4/7 Silver AMPS 202 - UPDATE

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Thanks for the report. It's good that he's eating and that they might have found the infection that contributed to this crisis. Ketoacidosis can mess with their electrolyte levels and potassium is part of that.

They always have some bacteria in or on them. The high sugar level of their urine makes it a very bacteria friendly place so they multiply there. In a non diabetic cat those same bacteria might not find the urine a good place to set up shop in large numbers - ie., an infection.
 
I’m glad the checked out his urine and found a UTI, not uncommon for diabetic cats, unfortunately, but when they culture it, they can find out what antibiotic will squash that infection and then they will give it to him. Asia has had a couple too. I don’t think you could do anything to give him one, UTIs happen, even to people, it’s not something only outdoor cats would get. I’ve heard of supplements people give to help them not get UTIs, but probably the best preventative is keeping his BGs under control (which is what we are all trying to do, easier said than done, I know).

Thanks for the update, I hope they can get his numbers down, but I’m so glad to hear he is eating, that’s a big deal. When the antibiotics kick in, the numbers should budge a bit. :bighug:
 
Stacy & Asia said:
I’m glad the checked out his urine and found a UTI, not uncommon for diabetic cats, unfortunately, but when they culture it, they can find out what antibiotic will squash that infection and then they will give it to him. Asia has had a couple too. I don’t think you could do anything to give him one, UTIs happen, even to people, it’s not something only outdoor cats would get. I’ve heard of supplements people give to help them not get UTIs, but probably the best preventative is keeping his BGs under control (which is what we are all trying to do, easier said than done, I know).

Thanks for the update, I hope they can get his numbers down, but I’m so glad to hear he is eating, that’s a big deal. When the antibiotics kick in, the numbers should budge a bit. :bighug:
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That's good. How do I handle the dose when I get him back given that they've given him short acting insulin. I don't know if they will also give him Lantus at his normal shot times. I should have asked. He's getting 24 hr care. Vet is there all night as he's at the ER. He may not need same dose if he got up there due to infection?
 
Juliet said:
Did I do something to make him get sick? How did he get the bacteria as an indoor cat?
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You did nothing wrong, we all have bacteria in or released of what type of “being” we are. Our antibodies and autoimmune system fight it, but at times it overcomes even the strongest and we/animals get sick. You’ll beat yourself up wondering why Silver got sick, as I have with Davidson especially when I tested him consistently. It is what it is and all we can do is try our best to get our pets back to health.

You’re at a great place here and many will contribute to give you good advise, and others will give your great support.
 
Juliet said:
That's good. How do I handle the dose when I get him back given that they've given him short acting insulin. I don't know if they will also give him Lantus at his normal shot times. I should have asked. He's getting 24 hr care. Vet is there all night as he's at the ER. He may not need same dose if he got up there due to infection?
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Will have to see where he is at BG wise when he comes home. It wouldn’t surprise me if he did need less insulin, but there’s no way to predict that in advance. The antibiotics can take a bit to work too, so keep that in mind. It won’t matter much if they give him L or rapid, whatever they are doing there is likely going to mess with the depot, but it’s nothing that can’t be figured out and managed when he’s home.
 
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Stacy & Asia said:
Will have to see where he is at BG wise when he comes home. It wouldn’t surprise me if he did need less insulin, but there’s no way to predict that in advance. The antibiotics can take a bit to work too, so keep that in mind. It won’t matter much if they give him L or rapid, whatever they are doing there is likely going to mess with the depot, but it’s nothing that can be figured out and managed when he’s home.
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Okay. I will post when I get him home and rest on his regular meter. It would be good if I got him home tomorrow so I have half a day with him before work. If he is staying overnight Monday I have already asked if I can go into work late and make up the time later. It's monthend busy time for bookkeeping so I won't be allowed to take the day off.
 
I just checked Silver's SS and saw that it said "in hospital" so jumped over to the board to see what's going on. I haven't been on much because one of my own kitties is in an ER vet in Toronto since Thursday on IV fluids & IV antibiotics :( I'm sorry to hear about the ketones & the UTI but I'm glad it isn't worse than a UTI. Sometimes cats can have a UTI for a while before we notice signs so that could explain why it's been hard to get Silver's numbers down. Hopefully once the infection is gone he will respond better to the insulin for you. Hugs to you & Silver!
 
LuanneP said:
I just checked Silver's SS and saw that it said "in hospital" so jumped over to the board to see what's going on. I haven't been on much because one of my own kitties is in an ER vet in Toronto since Thursday on IV fluids & IV antibiotics :( I'm sorry to hear about the ketones & the UTI but I'm glad it isn't worse than a UTI. Sometimes cats can have a UTI for a while before we notice signs so that could explain why it's been hard to get Silver's numbers down. Hopefully once the infection is gone he will respond better to the insulin for you. Hugs to you & Silver!
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Oh so sorry to hear! Hugs right back and keep me posted on your kitty!
 
I really am going to bed now - but I just sent this to my regular vet....maybe wise, maybe unwise? But they have no clue Silver lost his remission and may be upset I took on his treatment without informing or consulting them. Thoughts?

Hi,
I phoned today to update on Silver - he is at the emergency hospital since this morning and is staying overnight, possibly need more care and I may have to bring him in to see regular vet on Monday or even continue his hospital stay.

Would you please print the attached and put in his file?

The link is live and active so any time it is clicked on, you will get his updated numbers. Is there any way of getting the link (or this email) saved in his file so it can be referenced?


https://docs.google.com/spreadsheets/d/1ogEFwwcYHf7ZLndyYe9964BwQroQf-rnPZM3sUqQOAc/edit?usp=sharing


I am following the Start Low Go Slow Method laid out in the Feline Diabetic Message Board - this was approved by Silver's former vet at Animal Care Clinic where you got his records from so when he lost his remission, I went back to the method and went from there.

http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/
 
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I am so glad that they found the 3rd part of the trifecta and it is something simple to fix! The fact he is eating already is a great sign!

