Trinity crashed. BG 51

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Angie Haynie

Angie Haynie

Member Since 2019
Trin crashed with BG of 51. No external signs. Gave honey and syringe fed gravy food. That was at 5+, tested again, and now going to test again and update sheet.
The only thing I did different was apply trans dermal mirtazapine to her ear today

Please see her spreadsheet for more details. I’m supposed to have an appt. tonight but don’t know whether to keep testing hourly or if now that her number is going up wait til 10pm when I usually test, feed and shoot.
 
Angie Haynie said:
Trin crashed with BG of 51. No external signs. Gave honey and syringe fed gravy food. That was at 5+, tested again, and now going to test again and update sheet.
The only thing I did different was apply trans dermal mirtazapine to her ear today

Please see her spreadsheet for more details. I’m supposed to have an appt. tonight but don’t know whether to keep testing hourly or if now that her number is going up wait til 10pm when I usually test, feed and shoot.
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I started talking about this on another post but don’t know how to post a link to that thread.
 
Basic principles here:

1) when low, give some carb-y food and test every 30 mins until she is coming up
2) once she starts to come up, hold off on more food but keep testing
3) two safe numbers without food influence in a row, you can back off on testing, but keep an eye on her

There are some more details to all of this that we can fill you in on when the dust settles, but that's the basic strategy. We usually use 50 as the "take action" number on a human meter, but I think you were wise to go for it at 51, given how new Trinity is to all of this.
 
Nan & Amber said:
Basic principles here:

1) when low, give some carb-y food and test every 30 mins until she is coming up
2) once she starts to come up, hold off on more food but keep testing
3) two safe numbers without food influence in a row, you can back off on testing, but keep an eye on her

There are some more details to all of this that we can fill you in on when the dust settles, but that's the basic strategy. We usually use 50 as the "take action" number on a human meter, but I think you were wise to go for it at 51, given how new Trinity is to all of this.
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Thank you so much for this basic info. I took a picture for future reference. (I do everything on iPhone)
 
Only rose to 89. Is she safe? If she is above 200 at 10 pm (7 pm now) should I shoot 1 unit or decrease to 1/2 unit?
I usually go to bed an hour after her pm shot....
 
She looks good, but I'd get one more test without food influence just to be certain.

I will tag @MrWorfMen's Mom again about the dose tonight (I haven't been getting some tags, so she might have missed the earlier one). I haven't used ProZinc.
 
I got the tag but had stepped out for a quick shop when the first tag came so just seeing it now along with the 2nd one. :)

Well that was indeed a surprise. Great job looking after Trinity. So glad Nan was here to help.:bighug::bighug:

For tonight I would reduce dose to 0.75u if BG is over 200. If PMPS is lower but still over 150, I'd reduce to 0.50u. If it's under 150, I'd skip.

Not sure if you fed Trinity when you got that reading of 70 but in future, if you get a number under 90, give Trinity a snack of low carb food to keep her surfing right around that level. Retest just as you did and try to steer her with food to keep numbers from falling down quite so low. That said, Trinity was still safe but right on the edge of safe.

Chances are Trinity will bounce and end up with higher BG tonight and possibly for a few cycles to come. This is normal and just a normal defense response as a result of those lower numbers today that Trinity has become unaccustomed to.

Dose going forward from tomorrow will be 0.75u provided pre-shot is high enough to shoot because Trinity earned a reduction for dropping below 90 today.
 
MrWorfMen's Mom said:
I got the tag but had stepped out for a quick shop when the first tag came so just seeing it now along with the 2nd one. :)

Well that was indeed a surprise. Great job looking after Trinity. So glad Nan was here to help.:bighug::bighug:

For tonight I would reduce dose to 0.75u if BG is over 200. If PMPS is lower but still over 150, I'd reduce to 0.50u. If it's under 150, I'd skip.

Not sure if you fed Trinity when you got that reading of 70 but in future, if you get a number under 90, give Trinity a snack of low carb food to keep her surfing right around that level. Retest just as you did and try to steer her with food to keep numbers from falling down quite so low. That said, Trinity was still safe but right on the edge of safe.

