11/19 Webster AMPS=450 +6.5=46 +9.5=94 Dosing advice

Here we go again. This time Webster is sitting in the bathtub for the first time ever. I don't know if he's not feeling good or just angry at us for poking him so much. He seems to be alert and his eyes look okay. Hes refusing to eat chicken treats or even his favorite tempations. Trying to offer HC wet food right now.

He seemed to eat some HC dry food and some LC wet food last night. Maybe hes not eating enough pre shot? Maybe this is once again the result of yesterdays drop?

 

Re: 11/19 Webster AMPS 450 +3=83

He finally ate 4 treats - dipped in high carb gravy. Will retest in 20 mins.

 

Re: 11/19 Webster AMPS 450 +3=83

Just so you can factor this in...

It takes much longer for dry food or even Temptations to be metabolized and bring BG levels up. By the same token, the stuff hangs around for a very long time. This is why we us gravy-based, HC food. All of the carbs are in the gravy. If Webster is gluten sensitive or you want a bigger boost for your buck, add a drop or two of corn syrup (e.g., Karo), honey, maple, syrup, etc.

 

Re: 11/19 Webster AMPS 450 +3=83

Sounds like Webster isn't feeling so great. That's a big drop. I imagine it must feel funny when that happens. I was thinking, does Webster like to play at all? My Buster doesn't so I can't use that to perk him up or as a bonding tool, but maybe Webster might like a little playtime with you? Just a thought. I'm sorry you're having such a rough time. :YMHUG: I hope he stays safe for you today.

 

Re: 11/19 Webster AMPS 450 +3=83

Thank you. I understand. I purchased some HC gravy food for events such as the one today. However, he doesn't seem to have much of an appetite for the HC gravy at the moment. We managed to sneak in a drop of gravy onto 4 treats.

 

Re: 11/19 Webster AMPS 450 +3=83

Do you have a PetCo near you? Max is a picky eater but loves the Soulistic Triple Harmony pouches which I use as a high carb food. It's a combo of chicken, salmon, and tuna. That is the only store that carries it. If I really need him up in a hurry I give him that with a drop or two of karo.

 

Re: 11/19 Webster AMPS 450 +3=83

55 - 50 mins since last test. Trying to feed him anything dipped in karo

 

Re: 11/19 Webster AMPS 450 +3=83

He's not going for the treats dipped in karo. Syringe feeding him food + a few drops of karo

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55

I'm glad you were able to get some food into him. Test again in 30 minutes.

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55

Will do. BTW, I'm really sorry to hear about your loss of JD.

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55

Thank you.

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59

59 @ 4.5

No longer plummeting. He perked up, came out of the tub and sat up looking at the window.

Should I retest in 30 or 60?

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59

I'd retest in 30. If you see him sitting in the 50s for a couple hours, then you can know that he is just surfing along in the 50s, but for right now, lets just make sure that's what he's planning on or whatever. See if he will eat his regular LC, but not too much.

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59

Looks like he dropped down to 50. Trying to get him to eat LC wet food and he has little interest. Hes accepting temptation treats so gave him a couple. He ate a little of his old dry food. Will retest 1/2 hr.

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59

Has he been eating normally, otherwise? Do you have any MC? A teaspoon of that may help him up a bit.

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59

It's hard to say whether or not he is eating normally. He got out of the hospital on Saturday after going through DKA and did not have much of an appetite. His diet prior to the DKA incident and diabetes diagnosis was exclusively cheap dry food. Since his return home I have been putting out 3 bowls of different LC wet food as well as a small bowl of his dry food. He seems to eat mostly dry food but has showing some interest in one LC food in particular.

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59 +5=50 +5.5

He seems to be hanging in around the low 50's. Not eating much of any wet food at the moment that I put in front of him - MC or HC. He has however ate some of his old dry food.

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59 +5=50 +5.5

If it were me, I would test again at +6.

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59 +5=50 +5.5

Max would only eat dry food before he got pancreatitis. Another food to try while trying to transition from dry is Stella & Chewy's freeze dried chicken or turkey. It can be mixed with water to rehydrate if he likes it to transition to canned. It is a low carb food and comes in individual pouches to try and if he likes it then can be purchased from chewy.com. It might only be available at boutique pet stores locally.

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59 +5=50 +5.5

Dropping again +6.5= 46. Feeding temptations trying to get number up. Dipped one in karo and he ate it.

