DKA Now Home, Seeking Support! ♥

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Joelle & Ollie

Joelle & Ollie

Member Since 2018
Hi all! I'm new to the community and trying to stay as positive as possible, but things are looking down.

I've had Ollie since May. He's the sweetest shelter boy and other than having very sensitive skin, showed absolutely no health concerns until Tuesday night/Wednesday morning. We took him into the vet's office on Wednesday morning because he was having issues breathing. That's when he was diagnosed with heart issues, diabetes, and possible liver disease that we'll be testing for during his checkup in two weeks. He was kept overnight so that they could monitor his fluids/breathing/heart and it wasn't until we picked him up the next afternoon that we found out about his diabetes. He came home and spent 36 hours laying around, urinating and vomiting on himself and refusing to eat. We took him in this morning (Saturday morning, we were unable to take him to the emergency vet until then). His ketones were high and his glucose was so high that it wouldn't show up on a test. We've been given Royal Canin Glycobalance for him to eat, an RX for ProZinc that we're getting changed because no pharmacy within an hour drive can even order it, and two separate heart medications. He's been hospitalized until he starts eating on his own again and his BG levels drop significantly. He's currently being fed nutrient-rich food through a tube, is on an insulin pump, and is being given subq fluids. I have experience with diabetic animals (all dogs), but none of them have ever gone through something this harrowing.

I'm terrified for my little tailless wonder and really need some advice on how to keep this from happening in the future. We don't have an at-home BG test kit as of yet (funds are getting incredibly low with his recent hospitalization and we're going to struggle just to pay the bills this month) so I can't really give you a curve example, but as of 7pm his BG was 650. I have no idea of his ketone level right now because the vet hasn't done a test since we brought him in and I can't for the life of me remember what it was this morning. We're doing everything we can for him, but I'd like to know if there's anything else we should be doing other than food/fluids/insulin when he comes home? We've been warned that he's probably not going to be himself for a week or so, but should we try gentle, calm play to reduce his current emotional trauma? He's normally an extremely active cat who doesn't sit still for five seconds unless he's sleeping or devouring every bit of food in sight. Are there other safe ways to help raise his spirits a little bit? To reduce any and all stress, at least until he's feeling better?

Thank you so much in advance for any advice/well wishes! <3
 
First of all, so sorry your baby is so sick! DKA is dangerous but it sounds like they're doing the right things. You might want to make sure they're testing his electrolyte levels too while he's there. Low potassium is a common problem with DKA's.

Instead of ProZinc (which is a veterinary insulin only which is why you probably can't find it at a human pharmacy) you could ask for Lantus.....however, it's expensive in the US. Most of us are buying it from Canada because it's 1/3 to 1/2 the cost. But it takes about a week to get to you with a new script. You might call around and see if you can find a pharmacy that will sell you a single pen of Lantus Solostar. (It usually comes in boxes of 5 but occasionally you can find a pharmacy that will break open a box)

If you're low income, or need one time assistance, you should contact DCIN (Diabetic Cats In Need). We have compassionate assistance programs for emergency and low income caregivers! Feel free to contact me by private message if you'd like more information. Just click on my name and choose "start conversation".

When he's home, it'll be important for you to get enough food into him, enough insulin and possibly fluids for awhile to continue flushing any ketones out. Don't worry ….giving fluids isn't as hard as it might sound and we can help you (as well as your vet should show you how before you leave)

Learning to home test is important too. WalMart has their Relion Prime and Relion Premier blood glucose meters that are very affordable. DCIN also can send you the meter we use which is the Arkray Glucocard 01 Sensor (takes the tiniest blood sample size but the strips are a little more than the Prime/Premier)

You'll need a blood glucose meter (get one you can afford strips for), lancets (get 26 or 28 gauge which are a little thicker and easier to get a blood drop from) and if you want one, a lancet device. Most of us just freehand the lancet, but some prefer using the device. I always found it hard to see where I was poking. Some cotton cosmetic pads are great for holding against the ear so you don't poke your finger when you're poking his ear, and then folding over to apply pressure after you test. Some Neosporin with pain relief can help heal up those little pokes quickly too. (generic is fine)

Don't worry....we'll be here to help you every step of the way!!

Sending healing light to your "extra sweet" Ollie....and of course, my prayers for a quick recovery!!
prayers love healing light.jpg
 
You have got great advice and help from Chris.
I’m so sorry your little Ollie is so ill but he’s in the right place for treatment.
I would also get a bottle of Ketostix to test for ketones once you get home. It is a urine test and quite simple. The Ketostix can be bought at Walmart or pharmacies and only about $10. You will need to test daily once you get home until things settle down.
If he’s not eating enough you might have to syringe feed so make sure you have a couple of large syringes and some higher carb food as well as low carb wet food.

