it $100 monthly. Time is not on our side for researching grants, etc. I'll pray and check BG every 2 hours and be at the vet clinic when they open and see what they want to do which more than likely euthanize. They had already given me 2 options....a specialist clinic, which I can't afford, or euthanasia. I guess they were right but I thought Poncho was getting better until the curve attempts and I thought the drops were his pancreas starting up.
     
    Last edited: Feb 6, 2015
  43. BJM

    BJM Well-Known Member

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    Last edited: Feb 6, 2015
  44. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Poncho has large ketones and is "lethargic....more than usual.....sleeping" and not eating well. That's not good.

    I'm not there. I haven't talked to the ER. If you called them to explain Poncho's current condition perhaps they could work details out with you in the morning?
    I know, I'm grasping at any hope, but he really needs to be hospitalized if there's any possibility at all...
     
  45. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Where are you located (250 miles from the old vet in St Louis is quite a range!)?
     
    Last edited: Feb 6, 2015
  46. Critter Mom

    Critter Mom Well-Known Member

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    Hi Chris,

    How are you and Poncho doing?
     
  47. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Christoph, sorry, but I've got to crash. I'll check back when I wake up.
    Hoping this works out for you.
    If you're up, start a You Caring fund raiser online and if you have Facebook, share it everywhere. It may help you generate some funds to help with the bills.
     
  48. christoph

    christoph Member

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    Feb 2, 2015
    I've started a You Caring fundraiser but I'm still trying to get it finalized....not computer savvy.....I never knew that type of thing existed. Thank you for that link and help, BJM. I'm in Kansas City, MO.
    Critter Mom, Poncho's sleeping and I'm getting ready to check his BG again. I'll be up all night with him.....thanks and I'll keep updating. I'm going to look up an emergency clinic.....but my dealings with them in the past has always made me sick with their greed.
     
  49. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Positive thoughts and prayers are with you.
    Hope you can find an ER that will work with you.
    :bighug::bighug::bighug:
     
  50. christoph

    christoph Member

    Joined:
    Feb 2, 2015
    Thank you so much!
     
  51. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    Hi. I am up again now. I am not experienced in the way that BJM is but I will help where I can.

    So you have given some insulin and he has had some food? Now we need to try to flush out the ketones. You have been assisting with his water intake as well haven't you but not sub q's?
     
  52. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    @Meya14 has a lot of experience with DKA. she might be able to help
     
  53. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    I hope @Meya14 doesn't mind but i am going to quote her advice from other threads that I hope you will find useful. Obviously was was talking about cat but hopefully you will get the general principles of treating DKA.

    Is there a humane society vets near you that might be able to help?
     
  54. Meya14

    Meya14 Well-Known Member

    Joined:
    Jan 2, 2015
    Yes, at this point, your cat needs to be eating -every hour-, if this means force-feeding/syringe feeding, then that is what should be done. I don't have a lot of experience with prozinc so I can't give you dosing advice, but with the ketones you have, any reduction of insulin will cause the ketones to increase. If you have to add syrup to the food to keep his glucose up, that is better then reducing insulin. Test BS every 2 hours or so.

    A cat in DKA needs at least 6 oz of food - 1 large can (high cal/higher carb food - try kitten food) and 300ml or more of fluids each day. If the vet will show you how to do subQ fluids, you may be able to shorten the length he has to stay in the hospital if you take him in. DKA is very serious. If your cat does not get the calories, fluids, and insulin his health could deteriorate quickly. Start immediately with feeding and fluids.

    Other things he will need - ask your vet about:
    potassium suppliment
    anti-nausea medication
    pain meds

    Ideally, you need to keep the blood sugars below 300 without going too low. Use food to steer the sugars up if he starts to go low.

    For others on here.... what is the duration of prozinc for your kitties? Does anyone dose 3X a day in smaller amounts?
     
    Last edited: Feb 7, 2015
    Critter Mom likes this.
  55. phlika29

    phlika29 Well-Known Member

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    Sep 14, 2014
    For info the last reading tonight before insulin was 378 and he was given 0.5 units of insulin. Before that the vet had recommended stopping the insulin so none since Wednesday. Hopefully another reading will be coming soon.

    Christoph the main aim now is calories and water, even if that means waking him up and assist feeding. Are you able to do that.

    @Meya14 here is the prozinc protocol. It doesn't mention 3 times that I can see

    http://www.felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.109077/
     
    Last edited: Feb 7, 2015
    Meya14 likes this.
  56. Meya14

    Meya14 Well-Known Member

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    Jan 2, 2015
    If 0.5 units twice a day was the last good dose, then start there. You may need to increase once you get some food in him.
     
