1/28/10 - Bashful - PMPS 314 - Ketones down now

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Theresa&Bashful

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Yesterday's condo: viewtopic.php?f=9&t=4222

Good morning...

Bashful's Blood Ketone level was up this morning to 1.1 from last night's .90. I'm really worried, but trying not to freak out. nailbite_smile

I added water to his food, and I'm going to keep him locked in my bedroom today while I'm at work to see how much water he's drinking. I'll be checking his ketones again tonight as soon as I get home.

He seems to be acting normal so far and is eating well, but I'll be watching him the next 45 mins til I have to leave for work.

Thoughts? Advice? :cry: :cry:

Edit: I just scooped cat boxes and it looks like one of them (I have 3 other civies) has diarrea or at least very loose poo. I am guessing this is Bash and it's a side effect of the Clavamox? Should I discontinue use for 24 hours?
 
Re: 1/28/10 - Bashful - AMPS 415 - Ketone Number Up

If there is infection, then no I would not discontinue the Clavamox. Do you know for sure that Bashful has an infection or was the vet guessing? A/B can cause diarrhea, yes.

Ketones usually signal too little insulin or infection .. causing higher BG numbers. I'd be careful with this. Hydrate, which I see you have been doing. Diarrhea can cause more dehydration.

I have to be honest and say I have zero experience with ketones or a/b use. I hope some others that have been through this can help you out.

Plain yogurt can help with diarrhea.. I have done that successfully.

edit for spelling.
 
Re: 1/28/10 - Bashful - AMPS 415 - Ketone Number Up

A probiotic like FortiFlora is good to add to the food when you are giving antibiotics....
the diarrhea is one of the side effects of the meds.
(My Shadow vomited after about a week or so on Clavamox. i called my vet and they siad to stop it for 24 hours...but that was the vomiting side effect. You can call your vet if that happens after about 6 days or so...but definitely call the vet)

Yogurt is good as CD said or any kind of probiotic like the FortiFlora...can be ordered online. There was another type that someone used recently...will check out the name of that too....to replace the friendly bacteria that the Clavamox destroys.
 
Re: 1/28/10 - Bashful - AMPS 415 - Ketone Number Up

If there is infection, then no I would not discontinue the Clavamox. Do you know for sure that Bashful has an infection or was the vet guessing? A/B can cause diarrhea, yes.
Click to expand...

Vet was semi-guessing. We ran a urinary test last Sunday and they couldn't be definitive one way or the other. The urine was too diluted with water to be totally accurate, but the urine WAS cloudy, so they erred on the side of caution. He also had moderate gingivitis/tartar, which the vet said was also a good idea to have antibiotics for (he's having a dental at the end of the Clavamox cycle).

I'll go look for the Fortiflora and the plain yogurt at lunch. Will they eat yogurt? Or do you mix it in with the food? Unfortunately, I skipped this morning's dose of Clavamox, since I didn't know what to do and had to leave for work. I'll give him this evening's dose. I put a bowl of water right under his nose this morning after he ate and he drank a little. I left bowls of water in my room with him in a couple places to encourage the water intake.

Maybe I'll have to increase the insulin a little? Nadir is probably in the middle of the night, but I can set my alarm to get up and test if need be.

Thank you for the support and advice.

Edit: Ordered Fortiflora online, but delivery not expected til 2/3 - 2/8, so I'll check to see if they have it at the petstore also, in case I can get it sooner. In the meantime will get him the plain yogurt today.

