Newly Diagnosed also w/DKA, Pancreatitis and UTI - Day 2

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Good morning,

Baby is doing much better this morning! I took her back to my local vet and got her a shot of Cerenia for her nausea. She already had an appetite stimulant shot yesterday that is supposed to last 3 days so she didn't get anything extra for that. They sent me home with an anti-nausea pill (cerenia) to start tomorrow after todays shot wears off. They also showed me how to do sub-q fluids and gave her 150 units/ml(?) this morning. She is eating cooked chicken breast with a bit of tuna water this morning and ended up eating quite close to her BG test but I didn't want to stop her. She's was at 259 before I gave her 1 unit of Levemir. I was able to find Keto testing strips and got her a huge assortment of different foods for her to try.

Is it correct that right now (depending on her numbers) I test at +1, +3 and +6? Or do I do more testing?

I will get a keto test done as soon as she uses the litter box to check for ketones.

Hopefully things are heading in the right direction! Thanks again for all the support last night; I was losing my mind! So grateful for everything and feeling less hopeless today from knowing there are such good people out there willing to take the time to help me and my kitty

 

I just tested Baby's BGs and she's down to 52 at +5. Is this too low?? What now??

 

I would give some high carb food if you have any or rub a bit of honey on her gums…not a lot…just a couple of drops and then test again in 20 mins

 

She hasn't been eating large amounts at once, just snacking, all day but she is suddenly very hungry. She's eating Special Kitty shredded chicken in sauce and I will see what else she will eat, perhaps Temptations again like last night. She doesn't have any new symptoms (was wobbly, lethargic since yesterday). I have honey if needed and will test again in 10 minutes

 

Ok, thank you!just saw this after I sent my post. Will do and test again at twenty minutes

 

If she ate some higher carb food you could leave the honey and test in 20 mins and see if that has brought the Bg up a bit

 

I am very glad you got some subQ fluids into her and they gave you some to give at home. That’s great!
Also the Cerenia shot and tablets!
I’m very happy to hear she is eating much better for you. What a good girl …she must be feeling a bit better. That is fine if she is just snacking all the time.
52 is a safe number but as Levemir usually nadir later in the cycle, we don’t want her dropping too low earlier in the cycle

 

Ok, she had about 15 temptations slowly and is still working slowly at the pile I gave her

 

Yes, I am so happy too! The vet was great today and didn't hesitate to give me anything you had suggested and had a tech show me how to give fluids. Was so helpful to know what to ask for and to be listen to!
She hasn't been drinking much, would you suggest, if she still isn't drinking, that I give more fluids this evening or wait and see how she is acting?
That makes sense, I remember something similar with my cat that had diabetes. It was 10 years ago though and I feel like all the knowledge I had just fell out of my head!

 

Her BGs are holding at 52 20 minutes after+5 test

 

I would only give the sub Q fluids once a day….what dido the vet say and how much?
I’m so glad the vet was helpful. That’s great!
Keep posting. I have to go out shortly to take someone to work but I’ll keep in touch as much as I can.

Keep offering the food and test again 20 mins.
If it drops under 50 rub some honey on her gums

 

The vet tech said 150 a day would be good, unless she was showing obvious signs of dehydration (neck scruff staying in 's' shape, pale gums) and that giving too much wouldn't hurt her?

Ok, she's having more temptations, seems to start then get distracted and stop, then start again. I will test again and give honey if under 50.
Thank you!!

 

She's gone up to 63 at +5 hrs and 40 minutes.
Test again at +6 now?

 

Yes test again +6
Got to rush. Be back in about an hour
Stop the higher carb food now

 

Ok, will do!
Be safe on your travels!

 

Slight drop at +6 to 61

 

I add 3tbs of water to my sugar kitty & non sugar kitty's meals. They never drink water although it's offered to them daily. The only time Panzer drinks water is when his numbers get high.

 

That's a great suggestion, I'll try that, thank you!