Chances are Trinity will bounce and end up with higher BG tonight and possibly for a few cycles to come. This is normal and just a normal defense response as a result of those lower numbers today that Trinity has become unaccustomed to.

Dose going forward from tomorrow will be 0.75u provided pre-shot is high enough to shoot because Trinity earned a reduction for dropping below 90 today.
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Thank you for the detailed response. I appreciate it greatly! I did give honey and syringe feed 15 ml of puréed gravy food when I saw the 51 number. Also thanks for telling me what to expect.
 
It would be a good idea to make it a habit to check BG at least once on the night cycle given today's event. Grab a test every night before bed. It can provide clues that BG is going to drop a lot if BG is the same or lower than PMPS. Particularly important when BG at pre-shot isn't particularly high. ;)
 
Getting night tests is at top of my list. Other than being ill, my dr schedule has been nuts and I’m grabbing all the sleep I can.
That being said, Trin has stopped sleeping in my room and no longer comes when I call her. She hates having her ears pricked and it’s breaking my heart. Also her current dose doesn’t appear high enough as she’s staying in the 400s even 5 days after having BG of 51.
I give pets, treats, kisses as I test her ear. I alternate ears. I use neosporin ointment with pain relief... help I want my baby back in my room.
Shooting for night numbers tomorrow, then perhaps the group can advise me on a new Prozinc dose. @MrWorfMen's Mom
@Nan & Amber
 
:(

She may just be feeling yucky in those high numbers. Hopefully Linda can help advise on dose to get that more under control.

Are you hitting the ear vein? That can be painful, so we try to aim for the edge of the ear instead (even though it takes longer to get blood from there). Are you applying pressure to the poke sites after getting the blood drop? That not only stops bleeding, it prevents bruising and soreness.

If she really just hates having her ears poked, there's another possibility-- paw pad. With the caveat that only a small percentage of cats will even let you try that in the first place! But for some caregivers, it's a better option. You'll definitely have to use the smaller gauge (26 or 28) lancets if you want to try.
 
Nan & Amber said:
:(

She may just be feeling yucky in those high numbers. Hopefully Linda can help advise on dose to get that more under control.

Are you hitting the ear vein? That can be painful, so we try to aim for the edge of the ear instead (even though it takes longer to get blood from there). Are you applying pressure to the poke sites after getting the blood drop? That not only stops bleeding, it prevents bruising and soreness.

If she really just hates having her ears poked, there's another possibility-- paw pad. With the caveat that only a small percentage of cats will even let you try that in the first place! But for some caregivers, it's a better option. You'll definitely have to use the smaller gauge (26 or 28) lancets if you want to try.
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I aim for edge of ear, she is in habit of yanking her head away and the needle tearing a tiny piece of outer ear. I do hold pressure. Usually 30 seconds. Should I hold it longer? She allows me to trim her nails...grudgingly. I can try the . I read somewhere that it’s best to prick the side of the toe bean? Is that right? I use 26g lancets right now.
Also still being syringe fed 3/day. Total 90ml.
With her sugar this high she pees in one of the cat beds. . Will be glad to get more regulated.
 
Angie Haynie said:
I do hold pressure. Usually 30 seconds. Should I hold it longer?
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That should be more than enough. Sounds like she just plain doesn't like getting poked, argh. Most cats will eventually just put up with it, but I don't know how long it will take...

Angie Haynie said:
I read somewhere that it’s best to prick the side of the toe bean? Is that right?
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Good question-- I don't know, as my cat is definitely not one of the ones who will allow paw pad testing, and I have no personal experience with it. I know I've seen at least one youtube video where they just went straight in on the bottom of the pad (and got a lot of blood, yikes!), but I think there might be some concerns with infection poking on the walking surface. So doing it on the side makes sense from that perspective, I just can't say how well it works to do one way vs. the other.

I hope you can get her better regulated soon, too! Peeing on a cat bed is terrible to have to deal with any time, but especially when you are sick! Have you tried offering her something like puppy pads to see if she'll use those? I've recently started using them for the area around the litter boxes, as one of my kitties is elderly and sometimes forgets that not just her feet, but also (and especially) her butt has to be inside the litter box when peeing :confused:. They work pretty well-- not the cheapest option if she uses them daily, but a lot less work than dealing with peed-on fabrics you hope to rescue.
 
