3/2 Fortune PMPS 234 +1 307 +2 289 +4 183 + 5 118 +6 89 +6.5 86 +7 84+7.5 70+8 64+8.591+9175 +10173

RachelG

RachelG

Active Member
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Fortune is home, happy, and much more himself! :joyful: When he got out of his carrier he went right to the water fountain and then to Marty's (our civvie) food bowl to lick up the dried food from this morning! YAY!!

Since he was hungry I did give him a little snack. Ok, maybe two little snacks :smuggrin: I hope we didn't spoil his appetite for his dinner...but I'm just so happy to see him circling, meowing and asking for food! He also seems much stronger, and is so lovey!! UGH I'M SO HAPPY HE IS HOME!

We hope that the subq fluids prescribed (finally) will help maintain his kidney levels.

The IM increased his insulin to 3IU (again) this morning since he was over 600 last night. I have not been able to get the numbers, but I am having DH call again tomorrow to get them. They are not fans of me and my questions/requests. :oops:

I do think Fortune was likely due for an increase. He touched the 200s at 2.5 so it would have likely been a .25 increase once we were consistent with the cycles. But with him so high and having "early DKA," does it make sense to try this 3IU dose? I don't want to harm him by keeping him at too low of a dose, or too high of one.

I also pushed the IM for direction (directly) about if he drops to the 50s tonight like he last time she increased his dose to 3IU on discharge. She recommended not shooting at all if he is under 250 (!) and giving a half dose if he doesn't eat. I'm not sure I am comfortable skipping, and we are able to stay up if needed to make sure he is safe. What I'm not sure about is taking his dose down (again, like last time, but a smaller reduction because we are now at 2.5) or seeing how he does at 3IU.

Open to thoughts...
 
Welcome home Fortune! I would not skip after all he’s been through. See what the PMPS is and then decide if 3.0 seems right is what I would do. I sure hope he will eat. How much sub-q were you told to give and how often?
 
Thanks for all of the well wishes!! :bighug:

tiffmaxee said:
I would not skip after all he’s been through. See what the PMPS is and then decide if 3.0 seems right is what I would do. I sure hope he will eat. How much sub-q were you told to give and how often?
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Oh, I have no intention to skip! My question is, if I should stay at 2.5 (I don't think that's right though), up to 3 IU (which is what he got this am) or split the diff and do 2.75. (PS How are you feeling?!)

Bron and Sheba (GA) said:
One thing that helps keep ketones at bay is food so frequent small snacks is good.
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I'm trying to figure out how to give him small snacks without spoiling his appetite. :arghh: How do folks who feed frequently give wet food without it going dry/stale?


I also want to mention that he did not have ketones in his urine (YAY!), which I think helped a lot. We must have caught things super early?
 
I think I would shoot 2.75 but see what others think. When I fed some meals ofen igavejusr a few spoonfuls at a time. It didn’t dry up. You could put a bowl of ice or an ice pack under the dish. I am glad ketones were not in his urine. He was not DKA it seems. :)
 
Ooo that's a relief! When the IM called for the update she kinda sped through the part where she said, "he is no longer DKA because we flushed the ketones..." and I asked her to stop and explain when and how Fortune was DKA since no one had mentioned that in either of the previous updates/calls! He had trace ketones and was decimal beyond normal, so they tagged him as DKA because he was symptomatic (not eating well, tired, etc.). Who knows? I did just buy the ketone blood meter for peace of mind!

Do you measure the food in tsps? I'm weighing it currently to better track how much he is eating and to try and get some weight back on him :(

We are shooting in about 30 minutes, so hope folks chime in soon. :)
 
Happy homecoming, Fortune!:bighug:
I weigh all of butters's food. I've estimated with hers that 1 tsp = 7 grams (1/4 oz). But it's easier for me just to record all of her feedings in grams on her spreadsheet. I think it's a great idea for you to weigh his food and weigh him, too. I put butters on a baby scale at least once a week.
 
We used to have a baby scale back in 2014 when Fortune had his first IBD flare up! But then he chonked up and we didn't need it anymore, lol. I think it may be time since he has lost so much. IDEK how much he weighs rn - the IM hates when I ask questions, so I prioritized other things.

I think I'll switch to grams since it is more precise at a smaller amount. Thanks for the suggestion!
 
tiffmaxee said:
I sure hope he will eat. How much sub-q were you told to give and how often?
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I missed your question! 100ml every other day starting tonight.

