will not eat- help

Hi, I just joined and searched for 'won't eat' with no luck.
My 11yo DSH MN was just diagnosed. He got his 2nd dose of lantus 3U this am. I gave him Cerenia & 100cc fluid sub q & 3U last night, but I can't get him to eat, and I was looking for suggestions. I really don't want to have to force feed him. He hasn't really eaten in 5 days.
I am (many years ago) a vet tech, but it's different when it is your own child!
Does anyone have any suggestions??????

This is what I've tried: baby food 2 ham, chicken and turkey= nope
Fancy feast - all different varieties= nope
Boiled deli ham= nope LOL white American cheese= nope

 

This document has a section at the bottom on enticing your cat to eat: https://docs.google.com/document/d/1NSWUx2ak7wcs2_G5TXr7BhPMrU7CVmW_3ouKPTUQhhA/pub

3 units is a lot of lantus to start with. We usually start off at 1 unit and work up. When did you give it? I am very worried about a high dose of lantus yet no eating - thats setting you up for a hypo. My cat doesnt eat when too high ( weirdly enough) and may not feel like it when too low either.

Do you have a home blood testing kit? If not, can you pop out and get one? We need to know what his blood is doing - whether too high or too low or what... shopping list below.

Wendy

Getting started shopping list
1. Meter ie Walmart Relion Confirm or Micro.
2. Matching strips
3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool.
4. Cotton balls to stem the blood
5. Neosporin or Polysporin ointment with pain relief to heal the wound
6. Mini flashlight (optional) - useful to help see the ear veins in dark cats, and to press against
7. Ketone urine test strips ie ketodiastix or Relion ketone test strips- Important to check ketones when blood is high
8. Sharps container - to dispose of waste syringes and lancets.
9. Treats for the cat - like freeze dried chicken
10. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
11. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast

 

I know it is a high dose of lantus, but I believe the dose is .25U/kg. His normal weight is about 23 lbs (10.5 k). He's a huge cat. his glucose was 350.
I have pancake syrup if he goes hypo, but the vet thought 3 was good to start with - his ketones were high. He got 3 last night at 7:30 pm then again at 7:30 this am.
I broke the bank with his vet bills & meds, but my boss is diabetic (and really into gadgets) so I'll see if he has an extra meter.
Thank you so much for your suggestions!!!!
I really appreciate them!

 

Hi there I haven't had to feed with a syringe yet, but recently when my kitty started feeling nauseated (she has kidney disease and diabetes/remission) she would refuse to eat from the bowl but will eat off my fingers or off the spoon while I sit with her (wet food mashed up with water). It's messy but it worked ;-) She's now on slippery elm bark and Pepcid AC (as per the vet for her kidney disease stomach acid) so her appetite is much better.

Sometimes she will also eat when I move the bowl around (chasing with the bowl, some locations work and others not). Maybe you've tried these already but I wanted to mention it in case it helps :smile: I hope you can get the meter and test so you can monitor, it's a great tool and helps you know if kitty is safe. I got my meter free with 100 lancets when I bought the strips at my pharmacy and they said that's the norm (meter free with strips purchase). They have coupons on the different meter websites sometimes too to get extras like the lancets I got. Of course, if you broke the bank the strips do cost so maybe that suggestion doesn't help Good luck on the feeding of fuds

 

Thanks for the suggestions.... I currently have encrusted baby food in my hair, under my nails, on my desk, carpet, kitchen table cloth and walls!

 

What a visual, baby food everywhere! I feel your pain! I know how stressful it is when they won't eat :cry: Does your kitty have kidney disease too? You mentioned fluids. Sending good appy vines to you :smile:

 

His kidneys (BUN & creatinine) were within normal limits. My 17 yo Persian thinks it is Christmas morning finding little baby food presents all over the place.
Has anyone used mirtazapine as an appetite stimulant? I just found some.

 

Maybe try anything with a strong smell, tuna fish maybe. My cat ate Fresh Pet semi moist food, which is on the low carb list, when all else failed(they sell it at most super markets and walmart, probably pet food stores too, in the refrigerator.) It has a super strong smell. I also liquified his wet food making it almost baby food consistency in case he has a mouth sore that makes him not want to eat. At Petco they sell Halo brand "Spot's Stew" it's not the best on carbs but the new smell and super fine consistency made it easy to eat. Even at a bite at a time, it helps to get the calories in there.

Also if your cat has heartburn, try elevating his food dish so he doesn't have to bend over to eat. I wipe a little bit of food on my cat's lip so he gets a taste of what he's missing. Sometimes he can't smell the food unless he first gets a taste.

 

VELVEETA!!!
I finally got some in him. Microwaved, then cooled velveeta. It wasn't much, but at least it's a start. I'll run to the store and get some of the suggestions, and I'll post the foods the foods he'll eat, in hopes it may help someone else!

