Buddy post DKA thread (Part 3)

[DArcey and Buddy]

Starting a new thread as the other was getting long.

@Bron and Sheba (GA) Buddy weighs 10.6 pounds as of today. Usually closer to 11.2, but lost some weight through this experience.

@Judy & Fritz you are so right, the orange cats are overflowing with love and affection!

Link to the previous thread; https://www.felinediabetes.com/FDMB/threads/8-9-buddy-not-eating-post-dka.251084/#post-2834496

 

[Chris & China (GA)]

How's Buddy's appetite today?

Your picture in the previous thread is so adorable. My first kitten was an orange boy. They always seem to come in the "Extra large, family size" packaging!

 

[Bron and Sheba (GA)]

For her weight 2 mg three times a day is fine.

 

[DArcey and Buddy]

How's Buddy's appetite today?

Your picture in the previous thread is so adorable. My first kitten was an orange boy. They always seem to come in the "Extra large, family size" packaging!

Appetite has been down, and then, thankfully, up! This morning was super rough, she went to the vet and when she got back she seemed quite sick, desperately drinking water and refusing to eat.

Around noon we got the two anti nausea meds and the appetite stimulant into her, and over a few hours she started to eat a bit better! I’m dont want to jinx it but she is eating decently.

And a big of exciting news... we swung a string in front of her, and she played for a moment! And when we gave fluids tonight, she tried to fight us and leapt away and made us chase her... which was frustrating but SOO nice to see!!!!

 

[Bron and Sheba (GA)]

Go Buddy!

 

[DArcey and Buddy]

Go Buddy!

Yes! We are so praying she keeps improving! It was a hard morning but I hope we’ve got all the meds we need to keep her on track now!!

Btw, I still have to update the spreadsheet with the ketone info from today. We had some pee tests that showed trace, and some in between negative and trace. No negative yet, but I’m hoping and praying that this means these levels are just “normal” for her and don’t automatically mean we need to panic, provided she is getting food and insulin. Although, if the ketones could go down to negative and stay there, that would be even better, lol.

 

[Judy & Fritz]

Yes! We are so praying she keeps improving! It was a hard morning but I hope we’ve got all the meds we need to keep her on track now!!

Btw, I still have to update the spreadsheet with the ketone info from today. We had some pee tests that showed trace, and some in between negative and trace. No negative yet, but I’m hoping and praying that this means these levels are just “normal” for her and don’t automatically mean we need to panic, provided she is getting food and insulin. Although, if the ketones could go down to negative and stay there, that would be even better, lol.

Praying for sweet Buddy!

 

[DArcey and Buddy]

So far a pretty uneventful evening with Buddy. She has had lots of little bites to eat and is favoring the wet foods with some gravies, so not ideal in a carb sense but she is eating somewhat consistently. So because she isn’t liking her usual low carb pâtés, her numbers aren’t going as low as we would like. But she’s eating soo we can’t complain too much I think haha

 

[DArcey and Buddy]

Another update- Buddy is doing pretty well today so far, we think.

Still seeing urine ketones that are fluctuating between trace, and the area between negative and trace. We have not had any negative urine tests in the last 36 or so hours (losing track of time a bit lol)

She is eating pretty willingly today! She is still picky and so we are still offering her lots of options, including high carb wet gravy ones, which are her favourite choice right now, but we are just happy she is eating! And she eats a bit of regular fancy feast, which is good progress.

I am hoping this means we have the right combo of anti-nausea meds and appetite stimulant. Right now I have settled in trying 2mg ondansetron twice a day, 4mg of cerenia once a day, and we are going to see if doing the 2mg mirtazapine every second day would would well for her (the vet said we are okay to give her 2mg a day if needed, but I have seen other recommend giving it every 2/3 days, so I am going to attempt to do every second day for now. Though, if she does stop eating again, I’ll give it sooner). She is also taking 0.2ml bup three times a day, and 25mg gabapentin 3 times a day, and 100ml of fluids a day! Whew!

If anyone reads this and has dosing advice, I would be curious to hear your input, as Buddy has only made it down as far as yellows in past three cycles. Should we up the dose? Or could this be a bounce perhaps?

 

[DArcey and Buddy]

@Chris & China (GA) @Bron and Sheba (GA) @Judy & Fritz , I would be curious to hear any insight about this urine ketone test. We interpret this as somewhere between negative and trace. (We have seen darker than this in the last 36 hours- we have had definite “trace” urine tests”, but today this is the main colour we’ve been getting.

photo #1:

Photo 2 in different light:

And here is the test strip next to a negative strip:

We find the colour strange and hard to interpret, because it looks light violet to us.

