? Dosing Advice Prozinc 1

@MrWorfMen's Mom @Djamila

I'm exhausted. So Vet prescribed mirtazapine and rantidine/zantac. I gave him the mirtazapine at 9. The rantidine is a syrup so I have no idea when to give that? Any ideas?

I really need to go to bed earlier tonight, so I moved back his AM shot to 10:30 this morning, can I move his PM to 10PM tonight? Is that safe? Should I do a (+2) tonight?
 
Yes you can and by all means do so. That is a total time change for the day of 1 hour....totally fine. And a +2 test should give you an indication of whether he is just coasting or dropping. If dropping, try to get him to take a few Temptations to boost him up.

The ranitidine will help with any gas/acidity in his stomach which could be contributing to the not eating. You normally take that with meals in pill form so I assume the syrup would be the same.

Tomorrow, we should discuss raising the insulin dose slightly but right now you sound totally exhausted and we need you to look after you! I echo Djamila's comment that I wish we were closer to be able to help you out more.
 
MrWorfMen's Mom said:
Yes you can and by all means do so. That is a total time change for the day of 1 hour....totally fine. And a +2 test should give you an indication of whether he is just coasting or dropping. If dropping, try to get him to take a few Temptations to boost him up.

The ranitidine will help with any gas/acidity in his stomach which could be contributing to the not eating. You normally take that with meals in pill form so I assume the syrup would be the same.

Tomorrow, we should discuss raising the insulin dose slightly but right now you sound totally exhausted and we need you to look after you! I echo Djamila's comment that I wish we were closer to be able to help you out more.
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BEAR ATE RAVENOUSLY!!! Thank you Lord! He ate 2oz on his own. I didn't give him the syrup. I didn't want it to up his BG since most of his numbers are in the 3 hundreds.

Tomorrow I'm not sure if I can get the new needles but I'll keep it in my mind.

Let's see what numbers/BG Bear gives us tomorrow and go from there. He is improving and now he can eat, his BG'S might go down???

Who knows anymore what may happen.

I am so looking forward to laying in bed with a lighter load of worries in my mind and blissful sleep. YES!
 
Bear & Lora said:
Let's see what numbers/BG Bear gives us tomorrow and go from there. He is improving and now he can eat, his BG'S might go down???
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Agreed. They might go down just from him feeling better but if he is eating, it will be easier to increase his insulin a tiny bit without concern about being able to control any major drops so it's a WIN WIN either way.
 
WOOHOO!!!!!! Hearing that Bear ate has made my morning! I wasn't around last night (had an appt that ran late and I was so exhausted) so I'm just now catching up!

Okay, so I hope he keeps eating, but for future reference or anyone lurking and reading this thread: Feeding Tubes . They are really not as traumatic as they sound and they save lives. I wanted to give you that for any lurkers and also just to tuck the info away in case you ever need it!

Today, if he will eat and his BG is still high, I'd increase the insulin a bit. I noticed Djamila mentioning a fat 1.5, which sounds good.

Also, something to think about is that they make blood ketone meters. Ketones show up much faster in blood than in urine. They strips can be pretty expensive, so most people who get them have a kitty who has ketones in the past. They also use them just for those ketone tests and stick with their normal meters for the BG tests. Again, it's something for you to consider (not urgent). It can be helpful since you can get results much faster than stalking the litter box. :)

Looking forward to hearing how Bear is today and sending a ton more good appetite vines!
 
@MrWorfMen's Mom

I did my best to get a 1.75 in that needle. I will find a way to get different needles today. Let's get this beautiful boy's BG under better control.

Sleep is nice.

He didn't eat as much as I would have liked (0.3oz) but his attitude, appearance, and energy have all improved.

Last night his Ketones were negative. Wahoo!
 
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Awesome news! Hope you are feeling a little better today!
 
Yay yay yay!!!!!! Negative ketones is what I'm talking about!!!! Keep offering him food...maybe he needs some breaks between meals.

I bet sleep was everything to you last night! I hope you can take it easy today and maybe sneak in a nap if you need...or at least drink lots of coffee. :)
 
@MrWorfMen's Mom

Dang it! I wish I could have gotten his BG this morning but I had to take mom for lab work. We actually have a blue #. If Bear had a title, "Bear The Unpredictable" would fit him very well right now. His appetite has not only increased without the aid of the Mirtazapine, but is times two of his normal appetite. He is up to 4 oz of wet, plus Chicken Treats and we are in the early afternoon.