Best,
Theresa & Bashful
 
Re: 1/28/10 - Bashful - AMPS 415 - Ketone Number Up

Theresa....I'm back with the name of the other stuff...I asked Brenda & Morris what
she used...she wrote:
" I'm using a probiotic that contains bifidobacterium, which was recommended by Sienne. She really knows her stuff! The name of it is Digest-All and I got it at a local holistic pet supply place I found. Here's a link: http://www.thedogdenstore.com/whpetdiallpl.html "

So you might be able to find that locally...call pet stores to see if they carry it. Some kitty like the yogurt plain but I would try to see if he will take it or else mix it in...
You will no doubt need the Clavamox after the dental as well...so you might as well get the probiotic now. It takes awhile to recieve your online order anyway.
Hope this helps! :razz:
 
Re: 1/28/10 - Bashful - AMPS 415 - Ketone Number Up

Theresa&Bashful said:
Vet was semi-guessing. We ran a urinary test last Sunday and they couldn't be definitive one way or the other. The urine was too diluted with water to be totally accurate, but the urine WAS cloudy, so they erred on the side of caution. He also had moderate gingivitis/tartar, which the vet said was also a good idea to have antibiotics for (he's having a dental at the end of the Clavamox cycle).

I'll go look for the Fortiflora and the plain yogurt at lunch. Will they eat yogurt? Or do you mix it in with the food? Unfortunately, I skipped this morning's dose of Clavamox, since I didn't know what to do and had to leave for work. I'll give him this evening's dose. I put a bowl of water right under his nose this morning after he ate and he drank a little. I left bowls of water in my room with him in a couple places to encourage the water intake.

Maybe I'll have to increase the insulin a little? Nadir is probably in the middle of the night, but I can set my alarm to get up and test if need be.

Thank you for the support and advice.

Edit: Ordered Fortiflora online, but delivery not expected til 2/3 - 2/8, so I'll check to see if they have it at the petstore also, in case I can get it sooner. In the meantime will get him the plain yogurt today.

Best,
Theresa & Bashful
Click to expand...
It's ok that you skipped the Clavamox this morning. Maybe by this evening others can suggest what to do about the a/b in light of what is going on with teeth and with the questionable urine test. It is just that with the increased ketones, I worried about infection keeping the BG high and hope the a/b will make a difference in BG level as well as ketones.

My kitty did lick the yogurt right out of the bowl, he didn't eat much so I put some on a spoon and held it up and he licked more that way. I guess kitties just love the personal touch of hand feeding. Silly cats.

I've heard that cats really like the Fortiflora so that's good to have around.

As for increasing the dose... well, according to protocol it is a little early but exceptions can be made if ketones are present. Please post again with Bashful's numbers when you get home from work and I hope we can get more eyes to decide what to do. I would tend to go ahead with the increase, but Bashful did have some blues the other night. Like I said, let's wait and see where he is later today, Ok?
 
Re: 1/28/10 - Bashful - AMPS 415 - Ketone Number Up

Thank you CD - I'm picking up a probiotic from a holistic vet near my work at lunch called "Fast Balance" (the FortiFlora is on order). I'm also picking up some yogurt. I'll give both to him tonight and hopefully that will help. I'll get on with numbers when I get home from work.

Thank you all for all of your help.

T
 
Re: 1/28/10 - Bashful - AMPS 415 - Ketone Number Up

Theresa&Bashful said:
Bashful's Blood Ketone level was up this morning to 1.1 from last night's .90. I'm really worried, but trying not to freak out. nailbite_smile
Click to expand...

You are testing blood ketones, right? Do you know at what blood ketone level the ketones begin appearing in Bashful's urine as trace?
 
Re: 1/28/10 - Bashful - AMPS 415 - Ketone Number Up

The info that Ronnie gave you wasn't from me! Here's the link to the probiotic that Casandra had recommended to me. I found it at Whole Foods in the refrigerated supplement section.

I am concerned about the ketones. How is Bashful eating? Infection + not enough insulin + not eating = risk for DKA which is serious. If ketones are present and with these high numbers, I'd encourage you to call your vet. Ketones can get serious very quickly and DKA is not to be messed with. It is a life threatening condition. How are you testing for ketones? Is this with a meter? I just want to make sure I'm not over reacting since I don't test with a meter. I think it was above a 3 (maybe?) where you need to be concerned. Jill knows what the cut-offs are. Either way, it wouldn't hurt to check with your vet.

