? AMPS 588/PMPS 534 - Kaz

[Claire and Kaz]

Hi Bron

I am on cycle 5 this morning with cycle 6 coming up later this evening as I have been home for the past two days I have tested more and I did increase the dose to 1.75 units per your advice.

Seemed like the numbers were beginning to decrease but this mornings BG was the highest it's ever been.
I have been giving him more DM and less Tiki but I think maybe I need to do the opposite.

I will stick with the 1.75 units for this evenings shot but this will be cycle 6.
As of tomorrow I have to go back to work and on Friday I will be gone all day (usually work from home but have Jury Duty hoping Kaz's condition might get me out of it).

Claire

 

[Bron and Sheba (GA)]

When you say you have to go back to work, do you mean you are working at home or actually going out to work?
With jury duty….you can say you have a diabetic cat that is just covering from diabetic ketoacidosis and needs constant attention at the moment and monitoring to keep him safe and you can’t possibly concentrate on anything else at the moment…..they probably wouldn’t want you hopefully.

 

[Claire and Kaz]

I work from home Fridays then the weekend and today is Patriots Day (Massachusetts holiday) which my company does not recognize but its also the Boston Marathon so most streets around me are closed off so I am working from home today as well but tomorrow I have to be back on site then as I said this Friday Jury Duty.
I will tell them what you said and hopefully that will do the trick.

 

[Bron and Sheba (GA)]

Here is your last thread for continuity.
https://felinediabetes.com/FDMB/threads/kaz-amps-532-ketones-0-8-help.261952/#post-2939043

I think if you only gave him the tiki, he would probably be in lower numbers like he was on 4/9 but we really want to make sure he is getting enough insulin at the moment because of the recent DKA so I would keep feeding as you are, even though it is keeping the BGs higher.
He does need a dose increase up to 2 units after the 6 cycles, providing he doesn’t drop into blue numbers tonight.
How will you manage the food though if you have to go to work from tomorrow?

 

[Claire and Kaz]

Here is your last thread for continuity.
https://felinediabetes.com/FDMB/threads/kaz-amps-532-ketones-0-8-help.261952/#post-2939043

I think if you only gave him the tiki, he would probably be in lower numbers like he was on 4/9 but we really want to make sure he is getting enough insulin at the moment because of the recent DKA so I would keep feeding as you are, even though it is keeping the BGs higher.
He does need a dose increase up to 2 units after the 6 cycles, providing he doesn’t drop into blue numbers tonight.
How will you manage the food though if you have to go to work from tomorrow?

There is nothing I can do about food during the day till I get the Meowspace and train him how to use it.
I have to go to work everyone I do know works or lives way too far a way and my family is in another country so he is going to have deal with this for the next week till this device gets here.

I can not allow myself to get ill every time I leave my house I have a job that requires me to be on site I can not work from home. Again I am doing the best I can. I have said this over and over its not going to change. Without the job I would not be able to afford the extra food let alone all the insulin/test strips/etc.

This is how it has to be right now please don't make me feel guilty.

I can't take vacation as I then would not have enough for my trips to the UK plus my client would not be happy as I need to be on site to make sure all the projects are running smoothly.

I'm trying the best I can.

 

[Bron and Sheba (GA)]

can not allow myself to get ill every time I leave my house I have a job that requires me to be on site I can not work from home. Again I am doing the best I can. I have said this over and over its not going to change. Without the job I would not be able to afford the extra food let alone all the insulin/test strips/etc.

how it has to be right now please don't make me feel guilty.

I totally get this. I’m just checking to see what will happen that’s all.
I certainly don’t want to make you feel guilty at all. I’m trying to help you sort out a solution.
I know you have the feeder coming later this week or the next week which is great.
I think I would just feed him the DM on the days you have to leave for the day.
Do you have to leave straight away after the dose, or can you give him another snack before you leave?

 

[Claire and Kaz]

I totally get this. I’m just checking to see what will happen that’s all.
I certainly don’t want to make you feel guilty at all. I’m trying to help you sort out a solution.
I know you have the feeder coming later this week or the next week which is great.
I think I would just feed him the DM on the days you have to leave for the day.
Do you have to leave straight away after the dose, or can you give him another snack before you leave?

I usually leave within 15 minutes of giving the dose but when I go into work I usually give him more food right after the injection which he will eat.
Tomorrow I have three back to back meetings staring at 7.30am all of which I run so I have very little wiggle room.
I have been giving Tiki pre shot (usually chicken as hes finally eating this again) and the DM about 1/3 can (10% carb).

