09/03/10 Jakes AMPS 415 PMPS 391

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breayle and jake

breayle and jake

Member Since 2010
Jake and I have been having some problems over the past few weeks with his BG levels. The vet diagnosed it the somogyi effect. I've reduced his dose and have been getting better numbers, however now he has ketones in his urine :(

anyways... it's good to see everyone again, been a long while. love my new PC :)
 
Hi Breayle,

what is Jake currently eating? Still Fancy Feast?

with ketones, you'll want to be checking that daily.
Is there anything else going on? How's his teeth? Any infections? UTI?
Have you been in contact with your vet about the ketones?
 
Breayle --

I don't mean to be an alarmist but if Jake has anything more than trace ketones on a Ketostix, you've got to get him to an ER. Ketones are serious and can turn lethal very quickly. DKA nearly killed Gabby. If you are at the second level on a Ketostix, as your SS suggests, it's very possible that Jake needs IV fluids to flush the ketones from his system.

If there is a trace amount, Jake likely needs more insulin and you need to get as much water into him as possible. Add water to his food. If you're already doing this, add more. You need to help him flush his system.

Looking at your SS, Jake does not need to be on less insulin. Did the vet do blood work to test for an infection or were his teeth checked? An infection or inflammation can cause high numbers.
 
I totally agree with Sienne, if Jake is showing more than trace ketones please call the ER. You need to get ahead of the ketone situation before it turns to DKA. Can you get another ketone test now? And make his food as soupy as he will eat it. Come back and let us know when you get a ketone test or have talked to the vet.
 
Sienne and Gabby said:
Breayle --

I don't mean to be an alarmist but if Jake has anything more than trace ketones on a Ketostix, you've got to get him to an ER. Ketones are serious and can turn lethal very quickly. DKA nearly killed Gabby. If you are at the second level on a Ketostix, as your SS suggests, it's very possible that Jake needs IV fluids to flush the ketones from his system.

If there is a trace amount, Jake likely needs more insulin and you need to get as much water into him as possible. Add water to his food. If you're already doing this, add more. You need to help him flush his system.

Looking at your SS, Jake does not need to be on less insulin. Did the vet do blood work to test for an infection or were his teeth checked? An infection or inflammation can cause high numbers.
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Libby and Lucy said:
I totally agree with Sienne, if Jake is showing more than trace ketones please call the ER. You need to get ahead of the ketone situation before it turns to DKA. Can you get another ketone test now? And make his food as soupy as he will eat it. Come back and let us know when you get a ketone test or have talked to the vet.
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it's unanimous. i completely agree with both sienne and libby.
all 3 of us have kitties who survived DKA. not all kitties do. we know what we're talking about.
please read about ketones and how quickly it can turn into DKA here: http://petdiabetes.wikia.com/wiki/Ketones.
from the looks of jake's ss, it appears there's could very well be insufficient insulin plus some kind of health related issue causing the high numbers.
this is a recipe for DKA. it's nothing to fool around with...
 
Hey everyone, sorry to make you worry but I was working all day today.

I have not been able to check for ketones today but Jake seems to be doing fine! I just fed him and gave him his shot, he also got a dosecrease today from 2.0 to 2.25. The last few times I upped his dose he got some really gnarly numbers (above 500) so I'm really hoping he does OK.

As for the emergency vet... I do appreciate the advice to go... however I cannot. I do not have the money for a regular vet visit let alone 24 hour emergency care. I really hope no one judges me for that but I can't do much... if anyone knows an organization or they themselves are willing to help me with the vet bills then I will be more than happy to cart him over for everything and anything.

A question: How does everyone affoard paying all these vet bills? I get lots of advice from people here "bring him to the vet." But that so much easier said than done... if Vets were like people hospitals they would HAVE to treat them. However they do no do that, and I have crappy credit so I can't get that vet care card. I have a total of 6 cats... two who are over 15, one that pretty much hates anyone and everyone and whom I haven't seen in a couple days AND has an infected wound on her ear that I have been trying to get under control. I can't even affoard to take Jake to the vet! My income is roughly a little less than $1000 a month and I spend tons of cash cat food, kitty litter and more. By the time my paycheck is cashed, is basically gone in a couple hours. Many times it comes down to a vet visit or food for me, or bills. How am I supposed to take care of kitty when I'm hungry and without money to buy my own food?

