Cat recovering from DKA

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Liz & Sandy

Liz & Sandy

Member Since 2021
New member here, and also new to having a cat with diabetes. It all started Jan 8th with a sick visit to the vet. My cat had mucus coming out of his nose and sneezing. He looked dehydrated, down, and was eating and drinking less. I was told he had a cat cold, was given antibiotics and sent on my way. Monday vet called and said bloodwork was good but his glucose was 460 so he was probably diabetic. Gave me a follow up appointment. Well Tuesday night my cat would take 3 steps and lay down and he looked even more dehydrated so I took him to ER. He was limp, eyes closed, not breathing well. They admitted him and said he was in Diabetic Ketoacidosis. Had no idea what that even meant. He spent 5 days in ER, was told second day he just wasn’t going to make it his kidney levels went from 4 to 6.9 so I made the decision to put him down. That night his blood work improved slightly so I gave him another another day, which he kept improving from there. 5,000 dollars later and a lot of emotional stress he was discharged home where I’m injecting fluids, giving meds and insulin. His numbers have gone really high and then yesterday below 50, I’m panicking. I called my regular vet he said give him a meal. Helped but then back down so I gave him more food. He is on a lifestyle libre for now and that should last about another week.
I want to do what is best for him and any info or guidance I can get is appreciated.
What food is good?
What is a good meter for home testing?
Tips on what to do or not to do when levels are too high or too low?
 
Took a look at the spread sheet. I don’t understand it fully gives me an idea on what I need to learn to keep track. Thanks for the tips on food and going to be getting a meter soon. The one I have now it was attached to him and I can scan with phone but it’s only good for about 8 more days
 
How is Sandy today?
Just confirming he is on Glargine 1 unit twice a day...that’s what you said on the fb page.

What food are you feeding him at the moment and how is his appetite?
Are you doing subQfluids at the moment?
When a cat has had DKA and recovering at home there are some important things you need to be doing to stop ketones from coming back.
The recipe for DKA is not enough insulin, not enough food and an infection or an inflammation in the body. So we have to make sure that he is getting enough insulin, getting enough food and the infection or inflammation is being treated.
The plan is:
  • Sandy will need 1 1/2 times as many calories as he normally eats at the moment. This is because food helps the ketones from reforming. He will need his meals before his insulin shot and then he will need snacks through out the day and evening/night. I would offer a snack every 2 hours except for the two hours before the reshot blood glucose test. This is because we don’t want the preshot number to be food influenced.
  • Don’t skip insulin doses. Always test before every insulin dose to see it is safe to give the shot. If the BG (blood glucose) is under 200, stall, don’t feed and test again in 20 minutes to see if it is rising. And post and ask for help.
  • Test the urine for ketones at least once a day, more often if any ketones appear. Did you manage to get the bottle of Ketostix I mentioned on fb and test for ketones yet?
  • Give extra fluids in the food if he will accept it. If he is having sub Q fluids he will not need as much oral fluids.
  • If he is nauseated and doesn’t want to eat, make sure you have some anti nausea medication such as cerenia or ondansetron at home.

If you could set up a spreadsheet and enter any data you have, that would be very helpful and then we can help you with the dose of insulin.
Here is a link to how to set up the SS and the signature which will appear at the bottom of all your posts and will tell us about Sandy.
If you have any trouble with setting up the SS I will ask @Bandit's Mom to help you.
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

You can buy a ReliOn Prime or Premier meter from Walmart for a very reasonable price and the test strips are not expensive. You will also need to get the test strips and some cotton balls to put behind the ear to support it while you test.

At the moment it is really important that Sandy eats. The best food is low carb food canned food ....Link below... that is 10% or less carbs. But at the moment what ever he will eat is OK as he must eat. You will also need to have some higher carb food as well for if he drops low.
So buy some around 15% (medium carb) and some around 22% (high carb) to have for when he drops low. Look for the carbs amounts column.
https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

If you are not sure of anything please ask questions. I know this is all very new for you and mush be overwhelming. But I am so glad Sandy is improving after being so ill.
Bron
 
If Sandy dropped below 50 you will need to reduce the dose of insulin.
Can you confirm he has been having 1 unit of glargine (Lantus) please so that we can give you the new dose.
Do you have syringes that have 1/2 unit markings in them? If not, you will need to go out and buy them. You should be able to get them at Walmart or pharmacies.
Ask for the U-100 3/10 30 or 31 gauge, 6 or 8 mm insulin syringes with 1/2 unit markings on them. Thee are several brands to choose from.

After dropping below 50, Sandy is then going up into high numbers as he is bouncing from the low number. This is a normal response so don’t be alarmed. By feeding regularly during the cycles that will help Sandy from dropping so low. But we also need to adjust the dose.
We don’t want him dropping below 50 because that is too low.
 
Hi, thank you for the info,
After days in end not sleeping I crashed last night. Still woke up with alarms for Sandy’s readings and food/insulin times. He has his own room so he can recover and I’m right there with him.

