11/9 Luna - AMPS 264, +1 195, +2 245, +4 324, +6 318, +8 146, +9 108, +10 71, +11 108

[For_Luna]

Yesterday
Luna is still doing well; sleeping and grooming a lot...which is good, because she came back a little smelly. We tried to help out with some natural baby wipes.

It seems like she has a lot more energy despite not eating on her own yet. The new food should be here tomorrow or Monday, so hopefully that gets her to eat. In the meantime, we'll keep going with the feeding tube.

The freestyle libre is still attached and working great. I updated the spreadsheet with her numbers from yesterday, and they're weird. Especially overnight and the drop at +1. She had a 47 lime green at the vet the day she left, so I think yesterday was still a reaction to that. And her feeding tube food is higher in carbs, so there are a lot of variables in play right now. I'm interested to see what things look like once we're back to a normal routine.

 

[Amanda and a Loudogg]

What a fantastic update. I hope the new food does the trick for her. It's always hard to know how things are going to go once everyone is home. I imagine the libre helps take some of the edge off. I hope she continues to improve. I'm sending some more healing and comfort vines for Luna.

 

[carfurby (GA)]

I'm sure Luna is feeling better just because she is home. That helps a lot. I hope she keeps doing well and the new food will entice her to eat when you get it.

 

[Tomlin]

Thank you for the wonderful update ! Fingers crossed that she will enjoy the new food. In the meantime, grooming is a great sign !! There have definitely been, and there will continue to be, changes that will effect the #s as she recovers. In the meantime, enjoy your girl being at home doing more of the things she loves to do each day !

 

[Diane Tyler's Mom GA]

Great news, Luna is probably so happy to be back home

 

[Sonia & Leo]

So good to hear Dan! Love to Luna! Keep improving sweetie!

 

[Sandy and Black Kitty]

Go Luna!
So glad to see Lunas on the road to restoration

Are you testing for ketones with ketostix or a meter?

 

[For_Luna]

Go Luna!
So glad to see Lunas on the road to restoration

Are you testing for ketones with ketostix or a meter?

Yes, we tested last night. 0.5 on our meter. Info that came with it and what we found online said that's in the normal range... I hope.

 

[Olive & Paula]

You might want to put using libre meter in comments is as and the results of ketones. This way everyone knows.

0.5 is normal for ketones. Not sure which meter you have for that. Anything over 2.44 would warrant a vet visit immediately.

 

[Sue and Luci]

Love the news that she's feeling better and is grooming! Hope she gets the 'stinky' off soon

Love the Libre and all the info! It'll be interesting over time to see how she does and hopefully she gets those ketones under control!

Sending you support and vines for continued healing!

 

[Tomlin]

I was just thinking that maybe add the DKA, what meter for Ketones and Libre with start date all on your signature? If it all fits!!

More prayers & healing vibes your way

 

[For_Luna]

This Libre is cool, but it's just confusing me more. She is all over the the place. This food must be slow digesting. We did a big meal at AMPS and a smaller meal at +3 all through the feeding tube.

The vet wants us to send him Luna's numbers. Hope he's ready for this madness.

 

[Tomlin]

This is why the CGM is such a game changer. It is going to reveal trends with time (even if the trend IS fast ups & downs etx) so just sit back & give it time. You are getting to see the speed of movements vs just static numbers that you see with BGs. The vet will see the dynamic trends & be able to help you figure it out !! Keep in mind that digestion from one meal to the next or from one day to the next can also vary & therefore, even timing of meals isn’t a guaranteed predictor or what is going to happen with glucose.

 

[For_Luna]

This is why the CGM is such a game changer. It is going to reveal trends with time (even if the trend IS fast ups & downs etx) so just sit back & give it time. You are getting to see the speed of movements vs just static numbers that you see with BGs. The vet will see the dynamic trends & be able to help you figure it out !!

Yeah, it's crazy. Though I think we're seeing different things than before all of this stuff happened. There were days we tested a lot and never saw ups and downs like this. I think this thing will really show its usefulness once she's better.