 

My poor sick boy!

 

What a pretty kitty I'm glad you got something in him. Please keep us updated, I hope you find some things that will work to stimulate appetite nailbite_smile I'm sorry I don't know anything about mirtazaptine. Like Mary mentioned, tuna juice diluted with water and mashed up tuna in it works for Chyna too (tuna in water only, not broth! and low sodium if you can find it) or the tuna water diluted sprinkled on her food. I've used the blender to make it or her wet food into a liquidy baby food consistancy too and finger fed food rubbing on her lips to get her to taste

 

Have you tried literally hand feeding him? I had a CRF kitty and when she was ill she would not eat off the plate, only off my fingers. In fact, the last 10 months of her life I hand fed her like that.
Also, the Cerenia, I mentioned my recent post about the antibiotics that Katie is sensitive to meds, Cerenia being one of them. Cerenia does not agree with Katie at all. It will reduce the vomiting, but the medicine makes her so sick and she won't eat at all on it.... just a thought.

 

Hello!
Welcome! My DM kitty just went through a not eating, drinking, peeing episode in May of this year. I syringed food & water, but nothing helped until I gave him 5 pieces of dry kitten food (Whiskas, wouldn't touch Iams). Stella & Chewey's freeze dry raw dinners (quite pricy) might tempt, although, mine will only have those as dry food but won't eat it when reconstituted with water. Try spreading food on small shallow saucers, my cat seems intimidated by his usual food dish when feeling sick.
Best wishes, Sophie

 

There are a few things that are going on that may be useful to think about.

First and foremost, please get a meter and home test. You have the correct formula for the initial dose of Lantus. What we don't know is how your boy is responding. It's very hard to know whether this is a good dose of insulin or not and whether this is contributing to his not eating.

I am always concerned if a cat is not eating for more than 2 - 3 days. You risk hepatic lipidosis developing and then you have an additional issue that you have to deal with. There is a wonderful assist feeding group on Yahoo. That may be a resource for you.

In addition to the shopping list that Wendy provided, please pick up Ketostix. If your kitty isn't feeling well and if there's some sort of infection/inflammation brewing, you risk ketones developing. (ketones = infection + not eating + not enough insulin) Testing for ketones is the best bit of prevention that you can do. I am concerned that he tested for ketones with your vet. This could be why your cat isn't eating. Please either get Ketostix and stalk your cat to the litter box or see if you can borrow a ketone meter from your vet. You can purchase a blood ketone meter although the strips are expensive. Are you sure your cat is not experiencing diabetic ketoacidosis? Has the vet ruled out pancreatitis?

Another member put together some ways to entice your cat to eat:

 

I have to echo Sienne's concerns. If you are able to get Iams Max Calorie or Royal Canin Recovery RS from a vet, you can syringe feed him. Max Cal has alot of calories which a cat with ketones needs and it is only 3% carbs. The Royal Canin is a little better consistency for syringe feeding and it is 7% carbs so neither will affect his BG that much. But, when it comes to a cat eating, I will quote my friend Sienne "we don't care if you give them a hot fudge sundae" (without the chocolate of course).....whatever you can get them to eat because you can adjust the dose of insulin if BGs go up from food. But, of course, you must hometest.

Here is one of the best videos I've seen on Assist Feeding your Cat.

He might be nauseous. You will want to address any nausea before you give him the mirtazapine. If you can get a script for ondansetron (zofran), it will help with any nausea. It comes in 4mg tabs (cheapest I've seen is at Costco) and the dose is 1/4 tab (which is 1 mg) bid.

 

In addition to a little velveeta, I got him to lick the gravy from FF chicken hearts and liver. I found some mirtazapine and gave him 3.75 mg to see if that will stimulate his appetite (yes, I consulted with my vet 1st).
Although he got something in his stomach, I can still smell the 'ketoacidosis' on his breath, which has me worried. I'll be giving him his 3rd shot of insulin (3U) and Cerenia now. Already gave him 100 cc's fluid Sub q. Tonight is the 24 hour mark so I'm hoping he'll come around soon. I have the keto stix so I'll try to get a little urine.
In addition to everything I mentioned, I have a bowl of kitten crunchies, kitten cookies, and I even offered him T-bone steak- nada.
And yes, I've been trying hand feeding, hence the encrusted baby food underneath my finger nails (and everywhere else)!
Will keep you posted, and thank you so much to everybody who has responded!!!!!
What a heart wrenching thing to go through.

