? 10/31 Max AMPS 477 + 2 477 +4 402 +6 389 +8 411 + 10 446 + 11 490 PMPS HI on Libre 517 on ReLion

Besides trying to be patient, is there anything else I should do to help him? He acts like he’s miserable. I think these high numbers for so long are taking it’s toll on poor Max. I wish I could do something. Trying to decide if SQ fluids would be of any benefit. I’m cautious about giving those due to his heart. The doctor said I could if I thought he was dehydrated. He has eaten. 0.7 ketones on meter, up from 0.3. What do you think @Wendy&Neko Do you think this dose is going to be any better? Too soon to tell? Any other recommendations for us?
 
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Ketones are now 0.8 on meter. Libre read high again and +2 is 513. What is going on? Is there a chance my Levemir that I got from Marks is bad? I feel like I have really messed up and don’t know what to do. I am so upset. Max has had DKA before. Someone please help me.
 
Levemir onsets tend to be later than Lantus, so often you'll likely see not much of a drop at +2. It takes a bit of adjusting, until you get a feel for how the new insulin is working. Can you get a test around +5 Or +6 tonight and see where he is at? You just increased to 7.5u so it will take some time to get the depot settled. Ketones are still ok on the meter. Does he do ok with you adding additional water to his food?
 
I do add water to his food. He was acting really hungry just now so I gave him a little of his low carb. He didn’t eat all of his dinner from before. I will stay up and check. Should I do anything else?
 
Max & Lori said:
I do add water to his food. He was acting really hungry just now so I gave him a little of his low carb. He didn’t eat all of his dinner from before. I will stay up and check. Should I do anything else?
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Hungry is great! Keep checking daily for ketones, but remember, the basic recipe for developing DKA is an insufficient supply of insulin + inappetance + infection or other systemic stresses

I know the high numbers are hard to see, there's really not much to do there. Mav had some yucky higher numbers when we transitioned too from Lantus to Lev, but he doesn't have added complications. Perhaps Wendy might have some thoughts on dose, but I think I'd like to see a couple of more cycles on 7.5u.
 
Yes. These numbers are soooo hard to see. @Wendy&Neko what would you think about teaching Lori how to add in a little Novolin R? Although he may only be a few days/units away from better numbers. Forgive me. I empathize with what’s going on with Max. A few more days or patience? What do you think?
 
Max & Lori said:
Thanks y’all. I’m just so upset and exhausted. I’m sorry.
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Oh my goodness :bighug::bighug: don't apologize! Of course it is upsetting. I personally don't know if I'd throw R in the mix, since you're just new to Lev, and it is still early in the switch; we don't know his onsets and nadirs with Lev yet. R may complicate things, since you don't want R nadirs overlapping with Lev. That, and we suggest in instances where R should be used that an experienced member help in that process.
 
Max & Lori said:
Thanks y’all. I’m just so upset and exhausted. I’m sorry.
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Don’t be sorry. You are among friends. Many of us have been there with the former DKA cats and high numbers… the worry and anxiety. Get some rest. Things are changing and will change! You will see it soon. How hard it is to feel so helpless and watch our sweet, beloved cats feel poorly!!
 
Christie & Maverick said:
Oh my goodness :bighug::bighug: don't apologize! Of course it is upsetting. I personally don't know if I'd throw R in the mix, since you're just new to Lev, and it is still early in the switch; we don't know his onsets and nadirs with Lev yet. R may complicate things, since you don't want R nadirs overlapping with Lev. That, and we suggest in instances where R should be used that an experienced member help in that process.
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Yep, Christie. That’s why I asked Wendy about the R. I feel Lori’s pain. Thanks for being here. How’s your Mav?
 
Thanks so much y’all. I’m going to try and calm myself down. This is so unlike me, but I have been through so much with him and it’s heartbreaking to see him like this. I’ve put so much into caring for him and it’s so disappointing to always feel like I’m not getting anywhere. I know y’all know the feeling. Thank y’all so much for being there. I don’t know what I would do without you.
 
Max & Lori said:
Thanks so much y’all. I’m going to try and calm myself down. This is so unlike me, but I have been through so much with him and it’s heartbreaking to see him like this. I’ve put so much into caring for him and it’s so disappointing to always feel like I’m not getting anywhere. I know y’all know the feeling. Thank y’all so much for being there. I don’t know what I would do without you.
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Oh gosh, Lori. I said the same. Get rest! It will help you to help him! You are strong!
 
Lori - I am sorry about the higher numbers and Max not feeling well. :bighug::bighug::bighug: I agree with Christie, I would like to see more of the Levemir depot built before we decide to increase again. Don't forget that NDW may be also in play. Tomorrow may be a better day.

I also agree with Christie about R. It's best not to start R until you have a handle on how Max behaves on Lev. You need to be able to figure out the R action on top of the Lev action. Of course, if ketones become concerning, I would change that.
 
Wendy&Neko said:
Lori - I am sorry about the higher numbers and Max not feeling well. :bighug::bighug::bighug: I agree with Christie, I would like to see more of the Levemir depot built before we decide to increase again. Don't forget that NDW may be also in play. Tomorrow may be a better day.

I also agree with Christie about R. It's best not to start R until you have a handle on how Max behaves on Lev. You need to be able to figure out the R action on top of the Lev action. Of course, if ketones become concerning, I would change that.
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Yes. Thanks for saying that!
 
Thank you Wendy. I really appreciate you being so patient with me. Sometimes I just feel so overwhelmed. I’m trying to be patient. It’s just hard when I feel so helpless and tired. Thanks for your opinions though, that means so much.
 
Wow you seem very patient and level headed to me. When I was working as a nurse, I felt that I was that way too, but when it comes to your own pet, children or any other family member all of that goes out window. Marje helped me a lot too. Have a good night Wendy. I’m going to try and just chill out. Hopefully tomorrow will be better.:bighug:
 
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