I don't know what to say other than thank you for trying your best, but I'd like you to know that going to the vet isn't always an option with me.... I wish it was but it's not. Sorry if that disappoints people... I just don't have the money to bring him each time something is wrong. So once again, I'll do a shout out for people who might now of any type of organization or who is willing to donate at the very least $100.00 to take Jake to the vet... it's $40.00 just to see her, plus any meds she wants to give him or any blood tests she wants to do... so I'm going to say at the very least... bare minimum with no bells whistles it's gonna be $100.

Thanks!

Breayle and Jake
 
Sorry Breayle, the only thing I can suggest is that you check for ketones often.
You can't determine he is actually fine without checking for this.

Unfortunately if it keeps creeping up and hanging around the danger zone, it's not really something you can treat at home.
 
There are a couple of things you can do. You can ask you vet to teach you how to give fluids and keep a case of fluids at home. That will not cost much. Your vet can tell you when it's appropriate to administer fluids to help flush the ketones.

The choice of paying a few hundred dollars for Jake to be treated at an ER for ketones vs. a few thousand dollars to treat DKA is a decision you may have to face. Just understand that when Gabby was diagnosed with DKA, I had two vets tell me that not all cats survive. If you do not do something about the ketones, you may be jeopardizing Jake's life.

You can also contact Venita -- she's one of the moderators here. She runs an organization called Diabetic Cats In Need (DCIN). She may be able to help or be able to direct you to other resources.
 
Thank you, it is appreciated. I am fully aware that if Jake had DKA it would be far more expensive... I know this. It's not the point of not wanting to give up the money as much as the money does not exist. i would not be able to afford taking him to the emergency room even if that did happen. This is what makes me frickin' cry almost every night, that I cannot pay for the care he needs. He's my boy... he's been my boy for 17 years. This feeling sucks...

but i will ask her how to give him fluids, that's a fantastic idea. thank you so much! I have also heard of that Cats in Need site as well, I have not contacted them and now I will look into it.

I know I can check ketones often... at least when I'm home. The little fart ALWAYS pees when I finally give up and walk away! I mean it, he does this SO much! It's like he wants privacy :P

-Breayle and Jake
 
Breayle --

You also need to go back and re-read what Jill, Libby and I posted last night. Jake needs more insulin, not less. His numbers are, frankly, horrible. Given the abrupt shift in his numbers, it is likely that there is some infection or inflammation. It's one of the few explanations I can think of for such a rapid change in his BG values. If there is an infection present and you've reduced his insulin to the point that he's running in such high ranges, it increases the potential for DKA.

Your vet also needs to know that Somogyi has not been reliably documented in the literature.
Tight Regulation Protocol for Lantus & Levemir said:
Be aware that experimental studies in human diabetics over the last 15-20 have rejected the existence of the Somogyi effect (sometimes also called rebound). In cats, no studies have ever been done which properly demonstrate that such a phenomenon exists. Therefore, adjust the dose as described above, focusing on the nadir: don't do so-called rebound checks, as they only lead to unnecessary (and unhealthy!) hyperglycemia.
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Even if this were possible, you have given a reduced dose enough of a chance that a decreased dose trial has failed and there is now a medical risk for DKA. Please, raise Jake's dose. With the range his numbers are in, please bring his dose back to 2.5u in the morning.
 
DCIN was able to help my guy when we needed it, and the guidance we've received on the board has been invaluable. i hope everything goes well for you and jakes.

binks has now begun 'social peeing"...i'm keeping his box in the bathroom i use, and he joins me every time i'm in there. He even tries to chat me up...sez now he understands why girls head to the bathroom together.

good luck, and tell jakes we're thinking of him!

Celi & Binks
 
I put shadow in the bathroom all alone with his litter box....I put saran wrap over the litter so I could get a sample. Something like that might work for you and your private little guy.. :razz:
Good luck with the increase...maybe his numbers will start to look a little better after the increase of insulin...
 
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