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59 +5=50 +6.5

I think I would try to give him some more of that food with a drop of karo via syringe. Test again in 30 minutes.
I have to run to the vet but will be back before your next test.

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59 +5=50 +6.5

Maybe you should syringe the karo if he won't eat? Just a thought. On the other hand he should nadir fairly soon.

You will more than likely be reducing the insulin after that 46 but do post for advice later after we see how this cycle plays out. I know you wanted to stop testing. You may get your wish soon if you can get Webster on a low carb canned food. One step at a time though. I speculate way too early. I haven't dealt with drops from 450 to 46 even reducing doses. Maybe the infection is going away and helping as well? Hope so. Hang in there.

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59 +5=50 +6.5

Hi Mike,
Have you tried grinding up some of his favorite cheap dry food in a blender and sprinkling it on wet food? What brand of wet food are you feeding? Most cats really love the Fancy Feast varieties. When Rusty had pancreatitis the only thing he would eat was Fancy Feast Turkey & Giblets Classic (reputed to be 3% carbs, but I have always thought it was more).

Hang in there!

Ella & Rusty

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59 +5=50 +6.5

if you have no blender....
take a Ziploc bag and anything hard.... you can crumble anything inside the bag.....and have dust....

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59 +5=50 +6.5

He had a drop on a treat along with 4 treats. He appears content, laying on the bed grooming his self?

I really hope the Nadir comes soon. What ever happened to his liver responding to the dramatic drop? Shouldn't it have flooded his system with sugars?

I'm not sure if he has an infection. The vet did not specify that he had an infection but said to give him the AB as a precautionary measure.

If it doesn't increase when I check it in a few mins how much should karo should I syringe feed?

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59 +5=50 +6.5

And Congratulations on that dose reduction.....
:mrgreen:

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59 +5=50 +6.5

The bounce will come....


it takes 30 minutes for anything fed to really show up....
hopefully you won't need to add more syrup... but if so, add another drop.

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59 +5=50 +6.5

Iv'e been giving him several different ones to try. So far, the Friskies Special Diet Turkey and Giblets is his favorite. He will eat some of that along with some of his old dry food.

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59 +5=50 +6.5

I will try sprinkling some dry food on top of his wet this evening.

 

Re: 11/19 Webster AMPS 450 +3.75=55 +4.5=59 +5=50 +6.5=46 +7

+7=56. Up 10 points.

Should I just let it ride from here and keep testing or feed him more?

 

Re: 11/19 Webster AMPS 450 +3.75=55 +4.5=59 +5=50 +6.5=46 +7

10 up isn't really a difference with meter variance.

Continue monitoring.... you want rising numbers without the influence of food....
but since you are using dry.... it does take a little longer to see the effect.

 

Re: 11/19 Webster AMPS 450 +3.75=55 +4.5=59 +5=50 +6.5=46 +7

Test again at +7.5. It's late in the cycle, so his regular insulin should be starting to wear out, but he could still come down.
I think holding off on food is would be fine and we'll see what the next test is. 10 points up from a drop of karo isn't that much of a climb. I also think if he is hungry and wants to eat wet food, let him (up until +10). Others may say to stop feeding him now, but I am slightly concerned with his lack of appetite.

 

Re: 11/19 Webster AMPS 450 +3.75=55 +4.5=59 +5=50 +6.5=46 +7

63@ +7.5

Slight rise. He's seems very tired and is napping on the bed.

 

Re: 11/19 Webster AMPS 450 +3.75=55 +4.5=59 +5=50 +6.5=46 +7

I blended some of his old dry food into dust to sprinkle on his food later on as suggested earlier.

So far, I have imposed no restrictions on what he eats. I have been leaving out 3-4 low carb canned food choices as well as a bowl of his old dry food 24 hours each day. If he is not eating enough I doubt the reason would be because he doesn't like the food that's given to him. I'm allowing him the free choice to sample LC foods while not taking away his old dry food so that I can find one that he will actually enjoy eating.

 

Re: 11/19 Webster AMPS 450 +3=83 +3.75=55 +4.5=59 +5=50 +5.5

Hi Elise. Sorry I didn't catch you food suggestions earlier. I was in a bit of a panic. I just went back and took note. Thank you.

 

Re: 11/19 Webster AMPS 450 +3.75=55 +4.5=59 +5=50 +6.5=46 +7

Numbers are updated. He's holding steady at 94 which is the exact reading from the last hour.

