4/9 Silver AMPS 279 +4=311 +9=239 PMPS 268

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Juliet

Member Since 2017
http://www.felinediabetes.com/FDMB/threads/4-8-silver-update-new-pmps-207.193836/

Silver had a good night as far as I can tell. He woke me up nice and early wanting breakfast so that's back to normal. He seems a bit weak though. He had a hard time jumping onto my bed the first time but jumped pretty easily after that. He is eating and finishing off a full can of FF as we speak.

His preshot BG isn't that great, considering I also checked on the Accu-check - reason for this is that I discovered the Accu-check reads same as vet so I want an idea as to "vet" numbers for a while - that read a horrible red 419. I think they are using Alpha Trak.

Is this due to the half shot last night? I don't know how much Humulin they were giving him in the hospital but that is an in-out insulin right? So his depot is messed with?

I have to give the fluids for the first time today so I may jump back on here for advice on how to start. Am a bit nervous.

Heading back to bed as I didn't sleep well last night. Will do a few more spot checks today seeing as I am home. As I am home, how often should I feed? Oh and I completely forgot to put water in his FF - rats.
 
I'm glad Silver is home and wanting to eat. I'm glad your boss let you take the day off. He has been through a lot so his BG may be wacky for a little while. All things considered, the 279 is not bad. I'm not sure if you need to feed him more times than you normally do. I'm sure more people will jump in with some advice. Sending prayers.
 
Juliet said:
Is this due to the half shot last night? I don't know how much Humulin they were giving him in the hospital but that is an in-out insulin right? So his depot is messed with?
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Probably some....but also, if they only used Humulin while he was there, you have to re-establish the depot so he may be wacky for several days until his depot is full again

279 isn't awful.....hopefully getting him back to his normal dose and normal routine at home will help soon.

The weakness isn't a big surprise....he's been through a serious illness and his potassium was pretty low (which effects muscle tone) so it's going to take a little time to get his strength back and get everything back to "normal"

Glad to hear he's acting pretty normal this morning!! That's good news!!
 
I've heard it can take a couple weeks for a cat to recover from DKA-- it takes a lot out of them.

(by the way, apologies for the post I just added to yesterday's condo-- didn't see this one at first)
 
That's great news that he woke you up like usual and wanted food!

I know this is going to sound wacky, but you can't be focusing on his numbers right now, in the sense that they are too high. The higher they are means the more insulin you can get in him and this is to your advantage at the moment. The more food and insulin you can get in him means more calories metabolize and provide energy to his cells. When this happens with food and insulin, his body should stop resorting to breaking down his own fat and muscle for energy (which is where the ketones come from).

Yes, feed him today, feed him as often as he wants. Get in those calories and the insulin dose can be adjusted accordingly.

I don't know if your vet uses an AT or not, but when they did bloodwork, they should have checked his BG through their in house lab, I would try to find out what this number is as well, that is the accurate number we all hope our meters align with. Since you have a good hunch the accucheck is reading closer to the numbers the vets got, do you have enough strips for that meter that you could switch to it for a time? At least until this DKA episode is a bit behind you and until you can find a good (for now) working dose of insulin?

I hope Silver is a patient patient :cat: and allows you to administer fluids without too much bother. I believe others linked you to Marje's video, it's very thorough and detailed. Don't worry or focus on the things you may not have like an infrared thermometer. If your home is reasonably warm, you can give him fluids at room temperature or you can submerge them in some warm (not hot) water in advance and just open the line briefly to shoot some of the fluid on the inside of your wrist so you can make sure it's not too hot. The thing I remember most vividly from the first time I administered fluids is that I had to push the needle harder than I thought to break through the skin, that was the worst part for me was getting a feel for how much pressure is needed. It's pretty smooth sailing after that.

p.s. I know how inflexible and stressful month end is for people that work in finance. My mom was largely unavailable for a couple weeks out of every month because of it. This situation is very ill timed, but I'm so glad your employers allowed you to take the day off, it is a really big deal for that line of work. :bighug:
 
Stacy & Asia said:
That's great news that he woke you up like usual and wanted food!

