Is he unresponsive to insulin?

Previous thread: https://www.felinediabetes.com/FDMB/threads/early-dka-ketones-trace-small.273844/#post-3043296

I haven't seen any difference in numbers since starting insulin. His ketones are definitely changing, but not his BG. I'm so confused, he's been on doxy for 8 days for a uri that he still has symptoms for. And I don't know if I should bring him back in for fluids tomorrow morning. He was given 200 cc yesterday and 200 cc today. That seems to be clearing his ketones because now hes back at 1.2 ketones. I don't know how to proceed please help

 

Cats don’t always respond straight away to insulin. Insulin is a hormone, not a medication like an antibiotic. It can take time for the body to get used to the insulin.
The uri could be creating a bit of insulin resistance.
At the moment the main things are he is eating plenty ketones are not increasing.
Insulin does other things in the body apart from reducing the BG.
It helps blood glucose enter the cells so it can be used for energy and it stores blood glucose in the liver for later, so it is also working behind the scenes so to speak.
With the sub Q fluids…I would not let the vet give more than 100 mls each day. 200 mls is too much

 

Do you think I should skip today's fluids and go tomorrow for 100cc then? And thank you, I wasnt aware insulin did more than correct bg. He's been on doxy for nearly 9 days, at what point do I switch him to something else? 2 weeks? His urine has a ph of 5 with blood present and ofc tons of glucose. And a little protein now. I'm worried that he also has a uti and doxy isn't indicated in cystitis uti (I have interstitial cystitis I'm very utd on bladder stuff lol)

He taught me a new way to syringe feed him and he has had 2 cans since 10pm, I think I can get 5 or 6 cans in him in 24 hours now

Once this infection clears will his bg drop insanely? Im scared of hypo

 

If the entire bag of fluid that was under the skin has gone, he could have 100 ml but I wouldn’t give him any more than the that. If there is any left under the skin, I would wait until tomorrow.
Is the doxy helping the uri?
The only way to tell if he has a UTI is to get it tested. Maybe he has FLUTD (google it)
With a ph of 5…that is quite acidic ….bacteria is less likely to grow in an acidic urine. Not sure why it is that low though.
I have read where diabetic cats with uncontrolled diabetes can have a low urine ph because of a buildup of ketoacids.
Hopefully it will correct itself as he improves.
You could ask you vet.

If you are testing the BG you will be able to see it dropping.
Unlikely it will drop “insanely”.

 

I can't tell if all the fluid is gone so I guess I'll just wait until tomorrow and go heavier on the water in food today. I ordered urine test strips so that will be here later today. Thank you for letting me know it won't drop that fast. I've been scared of that. I just want to see those dang ketones gone. They've been haunting me in my sleep no lie

 

Ketones at 0.4! I can't believe how much food he's accepting! He's at 4 cans today so far at hour 15. He's def gonna get 5 cans at least

 

Ketones back to 0.7

 

Ketones of 0.4 and 0.7 are not anything you need to be worried about….just keep feeding as you are and giving the insulin, and sub Q fluids as needed.

 

Anis

0.7 is ok? My own blood showed 0.4 but I haven't eaten a real meal in a week. I spend all my time with jekyll and I have alot of food allergies so I'm essentially keto. No wheat = no carb lol. Do you think I should push for the 5/6 cans of FF a day? I'm starting to think he has a tooth issue. He won't accept the syringe on one side of his mouth, interestingly is the opposite side of his anisocoria eye

 

With blood ketone meter 2.4 to 2.55 is when we need to be concerned, although I like to see it lower than that.
If you did a urine test with a reading of 1 or 1.8 for example on the blood ketone meter, it would read negative.

if you think he has a tooth issue, definitely get that check out as it could be a source of infection and we need any infections treated, especially if there are ketones lurking around.

With the food, I would aim for 1 and a 1/2 times as many calories as he would normally eat.

Also you need to look after your self and eat properly. If you get sick, who will look after Jekyll?

 

THIS!!

 

ill take him tomorrow to a vet to check out his teeth, i may aim for a new vet although ill be hard pressed to find one i already dont like lol. im not sure what he would normally eat as he wasnt my cat. right now he is digging the food i cant believe he put back 5 cans so far! my remission cat is 18 lbs which is 5lbs more than jekyll and only eats 4 cans, and he wastes some of that too. if i calculate the bodyweight on the can of food it says to feed about 4 cans so 6 would be about 1 and 1/2 right?

i am unfortunate when it comes to food. i wish i could just grab something to eat but im allergic to most things that are fast and easy. taco bell is my go to and i just had it for dinner tonight! im feeling revived lol!

i care for a LOT of cats, jekyll has won over my husband and he is helping me alot. thats very impressive as my husband hates anything that stresses me out. He's letting jekyll slide and feeding me himself lmao