 

[Bron and Sheba (GA)]

@Chris & China (GA) @Bron and Sheba (GA) @Judy & Fritz , I would be curious to hear any insight about this urine ketone test. We interpret this as somewhere between negative and trace. (We have seen darker than this in the last 36 hours- we have had definite “trace” urine tests”, but today this is the main colour we’ve been getting.

photo #1:
View attachment 62134

Photo 2 in different light:

View attachment 62135

And here is the test strip next to a negative strip:

View attachment 62136

We find the colour strange and hard to interpret, because it looks light violet to us.

It is quite strange. We do have people who have trouble deciding if it is negative or trace but it normally isn’t violet. I used to fine it hard…..
I’m wondering if she is taking something that could be influencing the colour…….not if she has ketones or not ….but the colour of the negative…….I am just thinking aloud with this and I could be wrong.
The other thing you could do is buy another bottle of Ketostix from a different place…in case it is a batch of them affected…..and see if that makes a difference.

As long as the blood ketone results are OK and she is eating OK and is alert and active, I would not be concerned.
Regarding the SS and dose of insulin………how much low carb food and how much higher carb food are you feeding?

 

[DArcey and Buddy]

It is quite strange. We do have people who have trouble deciding if it is negative or trace but it normally isn’t violet. I used to fine it hard…..
I’m wondering if she is taking something that could be influencing the colour…….not if she has ketones or not ….but the colour of the negative…….I am just thinking aloud with this and I could be wrong.
The other thing you could do is buy another bottle of Ketostix from a different place…in case it is a batch of them affected…..and see if that makes a difference.

As long as the blood ketone results are OK and she is eating OK and is alert and active, I would not be concerned.
Regarding the SS and dose of insulin………how much low carb food and how much higher carb food are you feeding?

Yeah, that’s an interesting point about something she is taking affecting the urine! It could be! Good thinking on a new pack of ketostix- we had a similar thought and we did picked up a new box of them, and results seem to be the same. So weird eh! Im trying to be much calmer about it, and take it in stride. It does seem to fluctuate and sometimes it isn’t violet, sometimes it really is the exact same colour as trace. It’s definitely odd though! I’ll keep an eye on it but try my best not to panic ;-)

In terms of food, she is currently eating about 300-340 grams of food a day. That is typical for her, so she is eating well, it just takes a lot more effort on our parts than usual in terms offering variety, bringing it to her, offering tons of snacks, etc.

She is mostly eating high carb foods with gravy. Whenever we offer her a meal or a snack, we always offer a low carb fancy feast first (and we have evvvvvery flavour, lol) but often she won’t eat it. Then we offer her a higher carb food, and she tends to start eating that right away. The goal is to transition back to fancy feast eventually, but knowing what we know now, getting her to eat will always remain priority #1!!!

 

[Chris & China (GA)]

I don't know why it happens, but I have a DCIN client who has a cat that occasionally has some crazy test results too so as long as the blood ketone meter says it's OK, I'd just go with that.

Look familiar?

 

[Bron and Sheba (GA)]

She is mostly eating high carb foods with gravy. Whenever we offer her a meal or a snack, we always offer a low carb fancy feast first (and we have evvvvvery flavour, lol) but often she won’t eat it. Then we offer her a higher carb food, and she tends to start eating that right away. The goal is to transition back to fancy feast eventually, but knowing what we know now, getting her to eat will always remain priority #1!!!

Ah….I see she is just like all of us…we all love the high carb food! She could be bouncing from those blues, It if she doesn’t go back down, we can raise the dose. Or you can try persisting with some Low carb food…..but we do want her to eat, so it is hard…and I think she has figured it out!!
Try and find some of the lower high carb food if you can.

 

[Bron and Sheba (GA)]

I agree with Chris. Just stick with the blood ketone meter. That gives you an up to date accurate picture.

 

[Chris & China (GA)]

She is mostly eating high carb foods with gravy. Whenever we offer her a meal or a snack, we always offer a low carb fancy feast first (and we have evvvvvery flavour, lol) but often she won’t eat it. Then we offer her a higher carb food, and she tends to start eating that right away.

Have you tried adding some warm water to the pate to make your own "gravy"? Another thing you could try if you have the time to make it is to make some bone broth. Most cats love it straight or as extra fluid mixed into their food.

 

[DArcey and Buddy]

@Chris & China (GA) woah! Those urine strips sure do look familiar! Interesting. Yes, we will keep an eye on what the blood meter says. I admit I am a test-a-holic, lol.

@Bron and Sheba (GA) she LOVES the carbs. Weirdly she goes crazy when we eat bread. Obviously we don’t give her bread though, lol, but it’s adorable to see her try to get the bread from us haha.

