Kaz Hospitalized With DKA

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[USER=10387]@Claire[/USER] said:
I think I am going to switch it to 11-12pm tonight which would only be 3-4 hours earlier if I got up at 3am.

Medications - Appetite - Mirataz (mirtazapine) 2% transdermal ointment - apply a 1.5 inch strip to the inner ear (absorption gel/creams) easy to administer (once daily want to switch to this evening)
Cerenia - nausea/vomiting/decreased appetite - 1/2 tablet once a day (once daily want to switch to this evening)

RenaKare 2mEq (potassium gluconate) tablets HUGE - 2 tablets twice a day OR RenaKare Gel 5ml (1 teaspoon) by mouth daily. Tried this last night it went everywhere. Going to try this again tonight with a syringe as this will be easier than tablets.

Kaz is not due to eat for about 2 1/2 hours but he has literally just come to ask me for food WHAT DO I DO not sure if him asking is him liking a tiny bit or actually wanting to eat but I don't want to feed him now and then he won't eat before the insulin shot. I also don't want him to then not be hungry again in couple hours as I know if I ignore hunger pains they go away and I am no longer wanting food?????

Need the following answers:-

1) Can I give the two meds tonight instead of 3am (I THINK THIS IS OK)
2) I have to bring his insulin back to 6 / 6.30am time schedule due to work. Vets assistant told me it was ok to do it grudgingly
3) Kaz appears hungry now but insulin not due for 3 1/2 hours if i feed him now he probably will not eat in 3 1/2 hours plus until I actually put food in front of him will not know if he will eat.

Thanks Claire
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IMPORTANT

Sorry one more thing HOW MUCH FOOD IS ENOUGH TO GIVE HIM THE INSULIN SHOT (1 1/2 UNITS)
1 SMALL CAN/POUCH (3OZ FOOD 60 CALORIES)
2 SMALL CAN/POUCH OR ONE LARGE POUCH ADDING UP TO 150 CALORIES.

IF HE DOES EAT BUT ONLY A SMALL AMOUNT HOW MUCH DO I GIVE HIM?

VET SAYS HE IS SUPPOSED TO GET 300 CALORIES A DAY MOST IN THE TWO MAIL MEALS AND A SMALL SNACK IN THE EVENING IF HE WANT IT.
 
Ok first thing is feed him if he's hungry, we'll worry about insulin later. Just note roughly how much he ate, when, and what kind of food

Let me look at some med stuff real quick
 
It should be ok to move the meds back by just a few hours, I know I've mistakenly given them multiple times a day.

In my experience Cerenia does nothing unless they're actually vomiting, ondansetron is better for nausea. I would call them and see if they'll send a prescription to your nearest human pharmacy (it's relatively cheap med, at least here...like $8 for 30 pills
 
My vet (one with COVID) just called. He said the same thing feed him now and then as much as he wants till insulin time and then if he eats the full amount over this period to give him the 1 1/2 units if only a small amount to give him 1 unit only.

The cat is drinking huge amounts today and the Dr was saying its because the cat needs insulin so I must give him the 1 unit at the minimum.
BG is currently 362 (been around the same amount all day).
FrostD said:
It should be ok to move the meds back by just a few hours, I know I've mistakenly given them multiple times a day.

In my experience Cerenia does nothing unless they're actually vomiting, ondansetron is better for nausea. I would call them and see if they'll send a prescription to your nearest human pharmacy (it's relatively cheap med, at least here...like $8 for 30 pills
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Sadly just got off the phone and saw this after my vet is hard to reach right now as he has COVID but I can send him an email to ask if I can switch to ondansetron he may not respond till Monday though.


He also told me to change the two meds to this evening and to go back to the 6am and 6pm dosing now if I wanted to. I was going to go to 7pm earliest today as I am home over the weekend and then adjust back to 6pm by Monday.