  57. christoph

    christoph Member

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    Feb 2, 2015
    I'm going to check BG again. He is sleeping soundly curled up on his side and looks very comfortable.....almost hate to disturb him. It seems like he has been slowly giving up through this whole thing and he has been so stressed out at the clinic.....never been away from me in his 14 years. Anyway he has gotten close to 300 ml of subq and I forced fed him the ad critical care food about 20 ml.....fought me the whole way..... and he ate a little on his own. I think the vet should have lowered the dose instead of cutting him off for good. That probably raised the keytones because he was beginning to eat better. I generally don't like or trust vets anymore.
     
  58. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    I am not sure that it was but the higher reading did cause sudden drops below 50 according to christoph. Without a chart it is difficult to know but I think we felt it was a good starting point. BJM tried to gather the info so far.

    @christoph do we have a latest reading ? How is the feeding going?
     
  59. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    I don't think the lack of insulin helped. Your vet probably doesn't have much experience of this. An emergency vet would probably have seen more cases. Now you have the info to know what to do then at least you can give it ago or advocate for your cat at the vet.

    It's great that you have got fluids and water into him. Testing his ear might not disturb him too much but you will need to get more food into him I think.
     
  60. christoph

    christoph Member

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    Feb 2, 2015
    I gave him his last .5 shot at 10:45 last night after BG@378. Last dose before that was Wed afternoon @ 1 unit and he dropped from 379 to 37 in 4 hrs. I'm going to try to feed him again after BG.
     
  61. christoph

    christoph Member

    Joined:
    Feb 2, 2015
    I was getting ready to post BG and shot history when I got the keytone reading, so shifted to panic mode. I'll try to get that done soon.
    BG @2:15 am 229 on the Relion Confirm. Will check again at 4:15 am Not hungry so will syringe feed.
     
    Last edited: Feb 7, 2015
    Reason for edit: convenience
  62. Meya14

    Meya14 Well-Known Member

    Joined:
    Jan 2, 2015
    Christoph,
    Stopping the insulin probably did contribute, also if there is infection that needs to get resolved. Your vet doesn't sound too confident in treating diabetic cats, there may be one in your area more experienced?

    You are doing a good job. Keep doing what you are doing, and maybe call your old vet in the AM and see if he can guide you or knows a good vet in your area? If you take him someplace inpatient, make sure they have treated DKA cats before.
     
  63. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    You are doing great. Please don't think I am trying to push you at all. I know you have your hands full.
     
  64. christoph

    christoph Member

    Joined:
    Feb 2, 2015
    Thanks Meya14 and phlika29. I really appreciate the help and so does Poncho. The vet in question dropped the ball twice before and I called her on it. Poncho has an upper respiratory infection I've been treating with 3 antibiotics and is better. I thought that might have messed up the curve because it was peaking at that time before antibiotics. The vet was made aware of some nasal sniffles when I first took him in but disregarded it then while in ICU had sniffles and left eye was oozing mucous and disregarded again. Phlika29, I don't think you're pushing me......you're very helpful and if you were pushing me I wouldn't mind.....it would help keep me alert in this chaos. Thank you. Will update again.
     
  65. christoph

    christoph Member

    Joined:
    Feb 2, 2015
    Here's the history. After diagnosis put on IV for 1 1/2 days, released with prozinc dose between 1 and 1.5 depending on amount food eaten. Had trouble with appetite.
    1/19 BG@10:45pm 390 bad appetite 1 unit
    1/20 recheck BG@2:45am 205
    1/20BG@10:30pm 364 1.5 units
    1/21recheck BG@ 2:50 AM 155
    1/22Starting to crash. Put in ICU ate ok with regular insulin 1-1.5 units I assume
    1/24 BG@8:30pm 155 1.5 units (Before I found this site)
    1/251.5 units@9:00am
    1/25BG@9:30pm 457 1.5 units
    1/26BG@9:30am 168 1.5 units
    1/26BG@9:45am 475 1.5 units
    1/27BG@10:30am 487 1.5 units
    1/28 vet visit...3 day pain iject
    1/27 sedated BG@10pm375 1.5 units
    1/28BG@10am 294 1.5 units
    1/28 Good appetite, no BG test 10:30pm 1.5 units
    1/29BG@11am 165 1.5 units
    1/29Good appetite no BG test 11pm 1.5 units
    1/30no BG test 11am 1.5 units
    1/30BG@10:30pm 348 1.5 units
    1/31 pain inj @9am BG@10:30am533 1.5 units started sneezing....vet disregarded
    1/31BG@10:30pm361 1.5 units
    2/1BG@ 10:30am 373 1.5 units
    2/1Switched to seafood flavor good appetite BG@10:30pm 471 1.5 units
    2/2upper resp. worse BG@10:30am 498 1.5 units
    2/2 good appetite BG@10:30pm 379 1.5 units
    2/3 curve scheduled today BG@ 9:30am 60 gave food no shot rushed to vet. Finally given antibiotics for full blown upper resp infection
    2/3 pm no shot new curve scheduled 2/4
    2/4 2nd curve attempt failed preshot BG379 given 1 or 1.5 units 2nd BG166 3rd BG 37 Told no more insulin, consider specialist or euthanasia
    All along Poncho had a so so appetite so did some force feeding but probably not good diet overall except where noted. I don't think he could smell his food until the seafood flavor 2/1
     
