11/11 Luna - AMPS HI, +6 78, PMPS 345, +2 555 - She ate an entire meal!

Yesterday
Luna has been testing "HI" on her freestyle libre since 3AM, so I haven't been sleeping. Ketone tests have been 0.2 and 0.4. We're going to test again in an hour.

This feeding tube food is doing more to her BG than I originally thought. We really need to get her eating on her own again. Thankfully the new food is coming today. In the meantime, we're going back to 1.5U per the doctor's orders. We'd rather deal with lower numbers than keep her "HI".

There is some good news this early morning. We left down some of the glycobalance we used to feed her, and it's almost gone. It was equal to a small meal they want us to feed, so that's a pretty big deal. And to be honest, the glycobalance isn't much different than the new food we have coming, so we're hoping she won't notice the difference. It's still not a great option, but it's what the nutritionist says she needs right now, and I'll take anything over the feeding tube food.

 

That's great news that Luna is starting to eat on her own. Hopefully, the new food is lower in carbs.

 

I'm glad Luna is eating some on her own. I hope her numbers come down and the ketones don't go up. Sending prayers.

 

It's 10%. The Perative stuff we're blending with her food is really high. I don't know the percentages, but it's 40+g of carbs to 10g or so of protein.

She had a complete metabolic break down, so I get the need to pump her full of nutrients. It's just scary to see more bad tests after what she went through.

 

It's scary to see those high blood glucose readings after everything you've been thru, but hopefully it's food influenced to some degree. It's a real positive sign that she's eating again on her own and hopefully soon things will turn around for Luna and those numbers will start to come back down. I know it's a real balancing act right now for you trying to get her to eat a lot, but also watch those blood glucose numbers skyrocket. Sending strong healing vines and hugs your way today for Luna's continued improvement!

 

It's definitely food influenced. I think we'll be in a lot better shape once we can't stop the tube feeding.

 

If it's any consolation, try to remember it's not high numbers that were the crux of the problem. Plenty of cats sit in high numbers without experiencing DKA which, as you noted, is a complete metabolic mess. You're home testing and keeping a close eye on everything you possibly can. One of the points we try to remind everyone of is how is your kitty acting? The normal behaviors (purring, playing, peeing, pooping, and preening - I think these are the 5 P's -- I'm not sure about preening. I may have made that up.) are all indices of a cat who is healthy or on the mend.

 

SO great that she is eating !! I hope the new food works well! Maybe we can replace the preening with hissing for Luna ?!

 

AMPS still reading HI, but she ate normal food throughout the night and then again this morning, so we gave less feeding tube food. That should help those numbers come down. We also upped insulin to 1.5U.

3rd ketone test was .9, but our doctor said that's to be expected with numbers this high. And as long as she's still eating, drinking, and getting insulin, he's not too concerned about it. There's a difference between having ketones and it being a DKA emergency... Still, I'll be checking again this afternoon.

New food comes today. The doctor also said he doesn't really care what we feed as long as she eats on her own. Right now, glycobalance is the only thing she'll eat. Not sure what the nutritionist will have to say about it, but I'm glad he's ok with us trying...which we did. With about 5 different types of food.

 

Basically, the best food for your cat is the food that she'll eat!!

 

I always remind myself.......I have insulin. Eating is paramount & the #1 priority. Everything else is able to be adjusted & you will have all the time in the world to work on tweaking the rest so long as Luna is eating & stable from a clinical standpoint. You are keeping track of everything. I totally get your concerns. Its like PTSD after what you have just been through.

 

As long as ketones stay down and She is getting food, you can adjust the insulin. Don't worry about insulin dose getting to high right now, as she starts eating better and blood values settle into normal, dose will come back down. Right now she needs it.

 

Hi there! Glad Luna is eating! And drinking water and or you are adding it to her food, that helps to flush ketones. The recipe for DKA is: In appetence + not enough insulin + a systemic stress or infection.

My Bubba threw ketones in the 200s so its not high numbers that cause ketones.

