? recent DKA kittys reading is high at nadar 394??

Hi, So since Ive gotten home my kitty from the ER a week ago they had her on 2 units of Lantus

Then I tested her after a couple of days and it was 39 at the nadar, but rose to 335 before her nighttime shot.
the following day before her nighttime shot she read 34, so I brought her into the emergency vet to test her again and they said my freestyle meter read 34 but their alphatrak read 71.. so I have since switched to the alphatrak.
they also told me to lower her dose to 1 unit, which I read from here is too big of a change and because it was the Lantus pen, to buy syringes and dose her 1.5 units, which I have been doing..

ok so now we are in about 5 days dosing her 1.5 units and I just tested her blood sugar at 5 hours in from nighttime shot and she's 394????!? I tested her before her shot and she was 390.. shouldn't she be going down?
Is her dose now too low??
Im just so scared shell go DKA again, and after an 8000$ bill I can not afford to have her go back...

the vet doesn't even seem clear what to do and she told me to feed her twice a day, and everyone on here told me to feed her 4 times a day, but perhaps thats messing her up?

she hasn't eaten in 5 hours.

 

Hi Mimi's mom!

Deep breaths!

A saying I love around here: you're in the best place you've never wanted to be. You are part of a community now with so many experienced caregivers of diabetic cats. So many us live, breathe, and sleep feline diabetes (FD) and I personally, have learned SO much here. I don't think my cat would be alive if I didn't start posting here and learning from others.

The first thing I would do right now to better help us help you, is to set up a spreadsheet. Here are the instructions how: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

I would also remove the 911 tag unless kitty is having a medical emergency or hypoglyceamic. It doesn't sound like Mimi is judging from your post. But how is Mimi right now? How has her appetite been? Does she seem very lethargic?

I'll be posting more in a few minutes but I wanted to send you this first to get you started on the SS before others come on the board to help you.

 

Hi thank you! I attempted to do the spreadsheet but it told me I’d have to be approved or something (through google docs)
I said 911 because I want to know if I need to call the emergency vet?

I’m wondering if I should try 2 units tomorrow again... is that how it works- when you’re first diagnosed they start you off small and then gradually raise you? I know they do that with human diabetics... also what’s a common unit of Lantus administered to cats?

 

Judging from the numbers in your post, it sounds like, yes 2 units was probably too much for Mimi. And what often happens to some cats when they experience a low number, is they bounce from that low number into very high numbers. The body doesn't recognize that lower sugar level so it releases sugars into the bloodstream to prevent itself from a hypoglycaemic episode. In time, as our kitties get used to normal numbers, we hope our cats stop bouncing or at least don't bounce so dramatically.

The best way to figure out if 1 unit is an effective dose of Mimi is to test. And you're doing that so that is fantastic! Good job!

Most of us here use human meters because the methods of dosing we use are based on human meters and not pet meters. It's also more affordable. But it's up to you which meter you want to use. Just make sure you set up the correct spreadsheet as Pet meters have different reduction values based on the methods we use. Here's the SS for Pet Meters: https://docs.google.com/spreadsheet...1D3rUOY3yazVll8O3KJWY7J7I/edit#gid=1182885903

I'm assuming you don't have approval to use it because you need to actually make a copy of the SS and save it in your own google docs. I'd read through the instructions on how to set it up and try again. If you still can't get it, we can have someone help you

Thank you for removing the 911 tag! And it's alright that you used it since you weren't sure if this was a medical emergency. I would replace it with the '?' for now.

Do you know how to test for ketones? You can purchase ketone test strips to test Mimi's urine at your local pharmacy or online. Since she was recently DKA, we recommend testing ketones daily. Ketones can develop very quickly and is a medical emergency. Anything above trace level means you need to call the vet. Here's some more info about ketone testing:
http://www.felinediabetes.com/FDMB/threads/are-you-testing-your-cat-for-ketones-if-not-do-it.48383/

There are many ways you can test urine. I personally just stick the little test strip underneath my cat as he's peeing. Some stick a spoon underneath or some lay pieces of plastic wrap in the litter to catch urine.

The recipe for DKA is: not enough insulin + not enough calories + high blood glucose. I think it's important to keep Mimi eating. Feeding several small meals throughout the day is easier on the pancreas and keeps kitty happy. I personally feed 4-6 meals a day.

I have a few questions:
How is Mimi overall? Is her appetite and energy good?
What food are you feeding Mimi right now? Dry foods or high carb foods will raise blood sugar.

 

Hi Rosa,
How is Mimi today...looking at my world clock it is about 5.45 am in your part of the works.

With the recent DKA diagnosis there are things you can do to help Mimi.
The recipe for DKA is not enough calories, not enough insulin and an infection or inflammation in the body somewhere.

So the things you need to do are

• Feed Mimi often and encourage her to eat as much as you can. Food is like a medicine when recovering from DKA.
• Make sure she gets her insulin dose.
• Fill in the spreadsheet so we can see the numbers and can he,o you with doses
• Put some water In the food if she will tolerate it. It is important that Mimi drinks lots of fluids
• Test for ketones every day. This will keep you ahead of the ketones and can act on them immediately if they reoccur.

How is her appetite. If she is not eating you may need to get some anti nausea tablets from the vet such as cerenia and /or ondansetron. It is really important she eats.
Was she treated for an infection when she was in Hospital? And did she have antibiotics?
Does she seem lethargic or is she quite bright?

 

Hi thank you for replying! Mimi had mild pancreatitis and some gallbladder “sludge” while hospitalized and yes, did go home with antibiotics- Clavamox, Clindamycin, then Zofran for nausea and Urisidiol for the gallbladder I’m assuming?
I go on here for advice more than asking the vet because i really don’t think they have a huge grasp on feline diabetes... they told me to feed her prescription diet and compared my “raw” to a “candy bar” for diabetics... I wanted to say “are you an idiot?”

the feeding her 4-6 times a day is so hard with another cat.. automatic feeders are out of my budget right now- I have a huge 8000$ bill..
Having the number spike to make up for the difference does make sense.
Do you think the pancreatitis could have contributed to the DKA? It was weird because she got diagnosed with diabetes back August 28th, treated with Vetsulin, and then went DKA October 1st. Just weird to me because usually DKA patients are when they go undiagnosed.
I know the vet did say she was extremely difficult to regulate and they really didn’t think she was going to make it. She’s such a little fighter though. Her and her brother Batman are my everything

 

can you leave enough low carb food for the 2 cats, or Batman will eat it all during the day?

Yes, I would think that DKA can happen after the diagnosis, which is why we test ketones very regularly (I check every day). Pancreatitis must have been the trigger.
Regarding dosing, you can find the two protocols here: http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/
And if you have doubts, do not hesitate to post on the forum. Mimi might be bouncing, or she might need an increase. The only way for experienced members to help you is if you can set up the spread sheet with Mimi's numbers. It's amazing that you are able to test!