There is someone else on the forum dealing with DKA at the moment. You might like to read the thread as it is full of information and ideas. I’ll find the thread and send you the link.

Sending many vines to sweet Ollie
Bron
 
Bron and Sheba said:
I would also get a bottle of Ketostix to test for ketones once you get home. It is a urine test and quite simple. The Ketostix can be bought at Walmart or pharmacies and only about $10. You will need to test daily once you get home until things settle down.
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I knew I was forgetting something important!!

That's one of the reason's this message board is so great!
 
Thank you both so much! I've put in an application for one-time assistance with DCIN and hopefully, we'll be able to get some help.

I'm definitely going to ask about fluids when we pick Ollie up from the vet. Home-testing is something that I'm comfortable with since I've had multiple diabetic foster dogs through the years, we just don't have any kind of meter at home because I've always sent all testing supplies home with adopters.

I'll make sure to pick up some ketostix tomorrow evening! The fiance works 12 hour nights and it's difficult for him to be alive for more than an hour after work, especially on Sunday mornings during peak season as he's already pulled 5 12's. Lol I'll also be looking into picking up one of the Relion meters tomorrow as well as some lancets. I'm not sure if Ollie will be good to come home in the morning or if he's going to need another full day of hospitalization, but I'll be getting his new insulin prescription in the morning and we'll be running right off to get it filled if we can. Bills be damned, we can't wait for assistance with this first prescription fill, unfortunately. :/

I've never dealt with DKA before. Should I start with testing his BG every hour? At least to get a baseline "this is what's happening right now" or should I only test at +4 and +8 like I would if he were cycling normally? Also, I'm not a wet-food person, so I'm really not sure just how much wet food he should be eating? Before all of this, he was eating between 1 and 1 1/2 cups of dry food a day. Should I be working on the usual calories-by-pound basis? Or is the measurement different for him than other cats?

Sorry for all the questions, I've just never dealt with a diabetic cat before and want to make sure I'm doing good for him. I'm still in the process of reading all of the necessary literature (Including that thread!), so please forgive me if some of this stuff is already answered elsewhere. X3

This is my little Oliver from back when we first brought him home (he was quarantined in the back bathroom lol)

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Ollie is a very handsome boy! And I wish you the absolute best when you bring him home. Others that are more knowledgeable and experienced will help out with advice and answer your specific questions.
My contribution right now is to provide some links that will help your advisers. Make your signature so that Ollie's pertinent information is available with each of your posts. You can edit as needed. Here is the link: SIGNATURE
Set up your spreadsheet so you can record insulin injection times and dosages, plus the home testing results you will be getting. This is linked to your signature and the data is invaluable for dosing advice, and to see how the insulin is working. This link is to the area for spreadsheet instructions and understanding the grid: SPREADSHEET
Many of us are newer members and may not have specific answers, but believe me, we are reading your threads and support you while you are helping Oliver to get better. :bighug::bighug::bighug:
 
He is a beautiful boy!!

Here is Lisa Pierson’s food chart. For diabetic cats you need to get 10% or lower carbs. But it is a good idea to have some foods that are say 12 to 17 % carbs ( medium carbs) and some 18 to 24% ( high carbs ) in the cupboard for when the blood sugars drop low or he isn’t eating well and you need to get some carbs into him. As you buy them mark them with a texta so you know the number of carbs at a glance. Also make sure you have some honey or Karo on hand if needed.
https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

Initially, when his appetite is not great, any food he will eat is good but eventually he will need to go onto wet low carb food.
Recipe for DKA is not enough insulin, not enough food and an infection or inflammation. So when he gets home, getting enough insulin, getting enough food into him and getting any infection treated is paramount. Also enough fluids to flush out the ketones. If he has an issue with his heart you will need to ask the vet about how much fluid he can have.
 
Joelle Sullivan said:
Should I start with testing his BG every hour? At least to get a baseline "this is what's happening right now" or should I only test at +4 and +8 like I would if he were cycling normally?
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Which insulin? You usually don't need to test hourly unless he's running low. Generally speaking, you always test before shooting (to make sure they're high enough for insulin at all) and then get at least 1 mid-cycle test on the AM cycle and a "before bed" test on the PM cycle. Most insulins nadir at around +5 to +7 …..but we're very data driven here so if you can get more tests in (within reason), that's good with us!!

Joelle Sullivan said:
Should I be working on the usual calories-by-pound basis? Or is the measurement different for him than other cats?
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The general starting formula for calories is [weight x 13.5] + 70 but until his diabetes is better controlled, he'll probably need to eat more. Also, a DKA kitty needs more calories than a non-DKA kitty until he's more stable. Sometimes it's necessary to feed a higher carb food than we usually recommend so they can safely get a higher dose of insulin than a "normal" starting dose.