I'm also wondering if it wouldn't hurt to be aggressive with dosing and to consider raising Bashful's dose tonight. It's a little early but if ketones are present, it may make sense. Let's see what others say about the dose issue, though.
 
Re: 1/28/10 - Bashful - AMPS 415 - Ketone Number Up

With Sharyn and Fiona, who use the Precision Xtra extensively, Fiona's blood level for trace ketone spilling into urine was 3.0. There is more information in her profile on the old board:

http://www.felinediabetes.com/phorum5/p ... php?8,5868

I would get another ketone test in tonight. It is not a problem to raise the dose to 1.5u now in light of the blood ketone readings, IMO. You will be able to get more day spot checks this weekend?
 
Re: 1/28/10 - Bashful - AMPS 415 - Ketone Number Up

You are testing blood ketones, right? Do you know at what blood ketone level the ketones begin appearing in Bashful's urine as trace?
Click to expand...

Yes, testing for blood ketones. No, I don't know what number Bash is at before it spills into urine...just got the blood test strips day before yesterday and have been using those instead of the sticks. If his numbers are as high or higher tonight, I can test the urine with the sticks as well as with the meter to see how they relate.

I would get another ketone test in tonight. It is not a problem to raise the dose to 1.5u now in light of the blood ketone readings, IMO. You will be able to get more day spot checks this weekend?
Click to expand...

Yes, home all weekend, doing full curve on Saturday and could also do one on Sunday if you guys think that would give better data to have two days in a row full curve or even every 2 hours on the 2nd day or something.

I am concerned about the ketones. How is Bashful eating? Infection + not enough insulin + not eating = risk for DKA which is serious. If ketones are present and with these high numbers, I'd encourage you to call your vet. Ketones can get serious very quickly and DKA is not to be messed with. It is a life threatening condition. How are you testing for ketones? Is this with a meter? I just want to make sure I'm not over reacting since I don't test with a meter. I think it was above a 3 (maybe?) where you need to be concerned.
Click to expand...

Bashful is eating great, hearty appetite. He ate almost a full can of FF this morning. Bash had DKA four years ago when he was first diagnosed and almost died, so I know how serious it is and what the symptoms were like...that's why I'm being very watchful. I'll be checking ketones again tonight...if it's continuing to rise I'll call the vet also, altho I am guessing he will suggest raising the dosage (when I talked to them about it last weekend, they said "you can raise by a unit"... and I was a little concerned that they would up the dosage faster than you guys recommend and result in a rebound). From what I've read here it's usually around 3.0 when it spills into the urine and he was at 1.1 this morning, so it still might be considered less than trace, but definitely worth watching very very closely. We'll see where he's at tonight. Night before last he was at .90, then the next morning he was down to .30 and then back up to .90 last night and then 1.10 this morning, so he's been all over the place the last couple days. It seems that the higher his numbers are the higher the blood ketones (with what little data I have in 2.5 days).

I think I'll check Wholefoods before I go to the vet (it's next door!). : )
 
Re: 1/28/10 - Bashful - AMPS 415 - Ketone Number Up

Okay Kids - got the Ultimate Flora that Sienne recommended (thank you Sienne!) - also got some yogurt.

Left a PM for Sienne to see how much I should be giving and how often. : )
 
Re: 1/28/10 - Bashful - AMPS 415 - Ketone Number Up

Ok Wonder Woman! :thumbup Hoping that all is well tonight....
You have done a great job today already....maybe you will have good news and a
rest when you get home? Give Bashful a big hug.... :-D
 
Re: 1/28/10 - Bashful - AMPS 415 - Ketone Number Up

Theresa&Bashful said:
Left a PM for Sienne to see how much I should be giving and how often. : )
Click to expand...

I usually used 1/3 of a capsule sprinkled in food 1 to 2 times/day. If you are giving ABs as well, you want to make sure that you space the probiotics out between the ABs - at least a few hours after the AB dose is given.
 