 

I would suggest syringe feeding him some food. Did you check out the Feline Assisted Feeding Group? Here is a really good video on syringe feeding. He needs to eat. Mentioning Sienne's comment, have you tried vanilla ice cream, if he's not lactose intolerant? There are some Fancy Feast Delights flavors with cheese. They are higher in carbs, but again, he needs to eat.
Did you get a meter? We can help you to test his blood sugar.
With that high of a dose and him not eating and getting the fluids, his BG numbers could also be low.
I would definitely recommend testing him for ketones every chance you get, too.

I wish the best for you. Let us know if you have any questions.

 

Just after watching the syringe feeding video last night (although I have done this a million times before when I worked at the vet hosp), I look down and see the 1/4 mirtazapine pill lying on my desk, which I gave him at 3pm yesterday - #@$%!
So my BF wraps Spot Henry Dumpster Kitty in a towel (as seen on the video), I pop the pill way down, and by 11pm he's licking thru a can of FF. This morning he licked thru another can...... now he's only eating a little of the meat, but showing interest in food is a huge improvement.
I read a test study from (England?) on Mirtazapine and cats, and the study showed that cats actually metabolize mirtazapine faster than previously thought. Where the normal dose was every 3 days, they now believe it should be changed to every 48 hours. I will keep this in mind on Tuesday if he stops eating again.
You can't...... well, you can imagine the horror I went thru trying to get my poor boy to eat, knowing he was dying right in front of my eyes every time I tried to get him to eat and he refused everything. Yesterday morning I literally went thru my refrigerator and freezer trying everything! I was down to butter and velveeta, so thankfully he licked the velveeta and got something down.
I will get a glucose meter as soon as I can-I spent my whole paycheck at the vets so maybe Spot's Oma (my Mom) will help.

 

You can get a free meter on this sight. People donate them. There's a link at the top of the page, I think.

 

Remember you dont need the alphatrak - the relion at walmart is almost as good and much cheaper for strips etc.

 

So, are you saying he did not get the mirtz at 3:00pm, but at 11:00pm, instead?

I hope he keeps eating, once his tummy remembers how good having a full tummy feels.
I have gone to the grocery store, buying different cat foods, and treats, and tunas, and cheese, and meats, and fish, and baby food, and ice cream, desparately seeking something my cat would eat. I know how you feel, except you had to seek out what was in your frig.

Once you get some money, you might find that cyproheptadine works better for you as an appetite stimulant. It can be given daily and works in about 30 minutes. I use it as needed. I just found that with the mirtz my cat got agitated and it would work for about a day to a day and a half and then I would have to wait another long day to give him some more. I would feed your cat in small meals often, to fill him up, while he's eating.

Continued eating vines being sent to DumpsterKitty.

 

He got the mirtazapine at 11pm last night. By 11:30 he was chowing (licking - but I'll take that). This morning he was interested in food also - still licking.
Thank you for directions to the Home Testing Kits link - which was staring me in the face the whole time. I will give my boss and Oma another change to help me today. If I haven't got one by tomorrow, I'll see if I can get a donated one. I'll call the animal shelters in my area 1st. You never know.
I'll be done working by 2pm est. Thankfully, I work out of my house! If I had a real job, I'd be fired already.
What is so odd, is that I have always fed both cats small meals throughout the day- and only canned. Perhaps this diabetes had been going on for some time but since I always fed him small amounts, he was able to maintain - until he couldn't anymore.
Now let's call Oma to see if we can (play the violin and) take a trip to walmart and get a meter!

I am so grateful to everybody hear! You make my eyes well up with tears! I can't thank you enough!

 

It's a good thing I'm reading these posts over and over, there is a lot to absorb when your mind is in complete chaos.
So I need:
1) ReliOn Micro Blood Glucose Monitor
2) ReliOn Prime Blood Glucose Test Strips, 50ct
3) ReliOn 30G Ultra Thin Lancets 210ct
I found arkray 29 gauge lancets
?????

 

You want the 27-28 gauge lancets or you may not get blood starting out.

Also urine test strips - KetoStix (ketones only) or KetoDiaStix (ketones and glucose.)

Some Secondary Monitoring Tools in my signature link may be helpful, too.

 

I have ketostix, I'll look for a larger gauge lancet.

 

The larger gauge lancets are usually labeled "For Alternate Site Testing" on the box.

So glad to hear the appetite is better. Sometimes, those appetite stimulants are life savers.

Wow, avatar picture and signature data and everything. The only thing you need now is that google doc for the Spreadsheet. You can look in the Tech Support forum and look for "how to create SS and link to your signature" in the announcements section of the Tech Support forum.

Beautiful Kitty. Your Location says Jersey and Keys. Is that because you live in 2 different spots in the US? Does that stand for NJ and Florida Keys?

