11/19 Webster AMPS=450 +6.5=46 +9.5=94 Dosing advice

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for hydration....
does he like human tuna?

since we know you have a blender .... you can take a little of the tuna and some water and make a slurry....
more water than tuna....of course....
He might like drinking that if he's a tuna lover.
 
I was syringe feeding J.D. and giving him water via syringe was scary because it goes down a lot quicker than the thicker blended food. You do not want anything to go down "the wrong tube" into his lungs. Can you blend some cat food and add maybe just a teeny bit of water to it? Canned cat food is like 80% water anyway. You would have to be very careful when you give it to him. Watch this video, if you haven't before https://www.youtube.com/watch?v=U6o17wH6ujk I would still go to the vet, if I were you.
 
Ella & Rusty & Stu(GA) said:
If you skip the shot his bg will probably go up, but in general it is much safer to be too high than too low. You are very new at this and I believe that the "cut-off" number for a newly diagnosed cat is somewhere around 150. In other words, if Webster is below 150 at PMPS, skip the shot!

Ella
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Thank you Ella. His PMPS was 151 which is 1 pt above the "cut off". I don't feel comfortable giving him a shot so I will skip. Thank you for that.

Getting back, Should we force feed him? He's still willing to accept his favorite HC treats.

Also, I think he might be getting dehydrated. Is there anything we can do to help hydrate him?
 
Mikey had trace ketones, but not DKA. He's a pain in the butt to test, because he only pees when he's sure no one is around, but I got him a couple of days ago, and he was negative. Today I tried to get him, and he stomped out of the litterbox without going.

If Webster is dehydrated, your vet might want to give him sub-q fluids. He may even be willing to send you home with some. I've given them to two of our cats in the past, and it's really easy to do. Dehydration is no joke. If he was my cat, I'd want him hydrated promptly, but the more experienced people here may have more information on that than I do.

Hang in there, Mike, we're both going to get through this. Our boys are totally worth it.
 
Another thing to try if he won't eat is Gerber's or Beechnut all meat baby food. All my cats love Gerber's. I get the ham, chicken, or turkey. They are called 2nds. It's not good as an only food but helps when I need to make sure Max eats. I give him a spoonful after his gel capsule of medication every morning and add a little miralax to keep him regular as needed. It's also easy to syringe if necessary.
 
tiffmaxee said:
Another thing to try if he won't eat is Gerber's or Beechnut all meat baby food. All my cats love Gerber's. I get the ham, chicken, or turkey. They are called 2nds. It's not good as an only food but helps when I need to make sure Max eats. I give him a spoonful after his gel capsule of medication every morning and add a little miralax to keep him regular as needed. It's also easy to syringe if necessary.
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Going to store not to buy tuna and Gerbers. I'll give it a shot. Thanks for the suggestion.

BTW, Webster suddenly perked up and strolled around the house for a little. I gave him freeze dried chicken treats and he stuck around for more. No luck getting him to eat much regular food though. He drank a bit of water a little while ago.

I'm not really sure if hes actually dehydrated. The scruff test passed. Any other ways to test?
 
I think there's some concern about skipping his insulin shot entirely. You could give less than 0.5u - look at the New to the Group sticky to find pictures of the small insulin doses. But with DKA so recent in his past, and now him seeming off and not eating normally, it seems risky to skip the insulin entirely.

Remember the ketone recipe is not enough insulin + not enough food + infection/inflammation = ketones.

However if he's not eating at all, that's also a problem. I'm with Dyana, I think a vet consult is going to be a smart call if you can't get him to eat at least 50% of what you'd consider a normal volume of dinner. You can try to assist-feed - many people do that at some point. Can you at least phone the vet for suggestions?

There are some tricks to get kitties to eat. Here are a few off the top of my head. If you haven't tried them, that might be a good idea.

Warm the food up - it will smell more and may be more enticing.

Sprinkle on parmesan cheese, oregano (related to catnip), catnip, or tuna juice (make sure there are no onions/garlic on the ingredients)

Make little meatballs of the food

"Prime the pump" by putting food in his mouth with your finger. Sometimes getting them started will help them get more interested.
sprinkle on the crushed dry food, fortiflora (if you have any)

get some rotisserie chicken - most cats find that pretty irresistible. Lunchmeat might be something else tempting.

Add water to anything he'll eat to help him get hydrated.

That's off the top of my head - hopefully others will add some tricks.

I'm running out for the evening but am sending Webster some "eat your fuds" vibes.
 
