Never give up !!

[Photorecon]

I'm back from the thief Vet and we had a good men on men conversation.

Staying diplomat, I told him point to point what went wrong in our partnership. He had some good
point. He told me blood test for xyz I don't know the nature of should have been made and we not because I didn't want to spend money on them. So this was his explanation on why insulin was not raised...

''So let's put this aside for now and go with a fast action plan. What's next'' I told him.
His plan was has as pricey as I tought but still it was 650$ for 24h care and monitoring.
When I asked for details about all intervention listed (150$ for installation of a catheter within others), he told me it was to basically dehydrate, there was not question of fast acting insulin or anything else special.

I then told him I had no more then 500$ to put on this and even then. He then took some blood sample and went. Back to the observation room, with some results, he told me there was not much destruction, that he was 10% below hydration level a GL as I had been getting with my test but that it was not that bad.

Dont ask me if he got some remorse or what, but he came back with a new bill, 200$ and a crash course on how to administer water under the skin. (there is a therm for that but I don't know how to say it in english ).

So here we are, ER at home, will inject water, rise Lantus insulin from 1.0 morning .5 night to 1.5 morning and 1.5 night.

Dont know if this is just a way to extent the game to starve my wallet of it's money or if it's going to improve.. God only knows, my mother as well. She's by his side since I was born, (postpartum depression that turned bad), so she has some duty left. When waiting for the vet I told her ''if you gonna act, it's now, no matter what give me the best''.

Due the injection and test now, water injection at 4 this morning, next shot 8h after.

Let's go !

 

[scoobydoox]

I am happy to hear they got you sub q fluids (water under skin) to do at home. Wishing your cat a full recovery! +
Did they teach you how to do the blood glucose testing at home?

 

[Critter Mom]

I'm very glad to hear that you've found a way to get help for Small Kitty. Please keep us posted with how he gets on and also keep asking questions here.

Bonne chance, P'tit chat Minou!

Mogs
.

 

[Photorecon]

I am happy to hear they got you sub q fluids (water under skin) to do at home. Wishing your cat a full recovery! +
Did they teach you how to do the blood glucose testing at home?

I've become a master in this science (glucose testing). Little kitty knows when it's time, I take him
in my harms, put it on the table and it stays there while I prepare everything. I dont even have to hold
him, I can use both hands to rise the blood pressure in the hear vein and place very tiny pic.
Sqeese a little with thumbs and indexes until I get a nice bubble. With my tweeked Accucheck with
human strips I can get accurate results.

 

[BJM]

Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning, pre-shot, test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening, pre-shot, test)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

The nadir is the lowest glucose between shots. There is a general period when it will happen which is specific to the insulin being used and testing then helps make sure your cat doesn't go too low.

It is merely a grid for storing the info; no math required.

 

[Photorecon]

Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning, pre-shot, test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening, pre-shot, test)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

The nadir is the lowest glucose between shots. There is a general period when it will happen which is specific to the insulin being used and testing then helps make sure your cat doesn't go too low.

It is merely a grid for storing the info; no math required.

I'll proceed with that, very easy.

Since day one I've been taking pictures of the meter with the phone set with a stamp with date and time.
I have very single results, ketone test date and time (took pictures), weight..
All I need is go in the folder where the pictures are and slide.

I'll be testing all night and tomorrow all day. That's going to make quite a nice curve.

Thanks for everybody, there is lots of nice people here and you give me hope.

 

[scoobydoox]

I've become a master in this science (glucose testing). Little kitty knows when it's time, I take him
in my harms, put it on the table and it stays there while I prepare everything. I dont even have to hold
him, I can use both hands to rise the blood pressure in the hear vein and place very tiny pic.
Sqeese a little with thumbs and indexes until I get a nice bubble. With my tweeked Accucheck with
human strips I can get accurate results.

This may help for seeing the best spot to prick

 

[Photorecon]

Question.

I dont want to post full of new thread for everything that is going to my mind, so Hope someone will see this :


As you might have known, Little Kitty has had full scale ketone flooding this morning, I tough it was
the end. It wasn't, we're back home with home works on hands (under skin water injection every 8h, glucose test every 3h...).

I'll need to test for ketone tomorrow to see how it goes there. Problem I have is that he's not always
urinating, even with a topped up bladder.

I've done search on our forum and on the internet for technique on how to proceed to get the
urine out by squeezing the bladder but found nothing.

Is this something that can be done at home without breaking internal organs apart ?

