4/27 Alice PM vomiting / AMPS 231, +2 488, HI all day

AliceMeowliss (GA)

Member Since 2019
http://www.felinediabetes.com/FDMB/threads/4-26-alice-amps-335-1-25-291.213752/

I'm behind and still can't update my SS (sigh!!!) So here are the past few cycles since FS.

4/23
PM FS*
PS 268
+2 473

4/24
Cycle 1 4u
AMPS 446
+2 313
+7.5 199

Cycle 2 4u
PMPS 327
+2 308
+4.5 212
Ketones trace

4/25
Cycle 3 4u
AMPS 201
+2 HI/491

Cycle 4 4u
PMPS 486
+2 252
+4 243
+10.75 193

4/26
Cycle 5 4u
AMPS 335
+1.25 291
+7.66 193

Cycle 6 4u
PMPS 315
+2.33 219

4/27
Cycle 7 4u
AMPS 231
+2 488
Ketones trace
 
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I know it's awkward to look at it that way. I'm having to keep paper notes and I'm not the only one testing her now so some times aren't as "neat" as I, personally, would like. But catching up on sleep is crucial, too, and I have slowly been able to work in more of that. :)

I think she is looking rather perked. :)
20190427_113004.jpg
 
http://www.felinediabetes.com/FDMB/threads/4-26-alice-amps-335-1-25-291.213752/

I'm behind and still can't update my SS (sigh!!!) So here are the past few cycles since FS.

4/23
PM FS*
PS 268
+2 473

4/24
Cycle 1 4u
AMPS 446
+2 313
+7.5 199

Cycle 2 4u
PMPS 327
+2 308
+4.5 212
Ketones trace

4/25
Cycle 3 4u
AMPS 201
+2 HI/491

Cycle 4 4u
PMPS 486
+2 252
+4 243
+10.75 193

4/26
Cycle 5 4u
AMPS 335
+1.25 291
+7.66 193

Cycle 6 4u
PMPS 315
+2.33 219

4/27
Cycle 7 4u
AMPS 231
+2 488
Ketones trace
Maybe if @Ti-Mousse had time she could help you with SS... She’s a pro :cool:
 
Makes me sad to hear...
does she have any fave treats? Do you know Churu? When Nelli is not acting like she’s feelin too good, isn’t interested in her meal, I’ll dress it with Churu... it’s like kitty crack :cat:. YUMMY MOMMY, THANKS!
 
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Oh she also had a small bit of liquid poop. The rest of the bowel movements she had while I was gone were solid and decent-looking for her.

Going to do a +1 in a few min.

So I'm concerned about her possible ketones but of course I have to be lucky to catch a sample. Her polyuria seemed intense today but of course she was HI. Really visually sticky urine in the box. But that doesn't mean she is necessarily well hydrated.

Sigh. Weight was 2.3kg which is only slightly lower than her average low lately....
 
She's vomiting.

Or she did just a few minutes ago. Everything she ate.

I have mirtazapine and cerenia (??)...

Or since DKA th is month would a ER trip be needed?

I'm very concerned. :( Alarmed.
 
In the past 6 minutes she has suddenly improved some. +1.75

I offered her a purina dm kibble just to see if she would consider it. She purred. She's licked and nibbled the wet food and is weak but periodically getting up to drink a lot.
 
If she's been on 4U for 8 cycles (with no furshots), it's time to go up to 4.25U

If you have cerenia and she's still acting nauseous, go ahead and give it to her. As for mirtazapine, that's an appetite stimulation drug....if you're sick to your stomach, the last thing you want is to have to feel like you also need to eat, so it's important to get the nausea under control first.

@Ti-Mousse won't be able to help if she isn't approved to access your spreadsheet. If @Marje and Gracie set it up for you, she'll be the only one who can help put the numbers in.
 
How is Alice right now? And correct me if I'm wrong, but ketones are still trace?

I'd be testing ketones every time she pees now because of the vomiting and not to alarm you, but anything above trace is ER time.

In the future, I would see if you can get a bag of sub q fluids to give to Alice to help with flushing out ketones. For now, like @Chris & China (GA) suggested, give cerenia if you're able.
 
I agree that she needs more insulin and an increase to 4.25u is warranted.

I’m concerned with her not eating, the vomiting, and the sudden really high numbers. Trace ketones can rapidly increase. If she was eating a lot of calories, I’d be less concerned. If you can’t get a lot of calories in her as well as water and you can’t keep an eye on the ketones because she won’t let you catch a sample it might be worthwhile to have a vet look at her.

SS is working fine and I’ve updated it so I’m not sure why you can’t enter numbers. You’re doing a great job of testing!
 
