1. Lauryn Harriman

    Lauryn Harriman Member

    Joined:
    Mar 2, 2020
    Hello!

    @Bron and Sheba (GA) recommended I post here about my cat, Ramesses. Previous post was here:
    http://www.felinediabetes.com/FDMB/threads/ketoacidosis-please-help.226438/#post-2544689

    Ramesses' SS.

    It's a bit of a long story, but you can get the gist of it if you look at his spreadsheet. We've gotten him stabilized once before when he first went DKA. This is the second time he started showing symptoms of DKA, we caught it early and started home testing BG and urine for ketones. We think what initially started this was an infection of some kind - possibly UTI. We've gotten the ketones under control, and have been giving him subQ fluids 200mL every other day for awhile now. He's basically only tested "HIGH" for BG since he got sick - we're struggling to get the

    Recently switched from Vetsulin to Basaglar per our vet's recommendation - the vet believed he may have developed a Vetsulin resistance.

    We were at 2.5U vetsulin and switched to 2U of the glargine. After talking to some forum members on my other thread, we upped it to 2.5U, where we have been for about a week. The days really bleed together when you're sheltering-in-place!

    He's got personality still, and is acting more or less himself though his weight i. But the numbers are still "HIGH" and we're really wanting to bring that down. I understand I need to increase the insulin dosage slowly, so we've been patient in upping his dose again. Does anyone have suggestions on when to up the dose and how much?

    Thanks for all the help. Everyone on this board has been so caring and helpful!

    Bob & Lauryn
     
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  2. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    The dry Royal Canin Glycobalance food, is 27-32% carbs and is helping to keep your cat in HIGH blood glucose(BG) numbers.

    You do need to find something lower carb, but with sufficient protein.
    Does your cat eat wet or canned food? Even the RC Glycobalance canned food at 14% carbs, would be lower in carbs than the dry version of the RC Glycobalance.

    Since you are home testing, you can monitor the BG levels and safely switch food.

    Have you tested your meter for accuracy? Please, test yourself with a fresh lancet and test strip. Let us know what your meter says.
    Are you using the Relion Prime test strips? Please double check you have the correct strips.

    p.s. Your signature still says Vetsulin. Please update that to show you are now using Basaglar ( a version of glargine).
    What meter you are using should be in your signature, as well as on the spreadsheet.
    Thanks.
     
    Nan & Amber (GA) likes this.
  3. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Welcome to L/B+L!

    I agree with both of Deb's points-- check the meter, and then if that seems like it's not the problem, look to the food.

    Being in high numbers for this length of time does mean that some insulin resistance may have developed. Usually, that means increasing the dose until you can break through that resistance, and going from there. We have two methods we use for dose changes on this board, Tight Regulation (TR) and Start Low, Go Slow (SLGS). It's somewhat a personal preference as to which you use, but as long as you are feeding dry food, you are restricted to SLGS. If you are able to switch him over to low-carb wet food, you test frequently enough to make the move to TR, which has more aggressive dose changes.

    Regardless of the dosing method, and assuming your meter is working properly, I think he's been on 2.5U long enough, and you can bring him up to 2.75U. Gotta get him out of those black numbers!!!
     
  4. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Clarifying: the dosing methods (TR and SLGS) are for later on. Right now, with Ramesses being recently out of DKA and running so high, you're going to want to be aggressive with insulin, regardless.

    For the same reason, we're not going to be as insistent (yet!) about the food change if Ramesses is resistant to change. Being on low-carb food will be better for him in the long term and will bring those numbers down all by itself, but the last thing you want is for him to go "on strike" because he doesn't like the first few low-carb options you offer him. Not eating enough is one of the things that could send him back into DKA :eek: :eek: :eek:.
     
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  5. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    When a cat is solidly in the blacks and recently DKA, we don't need to wait as long. In fact, we would accelerate the process as long as you can keep up your testing. Once you've verified it's not a meter problem, we can talk about size of increase.
     
  6. Lauryn Harriman

    Lauryn Harriman Member

    Joined:
    Mar 2, 2020
    Meter is fine. I tested it when i first bought it and 2 weeks ago. It's still accurate.

    I switched him to half glycobalance dry and half fancy feast low carb wet food tonight at dinner. He slurped it up no problem. I'll switch him to full-time low carb in the next day or so.

    Number was at 589! :eek: Kind of shocked to not see it say "HIGH". Still not great, i know...But i'll take any progress!

    I'll keep the spreadsheet updated and see where it leads. Seems like changing food might be the trick.

    Thanks,

    Bob and Lauryn
     
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  7. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Can you get a +4 test tonight? Yeah for numbers!

    We might still need to do an increase, but now we can do so knowing it's not the meter. It'll take a few days for the food change to be fully realized.
     
  8. Lauryn Harriman

    Lauryn Harriman Member

    Joined:
    Mar 2, 2020
    +2 was 589 He was still hungry, and since i had only given him 1 can for dinner - I gave him some more food at this point.
    +4 was 597
    +6 was 592

    AMPS is 422. Given the drop in number I'm thinking i'll stay the course with the 2.5U and see how he responds today. I'll try to do a more complete curve to monitor him.

    As for quantity of food, this is Purina's recommendation for the Fancy Feast wet food:
    "Feed an average size adult cat 1 can per 3-1/2 pounds of body weight daily"

    He's about 11 pounds right now so that means 3.14 cans a day. Since I'm trying to keep him out of DKA by increasing food intake I'm planning to give him 2 cans 2x daily. Does that seem appropriate?

    Thanks!
     
    Nan & Amber (GA) likes this.
  9. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    All right! Numbers and a new color!!!!

    Sounds good on the food. I'm so glad he took to it immediately! You will still probably want to do the transition over a few days, though-- even if he likes it, a sudden complete shift can upset their digestive system.

    When you're ready, go ahead and start a new post for a new day. You'll probably have noticed that this board is pretty busy, one post per day is one way we try to keep things manageable (more details in The Basics: New to the Group? Start here!).

    Go Ramesses!!!! Several more colors on the spreadsheet to explore, dude!
     
  10. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    For amount of food, do you have a scale? Cats in high numbers aren't getting all the food into their cells so will need more than an average cat. Cats recently DKA will need even more. Regular weigh ins will tell you if you have the amount of food right. Did the vet give you an estimate how many calories per day he should get?
     
  11. Lauryn Harriman

    Lauryn Harriman Member

    Joined:
    Mar 2, 2020
    I don't have a scale yet. But he is definitely starting to put on weight. And his coat is looking better than it has in awhile.

    AMPS is 191 today. :eek:

    PS I'll start a new post for today. Look for it.
     

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