He is in fact at 1 Unit of glargine. He is also on
-Clavacillin 62.5mg every 12 hrs
-Cerenia 16 mg 1/2 tab every 24 hrs
-100 mLs Subcutaneous fluids
I’m feeding fancy feast poultry & beef 2x’s a day
When his glucose dropped I gave him another meal.
His numbers are all over the place, started really high, 2 days ago actually good for most of the day, now he’s all over the place again with 2 really low drops under 50.

Follow up today with vet, more blood work to check his kidney values, and I asked that he check his pancreas as well. Will hopefully get results back tomorrow.
Dropped insulin to 1/2 Unit
As far as Sandy’s mood...he is ok, sweet, purring, gaining weight back, big appetite sometimes and other times only eating a little. Peeing a lot at 1 time, averaging 2-3 pees a day, and has had 2 poops since Monday.
Will see if I can figure out the chart...this is all new to me so bare with me, and thanks for your help in advance.
 
Hi Liza,
Good to hear from you.
Are you feeding Sandy several snacks doing the day and evening. It is really important he is eating 1 1/2 times as many calories as he would normally eat.

Are you testing the urine for ketones every day? This is really important as we need to know that ketones are not coming back.

If you were giving 1 unit of Glargine before he dropped under 50, you need to change the dose to 0.75 units, not 1/2 unit (0.5unit).

If you are having trouble setting up the spreadsheet I will ask @Bandit's Mom to help you. If you can then put in the data you have collected so far that will be helpful.
 
Hi Bron,
I haven’t been feeding him any snacks other than when his BG is down I give him an extra meal. But I’m going to take your advice because he is not eating enough calories in the two meal a day that the vet told me to do.

I have not done testing for ketones as I had no idea how to collect his urine, but I just looked up some videos and showing I have to get a special litter for it. Could you let me know what you think is the easiest way? They did do a pee test yesterday at the checkup but they didn’t let me know what they were testing for, I’m going to call today and find out results and if they tested for ketones.

Regarding the unit of insulin, last night I gave the .5 when I gave him his 2nd meal at 8:30pm. I tested his BG before he ate and it was too high to read. At midnight down to 288, 6:30am 154. His next meal is at 8:30 I will test before to see where he is at.
I’m having a little bit of a hard time figuring out the spreadsheet, I see it on the google app, but can’t find it when I go into my drive, but I’m not very good at this stuff so I think just have to figure out how to add in on here once I complete it.
But do you still think I should go with the .75 with the numbers he showed from his last dose? Or should I stick to the .5?
Also I’m feeding him fancy feast classic pate which is what I saw a lot of people use with their diabetic cats.
Do you think this is a good choice?
Any suggestions for snacks throughout the day?
My goal is to get him into remission, I know it will take some time, but trying to figure out what is the best diet for that to happen. I’m not going to concentrate on that right now because the short term goal is to get him to eat.
 
Hi Liza,
Regarding the collecting the urine to test for ketones which is really important at this stage.....you can try putting a little plastic container or a large spoon under his butt as he pees. Or you could put the test strip directly under his butt and catch the stream of urine.
You need to read the test strip exactly 15 seconds after you dip it into the urine against the colours on the side of the bottle. The colour will keep changing after the 15 seconds and will then not be accurate.
Yes that would be a good idea to ask the vet if the test they did was a ketone test.
The strips you need to buy are Ketostix from a pharmacy or Walmart.

Regarding the food......the snacks you feed should be the low carb food you are feeding for the main meals. Fancy feast pates are fine.
Feed him well before the insulin dose then I would give a small snack every two hours except for the two hours before the preshot as we don’t want the BGs to be food influenced. Also feed him the snacks after the pm dose as well. These Snacks are really important as he needs all that extra food I mentioned. Food is like a medicine in cats recovering from DKA.

Regarding the spreadsheet. I am going to ask @Bandit's Mom if she can help you set it up. She is very good at doing it.

Regarding the insulin...it is very hard to give dosing advice without a SS to see the data, so I think it would be a good idea to stick with the 0.5 units at the moment, especially if he is dropping to 154. He is having big drops in BG which can trigger bounces back up high again so give those snacks I mentioned and the food should hopefully help slow down the big drops.
Try hard to get the ketones tests please as that will help tell us if the insulin dose is enough. We don’t want to see even a trace of ketones in the urine if we can help it. It is the insulin and the food that will stop the ketones from reforming.

Your first goal should be to get him recovered from the DKA. Your second goal should be regulation and your third goal can be remission :D. It is good to have goals.
Keep asking questions and posting each day and letting us know how he is and what the BGs are doing. Once the SS is up and running please keep it updated as we check it. Thanks
 
Bron and Sheba (GA) said:
Hi Liza,
Regarding the collecting the urine to test for ketones which is really important at this stage.....you can try putting a little plastic container or a large spoon under his butt as he pees. Or you could put the test strip directly under his butt and catch the stream of urine.
You need to read the test strip exactly 15 seconds after you dip it into the urine against the colours on the side of the bottle. The colour will keep changing after the 15 seconds and will then not be accurate.
Yes that would be a good idea to ask the vet if the test they did was a ketone test.
The strips you need to buy are Ketostix from a pharmacy or Walmart.

