Loki - Regulation Thread

LokiL

LokiL

Member Since 2019
Hello all!

Background Information:
My boy was diagnosed in December. After working with his vet and failing to get him regulated on either Prozinc or Vetsulin, I had him admitted to the ER after he began refusing food outright. He was in a state of ketosis, and was kept on r-insulin (I believe) while monitoring his glucose around the clock, given fluids, x-rays, ultrasounds...the whole 9 yards. He has lost a substantial amount of weight since he began insulin in December (at his peak, he was around 15 pounds which was a bit much, he's currently very gaunt and around 10 pounds) The final diagnoses were:
  • Diabetes melitis
  • Stage II/VI kidney disease
  • Ideopathic megacolon
  • We are awaiting a test to come back to see if he has some form of pancreatic insufficiency that is contributing to his weight loss

The did ultimately have to give him enemas to get him started back with a clean slate, and sent me home with him last evening.

Current Protocol:
I don't have the doses for anything other than Lantus sitting in front of me, I'm at work at the moment- so sorry for that.
  • Miralax & Lactulose every 12 hours
  • Potassium pill every 12 hours
  • Subcutaneous fluids every 24-48 hours
  • 4u Lantus every 12 hours
This internal medicine specialist was very excited that I wanted to do home monitoring, and said she doesn't ever like to handle diabetic cats without it. For help in getting us dialed in and making curves as stress free as possible, she placed a Freedom Libre sensor on him and just gave me the reader for it.

Concerns:
  1. They said he ate very well there and sent me home with the same food he was eating there. For me, he certainly has an apetite, but seems to struggle to eat this food. When he licks it, it just seems to crumble to bits. When he tried to eat the bits, they just fall out of his mouth and he gets frustrated and gives up. He is willing/able to eat any liquid that the food is with, foods in paste form (Inaba treats, baby food- I use these to sneak his medicine in). I've tried making this food into more of a paste texture but...it's proving difficult. Riding the line between "still chunky" and "it's soup now" is tricky. On top of that, I don't really know how much food I'm giving him when I do this. Either way, my first attempt at it resulted in him eating everything but the tiny bits that didn't get blended.
  2. How long do I wait to increase doses/is there any upper limit of blood sugar that I should be sounding alarms at? His sensor began picking up data at around 5 a.m., which would have been 10 hours after his 4u. At that point, he was in the high 400s.

Any advice here is welcome. I'm more than a little overwhelmed. I'm feel very comfortable with this specialist, but of course she can't always respond to me right away with advice. As I'm able to start getting more data, I can get a spreadsheet going- I'm just panicked to still see him so high...I can't afford another visit like this most recent one.
 
I'm in and out of reception right now, so this will be quick.
Another member used the Libre and found it helpful to post a screenshot of the graph at amps and pmps. He also found that a handheld glucose reader was essential for accuracy. the Libre is good for showing patterns and while away but shouldn't be used for dosing.
 
Hello and welcome :cool:

Hang in there. You have come to the right place. Your kitty has a lot going on that’s for sure.

Before I make any comments, I’m going to “tug and a few sleeves” and get some extra eyes here in your “condo”

I’ll be back...:cool:
 
Thank you for the quick replies. Majandra- hello again! Sorry to ghost out of that other thread, but my boy fell apart immediately after that thread, so I didn't really have anything to put in there that would have been valuable other than just all my worries!

Hi Sandy, thank you for the reply, and any sleeve pulling you can do.

As far as the accuracy of the Libre, we actually sort of talked about that at one point. In her experience:
"the libre definitely reads high in the high range so anything above 350 is probably not really that high- it kind of shoots up exponentially. It’s really good in the low numbers, though, which is why I really like it for cases like this. "

I do have access to an AlphaTrak2, as well. I haven't had a chance/need to use it just yet, but I can certainly attempt to throw in some tests alongside the Libre.
 
I’m sorry your Kitty was hospitalized with DKA. I went through it twice with my boy. It’s something to be avoided at all costs

Please let us know your geographic location.