Re: 1/28/10 - Bashful - AMPS 415 - Ketone Number Up

I usually used 1/3 of a capsule sprinkled in food 1 to 2 times/day. If you are giving ABs as well, you want to make sure that you space the probiotics out between the ABs - at least a few hours after the AB dose is given.
Click to expand...

That work thing is interfering again (why is it that we have to work for a living again? Oh yeah! To pay for the vetty bean! lol :-D ). I give the AB at the same time (roughly) as the insulin shot (it's supposed to be given every 12 hours also). In the morning I only have an hour post shot before I have to go to work. Is that okay? The other problem is getting him to eat again, altho I guess I could make sure he eats a little before the shot and then give him the rest an hour later? Evening is a little easier - as I could give it to him before going to bed (there's only a couple nights a week when I am not at home).
 
Re: 1/28/10 - Bashful - AMPS 415 - Ketone Number Up

Good luck with the scheduling Theresa....was wondering how Bashful was tonight...and if you were
able to check on the ketones....(in your spare time of course... :roll: ) Hoping you have a good night
when you finally get around to it.... :-D
 
Re: 1/28/10 - Bashful - AMPS 415 - Ketone Number Up

sounds like you're well stocked on probiotics now. :smile:

For what it's worth, I agree with the dose increase recommendations, in light of Bash's ketones. Sending ketone-ketone go away vibes....
 
Ohhhhh so relieved!!! Ketones down to 0.6 this evening. Numbers also coming down, actually came down from +11 (343) to PMPS at 314, go figure. I shot 1.25 Fat+ - I still don't have the 1/2 unit needles, but ordered from Hocks and should have this next week so will be able to see more clearly dosage at that point, altho I am very very careful about how much is in there.

Will be monitoring numbers tonight.

WCR - eating like a piggy and oh so happy to be sprung from jail. Ate most of a can of FF this a.m. and also ate the one I left in the dish while I was gone today, so I know he's eating good. He is definitely the one who has loose stool, so will give probiotics later tonight before bed to help with that. He's drinking water well also (in addition to what I am adding to food). In good spirits and active tonight...he was very unhappy Momma Bean locked him in her room today and glad to be out - he's kinda the Poppa Kitteh to the other civies...they came in and loved him up as soon as I opened the door after testing. He's very happy.

Feel like I'm on a roller coaster with this little guy. Momma Bean needs valium..lol

Thanks to everyone for all the advice and support today...I don't know how I would do this without all of your wisdom and guidance.

I'll check ketones again in a.m. also.

Happy joy joy!
Theresa & Bashful
 
OH Yes! Such good news on the ketones and very glad the BG numbers are a little lower too. All of that helps. Your whole post made me smile, with relief and with the cuteness of Bashful and his civies. Love the Poppa Kitteh designation for Bashful! That is so sweet.
 
So glad to hear that Bashful's ketones are coming down. That's wonderful. The Poppa kitty -- it sounds like all of your guys really love each other.

FYI - Hocks ships very quickly.
 
Re: 1/28/10 - Bashful - AMPS 415 - Ketone Number Up

why is it that we have to work for a living again? Oh yeah! To pay for the vetty bean! lol
Click to expand...

So very, very true!

I give the AB at the same time (roughly) as the insulin shot (it's supposed to be given every 12 hours also). In the morning I only have an hour post shot before I have to go to work. Is that okay? The other problem is getting him to eat again, altho I guess I could make sure he eats a little before the shot and then give him the rest an hour later? Evening is a little easier - as I could give it to him before going to bed (there's only a couple nights a week when I am not at home).
Click to expand...

Just try and space it out as much as you can then. He doesn't need to eat with his shot per se - with Lantus/Lev you have a few hours to get food in, especially with a higher preshot. You could maybe feed him part of his meal with the AB and then the other half with the probiotic as you suggested, or just give the probiotic SID (once/day) at night with a snack.
 
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