12/3 Tawny pmps 205; +2/273 Still Syringe Feeding

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DD & Tinkerbell

DD & Tinkerbell

Member Since 2009
Morning all, sorry I did not get any condos open yesterday, it was one of those days.

Last Condo 12/2/11: Tawny 12/2/11

I need advice on what to do about this morning's shot - she is off her food again - do I hoot or not? 2.75u - I will be home all day to monitor - her pm+11 / 254, I am updating her SS now.

Tawny is not doing very well I don't think and I am really worried again. I am getting ready to post s/thg this a.m.

She went off her food again last night, I cannot get her to eat at all. Funny thing is, anything that has gravy or sauce or water on it she laps it up like crazy, like she is starving. I have been watching her eat, when she eats, and at this point I honestly think there is s/thg wrong w/her mouth/teeth. If I can get her to eat anything today I will post a video if I can figure out how to do it.

The vets, as great as they have been, seem to be turning a deaf ear to several things: (1) blood ketone #s, they want only urine and I can't always get that,and they are ignoring the blood ketone readings (said they only want urine ketones); (2) me doing my own curves; (3) her needing a dental. Oh, and me raising her dose on my own, and those raises being .25u at a time.

Yesterday morning Tawny ate OK, last nite it looked like she ate a little dry food while I was at THS, then at pmps time and overnight she has not eaten , only lapped up the water from the Meow Mix and the sauce or water off the Friskies.

b/c she was lapping up the sauce/juice/water off the Meow Mix last nite @ pmps time, & b/c I was home all nite to monitor, I went ahead w/her 2.75u shot last nite.

I left a bunch of different kinds of food out for her overnight, she touched none. Watered down Meow Mix, non-watered down Meow Mix (which is what she will usually eat when she'll eat nothing else), 3 kinds of Friskies - watered down, some laced with treats, pate, flakes and shreds, and dry DM. She ate none of it overnight.

This morning she acts like she is hungry and wanted into the contraband room where most of the others eat their 9 Lives Plus Care. I thought maybe she wanted to eat w/everybody else and the whole point is to get her to eat so I let her in there with them. She ate a few kernels of that, then stopped. I brought her & a bowl of it upstairs to her room and she ate a couple kernels and stopped.

LVRC said they don't think she needs a dental. Dr. Penton (local vet) a year ago said she wanted Tawny regulated b4 she did the dental. This seems weird to me b/c part of the reason for the dental is to help a cat get regulated, is it not? Or am I wrong about this?

I think Tawny doesn't eat b/c it hurts her. Even the pate. She chews funny. I will call Dr. Penton in the morning (Monday) and ask her about the dental again. If I don't get anywhere I will talk to the other local vet about it. Of course the problem right now is Tawny has another week of Clav & 3 wks of Actigall to go. Her urinalysis last week did come back with "no growth".

What should I do (1) about her shot this a.m.?; (2) syringe feed her?
 
Re: 12/3 Tawny~Not Eating~Worried~Need Advice~Long, Sorry

she needs her insulin, and she needs to eat. You don't want her to go back down the road to DKA again. You say she will lap up gravy, so if you give her HC for breakfast will she eat that? What about some kind of people food? Baby food? If not, then you might need to syringe.
 
Re: 12/3 Tawny~Not Eating~Worried~Need Advice~Long, Sorry

I would keep practicing assist feeding. I know I sound like a broken record. Finger feeding, feeding when she's sleeping, finding a way she will tolerate syringe feeding, many times a day. It gets them over humps. MaxCal Recovery RS is only 6% carbs and has a high calorie content. Try things like in a small room or closet, on your lap unconstrained, beside you on the couch in between you and the couch arm, wrapped up like a burrito, two personed.... if you can't get enough calories on their own they need to be assist fed. I wish your vet had placed an etube. Can you bring him the instruction booklet which shows him the info he needs to understand the meters ketone levels?
 
Re: 12/3 Tawny~Not Eating~Worried~Need Advice~Long, Sorry

I have to run, so no time to read the condo.
Just sending mucho BIG strong eating vines to Tawny.
 