A more sensitive test for dehydration:
Press a finger firmly on the cat’s gums, then remove. If the gums immediately pink back up, all is well. If the gums stay blanched white, the cat is dehydrated to some degree. Also, if the gums feel sticky or tacky (dry), the cat is probably dehydrated.

If she is dehydrated, and you've got an oral syringe (no needle), you might cautiously start giving small amounts of fluids as tolerated - perhaps 1 mL at a time.
 
julie & punkin (ga) said:
I think there's some concern about skipping his insulin shot entirely. You could give less than 0.5u - look at the New to the Group sticky to find pictures of the small insulin doses. But with DKA so recent in his past, and now him seeming off and not eating normally, it seems risky to skip the insulin entirely.

Remember the ketone recipe is not enough insulin + not enough food + infection/inflammation = ketones.

However if he's not eating at all, that's also a problem. I'm with Dyana, I think a vet consult is going to be a smart call if you can't get him to eat at least 50% of what you'd consider a normal volume of dinner. You can try to assist-feed - many people do that at some point. Can you at least phone the vet for suggestions?

There are some tricks to get kitties to eat. Here are a few off the top of my head. If you haven't tried them, that might be a good idea.

Warm the food up - it will smell more and may be more enticing.

Sprinkle on parmesan cheese, oregano (related to catnip), catnip, or tuna juice (make sure there are no onions/garlic on the ingredients)

Make little meatballs of the food

"Prime the pump" by putting food in his mouth with your finger. Sometimes getting them started will help them get more interested.
sprinkle on the crushed dry food, fortiflora (if you have any)

get some rotisserie chicken - most cats find that pretty irresistible. Lunchmeat might be something else tempting.

Add water to anything he'll eat to help him get hydrated.

That's off the top of my head - hopefully others will add some tricks.

I'm running out for the evening but am sending Webster some "eat your fuds" vibes.
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Hi Julie. Thanks for responding! I too am concerned about skipping a dose and the the Ketones returning. By the same token, I'm afraid that giving even a small dose will send him on a fast downward spiral. For some reason he keeps dropping fast when given his shot.

Today (the past week) has been absolute HELL. I've been watching his closely for over 12 hours as he dropped like a rock this morning and I am getting really tired. I've taken off the past week of work (thank god I'm able to do this with my job) and my life has been turned upside down.

I would really like to bring him to a vet tomorrow morning. I'm trying to remain level headed and not rush him to the ER if not necessary. Sorry for the rant. Stressed to the max!

I am about to try your suggestions and others. Thanks you.
 
....also, does he seem nauseated at all? Lip smacking? Turning his head away from food? A nauseated kitty won't eat, and assist-feeding a nauseated kitty will open a big can of worms. I'd also keep a very close eye and not rule out a trip to the ER - given Webster's recent past, things like lack of appy are more magnified than they would be for most kitties.
 
BJM said:
Press a finger firmly on the cat’s gums, then remove. If the gums immediately pink back up, all is well.
If the gums stay blanched white, the cat is dehydrated to some degree. Also, if the gums feel sticky or tacky (dry), the cat is probably dehydrated.
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Moist to the touch and turn back to pink quickly when pressed. Scruff bounces back when tugged.

Maybe I was overreacting when pinching his belly and it didn't bounce back fast.

On a side note, his BG is up to 252 and he seems much more active. Do you think his low BG all day make him tired?

I just need to get him to eat. About to head to the store an pick up suggested items. Thanks everyone.
 
Cats that are spending time in the blood sugar range they aren't used to can be lethargic. Neko used to always be high (she has a high dose condition) and used to be very lethargic if she got into greens and pink was her happy zone where she played. Thankfully that's now reversed. After he spends more time in the greens, Webster will get used to normal numbers as being normal again.
 
Amy&TrixieCat said:
....also, does he seem nauseated at all? Lip smacking? Turning his head away from food? A nauseated kitty won't eat, and assist-feeding a nauseated kitty will open a big can of worms. I'd also keep a very close eye and not rule out a trip to the ER - given Webster's recent past, things like lack of appy are more magnified than they would be for most kitties.
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No symptoms of nausea. It's strange. He has done a 360 in the past few hours (once BG started to rise)

We just got back from buying Tuna and 2 types of baby food as suggested. Will let you know how it goes.
 
tiffmaxee said:
Another thing to try if he won't eat is Gerber's or Beechnut all meat baby food. All my cats love Gerber's. I get the ham, chicken, or turkey. They are called 2nds. It's not good as an only food but helps when I need to make sure Max eats. I give him a spoonful after his gel capsule of medication every morning and add a little miralax to keep him regular as needed. It's also easy to syringe if necessary.
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Webster went ABSOLUTELY NUTS over the turkey & gravy Gerber! Thank you so much for the suggestion!
 