Guys, I'm really going to need some help tonight as his next dose is due at 9PM eastern time (2 hours from now). He has been laying on the bed sleeping and grooming himself for the past several hours and seems to be a bit on the tired side. He's hasn't come out to the kitchen looking for food yet.

 

Re: 11/19 Webster AMPS 450 +3.75=55 +4.5=59 +5=50+6.5=46 +9.

Hi Mike. I just got back from a quick Costco run. In the first subject nix put a question mark . Erase some of the numbers. Keep the first, low, and lady . Then wrote dosing advice and someone will help you with it. I'd post on TR as well with a link to this thread.

 

Re: 11/19 Webster AMPS 450 +3.75=55 +4.5=59 +5=50+6.5=46 +9.

Thank you so much Elise! :smile:

 

Your welcome. I lt should have read last!

 

With the 46 today, he earned a dose reduction. You can go ahead and try one half unit. Good luck with the new dose.

 

Mike, I really am wondering if Webster and Mikey are somehow related! Take a look at his spreadsheet from yesterday. These two are going to drive us to drink! Hang in there. It looks to me like you're doing a great job.

 

Yes, good luck with the half-unit dose! You will not see an immediate reaction to the new dose because Webster's "shed" (or insulin depot) will still reflect the previous dose for a cycle or two (or three), but hang in there. It always takes a little while for a new dose to settle in.

I hope you will have a good night and that Webster won't have to have so many pokies!

Ella & Rusty

 

I'm afraid to give him any dose at this time.

He hasn't really eaten anything all day and took one bite of his food just now. His BG levels have traditionally been 300-500 around this time but are in the low 100's. I'm afraid that even a small dose is going to drive him way down because he has been dropping off very fast after his insulin.

He's refusing to eat and is lethargic. When I pinch his skin it doesn't bounce back fast, indicating dehydration. I would say that his condition is taking a turn for the worse. I checked his ketones as recent as last night and they were negative. I have not been able to get a sample today but by his symptoms I suspect that we are headed down that road again. :cry:

Should I try to force feed him a can of low carb food? I don't know what to do. :?:

 

I'm seriously ready to start chugging. I keep telling myself that I must stay sober to take care of my boy. Was Mikey DKA?

 

I would take him to the vet, for peace of mind, if think he is making a turn for the worse. My J.D. was a DKA survivor.
I know how scary that was. If you can get a ketone test that would be great, but if you can't and you are worried, I would go get him checked out. I'm guessing you know there are blood ketone meters that are like glucometers. You could maybe find one at a pharmacy, if you call around. I had to have the pharmacy order one for me.

Sending vines and hugs.

 

It may be the safest course of action to skip the shot tonight. But please wait for confirmation from one of the dosing experts. Another possibility would be to give a token dose, maybe .25 of a unit, just to have some insulin on board to combat any hint of a return of DKA. Try to get a keytone test. Try to get Webster to eat something and to drink. Mix some water into his wet food to get more fluid into him, especially if he seems dehydrated.

I hope someone with more experience in these matters will be along soon.

Ella

p.s. I just saw Dyana's post. A trip to the vet sounds like a good idea.

 

I have strips and he just peed. Negative on the Ketones.

 

How can I get him hydrated?

Skin is not bouncing back very fast when pinched. Should I force feed him? Should I force him to drink water with syringe.

I'm afraid to give him a dose of lantus. What will happen if I skip a dose?

 

Big sigh, and a "Thank God".

Is he on antibiotics? That may cause his tummy to be upset. Sometimes probiotics will help put back in some of the good bacteria into the gut.

 

If you skip the shot his bg will probably go up, but in general it is much safer to be too high than too low. You are very new at this and I believe that the "cut-off" number for a newly diagnosed cat is somewhere around 150. In other words, if Webster is below 150 at PMPS, skip the shot!

Ella

 

for hydration....
does he like human tuna?

since we know you have a blender .... you can take a little of the tuna and some water and make a slurry....
more water than tuna....of course....
He might like drinking that if he's a tuna lover.

 

I was syringe feeding J.D. and giving him water via syringe was scary because it goes down a lot quicker than the thicker blended food. You do not want anything to go down "the wrong tube" into his lungs. Can you blend some cat food and add maybe just a teeny bit of water to it? Canned cat food is like 80% water anyway. You would have to be very careful when you give it to him. Watch this video, if you haven't before https://www.youtube.com/watch?v=U6o17wH6ujk I would still go to the vet, if I were you.

