Charlie Update - High ketones!

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Katy and Charlie

Katy and Charlie

Member Since 2023
I'm getting a little worried about Charlie and need some guidance. His BG has been pretty consistently high the last few tests. I've had the suspicion that Charlie's BG drops low at night and he bounces during the day. With my schedule I have a hard time testing him so many times after the PM shot. I'm going to get some good tests in tomorrow night and this weekend. I've think he's been acting a little off today but he's still eating normal and even played for a little bit. Ketones are high at 0.6 mmol/L. I am at the end of the container of insulin but there is still some left. Do I need to switch to the new pen? Is it less potent at the very end? Let me know what we can do for him!!
 
Ketones at 0.6 are not high, 2.6 is when you really need to worry about DKA. But they are going up, so it's definitely time to be vigilant. And make sure he's eating plenty and getting lots of water. You can even add water to his food.

If your pen has been kept in the fridge all time (except at shot time), it should be good to the last drop.

On 2/19 he did a really big drop in the PM. I don't know if he kept dropping lower or just the large drop caused him to bounce. Tomorrow you should see if the bounce resolves. If he's still high after tomorrow, I'd go up to 3.25 units dose.
 
Wendy&Neko said:
Ketones at 0.6 are not high, 2.6 is when you really need to worry about DKA. But they are going up, so it's definitely time to be vigilant. And make sure he's eating plenty and getting lots of water. You can even add water to his food.

If your pen has been kept in the fridge all time (except at shot time), it should be good to the last drop.

On 2/19 he did a really big drop in the PM. I don't know if he kept dropping lower or just the large drop caused him to bounce. Tomorrow you should see if the bounce resolves. If he's still high after tomorrow, I'd go up to 3.25 units dose.
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Whew... I'm glad to read that. 0.6 is higher than I have ever tested his ketones so I got really worried. I know we arent out of the woods yet.. we've got to get those ketones and BG dropping. I'll work really hard to get some late tests the next couple days so we can see if he is dropping. Might need a lot of caffeine ;):coffee:.

He's eating plenty. I'll keep an eye on him and the water bowl. I did wake up to what I think is diarrhea on my rug. It seems maybe it was so urgent he couldn't make it to the litter box! That can cause dehydration also so I'll definitely mix a little water in his food.

The pen is always refrigerated but there was one day last week I left it out on the counter all night.:facepalm: What I googled made me think it would be okay but let me know your thoughts. I have a new pen and can start that any day now, just wanted to use all I can out of the other.
 
Ketones are still rising... AM test is 1.6 but BG is 428 so its dropping. I really wish I didn't have to work or I'd stay home with him! I'll stay on top of testing, food, and water! Hopefully things start looking better... I feel like I'm really bad at this. :blackeye:
 
@Katy and Charlie
Are you still feeding any kibble ?
Hi this is from the SLGS sticky
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are bunit
  • 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
After you can do a curve maybe on the weekend you might want to ask if you should increase Charlie's dose.

Maybe you might not need to do a curve looking at Charlie's BG numbers
I will tag Wendy for you for some advice
@Wendy&Neko
 
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@Katy and Charlie
If you ever need to bring Charlie's BG up to safe numbers instead of feeding the kibble we suggest feeding med or high carb wet food
Med and High Carb food



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. Doesn't have to be Fancy Feast just an example about the med and high carb foods


https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.
 
Diane Tyler's Mom said:
@Katy and Charlie
Are you still feeding any kibble ?
Hi this is from the SLGS sticky
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are bunit
  • 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
After you can do a curve maybe on the weekend you might want to ask if you should increase Charlie's dose.

Maybe you might not need to do a curve looking at Charlie's BG numbers
I will tag Wendy for you for some advice
@Wendy&Neko
Click to expand...


I do have dry kibble out during the day. Mostly because I am a little worried about transitioning my other cat to wet food. Her name is Annie, we rescued her from the wild and she has always been very skittish and scared. She doesn't come out and eat when I'm feeding Charlie wet food. She hides and comes out later and eats the dry food. But I'm sure Charlie is eating some of it too. I planned on eliminating the dry food this weekend. She will just have to learn that if she doesn't come out and eat when it's food time, she'll lose her shot.

