? 6/27/17,Sprocket, DKA experience ?s

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Darnell & Sprocket (GA)

Member Since 2015
Hi Everyone,
Got some questions since Sprocket is a repeat dka survivor & repeat ketone kitty.
He has been doing good as you can see on his SS. But I know I want to get him sitting in more lower 100s & little under but I cant seem to find a dose that is doing that without earning that reduction.
He did earn a reduction 2 times that I didnt take because I felt it wasnt a normal cycle & a 3rd time I fed the lower bg cause I couldnt monitor conpletely so I decided to try the reduction to see what happened. I did 2.5u for 9 cycles straight before I tried the 2.68u dose. I then did two 2.5 doses before trying the 2.68 dose straight. Now he has had 11 doses of 2.68u and he goes to mid 100s some.
??So question is is he safe at 2.5 or 2.68 dose either when I have alot going on & cant monitor?
?? Or if he stayed at that dose?
?? Or does he need to be more into lower 100s & into greens some more to stay safe?

When I say safe, I dont only mean going low for hypo but for ketones to stay away and his body to heal some. Bloodtests show his liver is already healing well.

?? Or do I need to go back to 2.75 and feed the lower bgs. If I do this will his body get more used to it and will he just start staying more flat in 100s & lower 200s?
Is that what usually happens?

Also take a look at his food intake too. When he eats a little less than the usual 2oz at each of the 6 meals in 24 hours then he tends to drop more.
I have also had to alter famotidine alot since he is vomiting furballs more often. He tends to not want to eat so I gave the famotidine again & he ate better. So I am trying to stop famotidine when he doesnt need it.
Which med has some appetite stim in it? Famotidine or ondansetron? I might try to stop cypro too. Just do as needed basis.

?? Is he considered unregulated for a diabetic kitty? Or only because he is ketone prone?

Ok your thoughts please.
Thanks alot.
 
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I have also had to alter famotidine alot since he is vomiting furballs more often. He tends to not want to eat so I gave the famotidine again & he ate better. So I am trying to stop famotidine when he doesnt need it.
Which med has some appetite stim in it? Famotidine or ondansetron? I might try to stop cypro too. Just do as needed basis.

?? Is he considered unregulated for a diabetic kitty? Or only because he is ketone prone?
Famotidine is for acid tummy, not hairballs. If kitty has an acid tummy he may not feel like eating so it may help that way. Normally cats should not be vomiting hairballs more than once a month. Ondansetron is for nausea. Kitties that are nauseas will eat better if they have an anti nausea medication. You ALWAYS want to treat for nausea before giving an appetite stimulant. Mirtazapine and cyproheptadine are two common appetite stimulants used for kitties.

I agree with Mandy that he needs an increase. With SLGS, you increase by 0.25 units if nadirs are above 150, which they are. I would increase to at least 2.75 units, possibly the full 0.25 units above the existing dose once you've given it the full 7 days.

Is Sprocket getting close to 12 oz of food a day? That's a lot! How much does he weight? My Neko maintained her 14-15 lb weight on 5.5 oz of canned food or 4 oz or raw food a day. If you want to control blood sugar drops with food, I would move to higher carb food in place of his regular food. By higher carb, maybe something closer to 8-10% carbs.
 
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Famotidine is for acid tummy, not hairballs. If kitty has an acid tummy he may not feel like eating so it may help that way. Normally cats should not be vomiting hairballs more than once a month. Ondansetron is for nausea. Kitties that are nauseas will eat better if they have an anti nausea medication. You ALWAYS want to treat for nausea before giving an appetite stimulant. Mirtazapine and cyproheptadine are two common appetite stimulants used for kitties.

I agree with Mandy that he needs an increase. With SLGS, you increase by 0.25 units if nadirs are above 150, which they are. I would increase to at least 2.75 units, possibly the full 0.25 units above the existing dose once you've given it the full 7 days.

Is Sprocket getting close to 12 oz of food a day? That's a lot! How much does he weight? My Neko maintained her 14-15 lb weight on 5.5 oz of canned food or 4 oz or raw food a day. If you want to control blood sugar drops with food, I would move to higher carb food in place of his regular food. By higher carb, maybe something closer to 8-10% carbs.


He seems to get upset tummy after vomiting a hairball. Its hard to know if he still needs the anti-nausea cause he appears good but I have to put alot of fortiflora on his food latelt to get him to eat more. He is on the cypro appetite stim. The other never helped him at all. He has been on it a few months now. Maybe I should try to reduce that?

Yes. If I increased it would be to 2.75u. I have already tried the fat 2.75u dose and he dropped hard and right away.

