Christi & Noodle said:
I still can't make sense of how fast he crashed and what I need to do to keep him safe.
yes, unfortunately, you've seen how fast kitties can crash. my alex was ketone prone. whenever i sensed a problem i would test her urine for ketones twice a day because they can and do develop quickly. i think the thing that helped me the most in keeping ketones at bay was to remember
the recipe for ketones:
an insufficient supply of insulin + infection OR other systemic stresses + a poor appetite/appetite that's off
all 3 of these "ingredients" have to be present to create the perfect ketone developing storm.
if i suspected anything being "wrong" or "off" in alex's body i would react immediately by stepping up feeding to increase her intake of food... syringe feeding if i had to. I'd also increase her intake of water by mixing as much water in her food as she would tolerate. i would also give her water by syringe whenever i'd walk by her.
i'd try to get as much insulin into her as safely possible (increase the dose)... even if i had to feed her high carb wet food to keep her from bottoming out.
another tool to have on hand is R insulin, BUT please have someone guide you in it's use. don't try it on your own. a little bit can go a long way. using R as a bolus insulin is considered an advanced technique. it can be downright dangerous if not used correctly.
sometimes administering sub-q fluids at home can help clear kitty's body of trace or mild ketones. discuss it with your vet. fluids are not suitable for cats with some conditions like heart problems.
vet visits are the best. they are very useful to identify and address illness, infection, or disease, but alex was extremely difficult to vet. she became cujo kitty the minute we walked into a vet's office. they had to put her under to do much of anything to her so i tried to do anything and everything i could at home before having to take her there.
that's why i tried to remove a couple of the ingredients that are necessary to prevent ketones from developing:
an insufficient supply of insulin (i increased the dose)
+ infection OR other systemic stresses + a poor appetite/appetite that's off (i increased her usual intake of food and water by at least half). by taking away 2 of the 3 ingredients necessary for developing ketones, we managed to ward off ketones turning into DKA whenever their was a problem. that doesn't mean we never saw the vet. all it means is that i was able to keep the number of vet visits down with her (not always an ideal situation, but necessary in her case).
make sense?
Christi & Noodle said:
Jill and Alex,
I see from your signature that you have used both Lantus and Levemir. If Noodle comes through all right, the vet thinks maybe we should try Levemir. Is Levemir dosed the same as Lantus at the beginning of the switch? He is on 3.5 U of Lantus right now, and of course had R at the vet for a quick dropping of the high BGs. Any thoughts or advice would be much appreciated.
generally we suggest a starting Lev dose at 70% of the current Lantus dose. the reasoning is we've seen many former lantus kitties tank within their first couple of doses of levemir. it's simply safer to initially start them out on a little bit lower of a lev dose than the current lantus dose.
HOWEVER, i would not suggest switching to a new insulin... any new insulin... until this DKA incident can only be seen as a distant object in your rear view mirror. noodle is currently too vulnerable and fragile to confidently reduce the dose as generally suggested when switching to a new insulin.
just my thoughts...
Edited to Add:
what does "SIBO" mean (10/16 spreadsheet comments)?
it looks to me like problems beginning mid-october led up to noodle's recent hospitalization. if you read through the comments section between then and now you've mentioned all 3 of the ingredients for developing ketones. data isn't just about the numbers. it's observations, too. you've done an awesome job recording noodle's data! take that information and learn from it because there's almost always a "next time".
He looks better in his eyes, not that dead, glazed look that had me so worried. So I am cautiously optimistic that he may pull through and we can get our ol' Noodle back. I will be back to visit him tomorrow and will update in the afternoon. Thank you so very sincerely for your continued prayers and encouragement.
