? 24/12: MITTENS - Novolin N, Small Ketones

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Just a few thoughts as I read over the posts this morning with my first cup of coffee..
The 7.5oz of food reported to be given in the summary, is 7.5ml of food.
The gravy baby food is okay to give. It just has a bit more carbs in it.
I think the idea of 300mls of fluids should be confirmed with Meya14.

You did brilliantly last night. Merry Christmas!!! Keep up the good work.
 
Dan&Heather said:
This is what we have right now, have mostly been just feeding fancy feast for last day or so.

Beech Nut Classics
chicken and chicken broth, we got it because the only ingredients are chicken and chicken broth.

2.5 oz jar:
calories: 70
total fat 4g total carb 0g
trans fat 0g fiber lessthan 1 g
sodium 25 mg sugars 0g
potassium 90mg protein 7g

Beech Nut Classics, turkey and turkey broth 2.5 oz:
calories: 60
total fat 4g total carb 0g
trans fat 0g fibet 0g
sodium 40mg sugars 0g
potassium 90mg protein 6g

I accidentally bought one jar of Gerber chicken and chicken gravy, we didn't give it to her because we noticed it was gravy not broth and wasn't sure. Not sure if you need the information for that one but here it is anyway just in case:
2.5 oz jar
calories 100
total fat 6g total carb 2g
trans fat 0g dietary fiber 0g
sodium 40mg sugars 0g
potassium 90mg protein 7g
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Perfect, thanks!

It turns out to be hard to get exact numbers here, because they are clearly rounding on those gram amounts, argh. Each food has the carb content listed, and if you trust that and assume 4kcal/g of carb, the first two have zero % carb and the last one is 8%, so they'd all meet the standards of low-carb fare. However, if I go through and calculate expected calories for the given number of grams of fat/protein/carbohydrates, I don't always add up to the number of calories given, so I think we have to assume that there's some wiggle room ±0.5g on all these estimates, and just calculate a range of possible carb values. Here's what I get:

Beech Nut Classics chicken+chicken broth: [4kcal/g*0g]=0kcal from carb (low estimate) to [4kcal/g*0.5g]=2kcal from carb (high estimate); % calories from carbs is 0/70 to 2/70 = 0-3% carbs.

Beech Nut Classics turkey+turkey broth: Same as above, but different total calories, 0/60 to 2/60 = 0-3% carbs.

Gerber chicken and chicken gravy: [4kcal/g*1.5g]=6kcal from carb (low estimate) to [4kcal/g*2.5g]=10kcal from carb (high estimate); % calories from carbs is 6/100 to 10/100 = 6-10% carbs.

Sum-up: first two are definitely good low-carb options, the third is possibly low-carb but may be a little higher, and will be a good food to have on hand if we need to give Mittens' blood glucose numbers a little more support on the TID insulin schedule.

 
Dyana said:
Just a few thoughts as I read over the posts this morning with my first cup of coffee..
The 7.5oz of food reported to be given in the summary, is 7.5ml of food.
The gravy baby food is okay to give. It just has a bit more carbs in it.
I think the idea of 300mls of fluids should be confirmed with Meya14.

You did brilliantly last night. Merry Christmas!!! Keep up the good work.
Click to expand...

I agree, we should confirm the 300mls amount, or else go by the vet's recommendations. I took that number from post #135:

24/12: MITTENS - Novolin N, Small Ketones

Linda referenced looking Meya14's instructions in the previous post, so I'm assuming it is from there but I haven't found it yet-- I think it must be in the previous thread, though.
 
Another thought I had as I was getting caught up this morning, was the difficulty in getting the old needle off the line. I remembered watching this giving fluids video again yesterday and noticed what they call the lure lock that seems to hold the needle in place. They talk about it at 12:15 on the video. I remember I had a heck of a time getting the needle off the first time too.
 
Nan & Amber said:
I agree, we should confirm the 300mls amount, or else go by the vet's recommendations. I took that number from post #135:

24/12: MITTENS - Novolin N, Small Ketones

Linda referenced looking Meya14's instructions in the previous post, so I'm assuming it is from there but I haven't found it yet-- I think it must be in the previous thread, though.
Click to expand...
I put in a link to a post Meya made on Ozzy Pawsbourne's thread. Might be helpful.
http://www.felinediabetes.com/FDMB/threads/newly-diagnosed-after-surviving-dka.169143/#post-1835133"
 
Yes, that must be it!!!!!