Re: 12/3 Tawny~Not Eating~Worried~Need Advice~Long, Sorry

i don't have advice on it either, so am just sending you a hug and sending tawny "EAT" vibes! :YMHUG:
 
Re: 12/3 Tawny~Not Eating~Worried~Need Advice~Long, Sorry

Try blending the food with a little water. I had two cats that I struggled to feed, and since I started blending their food, they eat consistently. It's the same food they wouldn't eat out of the can. If Tawny likes gravy, maybe the consistency would work for her. If she still won't eat it, since it's blended, it's easily syringed. On one of the cats I mentioned above, I've had to syringe feed for a few days a few times, but it got her over the hump. It will also put your mind at ease knowing she has food in her belly.

I use one the rocket blenders on their food.

Good luck,

Jason
 
Re: 12/3 Tawny amps 237 - syringe feeding - shot

OK, I skinnied up her dose but gave it @ amps of 237.

I syringe fed her 10mls of 19% HC Friskies and some gravy off the Meow Mix, probably another 5mls of that.

Her blood ketone reading is 4.9, which is actually down from 6.3 the other day. When it was 3.0 last wk when I called her vet about it, the vet said to get a urine ketone reading which I did and that was "small" when the blood ketones read 3.0.

The vet had said to watch her clinical signs and not even use the blood ketone meter (another vet rule I broke), so I did not call them when it was 6.3 b/c Tawny was still eating.

She is drinking water on her own.

How often should I syringe feed her and how much?
 
Re: 12/3 Tawny~Not Eating~Worried~Need Advice~Long, Sorry

have your tried tuna juice with her food vs water its works for my cats many a time and I would also do as Karrie advised start syringe feeding soon I also buy pedialyte and use it in place of water really helps to avoid dehydration and I use it to make my food mushy for syringe feeding
 
Re: 12/3 Tawny amps 237-syringe feeding-gave shot-bld K's do

Sending eating vines to Tawny. Jason's idea sounds good. Will she eat any of the fish flavors? Sometimes the smelly food is what they like best. I hope you can find a way to get food in her today.
 
Re: 12/3 Tawny amps 237; +1/216 - syringe feeding

Right now I am syringing .10 mls (EDITED: this is 10mls, not .10, however it's actually 20 mls, I mis-calculated~Desi) of 19% HC into her every hour. Trying to finger feed some small mushed up pcs, but after 1 or 3 she spits them out.

amps 237
+1 / 216

dropping, but not super-fast.

I wish they'd put the feeding tube into her too, and taught me how to give the SubQ fluids also.

Do I have this right?: giving the fluids are to help flush ketones?

Should I try to feed her more? I don't want her to puke. Her tail is flipping, but she is not exactly frisky, but not exactly lethargic, either.
 
Re: 12/3 Tawny amps 237; +1; 216 - syringe feeding

If you can feed her every hour that is great. Can you monitor what she eats on her own and put it in her spreadsheet also? With a normal healthy cat on the assist feeding forum we recommend a 5.5 oz can of food a day. A cat fighting DKA or illness needs more than this. And calories not quanitity is the big thing. Do you have any recovery RS or maxcal? Even wellness chicken has higher calories than most foods. Vet food like AD isn't enough calories. Violet mixed Clinicare in with her food for tube feeding even though it was 25% calories. Water has zero calories so when water is used to thin food it waters down the calorie count.

Tuna juice has high sodium. I don't know how this affects DKA. That is something to look into.
 
Re: 12/3 Tawny amps 237; +1; 216 - syringe feeding

Do you mean 10mls an hour? Not .10 mls?

You can try to feed more than this. Signs of nausea or that she's had enough will include lip smacking, lip licking, teeth grinding, and even stomach lurching. So you'll start to know her signs. Most people on the assist feeding forum can feed 20 - 30 ccs/mls at a time - every couple of hours. I would give pepcid to help if stomach acid is an issue.

And remember to make the assist feeding a good experience just like getting her shot. Brushing, love, singing etc.
 