I'll be going home for my lunch break soon and hope to see that BG and ketones dropping. Fingers crossed. I'll plan on posting here after getting doing a curve this weekend.
 
Diane Tyler's Mom said:
@Katy and Charlie
If you ever need to bring Charlie's BG up to safe numbers instead of feeding the kibble we suggest feeding med or high carb wet food
Med and High Carb food



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. Doesn't have to be Fancy Feast just an example about the med and high carb foods


https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.
Click to expand...


When he gets low, I've been giving him the Blue Buffalo Blissful Belly wet food that I had leftover from before starting my journey here. I only have one can left that I've been saving. I know that is not enough so I'll order a couple cans of the gravy lovers to keep on hand.
 
What percent of his food is now dry food vs. wet?

You don't have to feed the FF gravy food if you have another higher carb food he likes. The Fancy Feast contains wheat in the gravy, which some cats can't handle, as I found out.
 
Wendy&Neko said:
What percent of his food is now dry food vs. wet?

You don't have to feed the FF gravy food if you have another higher carb food he likes. The Fancy Feast contains wheat in the gravy, which some cats can't handle, as I found out.
Click to expand...


I would say 90% wet, 10% dry. This weekend I'd like to get rid of the dry food. I went home during my lunch and ketones are now 0.2 and BG was 65, I retested and got 90. I feel like I'm going to lose it, Wendy! :banghead: He is so all over the place! I gave him the last can of the BB Blissful Belly to keep him from dropping more. I will grab more high-carb wet food after work to keep on hand.

With today's low numbers, do you think we need to adjust the dose or should we wait and see what tonight's and this weekend's numbers bring?
 
Well, you have confirmed that he's bouncing due to lower numbers, so well done on catching that. When following SLGS, a 65 means a 0.25 unit reduction, a 90 is just on the line and means stay with that dose. How far apart were those two tests? My concern with waiting for more tests is that he might be still bouncing on the weekend from today.

Great news the ketones are lower!
 
Wendy&Neko said:
When following SLGS, a 65 means a 0.25 unit reduction, a 90 is just on the line and means stay with that dose. How far apart were those two tests?
Click to expand...


The second test was immediately after. I was shocked to see a number so low and thought maybe it was a mistake so I tested again. I know the ideal thing would be to stay home and keep testing and monitoring him but I just can't today. I have a camera on him so I can watch him from work. He's sleeping on the bed with his girlfriend Annie right now. I won't be able to test again until almost +10 and I'm sure he will be higher and rising by then.

I have some energy drinks and plan to stay up as late as I can tonight and test every hour after the PM shot.
 
Katy and Charlie said:
Her name is Annie, we rescued her from the wild and she has always been very skittish and scared. She doesn't come out and eat when I'm feeding Charlie wet food. She hides and comes out later and eats the dry food. But I'm sure Charlie is eating some of it too. I planned on eliminating the dry food this weekend. She will just have to learn that if she doesn't come out and eat when it's food time, she'll lose her shot.
Click to expand...
Does Annie like canned food? If so, have you considered leaving canned food down for her to eat while you’re gone? Cats like to graze, so even with my diabetics, I always had a tray of low-carb canned food down for them (and my other cats) to nibble on. All of mine are rescues so some will overeat, but mostly they become pretty good at self-regulating their intake.

Glad the ketones were lower.
 
JL and Chip said:
Does Annie like canned food? If so, have you considered leaving canned food down for her to eat while you’re gone? Cats like to graze, so even with my diabetics, I always had a tray of low-carb canned food down for them (and my other cats) to nibble on. All of mine are rescues so some will overeat, but mostly they become pretty good at self-regulating their intake.

Glad the ketones were lower.
Click to expand...


Annie doesn't seem to like wet food as much as Charlie does. When I open a can, she could care less. Charlie goes wild. I worry that if I leave wet food out, Charlie will just eat it and maybe end up eating more than he should. But I haven't removed the dry food to really see how Annie handles it. I want to try and do that this weekend! Maybe They will self regulate their intake like your kitties!
 
Just please be very, very careful to make sure Annie does actually eat. You can’t always trust that they will eat canned if they get hungry enough. Some cats will actually starve themself, and that can lead to liver problems and other medical issues (not saying that to scare you, but rather as a caution since I’ve see it happen).
 
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