 

[Tomlin]

Absolutely. It will be nice to have this data to look at & compare the trends as she improves. You will be able to see if the trends improve, stay the same etc.. Keep in mind even with testing a lot with BGs you are unable to get the amount of data the CGMs are able to provide that ultimately allow the production of very helpful dynamic trends vs static ones. This is what has made them a game changer for humans & pets. Even Endo experts were in for a surprise when they put them on some cats they thought were well regulated.....they weren’t! They just didn’t catch the moments of sudden fast highs or lows that were happening in between BGs.

 

[For_Luna]

I think our vet is starting to see what we've been dealing with. 471 PMPS last night to 65 at +10.5 tonight. We're going back to 1U to be safe (vet's decision). She's not eating more than a couple of licks on her own, so we're not confident we can keep her numbers up if she goes hypo. We have syrup ready to go, but that's not a long-term solution.

 

[Diane Tyler's Mom GA]

Oh Dan I'm praying Luna stays safe tonight.

 

[Crista & Ming]

Have you coupled the Libre with a blood glucose meter? I would do that for a few readings just to make sure the Libre isn’t giving you wonky numbers. That has happened to a client at work where she got a low number. Turns out the location of the Libre wasn’t the best and causing funky numbers and not working sometimes.

 

[For_Luna]

Have you coupled the Libre with a blood glucose meter? I would do that for a few readings just to make sure the Libre isn’t giving you wonky numbers. That has happened to a client at work where she got a low number. Turns out the location of the Libre wasn’t the best and causing funky numbers and not working sometimes.

The vet tested it against their fancy machine when they got that 47 and it was within a point or two. So I assume it's accurate unless these things can change over time.

 

[Tina and Salem]

This Libre is cool, but it's just confusing me more. She is all over the the place. This food must be slow digesting. We did a big meal at AMPS and a smaller meal at +3 all through the feeding tube.

The vet wants us to send him Luna's numbers. Hope he's ready for this madness.

After salems DKA hes numbers look like lunas numbers but he just started on insulin also right before he came home he got 2 units that was crazy we quickly changed that so now we are slowly going back up. i increased This PMPs so hopefully hes will start to look better tomorrow. I know its wearing you guys out ! Get some rest take turns watching her ! Prayers !

 

[J.J. and Phoebe Squeak]

Looks like Luna is back in the bouncy house. I'm so sorry you are dealing with all this, but I'm so glad she is home with you. And at least she doesn't need to be poked. I know being with you & your wife is the best medicine. Hang in there. Sending healing thoughts your way.

 

[For_Luna]

Looks like Luna is back in the bouncy house. I'm so sorry you are dealing with all this, but I'm so glad she is home with you. And at least she doesn't need to be poked. I know being with you & your wife is the best medicine. Hang in there. Sending healing thoughts your way.

Yeah, PMPS 118 to +2 429... I hope all of this data we're collecting leads to something helpful.

 

[Tomlin]

Hang in there Dan....it will! Hoping Dr Hess becomes involved if she isn’t already !

 

[Sandi and Toby]

... 9.5 is normal for ketones. Not sure which meter you have for that. Anything over 2.44 would warrant a vet visit immediately.

Ooops, Paula can you correct the typo in your comment, you meant "0.5" instead of "9.5". Anyone that reads Dan's comments and then the entirety of your comment could infer that it's a typo, but since it is going to live on the internet forever... Thanks!

Dan, you continue to do a phenomenal job with Luna!

 

[Olive & Paula]

Ooops, Paula can you correct the typo in your comment, you meant "0.5" instead of "9.5". Anyone that reads Dan's comments and then the entirety of your comment could infer that it's a typo, but since it is going to live on the internet forever... Thanks!

Dan, you continue to do a phenomenal job with Luna!

Thanks for letting me know. I fixed it.

 

[Gill & George]

Hi dan, sorry Luna's BG is giving you a run for your money!

I think our vet is starting to see what we've been dealing with. 471 PMPS last night to 65 at +10.5 tonight. We're going back to 1U to be safe (vet's decision). She's not eating more than a couple of licks on her own, so we're not confident we can keep her numbers up if she goes hypo. We have syrup ready to go, but that's not a long-term solution.

