911 TiTi, my diabetic cat is unable to eat and vomiting.

Tonight TiTi has been vomiting and unwilling to eat, after throwing up all her food last night. She has had diabetes for a little over 1 year, and has not responded well to insulin treatment. Her first diagnosis was pancreatitis, which she still has, and it is not being treated.

For 8 months I gave her 3-4 units/tid of insulin, based on my Vet's advice, but during all that time she urinated unbelievably amounts and drank well over a quart of water daily.

About 2 months ago, TiTi had a crisis, which turned out to be due to impacted stools. Her whole intestine was packed full of stools. 3 days of Lactulose and subq fluids did not work, so the vet put TiTi under and removed the stools. She also told me that her blood work indicated pancreatitis.

TiTi went back to drinking copious amounts of water, with urination amounts more suitable to a 30 pound dog than at 13 lb. cat. In that time, her coat has become quite unkempt. I believe she is walking on her back legs on her hocks, in that odd neurologically caused manner. Though her weight is fine, she is getting bony. I suspect she is using her fat for sustenance. I think most of her weight is due to her intake of water. Her belly is round and taut.

2 weeks ago, in frustration, and based on an article a vet wrote that few cats needed more than 8 units of insulin/tid, I, without consulting my vet, (bad I know), upped her insulin to 8 units/tid. Her urination became normal, ditto her water consumption. And her stomach lost the taut belly. Now 2 weeks later she is nauseated. My vet recommended Mirtrazapine before, and I had some left, so I gave it to TiTi . Now 3 hours later she's drinking water, but still won't eat, so I fed her 10mls of lactose free milk, in order to be able to give her her insulin for the night.

Even though she still shows no signs of a crisis, I am getting kind of desperate. I can't return to my vet, because I now owe them $400, and I do not think they will see me. I am one of the few, whom they allow to owe money, but enough is enough, I fear.

 

Can you tell us what insulin you are giving please?
Are you home testing the blood sugar levels?
Are you still giving TiTi 8 units of insulin? I know you are trying to help TiTi but upping the dose from 4 to 8 units is dangerous for TiTi, especially if you are not testing the blood sugar. We increase the dose 0.25 units at a time so as not to go past the right dose.
I have tagged someone who can help you. I am hoping she is still online.
If you have given TiTi 8units of insulin tonight, you will need to make sure she eats. It doesn't matter what she eats just make sure she eats something please.
@julie & punkin (ga) @Tricia & Cinco & Harvey
@Elizabeth and Bertie @Melanie and Smokey

 

Yes, I am syringe feeding her 9ml of lactose free milk, every couple of hours. I did this before giving her the insulin. She is on Lantus, which is horribly expensive. I started her 1 1/2 years ago on 8units/tid because I did not understand that those particular units were different from mls. She thrived on it for 4 months. Then the Vet corrected her down to 3 to 4 units/tid, and that went on for about a year, during which time she did very poorly indeed. I thought it safe to re-establish it, but I think I screwed up. Thing is I have kind of lost faith in my vet. She's a wonderful doc, but doesn't seem to know a whole lot about diabetes. TiTi is insulin resistant to some large degree, probably due to the pancreatitis. But Neither of us have any idea what to do about it.

 

Hello, and welcome

Have you given insulin this evening..?
Can you please clarify how much insulin you are giving, and how often. ('tid' means three times a day; are you giving 8 units Lantus 3 times a day....? )

Has TiTi ever been diagnosed with DKA (diabetic ketoacidosis)?
Does her breath smell strange, like acetone?
I strongly suggest that you get some ketone test strips from a pharmacy and test TiTi's pee for ketones. Anything above a trace reading is a reason for a vet visit pronto.
(Be aware also that some ketones don't register on the test strips, so a negative test - although reassuring - doesn't completely rule out the presence of ketones).

Are you willing to test your cat's blood glucose at home? You can do this with an ordinary glucose meter made for humans; and the test is done on a teensy weensy droplet of blood from the edge of the cat's ear.
We can help you learn.