Re: 12/3 Tawny amps 237; +1; 216 - syringe feeding

I think that the flipping tail may mean she's not feeling well, or a tiny big agitated, or both. I would also think that giving small amounts frequently (like every hour) would help, and giving her water if she doesn't drink on her own (which you said she's doing). She needs to eat. Eating = good. Not eating = bad.

Sending you and Tawny tons of positive thoughts, and healing vines. Hang in there. :YMHUG:
 
Re: 12/3 Tawny amps 237; +1; 216 - syringe feeding

Karrie and Maverick said:
Do you mean 10mls an hour? Not .10 mls?
Click to expand...

Yes, Karrie, thank you for catching that. I mean 10 mls. I have a 6 ml syringe and I fill it to 2 and do 2mls at a time 10 times, DUH! that's 20mls an hour. But I am going to up it per the info from others in your post. Thanks.
 
Re: 12/3 Tawny amps 237; +1; 216 - syringe feeding

I would do every 2 hours if you do more than 20mls. And until she's back to herself and zero ketones I would get up a couple times a night also. You can catch up on sleep but it will mean a lot to her.

I assist fed Maverick with his tube for ten weeks. I had to feed him through the night initially to keep his weight up. For some reason he needed 2.5 cans of the high calorie food to maintain his weight. Sicker cats often need more calories. He wasn't diabetic at the time. I would give anything to have him back and wake up every hour at night. I know most of you feel the same way. Tawny is a very very lucky girl.
 
Re: 12/3 Tawny amps 237; +1; 216 - syringe feeding

I don't have any advice- looks like lots of others have great ideas but just wanted you to know that I'm thinking about you and Tawny and hoping for some eating....
 
12/3 Tawny amps 237; +1; 216; +2.5/236; +4/190-syringe feedi

I sure hope I did the right thing giving her a skinnied up full shot this morning, now she is dropping and still not eating.

I finger fed her some Friskies Beef & Salmon HC 19% at the +4 BG of 190, I have to pry her mouth open, scrape my finger w/the food on it across her tongue, tip her head back slightly and hold her mouth shut til she chews and swallows. She doesn't really fight me tho. That was good advice, Karrie, to make it a special time, I brush her a little, talk to her, pet her & kiss the top of her head in between sticking my finger in her mouth.

Here are her meds: 1/4 tab Pepcid BID; Actigall 1x day; 62.5 mg Clav BID; Denamarin every 24 hrs on empty stomach. Plus insulin. :YMSIGH: :? :YMSIGH:

Now I am worried about tonight's shot already and that's about 7 hrs from now. If she doesn't start eating, I will probably give her half a dose. What do you all think?

It's such a difficult balance: needs insulin, ketones need to clear, needs to eat, doesn't eat, how much insulin to give, will the ketones clear w/1/2 a dose and not eating on her own?????? I am really struggling with what is the right thing to do.
 
Re: 12/3 Tawny amps 237; +1; 216 - syringe feeding

((((Desi)))) ((((Tawny))))
I'm sorry, too, not to have any advice to give, but you have a lot already. We are just wanting Tawny to eat, to feel better, to have no ketones, and to get well soon.
Rusty sends his love and is busy gathering the vines for another beautiful bouquet.

Love and hugs from us,
Ella & Rusty
 
Re: 12/3 Tawny amps 237; +1/216; +2.5/236; +4/190-syringe fd

Sending good eating, no ketones vines to Tawny. Desi, you are such a good bean and have so much on your plate! Hope Tawny gets stabilized soon.
 
Re: 12/3 Tawny So Far Today

She is still getting syringe fed and finger fed today.