Nan & Amber said:
That should be more than enough. Sounds like she just plain doesn't like getting poked, argh. Most cats will eventually just put up with it, but I don't know how long it will take...



Good question-- I don't know, as my cat is definitely not one of the ones who will allow paw pad testing, and I have no personal experience with it. I know I've seen at least one youtube video where they just went straight in on the bottom of the pad (and got a lot of blood, yikes!), but I think there might be some concerns with infection poking on the walking surface. So doing it on the side makes sense from that perspective, I just can't say how well it works to do one way vs. the other.

I hope you can get her better regulated soon, too! Peeing on a cat bed is terrible to have to deal with any time, but especially when you are sick! Have you tried offering her something like puppy pads to see if she'll use those? I've recently started using them for the area around the litter boxes, as one of my kitties is elderly and sometimes forgets that not just her feet, but also (and especially) her butt has to be inside the litter box when peeing :confused:. They work pretty well-- not the cheapest option if she uses them daily, but a lot less work than dealing with peed-on fabrics you hope to rescue.
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A friend that works in a nursing home gave me the puppy pad idea. I line the cat bed she prefers with that then lay a hand towel over it. Makes for easier cleanup and she has reduced from peeing 4/day to once a day. Thank heavens she prefers one bed now, at first she was going in every bed.
Weird question: how do you get your emojis to show. I type everything from my iPhone and all emojis show up as blank spaces...
 
Are you using the FDMB emojis (accessible by clicking the smiley on the bar at the top of the reply screen), or the ones on the iPhone keyboard? I don't have any special tips if that's not the problem-- I have never tried using the forum from a phone so I don't know the quirks.
 
Is Trinity too weak to go to the litter box or having trouble getting into the litter box? Does she even try to go to the litter box? Have you had her checked for a urinary tract infection? I am also concerned about the fact that you are still having to syringe feed her. Will she eat some of the Purina dry on her own? Is she still getting the Purina dry at all? Does she eat any wet food on her own? If her appetite is a problem, then the vet could give her an appetite stimulant to help. Peeing in her bed suggests to me, there is something more going on that needs to be checked out by the vet.

I would definitely recommend checking Trinity for ketones given how high her BG is although if she's peeing in her bed, not sure how you'd check. Perhaps a trip to the vet to check for ketones should be considered too.

While it certainly looks like Trinity needs her dose increased, without having a clue what she is doing at night, and knowing how low she went on the 13th, I'm a bit reluctant to suggest you increase again. I know getting night tests can be difficult and more so if you are not feeling well but they really would help to determine how best to proceed.
 
Trinity is not weak. She gets in her box to pee sometimes and to poo. She walks around and jumps up and down off the bed. I have seen her eating a little kibble (purina dm) but not enough to sustain her. Have tried giving her wet on my finger and in a bowel-she won’t touch it. She also drinks a little, at vet’s suggestion I also do 100ml SubQ fluids each day. She weighs between 9 and 10 pounds.

She loves being syringe fed. Loves the extra attention, the vet thinks the peeing out of the box is due to our newer kittens. We went from 3 to 8 cats this year.
No UTI. She had one a month or more ago and cleared it up. Her urinalysis is perfect. She has been peeing in the bed over a month. At this point vet thinks it’s behavioral and I think it could be because her BG is so high.

She has been on Mirtazapine transdermal for 4 days now. I will check for ketones, I bought a blood ketone tester.
Am going to do my best to get night readings tonight. It doesn’t help that I give her shot immediately before going to bed. Will just need to set a few alarms.
 
Nan & Amber said:
Are you using the FDMB emojis (accessible by clicking the smiley on the bar at the top of the reply screen), or the ones on the iPhone keyboard? I don't have any special tips if that's not the problem-- I have never tried using the forum from a phone so I don't know the quirks.
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:kiss: Found the FDMB ones. The ones on iPhone keyboard show up as blank spaces. :arghh:
 
It sounds like Trinity may be experiencing some stress from the new additions in your home and that too could be playing into those higher BGs. Has the vet suggested trying some medication for the suspected behavioural issues?
The ketone meter is a great idea and will help keep Trinity safe.
 