Joelle Sullivan said:
Sorry for all the questions, I've just never dealt with a diabetic cat before and want to make sure I'm doing good for him.
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No need to apologize!! We've all been beginners at one time or another and you've been thrown into the deep end quickly due to the DKA. You're in the right place though! There's lots of experience here to share with you!
 
We're not sure on what kind of insulin/dosing yet, though as soon as we know in the morning, I'll definitely be updating here. Also, it's nice to know that my anxiety is kicking in and telling me that I should be testing him *all the time*. Lol I'll def be testing before every dose, just wasn't sure how much/when to test beyond that. Through the DKA recovery, I'll probably end up testing 6-8 times a day for my own sanity. XD

Thank you guys SO much for the food info! Before the DKA, my vet prescribed low-carb prescription food (2.8%) and 1 unit of ProZinc twice a day. The dry food that my girls are currently on (and what he was on before all of this) is 41.8%. I'm probably going to be changing everyone's food, just so there's no possibility of him getting into their super high-carb noms while I'm not looking.
 
Joelle Sullivan said:
low-carb prescription food (2.8%)
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The "prescription" foods aren't that low in carbs either....Depending on which one it was, they run from 6% to 33%....and the ingredients are really pretty lousy.

Plain old Fancy Feast classics are low carb and the ingredients are actually better.

Joelle Sullivan said:
I'm probably going to be changing everyone's food, just so there's no possibility of him getting into their super high-carb noms while I'm not looking.
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That's a good choice.….not only do you not have to worry about what he might sneak into, but you're going to help lesson the chances that anybody else becomes diabetic!!
 
Oh, we're definitely going to be switching him to Fancy Feast at some point, we've just already bought the "prescription" food from the vet. Google said that the Royal Canin Glycobalance was 2.8% carbs, but I probably just looked it up wrong or looked at the wrong number. Lots of stress the past couple of days. Lol
 
Joelle Sullivan said:
Google said that the Royal Canin Glycobalance was 2.8% carbs,
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Dr. Lisa's site has it at 14%

You should be able to return it for a refund....the Prescription foods are usually 100% guaranteed ….I've even returned an open bag of dry when I found out how lousy it was for China. I just told the vet that she quit eating it.
 
Alright, so. Ollie didn't come home this morning, nor do we have a set prescription yet for his insulin. The vet is keeping him for another night. He's eating on his own (scarfed up his breakfast like he was starving, apparently), but the vet wants to keep him for monitoring until tomorrow to make sure he's definitely on the mend. He also wants to test and see if Ollie responds well to Vetsulin before trying to prescribe it long-term. His glucose is currently 487, so definitely an improvement from yesterday. He's off the pump! The vet is going to give us a run-down on home BG testing for cats because we may have to lance something other than his ears. His ears are full of scar tissue as he was an outdoor/indoor cat with his previous owners and got pretty badly chewed up by fleas and the like and the vet has been having difficulties getting enough blood out of them.

I've got a friend who works with diabetic doggos who's said that she's going to purchase an AlphaTRAK 2 meter and test kit and let me pay her back the next time I get paid, so I'll have that on Tuesday. Definitely picking up ketostix tonight as well as some lower carb food for the girls so that we can get started on switching them over for Ollie's sake. Everything is looking up!!

We've decided we're going to feed Fancy Feast since they have some pretty good seafood formulas (none of our cats have the tummy for beef or chicken) and I think all three of them will enjoy the overall switch from dry to wet food. :)

Thank you all SO MUCH for all of the advice so far!!! I'll be on later to give everyone an update once I have one (around 9:30 tonight is what the doc said), but for now, I'm going to sleep. It's been days since my head has met a pillow and I feel like I can breathe easy enough with this most recent update to get a few hours in me. X3
 
Joelle Sullivan said:
I've got a friend who works with diabetic doggos who's said that she's going to purchase an AlphaTRAK 2 meter and test kit and let me pay her back the next time I get paid, so I'll have that on Tuesday.
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If you really want the AT that's fine, but be warned.....the strips can cost up to $1 EACH going forward. There are some who buy human strips for their AT at a reduced price, but the official position on "strip swapping" is we don't really agree with it. If you're going to use human strips, you might as well use a human meter....and all our protocols here were developed using human meters so they're well understood. Another problem is that you have to be careful about keeping well stocked....since they're only available from your vet or online, if you run out of strips on a Saturday night and your kitty decides to drop too low that night, there's no place to get "emergency" strips. With a human meter, you can run to WalMart if you need to. Cats have the annoying habit of running low when we least expect it!

Yes, they usually test a little lower than the AT, but at the low numbers (that are the most important) they're pretty close. As the numbers go higher, the difference increases too...but too high is too high, whether it's on the AT or a cheaper human meter.