When is the next shot due?
Do you have any data from the Prozinc/vetsulin time? Please get a spreadsheet going ASAP with any data you have accumulated, even if it’s just a few readings it’s valuable. Going forward the ss will be your guide.

Are you monitoring for the presence of ketones in his urine or blood?

So that you have an understanding of how DKA happens -
When there is not enough energy from food making it into the cells, the body will breakdown fat and protein to try and fulfill the need for more metabolic energy. The excessive breakdown of these stored reserves creates a toxic by-product - ketones. As ketones build up in the blood stream, the resulting pH and electrolyte imbalances can very quickly develop to life threatening levels , a state of DKA.

The factors that open the door to the formation of ketones are-
•not enough insulin
•not enough calories
•infection/inflammation or some systemic stress.

You mentioned problems with him keeping food in his mouth while eating. Are there any dental issues?

Getting enough calories is very important. In general a kitty recovering from DKA should consume 1.5 times the calories required to maintain ideal weight.

 
Welcome to the group.

Do you happen to know if there was any infection or inflammation present when your kitty was diagnosed with ketoacidosis? This would include a dental problem. The food falling out of his mouth may mean that something is going on in his mouth. I would try to raise his bowl and see if that helps.

I've never used the Libre. Most of us use a usual human glucometer and poke our cats on the edge of the ear to get blood for testing. Also, be aware that comparing meters can make you crazy. The strips for the AT meter are expensive. I have no idea how it compares to the Libre. Most of us stick with one meter since it will give a consistent reading vs getting numbers to see how meters compare.

I would strongly encourage you to test for ketones. The quickest way to do this is to get Ketostix at any pharmacy. You dip a strip into your cat's urine stream, let it sit for the required number of seconds, and compare the color of the strip to the chart on the tube. It will tell you if ketones are present and to what degree. (Anything other than "trace" is a concern.) Alternatively, there are blood ketone meters that work in a way that's similar to a glucometer -- get a drop of blood and you get a numerical reading.

If you are mixing water into your cat's food and he needs a paste texture, consider using a blender or food processor. You can always make up a batch of food and portion and freeze the food. (Just remember to defrost enough for the next day.) Right now, it's more important that your cat eats than anything else. DKA is often the result of an infection/inflammation, not enough insulin, and not enough calories. If your cat isn't getting the calories needed, his body will start producing ketone bodies and throw off his electrolytes. Figure that you want to try to get at least 1.5 times the usual amount of food into your kitty.

When you have some time, please set up a spreadsheet. We are very numbers driven here so having information on what your cat's BG numbers look like will be helpful.

Please let us know how we can help.


 
Please let us know your geographic location.
Kansas City

When is the next shot due?
His shots are at 7:00 A.M/P.M CST

Do you have any data from the Prozinc/vetsulin time? Please get a spreadsheet going ASAP with any data you have accumulated, even if it’s just a few readings it’s valuable. Going forward the ss will be your guide.
Unfortunately, I don't. I hadn't found my way here in time to really get anything on my own, and the original vet was only doing spot-checks :(. Lesson hard-learned.

Are you monitoring for the presence of ketones in his urine or blood?
What's the best way to do this? Is there a best method to getting a stick into the stream? Last time I approached him while he was going, he bolted and left a trail of pee for my efforts. Also, how often should I be doing this?

You mentioned problems with him keeping food in his mouth while eating. Are there any dental issues?
His oral exam while he was under anesthesia during this visit didn't show any glaring issues. She theorized something may be uncovered during a cleaning, but was hesitant to delve much deeper given how fragile he currently appears to be.

Getting enough calories is very important. In general a kitty recovering from DKA should consume 1.5 times the calories required to maintain ideal weight.
I think this will be the crux of the issue. If he's having some sort of issue with absorbing nutrients from his food, then this will be tough to hit. Still awaiting that bloodwork, but is there something more calorie dense I can try to get in him in the interim? I know calorie boosters are largely sugary, unfortunately...

If you are mixing water into your cat's food and he needs a paste texture, consider using a blender or food processor
This is what i did this morning to some success. The concern here is I don't really have a strong grasp of how much he's eating at that point, then if I happen to mix too loosely he won't eat it. Is there anything that would thicken it back up?

