4/21 RK - AMPS 579 +2 HI +4.75 HI +6 HI PMPS 518 ketones 2.8 +2.5 551 +4 455 +6 423 +7 396 +9 444

JL and Chip

JL and Chip

Member Since 2009
Yesterday

The poor little thing just doesn’t feel well and really doesn’t want to eat. I have Ondansetron and mirtaz on board, will give cerenia as well. Hopefully she’ll perk up if we can get these numbers down. I’m syringe feeding and have caught her nibbling occasionally but I swear there is a slight yellowish tinge to her ears this morning. I’m considering adding in Denamarin. One of the vets said he could have a feeding tube in her in about 4 minutes but she wasn’t stable enough at the time and of course the anesthesia/sedation is a risk. If we don’t make some clear headway soon, I might have to pursue it even with the risks.

C’mon RK, put away some groceries for me. C’mon Lantus, do your thing.
 
You are doing such a good job with her. It must be disheartening for you though not seeing much progress. I’m wondering about increasing the dose of insulin to 0.75 to see if that helps. What do you think?
Its good to see the ketones down to 2.6
I think the feeding tube would be a very good idea if it’s possible.
Did you give R this morning? I can’t see it in the SS.
Let’s see what Wendy thinks about increasing the dose to 0.75U
 
No, I didn’t give R today. Wendy and I discussed in yesterday’s thread whether it might be a good time to see what Lantus can do alone, especially if R might be contributing to bouncing. I dunno. I’ll be glad to get through this transition period — sadly RK’s numbers looked better on N, but TID dosing is hard and we all know Lantus is a better insulin long term. It’s deceptively easy to want to only look at the short term and go back to N, but I know better. We’ll get there… (and disheartening — yep—it’s such a helpless feeling :( )
 
I’ve just read through the other thread and caught up with it all. I didn’t realise there was a lot more on it after I last saw it. I’ve been out a lot of the day to a grand daughter’s birthday. It’s 11 pm here now so I’ll be heading to bed soon. I see Wendy thought we should wait a bit longer before increasing the dose.
The drawback with using Lantus in the middle of DKA is the full effect of the dose is not felt for several days until the depot is full. That’s why ‘in and out’ insulins can be better initially and why you were seeing better numbers when using the N
I hope things improve for you both today. I’ll look in when I wake up in the morning.
 
Thanks Bron. That’s exactly what I meant by “transition” period—going from an in-and-out insulin to a depot insulin. I was hoping the R could provide an “assist” while the depot was building. Oh well.

Happy birthday wishes to your granddaughter! And thanks for looking in on us. I really appreciate it.
 
Today looks like a solid bounce day, not a good day to see what L is doing on it's own. One thought if she's still in the blacks at +6, add drop of R then. Or give fluids and see what it does. Do one or the other. Then we can observe L action tonight - fingers crossed.

Tonight would be cycle 6 of Lantus and in kitties high and flat, TR says it's OK to increase after then for cats seeing 300 and above. I'd definitely consider the increase for tomorrow cause it looks like the lower numbers were influenced by R. You don't shoot R on the same cycle you increase. I wouldn't want her to go three cycles without R help.
 
I opted for a drop of R at AM + 6. I had already given fluids earlier in the day.

Evening update:
She was eating when I went to give her the PM shot. It was high-carb dry food, but it was food. She then nibbled on some cheese and started in on the FF grilled I put down. I have no illusions that it’ll last for long, but I’ll take it.

Which brings me to another point—with DKA in the picture and her erratic and mostly non-existent appetite, I haven't been pulling her food two hours before shot time. If anyone feels strongly that that’s the wrong decision under the circumstances, please let me know. In my mind, groceries trumps a “pure” PS,

She’s bright and alert at the moment despite being in the 500 range at PMPS. Ketones are at 2.8
 
Pulling food 2 hours before shot time is what we tell new people. Until they have a good idea how much of a food bump their cat gets from food. Plus, it's only really important with much lower preshots. She didn't go from below 100 to 518 with influence of food. :rolleyes:

I would have liked to see a test after R, perhaps 2 or 3 hours after if it had been possible. Paws crossed it's going to give her a better PM cycle and you can start pinpointing Lantus onset etc.
 
Wendy&Neko said:
I would have liked to see a test after R, perhaps 2 or 3 hours after if it had been possible
Click to expand...
Agreed. That was my plan but was pulled away unexpectedly. It would have been a good data point to have. At least it nudged her away from being over 600 for the PMPS. :confused:
 
Yep, very happy indeed. :cat:
It was time for her dose of ondansetron but Thou Shalt Not Interrupt DKA Kitty With Head Buried In Bowl. So I’ll give it to her in a bit.

I’m hoping this g-force roller coaster soon turns into a gentle children’s ride. One can hope…
 
So there was at least some movement in the PM cycle but it stayed relatively high on Lantus alone.

I assume the depot should be relatively stable by now. Even if this is still some residual bounce action, it certainly looks like there’s plenty of room for an increase. Based on what we talked about earlier, I’ll bump up to 0.75u in the morning (unless someone has a different perspective).

On a positive note, our little feral princess plowed into another can of food tonight and seems more interested in her surroundings.

@Wendy&Neko @Bron and Sheba (GA)
 
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