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Dinah S

Dinah S

Member Since 2022
https://docs.google.com/spreadsheets/d/1xiZiV6v296Xo22Dsw6Ck5v_VrgAhynR-exmyH9ivDL8/edit

Hello,

My boy Shai seems to be what 4 vets call a difficult case…he is seen at 2 clinics depending on their opening days as 1 is closed during weekends…

I hope the spreadsheet is ok to open this way am on an old I phone & can’t see much…but decided to try ask for some help cause my frustration is growing it doesn’t seem to go anywhere…

He was “fine” til December when he had a dental & since it’s ‍♀️

Last in order is an ear issue…he had a flush & they couldn’t see anything much so they said give him anti fungal it might clear something inside…saying no drops cause of cortisone & that a specialist will get back at me but he isn’t…and his numbers are going up…

He was on 1 unit for ages til ketones so they said go up to 2 units but he was extremely hungry & numbers were not good so they said try 1.5 but it’s not doing the trick…

High 31.2 this morning & 30.2 tonight scare me

Would anyone have any suggestions please ?! I lost his son in November from heart failure & don’t want to lose my boy

thanks in advance ‍⬛
Shai Oriental Male will be 14 in May is close to 5kg but losing weight since a couple of weeks
He is on Fancy Feast Classic Pate & we are in Australia
 
Hello and welcome. Looking at your spreadsheet, you should not have done and increase from 1 unit to 2 units. You may have shot past a good dose for him. I see he hit a lime green :-( on 2/6/22. That should have triggered a reduction of .25 units, and another one on 3/5, another .25 units. And again on 4/5 when you should have reduced the dose by .25 units again. Then hold those doses for 7 days (unless another reduction is required) to see how it goes.

Doses are based on the nadir, or how low the dose is taking the kitty and are not based on the morning and evening pre-shot numbers. That's the only way to be safe.
 
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Good job on all the testing, by the way. Your kitty appears to be very bouncy. He is not used to low numbers so he bounces up high. Those bounces, especially in the early days, can take up to six cycles to clear. It is upsetting to see them in such high numbers, I know. Also, as you know, I am sure that the ear problems are contributing to the high BG. His diet is good for a diabetic cat, so that's not an issue here. I am so sorry. I know how frustrating it is from personal experience!
 
You probably should get them to do an actual culture on the ear gunk (or whatever is in there) so they can know for sure what it is (bacterial or fungal). What kind of drops did they give you? Or is it an oral anti-fungal?
 
Suzanne & Darcy said:
Hello and welcome. Looking at your spreadsheet, you should not have done and increase from 1 unit to 2 units. You may have shot past a good dose for him. I see he hit a lime green :-( on 2/6/22. That should have triggered a reduction of .25 units, and another one on 3/5, another .25 units. And again on 4/5 when you should have reduced the dose by .25 units again. Then hold those doses for 7 days (unless another reduction is required) to see how it goes.

Doses are based on the nadir, or how low the dose is taking the kitty. That's the only way to be safe.
Click to expand...


Thank you he had to be seen on a Sunday for ketones & both clinics decided increasing to 2 so I did what was suggested… I saw it wasn’t right after 48h as he was never that hungry before…
Thing is the syringes I have don’t even do halves so am now doing an estimate as they said try 1.5 but am getting lost with what is happening :/
Issue is like you saw he goes from high to low & they all seem to be puzzled not to add not explaining anything…
So how much should he get then ?! 1.25 ?!
 
Dinah S said:
Thank you he had to be seen on a Sunday for ketones & both clinics decided increasing to 2 so I did what was suggested… I saw it wasn’t right after 48h as he was never that hungry before…
Thing is the syringes I have don’t even do halves so am now doing an estimate as they said try 1.5 but am getting lost with what is happening :/
Issue is like you saw he goes from high to low & they all seem to be puzzled not to add not explaining anything…
So how much should he get then ?! 1.25 ?!
Click to expand...
How frequently are you feeding him?
 
Dinah S said:
Thank you he had to be seen on a Sunday for ketones & both clinics decided increasing to 2 so I did what was suggested… I saw it wasn’t right after 48h as he was never that hungry before…
Thing is the syringes I have don’t even do halves so am now doing an estimate as they said try 1.5 but am getting lost with what is happening :/
Issue is like you saw he goes from high to low & they all seem to be puzzled not to add not explaining anything…
So how much should he get then ?! 1.25 ?!
Click to expand...