He's now eating and drinking, hope it's not just for my beautiful eyes

 

[Chris & China (GA)]

Believe it or not, there are a few Youtube videos on expression urine from a cat! Hopefully one of them will help if you end up having to go that route

Here are some other Urine Testing Tips you might try before going to that though and see if you can get her to pee for you in a box

 

[BJM]

Crumple plastic wrap and place it around the perimeter of the litter box. Wait until you see him go for it - usually after a meal - then immediately follow and test what is caught on the plastic. It has to be fresh..

There are blood ketone meters - the NovaMax Plus and the Precision XTra - and since he has ketones, a blood ketone meter will pick up levels sooner, so you can take action more quickly.

 

[Squalliesmom]

Crumple plastic wrap and place it around the perimeter of the litter box. Wait until you see him go for it - usually after a meal - then immediately follow and test what is caught on the plastic. It has to be fresh..

There are blood ketone meters - the NovaMax Plus and the Precision XTra - and since he has ketones, a blood ketone meter will pick up levels sooner, so you can take action more quickly.

This seems much safer and more comfortable for kitty than trying to express her bladder at home without instruction from the vet!

 

[Critter Mom]

I have a blood ketone meter for my cat. It is very easy to check ketones at the same time you're testing for blood glucose and, as Lucy says above, it would be more comfortable for Small Kitty than trying to express urine from his bladder. It would also take away some of your worry because you would know you could check ketones regularly.


Mogs
.

 

[Mogmom and Goofus]

I have a blood ketone meter for my cat. It is very easy to check ketones at the same time you're testing for blood glucose and, as Lucy says above, it would be more comfortable for Small Kitty than trying to express urine from his bladder. It would also take away some of your worry because you would know you could check ketones regularly.


Mogs
.

Where did you get that blood ketone meter? I'd like to get one so I can keep a better watch on Goof, can't ever seem to catch him in the litterbox. I have 4 other cats so it's hard to isolate him. His glucose is an absolute mess right now and he's reached stage 3 renal failure.

 

[Photorecon]

Believe it or not, there are a few Youtube videos on expression urine from a cat! Hopefully one of them will help if you end up having to go that route

Here are some other Urine Testing Tips you might try before going to that though and see if you can get her to pee for you in a box

Thanks Chris & China. I'll keep this in reserve but I didn't have to go to this ''extreme''.
Little Kitty urinated tonight (following under skin injection of 2 5oz in 16h + 2 manually fed).
So I was able to test Ketone at night and this morning !

NEGATIVE !!!! I'M SO HAPPY !!!

 

[Photorecon]

 

[Critter Mom]

So I was able to test Ketone at night and this morning !

NEGATIVE !!!! I'M SO HAPPY !!!

Je suis très heureuse d'entendre votre bonne nouvelle, Sébastien!!!

Keep trying to get as much food as possible into Small Kitty. Both the food and insulin work together to keep ketone levels down. Did your vet give you any medications to help with nausea and appetite stimulation?


Mogs
.

 

[Critter Mom]

Just seen your kitty pics. He's a tuxedo!

 

[Meya14]

Looks like you are right on track for all the things you need for taking care of DKA at home. I'm glad to see your kitty is doing better. Put out a variety of foods for her in addition to the syringe feeding. There is usually some nausea when ketones get higher, and it might put her off her normal food. Treats and dry food is even ok too, just to get her appetite back. You might have to raise the insulin a little more when she starts eating again. The goal for blood sugars when recovering from DKA is between 150-200ish on a human meter (a little higher than normal). This allows you some wiggle room so you don't have to skip doses of insulin. Alpha track meters are about 30% higher than human meters, so that 169 is a little on the low side.

You should call and ask your vet about 2 things:
- can he give you an anti nausea medication to help her eat
- did he draw a potassium level lab.

If they didn't do a potassium level, you should have this done. Low potassium can add to the weakness and can cause heart problems. It should not be expensive.

 

[Critter Mom]

Alpha track meters are about 30% higher than human meters, so that 169 is a little on the low side.

Meya - it's 16.9 mmol/L - 304 mg/dL.

How does this affect the info Sébastien needs to know about Small Kitty's insulin needs?


Mogs
.

 

[Meya14]

Oh, my bad. Then it's just a tad higher than it could be. At that level, there could still some dehyration from the sugar in the urine. If I gathered from the thread, the current dose is Lantus 1.5U twice a day started this AM? Maybe give it 2 more cycles and evaluate the sugars and see if there is room to increase to 2U if the food intake is still good.