I know this is going to sound wacky, but you can't be focusing on his numbers right now, in the sense that they are too high. The higher they are means the more insulin you can get in him and this is to your advantage at the moment. The more food and insulin you can get in him means more calories metabolize and provide energy to his cells. When this happens with food and insulin, his body should stop resorting to breaking down his own fat and muscle for energy (which is where the ketones come from).

Yes, feed him today, feed him as often as he wants. Get in those calories and the insulin dose can be adjusted accordingly.

I don't know if your vet uses an AT or not, but when they did bloodwork, they should have checked his BG through their in house lab, I would try to find out what this number is as well, that is the accurate number we all hope our meters align with. Since you have a good hunch the accucheck is reading closer to the numbers the vets got, do you have enough strips for that meter that you could switch to it for a time? At least until this DKA episode is a bit behind you and until you can find a good (for now) working dose of insulin?

I hope Silver is a patient patient :cat: and allows you to administer fluids without too much bother. I believe others linked you to Marje's video, it's very thorough and detailed. Don't worry or focus on the things you may not have like an infrared thermometer. If your home is reasonably warm, you can give him fluids at room temperature or you can submerge them in some warm (not hot) water in advance and just open the line briefly to shoot some of the fluid on the inside of your wrist so you can make sure it's not too hot. The thing I remember most vividly from the first time I administered fluids is that I had to push the needle harder than I thought to break through the skin, that was the worst part for me was getting a feel for how much pressure is needed. It's pretty smooth sailing after that.

p.s. I know how inflexible and stressful month end is for people that work in finance. My mom was largely unavailable for a couple weeks out of every month because of it. This situation is very ill timed, but I'm so glad your employers allowed you to take the day off, it is a really big deal for that line of work. :bighug:
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I'm confused re what you mean re adjusting the insulin dose. I'm a little scared to do that as I'm not following TR and am used to changing up dose only once finding out what nadir is and I can only find out nadir on weekends. He's eating normally now and I've increased his food amount to a full can. How much more should I be giving him?

His lab number was 414. Pretty similar to what accucheck today. Accucheck measures same as lab. I have enough strips to test on both for the short term. I have freestyle strips enough to las til October thanks to a good find on eBay so reluctant to waste those it accucheck more accurate to vet as I have always said here.
 
Nan & Amber said:
Hope you got a good night's sleep, and that Sasha and Silver have reconciled!



Huh. That's interesting-- no antibiotics, but he recovered really really well nevertheless. Hmm. I see why the vet is now unsure about the UTI diagnosis.

We know that something was the trigger for the ketones, and also something got him feeling better and eating pretty quickly at the vet. I'm back to wondering about the possibility of pancreatitis? I see on the list of treatments that Silver was getting some pain meds at the vet-- pain is often pretty severe with pancreatitis, and the thing that makes them not want to eat.

If the culture indeed comes back negative, I'd ask the vet about this possibility, and about the possibility of continuing some pain meds for Silver (especially if you notice any decrease in his currently-wonderful appetite after he's been home for a while and the meds he got at the vet have started to wear off).

The other possibility is that it is a UTI, and just the fluids (and the pain meds-- UTIs are painful too!) got him feeling better enough to start eating and get the ball rolling. It'd be a good thing if it's that-- pancreatitis can be managed, but UTIs can be cured with just some antibiotics, it'd be nice to have something you could just wipe out.
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Actually he didn't get any pain meds. I chopped off the edge of the invoice with the costs and there was no dollar amount and a zero beside use of the narcotics. It was on the quote but never used. Same with oral meds. He didn't need them apparently.
 
carfurby said:
I'm glad Silver is home and wanting to eat. I'm glad your boss let you take the day off. He has been through a lot so his BG may be wacky for a little while. All things considered, the 279 is not bad. I'm not sure if you need to feed him more times than you normally do. I'm sure more people will jump in with some advice. Sending prayers.
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Per lab that 279 is over 400 tho. This weekend showed that the lab is almost the same as my Accucheck. I'm not surprised tho as the depot is likely drained After no Lantus since Friday night. Correct?
 
My cat had a bout of DKA two months after his diagnosis. The cause was most likely running in high numbers all that time because I was following the vet's instruction of dose for a week, do curve, adjust Lantus dose. At that time I had no idea how tricky he is in his responses to insulin and he'd likely bounced high and then got stuck up there from the effects of glucose toxicity (20/20 hindsight). The vet wanted to try "rebooting" him by stopping insulin for 48 hours. He was in DKA 24 hours after stopping. The ketones built up very quickly.