I actually like that the human meter tends to run a little lower....gives me a little extra "cushion" of safety
 
Just talked to the vet and got another update. Ollie was at 250 at his lowest today and went back up to a high of around 400 right before he got his evening insulin, so not perfect, but a lot better than he's been doing the past couple of days. It also looks like we're sticking with the vetsulin since Oliver didn't drop too fast on it. He's not jaundiced from the fatty liver anymore and his tongue has returned to a pretty red color. He's using the bathroom good and drinking up most any water they'll give him. We're also dropping one of his heart meds down to once a day since it's a diuretic. We're hoping to wean him off of the Lasix by the time his two-week checkup comes around and then work his Benazepril down to once a day. I'll be checking ketones daily til he sits at trace or lower for a week and then once a week thereafter until remission.

I'm not worried about the strip price, really. The vet recommended PetSure test strips for if we're ever in a financial bind and I told him about the worry for emergency strips and he's more than willing to provide emergency strips whenever necessary (it's a 24-hour office and we live less than two miles away). Even if I don't have the car and my fiance is at work, I can easily walk down there to get emergency supplies, which I can't do with our Walmart since it's almost a half hour drive away. That's why I wanted to get the AlphaTrak, actually. I have easier 24/7 access to emergency strips than I do with a human meter. :)
 
Great news Ollie is improving.
I am surprised the vet is not putting Ollie onto Lantus insulin. It is a longer acting and gentler insulin. And over time you will be less likely to get the higher numbers towards Preshot which you get with the shorter acting insulins as the dose wears off.
 
The vet said he'd like to see Ollie on ProZinc (which we can't get ahold of for another 5-6 days due to literally everyone including our vet needing time to order) or Lantus, but because of our finances right this minute, the vetsulin is what we can afford and he needs to be on insulin ASAP. We're basically just on the vetsulin to do our best to regulate until we can afford a gentler Rx. With all of this stuff popping up over the course of the past 5 days, we've already spent well over $2k on everything and can't swing a pricier prescription while also keeping the lights on. :/

UPDATE: Ollie is home as of about 10am. His AMPS was in the low 400's and he's comfortable and doing really well. Did a ketone test and he's low, so that's good. His meter won't be delivered til tomorrow, which means that I won't have BG tests for tonight's PMPS and tomorrow's AMPS, but I talked to my vet (who's been very excited that I'm testing at home and is going to be working with me to get him regulated and on the correct dose) has said that it's probably safe to do so for just the two injections because he's coming down from the high ketones and has been testing in the low-mid 400's on all pre-shot tests since yesterday morning (Sunday AM, so 3 tests in a row). What do you guys think about that? Is missing the test on two injections now while he's sort of plateaued at a solid 400 over three curves going to set us back? I'm going to keep feeding what they gave him at the vet clinic (don't want to switch him to the low-carb until I can effectively monitor everything) and will be keeping his dose steady at 1.5 units.
 
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Hi. That’s exciting Ollie is home. I know how expensive it is when our kitties get sick and have to stay in hospital.
Definitely stay on the same food until you can test the BSLs.
It is very important you keep giving the insulin so if you can’t test, it isn’t ideal, but start testing ASAP. Could the vet lend you a meter?
What was the food they were giving? You can always give some higher carb food if needed to keep him higher until you can test.
If you are going to work with the vet adjusting the dose of the insulin, make sure that you only increase/ decrease in 1/4 (0.25) unit increments. Most vets increase in 1 unit increments and it is too much. Also the dose is decided on the nadir( the lowest point in the cycle) not the Preshot. The Preshot is important to ensure it is safe to give the insulin.
It is imperative that Ollie eats so if you have trouble with food post and ask for help.
Please keep posting here so experienced people can assist and support you.
Keep asking questions. I would change your subject line now to something like ‘DKA now home seeking support ‘ so people can be alerted to current situation.
Good luck and please give Ollie a cuddle from me.
Bron
 
Joelle Sullivan said:
Just talked to the vet and got another update. Ollie was at 250 at his lowest today and went back up to a high of around 400 right before he got his evening insulin, so not perfect, but a lot better than he's been doing the past couple of days. It also looks like we're sticking with the vetsulin since Oliver didn't drop too fast on it. He's not jaundiced from the fatty liver anymore and his tongue has returned to a pretty red color. He's using the bathroom good and drinking up most any water they'll give him. We're also dropping one of his heart meds down to once a day since it's a diuretic. We're hoping to wean him off of the Lasix by the time his two-week checkup comes around and then work his Benazepril down to once a day. I'll be checking ketones daily til he sits at trace or lower for a week and then once a week thereafter until remission.