 

Thank you Ella. His PMPS was 151 which is 1 pt above the "cut off". I don't feel comfortable giving him a shot so I will skip. Thank you for that.

Getting back, Should we force feed him? He's still willing to accept his favorite HC treats.

Also, I think he might be getting dehydrated. Is there anything we can do to help hydrate him?

 

Mikey had trace ketones, but not DKA. He's a pain in the butt to test, because he only pees when he's sure no one is around, but I got him a couple of days ago, and he was negative. Today I tried to get him, and he stomped out of the litterbox without going.

If Webster is dehydrated, your vet might want to give him sub-q fluids. He may even be willing to send you home with some. I've given them to two of our cats in the past, and it's really easy to do. Dehydration is no joke. If he was my cat, I'd want him hydrated promptly, but the more experienced people here may have more information on that than I do.

Hang in there, Mike, we're both going to get through this. Our boys are totally worth it.

 

Another thing to try if he won't eat is Gerber's or Beechnut all meat baby food. All my cats love Gerber's. I get the ham, chicken, or turkey. They are called 2nds. It's not good as an only food but helps when I need to make sure Max eats. I give him a spoonful after his gel capsule of medication every morning and add a little miralax to keep him regular as needed. It's also easy to syringe if necessary.

 

Going to store not to buy tuna and Gerbers. I'll give it a shot. Thanks for the suggestion.

BTW, Webster suddenly perked up and strolled around the house for a little. I gave him freeze dried chicken treats and he stuck around for more. No luck getting him to eat much regular food though. He drank a bit of water a little while ago.

I'm not really sure if hes actually dehydrated. The scruff test passed. Any other ways to test?

 

I think there's some concern about skipping his insulin shot entirely. You could give less than 0.5u - look at the New to the Group sticky to find pictures of the small insulin doses. But with DKA so recent in his past, and now him seeming off and not eating normally, it seems risky to skip the insulin entirely.

Remember the ketone recipe is not enough insulin + not enough food + infection/inflammation = ketones.

However if he's not eating at all, that's also a problem. I'm with Dyana, I think a vet consult is going to be a smart call if you can't get him to eat at least 50% of what you'd consider a normal volume of dinner. You can try to assist-feed - many people do that at some point. Can you at least phone the vet for suggestions?

There are some tricks to get kitties to eat. Here are a few off the top of my head. If you haven't tried them, that might be a good idea.

Warm the food up - it will smell more and may be more enticing.

Sprinkle on parmesan cheese, oregano (related to catnip), catnip, or tuna juice (make sure there are no onions/garlic on the ingredients)

Make little meatballs of the food

"Prime the pump" by putting food in his mouth with your finger. Sometimes getting them started will help them get more interested.
sprinkle on the crushed dry food, fortiflora (if you have any)

get some rotisserie chicken - most cats find that pretty irresistible. Lunchmeat might be something else tempting.

Add water to anything he'll eat to help him get hydrated.

That's off the top of my head - hopefully others will add some tricks.

I'm running out for the evening but am sending Webster some "eat your fuds" vibes.

 

A more sensitive test for dehydration:
Press a finger firmly on the cat’s gums, then remove. If the gums immediately pink back up, all is well. If the gums stay blanched white, the cat is dehydrated to some degree. Also, if the gums feel sticky or tacky (dry), the cat is probably dehydrated.

If she is dehydrated, and you've got an oral syringe (no needle), you might cautiously start giving small amounts of fluids as tolerated - perhaps 1 mL at a time.

 

Hi Julie. Thanks for responding! I too am concerned about skipping a dose and the the Ketones returning. By the same token, I'm afraid that giving even a small dose will send him on a fast downward spiral. For some reason he keeps dropping fast when given his shot.

Today (the past week) has been absolute HELL. I've been watching his closely for over 12 hours as he dropped like a rock this morning and I am getting really tired. I've taken off the past week of work (thank god I'm able to do this with my job) and my life has been turned upside down.

I would really like to bring him to a vet tomorrow morning. I'm trying to remain level headed and not rush him to the ER if not necessary. Sorry for the rant. Stressed to the max!

I am about to try your suggestions and others. Thanks you.