He spent three days in the vet clinic's ER ICU getting similar treatment to Silver's: electrolytes, fast acting insulin, etc. No other meds that I can recall. He began eating well when he was there and they'd put him on the higher carb (10%) chunky version of DM prescription wet food. The vet recommended a switch to ProZinc insulin to see if he'd respond better to that. He was started at the usual starting dose of 1 u BID.

When I brought him home he was weak and lacklustre but eating well. I put him back on the DM pate (6% carbs) he'd been eating before the DKA. He had no meds/subQ prescribed. It took a few weeks for him to get his strength back. I gave 1 u of ProZinc as per prescription and picked up where we left off before the crisis - dose a week, curve, tweak dose. It was months before I finally decided this wasn't working and came to FDMB. Slow learner and loyal to a vet I liked a lot - common story here.

I realize now that I was very lucky in the DKA aftermath. I wasn't encouraged to check for urine ketones and I was completely clueless about how much worse it could have been. I didn't know enough to be worried about insulin dose, carb level of food needed after DKA and so on.

Not sure if this is of any help. Just thought I'd describe my experience. You have a lot more information going forward after Silver's bout than I did. :)
 
Kris & Teasel said:
My cat had a bout of DKA two months after his diagnosis. The cause was most likely running in high numbers all that time because I was following the vet's instruction of dose for a week, do curve, adjust Lantus dose. At that time I had no idea how tricky he is in his responses to insulin and he'd likely bounced high and then got stuck up there from the effects of glucose toxicity (20/20 hindsight). The vet wanted to try "rebooting" him by stopping insulin for 48 hours. He was in DKA 24 hours after stopping. The ketones built up very quickly.

He spent three days in the vet clinic's ER ICU getting similar treatment to Silver's: electrolytes, fast acting insulin, etc. No other meds that I can recall. He began eating well when he was there and they'd put him on the higher carb (10%) chunky version of DM prescription wet food. The vet recommended a switch to ProZinc insulin to see if he'd respond better to that. He was started at the usual starting dose of 1 u BID.

When I brought him home he was weak and lacklustre but eating well. I put him back on the DM pate (6% carbs) he'd been eating before the DKA. He had no meds/subQ prescribed. It took a few weeks for him to get his strength back. I gave 1 u of ProZinc as per prescription and picked up where we left off before the crisis - dose a week, curve, tweak dose. It was months before I finally decided this wasn't working and came to FDMB. Slow learner and loyal to a vet I liked a lot - common story here.

I realize now that I was very lucky in the DKA aftermath. I wasn't encouraged to check for urine ketones and I was completely clueless about how much worse it could have been. I didn't know enough to be worried about insulin dose, carb level of food needed after DKA and so on.

Not sure if this is of any help. Just thought I'd describe my experience. You have a lot more information going forward after Silver's bout than I did. :)
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Very helpful thank you! Did you increase his food when you got him home?

Following SLGS I am doing the same tho. Dose for a week. Do a curve. Tweak dose. For many reasons I can't do TR.

I wish I knew the cause of the ketones. Was it full blown ketoacidosis? I don't even know if the ketones have cleared. I should get my meter tomorrow I hope. The place I ordered from are very fast.
 
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Juliet said:
I'm confused re what you mean re adjusting the insulin dose. I'm a little scared to do that as I'm not following TR and am used to changing up dose only once finding out what nadir is and I can only find out nadir on weekends. He's eating normally now and I've increased his food amount to a full can. How much more should I be giving him?
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As the vet tech accurately said to you, with DKA in the picture, the rules get pushed to the side. You're going to have to increase the insulin to try to match the extra calories he is taking in, how much and how often is something we will have to think of and hatch a plan for, I would defer to the people with the most experience on these things. I'm sure it will be more accelerated than SLGS guidelines for the time being and that is how is has to be because that is what Silver needs at this moment. You will have to do your utmost to find out how low he is going so you can keep him safe with the increases, which because you need to be out all day, probably leaves you with the pm data to gather and leaving food out in the day.