 

[Bron and Sheba (GA)]

I usually leave within 15 minutes of giving the dose but when I go into work I usually give him more food right after the injection which he will eat.
Tomorrow I have three back to back meetings staring at 7.30am all of which I run so I have very little wiggle room.
I have been giving Tiki pre shot (usually chicken as hes finally eating this again) and the DM about 1/3 can (10% carb).

When you are away all day I would just give the DM as a Preshot meal as well, if you can to make sure he has enough carbs aboard while you are gone.

 

[Claire and Kaz]

Hi Bron

I can definitely do that. So tomorrow you want me to basically give him 2/3rds large can of the DM Select (1/3 can prior to the insulin then 1/3 after the insulin).

I thought that part of the reason Kaz's numbers were running so high was because of the carbs and that if I cut the carbs back down then maybe the BG would come back into the 300's still high but more acceptable. Every time I think I'm understanding it the line seems to move.

Anyway Tuesday morning - 2 units of insulin (next 6 cycles) DM in the morning both pre shot and post shot.

Thanks Claire

 

[Bron and Sheba (GA)]

thought that part of the reason Kaz's numbers were running so high was because of the carbs and that if I cut the carbs back down then maybe the BG would come back into the 300's still high but more acceptable. Every time I think I'm understanding it the line seems to move.

This is true that the 10% carbs are probably keeping the Bg higher than the 0 carbs. I like to see cats get around 5% carbs. But with the DKA we need to make sure that Kaz is getting enough insulin as well as enough food. So for a couple of weeks let’s just stay with some of the 10% carbs and then see how things are. It is also complicated by the unavoidable fact you need to go out to work and have to leave him.

 

[Claire and Kaz]

This is true that the 10% carbs are probably keeping the Bg higher than the 0 carbs. I like to see cats get around 5% carbs. But with the DKA we need to make sure that Kaz is getting enough insulin as well as enough food. So for a couple of weeks let’s just stay with some of the 10% carbs and then see how things are. It is also complicated by the unavoidable fact you need to go out to work and have to leave him.

Morning Bron
So I gave Kaz the whole tin of DM Select before I left along with 2 units of insulin. I will do this for 6 cycles.

Thanks Claire

 

[Bron and Sheba (GA)]

L

Morning Bron
So I gave Kaz the whole tin of DM Select before I left along with 2 units of insulin. I will do this for 6 cycles.

Thanks Claire

Let us know how the day goes.

 

[Lee Renfro]

You are doing awesum Claire. Kaz sounds like he's doing much better and I am so happy for him. Keep up the great work.

 

[Claire and Kaz]

L

Let us know how the day goes.

Sorry last 48 hours been nightmare (not Kaz work).

Kaz is fairing well so far on the new dose. His numbers seem to be a bit all over the place but there are less black numbers which has to be better.

Question - should a diabetic cat be kept on Potassium tablets indefinitely? If so does anyone know where to go to get a better price.

Also planning to do a Ketone blood test this evening in case you asked. Kaz's ear is not looking good with all the pricks and I know it hurts him a bit. For some reason he only wants me to use his left ear he gets a bit agitated when I go for the other and there does not really appear to be a reason why?

 

[Claire and Kaz]

You are doing awesum Claire. Kaz sounds like he's doing much better and I am so happy for him. Keep up the great work.

Thanks

 

[Diane Tyler's Mom GA]

Kaz's ear is not looking good with all the pricks and I know it hurts him a bit.

A lot of members
use pure coconut oil, I have copied this from one of the members posts
just make sure the only ingredient is coconut oil (mine is solid at room temp and I would take an itty bitty dab and rub on his ears, just make sure its pure coconut oi

 

[Diane Tyler's Mom GA]

Question - should a diabetic cat be kept on Potassium tablets indefinitely? If so does anyone know where to go to get a better price.

I wouldn't know sorry I can tag a few members for you to see if they know
@Bron and Sheba (GA)[/USE

 

[Claire and Kaz]

A lot of members
use pure coconut oil, I have copied this from one of the members posts
just make sure the only ingredient is coconut oil (mine is solid at room temp and I would take an itty bitty dab and rub on his ears, just make sure its pure coconut oi

Funny I actually threw this out a couple months ago as Kaz did not care for it. I bought it for his fur balls but he would not lick it off his fur or anything else so I gave up. It was pure coconut oil and was hard at room temperature. Never dreamed I would use it for anything else.

 

[Claire and Kaz]

I wouldn't know sorry I can tag a few members for you to see if they know
@Bron and Sheba (GA)

@Suzanne & Darcy

@FrostD

Thanks appreciate that

 

[Diane Tyler's Mom GA]

Thanks appreciate that

You're welcome.