 

I'm so happy that you got some food in him For lancets, I use the Accu-Chek Softclix, they are 28g. Some lancets don't say on the box but my pharmacist was really nice and let me read a bunch when I was first looking :lol: I hope everything continues to improve for you guys

 

I am doing research online to find the most affordable test strips.
I got Spot to eat 1/2 piece of bacon.... so now off to find meter.
I'm from Jersey, lived in the FL Keys- which is where Spot comes from, then came back to Jersey. He literally followed me home from a night of clubbing. He jumped in my truck, ran in my house, and lied down on my (late) BF's chest. my BF said "well, I guess he found his spot, hey his nose looks like my cousin Henry's nose". I found out later he was a dumpster kitty from behind the Cuban Market, and found his food between 2 guard dogs food bowls. The owner of the guard dogs said he can't get near them when they eat, but they didn't mind sharing with the 'dumpster kitty'.

 

Thanks for sharing Spot's story :smile: I'm glad he finally found you.

About the cheapest I've seen for test strips is the ReliOn Prime where you get 50 strips for $9 if you have a WalMart near you, or you can use the link to ADW (American Diabetes Wholesale) on this site where we get a percentage of the sales to FDMB, and get the Arkray Vital where you can get 250 strips for $45 and you get a free meter if you buy 200 strips. I use the Arkray and they are delivered very fast, and they have Free Shipping on all orders, right now (normally it's $3.95 shipping, I think). If you have a WalMart near by that may be the way to go, because if you run out of strips, you can always run to WalMart. Both of these choices are about .18 cents per test strip.

 

You mentioned that you can smell ketones. I'm presuming you mean you're smelling acetone on Spot's breath. Please test for ketones ASAP. If you can smell ketones it's likely that they are beyond trace levels and not manageable at home.

Please make sure you are getting water into Spot -- add water to his food. He may need subcutaneous fluids.

 

Yes, I can smell that he is in ketoacidosis. The only reason why he let me take him home is because I'm a vet tech. I am giving him 100cc's sub q daily.
I just came back from walmart with all the BG goodies. I'm reading the manual now. He is due for 3U at 8:30 so I'll test him before I give it.

 

Let us know how it goes with the BG testing.

That ketone smell on his breath is worrisome. He may need electrolytes in addition to the sub-q fluids.

Love the story of how he joined your family and got his name.

 

I have searched this forum all over the place... how often should I test Spot? Since he's in a 'delicate' situation now, I'd like to do it every hour- but I know that is not helpful. What are the recommended times for a new 'club member'? He gets his insulin at 8am and 8pm. Should I test right before?

 

Heres some testing tips if it helps https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

We recommend. you test always before every single shot. As a newbie I wouldnt shoot under 200 until you have the data to know how he will behave. Then a test mid cycle is 5-7 hours after the shot to see his nadir. Then a before bed test to see what his plans are overnight. Thats the minimum. Depending on what he is doing you might want some more tests and spot checks.

we also recommend you set up a spreadsheet to track trends etc - and we can look at it and advise too :http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Wendy

 

Did you get the urine ketone test strips to see the actual levels? Here are urine catching ideas https://docs.google.com/document/d/1quta5WLEjdO0Y_t2dAYSwN84h-LNZWxOdtVsJDKZ16A/pub

 

I've had the keto stix from an atkins stint, but haven't gotten any urine...... I can tell his ketones are high by his breath.
I've only done this a hundred times at the animal hospital, but it is different when it's your own baby. I've always gotten blood from the arm, but I've drawn blood from rabbits from the ear.
I'm setting up the monitor now. Will let you know.

 

Whoops. I went thru his ear and poked my finger. It was 65, and he had just eaten. I'm going to check it again.

 

Ok, it was 75. He's due for insulin soon, but I'll hold off until I hear from someone as to what to do.

 

At first I thought you meant you were at 65 :lol:

Uh, hold on, I'm going to try to get some other eyes from the Lantus forum to look at this post. brb.

 

Dyana asked me to pop on.

Let me read the thread, ok? I'll be quick. It will be ok to not shoot until I can catch up.

BRB.

 

How long until his shot? Is he still eating? Have you been able to get any urine to test his ketones?

I'm also concerned that you are still smelling ketones on his breath. Are you giving him LRS or Normosol R? I'm not sure that 100 mls sid is enough for a DKA kitty. Most of these cats need to be on IV fluids with some electrolytes added.

 

He's still eating, and due for his insulin now. I haven't smelled his breath today yet.
I have his meds in the signature

 

My BF said he did not smell ketoacidosis on his breath today, but he said the smell was very strong Friday night.

 

Here are my concerns:

---DKA kitty so he needs insulin and food

---you have no test data on him and so we do not know how he responds to food if his numbers are low

---you've only done a few tests (1 or 2?) and don't know if he will continue to allow you to do it if he goes really low

---he should be in the hospital so they can get enough insulin in him but monitor him closely in case his BG drops

You don't really have the option of not shooting this kitty.....he has to have insulin. Can you afford to be off schedule? I'm thinking you should stall and test in 30 minutes and see if he is coming up. You would have to shoot 12 hours from when you shoot tonight and make up the time 15 min/each cycle.