Eliz

 

No I don't test her at home. I could never afford the packet. It's been a nightmare affording the Lantus. After 4 months on 8units of Lantus she became normal in behavior and test as normal at my vet. But my vet was horrified at the dosage, so I went down to 3 to 4/tid, and then TiTi became ill.

 

@manxcat419 , April, can you recommend a cheap meter for TiTi's caregiver? (I don't know what's available in the US)
.

 

Thank you for your quick reply. No, no. I thought tid was twice a day. It is , in fact twice a day 8 units/per twice a day. I am willing to test TiTi, but have never been able to afford the package of supplies and the meter. The cost of Lantus alone is rather ruinous. From what I've read, she may be heading for a ketonic crisis. She's bony with a distended abdomen from all the water she drinks, and walks with a slayed gait. That's been going on for some time. She is more lethargic in the last 2 months than was ever the case before. Her breath smells normal to me, and she just made a mad dash out of the v=bedroom, so she feels better. I guess the metrazapine is working.

This is what I posted to Bron and Sheba: "Yes, I am syringe feeding her 9ml of lactose free milk, every couple of hours. I did this before giving her the insulin. She is on Lantus, which is horribly expensive. I started her 1 1/2 years ago on 8units/tid because I did not understand that those particular units were different from mls. She thrived on it for 4 months. Then the Vet corrected her down to 3 to 4 units/tid, and that went on for about a year, during which time she did very poorly indeed. I thought it safe to re-establish it, but I think I screwed up. Thing is I have kind of lost faith in my vet. She's a wonderful doc, but doesn't seem to know a whole lot about diabetes. TiTi is insulin resistant to some large degree, probably due to the pancreatitis. But Neither of us have any idea what to do about it."

 

Absolutely, Eliz. I use a ReliOn Confirm from Walmart - the meter was around $16, including a lancing device. The strips are around $35 for 100, or you can order them in bulk at a discount from ADW diabetes. There are other meters in the ReliOn range that are also good - the Micro uses the same strips and same very small blood drop as the Confirm. The Prime works out cheaper for strips, but needs a bigger blood drop so you can finish up wasting more strips with that one.

If you don't have a Walmart near you, the Bayer Contour Next is good as, I believe, is the Accucheck Aviva. I'm not sure on the pricing of those ones though.

 

Okey dokey, 8 units Lantus, twice a day...
Has TiTi actually been diagnosed with a high-dose condition?

Ketone test strips are pretty cheap, and I do strongly suggest you get some to test TiTi's pee.

Eliz

 

Hi again ....sorry we do not know your name ......would you like to tell us.......and welcome!....I forgot to say that in the first post.

Do you live on the U.S. . because you can get cheaper Lantus from a pharmacy in Canada which will post to you. Phew, I am glad you are giving the insulin twice a day!
The gait you talk about is from peripheral neuropathy which will resolve when the BSL comes under control.
There are some wonderful people who can help you here. If you can afford it it would be great if you can test the BSL. Someone can help you set up a spread sheet and you can document the BSLs. Then people can see what is actually happening.
But first up you need to make sure TiTi is eating something ....that is very important. Also if you can go to the pharmacy and buy some ketostix for testing ketones...that is important to.
Re the insulin dose..........I would not give the next dose until someone who is very experienced in dosing can help you.
A lot of vets do not know a lot about diabetes, because it is a specialty....But there are many people who live with it 24/7 here who can help you.
So take a deep breath........and here is a hug. Try and get more food into TiTi and try and get the strips to test for the ketones.
Keep posting and asking for help!
Bron

 

@manxcat419 - Thanks, April!

 

I hope I am posting correctly. Did you get my reply?. Oh, and TiTi looks a bit like your Bertie. She's black with golden eyes. Her jaw, however is undershot, and her face is vaguely Persian. I've had her since she was 6 weeks old. Found her under a neighbor's house.