I'm not worried about the strip price, really. The vet recommended PetSure test strips for if we're ever in a financial bind and I told him about the worry for emergency strips and he's more than willing to provide emergency strips whenever necessary (it's a 24-hour office and we live less than two miles away). Even if I don't have the car and my fiance is at work, I can easily walk down there to get emergency supplies, which I can't do with our Walmart since it's almost a half hour drive away. That's why I wanted to get the AlphaTrak, actually. I have easier 24/7 access to emergency strips than I do with a human meter. :)
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Rather than pet sure, try insulinx strips with the Alphatrak. I've found them to be accurate and $35/100 on amazon
 
Joelle Sullivan said:
The vet said he'd like to see Ollie on ProZinc (which we can't get ahold of for another 5-6 days due to literally everyone including our vet needing time to order) or Lantus, but because of our finances right this minute, the vetsulin is what we can afford and he needs to be on insulin ASAP. We're basically just on the vetsulin to do our best to regulate until we can afford a gentler Rx. With all of this stuff popping up over the course of the past 5 days, we've already spent well over $2k on everything and can't swing a pricier prescription while also keeping the lights on. :/

UPDATE: Ollie is home as of about 10am. His AMPS was in the low 400's and he's comfortable and doing really well. Did a ketone test and he's low, so that's good. His meter won't be delivered til tomorrow, which means that I won't have BG tests for tonight's PMPS and tomorrow's AMPS, but I talked to my vet (who's been very excited that I'm testing at home and is going to be working with me to get him regulated and on the correct dose) has said that it's probably safe to do so for just the two injections because he's coming down from the high ketones and has been testing in the low-mid 400's on all pre-shot tests since yesterday morning (Sunday AM, so 3 tests in a row). What do you guys think about that? Is missing the test on two injections now while he's sort of plateaued at a solid 400 over three curves going to set us back? I'm going to keep feeding what they gave him at the vet clinic (don't want to switch him to the low-carb until I can effectively monitor everything) and will be keeping his dose steady at 1.5 units.
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Glad he's home. Should be fine for a couple days while you wait for the meter
 
I'm glad he's getting insulin. I think he's probably high enough for you to give the 1.5 u dose without testing. The bigger risk is not giving insulin. Are you testing for urine ketones at home? That's very important post DKA.

Joelle Sullivan said:
he's sort of plateaued at a solid 400 over three curves going to set us back?
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Do you mean he hasn't gone lower than 400s at any time during those three curves? Once you have your meter and are testing you'll want to get an idea of how low he's going. That's the most important thing to know in assessing a dose.
 
Bron and Sheba said:
Could the vet lend you a meter?
What was the food they were giving? You can always give some higher carb food if needed to keep him higher until you can test.
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He couldn't, no, but we're getting ours tomorrow afternoon. He got his PM insulin just a few minutes ago and took it like a champ! The vet was giving him the Royal Canin glycobalance. I told him we were switching to a low-carb wet diet, so he just gave me a couple of cans to hold Ollie over until the switch. It's at 14%, so not so high in carbs that I'm worried about it.

JanetNJ said:
Rather than pet sure, try insulinx strips with the Alphatrak. I've found them to be accurate and $35/100 on amazon
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I'll definitely look into those! Thank you so much for the suggestion!! ♥

Kris & Teasel said:
Are you testing for urine ketones at home? That's very important post DKA.
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Yep! Got a reading earlier this morning that said he had low ketones, so not perfect, but better than mid-high.

Kris & Teasel said:
Do you mean he hasn't gone lower than 400s at any time during those three curves?
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Sorry, I'm bad at the lingo lol. He hasn't been higher than low-mid 400's for his pre-shot tests in the past couple of days. The lowest that the vet has seen him at was 250 at +7 the other day.

I'll definitely pass on all the well-wishes and cuddles. He'll really appreciate them! ♥
 
Kisses and hugs to Ollie! It's going to be great when you get your own meter and can see what's happening with him. More healing energies to the handsome boy.
 
Hi Joelle and Ollie! Sorry I didn't pop in yesterday, but I see you got excellent help already. I'm so glad you're getting a meter and going to be home testing...please keep us updated on how Ollie is! We'll be happy to help you with insulin dose too as you get some tests in. :)
 
I hope your meter comes today so we can help you get Ollie's BG into better numbers. :) Not dropping lower than mid 200s is an indication that the dose needs to go up. However a bit of baseline data on your spreadsheet will help. Here's the basic testing routine we recommend:
  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
This is useful: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Don't get discouraged if it takes some practice to get the testing thing working smoothly. There are lots of good tips in the link I included above.