 

70 at +6.5. Do I continue testing every 20 minutes or increase time between? (+6.5 test took a bit longer to get done, meant to do it at +6.3)

 

Looks like she is surfing nicely now. What has she eaten in the last hour? Low carb?
How long since any high carb food?
I would test again in 1 hour to see she is not dropping again.

 

She has snacked on a couple temptations, a few chunks of chicken and licked at the sauce from the chicken and sauce. She doesn't have much of an appetite still, so I gave her a few temptations (maybe 3) about 30 minutes ago. Is it ok to just let her eat whatever she wants still? I have the A/D food but she isn't interested in that.
Test at +8 (in an hour) or an hour after her last test (+7.5)?

 

I think test each hour while she is in green if you can. It would be good to get the data.
Also if you can put what she is eating in the remarks column of the SS that will be helpful to look back on.
Yes I would let her eat what she wants at the moment until her appetite improves. It’s important she gets as much food as possible.
Have you had any luck with the ketone test yet?

 

Ok, I'll test again at +7.5 and hourly until she's out of green.
Ok, I'll add that too. She's mostly just picking away so it won't be exactly accurate lol.

 

What is going to happen moving forward……do you have to go out to work each day?

 

No, I work full time days but from home 4 out of 5 days a week with one day in the office which is less than 10 minutes from home. I can speak to my boss about the one day a week in the office and see if I can work only from home all five days on a short term basis.

 

Oh that is good news!

 

Yes, it's so helpful!! It's going to make things a lot easier for me and Baby

 

Sorry, missed this. I have the tests but she hasn't peed today yet to get a test done

 

She tested at 101, so in the blue, at +7.5. Do I stop regular tests now until her pre-shot test?

 

As long as she keeps eating you should be fine to stop testing now.
Don’t forget to not give any food for the two hours preshot so the BG is not food influenced. So last food is +10.

 

Ok, I will stop testing now and stop food at +10.
Thanks again for all your help!

 

Sorry, couple more questions, when should I do her first test after her PM shot? And after her first test, how often after do I test if her numbers don't go low?

 

At the moment I would always get a +2 just to see how she is going. Then after that it will depend on what the BGs are. Sorry I can’t be more specific, but at the moment we are gathering data. She is not eating properly yet and the food is partly higher carb so the cycles will probably all look different.
The fact she has responded so well to the Levemir is very encouraging.
I really want to see if she has any ketones in the urine as I don’t know if we are going to be able to keep her on 1 unit for long. If there are ketones we don’t want to be reducing the dose and may have to feed her higher carb food to keep her on the 1 unit, to make sure she is getting enough insulin. We have to do this sometimes with DKA kitties to ensure they are getting enough insulin to stop the ketones.
How is she generally….is she walking any better, is she still lethargic? And how are her eyes?

 

No worries, I know it's not an exact science when she isn't eating consistently and low carb.

I'm not sure why she hasn't peed except if she is so dehydrated her body is keeping all the fluids it can? Is it dangerous for her to have 1 unit at her PM shot since she went a bit low today? She isn't interested in food much at all but has been snacking more on the temptations this evening over the chicken, which she was favouring earlier. Should I be trying to get a urine sample somehow?

She's pretty sleepy and chill but seems a lot more comfortable and aware than she was last night. She is a bit clumsy but not nearly as bad as last night. Her eyes seem more normal too, last night she just starred into space, now she's actually closing them and napping. She's making bread on my lap right now and purring so she seems to be generally happier.

 

If you put her into the kitty litter would she pee?
How long since she has peed?

As she is following TR she has not earned a reduction. But dropping that low in the first dose does mean that once the depot fills the effect of the dose could mean it might drop the BG under 50 as the depot fills. But because she is only just starting to recover from DKA, we don't really want to reduce the dose if we can help it. It will mean you will have to monitor the BGs closely when they start to drop.
Getting a ketone urine test will help with decisions.

That is encouraging she seems to be improving.

 

She just peed and I was able to test, it's negative for ketones

 

Fantastic. That is really good news!
You are doing an amazing job helping her get better!