Also - so far he has eaten 1.7oz (out of 2.6 offered), and eaten 4.7 since getting home. He stopped and went to nap...so I'm going to offer more when he gets up. We are shooting in about 20 minutes, so hopefully that will be enough to support the dose...:nailbiting:
 
You got greens on 2.5 units, then you had enough skips and partial doses that the 2.5 unit depot never got build up again to show what it can do. I'd be OK with 2.75, as long as you can monitor.
 
Ok, let's do the 2.75! Thank you! We will stay up and monitor.

We had 6 uninterrupted cycles of 2.5 IU back on 2/22-2/24, and he was due for an increase on 2/25 AM but we postponed because of the onc appointment. So technically he should have been at 2.75 since Thursday AM.
 
RachelG said:
How do folks who feed frequently give wet food without it going dry/stale?
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Feed it well watered, that prevents it from going crusty. If you use an autofeeder you put a gel pack under the feeder tray.

With recent ketones/close to DKA, I would not skip. Period. Until ketones are a lot further back in history. And do a minimum of half dose. Regardless of his appetite. Tonight you are fine with full dose.
 
Oooh can you share more info on the autofeed with a gel pack? I'll try the water tip, too! Thank you!

I know he went green - just to mess with me! LOL and maybe from the vet/fluids/chemo? IDEK.

Appreciate you @Wendy&Neko & @tiffmaxee for the advice! Shooting 2.75 now, and hoping for the best.
 
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One more thing - we are about to administer his fluids. Is there reason that should interfere with his insulin? We were just told to give them to him tonight, not "with dinner" or X hours after insulin...and now I'm nervous.
 
For some cats, not all, fluids can reduce the numbers. He's high enough it should be too much of an issue. But you still might want to separate the two by a couple hours or wait until you see him zooming up more. Shoot insulin not in the scruff/neck area when you are going to give fluids, which go in scruff. So separate by time and distance. I usually gave fluids after nadir, when Neko would be going up anyway. The one time she got fluids at the vet after her shot, she came down before onset. But she was in low blues, so more noticeable.

I used the Petsafe 5 feeder. Under the tray is a rectangular area that can fit a gel pack (or ice cubes for low tech). I just bought a small cheapo gel pack and folded to fit. The Catmate ice packs also fit the Petsafe spot, if you have that feeder already. You can also put an ice cube on top of the food and it'll keep things cool while it melts and adds water. Which would be good for him right now.
 
Thanks @Liz & Minnie this is awesome!

Liz & Minnie said:
Hope you got plenty of sleep while he was in the hospital :)
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I appreciate the thought, lol. Unfortunately, we didn't. Mostly because I was a nervous wreck that he would take a turn while hospitalized :nailbiting: It was a really hard decision for us to admit him overnight again, and I was very on edge. Just grateful he is home, and that there was something to make him feel a bit better.
 
Wendy&Neko said:
For some cats, not all, fluids can reduce the numbers. He's high enough it should be too much of an issue. But you still might want to separate the two by a couple hours or wait until you see him zooming up more. Shoot insulin not in the scruff/neck area when you are going to give fluids, which go in scruff. So separate by time and distance. I usually gave fluids after nadir, when Neko would be going up anyway. The one time she got fluids at the vet after her shot, she came down before onset. But she was in low blues, so more noticeable.
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Crap. DH determined that because the vet didn't indicate separating them, we are good to go and not question them constantly. :rolleyes: We gave about 75 of 100 ml, in the scruff, about 15 min after insulin. No idea what this will do, but it doesn't feel like it will help things. :banghead: I just hope Fortune is suffering from our inexperience! We will try and give the rest later on tonight.

Wendy&Neko said:
FI used the Petsafe 5 feeder. Under the tray is a rectangular area that can fit a gel pack (or ice cubes for low tech). I just bought a small cheapo gel pack and folded to fit. The Catmate ice packs also fit the Petsafe spot, if you have that feeder already. You can also put an ice cube on top of the food and it'll keep things cool while it melts and adds water. Which would be good for him right now.
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We don't have a feeder yet, but this is very interesting. The only problem would be our civvie Marty eating Fortune's fuds. Maybe we can craft an RFID thingy on it and put the key on Fortune's collar...Hmm...
 
We will find out soon! Both boys are snoozing - Marty barely ate tonight, now. I don't know what's going on :blackeye:

Going to do a +2 and see where we go. Also going to keep offering food cuz he needs the calories, and isn't eating a ton in one sitting.
 
It's ECID on whether a cat reacts to fluids by going lower. You will find out soon!

You can get more expensive feeders that react to RFID chips. Of if one cat is fatter than another, put the feeder in a box with a "doorway" the fatty can't get into.
 