He has eaten about a 1/2 tablespoon of his food vs all the others I bought. Not huge amount but progress he is also willing to eat his treats which is also a step in the right direction as a few hours ago nothing.

Sorry hoping not asking too many questions just don't really know where else to go.

Currently watching videos (looking for videos) on crushing tablets and then syringing them in case the get doesn't work.
 
Yes you can see the 1.5U last night and 0.5U this morning weren't enough. They don't need to eat a ton with the insulin, I know that's drilled into a lot of people's heads. So yes you'll want to reduce a bit but not a lot
 
I eventually bought a mortar and pestle. But I just used the back of a spoon on a plate to crush them. You want the pills to be the first thing you put in the syringe, in case he doesnt take it all - but also, a decent amount of food/whatever is left in the nozzle when the syringe is done
 
FrostD said:
I eventually bought a mortar and pestle. But I just used the back of a spoon on a plate to crush them. You want the pills to be the first thing you put in the syringe, in case he doesnt take it all - but also, a decent amount of food/whatever is left in the nozzle when the syringe is done
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Thanks that's good to know as I thought I crushed them and added water food broth does seem better. Sure I can find something with all the different foods I have now.

Thanks vey helpful
 
Some crushed pills are bitter. I know human ondanestron is. Have some tuna water in a second syringe handy to use as a chaser.
Even if the pills are not bitter, everything goes down better with a chaser.
 
I decided to go with the gel versus the crushed tablets as I realized I could pull the end off the big syringe I have and squeeze it straight in. Administration was not perfect but at least 95% went down the gullet.

Think as he basically got his full dose of insulin it's dropped his BG quicker than normal as he is tired but I believe he is ok and the BG is in the acceptable range at 270. I will get up in the night to check on him.

Thanks
 
[USER=10387]@Claire[/USER] said:
What does AMPS and PMPS on the spreadsheet mean please.
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AMPS is am preshot and PMPS is pm preshot.

Claire, do you have any higher carb food in the house? If Katz is not eating a lot and you need to give him his insulin, you can give some of the higher carb food during the cycle to keep the BG up high enough to be safe. It is OK to do that and we sometimes suggested that with DKA kitties who are not eating well. At the moment it doesn’t matter what he is eating.. he can eat the high carb dry if that is all he will eat. The most important thing is he will eat. We can worry about low carb food later when he is better.
You are doing a good job in difficult circumstances….hang in there!
 
I have been giving him the option of three kinds of biscuits and my understanding is that all dry food is high in carbs. Kaz loves dry food he's just not supposed to eat it due to urine blockage issues he has but the vet says due to the amount of water he's drinking it should not be a problem.
This medicine usually goes in his food. As soon as I realized he would lick the broth I put the medicine in a meal this afternoon.

Right now I try a couple of wet options and then end with a few dry biscuits. (only been eating 10-15 small morsels all he wants).

Still don't understand the AMPS and PMPS .... what preshot? I only give him insulin is there another shot other give?
 
[USER=10387]@Claire[/USER] said:
Still don't understand the AMPS and PMPS .... what preshot? I only give him insulin is there another shot other give?
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You give insulin in the morning and the evening at a designated time. Just the 2 insulin doses a day.
The AMPS is the blood glucose number you get before you give the dose of insulin. And the PMPS is the pm blood glucose number you take before giving the insulin. Does that make better sense?

are you giving Katz some snacks during the cycles?
 
ok I have been putting that as the last number +11

Thankful for the Libre button hoping vet will let me continue with it.
 
I gave him 1/2 dose while driving around trying to find oral syringes vet called me said there was not much else beyond a feeding tube. He also said to give him another unit if his BG was above 300 however its now at 229 down from 341 which is a bit of a drop in 2 1/2 hours.

Sounds like if this does not work the vet is hinting that I may want to have him put to sleep. I was hoping we were not at that stage. Defeated.

Must go into work tomorrow due to a meeting just not going well.
 
First, is this Dr. Brum at Angell Memorial? Is he the vet that is suggesting that you may have to euthanize Kaz?