 

Such good news!! Well that alter what dose amount I should give her next?

Thank you! I don't think I could do it without all your knowledge and support!

 

I would rather keep her at 1 unit for a bit longer if we can. Lets see what the preshot BG is.

 

Ok, sounds good!

 

Her pre-shot test is 389. Shall I continue with 1 unit tonight?

 

She is still refusing to eat anything but a couple chunks of chicken and temptations; she had about 12.

 

Gave her 1 unit as her pre-shot number was fairly high.

 

Sorry I went out thinking you wouldn't be positing until now about the shot. Anyway you made a good call.

 

No problem! Whew ok, good. Sorry, my time changed by half an hour today. So I'll test again in two hours and keep offering food to snack on? I've tried like 12 different kind of food and he's just not having it lol.

 

Oh yes I forgot to factor in the 30 minutes!
When Sheba wasn't eating well, I froze the food and marked the carbs on it and used it at a later date to stop wastage

yes please.
Its good she is eating some chicken

 

Good idea! Unfortunately, I don't know what the carbs are as I'm in Canada and the food list doesn't have many options for Canadian food. Some of the foods are on the American chart, would they be the same in Canada and the Canadian one just has foods that aren't listed in the US? My other kitties are enjoy little blobs of the ones she isn't eating, they're in heaven right now with all the options! Lol.

She's snacking on the chicken breast and temptation off and on still. I think she has to poop but she's uncomfortable so she's currently wanting to hang out near the little boxes but is wary of them

 

CANADIAN FOOD CHART

 

Thank you, I've seen that one but it only has three brands, none of which I have, unfortunately. I'm not sure if the US one that lists ones I have are the same or similar at all.

 

I cant help you there.
I will tag another Canadian who may be able to help with food
@Melinda and Kitkat

 

Another couple of Canadians
@Amy & Herman
@Chris and Checkers

 

She's going down slowly with 371 @ +2 (389 PS). Should I wait to test again at +5?

 

I think I would get a +4. If she does drop I don't want to miss it. Is that OK?

 

Yup, I can do that!

 

I am such a zombie, I laid down and THOUGHT I slept through the alarm, woke up and tested... and it's only +3.5 not +4... OMG I am clearly very tired LMAO. At +3.5 she is at 365. What time should I test again now? Sorry about that!!

 

It doesn't matter at all! Looks like she could be bouncing from the greens this morning.
You might need to change the +3 column to +3.5 not 4.5. You are just very tired!
I think you could leave it until +6 and if she is still high. leave it then until AMPS.

 

Good catch, thank you, I changed it.
Yes, so, so tired. Ok, I'll test again at +6 and see where she is. Thank you! Going for some sleep

 

She's coming back up again with 371 at +6. I'm off to get more sleep before work. I'll wait to test again until her AM PS. Hopefully I can get her time moved soon, it's not going to work doing it this way, way too late for tests after *zzz*

 

Once you get back to a better schedule and she is feeling better, it will be much easier.
I hope you manage to get some sleep.
She could bounce for up to 6 cycles. Once she starts coming down, she could come down quite quickly and keep coming down to the end of the cycle so just be on the look out.
It was a better day today than yesterday!

 

Hi, I'm in Canada. I mostly use the US food chart and can find some of the brands listed and assume that the carb content is the same in both countries. The Fancy Feast Classic on the chart is the same as the regular pates you find here in grocery stores. Some of the other brands you can find at Pet Smart and Pet Value stores. I feed Checkers Weruva, and they have the carb content listed on their website.

 

I did get a couple hours, luckily!
I will keep in mind that she's likely bouncing until likely Friday, correct?
Such a better day!! It's a challenge to do all this but so worth it seeing her improve

 

Hi Chris, thank you for the response and information! I feed Friskies (when she's actually eating) and only the pates as it's the most affordable with having 5 cats. Hopefully she will start eating that again soon! I will check out the US chart and find out what the carbs are for the ones I bought her to entice her to eat so I know for the future when giving those.

Thanks again!