 

[Critter Mom]

Oh, my bad

'Twas easier for me to notice because I 'speak' mmol/L. It's the US numbers that do my head in!

Thank you for your reply and for the additional info. You're the best, Meya.


Mogs
.

 

[Photorecon]

Je suis très heureuse d'entendre votre bonne nouvelle, Sébastien!!!

Keep trying to get as much food as possible into Small Kitty. Both the food and insulin work together to keep ketone levels down. Did your vet give you any medications to help with nausea and appetite stimulation?


Mogs
.

No nausea and appetite stimulation mediation.. quite surprising I tought. On my own for in this file.

Merci pour les encouragements, ce n'est pas facile mais j'ai déjà vu d'autre miracles. J'adore les avions de
la deuxième guerre mondiale, plusieur sont toujours en état de vol grâce à des gens dévoué et un peu fou.
Des crashs sont survenus, on pensait que ces avions était destiné à la féraille. 5 ans plus tard je les photographie
à nouveau.

* Thanks to all of you for the encouragement. It's not easy but I've seen other miracles. For years I've been
a big fan of Warbirds (World War II airplanes). I travel the continent blowing up my credit card purchasing
camera gear and planning trips.

You never know when the plane dedicated, crasy guys have put together fly planes recovered out of jungles or even from the bottom
of the see are going to crash. Shoot them (take pictures) now because it might be too late next year.
Me and my aviation photographer friends have seen that. Those crashed planes that are beyong repair are
coke cans now. But for those who can and have the money to put them back together nothing is impossible.

With some will, fanaticism, nothing is impossible.

NEVER GIVE UP !

 

[Photorecon]

Oh, my bad. Then it's just a tad higher than it could be. At that level, there could still some dehyration from the sugar in the urine. If I gathered from the thread, the current dose is Lantus 1.5U twice a day started this AM? Maybe give it 2 more cycles and evaluate the sugars and see if there is room to increase to 2U if the food intake is still good.

When I met the vet yesterday I told him that, why just 1 + 1.5, raising to 2 could not have been the way to go ??
The cat didn't tolerate it, he said.... But one month and a haft later story is different. Can jumping to 2 bring
evident symptoms to notice (and roll back). I'm sure GL would go down.

What do you think ?
(need some rest but glucose chart will come today), testing every 2h.

 

[Photorecon]

Looks like you are right on track for all the things you need for taking care of DKA at home. I'm glad to see your kitty is doing better. Put out a variety of foods for her in addition to the syringe feeding. There is usually some nausea when ketones get higher, and it might put her off her normal food. Treats and dry food is even ok too, just to get her appetite back. You might have to raise the insulin a little more when she starts eating again. The goal for blood sugars when recovering from DKA is between 150-200ish on a human meter (a little higher than normal). This allows you some wiggle room so you don't have to skip doses of insulin. Alpha track meters are about 30% higher than human meters, so that 169 is a little on the low side.

You should call and ask your vet about 2 things:
- can he give you an anti nausea medication to help her eat
- did he draw a potassium level lab.

If they didn't do a potassium level, you should have this done. Low potassium can add to the weakness and can cause heart problems. It should not be expensive.

Potassium level was fine from yesterday's test.
He made no mention of food, the technician told me the more the best.
What too much is ???

Is 50 cent/can cat food at 2.5 carb carb level food bad ? Beleive protein level of this food is 10%

 

[Critter Mom]

No nausea and appetite stimulation mediation.. quite surprising I tought. On my own for in this file.

An injection of Cerenia may get into the system relatively quickly to ease nausea symptoms. Thereafter ondansetron seems to have a stronger anti-nausea effect but it can take a day or two before you start seeing the benefit. Generic ondansetron is much cheaper than Zofran, the branded version. If your vet does prescribe ondansetron make sure that it's in tablet form. (The 'melts' have artificial sweeteners in them so not good for cats.)

For appetite stimulation cyproheptadine and mirtazapine are used. Cyproheptadine is gentler, doesn't stay in the cat's system as long, and it doesn't carry the risk of inducing serotonin syndrome (a potentially life-threatening condition). You need to have the anti-nausea treatment in place first.


Mogs
.

 

[Meya14]

Whatever food she will eat is the best. The more calories the better, so look to see if there is a calorie count on the food. Aim for about 200-300 calories a day for an average size cat. Whatever she will eat on her own, feed her, and continue to syringe feed until her intake is good.