He was on 2.75u for about a month straight before I tried the lower doses.

Yes. He is getting 12oz a day. He uses to get 15-16oz a day. He is about 15 lbs now. I just located a baby scale so hope i get that soon. He is part Maine Coon too so he is a large cat.

I cant imagine Sprocket eating under 9oz of food. My Cordelia is small(only 8 lbs) & she eats less but he usually likes his food.

I did have to feed a 7-9 carb to keep him up on bg a couple if times when he was on the 2.75u.

What about some of my other questions?
About his dosage. Fat 2.75 is too much but 2.5 is too little & 2.68 gets some blues but not low enough. So if I feed the 2.75 dose when needed will he flatten out eventually? Or just keep doing the drops yet I cant reduce cause it wont get him low enough. So what do i do?
 
Neko was also part MC, and with acromegaly she had excess growth hormone in her system. Using your scale is a good way to figure out what is a good amount of food. Did your vet give you an ideal weight for him?

I am not sure what other questions remain unanswered. I would increase, to 2.75 if you are cautious, and use higher carb food on those times he looks like he is going lower. Over time, and spending more time in normal numbers, they bounce less. There is no timetable for this, it is ECID.
 
IMHO a kitty with multiple DKA episodes must be super vigilant for a year.

Did Sprocket lose weight as a result of the DKA episodes?

Calories and insulin must be increased for recovery from DKA. Once weight is back to normal and any infection/inflammation resolved, if
BG is responding well to insulin, calories can be gradually reduced.

After his 2nd episode of DKA, my BK was down to 7lbs (and some change). During recovery he went through 15-16 oz per day - we would by dog food size cans of wellness. Eventually 2-3 cams of FF daily maintained his ideal weight of a little over 11lbs. FF
Kept in mind that treating FD is a dance and Sprocket is leading.
 
IMHO a kitty with multiple DKA episodes must be super vigilant for a year.

Did Sprocket lose weight as a result of the DKA episodes?

Calories and insulin must be increased for recovery from DKA. Once weight is back to normal and any infection/inflammation resolved, if
BG is responding well to insulin, calories can be gradually reduced.

After his 2nd episode of DKA, my BK was down to 7lbs (and some change). During recovery he went through 15-16 oz per day - we would by dog food size cans of wellness. Eventually 2-3 cams of FF daily maintained his ideal weight of a little over 11lbs. FF
Kept in mind that treating FD is a dance and Sprocket is leading.


Originally Sprocket did lose alot of weight before we knew he was diabetic. 2 yrs ago he was 18lbs. Then went to 12 when diagnosed. Back up to 16.5 then slowly down over 1& half yrs. He was 15.25 in march this year when he got sick again. He went down to 14.3. In early June went back to 15.6. Exactly what you said I did. Reduced his food slowly along with insulin as he earned reductions fast. He is at 12oz of food in 24 hrs. I will get scale soon.
Yes. I do think Sprocket is leading now. Which is why i want to keep him safe. I will go up to 2.75 soon. Got petsitting so cant monitor well at night a few more days.
Thanks.
Was that all my questions. I forgot. Gotta look at what i wrote originally...lol.
 
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Ok. Still need more opinions. Not all my questions answered.
Please please. I know he needs to go to 2.75 but the balance.
?? Also,How long does it usually take for them to balance out when in 100s more.??
Its hard to do the dance of...'can I leave the house or do I have to monitor him' for so long. Its summer. I do want to try day trips at least.
So need more opinions please.
@Chris & China , @Gill & George @Jill & Alex (GA) , @Sienne and Gabby (GA) @Meya14 @Nette Susan and anyone else who has followed Sprocket or knows dka.
Thanks
 
Nicer AMPS today. Maybe, he'll show you some blues and greens today. Fingers crossed.
 
Your numbers are very flat, that's great. I think that you still probably need more insulin to bring that whole system down a little bit. The honest answer to your question is that every cat is different and you really won't know his stability in those number until you try it. That said, most cats once they get flat numbers in the greens are very stable and do stay in safe numbers. They are actually more stable then cats who swing from high to low.
 
Hi Darnell,
I agree with the others it does look like he needs more insulin to bring his overall range down. My experience with George was that he became very flat, not varying by more than 15pts in a cycle when I got him into the green range, and it actually got easier for me to take time to do things for myself.

As Wendy has already mentioned when there were times I thought he was angling for a reduction I would use higher carb food to keep him safe while I went out.

All that said ECID, and there are no guarantees how he will respond, as you take him up you may need to keep an eye out to see if his patterns change before you feel comfortable leaving him to his own devices.
 
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