Yes we add warm water to all her food- thankfully she tolerates that very well! The bone broth is a very good idea. I will watch the video and look into that!! I know a local store sells bone broth, but I imagine it’s better to make it to be 100% what is in it?

Today she has eaten more fancy feast than the last few days- she is liking the beef and the tender liver & chicken (I am assuming these are low carb as the are FF pates though admittedly they are not our normal flavours and I haven’t verified). In terms of a medium carb food, I will check the carbs for the friskies pates- I thiiiink some of them, like the salmon pate, are more “medium” carb, though I could definitely be mistaken.

 

[Bron and Sheba (GA)]

Making your own bone broth is best if you can. Just chicken bones and water. I used to do it all the time for Sheba. If you add it warm to the low carb, she might think it is high carb gravy

 

[DArcey and Buddy]

Making your own bone broth is best if you can. Just chicken bones and water. I used to do it all the time for Sheba. If you add it warm to the low carb, she might think it is high carb gravy

That sounds pretty good! Okay, we will watch the video and hopefully do this in the next day or two! How much if the bone broth do you usually add- just a tablespoon or two for a can of food? Or more?

 

[Bron and Sheba (GA)]

That sounds pretty good! Okay, we will watch the video and hopefully do this in the next day or two! How much if the bone broth do you usually add- just a tablespoon or two for a can of food? Or more?

Making the broth is so simple. I used to buy about 8 or 10 chicken legs and put them in water. Bring to the boil. When the meat was cooked I got the meat off the bones and then put the bones and the meat that was left on the bones back in to simmer. The meat I used as part of Shebas diet, as I made her food myself but it can also be used as a basis of a meal for you. Buddy might like some of it mixed in with other food or as a snack on its own. As long as it’s not more than about 20% of the total food for a short time, it is fine…..
I used to give the stock information to Sheba in her autofeeder at night so she got extra fluids as she was always a bit prone to being a bit dehydrated.
Also a teaspoon to a tablespoon in each snack, depending on how much they will tolerate it.

Only issue is it is higher in phosphorus so if there is any CRD, which you do have listed, I would not give too much. But for a week or two it should be OK.

 

[Chris & China (GA)]

How much if the bone broth do you usually add- just a tablespoon or two for a can of food? Or more?

Some people do half a can of water to 1 can of food so you could give at least that much of the bone broth. It does add some nutritional value where plain water doesn't, but it will depend on Buddy!

As with everything else, the cat is in charge here. If you add too much, she may not be willing to eat it at all so you could start with a small amount and increase until you find the point where she starts to "complain"

If you put the bone broth into ice cube trays and freeze it, once frozen you can pop them into a baggie and use them as needed. (my handy tip for the day...LOL)

 

[DArcey and Buddy]

Making the broth is so simple. I used to buy about 8 or 10 chicken legs and put them in water. Bring to the boil. When the meat was cooked I got the meat off the bones and then put the bones and the meat that was left on the bones back in to simmer. The meat I used as part of Shebas diet, as I made her food myself but it can also be used as a basis of a meal for you. Buddy might like some of it mixed in with other food or as a snack on its own. As long as it’s not more than about 20% of the total food for a short time, it is fine…..
I used to give the stock information to Sheba in her autofeeder at night so she got extra fluids as she was always a bit prone to being a bit dehydrated.
Also a teaspoon to a tablespoon in each snack, depending on how much they will tolerate it.

Only issue is it is higher in phosphorus so if there is any CRD, which you do have listed, I would not give too much. But for a week or two it should be OK.

Good point about the CKD- and now that I think of it, I just reviewed the papers from the hospital, and they noted a few times that she has hyperphosphatemia, so maybe the bone broth won’t work well for her. We will probably try to redo blood work next week, if we can get into our vet again, to see how all her levels are, for kidneys and phosphorous levels and everything else.

We will definitely continue to add water. Similar to what @Chris & China (GA) suggested, we generally do a half can water for every can of food (hubby measures out exactly that amount, and I just eyeball it, and tend to do a little more than a half can per can) and she seems to like that- or at least she does when she is feeling well!!

 

[Bron and Sheba (GA)]

we generally do a half can water for every can of food (hubby measures out exactly that amount, and I just eyeball it, and tend to do a little more than a half can per can) and she seems to like that- or at least she does when she is feeling well!!

That is good she will tolerate that amount.

 

[DArcey and Buddy]

That is good she will tolerate that amount.

Yes we are so lucky! Although at the moment she is more picky, lol. Even before, on occasion we would accidentally make it too soupy, and she would be furious and refuse to eat it, LOL