So far today:

4 a.m. - 1/4 mirtazapine (appy stimulant)

amps 237 hooted s2.75, got 62.5 mg clav, denamarin (1 hr b4 food), 1/4 tab 10mg pepcid
+1 / 216 - syringe fed 20mls
+2.5 / 236 - syringe fed 20mls
+4 /190 - syringe fed 30 mls between +2.5 & +4.5 off and on & finger fed maybe 1/4 can HC Beef & Salmon (19%)
+6 / 207 - syringe fed 30 mls & 2-3 bites finger fed

She acts like she don't feel good but she is alert, walking around, talking a little,drinking on her own. You can see it in her face, it's almost like s/thg hurts, but she doesn't scream or squall anywhere on her body, believe me, I have been poking and prodding her all day, even around her mouth. My gut is still telling me it's her mouth or her teeth, I just have this weird feeling, kind of had all along, but we keep asking the vets about a dental and they keep saying it's not needed. Unless she has reflux. Do cats get reflux, I wonder? I know I don't eat much b/c I have it bad and everybody is always harping on me about eating more & my answer to that is "if every time you did s/thg it made you hurt or sick would you keep doing it?" NOT.
 
Re: 12/3 Tawny amps 237;+4/190;+6/207-syringe fdg

aw...still sending vines, desi....

Binks wanted to stop back by because he was worried,
but I also figured out he thought 'syringe fdg" meant "syringe fudge"...
and he does have a sweet tooth... :smile:
 
Re: 12/3 Tawny So Far Today

DD & Tinkerbell said:
My gut is still telling me it's her mouth or her teeth, I just have this weird feeling, kind of had all along, but we keep asking the vets about a dental and they keep saying it's not needed. Unless she has reflux. Do cats get reflux, I wonder?
Click to expand...

Hi Desi,
I am sorry that Tawny is still not feeling well. Cats can get acid reflux. I am attaching a link from Tanya's CRF site which discusses stomach acid problems. One suggestion that might work is raising her food dish up about 6 inches so the the mouth is not lower than the stomach. I wish I had more advice to offer you. It does sound like she should be rechecked by the vet.

http://www.felinecrf.org/stomach_acid.htm
 
Re: 12/3 Tawny amps +8/204; Blood Ketones 6.6; Temp 100.6

Antibiotics can cause a decreased appetite. Mirtz on top of feeling yucky can backfire. How much are you giving of the mirtz?

And is eating any better or worse after the denamarin? I don't recall giving this to Maverick on an empty stomach.
 
Re: 12/3 Tawny amps +8/204; Blood Ketones 6.6; Temp 100.6

Hi (((((Desi))))) Sending healing vines for sweet Tawny. I know when Jetta was so sick and on Mirtrazipine, she was not right at all. Someone here actually suggested to me to STOP the mirtrazipine to see if that helped, and boy did it. It's actually an anti-depressant that sometimes has a side effect of stimulating appetite. It's a fairly powerful drug to be giving to a small cat. I know ECID, but, it might be worth asking the vet (or someone far more knowledgeable than me!!!) if you need to continue with that or could try her without it. I think a lot of times with these sick kitties it's a matter of finding the right combination of stuff that works while trying to weed out what doesn't.
 
Re: 12/3 Tawny Urine Ketones

Karrie and Maverick said:
Antibiotics can cause a decreased appetite. Mirtz on top of feeling yucky can backfire. How much are you giving of the mirtz?

And is eating any better or worse after the denamarin? I don't recall giving this to Maverick on an empty stomach.
Click to expand...

She is prescribed a quarter tab of mirtz every 3 days as needed. she went about 5 days in between the one she got last thurs, it helped then she went off her food again last night when she would not eat at pmps. I did not know it was an anti depressant but based on the above comments I will probably stop it altogether.

the denamarin box reads "Tablets should be given on an empty stomach at least one hour before a meal for optimal absorption..." so that is why I have been doing that. The clinic did not prescribe it that way, gave no time line at all actually, nor did they say anything about giving pepcid a 1/2 hr b4 a meal. Actually now that you mention it it seems like she might eat better w/out the denamarin, cuz a couple times she didn't get it and she did eat good those days.

I just caught a pee and her urine ketones are in the purple. Getting another blood ketone reading as soon as I post this.

She is actually starting to act a little better than she did 3 hours ago but she is still not eating on her own.

I am tempted to pull her off all her meds, why does she need the clav anyway if her urinalysis came back Wednesday w/no growth?