For kitties recovering from DKA at home:
  • feed as much as you can in many small meals - too little food can cause ketone production
  • don't skip insulin - it's needed to prevent ketone development
  • you might need antinausea meds and possibly an appetite stimulant med to get him/keep him eating - we can advise
  • it can take a few weeks for him to feel normal.
 
Thanks so much, guys!!

Rachel said:
please keep us updated on how Ollie is! We'll be happy to help you with insulin dose too as you get some tests in. :)
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I'll definitely be keeping everyone updated! His AM shot is in about an hour. Since he's been home, he's been eating like the little piglet he is and he's even starting to play again!

Kris & Teasel said:
Not dropping lower than mid 200s is an indication that the dose needs to go up.
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Since I'm planning on switching him to low-carb food within the next couple of days, would you still recommend upping his dose? I don't want to raise it too high on him only to have to possibly drastically lower it again tomorrow or the day after. Also, his levels have been coming down over the past few days, as well. His low on Saturday in the PM (not sure exactly when tested, but he was consistently monitored all night due to the possible DKA) was in the 400's and his low on Sunday was 250. Should I wait til he balances out a bit more since it's only been a few days and his levels have only been going down?

Also, I'm really not sure if he was actually in DKA. The vet said "possible DKA", but he's recovering extremely quickly and I'm starting to wonder if we maybe caught his high ketones before he fully went into it or maybe right as he got into it? Or maybe we just got super lucky with the treatment he got? I'm waiting till I can catch him in the litter box again so that I can do today's ketone test. I'll update everyone once that happens. :)
 
Joelle Sullivan said:
Since I'm planning on switching him to low-carb food within the next couple of days, would you still recommend upping his dose? I don't want to raise it too high on him only to have to possibly drastically lower it again tomorrow or the day after. Also, his levels have been coming down over the past few days, as well. His low on Saturday in the PM (not sure exactly when tested, but he was consistently monitored all night due to the possible DKA) was in the 400's and his low on Sunday was 250. Should I wait til he balances out a bit more since it's only been a few days and his levels have only been going down?
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Agree. Keep him at the 1.5 u dose while you do the food switch but get a regular testing routine going to see what happens. Keep up the urine ketone testing too.

Joelle Sullivan said:
Also, I'm really not sure if he was actually in DKA. The vet said "possible DKA", but he's recovering extremely quickly and I'm starting to wonder if we maybe caught his high ketones before he fully went into it or maybe right as he got into it? Or maybe we just got super lucky with the treatment he got? I'm waiting till I can catch him in the litter box again so that I can do today's ketone test. I'll update everyone once that happens. :)
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Were his electrolytes being monitored at the clinic? Were they using doses of fast acting insulin to get his BG down? Was he on IV fluids? These are some of the usual DKA therapies. Regardless, the presence of "high" ketones was dangerous. Him eating well now and playing are great signs! Keep us posted.
 
Kris & Teasel said:
Agree. Keep him at the 1.5 u dose while you do the food switch but get a regular testing routine going to see what happens. Keep up the urine ketone testing too.
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Definitely will do! My vet and I have come up with a plan for the ketone testing since the high ketones came on so quickly. I'll be testing daily until he's at trace or none for more than a week, and then I'll be testing once a week thereafter to keep him monitored as well as doing any testing if he starts to show signs of them going up again.

Kris & Teasel said:
Were his electrolytes being monitored at the clinic? Were they using doses of fast acting insulin to get his BG down? Was he on IV fluids
Click to expand...
He was monitored constantly through both days that he was hospitalized and he was on an insulin pump for the first 24 hours. SubQ fluids were administered regularly. :)

I'll definitely be keeping everyone posted! ♥
 
It looks like this morning's shot may have been entirely fur. Ollie has been fighting the needle a lot and someone in another thread suggested switching to 31 gauge instead of the 29 gauge that the vet gave me. Question is: Are there u-40 31 gauge needles? Or would I need to switch to u-100 needles and use the conversion chart? I'm not opposed to switching to u-100, I just want to make sure that my limited google research ability isn't hindering me, here. Lol

EDIT: His PM shot is the one that was all fur. It's just that my "morning" is the PM since the fiance and I are both night-shift peeps. XD
 
Hmmm...it's been awhile since I needed needles, so I couldn't say for sure. But yes, a quick search hasn't shown them. I'm sure someone else will chime in on that. I can say that using u100s isn't hard and many people end up preferring it since they can do much smaller dosing increments with them. If you do decide to switch to u100s though, I strongly suggest you put the u40s in the back of a closet in a completely different room. No point tempting fate by having them within reach! And I'd print out the Conversion Chart so you cab always refer to it when drawing up a dose.