I know it's scary, but you can do this and the fear will lessen when you have some safety measures in place (pm data and daytime food availability).

The general rule with feeding and DKA/recovery is 1.5 to 2x's the usual amount.
 
Juliet said:
Very helpful thank you!

Following SLGS I am doing the same tho. Dose for a week. Do a curve. Tweak dose. For many reasons I can't do TR.

I wish I knew the cause of the ketones. Was it full blown ketoacidosis? I don't even know if the ketones have cleared. I should get my meter tomorrow I hope. The place I ordered from are very fast.
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You're following SLGS with the guidance of these knowledgeable people and data on a spreadsheet. My problem was that I wasn't doing any testing :eek:! except for those weekly vet curves. Very different scenario. Your circumstances make SLGS the best method for you once the crisis recovery is behind you. :)
 
Stacy & Asia said:
As the vet tech accurately said to you, with DKA in the picture, the rules get pushed to the side. You're going to have to increase the insulin to try to match the extra calories he is taking in, how much and how often is something we will have to think of and hatch a plan for, I would defer to the people with the most experience on these things. I'm sure it will be more accelerated than SLGS guidelines for the time being and that is how is has to be because that is what Silver needs at this moment. You will have to do your utmost to find out how low he is going so you can keep him safe with the increases, which because you need to be out all day, probably leaves you with the pm data to gather and leaving food out in the day.

I know it's scary, but you can do this and the fear will lessen when you have some safety measures in place (pm data and daytime food availability).

The general rule with feeding and DKA/recovery is 1.5 to 2x's the usual amount.
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Ok. I just gave him half a can FF with warm water. Lapped it up. Also did the fluids. Poor boy got a little wet as I forgot to tighten the screw nob that secures the needle to the line. But he got the accurate amount so all good.

Re the insulin. I am scared re not following SLGS. I cannot get nadir. I know you guys all say set alarms and test through the night but you all know I can't. Even in these circumstances. @Jill & Alex (GA) I know you want me to play safe with Silver. Your thoughts?

I tested just now. Three hours after shot and his food spike wasn't as high and horrible as usual. He was 311.4. Given the depot is pretty depleted I guess that's not too bad?? I did just feed him again though but as you and vet says I'm not to worry about the numbers right now but need to get him eating.

He is happy and purring but I'm scared still.
 
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Juliet said:
Ok. I just gave him half a can FF with warm water. Lapped it up. Also did the fluids. Poor boy got a little wet as I forgot to tighten the screw bob that secures the needle to the line. But he got the accurate amount so all good.

Re the insulin. I am scared re not following SLGS. I cannot get nadir. I know you guys all say set alarms and test through the night but you all know I can't. Even in these circumstances. @Jill & Alex (GA) I know you want me to play safe with Silver. Your thoughts?

I tested just now. Three hours after shot and his food spike wasn't as high and horrible as usual. He was 311.4. Given the depot is pretty depleted I guess that's not too bad?? I did just feed him again though but as you and vet says I'm not to worry about the numbers right now but need to get him eating.

He is happy and purring but I'm scared still.
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Having the urine ketone meter will give you a lot of peace of mind. When does it arrive? Lots of warm water in the wet food helps with hydration and flushing out ketones - along with the subQ fluids.

As Stacy said above you'll need to bump up his dose faster than SLGS allows, get whatever carby food he'll eat into his diet and be prepared to test at least once at night - at 1 or 2 AM? It'll be hard on you but it's not a permanent thing. I'll defer to the others for dose advice.
 
Juliet said:
Per lab that 279 is over 400 tho. This weekend showed that the lab is almost the same as my Accucheck. I'm not surprised tho as the depot is likely drained After no Lantus since Friday night. Correct?
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His depot will be off because of all the changes in insulin. He'll get back on track soon.
 
Kris & Teasel said:
Having the urine ketone meter will give you a lot of peace of mind. When does it arrive? Lots of warm water in the wet food helps with hydration and flushing out ketones - along with the subQ fluids.

As Stacy said above you'll need to bump up his dose faster than SLGS allows, get whatever carby food he'll eat into his diet and be prepared to test at least once at night - at 1 or 2 AM? It'll be hard on you but it's not a permanent thing. I'll defer to the others for dose advice.
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I just called. It should arrive tomorrow.