My sister used Dr. Brum and he was wonderful and she had a very complicated cat. If the vet that said this isn't Dr. Brum, talk to Dr. Brum.

I also want you to take a deep breath. You need to calm down or Kaz is going to sense your anxiety which is only going to throw him off further. Our kitties respond to our emotions. The more you communicate that you trust him and that you're doing your best to help him feel better, the easier this may become.
 
Sienne and Gabby (GA) said:
First, is this Dr. Brum at Angell Memorial? Is he the vet that is suggesting that you may have to euthanize Kaz?

My sister used Dr. Brum and he was wonderful and she had a very complicated cat. If the vet that said this isn't Dr. Brum, talk to Dr. Brum.

I also want you to take a deep breath. You need to calm down or Kaz is going to sense your anxiety which is only going to throw him off further. Our kitties respond to our emotions. The more you communicate that you trust him and that you're doing your best to help him feel better, the easier this may become.
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Hi Gabby

This is Dr Brum at Angel and as I mentioned he is in charge of the diabetes department. Main problem I have had here is that he has been out with COVID.
I send him emails every day and he try's to call me once a day.
He did not come right out and say it but said there is a point when you have to make the decision what your willing to put the cat through and yourself.
I like Dr Brum hes a good vet and he was the one that helped me through the 75% masses on Kaz's liver.

I have managed to get Kaz to eat 1/2 can of Fancy Feast (disgusting full wheat and animal by products) but I am letting him eat anything at this point. He also ate small amount dry food which I have allowed but concerns me due to the blockage issue but I need him to eat right now.
I'm guessing the dry food is spiking his BG levels as after he ate this it spiked back into the high 300s. Makes it hard to dose him.

Don't suppose your sister knows of housesitters/hospitals in this area that board/deal with diabetic cats?
 
I finally outsmarted Kaz. I keep putting saran wrap in the box and he keeps moving the wrap where he wants to pee but this time he did not move it enough and I was able to get a good sample.

Results are negative.

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Your doing great hang in there. I know you are exhausted not only physically but mentally & emotionally as well.That's good that he's eating for you a little bit, that's better than nothing. My boy has had a UTI for 2mons now, nothing compared to what you are going through but very scary. He went through a spell of vomiting, nausea & wouldn't eat. Someone on here told me to try parmesan cheese sprinkled on his food. I put it on his regular wet food & he gobbled it up. I had to do this for several feedings & then switched him up to fortiflora. He's now eating all or most of his food every feeding. Sometimes I have to use fortiflora but for the most part he is doing well with eating. I wouldn't worry so much about his #s until you get him eating regularly. Best of luck to you & your boy:bighug:
 
Chrispooky12 said:
Your doing great hang in there. I know you are exhausted not only physically but mentally & emotionally as well.That's good that he's eating for you a little bit, that's better than nothing. My boy has had a UTI for 2mons now, nothing compared to what you are going through but very scary. He went through a spell of vomiting, nausea & wouldn't eat. Someone on here told me to try parmesan cheese sprinkled on his food. I put it on his regular wet food & he gobbled it up. I had to do this for several feedings & then switched him up to fortiflora. He's now eating all or most of his food every feeding. Sometimes I have to use fortiflora but for the most part he is doing well with eating. I wouldn't worry so much about his #s until you get him eating regularly. Best of luck to you & your boy:bighug:
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Sorry to hear your boy is not doing well I have had a cat with URI issues and its not easy. Never heard the parmesan cheese trick before? I used fortiflora for awhile but switched to pet ultimates probiotics for cats my cats like the smell although Kaz has not had this in at least a week at this point.
 