Trinity’s ketone meter (Blood) says .9. I have done two night tests, which were tough as I stayed awake 2 hours after waking to test. I know her dosage of prozinc needs to go up. Not sure if I need to do anything about ketones... please advise. @MrWorfMen's Mom @Nan & Amber
 
I have never used a blood ketone meter, but my understanding is that 0.9 is fine-- it's only a problem if you get above 2 or so. Is there a guide that came with the meter you have that could clarify?
 
Nan & Amber said:
I have never used a blood ketone meter, but my understanding is that 0.9 is fine-- it's only a problem if you get above 2 or so. Is there a guide that came with the meter you have that could clarify?
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It said .1 to 1.5 in human means to monitor closely... Not sure what that means for cats. She isn’t showing any signs of being ill. Also, my vet is aware of new kittens and her stress but only recommended Feliway diffuser in the bedroom where she stays the most and I have that.
 
Angie Haynie said:
It said .1 to 1.5 in human means to monitor closely... Not sure what that means for cats. She isn’t showing any signs of being ill. Also, my vet is aware of new kittens and her stress but only recommended Feliway diffuser in the bedroom where she stays the most and I have that.
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To be urgent in humans it must be above 6, I think.
 
From Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters (in the Health Links forum)


When do ketones show up on a blood ketone meter such as the Nova Max Plus or Precision Xtra Blood & Ketone meters?

The latest published research/studies in cats indicate ketones will begin to show up at readings of 2.4 and 2.55 on a blood ketone meter:


Then there are a couple of linked pdfs with the details (hard to copy-paste here, but the whole forum article is worth reading through if you haven't already).

I suspect that what this means is that the human .1-1.5 range where you are supposed to monitor closely starts at 2.4 or so for a cat (with the difference attributable to the different blood chemistry). Unless your meter works very differently from others, I don't think I'd be too worried about the 0.9 reading.
 
Cat blood and human blood are different and the human guidelines for using the ketone meter do not apply. Any reading 2.4 or above is cause for an immediate vet consult on the ketone meter. If you are seeing ketones above 2.0 you need to step up monitoring, get lots of fluids into Trinity and make sure she is eating plenty and getting insulin. Given the history here, a phone call to the vet for any reading over 2 would be advisable.

I'd increase the insulin dose to 1u and get mid cycle tests and before bed tests to see how that dose is working. Hold the dose for 3 days barring any lows that warrant a change/skipped shot then re-evaluate. You've held the 0.75u dose for long enough and may be seeing some glucose toxicity at the moment which may require more than one dose increase to get past.
 
MrWorfMen's Mom said:
Cat blood and human blood are different and the human guidelines for using the ketone meter do not apply. Any reading 2.4 or above is cause for an immediate vet consult on the ketone meter. If you are seeing ketones above 2.0 you need to step up monitoring, get lots of fluids into Trinity and make sure she is eating plenty and getting insulin. Given the history here, a phone call to the vet for any reading over 2 would be advisable.

I'd increase the insulin dose to 1u and get mid cycle tests and before bed tests to see how that dose is working. Hold the dose for 3 days barring any lows that warrant a change/skipped shot then re-evaluate. You've held the 0.75u dose for long enough and may be seeing some glucose toxicity at the moment which may require more than one dose increase to get past.
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I will increase to 1u. Can’t get mid cycle tests on Monday or Wednesday because out of town dr appointments. All other days I will.
Thank you for the clarification on ketones. I will definitely call vet if I see above 2.0. Trin does get 100ml SubQ daily and she nibbles but is sustained by syringe feeding.
 
Trini
Angie Haynie said:
I will increase to 1u. Can’t get mid cycle tests on Monday or Wednesday because out of town dr appointments. All other days I will.
Thank you for the clarification on ketones. I will definitely call vet if I see above 2.0. Trin does get 100ml SubQ daily and she nibbles but is sustained by syringe feeding.
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is grazing on her purina dm kibble. Her number tonight is over 500 and nothing else has changed. She is walking around my bedroom yowling. What do I do?
 