When you get a chance , please add DKA and the date of hospitalization to your signature. The advice given to A DKA kitty will be different.

 

Dan, I have no advice to offer, I just wanted you to know that Phoebe Squeak and I are still here sending support every step of the way. Very happy Luna is eating again!

 

Ah, thanks for the reminder. I meant to update it when we got back on here.

We add water to all of her food. She doesn't visit her water bowl much, except for the last couple of days while her numbers have been up.

Luna was in the mid-200s to low 300s when they hospitalized her, which was part of the problem. Neither our regular vet or the emergency vet had a DKA cat in lower numbers.

 

Yay, we have a real number! +2 443. Never thought I'd be happy to see a red.

The Libre tops off at 500. We checked the first HI last night against our Relion Prime and the limit on that is 600. So I'm not really sure how high above 500 she was this morning, but at one point it was over 600.

 

Just a reminder, the CGM is measuring interstitial fluid (the thin layer of fluid that surrounds the cells of the tissues below your skin) vs. blood glucose. Therefore, the sensor glucose (SG) and BG readings will rarely match and are expected to be different. A greater difference will occur when the glucose is changing quickly *such as after eating.

I am going to attach a link to Medtronic's site explaining this in more detail. There are 2 videos on the page (to the right) that do a really great job making it easier to understand. They also point out the importance & reasoning behind CGM vs. BG:

https://www.medtronicdiabetes.com/c...y-sensor-glucose-does-not-equal-blood-glucose

You will see they state the importance of TRENDS vs individual #s:

"Here’s A Tip: Knowing the direction and speed of your glucose changes will be more useful than focusing on individual BG or sensor readings. When using continuous glucose monitoring (CGM) trends are the key. In fact, seeing trends and patters in your glucose is likely one of the primary reasons you started using CGM therapy. Trends highlight the direction that your sensor glucose readings are moving and the speed at which they are changing. Fingerstick blood glucose readings and sensor glucose readings are only snapshots of your glucose at that very moment. Trends can tell you if your glucose has been rising, falling, or appears to have been stable over several minutes, hours, and even the day.

So it’s important not to focus too much on the individual sensor glucose numbers (as it is likely to be different from your BG meter reading) and more on trends and patterns in your glucose levels."

I am also attaching the link for Libre & if you scroll down they also have a nice video called:
See the difference between blood glucose readings and sensor readings
https://www.freestylelibre.us/cgm-difference/benefits-of-cgm.html

 

Oh good - the +4 is looking a lot better! Luna darling - tons of get better wishes still coming right to you. Paws crossed you love your new fuds, yum yum.

 

Definitely better, but a little too quick getting there. Still have a lot of cycle left on a higher dose. Vet wants us to intervene under 100 with feeding tube if she won't eat on her own. Dose is going to be tricky as she starts eating more and we use the feeding tube less.

 

Dammit, I think we over did it. HI to 78 in 5.5 hours.
She didn't want to eat enough to come back up, so had to give a feeding tube meal. This is so difficult. Insulin dose is a moving target while she's beginning to eat on her own again.

 

So sorry, Dan! But very glad you are on top of it. Hang in there.

 

New food came today and Luna loved it. Ate her entire meal tonight, so no feeding tube. I hope we're done with that thing.

 

That is SO awesome Dan !!! It sounds like Luna is happy as well !! I wish you the best with it & hope you are done with the feeding tube as well!

What is the magic food??

 

Great news that Luna loves her new food and is eating on her own!!! Prayers for continued healing!

 

Oh that's great news!!! Go Luna!!

 

Purina Pro Plan DM Savory Selects. Wouldn't be my first choice, but she's eating

 

WTG Luna!!! Congrats Dan. The relief you must feel!

 

And then she follows it up with a broken Libre sensor and +2 555 (old school testing). She couldn't let us celebrate for too long.

 

Sorry Dan .....but SO happy she is eating!!

 

Good news on a kitty that's eating on her own!!!

And aren't you happy you learned how to home test. You have a back-up with your trusty glucometer.