I understand your point & wish I’d known but the ketones were stopped with the 2 units…not sure how else it could have been done it’s how they reacted to it ;/
 
Do you have access to syringes with half units there? This is very frustrating. Can you order any syringes with half unit markings. I'm going to tag one of our moderators who lives in Australia, she may be able to help you a lot. She's extremely knowledgeable and very kind. @Bron and Sheba (GA)
 
Suzanne & Darcy said:
How frequently are you feeding him?
Click to expand...
I tried a few options & now he is on a full can Am & Pm plus he eate 1/4 or 1/2 can as snack 3h after shot
Suzanne & Darcy said:
You probably should get them to do an actual culture on the ear gunk (or whatever is in there) so they can know for sure what it is (bacterial or fungal). What kind of drops did they give you? Or is it an oral anti-fungal?
Click to expand...

as he is asking for food…

they did & said nothing much to see but his ear is botherong him…
No drops antifubgal tablets
 
Dinah S said:
I understand your point & wish I’d known but the ketones were stopped with the 2 units…not sure how else it could have been done it’s how they reacted to it ;/
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How are you testing for Ketones? Urine strips. Since I was unlikely to catch my cat at the litter box, I opted to use a blood ketone meter (after my kitty went DKA and spent a week in the ER). I used the Nova Max Plus meter and only used it to test for Ketones. He did tend to still have high ketones for a long time, but never went into DKA again. The thing that set him into DKA was an infection combined with the higher numbers (although he was getting a lot of yellow numbers at the time.)
 
Suzanne & Darcy said:
Do you have access to syringes with half units there? This is very frustrating. Can you order any syringes with half unit markings. I'm going to tag one of our moderators who lives in Australia, she may be able to help you a lot. She's extremely knowledgeable and very kind. @Bron and Sheba (GA)
Click to expand...
No there isnt any thats the problem I saw I could try get some from UK but here the vets say none
Thank you so much hope am not missing any messages cause am not used to write here
 
Suzanne & Darcy said:
How are you testing for Ketones? Urine strips. Since I was unlikely to catch my cat at the litter box, I opted to use a blood ketone meter (after my kitty went DKA and spent a week in the ER). I used the Nova Max Plus meter and only used it to test for Ketones. He did tend to still have high ketones for a long time, but never went into DKA again. The thing that set him into DKA was an infection combined with the higher numbers (although he was getting a lot of yellow numbers at the time.)
Click to expand...

yes I use strips
 
I see on his spreadsheet that sometimes he does this big drop at +1 or +2. If you let him eat his morning meal when you give him the shot, and then try feeding him a teaspoon of food at +1 and another at +2, you may be able to head off any steep drops, which could then trigger a bounce. You may even need to feed more at different times, you sometimes have to play around with it. I just would not feed him much after his nadir as this can shorten the duration of the insulin.
 
Suzanne & Darcy said:
I see on his spreadsheet that sometimes he does this big drop at +1 or +2. If you let him eat his morning meal when you give him the shot, and then try feeding him a teaspoon of food at +1 and another at +2, you may be able to head off any steep drops, which could then trigger a bounce. You may even need to feed more at different times, you sometimes have to play around with it. I just would not feed him much after his nadir as this can shorten the duration of the insulin.
Click to expand...
Thanks I tried not feeding in between so 2 meals , tried less than what I give now but since the increase he is very demanding ‍♀️ & was told not to let him be hungry so trying to keep him happy which doesn’t seem to work for numbers…I’ll try your +1 & +2 haven’t done that yet thanks
 
Dinah S said:
Keto diastix
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Are you testing for ketones daily?

So as I was saying, ketones in and of themselves, while we don't like to see them, won't necessarily lead to DKA. When he gets into better BG numbers, you will see the ketones come down. You might want to make a column on your spreadsheet to record the ketone findings -- or just write them in the notes section. But then he has this ear thing going on. If it doesn't clear up, I would ask for a culture even though they say they don't "see" anything. I've seen cases on this Board where people had ear cultures done and have found something when the vets didn't see anything.

Has he had blood work done recently?
 
