Big George New Thread Dosing advise ASAP AMPS 83 and ketones .3

Hey there! I dosed a super skinny 1.25u this AM and am thinking that I should have just done 1u since he dropped below 90 last night! He has dropped below 90 again today, so tonight should I just shoot the 1u? Also, just curious of why not to go below 1u? I think it’s because he was DKA/had ketones but just trying to understand/know what to follow/handle since his numbers have been lower! I do see that he starts to rise after +4/+5 but still just trying to take all of this in! Thanks in advanced! 😊
 
Answering over here so it’s not on the old thread but @Marje and Gracie I’m glad that @Suzanne & Darcy was too! 😊 I appreciate everyone’s help on this so much!

As for tonight, am I okay to lower dose to 1u or do I need to stay at 1.25u (I did a super skinny this morning) since he fell below 90 overnight and he dropped below again today? I think that I’m supposed to stay above 1u because he was DKA/had ketones but just trying to understand! I think that all of the lower numbers are a great thing but being two weeks in, I still have so much to learn! Thanks!
 
He’s been a little lethargic the past day but I read that could be due to lower numbers but and going to get an appointment for bloodwork to make sure infection hasn’t returned! He is eating but not as much last night!
 
Steph & Big George said:
He’s been a little lethargic the past day but I read that could be due to lower numbers but and going to get an appointment for bloodwork to make sure infection hasn’t returned! He is eating but not as much last night!
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You can still shoot 0.75u. That ketone level is still within the “normal” range. But try to get more food in him today. Are you able to do subq fluids at home? If not, add lots more water to his food.

Be sure you get a +1 and +2. Will you be there to monitor him and feed if necessary?

We can’t skip like we might with another cat so I’m hoping you’ll be there to test/feed.
 
Steph & Big George said:
Thank you so much! Sorry, I’m at work and my Mom is handling for me! I really appreciate it! Will add more water to his food! I had backed off adding water since he wasn’t loving it! Appreciate it so much!
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Your welcome. Please be sure she is testing and can feed him the appropriate carbs if he drops.

Thanks for taking down the 911 😊😊
 
Marje and Gracie said:
Let’s hope he will be a very good boy today.
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I hope so! Thank goodness he doesn’t have teeth or just has numbs for teeth or we’d be in trouble! I’m sure he needs a dental and I know you or someone said the q-tip trick would show troubled teeth!

Is there a time period I need to wait, like until he gets more stable or when we are more than 2.5 weeks in, to think about a dental…or just wait to see if bloodwork shows any kind of infection!

I guess his ketones could just be that he didn’t eat as much last night (but did eat a lot with my mom during the day) and I stopped adding water to his food so he didn’t drink enough because there hasn’t been much water missing from his bowl? I need to go and read the ketones info again!
 
Steph & Big George said:
I hope so! Thank goodness he doesn’t have teeth or just has numbs for teeth or we’d be in trouble! I’m sure he needs a dental and I know you or someone said the q-tip trick would show troubled teeth!

Is there a time period I need to wait, like until he gets more stable or when we are more than 2.5 weeks in, to think about a dental…or just wait to see if bloodwork shows any kind of infection!

I guess his ketones could just be that he didn’t eat as much last night (but did eat a lot with my mom during the day) and I stopped adding water to his food so he didn’t drink enough because there hasn’t been much water missing from his bowl? I need to go and read the ketones info again!
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It “can” show a feline resorptive lesion but it’s not 100%.

Most often, when to the dental is not dependent on their diabetes but when the vet feels comfortable doing it. If he’s fairly stable and ketones are normal for a few weeks, it then depends on his labs, what might need to be done (how extensive & how long under anesthesia), and how the vet feels about doing it.
 
Marje and Gracie said:
It “can” show a feline resorptive lesion but it’s not 100%.

Most often, when to the dental is not dependent on their diabetes but when the vet feels comfortable doing it. If he’s fairly stable and ketones are normal for a few weeks, it then depends on his labs, what might need to be done (how extensive & how long under anesthesia), and how the vet feels about doing it.
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Gotcha! I’m in the process of trying to find another vet so I need to establish that first too! Thank you!
 
Does your mom have the ability to update the spreadsheet so we can see what’s going on? Does she know how to post here for help? I am sure she will contact you. If his +2 is lower, does she have higher end but still LC food options up to 10% carbs? Does she have medium carb foods to feed him?

Ketones are still very good at .3, but you are doing well to keep testing them every day since there is that possibility of the dental infection returning and then his ketones could rise quickly. It is also possible that he just isn’t as hungry right now because he’s in better numbers — that’s pretty normal. Also, you are right about the possibility that he could feel a little odd in these lower numbers that he’s not used to, and that could cause him to be a little lethargic. It doesn’t do that with all cats, but some do react that way. So many variables! If his tooth is hurting, that could definitely put him off his food and make him a little more subdued. I definitely hope that’s not it! Keep up the good work!
 
Thank you! I just updated the spreadsheet from what’s she sent! He was 77@+1 and 80@+2.25! She’s been giving him 5% food (normally eats 3%) a tsp every hour! I haven’t been out to get a good mid carb but I think you said previously we could maybe mix a little HC with LC to make a MC?

I have other FF medleys that I thought were mid carb but don’t exactly match the food sheet so I think they are HC and have FF gravy lovers for HC!

Also, for tonight….probably all depends on BG then and ketones, but do we keep the .75 or drop to .5? Sorry to get ahead but just trying to have a little plan!
 
Steph & Big George said:
Thank you! I just updated the spreadsheet from what’s she sent! He was 77@+1 and 80@+2.25! She’s been giving him 5% food (normally eats 3%) a tsp every hour! I haven’t been out to get a good mid carb but I think you said previously we could maybe mix a little HC with LC to make a MC?

I have other FF medleys that I thought were mid carb but don’t exactly match the food sheet so I think they are HC and have FF gravy lovers for HC!

Also, for tonight….probably all depends on BG then and ketones, but do we keep the .75 or drop to .5? Sorry to get ahead but just trying to have a little plan!
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It sounds like he’s doing very well, and your mom is doing great! Let’s wait and see how the rest of the cycle goes today – – at least let’s see what his nadir will be.
 
I would stop feeding him now if you think he’s taken in enough calories for the morning, but if not, just switch to the lowest carb food that you have and just remember to stop feeding two hours prior to PMPS.
 
I would like to see how he continues to do on the .75 unit dose, but I suppose we had better go ahead and follow SLGS for now and see — as long as his ketones are staying low. We can always go back up if necessary.
 
Suzanne & Darcy said:
I would like to see how he continues to do on the .75 unit dose, but I suppose we had better go ahead and follow SLGS for now and see — as long as his ketones are staying low. We can always go back up if necessary.
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Okay, so go with .5u since we dropped below 90 and then if we have to go back to .75u we can! Just want to make sure I got it right?
 
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