Do you happen to know if there was any infection or inflammation present when your kitty was diagnosed with ketoacidosis?
We did xrays, ultrasounds, and a visual exam of his mouth and throat. The only inflammation noted was mild pancreatic inflammation. I don't know how that is usually measured, but to dumb it down for me she said that on a scale of 1-10, that inflammation was maybe a 3.
 
LokiL said:
When is the next shot due?
His shots are at 7:00 A.M/P.M CST
Click to expand...
Grab a test/reading now and and another 1/2 hour before shot time and post the results here. Edit your post header to indicate shot time is approaching and you need help.

4u is a sizable dose. The fact that we don’t have any BG history and his eating off must be taken into consideration.

What is the brand and flavor you are feeding?

Do you have Karo syrup or honey at home? If not pick some up on your way home. In case you encounter any unexpected low numbers (<50 on a human meter), or numbers start to drop dramatically it’s critical to have on hand to bring numbers up quickly.
edited to add- Lantus is a different animal than Prozinc and Vetsulin. It slow acting and it’s effects are cumulative. No need to have food on board before shooting. Folks here test, feed and shoot within a 10 minute window. Onset will likely be around 2 hours after shooting.

I’m going to be out when your shot time comes around but will try and check in.
 
Last edited:
Sandy and Black Kitty said:
Grab a test/reading now and and another 1/2 hour before shot time and post the results here. Edit your post header to indicate shot time is approaching and you need help
What is the brand and flavor you are feeding?
Do you have Karo syrup or honey at home? If not pick some up on your way home. In case you encounter any unexpected low numbers (<50 on a human meter), or numbers start to drop dramatically it’s critical to have on hand to bring numbers up quickly.
Click to expand...

The only vague history I have offhand is that during a stay with the original vet, she said he was hovering around 300s on curves of 3u Vetsulin. The specialist thought this may have been high, and scaled back to 2u Vetsulin, before moving back to 3u . She said she didn't like what she was seeing with Vetsulin, and gave me a Lantus pen to try. I'll ask if I can have the curves from each clinic.

Won't be able to grab a reading right now- still at work. Assuming the Libre is indeed functional/accurate, it should have plenty of passive readings waiting for me to pull out of it once I'm home.

They sent me home with samples of Hill's m/d, since that's what they fed him during his stay and said he was eating it well. This is the one that seems to have a bit of a problematic texture.

Yes to honey in the cabinets.
 
LokiL said:
Won't be able to grab a reading right now- still at work. Assuming the Libre is indeed functional/accurate, it should have plenty of passive readings waiting for me to pull out of it once I'm home.
Click to expand...
Though the readings from the Libre are useful we are less familiar with those. When you get home if you could grab a tes straight away that would be great, and then another test just before you shoot.
 
Gill & George said:
Though the readings from the Libre are useful we are less familiar with those. When you get home if you could grab a tes straight away that would be great, and then another test just before you shoot.
Click to expand...
Will do my best- this will be my first attempt at nabbing a reading myself. Typically, I get home, feed, then dose at 7 (usually 30 or so minutes post-meal, if I'm lucky...but he's being finnicky). Should the test be immediately once I'm home, or immediately pre-dose?
 
LokiL said:
Will do my best- this will be my first attempt at nabbing a reading myself. Typically, I get home, feed, then dose at 7 (usually 30 or so minutes post-meal, if I'm lucky...but he's being finnicky). Should the test be immediately once I'm home, or immediately pre-dose?
Click to expand...
With lantus you would test feed and shoot, all within 10 minutes or so. To give you an idea with George I would test, decide of the number was safe to shoot, put his food down and give him his shot while he still had his head in the bowl.

What we were asking was for you to get two tests, one at least an hour before the shot and then another just as you are preparing to shoot.

Having those two tests will give us an idea of which direction the BG is going and if it is lower than you expected it will give you more thinking time for a plan.
Will this be his first Lantus shot? Or have they been shooting Lantus at the ER?
 