Suzanne & Darcy said:
I see on his spreadsheet that sometimes he does this big drop at +1 or +2. If you let him eat his morning meal when you give him the shot, and then try feeding him a teaspoon of food at +1 and another at +2, you may be able to head off any steep drops, which could then trigger a bounce. You may even need to feed more at different times, you sometimes have to play around with it. I just would not feed him much after his nadir as this can shorten the duration of the insulin.
Click to expand...
Funny enough I tried leaving the food he won’t eat it only gets it if given and since increase he eats a bit or more no matter the amount he eats it
 
Dinah S said:
Thanks I tried not feeding in between so 2 meals , tried less than what I give now but since the increase he is very demanding ‍♀️ & was told not to let him be hungry so trying to keep him happy which doesn’t seem to work for numbers…I’ll try your +1 & +2 haven’t done that yet thanks
Click to expand...
Yes. Let that boy eat! They can be so hungry at this stage because their bodies just can't make full use of the food that they are taking in. And you said he'd lost weight, right?
 
Suzanne & Darcy said:
Are you testing for ketones daily?

So as I was saying, ketones in and of themselves, while we don't like to see them, won't necessarily lead to DKA. When he gets into better BG numbers, you will see the ketones come down. You might want to make a column on your spreadsheet to record the ketone findings -- or just write them in the notes section. But then he has this ear thing going on. If it doesn't clear up, I would ask for a culture even though they say they don't "see" anything. I've seen cases on this Board where people had ear cultures done and have found something when the vets didn't see anything.

Has he had blood work done recently?
Click to expand...
I test them as often as I can got notes on my book but I’ll try to think of adding them to the spreadsheet
I will ask them again even if they already said no need to send away…2nd clinic said cats don’t often get ear issues so can be deap & ct scan needed then added not sure it is worth it…
 
Dinah S said:
No there isnt any thats the problem I saw I could try get some from UK but here the vets say none
Thank you so much hope am not missing any messages cause am not used to write here
Click to expand...
Well then you may want to invest in a set of digital calipers. Lots of our members use them for fine dosing, and it sounds like your need is urgent. He may be very sensitive to small changes in insulin dosage and "eyeballing" the dose can be very tricky if it's not on the whole unit line! Boy, this has been such a hard road for you!
 
Dinah S said:
I test them as often as I can got notes on my book but I’ll try to think of adding them to the spreadsheet
I will ask them again even if they already said no need to send away…2nd clinic said cats don’t often get ear issues so can be deap & ct scan needed then added not sure it is worth it…
Click to expand...

Oh my. I've just been talking in the last few days with another member whose cat is having major challenges with blood glucose and has a fungal ear infection (they cultured it.) She is frustrated in the extreme. The kitty, Victor, has now got his ears packed with something for the fungal infection and the packs will have to be changed every 3 weeks or so. She's in the UK, I believe.

We do see cats with ear problems here and it always affects their BG numbers.
 
Suzanne & Darcy said:
Well then you may want to invest in a set of digital calipers. Lots of our members use them for fine dosing, and it sounds like your need is urgent. He may be very sensitive to small changes in insulin dosage and "eyeballing" the dose can be very tricky if it's not on the whole unit line! Boy, this has been such a hard road for you!
Click to expand...
Digital calipers ?! New thing to me gotta look it up thanks very frustrating indeed
 
Suzanne & Darcy said:
Oh my. I've just been talking in the last few days with another member whose cat is having major challenges with blood glucose and has a fungal ear infection (they cultured it.) She is frustrated in the extreme. The kitty, Victor, has now got his ears packed with something for the fungal infection and the packs will have to be changed every 3 weeks or so. She's in the UK, I believe.

We do see cats with ear problems here and it always affects their BG numbers.
Click to expand...
Poor bubba must be annoying him too but at least he gets the help so it’ll hopefully go away
 
I'm tagging @H Allen, Victor's mum. She can share with you what's been going on with his ears. It's just that I'm not buying into what the vets are saying about cats not usually having ear problems. Some of her vets also suggested CT scans and MRIs, which she will not do. They say there could be ear polyps, etc.
 