Bron and Sheba (GA) said:
Claire, do you have any higher carb food in the house? If Katz is not eating a lot and you need to give him his insulin, you can give some of the higher carb food during the cycle to keep the BG up high enough to be safe. It is OK to do that and we sometimes suggested that with DKA kitties who are not eating well. At the moment it doesn’t matter what he is eating.. he can eat the high carb dry if that is all he will eat. The most important thing is he will eat. We can worry about low carb food later when he is better.
You are doing a good job in difficult circumstances….hang in there!
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Hi Bron I just listed some of the med and high carb foods for her :cat:



Claire here are some of the med and high carbs foods you could try
I see you live in Boston Mass thanks for the reply
You can see if he will eat any of these also

Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart.
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
 
Thanks Diane

Right now the only food he will eat is Fancy Feast and one particular High Protein Purina dry food. He has now eaten two small cans of wet food throughout the day and about 30 pieces of kibble.
Not happy about what he's eating but it is a struggle to get him to eat so right now don't really have a choice.

I have syringed 3 this morning and 3 this evening of DM Perina wet food. Don't really have the right syringes they arrive tomorrow plus Kaz really does not appreciate it. He got pretty upset but I think for now this is my only option.

I have some Purina Pro Plan Veterinary Diets DM Dietetic Management Savory Selects Wet Cat Food on order at Chewy waiting for it to be approved.

Good to know that Fancy Feast is high carb so I am going to keep some in the house in case of emergency's thanks for this information as I have been struggling with it.
 
Diane Tyler's Mom said:
Hi Bron I just listed some of the med and high carb foods for her :cat:



Claire here are some of the med and high carbs foods you could try
I see you live in Boston Mass thanks for the reply
You can see if he will eat any of these also

Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart.
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
Click to expand...

I just checked out that link. Happy to see that all Tiki food is zero carbs and thats what both my cats have been eating for about 3-4 years however some of the other brands are quite disturbing. Brands that I thought were healthy like Royal Canin and Science Diet not so much. Weruva was also a surprise I thought this food was similar to Tiki. Sooner I get Kaz back onto Tiki the better.

Thanks for this so helpful need to print and file it for easy viewing.
 
You are doing fantastic Claire!!! Way to go Kaz!♡!♡ I'm convinced that they know when we are trying to help them even though they don't like the procedure usually. Keep up the good work as I'm sure Kaz loves you dearly for it.
 
[USER=10387]@Claire[/USER] said:
Thanks Diane

Right now the only food he will eat is Fancy Feast and one particular High Protein Purina dry food. He has now eaten two small cans of wet food throughout the day and about 30 pieces of kibble.
Not happy about what he's eating but it is a struggle to get him to eat so right now don't really have a choice.

I have syringed 3 this morning and 3 this evening of DM Perina wet food. Don't really have the right syringes they arrive tomorrow plus Kaz really does not appreciate it. He got pretty upset but I think for now this is my only option.

I have some Purina Pro Plan Veterinary Diets DM Dietetic Management Savory Selects Wet Cat Food on order at Chewy waiting for it to be approved.

Good to know that Fancy Feast is high carb so I am going to keep some in the house in case of emergency's thanks for this information as I have been struggling with it.
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You are very welcome, you're doing a great job, I'm glad he's starting to eat :bighug::cat:
 
My sister passed away several years ago. I would ask at Angell to see if any of the vet techs do any pet sitting on the side. I believe Care.com also has listings of pet sitters. You can also start a thread on this board asking if anyone in the Boston area would be able to lend a hand with names.
 
Sienne and Gabby (GA) said:
My sister passed away several years ago. I would ask at Angell to see if any of the vet techs do any pet sitting on the side. I believe Care.com also has listings of pet sitters. You can also start a thread on this board asking if anyone in the Boston area would be able to lend a hand with names.
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Thank you Sienne and Gabby - I already have feelers out over here. I have a doctor and an assistant asking on my behalf and I also have feelers out on the adoption side. I used to volunteer with the animals till COVID hit so I know the director over here. She has been asking for about a week but so far no luck.
I have just visited Care.Com and joined that and posted an ad to see if anyone responds so thanks for that.