When was the last time you fed him, what did you feed, and how much? Do you have alot of HC food/gravy, test strips, and karo or other syrup there?

 

Hi, I'm sorry if I missed your name?

My kitty J.D. is a DKA survivor and he was hospitalized for 8 1/2 days, so that's why I'm so concerned about Spot.

Can you please smell his breath and if at all possible get a ketone test?

I was thinking, you may need to shoot a reduced dose, but I can't stay up with you to check on you, and we have a responsibility that if we say "shoot" to stay up with the caregiver, so that's why I asked for more eyes. Also, this is a little more than I am used to handling.
Spot may not make it without hospitalization. DKA is very very serious.
My cat was in critical condition when he went to the hospital. Lots of cats get DKA in the beginning, and some later on, and lots of cats survive it, but some don't. I know when J.D. was hospitalized his electrolytes were all off and his blood was acidic. He wasn't eating, and ended up coming home with a feeding tube for a few days.

The recipe for DKA is not enough insulin, not enough food, and a possible infection.

I hope we can help you to pull Spot through. Please keep assist feeding him if he won't eat on his own, and please keep testing him through the night if you decide to shoot.

ETA: I see Marje already posted.

 

Um stupid question but if he is at 75 why are we getting ketones? Remember all we have to go on is the "smell". I really think we need that urine sample

 

He ate right before I tested him. I have all the appropriate stuff. His breath does not smell now.

 

Good point, Wendy ;-) . Oh, I hope hope hope ketones are negative. Fingers crossed.

 

ok its been an hour since the test , can you get another one? You didnt shoot did you?

 

If you fed him right before you tested, then you absolutely have to stall if you want to get insulin in him tonight. If that 75 could possibly be a food spike then his BG could be even lower.

Can you take a look at all the questions I asked please and respond? Thank you so much!!! Just trying to figure out the best way to help him. And your name???



Wendy: Cats in DKA can still have a drop in their BG if they are getting enough insulin. His electrolytes can still be low.

 

I read here : http://petdiabetes.wikia.com/wiki/Blood ... guidelines
that if he tested at 75 you should reduce the insulin by .5 to 1. so I'm thinking of giving him 2U tonight?

 

Because ketones are from fat breakdown. Also if the cat isn't eating, the glucose may be low.

 

He's eating a little here and there FF morsels with gravy, but he is mostly licking the gravy. I would say he's had the equivalent of 1 can FF throughout the day. I have a ton of FF, test strips and I made a batch of syrup (boiled sugar & water).

 

That is not what we use as the guidelines and we're talking about a different situation here because of his DKA.

Have you retested and how long has it been now since he ate and you tested last?

 

Just to clarify, BG numbers do not have to be high for ketones to develop. There can be an underlying infection coupled with this kitty not eating.

I also want to underscore that IF Spot is experiencing diabetic ketoacidosis and not just throwing below trace level ketones, this can't be managed at home. Treating DKA requires IV infusion of electrolytes and constant monitoring to make sure the electrolytes are being properly titrated. None of us are equipped to run labs at home.

It is imperative that you get ketone tests whenever you can.

In a cat that is prone to developing ketones, getting insulin in is imperative. It's also critical that your cat eats. Frankly, I don't care if you have to feed your cat an ice cream sundae. If that's what he'll eat, that's fine. If he'll eat high carb food, that's fine. I do think we need to know if your cat will eat. If he's refusing to eat, it's going to be very difficult to give insulin and without insulin and food on board, you're risking ketones further developing.

Please respond to the questions that Marje raised.

 

We are scared for you and Spot.

We know you are a vet tech, but you may not be able to handle the DKA at home. It's very hard to be calm, cool, collected and objective when you are treating a member of your own family. Human doctors do not treat their own family.

 

His reading was 75 again. I'm afraid if I give him 3U he'll get too low.

 

Is that a preshot test? If yes, the dose is too high. Ideally you want a dose that may be shot safely every 12 hours.

We suggest newcomers not shoot unless the blood glucose is 200 or greater.

 

His glucose was 65 at 8pm --- 75 at 8:30, then 75 again at 10 pm. These were all pre-insulin which was due at 8:30pm. Spot has been licking his food throughout the whole time. I guess I'll hold off his insulin until I speak with the vet in the am.

 

Thank you thank you thank you!!!! You all kept my brain from exploding! We'll see what he is in the am.

 

I just have to go on record here that the worse thing you can do is NOT give a cat with DKA insulin. I'd rather you give some insulin and test every hour and prop up the numbers with HC if you have to.