 

I'm Kathy. My vet won't give me an rx. Not her fault, the guy who runs the clinic just built a palace of a clinic and is trying to pay for it. He set up his own store. He will allow me to buy Lantus at a discount pharmacy - 262 for 100 units. But he doesn't trust the Canadian stores, and my vet can't go against him - it's her job, after all. And she may agree with him. I have no idea. It's pretty easy to get the milk into her, and she tolerates it well. Thanks for all the hugs. are my posts going to the woman who has Bertie as well as to you? I don't quite know what I'm doing yet, as to posting correctly. Titi is back to drinking water. Before the Mirtrazapine, whihc I gave her 5 hours ago, she could not even drink water. However she will take the lactose free milk in a 3 ml syringe.I'm giving it to her every couple of hours. So far she's had 21 mls of milk (lactose free)

 

The tests TiTi had when she was on 8units/2Xday tested her at normal. After 3 weeks on 3 to 4 units/2x day, she was up to and stayed at 350. She has never tested at a high dose condition. Only normal to LBS - the 350, and looked pretty lousy on that dose, peed copiously, and drank about one quart of water a day. I never have understood why my vet finds that ok. Maybe she doesn't believe me when I tell her about the poly urea and polydipsia? At one point last summer , there was so much sugar in her urine that I found a long line of fire ants carrying off her urine soaked kitty litter sand, 1 grain at a time.

I think I may have 2 such strips. Are they long and do they show different colors depending on the blood sugar level?

 

Hi Kathy!
Yes you are posting correctly and everyone who is online and logged in can see you.
Can you get TiTi to eat any solid food, maybe sloppy and through the syringe. I know a lot of people have to do that. But I think at the moment a lot of the people who can help with syringe feeding food are asleep. I am in Australia and Elizabeth is in the UK....that is why we are online.
How long is it since TiTi has had any solid food. It is really important that cats do not go for more than I think it is Two days at the most without food as it can cause other problems.
If the vet will give you a script for lantus...he need not know where you get it from.
I can see someone else from Aus who can help you with syringe feeding. I will tag her.
@Vyktors Mum ...hi Serryn...are you able to help Kathy please.?
She is syringe feeding her kitty but only milk and she has given her the insulin. Thanks.

 

I haven't any baby food, which would be a piece of cake, but I intend to try her on some Friskie's wet cat food pretty soon. There is no way to syringe feed her that food so I just hope she'll eat it. I do know about the risk of fatty liver disease, if that is what you are referring to? Her last solid meal was the one she threw up last night around 11pm. Before that she did keep down her food 3 hours earlier. I feed her about 5 times a day. just small amounts. And she has been on a diet. But she's the right weight now. I thought milk was fine. Why must it be solid food?

 

I'm sorry I can't help you with your current dilemma with Titi but I just don't have enough experience to help you safely. I can help with meters though!

I use a Bayer Contour Next meter. I cannot recall how much the meters cost but I believe they are typically between $15 and $35 depending on the model and the store. Strips for the Contour Next are really overpriced if you buy them at a pharmacy - around $50 for a 50 count pack, that's a dollar a strip! However, you can get the same strips on Amazon for about $12.50 per 50 count (or less if you buy larger amounts) which is 25 cents a strip.

I have the USB meter which is one of the more expensive Bayer meters. I chose the USB model because I wanted to download the test results to my computer. The Bayer desktop software is not the most user friendly software so I wouldn't recommend downloading the readings from the meter to a computer unless you are accustomed to using more complex computer programs.

 

Milk is OK but if she will eat solid food that is better and might have more calories and carbs.
You sound like you are doing a really good job of looking after her Kathy.
You just need help with getting the blood sugar down and getting her to eat. Hopefully someome will come online soon who can help you further.

The strips you mention........what does it say on the bottle?

 

Good point about the rx.

I just looked it up. I pay 262 usd at Costco. In Canada, Australia, New Zealand, and etc., it cost the same or more. Talk about international price fixing.