The fact that Trinity is eating on her own is a good thing. Eating the DM dry food however is no doubt driving her BG up. It's too high in carbs. Have you considered trying either Young Again or Dr. Elseys Clean Protein kibble if that is all Trinity will eat on her own? Could she be yowling because she is hungry?

It looks like BG went down nicely mid cycle today and she could be bouncing a bit too causing that high PMPS. I'd give the 1u dose another day and then re-evaluate. Have you checked her for ketones at all lately?
 
MrWorfMen's Mom said:
The fact that Trinity is eating on her own is a good thing. Eating the DM dry food however is no doubt driving her BG up. It's too high in carbs. Have you considered trying either Young Again or Dr. Elseys Clean Protein kibble if that is all Trinity will eat on her own? Could she be yowling because she is hungry?

It looks like BG went down nicely mid cycle today and she could be bouncing a bit too causing that high PMPS. I'd give the 1u dose another day and then re-evaluate. Have you checked her for ketones at all lately?
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Yes, I used a blood ketone meter yesterday and she was at .9. So she’s safe unless she reaches 2. Then I need to call the vet. How often should I test for ketones? Given her high numbers...
I have some dr elseys clean protein but she isn’t eating any of it. Dm is 6% carbs. Right now I just want her to eat on her own again. Need to order a sample of young again. Should have time Thursday.
 
I agree she has to eat and if all she will eat on her own is the DM dry that's fine but then her insulin is going to have to be increased to deal with the extra carbs. One of the wet DM foods is 6% but the dry is 18%. There are other non prescription dry foods that are around 14/15% carbs....not great but still better than the DM if she doesn't like the Young Again.
With her numbers still running high, I'd test for ketones at minimum every couple of days...preferably daily.
 
MrWorfMen's Mom said:
I agree she has to eat and if all she will eat on her own is the DM dry that's fine but then her insulin is going to have to be increased to deal with the extra carbs. One of the wet DM foods is 6% but the dry is 18%. There are other non prescription dry foods that are around 14/15% carbs....not great but still better than the DM if she doesn't like the Young Again.
With her numbers still running high, I'd test for ketones at minimum every couple of days...preferably daily.
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Tested for ketones today. Blood meter says .4. She has a stopped up nose but vet said no infection. Showed vet her spreadsheet and she told me Trin had lost 1/2 pound in 4 weeks. Advised me to increase Prozinc to 1.5u in am and 1u in pm. She believes Trinity’s malaise etc is due to blood sugar consistently over 300.
I feel dosage increase is needed and this is a good small step. How do you feel @MrWorfMen's Mom? I have more details on my sheet. Please note day tests were missed on Monday and Wednesday of this week as I was at out of town doctor appointments.
 
Personally, I agree with a dose increase but I would increase to 1.25u twice daily rather than giving different doses morning and night. Consistent dosing usually works better and also gives you a clearer picture of what is going on with the BG readings. I also agree Trinity will feel better when her numbers come down some. Do you have half unit markings on your syringes?
 
MrWorfMen's Mom said:
Personally, I agree with a dose increase but I would increase to 1.25u twice daily rather than giving different doses morning and night. Consistent dosing usually works better and also gives you a clearer picture of what is going on with the BG readings. I also agree Trinity will feel better when her numbers come down some. Do you have half unit markings on your syringes?
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I bought some u40 syringes with half unit marking but I swear they are harder to read than my max dose 10 unit syringes. I think I need double reading glasses . I see your point... if I do it your way, which I agree is better, I will still have to increase again pretty fast like in 2-3 days. As she used to need 2u when she ate dm kibble regularly. She isn’t to that point yet and don’t know if she will be. Doc thinks I will be lucky to have her til Christmas. She is frail.
 
If you can get her BG down her appetite and weight will improve. I think vets can sometimes be very pessimistic. We've seen some pretty remarkable turnarounds here.

I know the syringes are hard to see but a magnifying glass can help. The other thing to consider is to get U100 syringes at the pharmacy if you can get them without a prescription in Virginia. That was you can finesse doses more using the lines on the syringe. You need our conversion table to do that but it's very easy.