Another thought is have you tried giving the shot when his face is buried in the food bowl? I usually gave Gypsy her shot then...waited til she'd eaten several bites, then just gave a quick shot. It was so funny because she'd look up at me and make an annoyed noise, but it never seemed to bug her much since more important than what I was up to was her food! :)
 
Bron and Sheba said:
Here’s the link.
Stay positive.
http://www.felinediabetes.com/FDMB/...a-vet-thinks-were-out-of-options-help.207460/
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Hey, it's me.

@Joelle Sullivan - Sorry to hear that Ollie's not doing too well. I understand all too well how stressful it can be seeing your buddy go through hard times. Just know that we are here to help with any concerns you may have.

Here's a few things I've learned while Simba has gone through DKA recovery the past few weeks. Our situation is a little different from yours, so your approach may need to be different.
  1. The people on this forum are great. Our vet told us they didn't think he had a fighting chance. The support here has helped us get through the tough times, and I really don't know where we would be without them.
  2. Your kitty may not look that great now, but that doesn't mean he's hopeless. It seemed for a while that Simba was just getting worse and worse. He eventually started to get better, and it seems like we're beyond the worst of it now. It's a huge relief to see improvements once they come.
  3. Syringe feeding is a godsend. Before all this, our guy was like yours - the Totally Ravenous Destroyer of Food. Because of the DKA and all the meds he was on, he wouldn't even look at his food for a long time. We had to syringe feed almost all of it. He's finally getting back to his old self & eating without much prompting. You can also water down the food more to make sure he gets enough fluids, as hydration is crucial.
  4. Treat any infections ASAP. He got a respiratory infection during his stay at the hospital & it almost made him relapse.
  5. AlphaTrak strips are EXPENSIVE. Human meters are recommended & widely used by members here. I'm looking into getting one myself.
  6. Get KetoStix. For me, having more data helps a ton with peace of mind.

And I second what Rachel said above. If possible, I always give the shot while he's distracted with the food. When starting insulin, I was worried that he would hate getting his shot. He doesn't even seem to notice 99% of the time. We use 30-gauge U100 syringes. Just make sure you do the proper conversion if you're using U40 insulin.
 
Eric and Simba said:
Hey, it's me.

@Joelle Sullivan - Sorry to hear that Ollie's not doing too well. I understand all too well how stressful it can be seeing your buddy go through hard times. Just know that we are here to help with any concerns you may have.

Here's a few things I've learned while Simba has gone through DKA recovery the past few weeks. Our situation is a little different from yours, so your approach may need to be different.
  1. The people on this forum are great. Our vet told us they didn't think he had a fighting chance. The support here has helped us get through the tough times, and I really don't know where we would be without them.
  2. Your kitty may not look that great now, but that doesn't mean he's hopeless. It seemed for a while that Simba was just getting worse and worse. He eventually started to get better, and it seems like we're beyond the worst of it now. It's a huge relief to see improvements once they come.
  3. Syringe feeding is a godsend. Before all this, our guy was like yours - the Totally Ravenous Destroyer of Food. Because of the DKA and all the meds he was on, he wouldn't even look at his food for a long time. We had to syringe feed almost all of it. He's finally getting back to his old self & eating without much prompting. You can also water down the food more to make sure he gets enough fluids, as hydration is crucial.
  4. Treat any infections ASAP. He got a respiratory infection during his stay at the hospital & it almost made him relapse.
  5. AlphaTrak strips are EXPENSIVE. Human meters are recommended & widely used by members here. I'm looking into getting one myself.
  6. Get KetoStix. For me, having more data helps a ton with peace of mind.

And I second what Rachel said above. If possible, I always give the shot while he's distracted with the food. When starting insulin, I was worried that he would hate getting his shot. He doesn't even seem to notice 99% of the time. We use 30-gauge U100 syringes. Just make sure you do the proper conversion if you're using U40 insulin.
Click to expand...
Keep your alpha but buy some insulinx strips. $35/100 on amazon and they work good
 
JanetNJ said:
Keep your alpha but buy some insulinx strips. $35/100 on amazon and they work good
Click to expand...
I've read that these aren't coded like the AT strips so the readings can be inaccurate. Is the variance small enough to be tolerable? And how do I know which code to use?
 
Eric and Simba said:
Here's a few things I've learned while Simba has gone through DKA recovery the past few weeks. Our situation is a little different from yours, so your approach may need to be different.
  1. The people on this forum are great. Our vet told us they didn't think he had a fighting chance. The support here has helped us get through the tough times, and I really don't know where we would be without them.
  2. Your kitty may not look that great now, but that doesn't mean he's hopeless. It seemed for a while that Simba was just getting worse and worse. He eventually started to get better, and it seems like we're beyond the worst of it now. It's a huge relief to see improvements once they come.
  3. Syringe feeding is a godsend. Before all this, our guy was like yours - the Totally Ravenous Destroyer of Food. Because of the DKA and all the meds he was on, he wouldn't even look at his food for a long time. We had to syringe feed almost all of it. He's finally getting back to his old self & eating without much prompting. You can also water down the food more to make sure he gets enough fluids, as hydration is crucial.
  4. Treat any infections ASAP. He got a respiratory infection during his stay at the hospital & it almost made him relapse.
  5. AlphaTrak strips are EXPENSIVE. Human meters are recommended & widely used by members here. I'm looking into getting one myself.
  6. Get KetoStix. For me, having more data helps a ton with peace of mind.