As for the insulin dose, having an infection really raises the body's need for insulin. The body needs insulin to allow it to heal from infection. Other things affect insulin use as well, so someone can be fine at 1 unit for a while, and the suddenly jump to 2 or 3 or more units. This is why we keep track on a chart and can see the pattern right away if insulin need changes and we can react to it. Ideally, you want to raise insulin by no more than 0.25 or 0.5 at a time to prevent overdosing. Some cats are very sensitive.

 

[Photorecon]

An injection of Cerenia may get into the system relatively quickly to ease nausea symptoms. Thereafter ondansetron seems to have a stronger anti-nausea effect but it can take a day or two before you start seeing the benefit. Generic ondansetron is much cheaper than Zofran, the branded version. If your vet does prescribe ondansetron make sure that it's in tablet form. (The 'melts' have artificial sweeteners in them so not good for cats.)

For appetite stimulation cyproheptadine and mirtazapine are used. Cyproheptadine is gentler, doesn't stay in the cat's system as long, and it doesn't carry the risk of inducing serotonin syndrome (a potentially life-threatening condition). You need to have the anti-nausea treatment in place first.


Mogs
.

Went at the Vet office this morning, could not meet him, had to deal with the 20 years old technician.

He told me that eat stimulant and anti-nausea were not required because Small Kitty had eaten this morning, that
quantity was not our current concern... Showed him the numbers... He didn't even looked at them, told me they are
useless as the real results will appear in a week and a haft...

When I told him that one day I had given I shoudn't and the effect was apparent the very next day... he told
me this kind of thing (... dont kow the word), candy for cat (small reward little square things for cat) had a drastic
effect the very next day, that it was different, that slow action insulin cannot show results within 24h.

Don't know if this making send.

One thing is good is that Small Kitty is eating pretty good by himself

Right now : Special Kitty Turkey and Giblet, 30% fat, 70% meat, 2.4 Carb, 10% protein, 78% moisture, 172 Calories

The ingredient on the label are very nice. No rice or none animal product. Torrine, vitamine, turkey,
fish oil, vitamine bxx... Seems alright to me. (full ingredients list below)

To make him eat Purina MD with 1% Carb I have to work very hard, he's gonna eat it
but barely. Only way to make it work for good is to liquefy and use a syringe to through it
in his mouth. It works, but no fun for him, probably.

The Vet technician said not to do this too much as the cat will become accumulated
to this new feeding method and that's gonna be it.

Is this Special kitty poison ? Better then nothing ? Good ?

* Ingrediants list

*

Ingredients: Meat By-Products, Poultry By-Products, Sufficient Water For Processing, Turkey, Poultry Giblets, Fish, Egg Product, Guar Gum, Added Color Carrageenan, Salt Potassium Chloride, Sodium Tripolyphosphate, Vitamins (Vitamin E Supplement, Thiamine Mononitrate, Niacin Supplement, D-Calcium Pantothenate, Pyridoxine Hydrochloride, Riboflavin Supplement, Vitamin A Supplement, Biotin, Vitamin D3 Supplement, Vitamin B12 Supplement, Folic Acid), Minerals (Ferrous Sulfate, Zinc Oxide, Copper Proteinate, Potassium Iodide, Manganese Sulfate, Sodium Selenite),Choline Chloride, Taurine.

 

[Meya14]

So the advice your vet gave about quantity not being important is absolutely wrong. There is no way to recover from DKA without adequate calorie intake. Without enough calories, the body tries to burn fat stores for energy, and this is how the ketones are made - byproduct of burning fat. Without enough insulin as well, the body tries to burn fat. So you need calories + insulin to prevent the ketones from coming back.

As for the test they are talking about, the fructosamine test measures the -long term- control of the diabetes. It's not at all an indicator of recovery from DKA. It shouldn't be used to evaluate insulin need in DKA. This test is similar to the A1C in humans if you are familiar. In fact, BS measurements aren't even the most important measurement in DKA. Really, the test that will give you the most information if he is recovering is the ketone dipsticks or the ketone meter. While it is true that the full effect of lantus is 3-5 days, sometimes increases need to happen quicker or longer than that.

About your food, the ingredients look ok, and I'm sure the food is fine. And personally, I would feed him anything he'll eat. Don't worry about getting lower carb food, in fact, sometimes recovery is easier with a little higher carb food cause its more calorie dense and some cats prefer it. Since your food has 172 calories per can, make sure he eats -at least- one can per day, better if he ate 1.5 cans. Anything less than one can is not going to be good.