Whether Trinity is going to need 2u again or not is unknown. She needs what she needs but without the dry food if she was getting better numbers with 2u while eating the dry, then I guess something in between 1u and 2u would likely be the magic dose.
 
MrWorfMen's Mom said:
If you can get her BG down her appetite and weight will improve. I think vets can sometimes be very pessimistic. We've seen some pretty remarkable turnarounds here.

I know the syringes are hard to see but a magnifying glass can help. The other thing to consider is to get U100 syringes at the pharmacy if you can get them without a prescription in Virginia. That was you can finesse doses more using the lines on the syringe. You need our conversion table to do that but it's very easy.

Whether Trinity is going to need 2u again or not is unknown. She needs what she needs but without the dry food if she was getting better numbers with 2u while eating the dry, then I guess something in between 1u and 2u would likely be the magic dose.
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Just gave 1.25. Usually I go to bed immediately after, tonight I’m sitting up til 11pm to get a test.
Remember I mentioned she was crying in a strange tone and I wasn’t sure why.... I might have figured it out. She drank from the fountain, then cried a bit. I think it’s because she can’t quench her thirst or satiate her hunger because of the high BG.
Thank you for all the support you give me on an almost daily basis. It’s easy to get confused and discouraged. You and this group help me stay sane and positive.
 
My old guy who is not diabetic yowls every time he goes to his favourite water bowl. It's almost like he's announcing himself. If his favourite bowl starts getting low, (I have 3 around the house) he lets me know pronto with even louder meows. Maybe Trinity is doing something similar. :)
 
MrWorfMen's Mom said:
My old guy who is not diabetic yowls every time he goes to his favourite water bowl. It's almost like he's announcing himself. If his favourite bowl starts getting low, (I have 3 around the house) he lets me know pronto with even louder meows. Maybe Trinity is doing something similar. :)
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Ok. Trinity is crying because of major UTI. I got past me til yesterday when she was incontinent twice as I held her then as I tried to go to bed she ran from litter box to her bed straining to pee in each spot and unable to do so.
No vet open til Monday. Have Clavamox left from her sinus infection (which is trying to read it’s ugly head). Started on Clavamox last night and made her as comfortable as possible in the bathroom where any accidents are easiest to clean up. I want to cry that I didn’t catch this sooner. I want to cry and yell that she’s going through so much. On the daily, She self isolates in a tent bed in my room. Gets most of her food via syringe but is grazing a little on her kibble...
Does she have a good qol? I don’t know. She still loves pets and scratches and treats.... Advice or guidance would be great.
 
I would whole heartedly suggest that you call your vet's office and see if they have any directions for care on the weekends. While the clavamox may be Ok, without seeing the vet, you just don't know for sure. You don't even have confirmation it is a UTI. Make sure to get as much food even if yu have to gve her the dry food and fluids into Trinity as possible and that she gets her insulin. Infections can lead to ketones so its important to test for those too. You can get ketostix at the local pharmacy and test her urine which should be easier if she is incontinent. Any ketone reading on the ketostix above trace means a vet consult is needed ASAP.
 
MrWorfMen's Mom said:
I would whole heartedly suggest that you call your vet's office and see if they have any directions for care on the weekends. While the clavamox may be Ok, without seeing the vet, you just don't know for sure. You don't even have confirmation it is a UTI. Make sure to get as much food even if yu have to gve her the dry food and fluids into Trinity as possible and that she gets her insulin. Infections can lead to ketones so its important to test for those too. You can get ketostix at the local pharmacy and test her urine which should be easier if she is incontinent. Any ketone reading on the ketostix above trace means a vet consult is needed ASAP.
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My vet office has male and female vet. Male vet has injured my cats more than once and I have directed the office that he never treat another animal of mine under any circumstances. The vet tech on duty this morning said to give her 1ml Clavamox and bring her in Monday morning when female vet is back. I described all symptoms.
Since she is alone in bathroom, I can see if she’s peeing at all (when I’m not holding her and accidentally pressing on her bladder). If she doesn’t go, I believe we need to drive 2 hours each way to the ER.
She is being tested and receiving fluids as usual and has her fave dry kibble and water in the room with her.
I have ketone stix but so far I can’t see that she’s peed. If she has it isn’t fresh. How fresh does it need to be? She doesn’t pee every time I hold her so getting a sample that way isn’t going to work.
My Mom and I have weakened immune systems and are frequently ill. We both currently have adenovirus and she has conjunctivitis. I have devoted 17 years of my life to Trinity and her ckd brother, Tristan. They are my children. But I’m starting to feel as though I’m drowning.
 
