1/5/25 Raven AMPS 369 +2 404 +3 358 +8 302 PMPS 284 +5 383 (Ketones elevated 0.8)

SophieFRA

SophieFRA

Member
Good morning, After cruising back up to over 500 midcycle (+4) last night, as he had done during the AM cycle, this morning Raven has reached his lowest preshot value at 369 since he came home from ER on 12-31. Fingers crossed that we can keep the numbers down. Ketones also at lowest level since I started measuring after ER stint/surgery at 0.4 (below 0.6 threshold = normal range).

He had a good appetite too. So I only administered meds (antibiotic and gabapentin as well as his fluids via tube).
 
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He has a great appetite today. I just gave him the rest of the can of RC rabbit and with that he‘s reached his calorie goal for first half of day (125 cals). He is asking for more. I think it‘s a great sign he‘s hungry (my vet said gabapentin may increase appetite and he’s also on Mirataz topical appetite stimulant) but I don‘t want to overfeed and raise his BG too much/make him nauseous. Any thoughts on feeding him more?

I was thinking about feeding him some of the RAWZ rabbit I have which is lower carbs, but it looks like it‘s 1.83 phospherus and 47.24 protein. So that‘s probably not ideal for kidneys? @Wendy&Neko

Looking at the kidney list I wonder if it‘s worth trying some of the fishbased RX foods that are low phospherus if needed (ie depending on his blood work going forrard)? I recall people often have concerns about fish based diet also for IBD I believe? But he seems to have done ok on his salmon based (15% carb) Purina Pro. Any thoughts on this?
 
You are looking for a balance between treating diabetes and IBD and kidneys. 1.83 is not perfect, but also not horrible. If you look at the foods in this CKD food list - the one for diabetes, you'll find some as high as 1.63. When you finally get a current stable phosphorus number for Raven, you'll be able to see if it's high. Worst case, you'll need to add a phosphorus binder to his food. Don't worry about the protein, you want good quality protein at this point. 15% carbs is considered high carb food and not ideal.

Feeding fish all the time is not good, but OK as a snack. However, it's also a common allergen along with beef and chicken. Dr. Pierson has a good description on why not fish in this section of her website: https://catinfo.org/commercial-cat-foods/#Ingredients

I think you'd be fine to give him a little snack of a lower carb food.
 
Thank you so much! Raven‘s great appetite continues and I did not have to tube feed to this point. He’s currently eating his dinner. This has been such a welcome change.

We also just hit yellow at 384 PMPS. Wohoo! I hope this won‘t make him bounce and I‘ll eat my words…

I am sticking with the high carb until Wednesday I think and will then discuss with internist based on his numbers whether to go with a binder or a special food. Thanks so much for all your help! Raven even wanted to explore the apartment today. He seems much improved.
 
SophieFRA said:
Thank you so much! Raven‘s great appetite continues and I did not have to tube feed to this point. He’s currently eating his dinner. This has been such a welcome change.

We also just hit yellow at 384 PMPS. Wohoo! I hope this won‘t make him bounce and I‘ll eat my words…

I am sticking with the high carb until Wednesday I think and will then discuss with internist based on his numbers whether to go with a binder or a special food. Thanks so much for all your help! Raven even wanted to explore the apartment today. He seems much improved.
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Sorry I meant to write hit yellow at 284. :)
 
I'm going to quote part of the SLGS dosing guidelines.
Sometimes there are circumstances such as ketones present, ... infection, a schedule change, ability to monitor, etc. which may call for adjustments to these guidelines and suggestions.
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You are seeing a rise in ketones. Although still not a visit to the vet level, a rise is a concern. We know from the amount of testing you do, that he's not getting low on this dose. How would you feel about raising the dose to 3.0 units in the morning? Especially since you are giving higher carb food. Note to any lurkers, the suggestion to raise the dose sooner than SLGS suggests is only for Sophie and Raven and their special circumstances.
 
Wendy&Neko said:
I'm going to quote part of the SLGS dosing guidelines.

You are seeing a rise in ketones. Although still not a visit to the vet level, a rise is a concern. We know from the amount of testing you do, that he's not getting low on this dose. How would you feel about raising the dose to 3.0 units in the morning? Especially since you are giving higher carb food. Note to any lurkers, the suggestion to raise the dose sooner than SLGS suggests is only for Sophie and Raven and their special circumstances.
Click to expand...
Thanks so much! Busy work morning. I ended up sticking with 2.75 u this morning, because BG was it‘s lowest yet at 248 as were ketones at 0.3 (normal range). I‘ll monitor and may increase PM dose if I measure ketones again today. I realize 248 is still much too high but since it‘s come down so much, I want to gather a bit more data.
 
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