The bumping up the dose faster than SLGS allows, is only possible if you know where the dose is taking him - eg nadir - I would think this is the case in every situation when increasing dose? I am home today but after that, I am not able to catch nadir until the weekend and that, to me, is dangerous. To increase dose without knowing how low it is taking him. I know his depot needs to be replenished, they gave him no Lantus in the hospital so its probably empty. I gave him 2u last night and back up to regular dose of 4.25 this morning. The regular dose may even be too high now. His numbers are horrible today due to me feeding him extra and the depleted depot (I am presuming that is why).

I was told high CALORIE not high carb. I have the Recovery food that the vet gave me.

I cannot physically get up in the middle of the night to test, no matter how much I love Silver. It is not possible for many reasons already stated. My health does not allow it. If I did get up in the middle of the night to test, it would be ME landing up in the hospital then there would be no-one at all to care for Silver. I do the best I possibly can.
 
carfurby said:
His depot will be off because of all the changes in insulin. He'll get back on track soon.
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Only four days til the weekend and a curve day - hopefully he will have settled by then. The keytone meter arrives tomorrow. I will check daily until I know he is safe. I am getting tests in every three hours today and feeding him when I test. I did the fluids although I hope I get better at that. I drowned him a little.
 
LuanneP said:
You're doing great @Juliet :) I'm glad Silver is home & eating & acting more like himself. Hang in there! Hugs :bighug:
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Thanks. He seems a little off since I gave him the fluids. He's lying down beside me but if I stroke him he swishes his tail. Don't think he's very happy.
 
You can only do what you can do. The water in the wet food and the blood ketone tests will be very helpful. I know you have your own issues to accommodate. Re calories versus carbs in food: the calories will help get his weight up and give his body enough food per meal to prevent it going to its fat and muscle tissue for nutrients. It's like people restricting their calorie intake to lose weight and forcing their body to consume fat. If they restrict calories too much they will start breaking down muscle too. The carb level can be used to raise BG in a way that would allow a higher insulin dose safely. A comparison is the way we can sometimes feel after we eat something high carb - you can almost sense your BG going up. That can trigger a release of insulin which is why our high carb snacks can cause us to droop from low BG after the insulin (over)does its work.
 
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Juliet said:
Thanks. He seems a little off since I gave him the fluids. He's lying down beside me but if I stroke him he swishes his tail. Don't think he's very happy.
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It can feel weird afterward for sure. I probably missed it but how much fluids did they say to give him in a session? The rule is 10 ml / lb of body weight (max) but I find a lot of vets say to give too much. I just gave Beau his fluids as well & he's 11.5 lbs so I'm giving 100 ml per day divided into two 50 ml doses am & pm because he has a grade 3/4 heart murmur so it's safer for him that way.
 
LuanneP said:
It can feel weird afterward for sure. I probably missed it but how much fluids did they say to give him in a session? The rule is 10 ml / lb of body weight (max) but I find a lot of vets say to give too much. I just gave Beau his fluids as well & he's 11.5 lbs so I'm giving 100 ml per day divided into two 50 ml doses am & pm because he has a grade 3/4 heart murmur so it's safer for him that way.
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I think I gave a little less than they said. He initially said 200ml then 150ml. But he also said I'd feel a lump forming and to give him a kiwi size lump of fluids. I found that easier than seeing the bag numbers. So he got a small kiwi lump.
 
He usually nadir's later in the cycle....let us hope that routine stays the same now.

Just popping in to check in on Silver. Sounds like he is doing ok and recovering nicely. Lots of help here. How are you holding up?
 
Juliet said:
I think I gave a little less than they said. He initially said 200ml then 150ml. But he also said I'd feel a lump forming and to give him a kiwi size lump of fluids. I found that easier than seeing the bag numbers. So he got a small kiwi lump.
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I'm glad you gave less than they said :) 150 is even too much unless he weighs 15 lbs.
 
Here's a thought all though probably not realistic. Can you do any work from home, like 1 day a week or even a few hours once a week? Or can you bring Silver to work 1 day a week, a day that maybe isn't so busy?
 