Gill & George said:
With lantus you would test feed and shoot, all within 10 minutes or so. To give you an idea with George I would test, decide of the number was safe to shoot, put his food down and give him his shot while he still had his head in the bowl.
What we were asking was for you to get two tests, one at least an hour before the shot and then another just as you are preparing to shoot.
Having those two tests will give us an idea of which direction the BG is going and if it is lower than you expected it will give you more thinking time for a plan.
?
Click to expand...

Thank you for clarifying the Lantus protocol for me! I will see if I can get home in time to make this work (icy roads+rush hour, I likely won't have an hour before 7:00 rolls around).

Gill & George said:
Will this be his first Lantus shot? Or have they been shooting Lantus at the ER
Click to expand...

I believe he had at least 1 dose at the ER- I'm not certain, though, as they didn't include the injection(s) in my itemized bill as they donated this pen to me. Aside from that, I administered one last night and this morning. This would be dose 3 from me specifically.

As an aside: probably a really stupid question- when I was dosing Prozinc, I accidentally gave a furshot once and, after that, got into the habit of swiping the injection site with a finger to check for moisture. With both Vetsulin and Lantus, I've noticed that even if I don't feel any moisture, my finger does end up with that band-aid-esque "insulin-scent" on it. Is this normal? I tend to insert the needle fully, inject, wait 5-10 seconds, then slowly remove. Again, I feel no moisture, but the scent transferring to my finger makes me worry that I'm messing up somehow.
 
Lantus differs from prozinc and vetsulin in that it is a depot insulin, so progressive doses have a cumulative effect.
Part of the dose goes to work straight away and part of it gets stored for slower release, the store, or depot, as it's known takes time to fill, it's not untill it stills that you see the full effect of the dose
The depot can take up to 6cycles to fill, but for example with George I would start to see a change in BG after 3-4 cycles (shots) so with this being your 4th cycle at this dose we might start to see some downward movement.

Take care on those icy roads,
Even if you don't have a full hour grab a test, just to give yourself some wiggle room to decide.

There's no such thing as a stupid question. I never touch the injection sight I just put my nose to his fur. Is it possible your squeezing some insulin out of the injection site when you 'swipe' ? I remember reading it's not recommended to rub the injection site . Or perhaps your getting some on your finger when drawing the dose?
I can't see anything wrong with the way you describe your shooting technique.
 
LokiL said:
As far as the accuracy of the Libre, we actually sort of talked about that at one point. In her experience:
"the libre definitely reads high in the high range so anything above 350 is probably not really that high- it kind of shoots up exponentially. It’s really good in the low numbers, though, which is why I really like it for cases like this. "

I do have access to an AlphaTrak2, as well. I haven't had a chance/need to use it just yet, but I can certainly attempt to throw in some tests alongside the Libre
Click to expand...

I'm very happy to see this acknowledgement from your vet however it is not only high range numbers that may read high. With the other cat recently fitted with the Libre we saw a 60 point spread between it and a Relion Prime human meter at moderate range readings and up to a 40 point spread in normal range readings (105 on Libre vs 65 on Prime). Funny enough it was almost like the meter "learned" after a time in lower range and appeared to be more accurate on the graph as low BG readings got more regular.
Since no comparisons have been done, it's difficult to say how the Libre readings would compare to those from the AT2 meter but since pet meters typically read higher than human readers with the difference getting larger the higher the BG, it's possible that the stark differences we witnessed would not be as troubling.
 
Having 0 luck on drawing blood to get the measurement. Tried for 15 or so minutes before Loki was done tolerating me...not sure how to proceed here. I went ahead and pulled the Libre data so I wouldn't lose it (rolls over at 8 hours), but I'm coming up dry on the glucometer test :(
 