You did all you could do in this case, took Silver in when he was in obvious distress.

Big Hugs for you. Hope you get a great sleep. Vines for Silver for a quick recovery.
 
No
Juliet said:
Did I do something to make him get sick? How did he get the bacteria as an indoor cat?
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NO! You didn’t, my vet explained cats diabetes get it more because when their sugar gets in their urine the bladder is a breeding ground for bacteria, you didn’t do anything, bella has had 2 in the past 6 months. Believe me I asked the same thing
 
Bellasmom said:
No

NO! You didn’t, my vet explained cats diabetes get it more because when their sugar gets in their urine the bladder is a breeding ground for bacteria, you didn’t do anything, bella has had 2 in the past 6 months. Believe me I asked the same thing
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How did you catch the infection each time? I mean how did you spot it and what did you do?
 
He kept going back and forth to the cat boxs over and over and over again, even tried to pee out of cat box, he had the urge but it hurt him to pee, he was dribbling
 
First time I took the er vet my vet was closed, they wanted to do the same and test it but I could not afford the 230 extra dollars so they gave him a wide range antibiotic the 2nd time I took him to my vet and they gave him antibiotics, something to relax urethra, and pain medsand something to make him pee more
 
I want to tag on to some of the suggestions that others have made.

Another option for getting a urine sample for a ketone test:
  • Stacy mentioned using a paper cup. Others have used a ladle or a BIG spoon. It sounded like Silver likes her privacy when using the litter box so that may not work.
  • Using aquarium gravel (the small stones that are used in a fish tank) rather than litter will also work. The gravel doesn't absorb the urine so you can test directly in the box. The hassle is that you have to wash the gravel or it gets rather stinky.
The emergency vet is doing exactly what needs to be done to manage ketones. They are most likely using doses of what we refer to as "R" (Humulin R/Novolin R) which is a short acting insulin to keep Silver's BG from going too high. From what you said, I don't know if they are also using a longer acting insulin, too.

You mentioned that Silver's potassium levels were off. They are likely giving her a potassium supplement. I'm guessing they have her on IV fluids. The fluids will help to flush the ketones and it's a good way to give medications.

It's also likely that they will start to get Silver back on her own insulin or at least a longer acting insulin before you bring her home.



 
Sienne and Gabby (GA) said:
I want to tag on to some of the suggestions that others have made.

Another option for getting a urine sample for a ketone test:
  • Stacy mentioned using a paper cup. Others have used a ladle or a BIG spoon. It sounded like Silver likes her privacy when using the litter box so that may not work.
  • Using aquarium gravel (the small stones that are used in a fish tank) rather than litter will also work. The gravel doesn't absorb the urine so you can test directly in the box. The hassle is that you have to wash the gravel or it gets rather stinky.
The emergency vet is doing exactly what needs to be done to manage ketones. They are most likely using doses of what we refer to as "R" (Humulin R/Novolin R) which is a short acting insulin to keep Silver's BG from going too high. From what you said, I don't know if they are also using a longer acting insulin, too.

You mentioned that Silver's potassium levels were off. They are likely giving her a potassium supplement. I'm guessing they have her on IV fluids. The fluids will help to flush the ketones and it's a good way to give medications.

It's also likely that they will start to get Silver back on her own insulin or at least a longer acting insulin before you bring her home.
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Yes that's exactly right. They said they were giving him humulin and the potassium stuff in his bag of fluids. Re the pee - an going to try the Saran wrap idea. I struggle with dealing with the cat litter due to bad back so will find it hard to clean out the mess of stones. Trying to find easiest way.
 
and before Juliet gets any further urge to post.


Silver is a bloke. A lad. A boy. :p


Juliet- Shuts your eyes. Turn off your devices.
You don't want me recording and sending over a lullaby. :eek:

Oh. And worry not on the ketone testing wee thing. You have a meter that will do a ketone blood test . I will sort something and you shall have those strips to do that.
I cannot have you rolling around on your own wooden flooring , stalking Silver's bum for an imminent wee stream. You have enough on your plate as it is.

M
x
 
More vines and hugs for Silver and you. :bighug::bighug::bighug: this should be you though knowing your baby is eating better and has a treatable infection. :bighug:
depositphotos_127158816-stock-photo-gray-kitten-sleeping-sweetly-on.jpg
 
PussCatPrince said:
and before Juliet gets any further urge to post.


Silver is a bloke. A lad. A boy. :p


Juliet- Shuts your eyes. Turn off your devices.
You don't want me recording and sending over a lullaby. :eek:

Oh. And worry not on the ketone testing wee thing. You have a meter that will do a ketone blood test . I will sort something and you shall have those strips to do that.
I cannot have you rolling around on your own wooden flooring , stalking Silver's bum for an imminent wee stream. You have enough on your plate as it is.

M
x
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Lol you make me laugh. You are so kind.
 
@Juliet catching up here. Glad to see Silver doing better and hope he is home soon. Another tip for collecting urine. Use lentil beans. Buy a bag, rinse some off and scatter in a small clean box. They don't absorb so you will get some. I put plastic wrap on bottom of pan than some beans. My Olive is such a digger. She must have something in the pan to use it. You can rinse after and reuse them.

Also if possible a blood ketone meter would be the best. Ketones show up quicker in the blood than in urine. Check the supply closet to see if anyone is offering one. You can also post that you are looking for one. Strips are expensive though.
 
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