Regarding the food......the snacks you feed should be the low carb food you are feeding for the main meals. Fancy feast pates are fine.
Feed him well before the insulin dose then I would give a small snack every two hours except for the two hours before the preshot as we don’t want the BGs to be food influenced. Also feed him the snacks after the pm dose as well. These Snacks are really important as he needs all that extra food I mentioned. Food is like a medicine in cats recovering from DKA.

Regarding the spreadsheet. I am going to ask @Bandit's Mom if she can help you set it up. She is very good at doing it.

Regarding the insulin...it is very hard to give dosing advice without a SS to see the data, so I think it would be a good idea to stick with the 0.5 units at the moment, especially if he is dropping to 154. He is having big drops in BG which can trigger bounces back up high again so give those snacks I mentioned and the food should hopefully help slow down the big drops.
Try hard to get the ketones tests please as that will help tell us if the insulin dose is enough. We don’t want to see even a trace of ketones in the urine if we can help it. It is the insulin and the food that will stop the ketones from reforming.

Your first goal should be to get him recovered from the DKA. Your second goal should be regulation and your third goal can be remission :D. It is good to have goals.
Keep asking questions and posting each day and letting us know how he is and what the BGs are doing. Once the SS is up and running please keep it updated as we check it. Thanks
Click to expand...
Ok and thank you for this. I feel very lost and confused most of the time so all this really helps. I did get the strips you mentioned from what you had said on fb page. Brought them home and was thinking how in the heck am I supposed to collect his pee? ☹️
I will definitely be giving him snacks every couple of hours. I’ll keep the insulin at .5 for now and see how it goes.
And now that you mention the insulin after eating. So the vet told me to give it to him as he’s eating. Understand this a little more now. I’m thinking his drop might have been so to him just not eating much when I give him the shot. Like I said sometimes he eats a lot and then not so much at the feeding times I’m giving the shot.
How long after he eats do you think I should give him the insulin? Also what if his BG is 150 or under when it’s time for the shot? Should I still give it or should I skip until next dose?
 


  • when you get a chance ,It would be helpful if you can set up your signature so we don't have to ask you the same questions over again. Members will look at this first . Members would have to look up your previous posts to see what insulin you are using
  • It appears after each post in gray, look at mine,



  • On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
    • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
    • Add any other text, such as
    • Caregiver & kitty's name (optional)
    • DX: Date
    • Name of Insulin
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.


tap on your avatar where it says your name ,then hit profile page ,tap on that ,then go up to the very top, upper right hand side and tap on your name ,it will bring down a drop box, tap on signature, the signature will be under settings, tap on the signature then and you can start to add what I posted above, make sure you hit save ,
Welcome to the best place you could ever be and an awesome group of people
You can also add where you live in your profile, not your signature

This is at the bottom of every ones post in grey
 
Last edited:
Diane Tyler's Mom said:
  • Hi Liza

  • when you get a chance ,It would be helpful if you can set up your signature so we don't have to ask you the same questions over again. Members will look at this first . Members would have to look up your previous posts to see what insulin you are using
  • It appears after each post in gray, look at mine,


  • On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
    • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
    • Add any other text, such as
    • Caregiver & kitty's name (optional)
    • DX: Date
    • Name of Insulin
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.


tap on your avatar where it says your name ,then hit profile page ,tap on that ,then go up to the very top, upper right hand side and tap on your name ,it will bring down a drop box, tap on signature, the signature will be under settings, tap on the signature then and you can start to add what I posted above, make sure you hit save ,
Welcome to the best place you could ever be and an awesome group of people
You can also add where you live in your profile, not your signature

This is at the bottom of every ones post in grey
Click to expand...
Ok thank you for explaining it. I’m really having a hard time with figuring it out. I really don’t fully understand the spread sheet and what’s on there means.
I’ve got it downloaded to my google app, not even sure how I did it so now I just have to figure out how to insert the numbers and get it on here
 
Liza Morales said:
Ok and thank you for this. I feel very lost and confused most of the time so all this really helps. I did get the strips you mentioned from what you had said on fb page. Brought them home and was thinking how in the heck am I supposed to collect his pee? ☹️
I will definitely be giving him snacks every couple of hours. I’ll keep the insulin at .5 for now and see how it goes.
And now that you mention the insulin after eating. So the vet told me to give it to him as he’s eating. Understand this a little more now. I’m thinking his drop might have been so to him just not eating much when I give him the shot. Like I said sometimes he eats a lot and then not so much at the feeding times I’m giving the shot.
How long after he eats do you think I should give him the insulin? Also what if his BG is 150 or under when it’s time for the shot? Should I still give it or should I skip until next dose?
Click to expand...

Hi Liza,

I am not experienced as the other members here but I will do my best to help you out.

The first thing I want to say is just breathe!!! I know it's a lot easier said than done especially considering the scary circumstances that you went through, but I have to say that a lot of the comfort of knowledge about how to do things certainly comes with experience. If one thing doesn't work, try something different! I also had a lot of trouble thinking of how to collect my fur baby's pee, but I know with her schedule she always goes after her nightly feeding at around 11pm and made sure to catch her pee then. I guess she had to go so bad she didn't mind me lifting the lid and sticking the strip right underneath.

