Snickers and family introduced to DM via DKA.

Discussion in 'Welcome to the Group - Post an Introduction Here' started by Eric Minor, May 14, 2017.

  1. Eric Minor

    Eric Minor Member

    Joined:
    May 13, 2017
    Snickers was taken to the ER on the evening of May 3 and seemed to be near death. We didn't realize there was any problem up till then, but in hindsight there were some signs we didn't take notice of like excessive water drinking and high urine volume going on for perhaps 6 months.

    It was touch and go for several days but she made it through and has been home now 4 days. We are trying to get insulin dosing figured out and she is no where near regulated as of yet, usually in the 550 or 600 range before insulin injection and getting down to about 350 at nadir for the first curve I did on day 2. We started at 1 unit of glargine twice a day but after 2 days of mediocre results we bumped that to 2 units twice a day.

    Still we wind up back at 550 before the next shot so today I tried a 1 unit booster (still Glargine) at the 6 hour mark. For the regular shot tonight at 8:30 PM we were at 460, which is better than 550 or 600 in my mind. We will see how the nadir tonight looks and what we wind up at tomorrow morning.

    We need to get food figured out. She had been on dry her whole life. She came out of the ER DKA trauma skin and bones so we have been giving her Nutro wet food and she has been eating it well. We ordered a dry food called "Young Again" which hasn't arrived yet which claims to be a good diabetes dry food and claims to get a good number of cats into remission.

    We are also giving her 1 ml Pet-tinic and 2.5 ml VetOne RenaPlus Potassium Gluconate twice a day per the ER vets instructions. I'm poking her ears frequently for blood samples. She tolerated it better than I would have expected to start but is getting angry with me now -- but we need data so that is that.
     
  2. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

    Joined:
    Oct 11, 2015
    Hi and welcome...
    Lantus is a depot insulin so giving it every 12 hours is best as you don't know when the depot will fill and cause a possible hypo. AWESOME that you are testing!!

    There are many very educated advice givers on the board so I will bump this up for the "wise" ones to give more insight. I do want to let you know that if you are switching to a low carb food that is great BUT it is VERY important to test as the food alone could drop the numbers dramatically. Also there is another low carb dry made by Dr Elsey and it is a bit less rich and seems to be a bit easier on the digestion than YA in my experience with several cats.
    If you have issues with YA they do have a decent return policy. Dr Elsey will send a sample if you request it.
    Wet food is preferred and under 10% carb is best (there is a list in a sticky )
    Most all of the fancy feast CLASSIC variety are ok-there are many others as well.
    Try not to be overwhelmed as feline diabetes is a challenging disease but it is manageable and you are doing fantastic!
    Bumpity....
     
  3. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

    Joined:
    Oct 11, 2015
    1 more thing--if you get time to read as much as you can on the forum it will be of great value to you--
    we recommend increasing in 1/4 units because sometimes you can skip right over the "right" dose and/or put kitty in a dangerous situation of hypo-
    1 drop makes a huge difference with my boy.:bighug:
     
  4. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

    Joined:
    Oct 11, 2015
  5. Eric Minor

    Eric Minor Member

    Joined:
    May 13, 2017
    Thanks for the advice. Planning to read as much as I can on this site.
     
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  6. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    Hi Eric, welcome to you and Snickers. Glad you're home testing! Like Jayla said, we usually go up in .25-.5u increments. It also takes a few days for the depot to stabilize, so you don't want to change the dose too often, once every 3 days at the most. Do I understand you gave a second shot 6hrs after the first? We never do that because it can give you two nadirs and possibly bring the cat too low. I agree though, that with her high numbers and past DKA, you need to fast track. Come to the main health forum or the Lantus forum and we can help you get Snickers' BG under control. Also, Are you home testing for ketones? If not, you should pick up some test strips, available at any pharmacy.
     
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  7. Eric Minor

    Eric Minor Member

    Joined:
    May 13, 2017
    Yes, I gave a second shot 6 hours after the first. I was aware that it would give me a 2nd nadir and (I thought) I wanted that. I was (I thought) no where near being too low and felt like I wanted to get her baseline BG to drop a bit in advance of the evening shot...just felt like I was stuck up in the mid-500's and 600's and needed something to change.

    From the first several readings after that experiment I felt like it did what I wanted. Two hours later it had dropped slightly from the AM+6 reading and at the PMPS reading it was about 100 points lower than all the previous pre-shot readings (464 instead of 550's or higher). I read about the Simogyi effect and was pretty sure that wasn't in play. However, the 3 readings since the evening shot have gone poorly and entirely in the wrong direction. I can't decide if the evening shot was poorly executed (she moved on me a bit) and delivered nothing or if there is in fact something else going on. We went from 464 PMPS to 513-513-646 at 2 hour increments. I'm dreading what I'm going to find at the morning reading and if I'm going to have to haul her into another ER for IV insulin to try to get her down into an acceptable range.

    I haven't tested for ketones yet but have been intending to. With these BG levels I have to believe they are probably present. I'll post this in that other forum as well.
     
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  8. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    Welcome Eric and Snickers!
    Glad you are already home testing and not letting her "temper" dissuade you from testing :smuggrin:. There is a big Lantus community here that can help you with dosing and a couple have already responded here. Only thing I can really add is that we have a saying, This is a marathon not a sprint, when doing the sugar dance. The others have already mentioned jumping whole units is not ideal and can have the negative effect of keeping her BG high if it's too much insulin. So for my addition I guess, take a deep breath and slow down a bit :bighug:. She didn't get sick overnight so diabetes is not a quick fix. You're on the right track but don't speed up so much as you might send the train off them :cat:. I mean no ill-will by what was said, I am a very blunt person so I tried to soften it as best I can. Feel free to tell me it wasn't soft enough. We just try to help each other while looking from the outside ;). This is a support group for Snickers and You :)
     
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  9. jayla-n-Drevon

    jayla-n-Drevon Well-Known Member

    Joined:
    Oct 11, 2015
    so glad @Sharon14 and @Yong are here!!
    I don't explain things nearly as well!
    Your in great hands :bighug:
     

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