I agree with Crista. Your priorities are ketone testing, getting her to eat, preferably liquid food to help flush ketones.

Thanks @Marje and Gracie on the spreadsheet.

Last night she had a big drop from PMPS to your +2.33 test. In all likelihood she hit blues last night, but there was no further testing. When you see a big drop between preshot and +2 or 2,5, you should try getting another test in that cycle. Last night was also the sixth cycle after the furshot, and the depot was full, a time when you might see action. Today she is bouncing again.
 
I'm a little scattered right now so thank you for all the responses, a lot to go through individually right now.

I will give her the Cerenia if still warranted?
 
I agree with Crista. Your priorities are ketone testing, getting her to eat, preferably liquid food to help flush ketones.

Thanks @Marje and Gracie on the spreadsheet.

Last night she had a big drop from PMPS to your +2.33 test. In all likelihood she hit blues last night, but there was no further testing. When you see a big drop between preshot and +2 or 2,5, you should try getting another test in that cycle. Last night was also the sixth cycle after the furshot, and the depot was full, a time when you might see action. Today she is bouncing again.
I looked at that testing gap later and thought "d'oh!"

How much is considered a big drop? 100? 150? Or a percentage? I'm still not sure how to judge.

When she gets into the blues it seems to trigger a bounce as far as I can tell, right now.
 
I feel bad because I didn't mean to disappear for a bit and have everyone worry. My phone is completely broken and the one I have to borrow is slightly broken and difficult plus I'm borrowing it at all...

Thank you all for caring. We appreciate it very much! :)

I fed her more by hand (wet pate on my bare hands, it's love lol) then made more with water and she knows when the water runs it's me getting her a dish, so she perked up and got up to wait for it.

She scared me. DKA scared me this month. I've been an anxiety ball today. She usually doesn't act quite so ill from her HI days.

*ketones: I will check when I catch a sample and I will update but they were trace earlier today. Not that that says anything about now.

I'll test at +5/6ish.
 
Thanks for updating us, Cassandra. I’m sorry Alice isn’t feeling well and your phone is acting up. Don’t feel bad about making us worry though!

Hope Alice’s next tests, both blood and urine, are good. I’m glad she’s eating. Keep it up!

I’d go find out if you can get some fluids from the vet or pharmacy. Have you ever given sub q fluids before?
 
Thanks for updating us, Cassandra. I’m sorry Alice isn’t feeling well and your phone is acting up. Don’t feel bad about making us worry though!

Hope Alice’s next tests, both blood and urine, are good. I’m glad she’s eating. Keep it up!

I’d go find out if you can get some fluids from the vet or pharmacy. Have you ever given sub q fluids before?
I have not yet. It scares me more tha the rest and I'm not fully clear how to know when to even do it. My vet did show me. But I need the supplies and don't have $$ at the moment. I'll see if a nurse friend has some saline bags etc. :)
 
Yay for nurse friend! Hope she has something to give. For now, adding extra water to her food will help if you can’t quite do fluids.

I would ask your vet how often and how much fluids to give. Typically it’ll be around 100-150 mL per week or as needed. It’s important to make sure Alice’s heart can take it as well so check with the vet about that too but since he showed you, I’m assuming she’s cleared for that. Too much fluid can make heart issues worse.

I give Ming 100 mL of fluids when he’s high just to flush out ketones in case. Some cat’s BSL can go drop when given fluids as well so I would observe Alice’s BG if you do give fluids in the future.
 
I have not yet. It scares me more tha the rest and I'm not fully clear how to know when to even do it. My vet did show me. But I need the supplies and don't have $$ at the moment. I'll see if a nurse friend has some saline bags etc. :)
You have to be careful which subq fluids you use with DKA because different ones have different electrolytes. You should ask your vet if Saline, Normosol, or Lactated Ringers is best for her. Normosol often stings.

Here is a video my DH and I did to teach members how to do subq fluids at home. I’m glad she’s doing a bit better.
 
Yay for nurse friend! Hope she has something to give. For now, adding extra water to her food will help if you can’t quite do fluids.

I would ask your vet how often and how much fluids to give. Typically it’ll be around 100-150 mL per week or as needed. It’s important to make sure Alice’s heart can take it as well so check with the vet about that too but since he showed you, I’m assuming she’s cleared for that. Too much fluid can make heart issues worse.

I give Ming 100 mL of fluids when he’s high just to flush out ketones in case. Some cat’s BSL can go drop when given fluids as well so I would observe Alice’s BG if you do give fluids in the future.

Thank you, that was all informative and helpful! :)

I typically mix water in with her food but there's a weird perfect ratio or she doesn't like it. Lol.
 
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