I also use Glargine for my kitty and I shoot her after she eats, 1) because she gets cranky if I try to inject her before food and 2) if there's ever a problem with her not eating I don't panic after. Sometimes she just gets picky and likes to eat throughout the day. This is just a personal preference.

For people newer to insulin and don't have quite an idea of how insulin affects their cat at certain doses, as mentioned earlier the rule of thumb is to not shoot below 200. If the number is before 200, you "stall", ie you don't give food and retest within an hour to see if the numbers come up by themselves. If they don't, you have options from there. Post and ask. It really is a balancing game because too high a BG and you risk keytones, too low and you risk a hypo episode. Unfortunately this is just part of the process for many people until you find out what works best for your cat. That's why it's so important to keep the spreadsheet up to date so members can have an idea of how to help you better, more datapoints allow for more knowledge about how to move forward when stuff like this does happen. You will see it time and time again on this forum, that every kitty is different.

As for meters I personally use Alphatrak 2. It's stupidly expensive, but I find it helpful to have on hand if her BG goes too high or too low. There have been MANY members here with success with regular human meters. If you have the mental capacity to read up on human meters and pick one you like, do that. If not, stick to what you have currently. Throughout this entire process, it's important to be kind to yourself.

I know this is all very new and very overwhelming.... Try to take it step by step. There is a LOT of knowledge to learn and get used to throughout this process, it doesn't happen overnight.
 
Hi Liza
What type is meter did you get? I mentioned the ReliOn meter which is a human meter and is very suitable for cats.
Some people are using the alphatrak pet meter which is a lot more expensive to run. We do not recommend you use that as our dosing methods are based on the human meter. We can’t give you exact equivalent numbers on the alphatrak meter as none have been properly documented so I would encourage you to get the ReliOn meter.
 
Lizzee said:
Hi Liza,

I am not experienced as the other members here but I will do my best to help you out.

The first thing I want to say is just breathe!!! I know it's a lot easier said than done especially considering the scary circumstances that you went through, but I have to say that a lot of the comfort of knowledge about how to do things certainly comes with experience. If one thing doesn't work, try something different! I also had a lot of trouble thinking of how to collect my fur baby's pee, but I know with her schedule she always goes after her nightly feeding at around 11pm and made sure to catch her pee then. I guess she had to go so bad she didn't mind me lifting the lid and sticking the strip right underneath.

I also use Glargine for my kitty and I shoot her after she eats, 1) because she gets cranky if I try to inject her before food and 2) if there's ever a problem with her not eating I don't panic after. Sometimes she just gets picky and likes to eat throughout the day. This is just a personal preference.

For people newer to insulin and don't have quite an idea of how insulin affects their cat at certain doses, as mentioned earlier the rule of thumb is to not shoot below 200. If the number is before 200, you "stall", ie you don't give food and retest within an hour to see if the numbers come up by themselves. If they don't, you have options from there. Post and ask. It really is a balancing game because too high a BG and you risk keytones, too low and you risk a hypo episode. Unfortunately this is just part of the process for many people until you find out what works best for your cat. That's why it's so important to keep the spreadsheet up to date so members can have an idea of how to help you better, more datapoints allow for more knowledge about how to move forward when stuff like this does happen. You will see it time and time again on this forum, that every kitty is different.

As for meters I personally use Alphatrak 2. It's stupidly expensive, but I find it helpful to have on hand if her BG goes too high or too low. There have been MANY members here with success with regular human meters. If you have the mental capacity to read up on human meters and pick one you like, do that. If not, stick to what you have currently. Throughout this entire process, it's important to be kind to yourself.

I know this is all very new and very overwhelming.... Try to take it step by step. There is a LOT of knowledge to learn and get used to throughout this process, it doesn't happen overnight.
Click to expand...
Thank you for this. I had a shutdown today. I couldn’t even freak out I have been so tired from not sleeping that I had no energy left.
He is currently on lifestyle libre and it was great to just scan the sensor. Well 2 days early it’s telling me that I need to change it, it was supposed to be a 14 day. So being new to all of this it caught me off guard, I just got sad as I haven’t learned to prick ears when it happened and I was just hoping he’d be ok. 1 hour later my mom calls me, she is 74, tells me she has covid. Another hit. But I bounced back quick because that’s what I do under pressure so I went to get a meter at cvs and some supplies for my mom since she is going to be under quarantine. On top now I have to get tested for covid because I just saw her last week, I feel good so I hope I am good.
My poor boy Sandy is bearing with me I swear he just looks at me and is thinking “mom can you just stop with the meds and the poking me” . He is on fluids at home, 3 more days, and the dang needle is 18gage and so long. I struggle with him and he sounds like he’s growling at me.
He threw up today for the first time since he’s been home and I’m worried hoping it’s nothing serious. good news is I got a meter, one that I grabbed quick at CVS because I’m looking to get the Relion one but they were out at the Walmart that’s close to me. I successfully got blood from the ear but it took 3 tries and he was pretty mad at me.
I have yet to figure out the spread sheet and borrowing a laptop tomorrow because I just can’t figure it out on my phone.
 