I saw that someone linked you instructions for starting our chart, this would help us be able to look at your blood sugars and figure out how much insulin is appropriate.

Also, try to get the ketone stick test done once a day, or even twice a day if you can. You can put a piece of plastic wrap over the kitty litter where your cat usually aims, and that's usually enough to catch a few drops.

 

[Larry and Kitties]

I would skip the DM and stick with the Special Kitty as long as the cat is readily eating the SK.
Per
http://catinfo.org/docs/FoodChartPublic9-22-12.pdf
MD gets 14% of calories fro carbs

 

[Tuxedo Mom]

You are trying so hard to get Small Kitty back to health and you are doing such a good job. The vets/techs you have talked to are not actually giving the best advice. FOOD is very important. You need to keep him eating and getting a good amount of food..whatever if takes to keep him eating. If Small Kitty is eating the Special Kitty with no problem then give him that. The more food he eats the better to recover from DKA. As was already said the fructosamine test is of little use for determining how well he is recovering from DKA. Doing multiple testing at home AND testing the ketone levels in the urine is much more accurate than a Fructosamine test.

I Have already suggested a couple of times about getting a spreadsheet up...not to sound like I am nagging, but the spreadsheet with proper monitoring will tell much more than a visit to the vets. Please try to get it set up or ask for help if you can;t figure it out.

 

[Photorecon]

Both Moms, Larry, Meya... all of you, ARE SO NICE !!!!!

I think YOU deserve part the 1200$ a night I as asked for to save Small Kitty.

By reading your post I realized food is no small thing. The guy who has Master Degree
never say a single word about food. ''Spec are nice'' he told me. Just worry about water (liquid),
that's the only concern and this is what he would have taken care of for 800$.

With all that I was putting full scale energy on liquid but let the food file going by itself.
I beleive he's eaten the quantity of a 5oz can, but I'm not sure. One thing I know is that
I went on with manual feeding giving him four (3X) 50CC syringe of Purina DM diluted
with water. I was eating like made that way. Apart from that, I guess that by himself
he must have eaten maybe 1 can of different sort of food (Raw with all ingredients, Special Kitty,
very little bit of dry Purina MD for diabetic and canned purina md) A full mix.

The vet technician told me to be careful about syringe feeding, that the cat might become
accustomed and only eat that way... Should I let Small kitty eat when and how much he wants
to eat ? Manual feeding of Purina MD works very well. I know when he's finish and stop.

Should I go full scale with no reserve up to 2 cans ?

Thanks.

 

[Photorecon]

I would skip the DM and stick with the Special Kitty as long as the cat is readily eating the SK.
Per
http://catinfo.org/docs/FoodChartPublic9-22-12.pdf
MD gets 14% of calories fro carbs

Problem is that Special Kitty does not work in manual feeding. The is pieces of meat jamming the syringe.
On the + side, this is what he will eat by himself more then anything else but this also mean that he's the
one controlling the food intake. If I want to increase it works better with Purina MD. With mixer an a little
bit of water is goes straight in.

 

[Tuxedo Mom]

Both Moms, Larry, Meya... all of you, ARE SO NICE !!!!!

I think YOU deserve part the 1200$ a night I as asked for to save Small Kitty.

By reading your post I realized food is no small thing. The guy who has Master Degree
never say a single word about food. ''Spec are nice'' he told me. Just worry about water (liquid),
that's the only concern and this is what he would have taken care of for 800$.

With all that I was putting full scale energy on liquid but let the food file going by itself.
I beleive he's eaten the quantity of a 5oz can, but I'm not sure. One thing I know is that
I went on with manual feeding giving him four (3X) 50CC syringe of Purina DM diluted
with water. I was eating like made that way. Apart from that, I guess that by himself
he must have eaten maybe 1 can of different sort of food (Raw with all ingredients, Special Kitty,
very little bit of dry Purina MD for diabetic and canned purina md) A full mix.

The vet technician told me to be careful about syringe feeding, that the cat might become
accustomed and only eat that way... Should I let Small kitty eat when and how much he wants
to eat ? Manual feeding of Purina MD works very well. I know when he's finish and stop.

Should I go full scale with no reserve up to 2 cans ?

Thanks.