 

Hmm. I am near a Walmart's and a Costco. Well, I live in the country, so near is 30 to 40 miles. Ilive in the Hill Country in Central Texas, so I'm pretty far from everything except Baptists.

 

It sounds like you have one of the more common test sticks for urine glucose - Diastix. What you actually want are the Ketostix which measure ketones or the Keto-Diastix which measure urine glucose and ketones. This website has a picture of the Bayer brand Ketostix box and bottle: http://ketostix.net/

Edited to add: It is almost impossible to find Keto-Diastix at brick and mortar stores. If you go to a local store you will probably only be able to find Ketostix

 

I know the insulin is much cheaper on Canada so keep that in mind.
I use Levemir which is a similar insulin to Lantus ..... It is a long acting insulin like Lantus. It costs me 94$aus for a pack of five.
Would TiTi eat something like cooked chicken?
If she has pancreatitis she may well be feeling nauseated. My Sheba gets pancreatitis and when she does I need to get her something for the pain, something for the nausea, and often some subQ fluids. Did the vets treat the pancreatitis when they told you the blood work indicated pancreatitis?

 

It's not a bottle. It's two strips my vet gave me to try out. I never used them since TiTi was stable at the time, well, at 350, didn't seem so good to me, but at least she was maintaining. I can't find them now. They ay have deteriorated too much to be used. Or I may just be too tired to think of all the"logical " places I may have put them.

 

Ok. I'll get them online then. Thank you.My vet prescribed Cerena for the pancreatitis , and after a week it ended. I looked up Lantus and it costs the same everywhere. I think the drug company found a way to lock it up, or I may have been on a faulty web site. $264 thru $288 was the price range.

 

I agree that pancreatitis is a real possibility. Bama wouldn't eat and was vomiting during her first pancreatitis flare. The following day she was clearly having quite a bit of pain and looked absolutely pitiful. She was also showing symptoms of moderate dehydration.

Can you check TiTi for signs of dehydration? Keep in mind mild dehydration likely wouldn't have any physical symptoms. If I recall correctly it is at about 5% dehydration where you would start to see symptoms. Since you are giving her liquids she is probably at a lower risk for dehydration but diabetes and pancreatitis can really change how much water is needed by the body.
http://www.wikihow.com/Check-Cats-for-Dehydration

 

they won't be much good without the bottle to hold the strips against and see the result.
It must be getting pretty late where you are. Why don't you just concentrate on feeding Titi now and try and get some sleep?
Then tomorrow some of the others should be online and can help you sort things out.
It is great you have posted on FDMB to get help for TiTi.

ETA.........a good point Bama to check for dehydration.
If you check her gums....if they are moist, that is good. If they are tacky it probably means she is a bit dehydrated. Also lift up the skin on the scruff of the neck. If it goes down quickly that is good. If it goes down slowly that can also mean she could be dehydrated.

 

As well as the 21 mls of milk, she's been drinking a lot of water, so I suspect she's rehydrating herself. Her skin springs back quickly now, though 4 hours ago it was not so springy. I have the equipment for sub-q's if she needs them, but at present she's looking a lot better. I just remembered, that after her first vomiting of food, she only spat up white foam ( not bile thank god), and several small hunks of her fur. I wonder if she has hairballs.

 

She does pass that test, though earlier it was a bit slow going down. Sleep does sound like a good idea, and I must work tomorrow. Fortunately, I work from home.

I do wish I'd joined when this first came up, a year ago. Very glad for the help now. It's a scary condition. TiTi is getting pretty huffy about her syringe feedings. Does Mirtrazapine have any anti-inflammatory properties?
Well, anyway, I do not think she is going to croak tonight; she better not! and with her sleeping beside me, I'll know if she is convulsing or any such, so i think going to bed is safe now. I want to thank everyone for your considerable help. I'll be back on online tomorrow, trying to
learn all I can about this insidious disease. I've made too many mistakes to feel very knowledgeable . TiTi would thank you if she could, I am sure. G'nite

 

Were the strips individually foil wrapped? If so they may still be good. If your vet just gave you loose strips they are definitely bad, they have a short shelf life once the bottle seal has been broken. Bron makes a good point about not having the bottle for comparison.