Mike,

JuJu wasn't eating much when we first brought him home from the hospital, either. I was getting concerned. I took him back about two days later because I wanted to get his BG checked (we didn't have a BG meter yet). I told the doc he wasn't eating much and had diarrhea. The doc gave us FortiFlora (pro biotic) and Mirtazapene? Spell check (appetite stimulant). We gave him a quarter of the Mirt and sprinkled the FortiFlora on some wet food and he started eating like a horse! I was so relieved! We continued sprinkling the FortiFlora on his food for about a week (until normal stool) but never did give him anymore of the app stim. Just wanted to let you know what worked for us so you would have another option if you so choose.

Keep grinding, your dedication is awesome!
 
I'm so glad he liked the baby food. All my cats have liked the Gerber's. That and the Soulistic Triple Harmony are my best shot of getting Max to eat if he isn't feeling well. You could try putting a little on top of the cat food and see if that gets him to eat it but chances are it won't.

The appetite stimulant that Matt used for JuJu is mirtazapine. Another one that I happen to like better is cyproheptadine. Both are human medications. I like cypro best because it can be dosed once or twice a day if needed. Just a sliver of a 4mg pill, maybe 1/8 gets Max eating. I don't like to use it if he is nauseous becasue it can lead to food aversions. I'm hoping that you won't need either since eating the baby food might be enough to get Webster back to being interested in food.
 
JuJu09 said:
Mike,

JuJu wasn't eating much when we first brought him home from the hospital, either. I was getting concerned. I took him back about two days later because I wanted to get his BG checked (we didn't have a BG meter yet). I told the doc he wasn't eating much and had diarrhea. The doc gave us FortiFlora (pro biotic) and Mirtazapene? Spell check (appetite stimulant). We gave him a quarter of the Mirt and sprinkled the FortiFlora on some wet food and he started eating like a horse! I was so relieved! We continued sprinkling the FortiFlora on his food for about a week (until normal stool) but never did give him anymore of the app stim. Just wanted to let you know what worked for us so you would have another option if you so choose.

Keep grinding, your dedication is awesome!
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Are these two OTC?
 
JuJu09 said:
Glad to hear he liked the Gerber!

Nice call, Elise. ;-)
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Yes, nice call indeed. He licked his chops for several minutes after attacking half a jar of the watered down Turkey gravy. He's been grooming his self for several minutes and even started to purr.

What the heck is going on? He is Lethargic and out of it for several hours and almost back to normal a few hours later. I can only speculate that it's the prolonged drop in BG today made him tired. Sounds like Wendy had a similar experience with Neko.

Anyone have any additional thoughts?

As for dosing tomorrow, what should I do. I think he is surely due for a reduction to .5. What factors should I consider tomorrow morning before shooting? How much he ate? What his AMPS numbers are? What food amounts and BG numbers should I be looking for as far as indicators before giving it the green light? I'm looking at 9:00 am eastern time tomorrow.

Thanks everyone.
 
We got them directly from the doc at the hospital, so I'm not sure. I do believe they are prescription, though.

Hopefully, the Gerber will jump start his appetite so you won't need the app stim or the pb.
 
You definitely should go to .5 units tomorrow morning. I suspect he will be bouncing. As long as he eats at least 1/2 a meal, I think you are good to shoot. With his history of DKA, it's good to get insulin in him. Even if he will only eat high carb food, that's fine.

You can also get FortiFlora from your vet, more expensive but faster. The other two drugs mentioned are not OTC.
 
Since you skipped the shot last night, if you want to change your shot time schedule to earlier, you can do that now, since it is more than 12 hours between doses. If you go to the vet, you can probably pick up the FortiFlora and an appetite stimulant while you're there.
 
Wendy&Neko said:
You definitely should go to .5 units tomorrow morning. I suspect he will be bouncing. As long as he eats at least 1/2 a meal, I think you are good to shoot. With his history of DKA, it's good to get insulin in him. Even if he will only eat high carb food, that's fine.

You can also get FortiFlora from your vet, more expensive but faster. The other two drugs mentioned are not OTC.
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Just saw your advice after posting today's condo. Thank you Wendy.
 
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