I think even if he does not have ketones, you are taking a risk by not shooting something. IMHO.

 

Now he's eating crunchies. He's really acting like he is feeling fine, but I'll check it one more time in an hour, and follow him to the commode with stick. If there are no ketones, I'll wait til the morn, if there are; I'll give him a reduced dose of insulin.

 

The preceding statement may be correct IF the cat is not prone to ketones or has some other medical reason that insulin needs to be given.

I'm going on the record along with Marje. Your cat appears to be prone to developing ketones. It is imperative that you provide insulin to a ketone prone cat or you risk the cat developing DKA. The primary cause for DKA is insufficient insulin. Ketones can develop quickly and can be lethal.

 

If he's barely eating and dealing with DKA, adding insulin and causing a hypo on top of it doesn't make a lot of sense either. I think the cat needs to be hospitalized in that case.

If he is actually eating enough, you'll want to be careful with the dose.

Is he eating?
Is the glucose rising?

 

The reason we test and manage the curve with food..including HC, if needed...is to prevent a clinical hypo. That's why I said " test every hour if you have to".

 

I want to put what everyone said in context here. We are worried because we have seen too many kitties die of DKA. We want to be sure it doesn't happen here.

Please, for everyone's benefit, start testing for ketones on a daily basis using the strips. I think I gave urine catching ideas above.

Guys, how much insulin do you want her to give? I am guessing not the full dose based on the low readings?

Wendy

 

Depends on what his BG is now. Normally if we stall, we shoot the full dose since stalling acts like a reduction.

 

He's eating fine now- he has successfully licked the gravy out of 6 cans of FF, and got quite a bit of meat down too. I retested at midnite and it was still 75 (I even tested my blood to make sure meter was working). His ketostix was negative, so I feel a little better skipping his insulin.
He's acting like nothing is wrong- but don't worry, I won't be lulled into falsely thinking he's cured. 1st thing in the am I'll test him and call the vet.

 

It'd not unusual to get two tests the same but three is......

Are the ketostix fresh? Please be sure you stay on top of testing his ketones. I still wish you had shot....

 

So this morning his BG was 333 - after he ate, so I gave him the 3U. Keto stix are good and fresh so I'll check again today.

 

the higher bg number was to be expected after dropping low and skipping a shot.

happy to hear your ketostix are fresh. several of the ketostix brands expire 3 months after opening the container.
my cat is ketone prone. if appropriate and whenever possible, i try to check her urine for ketones twice a day.

i don't think anyone asked...
is 23 pounds an "ideal" weight for spot? in other words, is he overweight at all? the reason i'm asking is the starting dose of 3u bid does seem rather high and it left him in double digits 12 hours after only the second fourth shot. the Tight Regulation formula used to calculate an initial starting dose of lantus is based on ideal weight rather than actual weight.

"if" 23 pounds is an ideal weight for spot, the initial starting dose would be 0.25u x 10.5kg or 2.62 units. *usually* we'd suggest rounding that off to 2.5 units shot twice a day.

lantus is a depot insulin. it has a cumulative effect. one dose builds upon the next. if spot is throwing double digits after receiving only two four shots of lantus... one has to seriously consider the initial starting dose could have been set too high.

 

true, but there are always exceptions to the norm.

even with a stall... unless kitty's numbers zoomed to the moon within a reasonable amount of time... i'd have a hard time suggesting shooting a full dose without presuming the initial starting dose is "correct", some data to support to suggest shooting a full dose into a cat who is not eating as well, and knowing if kitty is actively throwing ketones... given the fact that kitty was in double digits after only the second fourth shot of lantus. too many unknowns for my comfort level, but that's not to say i advocate skipping the shot. providing an adequate supply of insulin to a kitty with a recent history of ketones/DKA is imperative.

just my thoughts...

 

another true statement, but the suggestion not to shoot unless blood glucose is 200 or greater can be downright dangerous when there's been a recent history of ketones or in a ketone prone kitty. imho, we have to recognize the exceptions when there are other complications to consider.

 

Spot's double digit reading - 75, was after 4 shots of insulin (I did not realize it was cumulative) Fri nite 3U -- sat am 3U -- sat nite 3U & sun am 3U. Sunday was really his 1st full day of eating.
I believe he was in ketosis because of not eating for so long, but I'm still trying to get another ketostix reading... he's become 'pee shy' LOL.
If you see me either repeating myself, or not answering, please forgive me. I am trying to read and absorb and re read and..... well try to remember how you were when your kitty was 1st diagnosed. It is a lot to swallow.
My 17 yo (avatar) requires a lot of attention too, and now that Spot is feeling better, it is a constant battle of 'who can get Mommy's attention the most".