Feed Small Kitty that is the important thing. The less food a kitty has the more it relies on the stored fats in the body...which can cause ketones and DKA. Fluid is definitely important to flush out the ketones but food helps to stop the cycle, Whatever you need to do to keep Small Kitty eating is all good. If Small Kitty is eating on his own then you can add some extra water to the food. If he is not eating much then you could give some more SubQ fluids if you have some left...I am thinking around 100cc if he has not had any today already

 

[Photorecon]

Another night of injection / monitoring ?

Last trace of ketone (0.5) was last night at 2 at the morning.
Under skin liquid injection (60 CC syringe) stared Friday at 6pm
and given every 8h since then (last injection something like an hour ago).

At 8 this morning Ketone had been flushed and gone and 2 other test were
negative during the day.

I have 2 needles with hoses for injection left from the kit the Vet gave me but
his instruction sheet doesn't mention for how long I should administer SCI
injection.

Would you go on with another night of water administration and glucose
monitoring every 4hs ? I've no trouble with it but is it necessary ?

Hope someone is there to answer, otherwise I'll go on with it.

Thanks again to all.

 

[Photorecon]

Feed Small Kitty that is the important thing. The less food a kitty has the more it relies on the stored fats in the body...which can cause ketones and DKA. Fluid is definitely important to flush out the ketones but food helps to stop the cycle, Whatever you need to do to keep Small Kitty eating is all good. If Small Kitty is eating on his own then you can add some extra water to the food. If he is not eating much then you could give some more SubQ fluids if you have some left...I am thinking around 100cc if he has not had any today already

Small kitty got 60CC at 1 a the morning, another 60cc at 9am and another 60 at 6h30pm + some more by
himself and probably 2-3 25cc manual feed.

Any Idea for the night ?

 

[Chris & China (GA)]

Are you able to get ketone tests done pretty regularly?

 

[Tuxedo Mom]

At this point let Small Kitty eat what he will. You DO need to continue testing for ketones AND you need to monitor the glucose levels. Again...it would be very helpful to try to give the best advice for Small Kitty if you could set up a spreadsheet with all the glucose readings that you have

 

[Photorecon]

The numbers :

I know this is not the spread sheet but I had to take some rest today and it was beautiful sun
outside.

Numbers are as follow :
Friday (ketosis day)


06.00h: 324mg/dl - 18.0 mmo-dl
9.00h : 300.60 - 16.7

Food - 18h
1.5 unit Lantus 19.00h

19.00h : 354.60 - 19.7

23.00h : 304.20 - 16.9

60CC water injection - 00.45h

Ketone test - 02.00h .5 (traces)

06.00h : Small kitty eating drinking (regular routine)

07.00h : 1.5 unit lantus + 50mg Clavaseptin antibiotic administration.

07.00h : 417.60 - 23.2

Ketone test 08.00h (this morning), Negative

08.00, drikning and eating

09.00 : 327.60 - 18.2

60CC water injection 09.00h

10.00h : 316.80 - 17.6

13.00h : 379.80 - 21.1

Ketone test 15.00 : negative

Eating special kitty 15.00 (third of a can).

14.00h : 538.20 (2 eating sessions before) - 29.9

Water injection 18.30, 60CC

Ketone still negative 18.40h

1.5 unit Lantus 19.00h + antibiotic (administration twice dayly)

50 CC of Purina MD feeding manually : was eating well 19.00h

19.00h : 390.60 - 21.7


I know this is not the spread sheet but I'm lacking concentration with so little sleep, having a look at all
pictures of results I took with the phone is not too hard + I start to be hungry, need to eat !

Hope it's not total mess.

 

[Tuxedo Mom]

The numbers :

I know this is not the spread sheet but I had to take some rest today and it was beautiful sun
outside.

Numbers are as follow :
Friday (ketosis day)


06.00h: 324mg/dl - 18.0 mmo-dl
9.00h : 300.60 - 16.7

Food - 18h
1.5 unit Lantus 19.00h

19.00h : 354.60 - 19.7

23.00h : 304.20 - 16.9

60CC water injection - 00.45h

Ketone test - 02.00h .5 (traces)

06.00h : Small kitty eating drinking (regular routine)

07.00h : 1.5 unit lantus + 50mg Clavaseptin antibiotic administration.

07.00h : 417.60 - 23.2

Ketone test 08.00h (this morning), Negative

08.00, drikning and eating

09.00 : 327.60 - 18.2

60CC water injection 09.00h

10.00h : 316.80 - 17.6

13.00h : 379.80 - 21.1

Ketone test 15.00 : negative

Eating special kitty 15.00 (third of a can).