Bron and Sheba (GA) said:
Hi Liza
What type is meter did you get? I mentioned the ReliOn meter which is a human meter and is very suitable for cats.
Some people are using the alphatrak pet meter which is a lot more expensive to run. We do not recommend you use that as our dosing methods are based on the human meter. We can’t give you exact equivalent numbers on the alphatrak meter as none have been properly documented so I would encourage you to get the ReliOn meter.
Click to expand...
I went to Walmart but they were out of the Relion one and told me they would have more soon. I had to opt out for a cvs brand one. But successfully got blood from ear after 3 tries.
Wanted to let you know I successfully tested his irons and no signs of ketones. Held it right under him as he peed just like you suggested.
I had a tough day today, the lifestyle libre stopped working 2 days early and the app said I needed a new sensor. My 74 yr old mother found out she has covid so now it’s another worry for me. I just saw her last week but I’m always careful with everyone including her so I wear my mask and sanitize so I’m hoping I don’t have it. I feel good, no symptoms, but regardless getting tested Monday.
Sandy is getting pretty mad with the pokes, he knows what’s coming and he gets anxious and irritated. So I’m sad. But he’s only got 3 more days of the fluids.
I wanted to ask how many times should I prick his ear to test BG? And before meals? And after meals? Some hours after meals? I hope it’s not too much because it’s making anxious myself.
Last I’m borrowing a laptop tomorrow to try and figure out the spreadsheet. I can’t for the life of me figure it out on my phone.
 
Bron and Sheba (GA) said:
Hi Liza
What type is meter did you get? I mentioned the ReliOn meter which is a human meter and is very suitable for cats.
Some people are using the alphatrak pet meter which is a lot more expensive to run. We do not recommend you use that as our dosing methods are based on the human meter. We can’t give you exact equivalent numbers on the alphatrak meter as none have been properly documented so I would encourage you to get the ReliOn meter.
Click to expand...
Sorry meant to say tested urine not irons, spellcheck mistake
 
Liza Morales said:
Thank you for this. I had a shutdown today. I couldn’t even freak out I have been so tired from not sleeping that I had no energy left.
He is currently on lifestyle libre and it was great to just scan the sensor. Well 2 days early it’s telling me that I need to change it, it was supposed to be a 14 day. So being new to all of this it caught me off guard, I just got sad as I haven’t learned to prick ears when it happened and I was just hoping he’d be ok. 1 hour later my mom calls me, she is 74, tells me she has covid. Another hit. But I bounced back quick because that’s what I do under pressure so I went to get a meter at cvs and some supplies for my mom since she is going to be under quarantine. On top now I have to get tested for covid because I just saw her last week, I feel good so I hope I am good.
My poor boy Sandy is bearing with me I swear he just looks at me and is thinking “mom can you just stop with the meds and the poking me” . He is on fluids at home, 3 more days, and the dang needle is 18gage and so long. I struggle with him and he sounds like he’s growling at me.
He threw up today for the first time since he’s been home and I’m worried hoping it’s nothing serious. good news is I got a meter, one that I grabbed quick at CVS because I’m looking to get the Relion one but they were out at the Walmart that’s close to me. I successfully got blood from the ear but it took 3 tries and he was pretty mad at me.
I have yet to figure out the spread sheet and borrowing a laptop tomorrow because I just can’t figure it out on my phone.
Click to expand...

I'm so sorry to hear that Liza, I will keep you and your mom in my thoughts. Hope you and your mom will pull through ok.

Don't be discouraged! It takes a while for cats to become used to their new regimen, they're probably thinking "why is my human poking me so much?" My furbaby took a while to get used to it, and used to throw tantrums all the time. It was especially awful when we were giving her meds after a suspected liver infection. She HATED the big blue pill. She would throw things off shelves in protest, and even a couple of months after her diagnosis refused to eat much for two days because she was so upset... But after we laid out 6 different cans of food on 6 different plates for her I think she got the hint that we're only doing this because we care about her. Sandy will get used to it in time. Even our furbaby didn't take to pricking her ears well, there was one time where no matter what we did we could NOT draw anything after 10+ attempts. She was very cranky after that. Now I can poke her while she lies down after her foody time and she barely flinches, and giving her the insulin shot just gets us a soft huff instead of hissing. At one point she learned to go for the face....

In any case, keep an eye on your Sandy. Fingers crossed everyone pulls through from this mess and you can look back on this time and not feel so anxious.

And don't forget to get your spreadsheet situated when you have the time and the energy!

Wishing you all the best.
 
Hi Liza. I’m so sorry your Mom has covid. I send my best wishes to her.
Great you got a human meter. You need to test before every insulin dose to see it is save to give the insulin. If you are unsure if it is safe to give, stall, don’t feed and test again in 20 minutes to see if the BG has risen. Post and ask for help.

You also need to test during the cycle, especially the first half to see how low the insulin is taking the BG. Are you giving a treat each time you test?

I’m going to ask @Bandit's Mom if she will help you with the spreadsheet. She will contact you and please send her a private message.

Great there are no ketones! Keep testing each day please... really important!