 

[Bron and Sheba (GA)]

Question - should a diabetic cat be kept on Potassium tablets indefinitely? If so does anyone know where to go to get a better price.

Claire, no one here can tell you how long to keep Kaz on potassium tablets. Only the vet can do that after testing the blood again to see what the current potassium level is.

 

[Claire and Kaz]

Claire, no one here can tell you how long to keep Kaz on potassium tablets. Only the vet can do that after testing the blood again to see what the current potassium level is.

ok I have an email into my vet.

Kaz's Ketones are at a 0.1 on the blood monitor so this is really good. His BG has also dropped quite a bit but am going to give him some more DM now so as to even it out as I know I don't want it to drop too fast.

 

[Suzanne & Darcy]

Hi. Hope you can get out of jury duty. Your vet would have to recheck the potassium blood levels to see if they’ve normalized — as Bron mentioned. I have used the Vetoquinol Renal-K powder on all of my cats needing a potassium supplement. They eat it in their food just fine (chicken liver flavor). This is just a suggestion in case you should need to continue with the potassium (hopefully you will not.). It’s dangerous for potassium to either drop too low or go too high, so it is worth checking it out.

 

[Claire and Kaz]

Hi. Hope you can get out of jury duty. Your vet would have to recheck the potassium blood levels to see if they’ve normalized — as Bron mentioned. I have used the Vetoquinol Renal-K powder on all of my cats needing a potassium supplement. They eat it in their food just fine (chicken liver flavor). This is just a suggestion in case you should need to continue with the potassium (hopefully you will not.). It’s dangerous for potassium to either drop too low or go too high, so it is worth checking it out.

I just looked this up it looks similar to the canister of Probiotics I use so I am guessing this would last one cat about three months? Still waiting on vets response but if he says he needs this forever I will ask about the supplement verses the tablets that are huge.
Thanks

 

[Claire and Kaz]

Claire, no one here can tell you how long to keep Kaz on potassium tablets. Only the vet can do that after testing the blood again to see what the current potassium level is.

Hello Bron
I know this evenings shot will be the 6th in the cycle. I was really surprised to see Kaz's BG at 594 this morning. His numbers are all over the place.
Should I hold at 2 units for another 6 cycles? Bit wary about going up again so fast as his numbers have been up and down this cycle and I should have the MeowSpace set up this weekend although not sure how long it will take to train him to use it.
Hoping that once he was able to get two additional small meals during the day it might help with these numbers.

 

[Bron and Sheba (GA)]

I think he is bouncing up to the red and black BGs from the yellow BGs as he is not used to the “lower” numbers any more. This is normal so don’t worry about it. There is nothing you can do about it except let him get used to more numbers again.
I would hold the dose until tomorrow anyway and see how he goes.He does have room to increase. Maybe look at it again this time tomorrow. Good there are no ketones still.

 

[Suzanne & Darcy]

I just looked this up it looks similar to the canister of Probiotics I use so I am guessing this would last one cat about three months? Still waiting on vets response but if he says he needs this forever I will ask about the supplement verses the tablets that are huge.
Thanks

It also comes in a gel. I’ve not tried that yet.

 

[Claire and Kaz]

I think he is bouncing up to the red and black BGs from the yellow BGs as he is not used to the “lower” numbers any more. This is normal so don’t worry about it. There is nothing you can do about it except let him get used to more numbers again.
I would hold the dose until tomorrow anyway and see how he goes.He does have room to increase. Maybe look at it again this time tomorrow. Good there are no ketones still.

Hi Bron

I just checked Kaz's BG (PMPS time) and to my shock his BG is at 641 I checked his Ketones immediately and they were 0.2 on blood monitor so that's fine.
Only change is that he has been off the Potassium tablets 24 hours as I had to wait for the vet to renew the prescription. Just got these and will be giving these next followed by 2 units of insulin.

 

[Claire and Kaz]

It also comes in a gel. I’ve not tried that yet.

I have the gel Kaz will not take it he literally foams at the moth if I try.

 

[Suzanne & Darcy]

I have the gel Kaz will not take it he literally foams at the moth if I try.

Poor Kaz.

 

[Suzanne & Darcy]

Sorry he's been in black today. Looks like he bounces high after yellow numbers. I hope he will come back down. It's a real relief that he is not having significant ketones at this time.

 

[Bron and Sheba (GA)]

Hi Bron

I just checked Kaz's BG (PMPS time) and to my shock his BG is at 641 I checked his Ketones immediately and they were 0.2 on blood monitor so that's fine.
Only change is that he has been off the Potassium tablets 24 hours as I had to wait for the vet to renew the prescription. Just got these and will be giving these next followed by 2 units of insulin.