14.00h : 538.20 (2 eating sessions before) - 29.9

Water injection 18.30, 60CC

Ketone still negative 18.40h

1.5 unit Lantus 19.00h

50 CC of Purina MD feeding manually : was eating well 19.00h

19.00h : 390.60 - 21.7


I know this is not the spread sheet but I'm lacking concentration with so little sleep, having a look at all
pictures of results I took with the phone is not too hard.

Thank you for the information. Until you are able to get your spreadsheet set up this will give a good idea what is happening.

What dose are you giving Small Kitty. My thoughts with the information you provided are that it might be an idea to increase the dose. ...if you can monitor through the cycle.But I would rather have some other people give their opinions before advsxing you to change,

 

[Photorecon]

Are you able to get ketone tests done pretty regularly?

4 times today :

2.00h (2am) : .6 (traces
08.00h : negative
15.00h (3pm) : negative
18.40h (6h30pm) : negative

Was red hot Friday at 11.00h (above 160)

 

[Chris & China (GA)]

Did your vet give you any advice on how long to continue the fluids?

I'd think as long as he continues to test negative, you could probably reduce how often you're giving them (like do them twice a day) but I wouldn't stop just yet....we want to make sure he stays well hydrated to keep flushing any possible ketones out

Is she eating normally on her own? We do want to make sure she's getting enough calories too

 

[Meya14]

*Note for people following, BS numbers are alphatrak.

I think you are doing great, and if he's eating, you can add extra fluids to the food and reduce the subQ if you are running out. The fact that ketones were negative is a great sign. For now, the blood sugars are still a little high, which can cause the dehydration to be an issue. I would stay at the current dose for one more day, and see where the numbers are. If tomorrow they are still above 14.4 mmol/L (260mg/dl) all day then I would raise the dose by 0.5U. You should aim for a BS range of 10.6-14.4mmol/L (190-260 mg/dl) until he is a few weeks without ketones.

 

[Photorecon]

Did your vet give you any advice on how long to continue the fluids?

I'd think as long as he continues to test negative, you could probably reduce how often you're giving them (like do them twice a day) but I wouldn't stop just yet....we want to make sure he stays well hydrated to keep flushing any possible ketones out

Is she eating normally on her own? We do want to make sure she's getting enough calories too

Typical eating habits are early morning 6.00h and and feed them (Small Kitty and his Big brother) at 18.00h (6pm).

This morning was like no other, he came back from the way he was before going down hill up to ketonisis last Thursday.

Seems extra water brought appetite back as he ate a combo of 3 sorts of foods like mad. I would say haft
a can approximate. After the morning rush and 1rst injection of the day (1.5 Lantus), seems like he was slowing
down before noon (had to manually feed him). By noon we probably had slithly below 3/4 of a can. Afternoon came
back strong with maybe not a third of a can of Special Kitty Giblet and Turkey cat food. This is the ''junk food'' he likes.

During the afternoon (15.00h) when GL is at it's peak, (538), I feel my Little Kitty is depress / confused. No
ketone, walking right, as ''energic'' as he can be in it's condition, but not in the mood to eat. There was
plenty of fresh food and water available but he didn't seem to be in the mood. The is when I had to feed him
manually.

After each shot seems he's getting a boost and gears on. I noticed a big difference between 1 - 0.5 units morning an night for 6 weeks, then 1.0 morning 1.0 at night last week and now at 1.5 Lantus morning and night (07.00 - 19.00h), he's spinning.
This dose is freshly raised from Friday and should have been set 3 weeks ago...

Everywhere on the internet they say not to touch doses until Vet decide to, but there is exceptions I guess.

No instruction on Plasma Lite injection and I have quite a load of it.

I'll keep on flushing I guess this is probably what made him start eating and
drinking again. Almost like it's Big brother.

 

[Chris & China (GA)]

Everywhere on the internet they say not to touch doses until Vet decide to, but there is exceptions I guess.

Actually, the people here have a lot more real life experience with using Lantus than most vets ever will

Have you read the information (written by a vet) in the Tight Regulation Protocol?

 

[Photorecon]

*Note for people following, BS numbers are alphatrak.