And as far as her insulin shot tonight, in about 2 hours from now, I am seriously considering reducing it considerably like, by at least half. Actually on her discharge pprs the clinic said to feed her b4 giving any insulin and that if she did not eat to cut her dose in half.

Any thoughts, advice?

Urine ketones in the purple but blood ketones down from a couple hrs ago, now @ 5.6. +10.5 BG 191
EDITED TO ADD:
So far today:

4 a.m. - 1/4 mirtazapine (appy stimulant)

amps 237 hooted s2.75, got 62.5 mg clav, denamarin (1 hr b4 food), 1/4 tab 10mg pepcid
+1 / 216 - syringe fed 20mls
+2.5 / 236 - syringe fed 20mls
+4 /190 - syringe fed 30 mls between +2.5 & +4.5 off and on & finger fed maybe 1/4 can HC Beef & Salmon (19%)
+6 / 207 - syringe fed 30 mls & 2-3 bites finger fed, blood ketones 6.6, temp 100.6
+8 / 204 / finger fed & syringe fed
+10.5 / 191, urine ketones purple, blood ketones 5.6 down from earlier
 
Re: 12/3 Tawny Urine Ketones

Insulin is one of the best ways to keep ketones in check. I'll go back to what I said in a different condo -- I don't care if you need to feed Tawny a hot fudge sundae to get food into her to offset the effect of the insulin. Insulin fights ketones. I am very, very concerned about the level of ketone readings you're getting. This is dangerous territory. If this were my cat, I would not even contemplate reducing the dose and I'd be on the way to the ER. I am not comfortable suggesting that anyone can manage this level of ketones at home.

I'm beginning to think you are going to need to work with someone who's experienced in using R to help you manage Tawny's numbers and learn how to give fluids at home.
 
Re: 12/3 Tawny Urine Ketones

Sienne and Gabby said:
Insulin is one of the best ways to keep ketones in check. I'll go back to what I said in a different condo -- I don't care if you need to feed Tawny a hot fudge sundae to get food into her to offset the effect of the insulin. Insulin fights ketones. I am very, very concerned about the level of ketone readings you're getting. This is dangerous territory. If this were my cat, I would not even contemplate reducing the dose and I'd be on the way to the ER. I am not comfortable suggesting that anyone can manage this level of ketones at home.

I'm beginning to think you are going to need to work with someone who's experienced in using R to help you manage Tawny's numbers and learn how to give fluids at home.
Click to expand...

Sienne, I could not agree more! & would only add that she needs a feeding tube too. & I know those experienced persons here will help me.

Man o man if she'd eat a hot fudge sundae i'd make her asmany as she wants!

I am glad u said what u said about not reducing her dose - my concern is/was that if she is not eating she could hypo?????

i am on the phone w/ER clinic now. on hold. will post as soon as i know s/thg.
 
Re: 12/3 Tawny Urine Ketones; Blood Ketones 5.6 down; BG 191

sending our fervent prayers and healing vines for her, Desi...
 
Re: 12/3 Tawny Urine Ketones; Blood Ketones 5.6 down; BG 191

I'd listen to Sienne. Violet was giving the special insulin to keep Garland okay - insulin and food are the critical medicines for DKA which you know is very serious.

Try giving the denamarin with food.

How long has she been on the clavamox? You can't stop them early. How long were they prescribed for? What was the diagnosis? UTI/kidney infection etc.
 
Re: 12/3 Tawny - ER Clinic Advises.../ I Need FDMB Experts

The clinic asked how much food have I gotten into her today, is she laid out (no, but she is curled up on a blanket right now, probably tired), and the ER dr. advised cutting her insulin dose in half.

Now I am really conflicted about this b/c of what Sienne has said & what I have learned about this since Tawny's ketone issues these past few wks (all learned here at FDMB & I am talking a wealth of good info!), which bottom line is really that Tawny needs the insulin to fight the ketones.

The clinic also advised to not keep syringe feeding her overnight b/c she will start associating food w/this yucky thing (my words, not theirs), and I remember s/one on this board mentioned s/thg when Tawny first got sick in Nov. about being careful for her not to develop a food aversion thru force feeding.