How is his appetite. Is he eating plenty?
 
Bron and Sheba (GA) said:
I’m going to ask @Bandit's Mom if she will help you with the spreadsheet. She will contact you and please send her a private message.
Click to expand...

Bron, I'm really really sorry. This is the 4th time you have tagged me in this condo and I'm not sure how I've missed it. I have just sent Liza a PM for the details I need to set-up the spreadsheet.
A thousand apologies! :oops:
 
Bron and Sheba (GA) said:
Hi Liza. I’m so sorry your Mom has covid. I send my best wishes to her.
Great you got a human meter. You need to test before every insulin dose to see it is save to give the insulin. If you are unsure if it is safe to give, stall, don’t feed and test again in 20 minutes to see if the BG has risen. Post and ask for help.

You also need to test during the cycle, especially the first half to see how low the insulin is taking the BG. Are you giving a treat each time you test?

I’m going to ask @Bandit's Mom if she will help you with the spreadsheet. She will contact you and please send her a private message.

Great there are no ketones! Keep testing each day please... really important!

How is his appetite. Is he eating plenty?
Click to expand...
Hi Bron, I called and asked vet for another lifestyle libre, he called it in to my pharmacy and I picked up and successfully put it on Sandy. So I’m back to scanning, hopefully for another 14 days this time. He was in high numbers again today, 250 to 500, and thats as high as the libre goes. I drew blood from the ear and he is at 538 on the human meter now at 12am. His meal and insulin were at 9:30pm. Still has his appetite and I’ve been feeding small meals every two to 3 hours so he gets calories. He did throw up yesterday but today he was fine. I tested the urine again tonight and no ketones.
Thank you for your support and bearing with me, both Sandy and I are a work in progress.
I received the message with the spread sheet. I never do anything on computers like copy and transfer stuff so even that’s just all new to me. But I know I’ll figure it out
 
Hi Liza, I can see your SS! Great!
I’m very pleased to hear he is eating for you and you are giving snacks every few hours
And fantastic there were no ketones in the urine. Keep testing every day please and if you could put the result into the SS in the remarks column that would be very helpful...thanks!
Are you able to put some of the BG data in the SS so we can see please.?

Can you tell me how much insulin you are giving him at the moment please.

How is your Mom doing?
 
Bron and Sheba (GA) said:
Hi Liza, I can see your SS! Great!
I’m very pleased to hear he is eating for you and you are giving snacks every few hours
And fantastic there were no ketones in the urine. Keep testing every day please and if you could put the result into the SS in the remarks column that would be very helpful...thanks!
Are you able to put some of the BG data in the SS so we can see please.?

Can you tell me how much insulin you are giving him at the moment please.

How is your Mom doing?
Click to expand...
Hi Bron, Bandit’s mom helped me!
Bron and Sheba (GA) said:
Hi Liza, I can see your SS! Great!
I’m very pleased to hear he is eating for you and you are giving snacks every few hours
And fantastic there were no ketones in the urine. Keep testing every day please and if you could put the result into the SS in the remarks column that would be very helpful...thanks!
Are you able to put some of the BG data in the SS so we can see please.?

Can you tell me how much insulin you are giving him at the moment please.

How is your Mom doing?
Click to expand...
Bandit’s mom helped me!
My mother is ok, she ran a fever last night but that’s her only symptom so far.
I’m giving Sandy .5 of glargine. I’m not sure what’s going on no because his numbers are really high again since yesterday. He threw up Saturday and then again today after his breakfast this am. He was taking anti nausea medicine but he finished it on Friday, not sure if that’s why he’s throwing up now. The laps in numbers in the SS is because I had to get another lifestyle libre because the other one stopped working so I didn’t get any numbers during that time. Back to scanning now. But am worried about him throwing up and I gave him the insulin. Gave him a few pieces of cooked chicken and he held it down but it was small amount
 
Hi Liza,
I think Sandy needs more cerenia or you could also ask for ondansetron which is another antinausea medication which works on a different pathway and can be given at the same time as cerenia.
You really need him to be eating well at the moment so make sure you get the cerenia today.
I don’t like seeing those black BGs. Have you been giving 0.5 units every 12 hours? Nothing is entered into the SS..
Have you been taking the BG before every shot? It is very important that you do to ensure it is safe to give the insulin.
You enter the preshot numbers under the AMPS and PMPS column.
Then next to that column is the units column (U) where you put the number of units of insulin you give.

How does he seem? Is he alert and interested in the food?
 
Hi Bron,
I got more cerenia yesterday so he is back in that. I’m going back and for the from the lifestyle app to put in the numbers and I missed putting those in, but have gone back and did it. Now that I cae the SS here it will be easier to update it daily instead of trying to put in days worth of numbers. I have been giving Sandy .5 Glargine every 12 hours. Last night his numbers started dropping and just this am it’s 101, so I’m not sure what to do but I’m worried if I give insulin his number will drop really low so I’m holding off. Should I skip this dose completely?
And Sandy is alert, even being playful with those high numbers so I’ve just been watching him closely. Urine is still negative for ketones, got the hang of testing that now thank goodness
 
Hi Liza,
Can you add the 101 to your spreadsheet?
I would test him again to see if his BG has gone up. Has Sandy eaten yet? If so, is he keeping his food down? It is not recommended to skip a dose of insulin for a cat who recently had DKA. Lets see what others have to say, but maybe depending upon his numbers, you could give him at least half a dose. Do you have high carb food or syrup to help steer his numbers, for just in case?
 