I think you are doing great, and if he's eating, you can add extra fluids to the food and reduce the subQ if you are running out. The fact that ketones were negative is a great sign. For now, the blood sugars are still a little high, which can cause the dehydration to be an issue. I would stay at the current dose for one more day, and see where the numbers are. If tomorrow they are still above 14.4 mmol/L (260mg/dl) all day then I would raise the dose by 0.5U. You should aim for a BS range of 10.6-14.4mmol/L (190-260 mg/dl) until he is a few weeks without ketones.

Thanks for the advice. Those numbers your're talking about (10.6-14.4) have never been seen here. I have pictures of all the
tests, at least once a day, twice a day 6 weeks ago, and I've never seen that. When I see a sporadic 17 that makes me feel good,
typical is 19-22mmol/l.

In regards of liquid, I have 1000ML of Plasma Lite. At 60CC every 8 hours and more then 10 needles with hose (that I hadn't seen),
this could last for quite a while. Will call the Vet tomorrow and ask what the plan is.

I'm sure I'll fall on the young technician who's gonna make himself know what he's doing and pitch a guess.
This morning he didn't even looked at the numbers collected during the entire night. Sucker (oups, sorry )

You seems to know way much more then what I can expect from a too busy of a vet putting his trust on
technician having to prove himself...

Thanks again all, your advice a greatly welcomed. Praying is not worthless.

 

[Photorecon]

Weight gain in 72h : 2.82 pounds !!!

Morning all,

This morning I went on to weight Small Kitty to see if there was a difference between Friday
while in ketoacidosis (DKA) crisis and after at home ER treatment involving all the above.
(the vet had to me Friday not to care about ketone tests and watch the weight)

At the vet on Friday the cat was weighting 2.65 kg after more then a week of little eating and drinking.

Using a human balance this morning, by making the difference between my weight with the ca
in my harms and without, I got some unbelievable results.

4 KG... ???

So I called the vet and ask if this could be right. They said that no, it wasn't possible, 1.35kg
gain in 72 cannot be right, to come an see with their equipment.

So this is what I did. Once there I took Small Kitty in my harms so he would relax and
not jump all over the place. Just when I was taking him out of my cat carrier modified sport bag
I realized he was just starting to pee. I barely had time to raise him up facing the cabinet
office bay window that he started releasing (peeing).

He must have dropped 1 full cup of urine all over the place , good for them
Small Kitty was expressing his opinion about their prognostic

Once in the observation room the technician perform the weighing weight, we
got the results :

3.93 KG

The technician said there must have been a mistake in the numbers on Friday,
that this couldn't be. ''I was there and this is what it was'' I said. And it was written
in the file. She raised her eyebrows.. Remove the weight of urine released
and my calculated weigth of 4 KG makes sens

So my little baby gained 2.82 pounds in less then 72h.

Isn't this amazing or what !!!

The skin is also not loose anymore (coming back to normal after twisting),
bones are still touchables but way less then Friday.

A couple of Ketone test during the last 24h have all been negative.

I think we're out of trouble but will still need insuline dose adjustment.
We're back to to square one at 360 mg-dl test results done 3h more after
meals but there is lot's of fluctuation in between affected, I guess, by food
intake rising GL.

Now it's me who need to eat and have some rest.

I'll post the full night chain of events and numbers later.

Thanks to all for your support !

 

[Photorecon]

18 yo Technician recommendations for days to come :

The technician recommended to stick with 60CC plasmalite subcutaneous injection at
8h interval and twice a day next week (cause I need to get back to work);
testing for glucose but stop ''force feeding''...

Make sens ?

 

[Photorecon]

AMAZING - AMAZING - AMAZING !!!!!

Just performed the GL test and you guys are not gonna believe the results :

235 !!! (13.1) !!!!!!



And this is after a fully flushed meal and 1.5 Lantus injection at 7 at the morning

No false results sure, I made the test with 2 kind of strips and meters, the is the real thing !

Can't beleive it, NEVER SEEN SUCH LOW NUMBERS !!!!!!

Tears falling down now..

 

[Critter Mom]

 

[Meya14]

Keep on doing what you are doing! I'm not sure if the weight gain is that high (differences in scales and stuff) but it's good he's gaining, he was probably pretty dehydrated. Be aware, in rare cases with subQ fluids, they can overload the heart and a massive weight gain would be a symptom of this. It's probably not the case, but it was a concern when I saw your post. More likely, he's just better hydrated, got a full belly, and feeling better.

I'd hold the dose your on (1.5 units?) for another couple days, and keep making sure that he's getting enough calories. If he's eating enough on his own, you don't have to syringe. If his appetite starts getting worse, you should start again.