 

His normal weight should be 25 lbs. When he followed me home, I thought he was a full grown adult... when I checked his teeth to see how old he was I was shocked to see kitten teeth! He is a huge cat. We laugh when we see pictures on the web of 'large cats' because Spot is every bit as big as them.
5 years ago he got to 29 lbs, so we built a floor to ceiling cat poll with shelves. I found some of those freeze dried chicken treats (which much to my dismay, I can not find anymore), and invented a game of throwing the treat down the hallway, then putting one up on the top shelf. He loved it and lost the extra weight in about 3 months!

 

Try Halo Liv A Little or PureBite treats.

Some dried meat treats in the canine section may be less expensive, though you'll need to break them into smaller pieces.

 

cat pole on far right. Ignore the mess please.... this was taken after hurricane sandy! I have a better pic on my other computer.

 

Now he's 275 6 hours after I gave him the 3U insulin. Still no luck with the ketostix today yet, so I have to be a little more stealthy. I'm going to give him 100cc's of fluid now so hopefully I'll have a urine sample soon.

 

BG is 281. I'm thinking about slightly lowering it to 2 1/2 U. I went thru some charts and it looks like his average weight is 23 lbs.
Does anyone have any thought on this?
How often should I be testing his BG?

 

Did you get a ketone test? The result of that test will determine whether to lower the dose or not. How has he been eating, today? Good, I hope.

 

thanks for the correction on the number of shots given. i'll fix it on my other post.

the action of the two long-acting insulins, lantus and levemir, is cumulative. *usually* we hold the initial starting dose for 5 - 7 days to see what the dose can actually do... unless there are indications a reduction is needed because the dose was set too high or kitty drops below 50 OR an dose increase is needed because numbers are high and flat or in the presence of ketones.

you can read more about the Tight Regulation Protocol here: Protocol: Tight Regulation with Lantus®or Levemir® for Diabetic Cats.
the American Animal Hospital Association guidelines can be viewed here: AAHAD Diabetes Management Guidelines for Dogs and Cats.

this is definitely overwhelming... especially at first. you've also been under pressure to get spot to eat coupled with the threat of ketones. it becomes exhausting both physically and emotionally. we understand. in spite of that you're doing great! how's his appetite today? hope he's eating well and on his own.

BG is 281. how many hours after the shot did you get the 281?

lowering the dose to 2.5u sounds reasonable to me, but let's see what kind of results you get on the next ketone test before adjusting the dose.

as far as how often to test goes... you'll have to let the numbers be your guide. you'll want to get random spot checks done to give you an idea where his numbers are headed in that cycle. for example, a +2 with lantus (test taken 2 hours after the shot) will often provide a clue. if the +2 is around the same or lower than the preshot number chances are you'll be looking at an active cycle. an active cycle means that you could see a substantial drop. in that case you may want to test every couple of hours until the numbers begin to rise again. if you post your test results there are many who can help guide you until you get the hang of things.

since we have members from all over the world and we live in different time zones we speak in what we call "plus hours":
amps = preshot number taken in the morning just before the shot
+1 = test taken 1 hour after the shot
+6 = test taken 6 hours after the shot
+9 = test taken 9 hours after the shot... and so on
pmps = preshot number taken n the evening just before the shot

each cycle has 12 hours in it.


edited to add: wow! that's quite a cat pole for such a handsome guy! :mrgreen:

 

OK. Spots BG was 281 11 1/2 hours after his morning 3U. It was high throughout the day, so I cut his dose back by .5U meaning I gave 2.5U which seems more appropriate for his weight. He is eating regularly, but he is waiting for me to go into the bathroom so he can use the litter box - too smart for his own good. I'll get saran wrap tomorrow so I can check his ketones, but his breath smells fruity now.
I'll finish reading everyone's post tomorrow and answer more questions...... I'm seeing cross eyed now. Strange how quickly your life can change.
Thank you everybody!!!

 

if spot's breath smells like he's throwing ketones (fruity odor), it's more important than ever to grab a ketone test. if alex's breath smelled fruity i'd be on the phone with my vet. reducing the dose "if" spot is throwing ketones is not a good idea.

is it possible to line a litter box with a plastic bag and isolate him in a separate room (bathroom, bedroom) with the box? you could put a light dusting of litter on top of the plastic. you'd probably be able to grab some urine for testing purposes. his breath smelling fruity is concerning.

ketone odor on the breath is one of the signs of diabetic ketoacidosis.

 

Keeping Spot in one room is impossible, so I'll get saran wrap for the keto test. I also want to pick up a smaller gauge lancet. I do not smell the acetone on his breath, and haven't for the last couple of days.
This am his BG is 118 before insulin.