Reading this, I withdraw my 3x day suggestion (in fact I'm going to go back and edit if I can)-- the 300ml/day is the total amount of fluid needed, in both food and supplemented, so 300ml of subQ would be way over the top (and possibly dangerous). Ack!!!!
 
One last thing and this is a bit of a hijack for which I apologize.

There was a new poster last night in Health who has their cat on 8u of Caninsulin after only 1 month of treatment.:eek::nailbiting::eek::nailbiting: I just got under my blanket when I realized I never finished my post to them. So up I got! I am seriously concerned about this cat and their pet parent. I have suggested backing the dose up and starting over and asked that they set up a spreadsheet. Can someone keep an eye out for any response from the poster? Here is a link to the thread
http://www.felinediabetes.com/FDMB/threads/diabetes-initial-treatment-need-advice.170191/
Thanks so much and with that I am outta here! :D:D:D:D
 
MrWorfMen's Mom said:
One last thing and this is a bit of a hijack for which I apologize.

There was a new poster last night in Health who has their cat on 8u of Caninsulin after only 1 month of treatment.:eek::nailbiting::eek::nailbiting: I just got under my blanket when I realized I never finished my post to them. So up I got! I am seriously concerned about this cat and their pet parent. I have suggested backing the dose up and starting over and asked that they set up a spreadsheet. Can someone keep an eye out for any response from the poster? Here is a link to the thread
http://www.felinediabetes.com/FDMB/threads/diabetes-initial-treatment-need-advice.170191/
Thanks so much and with that I am outta here! :D:D:D:D
Click to expand...
I'm on it, Linda. I responded first last night and was very concerned at the 8 u dose when I read that this AM.
 
MrWorfMen's Mom said:
One last thing and this is a bit of a hijack for which I apologize.

There was a new poster last night in Health who has their cat on 8u of Caninsulin after only 1 month of treatment.:eek::nailbiting::eek::nailbiting: I just got under my blanket when I realized I never finished my post to them. So up I got! I am seriously concerned about this cat and their pet parent. I have suggested backing the dose up and starting over and asked that they set up a spreadsheet. Can someone keep an eye out for any response from the poster? Here is a link to the thread
http://www.felinediabetes.com/FDMB/threads/diabetes-initial-treatment-need-advice.170191/
Thanks so much and with that I am outta here! :D:D:D:D
Click to expand...

I saw this one. Haven't checked this morning yet. I'm watching it.
 
@Nan & Amber - Sterling job on the food info - will be adding it to the top-of-thread summary.

Kris & Teasel said:
I put in a link to a post Meya made on Ozzy Pawsbourne's thread. Might be helpful.
http://www.felinediabetes.com/FDMB/threads/newly-diagnosed-after-surviving-dka.169143/#post-1835133"
Click to expand...
Great minds think alike, Kris. I did the same earlier in the thread. I'm going to incorporate this link into the 'top of thread' summary for today (and following days as needed).

Thanks to everyone for the contributions! :bighug:
 
Critter Mom said:
Please can you post brief details of the amount & frequency of fluids recommended by your vet prescribed ASAP.
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She said to give 100mL once every 24-48 hours depending on how much water she is drinking on her own. I felt like she needed it today because she drank barely any at all.

Dan is awake, I stayed up to see what her BG was going to be, right now it's +1.5 -268. He's got the times written down that he is going to test at, he will post the numbers here as he gets them. I have to sleep for a little while. Thank you so much to everyone and Merry Christmas!
 
Dan&Heather said:
She said to give 100mL once every 24-48 hours depending on how much water she is drinking on her own. I felt like she needed it today because she drank barely any at all.

Dan is awake, I stayed up to see what her BG was going to be, right now it's +1.5 -268. He's got the times written down that he is going to test at, he will post the numbers here as he gets them. I have to sleep for a little while. Thank you so much to everyone and Merry Christmas!
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Ta for info, Heather - and for doing such a great job! Wishing you a restorative sleep. A Merry Christmas to you, too!

:bighug:

.
 
OK, that 268 is a good number-- she's coming down, but not dropping like a rock, so that's a nice response. Looking good so far today!

Get some rest, Heather, you've earned it!
 