Dyana said:
Hi Liza,
Can you add the 101 to your spreadsheet?
I would test him again to see if his BG has gone up. Has Sandy eaten yet? If so, is he keeping his food down? It is not recommended to skip a dose of insulin for a cat who recently had DKA. Lets see what others have to say, but maybe depending upon his numbers, you could give him at least half a dose. Do you have high carb food or syrup to help steer his numbers, for just in case?
Click to expand...
Hi Dyana,
Just added it and I just took it again (1hour has passed) and it’s 106. Sandy did eat, he’s not having a lot in a sitting when it’s time for his shot, so I’ve been giving him food about every 3 hours when he’s awake just to get calories into him. He is holding his food down now, although I think it’s because he’s back in cerenia. I do not have high carb food as I thought this was not good, but this is all new to me. I did get some syrup to have on hand in case his numbers drop again. When they dropped before (2 times) he was able to have a meal and his numbers went up.
 
Hi Liza,
Sorry I wasn’t online to answer your question. I’m glad Dyana could help. I live in Australia so my hours are quite different to yours.
What did you end up doing? there are no units written in the SS for the last two cycles?

As Dyana said it is not good to skip insulin after DKA. If this happens again change your subject line and ask for help.

I’m glad he is responding to the cerenia.

Yes you need some higher carb foods for if he drops lower. The FF gravy lovers are high carb and you can look on the link I will post for more options.

https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
 
Bron and Sheba (GA) said:
Hi Liza,
Sorry I wasn’t online to answer your question. I’m glad Dyana could help. I live in Australia so my hours are quite different to yours.
What did you end up doing? there are no units written in the SS for the last two cycles?

As Dyana said it is not good to skip insulin after DKA. If this happens again change your subject line and ask for help.

I’m glad he is responding to the cerenia.

Yes you need some higher carb foods for if he drops lower. The FF gravy lovers are high carb and you can look on the link I will post for more options.

https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
Click to expand...
Bron and Sheba (GA) said:
Hi Liza,
Sorry I wasn’t online to answer your question. I’m glad Dyana could help. I live in Australia so my hours are quite different to yours.
What did you end up doing? there are no units written in the SS for the last two cycles?

As Dyana said it is not good to skip insulin after DKA. If this happens again change your subject line and ask for help.

I’m glad he is responding to the cerenia.

Yes you need some higher carb foods for if he drops lower. The FF gravy lovers are high carb and you can look on the link I will post for more options.

https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
Click to expand...
After hearing it’s not good to skip a dose and looking it up I decide to give him 1/2 dose, so .25, his number went up to 187 then started dropping and all day so far it has pretty much been in normal range. He’s only eating small amounts every 2-3 hours. But has kept food down. One thing I noticed is that when he eats bigger meals is when he tends to throw up. His BG right now is 75, I gave him a snack I’ll watch how his number goes next couple of hours. One thing I’m worried about is his super high numbers couple days in a row, then normal numbers like today. I’ve been writing a lot down but think I’m going to start putting down the flavor of food he is eating. I got the variety fancy feast classic pate and not sure if this is why his numbers are changing so much depending on the flavor he eats.
 
Test him again in an hour after the last test to see he’s not dropping down further. I’m glad you gave him a snack.
I’ll write more but wanted to tell you this first..I’ll be back soon.
 
Well done giving the 1/2 dose.
Did you give the 0.25 units for the am or the pm dose or both.
At the moment your SS is saying you gave the 0.25 units at the am dose.
Is that just an error?

Don’t be concerned about the high black numbers. Sandy was bouncing from the lower blue numbers he had the days before that. bou ding is quite normal especially in newly diagnosed cats. Bouncing happens when the cat drops too low, too fast or drops in lower numbers that he is not used to having any more...these numbers can be blue or yellow numbers if he is used to being in higher than that numbers. When all that happens, his body thinks it has to save itself and it dumps stored glucose and regulatory hormones into his system which shoots up the BGs.
Bouncing can last for up to 6 cycles and there is nothing you can do about it. Just wait it out.
When they come off the bounce, they will come back down to more normal numbers that they were having before the bounce. Sometimes when they are coming off the bounce they can drop quite quickly down to lower blue or green numbers.

If you get a green number like you did this morning 86 at +5, always test again in an hour to see the number is not dropping further.
And always give a snack.
 
Bron and Sheba (GA) said:
Well done giving the 1/2 dose.
Did you give the 0.25 units for the am or the pm dose or both.
At the moment your SS is saying you gave the 0.25 units at the am dose.
Is that just an error?