A few tips that may help you out with manual testing.
Make sure Loki's ear is warm. Some folks use a rice sock that they can warm quickly in the microwave or an old Rx pill bottle filled with hot water works too.
Put a tiny skim of Vaseline on the spot you intend to poke. It helps the blood to bead up instead of spreading out into the fur on their ears.
Hold a folded up tissue or cosmetic pad behind the ear to support it when testing. This also serves to protect your finger.
If you are using the lancing device, remove the cap. The device is designed for a fleshy finger not a flimsy ear. Other option is to use the lance free hand without the device.
Lightly massage Loki's ear from the base (head) up to the poke spot to encourage a bead of blood to appear.
Give Loki a low carb treat whether your testing is successful or not. This will teach him that testing comes with a reward and make him a good patient.
Last but not least, RELAX. We all worry about hurting our furry companions but they don't have many nerve endings in their ears and feel nothing compared to what we feel when we are poke a finger. If we are anxious our furry friends get nervous too. A "can do" attitude goes along way! ;)
 
majandra said:
Can you post a screenshot of the libre reading and graph?

Eta- if that's absolutely all you can get, it's better than shooting blind.
Click to expand...


This is his current Libre reading. Feeding time would have been between 6:15 and 7:00 with 4u dosed at 7:00 sharp.

1mD9Can.png


Thank you MrWorfMen'sMom! I tried most of those tips, but he just wasn't having it. He's now retreated into his "safe space" tower. Hopefully I didn't ruin his appetite!

H8gS7aK
 
Last edited:
LokiL said:
Having 0 luck on drawing blood to get the measurement. Tried for 15 or so minutes before Loki was done tolerating me...not sure how to proceed here. I went ahead and pulled the Libre data so I wouldn't lose it (rolls over at 8 hours), but I'm coming up dry on the glucometer test :(
Click to expand...

At first getting blood to come out can be tricky, it gets easier once the capillaries form in the ear.

Have you warmed his ears, if his ears arevwarm they bleed more easily. I use my hands (I have warm hands) rubbing by boys ears until they are warm, he seems to like this. Others fill a sock with rice and warm it in microwave,. Holding that to the ear.
 
LokiL said:
This is his current Libre reading. Feeding time would have been between 6:15 and 7:00 with 4u dosed at 7:00 sharp.

https://imgur.com/a/H8gS7aK

Thank you MrWorfMen'sMom! I tried most of those tips, but he just wasn't having it. He's now retreated into his "safe space" tower. Hopefully I didn't ruin his appetite!

H8gS7aK
Click to expand...
Thanks for posting that. Do you have data for the last couple of days? Or is this all you have?
 
Gill & George said:
At first getting blood to come out can be tricky, it gets easier once the capillaries form in the ear.

Have you warmed his ears, if his ears arevwarm they bleed more easily. I use my hands (I have warm hands) rubbing by boys ears until they are warm, he seems to like this. Others fill a sock with rice and warm it in microwave,. Holding that to the ear.
Click to expand...

Didn't try a rice sock. I did try to warm by rubbing with my hands, which he was eager for attention so that was simple enough. The actually lansing- no luck. Tried it both with the lancing device and just manually pricking him. Loki has snapped at me exactly once in his life- and that was when a vet tried to have me demonstrate this method.
 
Gill & George said:
Thanks for posting that. Do you have data for the last couple of days? Or is this all you have?
Click to expand...
All I've got for now. He was just fitted with it and released to me last night, and the device had a primer time of 12 hours, so this is all I've got for now
 
.....and i muffed the shot. I think this was a 100% fur shot- in and out the other side....:( So there goes this curve...

On the plus side, I now know what a Lantus fur shot smells like, and it wasn't what I described earlier.
 
We'll he's not too low, but my worry is that I don't know what hus BG has been the previous 2cycles.

You see a kitty can drop down into lower ranges, then their liver reacts, panics, if you like and dumps glucose into the bloodstream causing BG to rise. We call this a bounce. It can last for up to 6cycles. But for dosing purposes we largely ignore the bounce and look to the nadirs/lows my problem is that I don't know if his numbers are high or if this is a bounce.
With DKA in the mix it's important he gets enough insulin, so with the limited data I wouldn't want to reduce the dose that the specialist prescribed. However, being data driven I am nervous and would urge you to play close attention to his BG, looking for a sudden significant drop, if you see that you will need to monitor more closely.
With someone using a regular monitor if suggest checking at +2(hrs after shot) and then again at +4 or +6 depending on what the +2 looked like. I'm not sure how you can manage that with the libre.