I was going to start a new post I was just waiting for Kaz to get a bit better first. Hard to think how anyone else would manage especially if the cat refused to eat and needed insulin.

Thanks
 
Bron and Sheba (GA) said:
How are things going with Kaz?
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Yesterday everything really caught up with me. I finally ate after 4 days and I think it was because Kaz has finally started eating. Have to say its a fantastic weight loss plan.

I have been filling out the chart but it seems like I finish one thing and then it's half hour to start the next.

Today Kaz has eaten two small cans of Tiki (about 120 calories) and I think he might eat more he seems like he's getting his appetite back. I also figured out that if I gave him the appetite stimulant at around 9pm then by morning he's really hungry and even though its still taking about 45 minutes to get him to eat the can he is eating it.

He seems to be switching between the pink and yellow on the spreadsheet which I am guessing means he needs more insulin but right now we are good where he is.

Trying to get on Dr Brums schedule for next week as the button stops working next week and I want another put on till Kaz is back to fighting form.

Thanks
 
The Libre button stopped working sometime last night.

I set up another BRAND NEW Alpha Track 2 (now have two) can not get either to work so am now flying blind again. Don't know what I am doing wrong.

Set up the date and time set meter to 92 for a cat. Put in test strip and then insert test strip and it does not work. I used to get an error message if I did it wrong or it would time out as I was not fast enough.

Tried it on myself over and over and nothing. How can I get two bad machines doing same thing. Has to be me.

Have a people one but it means nothing as I don't know the conversion no point putting cat through needless test HELP what am I doing wrong.
 
Most of us here use a ,"people one". I use a Relion meter from Walmart. The numbers aren't all that different. Just take a deep breath and show Kaz that your relaxed. Even my Vet said that the people meters are fine for cats, (a 20% variance at best) and to save money and use the cheap Walmart meter. This website also goes on he people numbers for our cats unless you specifically tell them you're using an AlphaTrac.

You are doing fine, Claire, and Kaz loves you for your hard work.
 
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I have a people one which I can try when I get home but if it says 300 does that mean its 300 or 250 or 350 its a big difference when administering insulin especially for someone that's inexperienced.

As soon as I get another button on I will start using the people one so I can get an accurate conversion. Thought the button would last another 8 days it never came off its stuck on pretty good just simply stopped working.

Don't think I can get to vet till 13th which is a week from today as there are no appointments.
 
Hi Claire
The Freestyle Libre Button is a human meter and that's what you have been using. I used the Button, the alphatrak2 and now i am using the freestyle Lite human meter.
Its not the Exact number that matters...its the patterns over time.
Hope this helps.
 
I'm so sorry for Kaz. I hope everything will be fine with it and get rid of DKA. Yes, the treatment is quite expensive, but it is worth the money for Kaz to stay alive. But be careful what vet you choose to treat Kaz. Unfortunately, many non-professional veterinarians cannot even identify a problem correctly. I also have a cat, and she suddenly started sleeping with her head upside down. This is my first cat, and I had no experience with cat problems. I took him to a vet who told me to take treatment for my cat. I agreed until I talked to some friends about this problem, telling me that this is not a problem and that cats sleep with their heads upside down to maintain a warm temperature in their bodies. And indeed, it is true. The vet just wanted me to lose money. So be careful.
 
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The button stopped working so I had another put on yesterday as Kaz is still not himself and I don't want to do add stress right now. I am hoping the button lasts but am planning on starting blood pricks again on Saturday. Just one a day to see if he will allow me to do it and not get stressed. Currently trying to get a urine sample.
His BG was all over the place yesterday. We had a low of 132 and high of 475 which seems like a big swing. He was still high when I left for work but came back at lunch and he's dropped back to 280. Wondering if the stress of going to the hospital played a role in this.

Not much else to report.
 
Hi Claire can you please start a new thread? Once that's ready I can reply over there.

I'd title it "4/8 Kaz AMPS 351"
 
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