And I second what Rachel said above. If possible, I always give the shot while he's distracted with the food. When starting insulin, I was worried that he would hate getting his shot. He doesn't even seem to notice 99% of the time. We use 30-gauge U100 syringes. Just make sure you do the proper conversion if you're using U40 insulin.
Click to expand...
Hi Eric! Thank you so much for sharing all of the amazing lessons you've learned! I've been reading and keeping up with your Simba updates (though didn't post because I don't really have anything to offer except well-wishes and snuggles for the sweetheart) and it's so exciting to see him feeling so much better today! GO YELLOWS! <3

This place is AMAZING! I don't know what I'd do without everyone's wealth of knowledge and support!

JanetNJ said:
Keep your alpha but buy some insulinx strips. $35/100 on amazon and they work good
Click to expand...
I'm not worried about the strip expense for now, our only expense issue has been this pay cycle because of Ollie's hospitalization. The strips aren't too expensive (one of my girls is currently on a medication that costs us almost $300 a month for her neurological problems) and we'll be more than able to handle keeping him on the AlphaTrak. :) Plus, our vet using the AT, so we know that our test results are very close to theirs and they can easily look over our spreadsheet and know exactly what's going on with his numbers. :)

Onto an awesome update! I'm not sure if I'm reading this right (sorry the pic is a little blurry, the camera on my phone is completely horrible) but I *think* this is a negative? Box on the left is negative, box on the right is trace. What do you guys think?

GQC2rkz.jpg
 
Make sure you follow the directions exactly....it's really important to only let it "sit" for the required time because the longer it sits, the darker it'll become. (I take that into consideration too since it takes a little while to get a picture of it)

Also, the lighting in the room can make a difference too. Make sure it's a good, bright light.
 
187 AMPS... I'm not sure what's going on? His pre-shot numbers have regularly been in the 3-400 range up until now. I'm going to check his sugar again in 20 minutes to make sure it's going up, but could this be a sign of good things to come? Or is it just a fluke? He's eaten all of his night-time free-range wet food, so I know he's not low due to not eating. Could it be that with the ketones gone (as far as we can tell, still testing daily) that he's starting to regulate on his current dose?
 
Joelle Sullivan said:
187 AMPS... I'm not sure what's going on? His pre-shot numbers have regularly been in the 3-400 range up until now. I'm going to check his sugar again in 20 minutes to make sure it's going up, but could this be a sign of good things to come? Or is it just a fluke? He's eaten all of his night-time free-range wet food, so I know he's not low due to not eating. Could it be that with the ketones gone (as far as we can tell, still testing daily) that he's starting to regulate on his current dose?
Click to expand...
That's a lovely AMPS. Yes, check again in 20 minutes and post with the number. If he's on the way up, give 1.5 u. Try hard to get some middle of cycle data to see what the dose can do. The PSs are only useful in telling you it's safe to give insulin (mostly). The lows are much more important in assessing a dose.
 
Will do! I've just never seen him this low at PS and I know the "no dose" number is supposed to be above 200, but he's just regularly been so high and I don't want to cause him to be hypoglycemic. Lol

Testing again now, then straight to food (he and the girls are all yelling at me about breakfast XD)
 
Okay, the second test put him @235 so I'm going to go ahead and give him the full 1.5 u. I'll be checking at +4 and again at +7 to be sure I can pinpoint some kind of low. I'll be doing his curve most likely the 30th-31st (don't have the strips right this second to be able to do a curve and also make sure his PSs are high enough to shoot), but even with the 235, I'm super excited, it's an amazing number!
 
Joelle Sullivan said:
Okay, the second test put him @235 so I'm going to go ahead and give him the full 1.5 u. I'll be checking at +4 and again at +7 to be sure I can pinpoint some kind of low. I'll be doing his curve most likely the 30th-31st (don't have the strips right this second to be able to do a curve and also make sure his PSs are high enough to shoot), but even with the 235, I'm super excited, it's an amazing number!
Click to expand...
You don't actually have to do a curve. If you follow the basic testing routine we recommend you'll get the data you need over several days to know how well a dose is working. Once in a long while you might do a full curve to pinpoint where his nadir is, etc.

Here's the basic testing routine:
  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
This is useful: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
 
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