? 11/18 Pino AMPS 452 PMPS 483

Bandit's Mom said:
From the sticky on
Info Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters

"When do ketones show up on a blood ketone meter such as the Nova Max Plus or Precision Xtra Blood & Ketone meters?
The latest published research/studies in cats indicate ketones will begin to show up at readings of 2.4 and 2.55 on a blood ketone meter"
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I increased to 3.5 and hoping to see some drops.
The whole time i tested him with urin stripes and it showed negative, today i tried with blood meter for the first time.
 
Ariana said:
I increased to 3.5 and hoping to see some drops.
The whole time i tested him with urin stripes and it showed negative, today i tried with blood meter for the first time.
Click to expand...
I think anything over a trace when testing urine is a cause for concern but with blood ketone meters, the levels to watch are if they cross 2.4.

Is he eating okay? If he won't drink water, you could add a little water to his food.
 
Bandit's Mom said:
I think anything over a trace when testing urine is a cause for concern but with blood ketone meters, the levels to watch are if they cross 2.4.

Is he eating okay? If he won't drink water, you could add a little water to his food.
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Thanks for this information.
He's eating just fine, he's hungry all the time so he doesn't leave anything for later.
I am adding water the whole time from the start of his DX.
 
Ariana said:
He's eating just fine, he's hungry all the time so he doesn't leave anything for later.
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The higher numbers will make him hungry. His body cannot process the food which is why he is always hungry. His appetite will reduce as his numbers improve. Feed him as much as he wants.
How is his weight?
 
Bandit's Mom said:
The higher numbers will make him hungry. His body cannot process the food which is why he is always hungry. His appetite will reduce as his numbers improve. Feed him as much as he wants.
How is his weight?
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He is stable at 6 kilos (13pounds) since he came home from the vets (october).
 
I agree with @Bandit's Mom.
How much food are you feeding him? A kitty who has had DKA needs 1 and a half times as many calories as you would normally feed. This helps keep the ketones away. I would feed the 2 main meals and then give multiple snacks during both cycles except for the two hours preshot.
Are you adding a teaspoon of warm water to the food to increase fluids?
Post DKA you need to make sure he is getting plenty of food, enough insulin and plenty of fluids.

Have you looked at the two dosing methods that are at the top of the Lantus page in the yellow stickies? It looks as if you haven’t chosen a dosing methods yet. I would recommend you follow TR if possible so that you can get your kitty into better numbers more quickly, especially after DKA. At the moment he is still in too high numbers.
I am really glad to see you are testing very frequently for ketones. This is really important.
 
Finally some better numbers. Should I be expecting some bouncing tomorrow or is it too early?

Bron and Sheba (GA) said:
I agree with @Bandit's Mom.
How much food are you feeding him? A kitty who has had DKA needs 1 and a half times as many calories as you would normally feed. This helps keep the ketones away. I would feed the 2 main meals and then give multiple snacks during both cycles except for the two hours preshot.
Are you adding a teaspoon of warm water to the food to increase fluids?
Post DKA you need to make sure he is getting plenty of food, enough insulin and plenty of fluids..
Click to expand...
I give him 2 main meals at the shoot time and 2 snack between shoot time (usually at +4 and +8). If I see that he is asking or standing by the bowl i give him some more but i never knew how much food is enogh for him. He never gets food 2 hours preshot, and I always add 1-2 teaspoons of water into the meal - wet food.

Bron and Sheba (GA) said:
I agree with @Bandit's Mom.
Have you looked at the two dosing methods that are at the top of the Lantus page in the yellow stickies? It looks as if you haven’t chosen a dosing methods yet. I would recommend you follow TR if possible so that you can get your kitty into better numbers more quickly, especially after DKA. At the moment he is still in too high numbers.
I am really glad to see you are testing very frequently for ketones. This is really important.
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I have looked and I think i will follow the TR protocol because of the precision and really wanting to find the real dose for my kitty. Also i really try to test as much as I can. If not after the AMPS i always test him regurally after PMPS when I am always home.
I have keton urin stripes and also a blood meter (even though the strips are really expensive in Slovenia) to be sure.
 
Looks like the new dose is better. Can you put TR in your SS and signature please so we know what you are following please.

bouncing can happen anytime so it is possible he might bounce.

You are doing a great job caring for him.
 
I gave him some trests or food after testing yes.
I red on the FB group it is recommended that the kitty eats 20 calories per pound? For Pino that is about 260 kcal. I give him everyday around 300-350 kcal (3.5 cans). Is that okay or too much?

Vet recommended to try to feed him 2 times per day but that is IMPOSSIBLE.
 
Ariana said:
red on the FB group it is recommended that the kitty eats 20 calories per pound? For Pino that is about 260 kcal. I give him everyday around 300-350 kcal (3.5 cans). Is that okay or too much?
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That’s fine!

Ariana said:
Vet recommended to try to feed him 2 times per day but that is IMPOSSIBLE.
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That’s crazy. Cats do much better and are much happier with more frequent smaller meals. And I’m surprised he would say that about a post DKA cat….they need to eat more often than twice a day.
 
Bron and Sheba (GA) said:
I’m surprised he would say that about a post DKA cat….they need to eat more often than twice a day.
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My vet clinic said the same thing. I don’t think most non-specialists know what to do with post DKA… they want to treat it exactly like a cat that’s never had ketones. Mine is mostly worried about “not seeing a true nadir” and ignoring other contributing factors to the situation. At least in my short-so-far experience.

Although I think they’re starting to give up on me following all advice closely. I was calling the office all the time before starting here, have barely talked to them since. They haven’t called me either… I guess they’re figuring no news is good news? Or something. I don’t know. I do know they were really hung up on the two meals thing, they also wanted to decrease his caloric intake so the insulin would work faster. I haven’t been a cooperative owner on the feeding front, though I was trying to make it a team effort other than that.
 
Skye & Jackson said:
My vet clinic said the same thing. I don’t think most non-specialists know what to do with post DKA… they want to treat it exactly like a cat that’s never had ketones. Mine is mostly worried about “not seeing a true nadir” and ignoring other contributing factors to the situation. At least in my short-so-far experience.

Although I think they’re starting to give up on me following all advice closely. I was calling the office all the time before starting here, have barely talked to them since. They haven’t called me either… I guess they’re figuring no news is good news? Or something. I don’t know. I do know they were really hung up on the two meals thing, they also wanted to decrease his caloric intake so the insulin would work faster. I haven’t been a cooperative owner on the feeding front, though I was trying to make it a team effort other than that.
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We all know that cats need to eat and eat well. So to suggest a diabetic cat eat less is asking for trouble in my opinion. Especially a cat who has had DKA.
All cats needs to eat all they requires and then the insulin dose is decided around that, not the other way around. If diabetic cats don’t get enough to eat, we are inviting ketones into the picture.
If you are feeding your kitty the amount it needs and giving the appropriate dose then that will get a true nadir.
 
I think they were going off of some recommended calories per pound guidelines on paper. I didn’t say I agreed… hence me being less than cooperative about that. The vet just didn’t seem to understand any way of seeing a curve (or lack of perfect-sine-wave curve) other than the traditional two-meals-only, predictable-drop-every-time concept. Something like the curves I have seen pictured on the Vetsulin website. Even though the vet said Lantus was a good choice, they want to see it look like Vetsulin I guess.

Or maybe something else I’ve heard/read is true, and the vets simply are more used to how dogs handle things, instead of cats who are apparently much more complicated in their responses to insulin and sugar.
 
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