RachelG said:
Fortune is home, happy, and much more himself! :joyful: When he got out of his carrier he went right to the water fountain and then to Marty's (our civvie) food bowl to lick up the dried food from this morning! YAY!!
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LOL you are such a mom, bragging about your boy cleaning plates after getting home. :)

I have the spendy microchip feeder. It's been a godsend as I don't have to worry about Olive eating Ruby's food and vice versa. I only wish they had a timed version, but I'm sure it's in the works.

Enjoy kitty cuddles this evening! :bighug:
 
Katherine, I am such a mom! I remind myself of my grandmothers because they were always telling me to "eat, eat, one more bite before you get up, do it for me," and I am telling Fortune the same thing :p

I like the autofeeder ideas - when I first looked into them we had them on the same food, and fed 2x/day separately. Now one is a diabetic and both have CKD, and one is on a diet. I am wary of introducing something that may deter Fortune from eating. If he gets his full appetite back (please G-d) I think I'll spring for it!

Appreciate the advice on the feeders overall!
 
Gave the remaining fluids with him snuggled in my arms. I'm worried the needle is uncomfy - it's a 20 gauge. I'm glad I can snuggle him during it, at least, and provide some comfort. I hope it will rev up his appetite, too!

+2 is higher than PMPS, but a +4 for good measure post fluids couldn't hurt? Or can I go to bed?
 
I’d probably do a +4 because of fluids. The best needles are the terumo needles. Really sharp. I think 20g are fine. I even at one point used 19g with Tiffany because they were faster. You can buy them on line.
 
This is so great! Fortune is home!! And eating!! I always separated Darcy's fluids by about two hours from his insulin. It didn't seem to affect his BG much... but it did help his ketones to go down.

I will go to sleep with a smile on my face thinking of Fortune at home again tonight! Hugs, Rachel! Kiss that boy!
 
Oh, yes. Definitely buy Terumo needles. I just ordered more from Thriving Pets a bout two weeks ago. 20 g is good (I prefer it to the larger needles.) I have 19s and 20s. 19s are for a cat that won't hold still long enough. I won't use the bigger gauge needles that the vet tries to give me. They are harpoons.
 
Suzanne & Darcy said:
This is so great! Fortune is home!! And eating!! I always separated Darcy's fluids by about two hours from his insulin. It didn't seem to affect his BG much... but it did help his ketones to go down.

I will go to sleep with a smile on my face thinking of Fortune at home again tonight! Hugs, Rachel! Kiss that boy!
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Thank you Suzanne!! We have been lovin on him all night, and he has barely left my side all night :woot: I'm in heaven. I cried the whole way home because I was so happy to see him, and see how energetic and happy to see me he was - pushing against the carrier when he saw me, circling, etc. It was a complete 180! @Bronx's dad (GA) I thought of how you described your trip home with Bronx after SRT :bighug:

tiffmaxee said:
I’d probably do a +4 because of fluids. The best needles are the terumo needles. Really sharp. I think 20g are fine. I even at one point used 19g with Tiffany because they were faster. You can buy them on line.
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I'm not sure if I'm reading into him snuggling/burrowing into my arm too much - he used to do it all the time. I'll check the terumo out!

He just had some more food before we turn in for the night. We resorted to food with questionable measures of carbs and phos in an effort to get him to eat. I need to order a phos binder - the IM wants to "wait and see," re: phos binder yet feed him "whatever will get him to eat." Every time I ask for things (like subq, or potassium supplement, etc.) she shuts me down until a different doctor intervenes, so I'm going to get DH to ask instead. :smuggrin:
 
Just kidding - I'm here cuz it's 183. DH will check +5, and if it's the same or lower Ill check +6.

It's all worth it to have him snuggled in bed with me rn.
 
Well, we are at 118 @ +5. Fortune was not interested in a snack, so waiting an hour and testing again.
 
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Should we feed high carb, medium carb or low carb? Fortune at a little bit (1.1oz ) @ +6 but it was LC
 
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Thank you, Wendy! :bighug:

84 @ +7. Not sure if he is flattening out because he an ounce of low carb @+6. We got 10oz into him this afternoon / evening since he got home and now he isn’t that hungry. :banghead:

He had a few small nibbles of MC/LC mixed - the only thing that would entice him. Hopefully it will keep him flat or raise things...

Should we test in 30 or at +8?
 
Hi Rachel,

I'm too new around here to give much advice, but I just want you to know that I'm following your journey all the way from across the country and cheering you and your husband on every step of the way! I am very happy to hear that Fortune is feeling much better today :)
 
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