Perhaps after you and Loki have had a rest you can have another go at the testing.heres a link to more tips for home testing including some picshttp://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
 
I've got to go to bed it's 2am and I'm up at 5.30 to shoot my kitty. I'm struggling to keep my eyes open.
Sandy should be round a little later, and some others who had their sleeves pulled.
 
For a +2 post shot test with the Libre, you can just move the sensor over the device installed and it will give you a reading and an arrow showing what direction the BG is going. The only question we haven't sorted out yet is whether the arrow is predictive or telling us the BG has gone up or down since last reading. If you could take a screen shot of that for follow up tests, it will at least provide us some data.
I'll be around for a few hours yet too, so you aren't alone. :)
 
MrWorfMen's Mom said:
For a +2 post shot test with the Libre, you can just move the sensor over the device installed and it will give you a reading and an arrow showing what direction the BG is going. The only question we haven't sorted out yet is whether the arrow is predictive or telling us the BG has gone up or down since last reading. If you could take a screen shot of that for follow up tests, it will at least provide us some data.
I'll be around for a few hours yet too, so you aren't alone. :)
Click to expand...

Thanks! I'm not sure how valuable it'll be since I miffed the shot, but I'll still grab the readings. Bummed out to miss that shot, because I actually got a good amount of food in him this time!

Also don't know what this specialist did, but this cat adores treatment now. Purrs when I inject him and lies down and purrs for sub-q fluids as well. Ear pokes are off the table for him though...of course.

On a related note, is there an optimal time to do sub-q fluids in relation to an insulin dose? I tried searching the forum a bit and don't see a *resounding* consensus. Obviously I won't want to use the same spot, but any worry that fluids would somehow dilute the dose? His only easily grabbable spots right now are his scruff and closer to the side of his chest. Flanks are pretty tight
 
PM+1 = 493 (Freestyle)
PM+2 = 500+ (Freestyle) 665 (AT2)

Freaking out a bit. Looks like Freestyle will list anything as over 500 as "500". AT2 showing REAL high right now. Help!
 
I've never done SQ fluids myself but I believe there could potentially be a effect if the SQ's are administered too close to giving the insulin shot. Hopefully someone with experience can chime in here. In the meantime, I am going to do a bit of searching for some information as I'm sure there was a thread about this not that long ago.

LokiL said:
Freaking out a bit. Looks like Freestyle will list anything as over 500 as "500". AT2 showing REAL high right now. Help
Click to expand...

No need to freak out. If you gave a fur shot, we can expect the BG to be high tonight. The Freestyle human meter will not read as high as the AT2 meter because of the different scale of BG used for each species. The difference you are seeing between the FS and AT2 is expected too. And the FS reading at +1 and +2 is essentially the same. Lantus onset starts around +2 so if some insulin got into Loki, then you might see some change around +4. Let's see what the +4 says.
 
It's Ok. :) As much as we all understand your angst, Loki is in no immediate danger so can you remove the 911 from your Title? We reserve 911 for immediate danger situations.
 
MrWorfMen's Mom said:
It's Ok. :) As much as we all understand your angst, Loki is in no immediate danger so can you remove the 911 from your Title? We reserve 911 for immediate danger situations.
Click to expand...

Sure thing- removed. Sorry- I'm still not knowledgeable enough to know what is an emergency and what's not. After the ER run visit, to say I'm anxious is an understatement. In my stress-addled head, anytime I see a high number I panic and think "what if we're not regulating him quick enough, what if ketosis again, what if the ER again, I can't afford this" and have a mental breakdown.
 
I understand completely. Any situation with our furry ones is stressful but dealing with this is even more over the top. Unfortunately, fur shots do happen to all of us and it's just not safe to give insulin again because we never know how much went in the cat and how much went into the cat's fur. In the meantime, making sure Loki is getting food and lots of fluids is all you can do. I know the numbers look high and this is scary, but Loki will be fine.
 