  66. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    Thanks. Do we have a mid cycle reading for today. We need that to help decide on the next dose. Will review the info above.
     
  67. christoph

    christoph Member

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    Feb 2, 2015
    BG@4:30am is 180
    Last night I skipped his 11pm antibiotics and gave at 4:30am also
     
  68. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    Sorry just seen your second BG reading for today.

    So today so far

    PMPS (evening preshot) was 378
    +3.5 (2.45 am) was 229
    +5 (4.30 am) was 180

    You have given 300 ml of sub q's and have force fed ?? Food.

    Is this round up correct?

    So far so good. Can you get another reading in another 2 hours. Are you okay as it is the middle of the night where you are. It would be great to get another reading if possible. If we were to bring the next dose forward by an hour or two would that suit you? Am I correct in that the next dose is due 10.45 am so in approx +7 hours ? Do you dose at the time on purpose?

    Finally try to keep the antibiotic dosing regular as it helps keep the dose level in their system. Keep up with them but make sure to follow the instructions. Ie if it says give with food, then give with food.

    Keep up with the syringe feeding.

    Finally to feel it is very important to get some more anti nausea medication for the next few days. Either ondansetron or cerenia tablets.
     
    Meya14 likes this.
  69. phlika29

    phlika29 Well-Known Member

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    Sep 14, 2014
    @Elizabeth and Bertie I see you are online. You may have more experience of prozinc. Can you comment as to how well the reduced dose of 0.5 is working in relation to Poncho 's blood glucose? He previously tanked on 1.5 u it's twice a day so the vet said to just stop the insulin.

    At the moment he is showing high ketones and unfortunately the cost of treating at the vets is prohibitive for christoph. So we advised to try 0.5 units. He has had sub q's and syringe food. If you look back a few posts you will see the roundup of the last few days BG results and my roundup of today above.
     
  70. phlika29

    phlika29 Well-Known Member

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    Sep 14, 2014
    @Sue and Oliver (GA) I know you are away but if you check in maybe you could also comment on the 0.5 dose.
     
  71. christoph

    christoph Member

    Joined:
    Feb 2, 2015
    Yes, the numbers are correct. I'll be up for good....can't sleep anyway. Next reading is 6:30. I always dosed his sister around 11am/pm since I'm a night owl so just continued the tradition. I'll see if I can get some appetite pills. I'm thinking if I can keep him stable I might drive him to my old vet in St Louis Monday morning. I don't know any other vets here and don't trust them generally speaking. The syringe feeding is so traumatizing to him I can only get 10ml in him before he almost shuts down. How often at that amount should I feed him without stressing to the point of harm? The food is the prescription food ad critical care so I assume it's concentrated.
     
  72. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    That drop looks pretty nice to me, Sarah (and Chris!). And that was on .5 unit?
     
  73. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    Yes @Elizabeth and Bertie 0.5 unit. Are we nearly where we want to be taking into account that the 1.5 was too high but we have ketones and a reduced amount of food intake

    @christoph Is it in a tin? Does it say how much is needed at all? @Meya14 talked about getting at least one tin per day. But more is better. I think just doing 10ml at each go is fine. How many would he need to get through a tin? That is what I did. I think an anti nausea tablet would help him accept it easier. Please try to get some.
     