Take a deep breathe. You are doing everything you can and that is all you can do. If you spoke with the vet tech and she was Ok using the Clavamox then that is fine. The urine sample should be relatively fresh but I'd test anything you can get right now if Trinity has another accident. You've obviously taken excellent care of Trinity up till now and she's a very lucky kitty to have such a devoted person to look after her. I know this can get overwhelming and that much more so when you are not feeling well but just do what you can. If Trinity will eat her dry food on her own then you don't need to be syringing food into her right now and can use your energy to just check up on her and clean up if she has an accident. It's a matter of trying to balance out Trinity's and your needs so both of you are Ok. :bighug::bighug::bighug::bighug:
 
Ditto to everything that Linda said. You have to take care of yourself so that you can take care of Trinity. I can tell you that I drove a friend to the ER on Thursday night because her cat had a suspected UTI, and they gave Clavamox, but the tricky part here is that they got a urine sample first to look at under the microscope for bacteria, but also so that they could culture it for 3-5 days to see if Clavamox was the right med for it. Now that you've already started antibiotics, I don't know if looking at a smear or trying to culture it is still useful/valid? I honestly don't know. But you have to do what you have to do -- especially since our babies always seem to know how to show us their symptoms at night or on weekend. Ugh! And I assume that she has had Clavamox before since you have it on hand, or do you have it from something that Tristan had? I ask because Clavamox CAN make kitties feel bad, and negatively affect their appetite, so just keep a watch on that because then you'd almost have to switch to a different antibiotic.

Quality of life is tough to assess if there is an infection going on. It can make them look and feel just terrible, so I don't know that I'd even be thinking longer term right now, I'd just focus on the presumed infection. She could look tons better if you can get this problem cleared up, and then you can reassess at that time?

Take care of yourself.
 
Thank you for your kind reply and for telling me to focus on the immediate problems-my illness and her UTI.
Trinity has taken Clavamox in the recent past for a sinus infection. It gives her mild diarrhea. I do give 100ml fluids (SubQ) daily and her syringe fed hills urgent care is mixed with water for hydration.
My vet is in a small town and doesn’t have a lot of equipment. Trinity has had several UTI infections since becoming diabetic 3 years ago. My vet has never taken a culture. Trinity has been lucky that what has been prescribed has always worked.
I wanted to take her to vet this morning, but when I called the vet gave approval for another bottle of Clavamox and said to come back if Trinity isn’t feeling better and the bottle is empty or if symptoms worsen.
I really wish my vet had more equipment and weren’t so “back woods.”
Trinity has been placed in the bathroom where I can monitor her water intake and urine output (in the litter box). And she appears to feel a little better as she’s screaming her lungs out. Can’t cause that much fuss and not feel a little better.
As I’ve mentioned to @MrWorfMen's Mom, Trin only eats kibble- her purina dm kibble and that is when she eats at all. She is mostly syringe fed right now, but I have some dr elseys clean protein here...she just won’t eat it.
Of serious concern to me was her 500+ BG this morning which is a direct result of her eating more dm kibble on her own last night. I don’t want to take it away as I need her to eat... I did add a second bowl that has dr elseys clean protein in hopes she gives it a try. when I blood test at 3pm I will test for ketones.
I still feel like I’m drowning and have several good cry’s over the past few days. Deep breath. One day at a time.
 
That high this morning looks like it could be from a bounce suggesting Trinity may have gone lower last night than she is used to or she ate more than usual of the DM dry. It's important she eats and insulin can be adjusted to accommodate that. BG will also be elevated due to the infection. It looks like a dose increase to 1.5u would be fine but I would change the dose on a day cycle when you can monitor a bit more to be sure she stays safe. Hopefully that will help bring her numbers down till the infection clears.
 
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