I agree he is bouncing from the yellow BG

 

[Claire and Kaz]

Does this mean I just need to wait and his current dose of insulin along with food will help it come back down. I’m assuming that even though it’s this high he’s ok as there are no ketones in his urine.

 

[Bron and Sheba (GA)]

Does this mean I just need to wait and his current dose of insulin along with food will help it come back down. I’m assuming that even though it’s this high he’s ok as there are no ketones in his urine.

I would give it 24 more hours to see if the BG comes down (providing there are no ketones) and then if there are no blue BGs I would increase the dose by 0.25 units

 

[Claire and Kaz]

I would give it 24 more hours to see if the BG comes down (providing there are no ketones) and then if there are no blue BGs I would increase the dose by 0.25 units

Hi Bron

I finally managed to get the Libre button off but the wound is bleeding and looks a bit swollen. The adhesive is still on but worried to remove this as I don’t want to irritate it. I also don’t want an infection so I was wondering if you had advice. Kaz keeps scratching.
As the adhesive is still on I was going to put a plaster\band aid on but I think antiseptic might hurt him.

 

[Bron and Sheba (GA)]

I have no experience with something like this. I’ll tag @Suzanne & Darcy to see if she knows

 

[Suzanne & Darcy]

At the vet they have special adhesive remover for this purpose. One thing you could try would be a little extra virgin olive oil. It is safe and has been used on wounds for centuries. I would worry a little about the open sore. Is it quite small? Just where the probe went in? If it’s bleeding, I am thinking your vet may want to prescribe Clavamox for possible skin infection.

 

[Suzanne & Darcy]

I would not put an antiseptic on it. I mean, you could technically- something like chlorhexidine (they use this a lot at the vet) but I am afraid it would be painful. He probably will clean it himself and that may be the best thing (if you get the adhesive off.)

 

[Claire and Kaz]

At the vet they have special adhesive remover for this purpose. One thing you could try would be a little extra virgin olive oil. It is safe and has been used on wounds for centuries. I would worry a little about the open sore. Is it quite small? Just where the probe went in? If it’s bleeding, I am thinking your vet may want to prescribe Clavamox for possible skin infection.

Not the adhesive ring that's bleeding its where the button has come off. The adhesive ring is still on him I don't dare tackle that right now. He keeps scratching it. I have ordered some anti itch stuff specifically for wounds along with an ecollar. Sadly not a lot else I can do between now and tomorrow as everything is closed.
Thanks for the response.

 

[Suzanne & Darcy]

Not the adhesive ring that's bleeding its where the button has come off. The adhesive ring is still on him I don't dare tackle that right now. He keeps scratching it. I have ordered some anti itch stuff specifically for wounds along with an ecollar. Sadly not a lot else I can do between now and tomorrow as everything is closed.
Thanks for the response.

Do you have a little shirt to put on him?

 

[Suzanne & Darcy]

I agree about being careful putting anything on there since he will lick off anything you put on- so it would have to be harmless to a cat. I’m hoping you have a baby shirt that you can put on. A lot of people use these to go over the Libre sensors.

 

[Claire and Kaz]

No I don’t have anything like that in the house I contemplated a bandage or plaster but I think that could make it worse as it will stick and then when removed it will bleed again. He usually sleeps pretty heavily during the night.
Also think that his water consumption has finally decreased slightly and his weight is nearly back to normal so all positive signs just need to get the BG stable.

 

[Suzanne & Darcy]

No I don’t have anything like that in the house I contemplated a bandage or plaster but I think that could make it worse as it will stick and then when removed it will bleed again. He usually sleeps pretty heavily during the night.
Also think that his water consumption has finally decreased slightly and his weight is nearly back to normal so all positive signs just need to get the BG stable.

I hope Kaz will sleep peacefully tonight then. And you as well, Claire. Weight gain and normal water consumption are both very good signs!

 

[Claire and Kaz]

I would give it 24 more hours to see if the BG comes down (providing there are no ketones) and then if there are no blue BGs I would increase the dose by 0.25 units

Hi Bron

Kaz's numbers are really high again today so tomorrow morning planning on starting the new dose from 2 units to 2.25 unless you tell me otherwise. I am going to test his Ketones again during next ear prick. For some reason there has not been as much blood over past couple days its weird.

Also did get the Meowspace which I set up today and have started training him I spoke to the owner of the company today and she said it could take about a week to get him used to going in with the door closed. He is goin in with door open already so that's positive. So I am hoping that within the next week I will be able to leave additional meals out for him so another step in the right direction.

Thanks as always for your help.

