? 12/12 Millie/PM+11 280/AMPS 242/3.5U/+2 272/+4 278/+6 227/+8 241/+10 235/PMPS223/+5 222

WTH? I know it takes a bit for the new dosage to take effect, build up, whatever. I, as doting Italian grandmother (not even Italian but German and Irish grandmothers don't dote), I am always concerned about appetite. She has decided that she doesn't want soupy food, so I will have to start monitoring her water intake. Anyway, concerned with the numbers this morning, I decided to test her ketones with a meter. She read .6 two hours ago and .5 a few minutes ago. Before it was always less than .1. Everywhere I have looked, it says that it is the upper limit of normal. No bueno. I need to get more water intake, correct? I am tied up most of today, so can't get into the vet. She is acting fairly normal, maybe a little off. Obviously, not a smooth progression here. Is there anything, in particular, that I need to make sure to ask the vet? Any test numbers that I need to make sure to get? I don't want my vet to fire me for being pushy but want to cover all my bases.

@Bandit's Mom
 
SOOOO....Millie is way off of her feed today and definitely is not herself. She ate fine last night but only ate part of her breakfast. She has only picked at her snacks and didn't even finish her Young Again snack...unheard of, although she eats the pieces I give her after her BG tests. So her numbers have been over 200, and pretty level, all day long. As I noted above, her blood ketones were at .6 this morning and have been .5 twice today. It doesn't look like she has drunk much today and she no longer likes her food watered down. I stopped at the store, between appointments that I had today, and got her some different Merrick and Wellness wet food. She's licking at the juice but not eating more than a bite or two. Here's the deal. I have a work function that I have to attend tonight. I have to leave right after her shot and won't be back for 3 or 4 hours. I have inched her shot up to an hour and 15 minutes before her normal time. She has a vet appointment at 5PM tomorrow. So, since I won't be home and won't know if she is eating her dinner completely, and she has ketones, do I give her the new dose? Do I adjust it? Should I give her some fluids? A friend lost her CKD kitty recently and has a stash of Ringers and will give me a bag and needles, etc... I have done it before. I am not in a position to spend thousands at the emergency vet. Do I use Mirataz just to get her to eat something, anything? Every time I try to logic my way through this, I realize that I don't have a grasp on this diabetes thing. Guidance, please, if anyone has any to spare.
 
Hi Heidi, sorry I didn't see your post last night. Has Heidi eaten anything since your last post? You definitely want to give her the increased dose. If there are any ketones, you do not want to skip or give less insulin. Her numbers are pretty flat. I will tag @Bron and Sheba (GA) who has more experience with ketones and DKA.

I wonder if pancreatitis is also a possibility. You might want to ask the vet to test for that.

Do you have any ondansetron? Does Millie look nauseous?
 
Bandit's Mom said:
Hi Heidi, sorry I didn't see your post last night. Has Heidi eaten anything since your last post? You definitely want to give her the increased dose. If there are any ketones, you do not want to skip or give less insulin. Her numbers are pretty flat. I will tag @Bron and Sheba (GA) who has more experience with ketones and DKA.

I wonder if pancreatitis is also a possibility. You might want to ask the vet to test for that.

Do you have any ondansetron? Does Millie look nauseous?
Click to expand...

I am not home yet. She was eating a bit when I tested and gave her her shot. My vet called and wants me there first thing in the morning. She ate some this morning and eats the YA when I was testing her. I don't have anything for her. I will definitely ask about pancreatitis. She's been doing fine except for numbers. She was crying for food this morning but then only ate half and then picked the rest of the day. She jumped right up on the ottoman, to get tested and get her treat. However, she did hide out a bit this afternoon. It just was more obvious as the day wore on. I made an appointment for tomorrow at noon but the vet called to have me come in first thing. She was at .6, then .5 and remained there. Ugh. I looked up the cost of DKA treatment. I flat out don't have it. I'm sick about it.
 
0.5 and 0.6 on the blood ketone meter is normally not anything to worry about. Most cats that are tested for blood ketones have a number under 1, occasionally 0 but not often. I would be more concerned that she is not eating well. I’m glad you are going to the vet in the morning. If you can collect a urine sample take it with you and get the vet to test for urine ketones.

As Bhooma suggested it’s possible she has pancreatitis and may need an antinausea such as ondansetron. In the meantime I would offer her anything you think she might eat, even if it’s not diabetic friendly. The most important thing is she continues to eat. It is food and insulin that will keep the ketones at bay. I would ask the vet about subQ fluids first before you give them if he hadn’t given you the OK before.
 
After just missing closing time on 3 grocery stores and pharmacies, I found a CVS whose first night being open until midnight was tonight. I now have 100 ketostix. Now to actually try to catch it. I will see if I have any of those little plastic pellets and put those in a box, instead of her regular litter box. I originally bought the ketone meter because I read that it was more accurate than urine and certainly easier to use. When I got home, she was brighter than she has been today but didn't eat much, if any, of her dinner. However, she is begging for the Young Again and jumped right up to get tested so she can have some. I will start opening cans to see if anything appeals. I gave her fresh water (exactly 5 oz.) before I left this evening. It looks like she might have drunk some of it but I have a cup to measure what she has had.

I know I have likely asked this a million times but what are the normal ranges for a human meter, compared to the alpha trak? My vet originally told me that it was very important to use the pet meter. However, the cost differential is $1/strip, compared to $.38 for the FreeStyle Lite (if I buy 10 boxes at once).
 
I would say the majority here use a human meter. I did. Our methods were based upon that. Some vets don’t like it. If yours doesn’t you could use a human meter but do a curve for your vet with a pet one. The normal range us 50-100 with human meters.
 
Good to hear that she is brighter! Fingers crossed that she eats. If Young Again is all she wants to eat, that's fine for now.

It's amazing how vets will insist on a pet meter but are happy to use the Libre (which is a human CGM) on cats! The normal range on a human meter is 50-100 mg/dl or even 120. On a pet meter it is a little higher - 68-120.
 
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