  74. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    So far the blood glucose has dropped by 50% by +5 on this dose. That's a 'nice' drop.
    And it's probable that it will drop a bit more too in the next hour or so. But the rate of drop between the last two tests was nice and gentle. This is looking good to me so far....
    (I agree it would be good to get another test.)

    Sarah, thanks so much for collating the info in the posts above (definitely one of your many strengths!).

    Re Prozinc; I've not used it, but have used two different PZI's and they're sort of in the same 'family'.
     
  75. christoph

    christoph Member

    Joined:
    Feb 2, 2015
    Yes. I'll check the can for feeding dose and get cerenia if possible.
     
  76. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    @christoph so it sounds like we are in the right ball park on the dose, please post up the next BG result when you have it. Post up the food brand if you can't find the info on the packet and we can look it up.

    When it comes to the next dose make sure you get a pre dose reading and then unless someone tells you otherwise give the same amount as before. The feeding is so important as meya explained, with ketones you need to be able to give insulin and to be able to give that safely you need to make sure they can eat. You also need to get that infection under control by keeping the antibiotics consistent.

    You have enough sub q's for the rest of the weekend?

    Finally Don't forget to get another ketone reading when poncho next goes for a pee. Make sure you measure exactly when they say to take a reading as it will continue to develop.
     
    Critter Mom likes this.
  77. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Glad you're still hanging in with us.
    I'm glad the 0.5 units of ProZinc is working.
    How's his breath smell?
    You can check for moderate to severe dehydration by gently pulling the scruff of the neck and releasing. If it snaps right back, he's doing well: if it stays pulled up - tented - he's dehydrated. With higher glucose levels, it goes out in the urine and pulls water out of the body.
    Were you able to get the YouCaring fund set up? If yes, ask if you may post it here - in your signature will show with every post.
     
    Critter Mom likes this.
  78. christoph

    christoph Member

    Joined:
    Feb 2, 2015
    BG @ 6:30 am 160
    The food I'm syringe feeding is Hill's ad critical care in 5.5oz can but instructions are "as directed by vet.". I fed him another 10 ml.....it's so stressful for him it's scary.....but he gets over it. I'm waiting and watching for him to head to the litter box for another ketone test. I think I have 700 ml of fluid left so will have to get more. When I picked it up they said I need to give 100ml per day so I hope they don't balk.
     
  79. christoph

    christoph Member

    Joined:
    Feb 2, 2015
    Thank you for hanging in with me.....I couldn't get thru it right without all the help. When I try to smell his breath I can't smell much because of the smelly food which I feed him and gets all over his face as he protests. I'll clean him up and try to detect the ketone smell. I got the fund set up so I'll try to get OK'd for posting on here. I'll be giving more fluids soon. Should I test again 8:30am or wait till shot time 1o:45am?
     
  80. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    Is it this food? Can some one advise on this I am not so good with calories,etc.

    Chris how much does poncho weigh? By the look of it my 5kg cat would need 1 1/2 cans per day if you follow schedule 2 for feline hepatic lipidosis. But they indicate you can work up to it. So I would estimate that at least a can per day and you can dilute it with water if it makes it easier to syringe. But again someone can advise better I think

    http://www.hillspet.com/products/pd-feline-ad-caninefeline-critical-care-canned.html

    I think the nausea might not be helping with syringe feeding. Sorry I know I am repeating myself but if you can get something g for that cerenia or ondansteron that would be great.

    I think 100ml sub q per day is about average.

    Insulin level still seems okay.

    +7 is 160. If you can get another at +9 then do. Please take care of yourself though. And make sure you have more strips for the next cycle.
     
  81. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Go ahead and test now. If he's high enough, you can shoot a little early with ProZinc.
     
  82. christoph

    christoph Member

    Joined:
    Feb 2, 2015
    Yes phlika29 that's the food. I've read that the prescription foods aren't really any better then the average pate from Friskies or Fancy Feast. Poncho was a little over 8 lbs last Sat.....up 1 lb from admission time, but don't know present weight.
    So, BJM, test now at 9 hrs from last shot and shoot .5 if over 200? Or wait till about 8:45 or 9ish central time....around +10? First shot was 10:45. What's my no shot threshold....200? I'll need to go to pick up anti nausea meds if they'll give them to me and there will be no one to watch Poncho....like an hour's time and they close at 3. What's the best time to leave Poncho for that length of time?
     