 

Another question..... I held off the insulin this morning (118) and tonight I'll test. If he is over 200, I will go to 2U of lantus (spoke with vet). He is eating and back to his devilish self.
About the lancet, what is the easiest way of getting his droplet of blood? I got the 26g, and if I do it lightly I don't get enough blood to test, which has brought me to this:
In order to puncture his ear successfully, I'm going straight thru his ear and into my finger (don't worry- I'm testing HIS blood- not my own LOL).
I need suggestions.... my fingers hurt and I don't want him to shy away from me touching his ear.

 

Heres some testing tips - you want to go in at a 45 degree angle and have something hard behind the ear to press against. Will help you poke at differnet depths and save your fingers lol

https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

 

I have no problem finding the vein, I just need to figure out what size & length lancet I need, and if I should get one of those lancet holder device thing???

 

Newbies usually use 28 or 29 g. Are you going in at a 45 degree angle? Are you putting something hard ( like a pill bottle lid) behind the ear? Both give you more control.

You could try a lancet tool too.

 

I felt like I had better control using the lancet free-hand. Whatever works for you is OK.

 

When I go in at a 45° angle, I don't prick it hard enough, and when I hold something (other than my finger) against his ear; he squirms away. I need to find the right gauge, depth, and tool to use. Any suggestions would be appreciated. Unfortunately trial and error is not an option at the moment.

 

good morning! i have to admit, i'm confused. :?

last night you said:

this morning you said:

smelling fruity/acetone breath is one of the signs of DKA. it's why we've all been so concerned.

it's so good to hear he's eating and acting like himself! love hearing that news! :mrgreen:
i'm glad you spoke to your vet to let him/her know what's been going on. regularly testing spot for ketones will give your vet a better idea about dosing.

you might have to experiment with the depth selections on the lancet to find the one that works best for spot. i find it helpful to fold a tissue into a small square to place between kitty's ear and my finger. the tissue acts like a cushion and allows me to apply slight pressure when using the lancet.


most of us use a spreadsheet to keep track of kitty's glucose readings. a spreadsheet will help you spot trends and patterns as well as a place to record pertinent notes and observations. directions for setting up a spreadsheet can be found here: How to Get a SS and Link in your Signature *updated 2/13/12. ask for help if you have trouble with it. there are several members who are able to offer assistance.



i won't be able to get back here until late tonight (long work day), but don't be shy about posting if you have questions or need any help. members are very generous with their time and support.

have a good day! :mrgreen:

 

we don't aim for the vein. here's a picture of Laur and Danny's Famous Photo of "The Sweet Spot ": http://i106.photobucket.com/albums/m267/chupie_2006/testingear/sweetspot.jpg

you can also find a slew of hometesting tips and tricks as well as videos here: Hometesting Links and Tips.

using a lancet device... or not... is a matter of personal preference. i find i have better control if i use a lancet device, but others prefer poking freehand. when i first started hometesting, i was able to get blood every time with 25 & 26 gauge lancets.

 

Thank you. I have been using the booklet that came with the meter to record his BG for now. I tried the spread sheet link thing, but I think I overloaded my brain trying to figure it out. I'll have to have the BF figure it out.

 

BTW, my name is Pip.... (don't ask LOL)!
Which lancet device gives you depth options? what size needle works best when you use the device? Should I keep his insulin refrigerated so it will last 5 months?

 

Any lancing pen should have depth adjustments on it.
It's not a question of which size needle works best with a lancing pen. It's a question of which lancet fits the lancing pen. As long as you buy lancets made by the same manufacturer as the lancing pen, the lancets should fit just fine.

Yes, keep the insulin refrigerated. I keep mine in the original box (to protect from light), on a lesser used shelf in the fridge (not in the door of the fridge because it's a bit warmer and shakes every time you open the door), in a coffee mug with some paper towels stuffed around the inside of the mug and the box of insulin. Mug handle gives me a good surface to grab onto. Less chance of dropping the insulin inside the coffee mug on my tile floor and shattering the vial.

With proper care, a vial of Lantus can last you 4-6 months refrigerated.

 

Can anyone suggest an easy to use lancet device?

 

The WalMart ReliOn lancet pen had depth adjustments and seem to work with their lancets just fine.

Practice with both on something like an apple or your arm to get a feel for both tactics.

I have vision issues, so free-handing worked better for me - I could see where the lancet was going and felt like I had more control.

 

Thank you all for being there when I didn't know where to turn! You saved my sanity and my beloved Spot's life!
My Dad had an emergency.... just when things started to calm down with Spot.
Spot has been on 2U BID since Tuesday night and he's been testing in the 200s (220 last night and 240 this am).
What BG #'s should I be shooting for?

 

Do you have nadir (the lowest point in the cycle) tests?

 

No I haven't. As soon as feasible I will get a lancet which suits our needs. The 26g he can't stand and I don't want to make him ear shy, so I'm only checking him before his am & pm insulin.
(As an aside, my boss is currently writing a book on diabetes!)