Claire/Kaz

 

[Claire and Kaz]

Hi Bron

Kaz's numbers are really high again today so tomorrow morning planning on starting the new dose from 2 units to 2.25 unless you tell me otherwise. I am going to test his Ketones again during next ear prick. For some reason there has not been as much blood over past couple days its weird.

Also did get the Meowspace which I set up today and have started training him I spoke to the owner of the company today and she said it could take about a week to get him used to going in with the door closed. He is goin in with door open already so that's positive. So I am hoping that within the next week I will be able to leave additional meals out for him so another step in the right direction.

Thanks as always for your help.

Claire/Kaz

Hi Bron

I also wanted to mention that over the last 48 hours if I did not know there was something wrong with Kaz we would have just been carrying on our old lives. He has started running around the house again, cleaning himself hanging out with me and sleeping in the bedroom. This all happened within last 48 hours and his BG has sky rocketed. Hes not feeling unwell quite the opposite.
Find this weird as I would have thought he'd be feeling unwell with it being this high I know I would.

 

[Holtfam6]

on the libre button, I read somewhere to use 100% coconut oil.. It will help loosen the adhesive ring. Use a qtip or cotton ball Don't pull it off but work slowly on loosening it. It may take a couple days. I'm worried about the injection point from the libre. How big is the wound? Is there any drainage? If it's swollen, it could be infected and need an antibiotic. You could put a non adhesive 4x4 dressing on it and wrap it with an ace wrap or cobain dressing secure with tape to keep him from scratching at it.

 

[Claire and Kaz]

on the libre button, I read somewhere to use 100% coconut oil.. It will help loosen the adhesive ring. Use a qtip or cotton ball Don't pull it off but work slowly on loosening it. It may take a couple days. I'm worried about the injection point from the libre. How big is the wound? Is there any drainage? If it's swollen, it could be infected and need an antibiotic. You could put a non adhesive 4x4 dressing on it and wrap it with an ace wrap or cobain dressing secure with tape to keep him from scratching at it.

I have ecollar arriving tomorrow and coconut oil (for his ear) I also got Vetericyn +plus spray today. This is a antimicrobial wound & skin care (cuts, abrasions, sores and skin irritations) spray.
I did contact my vet who said just to clean it with warm water and a cloth and leave it to the air to heal. So far it appears that he has stopped scratching but if he starts again I was going to try the spray as its supposed to help with the itching too.
Trying to leave it a lone as I know a cats biology is very different to a persons and creams etc can make it worse. The swelling appears to have gone down and it does not appear to bother him if I touch the area.
Waiting a couple days for this to heal before removing the rest of the adhesive.

 

[FrostD]

on the libre button, I read somewhere to use 100% coconut oil.. It will help loosen the adhesive ring. Use a qtip or cotton ball Don't pull it off but work slowly on loosening it. It may take a couple days. I'm worried about the injection point from the libre. How big is the wound? Is there any drainage? If it's swollen, it could be infected and need an antibiotic. You could put a non adhesive 4x4 dressing on it and wrap it with an ace wrap or cobain dressing secure with tape to keep him from scratching at it.

What about something like Saran wrap underneath, or not advisable because not breathable? Just trying to think of stuff she may have at home.

Seconding coconut oil, it's great for both removing sticky stuff (I use it all the time when kids get covered in pine sap) but also wound care (not saying I'd put it on the sound, just that it's ok if a little happened to get on when trying to remove it). I just don't want him to make things worse by scratching at the adhesive

 

[FrostD]

I have ecollar arriving tomorrow and coconut oil (for his ear) I also got Vetericyn +plus spray today. This is a antimicrobial wound & skin care (cuts, abrasions, sores and skin irritations) spray.
I did contact my vet who said just to clean it with warm water and a cloth and leave it to the air to heal. So far it appears that he has stopped scratching but if he starts again I was going to try the spray as its supposed to help with the itching too.
Trying to leave it a lone as I know a cats biology is very different to a persons and creams etc can make it worse. The swelling appears to have gone down and it does not appear to bother him if I touch the area.
Waiting a couple days for this to heal before removing the rest of the adhesive.

Oh ok, glad he seems to be leaving it alone and it looks better!

 

[Holtfam6]

Saran wrap wouldn't be bad for a short term. would be considered an occlusive dressing such as used for IVs. it may help the coconut oil absorb better into the adhesive ring and loosen up quicker with less messing with it. It would make it more of a warm moist environment. I probably wouldn't wrap it around him but just over the site itself. The only contradiction I can think of off the top of my head, is you wouldn't want to use it if it's highly infected, could multiple bacterial growth quicker.