Juliet said:
Actually he didn't get any pain meds. I chopped off the edge of the invoice with the costs and there was no dollar amount and a zero beside use of the narcotics. It was on the quote but never used. Same with oral meds. He didn't need them apparently.
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Oh, OK. Well, let's just wait and see the results of the culture, then!

This makes me feel even more positive about the situation, even if it is a tad more mysterious now. I think it's an excellent sign that he turned things around so quickly with (relatively) few interventions. As stressful as all this is, try to focus on that, and keep in mind a lot of the advice you're currently getting is worst-case-scenario type advice. Those of us who have been here any amount of time have seen several cats who have gone through very severe DKA episodes, and are very "delicate" for a while afterward. So we're trying to let you know what might be involved in Silver's aftercare. But Silver has done so well so far, I'm very hopeful that he's going to recover without you having to do things on the more aggressive end of the suggestions.

Juliet said:
I cannot physically get up in the middle of the night to test, no matter how much I love Silver. It is not possible for many reasons already stated. My health does not allow it. If I did get up in the middle of the night to test, it would be ME landing up in the hospital then there would be no-one at all to care for Silver. I do the best I possibly can.
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I totally, absolutely, get this. We probably don't have the same issues, but it's the same outcome for me, just not possible to test all night. If you look at Amber's spreadsheet, you'll see that middle-of-the-night tests are vanishingly rare-- and there have been plenty of times when it would definitely have been a good idea. You just have to do what you can. It will be enough.
 
One last thing about carbs post DKA: Carbs are readily turned into glucose through digestion and insulin "goes after" carbs. That's why you want a good supply of glucose from carby food in the bloodstream - something for the higher insulin dose to work on.

High calorie food might be high in fat and protein but low in carbs. There are complex ways the body can get glucose from those but they don't dump a ready source into the bloodstream for injected insulin to act on.

I'm done now ... ;)
 
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Tracey&Jones said:
He usually nadir's later in the cycle....let us hope that routine stays the same now.

Just popping in to check in on Silver. Sounds like he is doing ok and recovering nicely. Lots of help here. How are you holding up?
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Silver is lying under the table. I don't think that's a good sign? I'm still concerned about him. I just gave him 1/4 can of the high calories Recovery food so he's had a can and a half of FF and that so far today.

He's not happy. What should I do?
 
Love-Paula aka Woodsywife said:
Here's a thought all though probably not realistic. Can you do any work from home, like 1 day a week or even a few hours once a week? Or can you bring Silver to work 1 day a week, a day that maybe isn't so busy?
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Unfortunately no to both. I take the train two hours to work and working from home not an option at my level of employment. The stress of the car and train ride would not be good for him.
 
Nan & Amber said:
I totally, absolutely, get this. We probably don't have the same issues, but it's the same outcome for me, just not possible to test all night. If you look at Amber's spreadsheet, you'll see that middle-of-the-night tests are vanishingly rare-- and there have been plenty of times when it would definitely have been a good idea. You just have to do what you can. It will be enough.
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I completely agree. I have my own problems that make getting up to test in a sleepy, dazed state a risky situation - inviting a fall, etc. I do it as much as I can manage and have to be very, very careful when I do. Teasel has late onset with Lev so a before bed test is of very little use. He nadirs around +7 so my night time test requires an alarm to be set for 3 AM. That's when I might get useful info if he isn't bouncing and it's often hard for me to get back to my much needed sleep.

I'm saying this to support you doing what you need to do for your own health. I, like you, simply can't do the amount of testing that others do. We all have to stick with what works for us. :)
 
Kris & Teasel said:
One last thing about carbs post DKA: Carbs are readily turned into glucose through digestion and insulin "goes after" carbs. That's why you want a good supply of glucose from carby food in the bloodstream - something for the higher insulin dose to work on.

High calorie food might high in fat and protein but low in carbs. There are complex ways the body can get glucose from those but they don't dump a ready source into the bloodstream for injected insulin to act on.

I'm done now ... ;)
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You've been very helpful. Thank you
 
So happy silvers home, I’m sure you and his sibling are too, when I take one of my cats to vet most of the one that stay at home hiss at the one who went, they know that vet smell lol.
Have a wonderful day
 
Juliet said:
ilver is lying under the table. I don't think that's a good sign? I'm still concerned about him. I just gave him 1/4 can of the high calories Recovery food so he's had a can and a half of FF and that so far today.