Dan&Heather said:
She said to give 100mL once every 24-48 hours depending on how much water she is drinking on her own. I felt like she needed it today because she drank barely any at all.
Click to expand...


This is correct. A cat needs 300ml ****ORAL**** fluids total daily. Since the typical intake of wet food has about 200ml, then there can be about 100ml deficit. Any more than 100-150ml subQ a day could cause electrolyte imbalance or fluid overload and put stress on the heart. Please give fluids per your vet recommendation, it is correct.
 
We just tested her again about 5 minutes ago at 10:15 +2.5 -228 right now.

We fed her at 9:30. She still squirmed but not as bad it seemed, she actually did good enough that we decided to try a second syringe full. She didn't seem impressed by that and got pretty stubborn and wouldn't open her mouth at first but then got a little better. We spilled kind of alot, but I'd say we got a solid 13mL in her this last time, which is nearly twice as much as we can usually get into her. She also took a few drinks of water, a little while ago.

Ok, now I really am going to sleep for a while and letting Dan take over. He said he will keep up on posting her numbers and feedings. Good night everyone!
 
If you have some kibble in the house, try putting out a bowl of kibble and see if she'll graze on it. Although most of the time, we worry about carbs in diabetic cats, when ketones are involved, you actually can increase the cabs, as it allows higher insulin doses to be given which will help clear ketones. So if kibble is all that she'll eat on her own, or treats, etc, it's fine to leave them out.

The goal for blood sugars until she is feeling better is 150mg/dl-220ish mg/dl. This is a little higher than "normal" but it gives some wiggle room for safety in an ill cat.

Also, if you do stop by walmart again, look for Iams kitten food. This is a very high calorie food that has a consistency that is easy to syringe.
 
@Dan&Heather -

Hi Dan,

How is it going?

* Please post when when you have the +4 BG result.

* Also, please can you post details of when and how much you have fed to Mittens since AMPS (in '+' notation if possible).


Mogs
.
 
FAO Members Helping Dan & Heather:

To avoid confusion with this cycle, I'm going to wait till after the +6 BG test before kicking off a new thread.

In the meantime, here's an abridged SITREP:

----------------------------------------------------------------------------------------------------------------
INSULIN - Novolin N (U100 Insulin) - 8/8/8 DOSING - RELION METER
--------------------------------------------------------------------------------------------------------------
24 Dec 2016

AMPS - *** - (no insulin)

PMPS - 305 - Dose: 0.25IU (22:30 EST) - Assist fed 7.5ml - tested immediately after food.
+1.50 - 306 - 7.5ml food after test
+2.50 - 263 -
+4.00 - 228 - 7.5ml food before +5
+6.00 - 284
+8.00 - *** - Sub-q fluids 100ml given some time between +7 and +8 (05:30 - 06:30 EST)

(Technical hitch with fluid giving set. Next insulin dose will be slightly later than scheduled.)
--------------------------------------------------------------------------------------------------------------------
25 Dec 2016

NB: Dosed at +9.25 relative to previous insulin dose (fluids given >1.25 hrs BEFORE insulin)

AMPS - 298 - Dose: 0.25IU (07:45 EST) - 7.5ml (?) food + Potassium supplement (07:00-07:15 EST)
+1.50 - 268 -
+2.50 - 228 -
+4.00 - 236 - [Dan to feed after this test]
+6.00 -
---------------------------------------------------------------------------------------------------------------------
 
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S
Critter Mom said:
@Dan&Heather -

Hi Dan,

How is it going?

* Please post when when you have the +4 BG result.

* Also, please can you post details of when and how much you have fed to Mittens since AMPS (in '+' notation if possible).


Mogs
.
Click to expand...

We fed her one syringe of fancy feast(7.5ml) a half hour after her insulin, and again 2 1/2 hours later this time we got 2 syringes of food in her(7.5ml and 10ml). About to feed her again right now.
 
FYI - The reason for keeping track of this info is to judge safety/efficacy of insulin dose and as a guide to how many calories Mittens is getting each day.

Dan&Heather said:
We fed her one syringe of fancy feast(7.5ml) a half hour after her insulin, and again 2 1/2 hours later this time we got 2 syringes of food in her(7.5ml and 10ml). About to feed her again right now.
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Yiss!!! :woot:

You guys are da bomb! :cool:

Go Mittens! :cat:
.
 