  83. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Let's list the numbers from last night using our +# from time of shot
    348 @ pmps (10:45); 0.5 units
    180 @ +6 (4:30)
    160 @ +8 (6:30)
    so far, the max drop starting at 350ish is about 190 mg/dL for 0.5 units of insulin.
    We can use that to estimate a dose, based on what you get as a pre-shot.
    We might figure that 0.25 units (eyeballed) could drop him around 85 mg/dL.
    We want him to stay safely above 50 mg/dL on a human meter.

    No shot if under 200 mg/dL.
    If you can get U-100 syringes, you can measure smaller doses.

     
  84. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    But with increased ketones we need to get insulin into poncho. So my understanding that there is no option of not giving insulin. Or maybe you mean don't give the shot until he goes over 200.

    I personally would have thought it better to keep to the schedule or bring it forward just a little and give 0.5 rather than give it very early but give a reduced dose of 0.25 and have him higher for the whole cycle. Again maybe I am reading it wrong. Or perhaps if you catch it at a lower blood glucose level then I guess it stays lower throughout the whole cycle. This is where my knowledge gets sketchy. It would be great if someone could clarify.
     
  85. christoph

    christoph Member

    Joined:
    Feb 2, 2015
    I have a keen eye for measuring but will look for u-100 if needed. The pre shot BG was 378, if that makes a difference in the calculation...if not then shoot .25 if over 200 at +10 or +11, +12?
     
  86. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    There will be a variable drop based on the insulin dose and starting glucose.
    You don't want to keep the ProZinc dose static or you'll run into a hypo situation on top of everything.
    What you can do is stall until the number is shootable.
    If he is 200 and 0.25 might drop him 85 mg (estimating here), and you can monitor him, you could shoot.
    We don't know how much he'll drop based on less than 12 hours of data.
     
    Last edited: Feb 7, 2015
  87. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    Chris it sounds like you understood it just fine. BJM has lots of experience with insulins so I would listen to her:).
     
  88. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    What you might wind up doing is "chasing the numbers". As you collect data on response (we really need to get that spreadsheet set up), every time he gets to a shootable level at around +8 to +12 hours, you shoot if he's high enough based on your data.

    This can be done with ProZinc; it is NOT something you do with Lantus or Levemir!


    And speaking of the spreadsheet, instructions are here.

    Understanding the spreadsheet/grid:

    The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

    Each day is 1 row. Each column stores different data for the day.

    From left to right, you enter
    the Date in the first column
    the AMPS (morning pre-shot test) in the 2nd column
    the Units given (turquoise column)

    Then, there are 11 columns labeled +1 through +11
    If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
    If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
    and so on.

    Halfway across the page is the column for PMPS (evening pre-shot)
    To the right is another turquoise column for Units given at the evening shot.

    There is second set of columns labeled +1 through +11
    If you snag a before bed test at +3, you enter the test number in the +3 column.

    We separate day and night numbers like that because many cats go lower at night.

    It is merely a grid for storing the info; no math required.
     
  89. phlika29

    phlika29 Well-Known Member

    Joined:
    Sep 14, 2014
    So by chasing the number and shooting as soon as you get over 200 does that mean Chris always gives 0.25 dose or is it more complicated than that?
     
  90. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    " shoot .25 if over 200 at +10 or +11, +12?"
    Yes. And be monitoring at +2 or +3 to observe drop and be prepared to intervene.

    We're still working out how much drop Poncho gets at starting glucose levels. I am guessing/estimating about 85 mg/dL for 0.25 units; I don't KNOW that. We need to collect more data to work this out.
     
  91. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Can't help with the calorie requirement, but I wonder if that's something that the vet might advise on for free (if they're feeling kind)...

    Hill's A/D is higher carb than we'd normally feed a diabetic: According to Binky's list it's 13% cals from carbs, (with 33% coming from protein, and 54% from fat)
    http://binkyspage.tripod.com/CanFoodNew.html

    But the important thing here is to keep getting food into the kitty.
    Hills A/D does contain an increased amount of potassium apparently, and also B vitamins. And it's consistency makes it easy to syringe.

    Is Poncho eating any food on his own?
    .
     
  92. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    Chris

    I can set the SS up for you and fill in the numbers from this thread. All I need is for you to have a Google account (which is free) and the email address associated with that Google account. If you look at the SS link BJ gave you above, you will see the link for getting a google acct if you don't have one. It will take me two seconds to set up his SS and just a little longer to put in the numbers and doses.

    I'm going to send you a private message to get your Google email address. You will see a red letter up on the right by "Inbox". Click on Inbox and you'll see your messages.