I'm not sure what you are referring to here. If you are referring to the Keto-Diastix I would just get the Ketostix from a local store. It is better to test for ketones sooner rather than later, I merely mentioned the availability so you wouldn't be looking for something that would be hard to find. Looking back my statement wasn't very clear. If it is harder for you to get to the store due to distance but you could get the strips faster online through something like Amazon Prime then I would recommend getting the sticks that measure both ketones and urine glucose.

Since you aren't testing blood glucose at home yet it might be helpful to review this information about secondary monitoring tools linked in @BJM's signature.
https://docs.google.com/document/pub?id=1r6ktdF7AMJCYHgPkVQWFUFy5Ag6OnbmfNfQqL3zX_88

 

If the strips are still good (and assuming they are actually ketone test strips) then one strip could be used for the test and the other could provide a 'control' for comparison, maybe..?
So, if the strip doesn't change colour (remains the same colour as the 'control' strip) then the ketone result would be negative....?
.

 

Good idea. I might be going off on a bit of a tangent here but you got my gears turning… Squiffer - If you do not have the test strips your vet gave you go ahead and skip this post. Without the test strips this post will not be useful to you and if you buy new test strips you will no longer have the problems I am trying to solve in this post.

I checked my Bayer strips - the ketone chip is tan and the glucose chip is turquoise. The strips themselves only say Bayer with no indication of what they are testing.

During testing the ketone chip doesn't change color at all for negative. The glucose chip changes ever so slightly for a negative result, I would describe it as a muting of the turquoise to more of a teal color. Any hint of green means there is glucose in the urine. For reference the color range for the ketone test goes from tan to dark purple and the glucose test goes from teal to brown. It should be noted that due to color differences in photos and monitors it is not advisable to use a picture from a website for color comparison to determine the actual level of ketones or glucose. In this instance one would merely be looking for a positive or negative result with the understanding that the strips may be compromised which could provide a false negative. Any test where a false negative could jeopardize the cat's health (i.e. ketones) should ideally be repeated as soon as possible either by a veterinary professional or with new and/or uncompromised materials.

I did a little experiment and found that corn syrup thinned with water quickly maxed out the glucose chip. Table sugar dissolved in water only changed the chip halfway very slowly. I have no idea what I could use to test the viability of the ketone chip. Theoretically one could use the control strip post testing to verify that the chip is still active. I certainly wouldn't recommend this as a regular practice but it could be useful in emergency situations.

If any of the more experienced members feel this post is inappropriate please let me know. I will edit this post to remove any or all information if requested.

 

This is probably going to sound bizarre but if Kathy is NOT diabetic herself, couldn't she use her own urine to test for a control to compare TiTi's to?

 

I don't see why not as long as she's not on a ketogenic diet of any kind.

 

As of this morning TiTi still refuses to eat. She drinks a lot of water though. So, to be on the safe side, I've started her on subQ fluids. I also liquified some fancy feast pate, and am feeding her through a syringe. She's not crazy about it, but she swallows and she keeps it down. fter she had about 12 mls , I gave her 7 units of insulin. She's been straining in the kitty litter which is what happened several months ago when she got badly constipated and thus blocked, so I also started her on 2mls lactose every 8 hours as per the last time. The only drug I am missing is cerena. I'd have to get that at my vets, and without paying them some money down on the $400 I owe them, I do not think they will prescribe the cerena. I've been out o work for 2 months. Just started a job this last week, but it is only for 3 weeks duration. Struggling here, and doing my best.

 

OK, does anyone here have the contact details for someone at DCIN to see if they could maybe help with start-up costs for home testing. I'm concerned that if TiTi isn't eating, is on 8 units of insulin and isn't being home-tested that there's a fair chance she's actually on too much insulin rather than too little, especially if 4 units was the starting dose as that might already have been too high a dose for her. And the only way to find out what's really going on with her is home-testing.