Suzanne & Darcy said:
I'm tagging @H Allen, Victor's mum. She can share with you what's been going on with his ears. It's just that I'm not buying into what the vets are saying about cats not usually having ear problems. Some of her vets also suggested CT scans and MRIs, which she will not do. They say there could be ear polyps, etc.
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Thank you I’ve honestly lost trust in most of them since November (when I lost my other cat) & since they all seem to be lost at what to do about it all now that Shai is up then down…
 
Suzanne & Darcy said:
I'm tagging @H Allen, Victor's mum. She can share with you what's been going on with his ears. It's just that I'm not buying into what the vets are saying about cats not usually having ear problems. Some of her vets also suggested CT scans and MRIs, which she will not do. They say there could be ear polyps, etc.
Click to expand...
They sedated him & checked so was told no polyps but a ct scan could show deeper inside in case
 
If it were my cat at this point I would hold this 1.5 dose for 7 days, unless he drops below 50, and reevaluate. Although if you choose to do the SLGS (start low, go slow) protocol, then the reduction point would be 90. All the information is in the link I provided above.
 
Dinah S said:
Thank you I’ve honestly lost trust in most of them since November (when I lost my other cat) & since they all seem to be lost at what to do about it all now that Shai is up then down…
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I'm sorry for the loss of your other cat. I know how painful that is. Did you have a bad experience with the vets then as well?

Most veterinarians are not given much training in feline diabetes so they really don't know how to handle it very well. This is the right place to be to get help. The moderators and many of the members here have LONG experience in dealing with FD.
 
Suzanne & Darcy said:
If it were my cat at this point I would hold this 1.5 dose for 7 days, unless he drops below 50, and reevaluate. Although if you choose to do the SLGS (start low, go slow) protocol, then the reduction point would be 90. All the information is in the link I provided above.
Click to expand...
Thank you I will hold & see though the high numbers like today scare me
Not too sure which link but will look again…bit odd on the phone sorry many thanks for your time & care
 
I almost forgot... are you feeding him within two hours of his pre shot tests? Don't feed within 2 hours of those pre-shot tests because then your meter reading will be "food influenced" and you won't have an accurate reading. His pre-shots are usually pretty high so it's most likely safe to shoot, but I do see a few days where the pre-shot test was quite low (and you rightfully skipped the dose). Later you will be able to shoot green when you have a lot of data on your kitty.
 
Suzanne & Darcy said:
I'm sorry for the loss of your other cat. I know how painful that is. Did you have a bad experience with the vets then as well?

Most veterinarians are not given much training in feline diabetes so they really don't know how to handle it very well. This is the right place to be to get help. The moderators and many of the members here have LONG experience in dealing with FD.
Click to expand...
Thank you they did a lot to help him but at the end am not sure anymore if it was the right things to do…you know you fight for the heart it goes on then the kidneys say bye…so it’s :-/
I surely can appreciate that out of them some even go on the net or open a book during a consult. Told one I was concerned about neuropathy & he had to google it which made me grin
 
Dinah S said:
Thank you they did a lot to help him but at the end am not sure anymore if it was the right things to do…you know you fight for the heart it goes on then the kidneys say bye…so it’s :-/
I surely can appreciate that out of them some even go on the net or open a book during a consult. Told one I was concerned about neuropathy & he had to google it which made me grin
Click to expand...
:facepalm::facepalm::facepalm:
 
Suzanne & Darcy said:
I'm tagging @H Allen, Victor's mum. She can share with you what's been going on with his ears. It's just that I'm not buying into what the vets are saying about cats not usually having ear problems. Some of her vets also suggested CT scans and MRIs, which she will not do. They say there could be ear polyps, etc.
Click to expand...
Hi there- I'm in Canada not the UK- but yes we sent away for cutlure- no bacteria- just fungal so we have had his ears packed with enro/keto/triamcin which last 3-4 weeks. He's also been on Pred - but everytime I try to wean him off that we end up with these ear infections. You can't see the complete nasal/ear cavity without an actual mri or cat scan....I could still be dealing with polyps but who knows and we will not ever be certain because I refuse to put my 14 yo cat thorugh that- he already suffers with balance issues when these ear infections rear their ugly heads. I'd get his ears packed.....We now are dealing with diabetes as a suspected result of the prednisolone....and I have not had any luck getting it regulated...
 