 

....also, does he seem nauseated at all? Lip smacking? Turning his head away from food? A nauseated kitty won't eat, and assist-feeding a nauseated kitty will open a big can of worms. I'd also keep a very close eye and not rule out a trip to the ER - given Webster's recent past, things like lack of appy are more magnified than they would be for most kitties.

 

Rant away...we understand here in LL!

 

Moist to the touch and turn back to pink quickly when pressed. Scruff bounces back when tugged.

Maybe I was overreacting when pinching his belly and it didn't bounce back fast.

On a side note, his BG is up to 252 and he seems much more active. Do you think his low BG all day make him tired?

I just need to get him to eat. About to head to the store an pick up suggested items. Thanks everyone.

 

Cats that are spending time in the blood sugar range they aren't used to can be lethargic. Neko used to always be high (she has a high dose condition) and used to be very lethargic if she got into greens and pink was her happy zone where she played. Thankfully that's now reversed. After he spends more time in the greens, Webster will get used to normal numbers as being normal again.

 

No symptoms of nausea. It's strange. He has done a 360 in the past few hours (once BG started to rise)

We just got back from buying Tuna and 2 types of baby food as suggested. Will let you know how it goes.

 

Webster went ABSOLUTELY NUTS over the turkey & gravy Gerber! Thank you so much for the suggestion!

 

Mike,

JuJu wasn't eating much when we first brought him home from the hospital, either. I was getting concerned. I took him back about two days later because I wanted to get his BG checked (we didn't have a BG meter yet). I told the doc he wasn't eating much and had diarrhea. The doc gave us FortiFlora (pro biotic) and Mirtazapene? Spell check (appetite stimulant). We gave him a quarter of the Mirt and sprinkled the FortiFlora on some wet food and he started eating like a horse! I was so relieved! We continued sprinkling the FortiFlora on his food for about a week (until normal stool) but never did give him anymore of the app stim. Just wanted to let you know what worked for us so you would have another option if you so choose.

Keep grinding, your dedication is awesome!

 

I'm so glad he liked the baby food. All my cats have liked the Gerber's. That and the Soulistic Triple Harmony are my best shot of getting Max to eat if he isn't feeling well. You could try putting a little on top of the cat food and see if that gets him to eat it but chances are it won't.

The appetite stimulant that Matt used for JuJu is mirtazapine. Another one that I happen to like better is cyproheptadine. Both are human medications. I like cypro best because it can be dosed once or twice a day if needed. Just a sliver of a 4mg pill, maybe 1/8 gets Max eating. I don't like to use it if he is nauseous becasue it can lead to food aversions. I'm hoping that you won't need either since eating the baby food might be enough to get Webster back to being interested in food.

 

Glad to hear he liked the Gerber!

Nice call, Elise. ;-)

 

Are these two OTC?

 

Yes, nice call indeed. He licked his chops for several minutes after attacking half a jar of the watered down Turkey gravy. He's been grooming his self for several minutes and even started to purr.

What the heck is going on? He is Lethargic and out of it for several hours and almost back to normal a few hours later. I can only speculate that it's the prolonged drop in BG today made him tired. Sounds like Wendy had a similar experience with Neko.

Anyone have any additional thoughts?

As for dosing tomorrow, what should I do. I think he is surely due for a reduction to .5. What factors should I consider tomorrow morning before shooting? How much he ate? What his AMPS numbers are? What food amounts and BG numbers should I be looking for as far as indicators before giving it the green light? I'm looking at 9:00 am eastern time tomorrow.

Thanks everyone.

 

We got them directly from the doc at the hospital, so I'm not sure. I do believe they are prescription, though.

Hopefully, the Gerber will jump start his appetite so you won't need the app stim or the pb.

 

You can get Forta Flora online at Amazon; mirtazapine is prescription only through your vet.

 

You definitely should go to .5 units tomorrow morning. I suspect he will be bouncing. As long as he eats at least 1/2 a meal, I think you are good to shoot. With his history of DKA, it's good to get insulin in him. Even if he will only eat high carb food, that's fine.

You can also get FortiFlora from your vet, more expensive but faster. The other two drugs mentioned are not OTC.

 

Since you skipped the shot last night, if you want to change your shot time schedule to earlier, you can do that now, since it is more than 12 hours between doses. If you go to the vet, you can probably pick up the FortiFlora and an appetite stimulant while you're there.

 

Just saw your advice after posting today's condo. Thank you Wendy.