I bought the wrong needles at Walmart. When my husband opened a pack with scissors the needle was at least half the length of the U40's. I gave them to mom's nurse so they can be put to good use. I will try to order some from Amazon.

I really don't know why Bear is in the blue, if this has something to do with his food consumption being up, or the more intermittent feeding, or because his health is sooo much better.

If his liver dumped those ketones Sept. 25 like the Vet suspects then Bear's SS and health was under the influence of Ketones most of the time.

So many unanswered questions that we might never know the reasons only suspect.

With this blue 141BG when would you recommend I retest?
 
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He's looking good with those blues, today! I'm SO excited to hear he's eating so much! It's such a relief. Now that he's doing so much better, just a reminder that you'll want to test for ketones fairly often still. A cat who has had ketones is more likely to develop them again (NOT SAYING HE WILL) so it's just something to stay on top of.

As you said, you can spend this weekend learning more about diabetes now! So please feel free to post here and let us know what you want to learn. We're happy to help and now that the crisis is over, we can try to focus more on longer term things.

I would start a new thread when you post next. This one is getting kind of long and now that we're back in a good place, it's a good time for a new one!
 
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Always love more good news! Love those blue numbers. Have to admit I was beginning to wonder what he was up to with all that pink yesterday. The only caveat is we don't know where he started from but we'll take it. I think another test around +8 would be good. I think those numbers are probably a combination of all the improvements combined.

As for the needles, let us know what length you got. The ones I told you to get are no doubt shorter than what you are used to but they are fine and what most folks use here. Some even use shorter ones. I'm betting you have 1 inch needles and I don't think you'll find any that length in the human diabetic syringes.
 
@MrWorfMen's

Mom The mistaken bought needles were 15/64" which when using a tape measure they were about 1/4". They definitely wouldn't have worked well in Bear's very nice, thick fur, which is why I gave them to the home health nurse.

The U-40 that we got in August from the vet 1/2".

I will just have to order them or look at some of the other pharmacy s.

Amazon has them for 47.99, 100 count. Does that sound about the right price?
 
To be honest, that sounds expensive to me but I am in Canada. I paid approx. CDN $40.00 for 100 and our costs are notoriously higher than yours for everything other than the insulin. You might want to check out ADW. Lots of folks order from them. Looks like they have the syringes I used for about $20.00 US. These are the ones I used. https://www.adwdiabetes.com/product/6941/bd-ultra-fine-insulin-syringes
or if you want the 1/2 inch needle, some folks like the Monoject syringes these but the gauge is larger and might not be as comfortable for Bear although I think the syringes you are using now may be 29G in which case, these would be just fine.
https://www.adwdiabetes.com/product/1289/monoject-ultra-comfort-u100-syringes-29g-3-10cc-1-2in-100ct

I've never seen them labelled at 15/64" but that sounds like the same size I used and Menace has a very dense coat too. As short as that needle looks, it's really not that much shorter than the half inch....just a smidge under. There are shorter needles and those definitely were more problematic for me. As long as you get U100 syringes with half inch markings, 3/10cc, the gauge and length of the needle are a matter of preference.
 
Oh, and Sam has super thick fur too. I used to be the queen of fur shots around here since between his refusal to hold still, and the way his fur would trick me into thinking I had pierced through something, I missed a lot of shots. I found that the shorter needles helped me be more accurate. Well, that and finally just getting better at it.
 
Djamila said:
Oh, and Sam has super thick fur too. I used to be the queen of fur shots around here since between his refusal to hold still, and the way his fur would trick me into thinking I had pierced through something, I missed a lot of shots. I found that the shorter needles helped me be more accurate. Well, that and finally just getting better at it.
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Thank you. I'm a visual person this will help.
 
Kris & Teasel said:
Here's a compilation of DKA advice I pulled from various FDMB posts that helped me once Teasel was home. I think much or most of it came from @Meya14 who rarely posts anymore but is very knowledgeable about DKA. This might be helpful to you:
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Thank you for the (Treating Post-DKA). Bear is doing much better. His appetite is great, bigger than I have ever seen it and I am feeding him the higher carb wet food. Looking at the food chart yesterday's food consumption was 330 to 350 calories. His fur isn't as loose and he is a bit rotund. :) If you have anymore tips, and knowledge on how to keep his ketones low I am all ears. I will have a little more time this weekend to devote to educating myself on Bear's situation. I hope you and your beautiful boy are doing well. ( He is looking so much better. I have never scooped his litter after each use nor had the top off. I guess he thought it was nice enough to take a rest there, lol)
Bear 10-04-18 (1).jpg
 
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