Dan with taking her dose down, high numbers, and the feeding problems, I would strongly recommend that you monitor regularly for ketones, maybe a couple of times a day . Especially vthis close after her dka episode.
They can go from trace to moderate in a flash, if she starts trending up you want to catch it quickly.

Do you think you could note the results from the ketone test in the SS? noting the time in +hrs. You could pop it in the comments section. It will make it easier to see trends for anyone that's stopping by, and for you as well.


Reducing the insulin by 0.5u worries me in a post dka cat. Not enough insulin is one of the key 'ingredients' in developing dka.

http://www.felinediabetes.com/FDMB/...oacidosis-dka-and-blood-ketone-meters.135952/

The above link has a lot of great info on dka ketones and meters as well as further links to studies, and threads where you may find helpful info.

Hope she starts eating better, on her own soon.

 

[For_Luna]

Hi dan, sorry Luna's BG is giving you a run for your money!
Dan with taking her dose down, high numbers, and the feeding problems, I would strongly recommend that you monitor regularly for ketones, maybe a couple of times a day . Especially vthis close after her dka episode.
They can go from trace to moderate in a flash, if she starts trending up you want to catch it quickly.

Do you think you could note the results from the ketone test in the SS? noting the time in +hrs. You could pop it in the comments section. It will make it easier to see trends for anyone that's stopping by, and for you as well.


Reducing the insulin by 0.5u worries me in a post dka cat. Not enough insulin is one of the key 'ingredients' in developing dka.

http://www.felinediabetes.com/FDMB/...oacidosis-dka-and-blood-ketone-meters.135952/

The above link has a lot of great info on dka ketones and meters as well as further links to studies, and threads where you may find helpful info.

Hope she starts eating better, on her own soon.

I added the ketones test to comments. Last two nights have been 0.5 and Low; the packet of information that came with our meter says low is below .1.

We'll continue to watch her, but we're giving more insulin than before this all started. That 1.5u was based on a starting dose of 2u when she came off the insulin drip. She dropped into the 40s so they sent us home doing 1u. But she bounces so they thought those high numbers needed more insulin, so we went back to 1.5u... so much has changed, we're not sure what she needs right now, so we're trying to get her in decent, flat numbers until she's recovered and we can be more aggressive. I'm going to recommend we try 1.25u if we need to increase again.

And she's getting plenty of calories through the feeding tube. We're on a weight gain plan to get back some of what she lost in the hospital.

 

[Gill & George]

I added the ketones test to comments. Last two nights have been 0.5 and Low; the packet of information that came with our meter says low is below .1.

Thanks Dan, that all sounds good, you guys are doing great.

I'm going to recommend we try 1.25u if we need to increase again.

Seems a sensible suggestion. They probably don't realise that it is possible to dose 1.25u. I know my vet couldn't believe I could dose 0.25u until I demonstrated it to him.

But she bounces so they thought those high numbers needed more insulin,

Seems like they may still be thinking in terms of in/out insulins. You still need to look at the nadirs, ignore the bounces, with a long acting insulin like lantus, even in a post DKA cat.
I hope you can get to a better dose that doesn't see her in lime greens.

And she's getting plenty of calories through the feeding tube. We're on a weight gain plan to get back some of what she lost in the hospital.

Excellent, I was on very quickly this morning and wasn't sure if you were still managing ok with the feeding tube. Getting those calories in her helps keep those ketones at bay.

 

[For_Luna]

Seems like they may still be thinking in terms of in/out insulins. You still need to look at the nadirs, ignore the bounces, with a long acting insulin like lantus, even in a post DKA cat.

I think the issue is they don't have a ton of experience with a cat that bounces like this. That's why we agreed to the glucose monitor and we connected our vet with a specialist that studies diabetic cats and the freestyle libre. Hopefully she can provide some insight.

 

[J.J. and Phoebe Squeak]

I am really hopeful that you can get someone who understands what's going on and help you. I don't think many vets are familiar with bouncy diabetic kitties. Glad you found a specialist.