MrWorfMen's Mom said:
I understand completely. Any situation with our furry ones is stressful but dealing with this is even more over the top. Unfortunately, fur shots do happen to all of us and it's just not safe to give insulin again because we never know how much went in the cat and how much went into the cat's fur. In the meantime, making sure Loki is getting food and lots of fluids is all you can do. I know the numbers look high and this is scary, but Loki will be fine.
Click to expand...

He ate his entire dinner, and has a bowl of water and a fountain both available. In addition, i gave him probably ~75ml of subcutaneous fluids in the last couple hours, so I imagine that's about as hydrated as he can get. As far as food, are you implying I should make more available now, or simply to make sure he's eating a "normal" amount throughout the day?
 
Given the ketones, feeding him a bit more than his "normal" is probably a good idea. Diabetics can't adequately metabolize the food they eat so they need more food. Offer Loki whatever he will eat right now and don't worry about him getting too much. It's better for him to get more than less as that extra food intake will also help to ward off ketones.
 
MrWorfMen's Mom said:
Given the ketones, feeding him a bit more than his "normal" is probably a good idea. Diabetics can't adequately metabolize the food they eat so they need more food. Offer Loki whatever he will eat right now and don't worry about him getting too much. It's better for him to get more than less as that extra food intake will also help to ward off ketones.
Click to expand...

Gave him a snack after this- thank you. Little guy is tuckered out. Snuck a Libre scan just now and we're showing 453. Should I wake him up to go for another AT2? Wasn't sure how valuable it will be on a fur shot dose, or to just be satisfied with "we've started dropping."
 
I think since you are sure it was a fur shot, the Libre scan is more than sufficient. Looks like you did get some juice into the little guy and I'm sure you're feeling a bit better now. I'm signing off soon but there are usually folks from the west coast around for awhile and I'm guessing you'll be turning in fairly soon yourself. Loki should be fine but if you happen to be up and can grab another Libre scan later, all data is helpful. :)
 
MrWorfMen's Mom said:
I think since you are sure it was a fur shot, the Libre scan is more than sufficient. Looks like you did get some juice into the little guy and I'm sure you're feeling a bit better now. I'm signing off soon but there are usually folks from the west coast around for awhile and I'm guessing you'll be turning in fairly soon yourself. Loki should be fine but if you happen to be up and can grab another Libre scan later, all data is helpful. :)
Click to expand...

Thanks for hanging out with me and keeping me calm- I'm probably going to be a bit erratic until I'm a bit more used to this world. Off to bed here as well- goodnight, and thank you again!
 
LokiL said:
After the ER run visit, to say I'm anxious is an understatement. In my stress-addled head, anytime I see a high number I panic and think "what if we're not regulating him quick enough, what if ketosis again, what if the ER again, I can't afford this" and have a mental breakdown.
Click to expand...
Learning to care for a diabetic cat is not easy, and starting out with a very recent hospitalization for DKA in the picture ...is nothing short of an initiation by fire. Many of us have been through it. All of a sudden tons of information , instructions, recommendations and warnings come flying at you- at times contrary to the recommendations of your vet. It’s beyond nerve jangling.

One thing to be clear about is that crazy high numbers alone do not lead to the formation of ketones. Ketones can develop with numbers in the 200s. Every cat is different (ECID).

Your first line of defense is to closely monitor for ketones, testing a couple times per day. Testing will go a long way in reducing your anxiety.

Forewarned is Forearmed.

My BK did not mind my constantly stalking him at the litter box so I don’t have any advice to offer on that. Someone is bound to chime in with tips and tricks. However time is of the essence as ketones can develop to life threatening levels quickly. BKs ketone level went from negative to large in exactly 24 hours once. Needless to say a trip to the ER followed.

A special glucometer that gives blood ketone readings may be a better option for you. The strips are pricey however you only need to use them for your ketone testing.

MrWorfMen's Mom said:
Give Loki a low carb treat whether your testing is successful or not. This will teach him that testing comes with a reward and make him a good patient.
Click to expand...
It’s true. I never thought I would be able to test BK .but before long I would shake the treat jar and BK would come running to our testing spot.
LokiL said:
He ate his entire dinner,
Click to expand...
that is wonderful. You mentioned he lost a good deal of wieght. focus for now on restoration, which requires energy. That’s in part why extra calories are recommended.