BTW - Even though I'm not posting much here at the moment, I'm keeping an eye on the thread all the time. I'm beavering away in the background trying to gather together stuff that might be of assistance to you and the members helping out here.

I am *so impressed* with how well the two of you are doing! Intensive nursing isn't easy at the best of times. You two have had to get to grips with so much stuff in such a short space of time and you're both handling things like absolute pros!!! :cool:

If I'd had to deal with all the stuff you've been through in the past few days I'd be in a home for the bewildered by now. :confused: You two are just AWE-SOME!!! :woot:

(((Team Mittens)))

:bighug:


Mogs
.
 
Just fed her 7.5ml of Fancy feast, and was able to get another ketone test(not sure if i needed to or not), it came back small.

Gonna try another syringe of food in a few minutes since she seems to be getting easier, shes atleast trying to bite the syringe every once in a while so that makes it easier to get food in as appose to when she wouldnt budge and shes not retreating behind the couch after feeding her like she was.

She also gave out a little grunt(its not really a "grunt" she makes but idk how to describe her meow lol) earlier when i went down to pet her like she use to do before she got sick. It may be nothing but it made me feel like she was feeling maybe a little better. :)

Critter Mom said:
BTW - Even though I'm not posting much here at the moment, I'm keeping an eye on the thread all the time. I'm beavering away in the background trying to gather together stuff that might be of assistance to you and the members helping out here.

I am *so impressed* with how well the two of you are doing! Intensive nursing isn't easy at the best of times. You two have had to get to grips with so much stuff in such a short space of time and you're both handling things like absolute pros!!! :cool:

If I'd had to deal with all the stuff you've been through in the past few days I'd be in a home for the bewildered by now. :confused: You two are just AWE-SOME!!! :woot:

(((Team Mittens)))

:bighug:


Mogs
.
Click to expand...

Thank you all so much again, its alot to deal with but having access to this forum and you great people makes it alot easier! Im sure you all need some rest by now. we really do appreciate all the time and effort from everyone here, and i will continue to post her +6 and +7.5 results as soon as i get them.
 
Dan&Heather said:
Just fed her 7.5ml of Fancy feast, and was able to get another ketone test(not sure if i needed to or not), it came back small.
Click to expand...

Hmm, not liking that as much.... My understanding is that there's a bit of time lag between when ketones are circulating in the blood and when they show up in urine, so maybe this is the effect of yesterday's skipped dose? I will leave the full interpretation to the experts. The fact that she is showing signs that she might be perking up a bit :) isn't consistent with a current resurgence of the ketones, so I'm going to think positive until I hear otherwise from the experts. No matter what, you guys are doing everything right, keep doing it!!!!!
 
Nan & Amber said:
ketones are circulating in the blood and when they show up in urine,
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This is speculation and nothing more but could it be that the ketones in the urine would show higher from the SubQ fluids flushing the system a bit more. They gotta go somewhere and urine is the body's way of clearing them! I'm hoping the "small" ketones is actually good news!
 
Woodsywife said:
Yeah Mittens, keep working with mum and dad, they will get you through this.

Just a suggestion here, next time you give her some food, see if after a squirt she will eat some off a spoon, finger or plate. Hopefully she will perk up enough to at least try.
Click to expand...

Thats a good idea, i will try it after her next BG test.
 
Nan & Amber said:
My understanding is that there's a bit of time lag between when ketones are circulating in the blood and when they show up in urine [...] The fact that she is showing signs that she might be perking up a bit :) isn't consistent with a current resurgence of the ketones
Click to expand...
The urine voided for that test is for the last 6.5 hours or so; it's looking back in time. Here's tracking info:

URINE KETONE STATUS:
23 Dec - c. 12:00 EST - Positive SMALL (at vets)
25 Dec - c. 06:00 EST - SMALL to TRACE (closer to Trace) - +7.5 post-insulin
25 Dec - c. 12:30 EST - SMALL / +4.75 post-insulin / +6.5 post-subq


Since the previous ketone test Mittens has had fluids and insulin, and she has been eating more thus far in this cycle. Hopefully the subqs

The subtle improvements in Mittens' clinical signs are encouraging (anti-jinx!). One foot, one paw ...

No matter what, you guys are doing everything right, keep doing it!!!!!
Click to expand...
A-MEN!!!

:bighug:
.
 
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