 

I believe this is the contact number:

DCIN

Jenna Marie Watts 410-499-3390

Jenna@dcin.info

and website:

http://fdmb-cin.blogspot.ca/p/compassionate-assistance-program.html

 

Your kitty really does need the Cerenia for the vomiting and it wouldn't hurt to give a 1/4 of a 10 mg famotidine for tummy acid. She may benefit from a B12 injection and Reglan to stop stomach contractions. Squeaker had a never ending battle with pancreatitis and in your initial post you stated that TiTi has pancreatitis that is not being treated. Fluids, Cerenia, famotidine, something for pain, B12 injection, possible Reglan boost is the treatment that Squeaker always received. Pancreatitis is probably the reason your cat is not eating. I would not advise giving milk to a diabetic cat as it contains sugar. Pancreatitis causes dehydration, pain, nausea/vomiting, lack of appetite, stomach acid. Not treating it can lead to death. To get TiTi to eat, if she will not eat her normal fare the best offering is plain baby food meat without onion, garlic or vegetables. It is easy to pull into a syringe for assist feeding if she continues to refuse food.

 

Awesome, thank you Mary Ann. I hate to see anyone who cares enough to join this site and try to figure out what's going on with their cat not be able to do it because of funds - and we all know how expensive it can get, especially early on!

 

I have 1/2 cerenia left. I can give it to her. I assumed her electrolytes were out of balance, so have started subq therapy 200 mls to start, 100 more tonight and so on. I gave her some badly degraded mirtrazapine (From 6 years ago) last evening and it seemed to work, in that she was able to drink water again, but still refused food. I thought about the milk last night as I drifted off, and then thought, oh hell, milk sugar - very high. This morning I liquified some mixed grill Fancy Feast (I have a really good blender) , and I've been syringe feeding her that. She's swallowing it, rather than spitting it out, so I guess she likes it. The problem, of course, is to make sure I don't give her so much that she throws up. So far, so good. During her last pancreatis attack my vet prescribed 2.5 Mirtrazapine every 3rd day. I have some left so gave her one dose. I really don't think the mirtrazapine yesterday did any good. It was crumbling and 6 years old. Also have 1/2 cerenia left. After TiTi rests, I'll give her it. She gets upset when being pilled. Also the last attack was accompanied by an impaction of stools. In fact an sray showed that here whole intestinal tract was chock full of packed in stools. Based on that and the fact that she cannot seem to pass a stool, I gave her 2 mls of lactulose. I have no famotidine , nor b12.

 

Kathy, how much does TiTi weigh? 200 ml is an awful lot of fluid for an average-sized cat all at once.

Actually, the lactose-free milk may not be too bad for sugars. Lactose is the milk sugar, though milk of any kind isn't anything close to a complete diet for a cat.

 

She weighs 13 pounds. I gave her 100,ml on one side, and 100ml on the other. It was vet recommended last time this happened, and I was kind of surprised, too. When treating my kidney disease cats, I always gave 100ml at a time. Then if it was all gone in 3 hours, another 100ml and so on. Glad to hear it about the milk. She seemed to like it, just won't drink it on her own. But I switched to the liquified mixed grill this morning. I have a marvelous blender. She liked the mixed grill liquid, too, but just won't eat on her own yet. I am hoping that with no more need to drink so much water to keep her kidneys functioning, she will have room for some food. She has stopped drinking. Hopefully the Mirtazapine will kick in. I think I may have some famotidine you rub into the ear. Gonna go check my icebox, cat meds drawer.

 

You can make friskies into catsoup if you have a blender or magic bullet. Just add couple to table spoons of water to the can and blend.

 

ok, yes I have it. put some on her ear.

 

Please be very careful with this. There's some good info about it here http://www.felinecrf.org/subcutaneous_fluids.htm explaining how some vets think you can't over-hydrate a cat even with large amounts of fluid (if you've had CKD cats previously, you may already be familiar with this information of course).