It will be a balancing act for a while. Hang in there and hang in here :cool:

 
Hi, for the urine catching I tried the "form a trough of aluminum foil" and placed it in her usual pee corner; she just peed in another corner. May work for you; tape the edges to the Litter box.

She hated me chasing her to the box and trying to reach in with a teaspoon or whatever, because I had to touch her to get in there (also, long fur lol) but the teaspoon apparently works for some cats.

What works for Willow is keeping a tiny glass bowl beside the litter and sticking around watching so when I see her start towards the litter, I beat her there. That way when she steps in I'm already holding the glass bowl low in the litter box, and as she gets in position I just reposition the bowl under her. Just the "not having to reach in and around her" seems to make a big difference for her.

Hope this helps, with love, nikki
 
Instead of aluminum foil, you could try putting some plastic wrap in the LB where kitty usually pees. My cats HATE the sound of aluminum foil when I crinkle it in the kitchen so I'd be afraid putting it into the LB could cause some LB avoidance.
 
Good morning!

I got very little sleep last night with Loki trying to wake me up all night to feed him- which I'm oddly happy to be so dead tired because this is closer to my Loki than the one from a week ago. No manual glucose measurement captured this morning- I hadn't reset my alarm early enough to account for the ensuing struggle (he was docile when I got his reading last night, this morning was sheer excitement that it was breakfast and he wasn't holding still for anything).

Something I did realize last night that I wish I hadn't overlooked- the Libre Freestyle reader has a built in FreeStyle Precision Neo meter as well...so there was 0 need to try to keep track of a separate device (AlphaTrak2, in my case). Just a little nugget of info if you stumble upon anyone else trying to use one!

Hopefully this weekend will be a bit smoother and we can build some trust around ear pokes- for now I'm just trying to count my blessings that he ate all his meds and his blended up food.

As far as the aluminum foil/plastic wrap ideas, I'm assuming you just dig a little trough and line it- no trying to mask it with litter? I feel like this is likely my best shot, but Loki also likes to throw his litter around before and after going
 
Good morning. Sorry you didn't get much sleep but Loki being a bit demanding is a good sign. If you don't leave food out for him at night, you might want to consider doing so, not only so you can get some uninterrupted sleep but also so Loki gets some extra calories even when his kitchen staff are not on call! :D

With the plastic wrap, folks will kind of crumple it and lay it in the box hoping to catch a few drops of urine. You don't need much. With a super digger, this could be problematic but even if you find a wet spot in the litter itself or even if litter has been kicked onto the plastic wrap, you might be able to find a spot with some urine that has not yet soaked into the litter and can use that.

Interesting to know there is a meter within the Libre reader. When I was reviewing the information online, it sounded like there might be a meter included but there was no instruction manual online to know how to access it. Glad you found it. I guess it would track manually taken readings as well as those from the sensor.
 
Alright- good advice for the urine capturing. I'll give that a whirl tonight/over the weekend!

As far as snacking- I can certainly try to sneak some food in there for him to discover overnight, but he watched me like a hawk with his food bowl and sauntered in anytime he even thought I was going to put something in it and would eat it right away. Despite trying to wake me up, he still had some of the "crumbles" that didn't get blended into his food well enough in his bowl. He just won't eat them, apparently- no matter how hungry he is. I gave him a couple small treats to make sure he wasn't just having issues with solids in general, and he ate those with no issue ¯\_(ツ)_/¯

On another aside, he did poop for me! He hadn't gone since coming home with me on Wednesday (though they did fully clear him out Tuesday night/Wednesday morning), and he went overnight and again after breakfast. Not the biggest movements, and not the most well formed, but the texture was closer to normal (was more like dark brown clay before- this was closer to a thin light brown membrane of playdough and soft in the center. Going to sound odd, but his movements had been so large that I frankly don't know what size they *should be*, hah! I figure some movement is, at a minimum, better than none.
 
You must log in or register to reply here.
Back
Top