Don’t be concerned about the high black numbers. Sandy was bouncing from the lower blue numbers he had the days before that. bou ding is quite normal especially in newly diagnosed cats. Bouncing happens when the cat drops too low, too fast or drops in lower numbers that he is not used to having any more...these numbers can be blue or yellow numbers if he is used to being in higher than that numbers. When all that happens, his body thinks it has to save itself and it dumps stored glucose and regulatory hormones into his system which shoots up the BGs.
Bouncing can last for up to 6 cycles and there is nothing you can do about it. Just wait it out.
When they come off the bounce, they will come back down to more normal numbers that they were having before the bounce. Sometimes when they are coming off the bounce they can drop quite quickly down to lower blue or green numbers.

If you get a green number like you did this morning 86 at +5, always test again in an hour to see the number is not dropping further.
And always give a snack.
Click to expand...
Ok thank you for explaining that, I’m just so confused I get so happy when he gets into normal numbers and then he shoots back up. I still have days prior to put in just hard going back and forth from the app to the chart but I wanted to show what’s been going on past few days. The .25 was his morning dose. It was delayed because I didn’t know what to do. So now I’ll give him the next dose 12 hours from then. If his numbers are still low do you think I should do the .25 again?
 
Liza Morales said:
Ok thank you for explaining that, I’m just so confused I get so happy when he gets into normal numbers and then he shoots back up. I still have days prior to put in just hard going back and forth from the app to the chart but I wanted to show what’s been going on past few days. The .25 was his morning dose. It was delayed because I didn’t know what to do. So now I’ll give him the next dose 12 hours from then. If his numbers are still low do you think I should do the .25 again?
Click to expand...
Ok I understand now about the dose and when.
So you need to adjust the SS to show that. At the moment it looks like you gave the am dose on time and then skipped the pm dose.

So this is what you need to do:
What was the BG when you tested at AMPS? 101?
What was the BG and the time when you tested and decided to give the 0.25 units of insulin?135?
In the AMPS column you need to stack all that information because the new AMPS time is when you gave the dose of 0.25.
So it will look something like this......101@+12; 135@+? (This is your new AMPS)
Then the BGs you did afterwards are from that time, not the original AMPS.
So if all those BGs you have taken since you gave the insulin today are before the pm dose, they need to go into the am cycle.
In the appropriate spot.
Does that make sense?

I’m going to ask @Bandit's Mom to contact you to have a look and help you if needed, she will be online a bit later. Bit in the meantime if you could RY and fix it, that would be great.
 
Bron and Sheba (GA) said:
Ok I understand now about the dose and when.
So you need to adjust the SS to show that. At the moment it looks like you gave the am dose on time and then skipped the pm dose.

So this is what you need to do:
What was the BG when you tested at AMPS? 101?
What was the BG and the time when you tested and decided to give the 0.25 units of insulin?135?
In the AMPS column you need to stack all that information because the new AMPS time is when you gave the dose of 0.25.
So it will look something like this......101@+12; 135@+? (This is your new AMPS)
Then the BGs you did afterwards are from that time, not the original AMPS.
So if all those BGs you have taken since you gave the insulin today are before the pm dose, they need to go into the am cycle.
In the appropriate spot.
Does that make sense?

I’m going to ask @Bandit's Mom to contact you to have a look and help you if needed, she will be online a bit later. Bit in the meantime if you could RY and fix it, that would be great.
Click to expand...
Ok yeah I messed up then, I think I get it now. Will fix my numbers. And sorry thanks for bearing with me. I have my numbers flipped between am and pm
 
Hey Liza
I just saw on the Facebook page that you said Sandy had dropped down under 50 a couple of times.
Is that correct? I can’t see that on his SS.
If he dropped under 50 he needs to have the dose reduced.
Can you can confirm please?
 
Bron and Sheba (GA) said:
Hey Liza
I just saw on the Facebook page that you said Sandy had dropped down under 50 a couple of times.
Is that correct? I can’t see that on his SS.
If he dropped under 50 he needs to have the dose reduced.
Can you can confirm please?
Click to expand...
Yes he dropped low couple of times, I just have to put the test of the previous days in. But I wrote it all down from the lifestyle app now so I have to redo it now, on the app it goes from bottom to top if that makes any sense and this is the reason I was having a hard time figuring out how to transfer it over. Once I’m done hopefully it will make sense
 
Liza Morales said:
Yes he dropped low couple of times, I just have to put the test of the previous days in. But I wrote it all down from the lifestyle app now so I have to redo it now, on the app it goes from bottom to top if that makes any sense and this is the reason I was having a hard time figuring out how to transfer it over. Once I’m done hopefully it will make sense
Click to expand...
Ok I can see lots more tests have been put into the SS, thank you.
Try and keep it updated is you can, especially with any low numbers, as we look at the SS before we help you.
I can see you dropped from 1 unit to 0.5 units when Sandy dropped to 48 a week ago so no need to reduce again. normally we reduce by 0.25 units not 0.5 units but leave it at 0.5 units now as he has been on it for a week and doing well.
I see he is bouncing a bit today from the lovely green numbers yesterday.
Thank you for putting the ketone results into the SS. ...that very helpful and it’s great they are negative!
You are doing a really good job helping him recover from the DKA.
Is he still eating well?
 
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