He's not happy. What should I do?
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Lying...like loafing or just relaxed like?

ETA - what food were they feeding at the ER? Just wonder if it is tummy upset from new food.

ETA2 - I went back but couldn't find it...did they send you home with any Cerenia or pain meds like they gave in the ER?
 
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Juliet said:
Silver is lying under the table. I don't think that's a good sign? I'm still concerned about him. I just gave him 1/4 can of the high calories Recovery food so he's had a can and a half of FF and that so far today.

He's not happy. What should I do?
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Good morning, Juliet,
If he eats well than I say just over him. He has been thru so much lately - it's ok that he is Off. I do hope that he will show signs of improvement soon but give it a little time for him to recover from the hospital and car ride stress.
 
Tracey&Jones said:
Lying...like loafing or just relaxed like?

ETA - what food were they feeding at the ER? Just wonder if it is tummy upset from new food.

ETA2 - I went back but couldn't find it...did they send you home with any Cerenia or pain meds like they gave in the ER?
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They were giving him 1/4 can of Science Diet Recovery and sent me home with three cans.

He didn't receive any pain meds when he was in the hospital but he did get Cerenia. Was not sent home with any. They said he was eating well and happy with his progress.

He is doing better now. Just not quite himself and I am noticing it as I am home. He is interested in food whenever I go upstairs. So I just give him some.
 
Tanya and Ducia said:
Good morning, Juliet,
If he eats well than I say just over him. He has been thru so much lately - it's ok that he is Off. I do hope that he will show signs of improvement soon but give it a little time for him to recover from the hospital and car ride stress.
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Yes I think that's it. He is definitely more perky and happy than he was. Just took this pic just now:

0D9BDD66-5ACD-4F2B-B14F-7C06036FAA3D.jpeg
 
Juliet said:
They were giving him 1/4 can of Science Diet Recovery and sent me home with three cans.

He didn't receive any pain meds when he was in the hospital but he did get Cerenia. Was not sent home with any. They said he was eating well and happy with his progress.

He is doing better now. Just not quite himself and I am noticing it as I am home. He is interested in food whenever I go upstairs. So I just give him some.
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Teasel was weaker and much less energetic for a couple of weeks after his bout. He ate well though.
 
Juliet said:
This momma bean a little paranoid over him then. If he even swishes his tail I'm worried.
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I know exactly how you feel. I watched Teasel like a hawk and kept notes from the start of his episode at home, through his stay at the ER and for a couple of weeks after he was home. This allowed me to see his progress better than relying only on memory.
 
Kris & Teasel said:
This is a human's description of DKA. No wonder a kitty is left feeling drained afterward!
https://www.diabetesselfmanagement....ood-glucose-management/diabetic-ketoacidosis/
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That was interesting reading. Although he had ketones I'm not sure it was full blown DKA?? He didn't vomit, wasn't excessively thirsty although he was severely dehydrated. But I don't know how it can be too little insulin. He was on 8.5 units a day. I want to test for ketones as they didn't tell me if they were cleared or not.
 
Juliet said:
That was interesting reading. Although he had ketones I'm not sure it was full blown DKA?? He didn't vomit, wasn't excessively thirsty although he was severely dehydrated. But I don't know how it can be too little insulin. He was on 8.5 units a day. I want to test for ketones as they didn't tell me if they were cleared or not.
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The vet can tell you if it was full blown DKA. Aside from blood ketone levels they would monitor the pH of the blood (degree of acidity) and a variety of other things. It's a complicated whole body process. The degree of severity can vary from borderline to critical. Here's a very technical but thorough article:
http://www.vetfolio.com/internal-medicine/understanding-and-treating-diabetic-ketoacidosis
 
I'm not upset by these numbers given that I have been feeding him quite a lot today. He has had one and a half cans of FF plus a full can of the Recovery (which he loves by the way). He has had 100-150ml fluids (I am not very good at eyeballing it as it goes down the bag but he got a kiwi size lump of fluid in his neck which is what vet said to aim for).

He has been pretty happy all day if a little quiet.
 
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