 

Thank you. It's been some time, so I did not remember all this. TiTI's kidneys are already working too hard just taking over some of the duties of the pancreas.
By the way, since it is true that the kidney assumes some of the work the pancreas are no longer able to perform efficiently, is not this a strain on the kidneys that could lead to their rapider than ordinary deterioration? I've been worrying about this for some time now.

 

By the way, thank you for being so polite and gentle about this, rather than snorting, "YOU IDIOT! I do feel rather idiotic, not to have remembered this.

 

No need to feel idiotic at all - none of us can remember everything...and a lot of us land here early on knowing nothing at all! One of the things I love about this board is that no-one assumes any level of knowledge, and no-one criticizes. We all just try to help each other.

It is true that unregulated diabetes can accelerate kidney issues, or possibly even cause them. But the closer she gets to being regulated with insulin, the less strain her kidneys will be taking. I'm not sure where her glucose numbers are averaging, but if you can keep her below the renal threshold (which unfortunately does vary from cat to cat, but the more time she can spend under 250 the better), then you are protecting her kidneys from damage.

 

That's a huge relief. I knew 350 was too high, but my vet seemed ok with it. I mean she wasn't dancing, but she sort of shrugged. She's a very good doctor, an amazingly skilled surgeon, but seems a bit out of her knowledge base here. I noticed that with my chronic kidney disease cats also. Good vets but a bit out of wwater with it. The CkD group was incredibly good and helpful. I wish I had not waited so long to join this group. It is a great relief to hear much of what all of you are saying. It adds greatly to my ability to help TiTi.

If I have this correctly. I need to institute the testing, keep a spread sheet of the test results, make sure I have the sugar testing strips and the ones that check for ketones in the blood, find a consistent way to treat her recurring, and possibly ongoing pancreatis, and lower or raise her insulin no more than .25 of a unit per day. Is that correct?

 

A lot of vets don't fully understand the best way to treat diabetes in cats. It's a sad situation, but unfortunately true - they have to know a lot about many different illnesses in many different animals and they can't always be completely up to date with every last thing. My vet has actually told me that some of the things I've asked about for Rosa's CKD are beyond anything she's familiar with, but she is at least prepared to learn and, when we don't agree on something, she will quite often humor me with a medication as long as it isn't something that can cause harm. If your vet will at least work with you to achieve the results you want, that's quite often as good as you're going to find.

The testing will make a huge difference to you being able to take control of all this for TiTi. With the dose she's on right now, you might even find you save a good part of the testing costs back by being able to give less insulin each day. We do only adjust doses by 0.25 of a unit, but especially if we're increasing the dose, we would hold the new dose for a minimum of 3 days to allow the depot from the Lantus to 'catch up' to the dose so that we know we're getting the true readings for that dose before thinking about increasing again. If you have blood glucose test strips, which I believe are less expensive than the ones that check for both glucose and ketones, you should be able to cover ketone testing with just the regular ketostix from any pharmacy - that way if TiTi is running in high numbers, you can test her urine for ketones. That reduces the ketone testing to being on an 'as needed' basis rather than paying for strips that test for ketones every time when it isn't always necessary. The pancreatitis does need to be treated though - that may well be contributing to the difficulties in getting her numbers regulated and will almost certainly be the cause of her reluctance to eat.

 

Something with acetone in it, such as some nail polish removers, or paint cleaners.

 

I tried testing with "regular" nail polish remover where acetone was the first ingredient and got nothing. Pure acetone might yield different results.

 

The concentration may make a difference, too.

 

I use a CVS meter, which is 19.95, and the strips are 100 for 22.50. It's been a good meter so far, and you can't beat the price on the strips. You can also buy them, 50 for 11.22. I wish I could help on the Lantus, but I'm on Prozinc

Well, Dottie is on Prozinc I'm just the administrator

 

Good morning, Kathy. How is TiTi doing?