    Another good food to give via syringe is Iams Max Calorie. It is very high in calories and low in carbs. It is prescription so you'll have to see if your vet has it.

    Even though I've assist fed many cats, I found this video very helpful:


    Also check with the vet on the potassium because lactated ringers solution does contain it but the vet will know if he will need additional potassium.

    Sending prayers for recovery.
     
  93. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    Chris sent me his gmail addy so I will be setting up his SS shortly and filling in the data we have to date.
     
  94. christoph

    christoph Member

    Joined:
    Feb 2, 2015
    Ok. His BG @ +10 was 221 so will give .25 @ +11 and monitor. He's not eating on his own.....just very out of it. I called the clinic re anti nausea and had to leave a message so they might ignore me. I'll also try my old vet and see if they can call in a prescription. Thank you all so much!
     
  95. Meya14

    Meya14 Well-Known Member

    Joined:
    Jan 2, 2015
    I would err very cautiously with holding insulin at this point. If you have to shoot a very reduced dose, or give him syrup in the food to keep the numbers up while still shooting, you should do that. It seems counterintuitive, but more insulin is what his body needs and in order to give more insulin, the insulin needs a substrate to work on (food). Carbs are OK until he is out of the woods. Ketones will increase if your cat doesn't have insulin for half the day if you skip a shot.

    The critical care food you have right now is perfect. You need 1 can a day at least. Usually this is like 1-2 syringe-fuls of foods every hour. That was tolerable for my cat when he was sick. It was a struggle, but once we got the cerina, it was much easier. You are in the hardest part, but cats can bounce back quickly as well, usually feel much better after about 2 weeks of supportive foods/fluids.

    What subQ fluids are you giving? Is it 0.9% Saline or Lactated Ringers? If you are giving 300ml a day, split this up into 2 doses. 300ml is hard for kidneys to process all at once.

    Pain meds may make a difference as well. Pancreatitis can cause nausea and discomfort. People here I think use an injectable? Can anyone comment?
     
  96. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    many use buprenorphine
     
  97. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Cerenia - for nausea and vomiting - can be injected. (It's available in tablet form for dogs in the UK. I think that it may be possible to get it in tablet form for cats in the US but I'm not certain). I think the effects of Cerenia can last a couple of days in some cats.

    GENERIC ondansetron is also good for anti-nausea support. (NB Zofran, the branded version of ondansetron is extortionately expensive.) Ideal for home treatment.

    Buprenorphine is recommended by IDEXX for pain management, and several members here use it for their cats with pancreatitis (including me on occasion). Some members here inject. Others like myself can only get an Rx for the liquid bupe which is given sublingually.

    Cyproheptadine (antihistamine) can be used for appetite stimulation - really needs to be used in conjunction with anti-nausea meds (to avoid cat becoming distressed from feeling compelled to eat something that's making it queasy, and also to avoid potential future food aversions).
     
    Last edited: Feb 7, 2015
    Elizabeth and Bertie and Meya14 like this.
  98. dirtybirdsoaps

    dirtybirdsoaps Member

    Joined:
    Jan 7, 2014
    Would Fortiflora help at all? I know its easily obtainable.
     
  99. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    It might help if appetite is slightly off, or it might not. Saoirse used to like it at first, but it nauseated her and then she wouldn't go near the stuff. Another member whose cat has pancreatitis reported her cat experiencing a similar reaction to FortiFlora.

    If the nausea's really bad and the cat is highly inappetent, then based on my experience and reading about the experiences of others here the supportive meds are the way to go when a kitty's struggling with food. (They can make the world of difference.)
     
  100. christoph

    christoph Member

    Joined:
    Feb 2, 2015
    Meya14, the sub q is lactated ringers, which I just gave.....really hard to see where the fluid is at in the bag....I wish the fluid had color. Are there any tricks, like counting seconds with the flow wide open or 1/2 open? I don't want to give more than 150ml at once but it's hard to determine the level. I just gave Poncho his +11 shot of .25......kind of hard to eyeball but I'm sure I got it right. Next up is another round of forced feeding.....poor guy. I only had 1 can of ad and it's 1/2 gone since yesterday so might need to substitute. I do have 2 cans of Purina EN Gastroenteric but it's not as easy to draw into the syringe and push out without a blender which I don't have yet. I'm wondering if the clinic will call back about the cerenia since they cut us loose Wed. They did give me the fluids yesterday but getting the feeling I'm a bother.
    So where can I get the FortiFlora? Anything OTC for nausea in case the clinic doesn't come through?
     
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