Suzanne & Darcy said:
I almost forgot... are you feeding him within two hours of his pre shot tests? Don't feed within 2 hours of those pre-shot tests because then your meter reading will be "food influenced" and you won't have an accurate reading. His pre-shots are usually pretty high so it's most likely safe to shoot, but I do see a few days where the pre-shot test was quite low (and you rightfully skipped the dose). Later you will be able to shoot green when you have a lot of data on your kitty.
Click to expand...
I used to watch that til I was told food isn’t influencing it…I don’t feed him as such if he is hungry he gets his snack at 6.30pm then test at 9pm…
 
If you have any bloodwork you can share, I'd love to see it. How are his kidneys and heart doing? You can either add it to your labs tab on your spreadsheet when you get time. Or you can copy and past a photo of it here (covering up personal info like your address if it's on there.)
 
Suzanne & Darcy said:
If you have any bloodwork you can share, I'd love to see it. How are his kidneys and heart doing? You can either add it to your labs tab on your spreadsheet when you get time. Or you can copy and past a photo of it here (covering up personal info like your address if it's on there.)
Click to expand...
I don’t have any some were done in Dec supposed all ok but don’t have them
 
H Allen said:
Hi there- I'm in Canada not the UK- but yes we sent away for cutlure- no bacteria- just fungal so we have had his ears packed with enro/keto/triamcin which last 3-4 weeks. He's also been on Pred - but everytime I try to wean him off that we end up with these ear infections. You can't see the complete nasal/ear cavity without an actual mri or cat scan....I could still be dealing with polyps but who knows and we will not ever be certain because I refuse to put my 14 yo cat thorugh that- he already suffers with balance issues when these ear infections rear their ugly heads. I'd get his ears packed.....We now are dealing with diabetes as a suspected result of the prednisolone....and I have not had any luck getting it regulated...
Click to expand...
Thanks! Sorry, I forgot you are in Canada! I mixed you up with another member. I'm afraid I'm getting people mixed up as I'm trying to help so many. I should make a chart!
 
Dinah S said:
I don’t have any some were done in Dec supposed all ok but don’t have them
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I'm glad they said everything is normal. I always ask for my cats' bloodwork - nowadays they just email it to me usually. I keep a file on each kitty. I analyze it. Then I can ask the vets questions if I have any. Also, it has come in handy to have it with me, in hand, when taking a cat to the emergency vet in the middle of the night or weekend.
 
Suzanne & Darcy said:
Good job on all the testing, by the way. Your kitty appears to be very bouncy. He is not used to low numbers so he bounces up high. Those bounces, especially in the early days, can take up to six cycles to clear. It is upsetting to see them in such high numbers, I know. Also, as you know, I am sure that the ear problems are contributing to the high BG. His diet is good for a diabetic cat, so that's not an issue here. I am so sorry. I know how frustrating it is from personal experience!
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Oh dear just seeing this one now this is becoming confusing hahahahaha thanks
 
T
H Allen said:
Hi there- I'm in Canada not the UK- but yes we sent away for cutlure- no bacteria- just fungal so we have had his ears packed with enro/keto/triamcin which last 3-4 weeks. He's also been on Pred - but everytime I try to wean him off that we end up with these ear infections. You can't see the complete nasal/ear cavity without an actual mri or cat scan....I could still be dealing with polyps but who knows and we will not ever be certain because I refuse to put my 14 yo cat thorugh that- he already suffers with balance issues when these ear infections rear their ugly heads. I'd get his ears packed.....We now are dealing with diabetes as a suspected result of the prednisolone....and I have not had any luck getting it regulated...
Click to expand...
Thank you for your time sorry for you both :( the boys of trying to help treat one thing & another shows soooo annoying I know the feeling :-/
Hope your luck will turn
 
T
H Allen said:
Hi there- I'm in Canada not the UK- but yes we sent away for cutlure- no bacteria- just fungal so we have had his ears packed with enro/keto/triamcin which last 3-4 weeks. He's also been on Pred - but everytime I try to wean him off that we end up with these ear infections. You can't see the complete nasal/ear cavity without an actual mri or cat scan....I could still be dealing with polyps but who knows and we will not ever be certain because I refuse to put my 14 yo cat thorugh that- he already suffers with balance issues when these ear infections rear their ugly heads. I'd get his ears packed.....We now are dealing with diabetes as a suspected result of the prednisolone....and I have not had any luck getting it regulated...
Click to expand...
Thank you for your time sorry for you both :( the boys of trying to help treat one thing & another shows soooo annoying I know the feeling :-/
Hope your luck will turn
 
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