They did say to skip all her other meds tonight (pep, actigal, clav) and to call her regular vet, Dr. Hebert, in the morning. She can get the actigal in the morning if Dr. H. still wants her to have it.

I gotta go down to the barn & feed the horses, brb. I am now back on the other side of the fence w/her dose tho, which is to go w/the full dose (despite what the ER dr. said) and just get up every 2 hrs to syringe feed her overnight & ck on her. Bottom line is, she needs the insulin to fight the ketones. Any more thoughts, anyone?
 
Re: 12/3 Tawny Urine Ketones; Blood Ketones 5.6 down; BG 191

Karrie and Maverick said:
I'd listen to Sienne. Violet was giving the special insulin to keep Garland okay - insulin and food are the critical medicines for DKA which you know is very serious.

Try giving the denamarin with food.

How long has she been on the clavamox? You can't stop them early. How long were they prescribed for? What was the diagnosis? UTI/kidney infection etc.
Click to expand...

UTI but urinalysis came back no growth Wed last. Dr. said to give clav 14 days from 11/28/11. ER doc said to skip it tonite. 62.5 mg BID.

I am convinced that going w/the full dose is the best course of action.

brb gotta go to barn to feed or will have sick horses too...
 
Re: 12/3 TawnyER Clinic Advises... / I Need FDMB Input Pls

I agree with Sienne, too.

I was hoping if you're going to work tomorrow, that you could take her with you, with LC, HC, feeding syringes, fluids, insulin, R insulin, the works, and have access to help here if you need it. But, I guess that's not possible, the internet access and posting, the no? experience with R or giving fluids. I'm just guessing you don't know enough about them, yet.

I wish you lived closer. We could trade shifts. I work 12 hours and then do 12 hours of cat care, and then visa a versa.

All I can do is give you hugs and keep Tawny in my prayers and well wishes.

Don't mark my words on this, but I think when a cat is in the hospital because of ketones, they give them R insulin to get the numbers down and also at the same time have them on a dextrose drip, and everything is monitored pretty much constantly.
 
Re: 12/3 TawnyER Clinic Advises... / I Need FDMB Input Pls

Desi, I think you should go with what you know Tawny needs right now: insulin, food, and water.
We are sending much love, healing vines, hugs, and strength. I wish we could be there with you to help you and your beautiful girl.

:YMHUG: :YMHUG: :YMHUG: from Rusty and me,

Ella
 
Re: 12/3 TawnyER Clinic Advises... / I Need FDMB Input Pls

Sending Tawny healing vines. I trust Sienne implicitly with her advice.....
 
Re: 12/3 TawnyER Clinic Advises... / I Need FDMB Input Pls

all I can offer here are my positive thoughts and prayers .. :YMHUG: hang in there, I know it's tough!
 
Re: 12/3 TawnyER Clinic Advises... / I Need FDMB Input Pls

She has to eat. They are wrong. When you syringe feed, you syringe feed a food that she doesn't eat daily - not one that she would normally eat or that you would want her to continue eating on her own. This is to avoid food aversion. You feed the one with the highest calories. Mirtz can cause food aversion because the medication is telling them to eat when they aren't feeling well. But syringe feeding is done with hundreds of cats a year on the assisted feeding forum. It saves lives.

This forum knows diabetes and DKA. You don't want her back in emergency. You have two prescriptions... food and insulin. You have the diabetes experts here with you. They help thousands of cats over the years.... the ER hospital doesn't get that kind of experience.

I have wondered why you aren't using R and Violet was with Garland to keep her DKA from returning.
 
Re: 12/3 TawnyER Clinic Advises... / I Need FDMB Input Pls

Hi Desi,

I don't know anything about feline DKA - never been through it, so I'm not qualified to advise. However...

Dyana said:
Don't mark my words on this, but I think when a cat is in the hospital because of ketones, they give them R insulin to get the numbers down and also at the same time have them on a dextrose drip, and everything is monitored pretty much constantly.
Click to expand...

This is true for human DKA. We treat the ketones with an insulin drip and fluids, and keep the BG up reasonably high with dextrose - so we can keep giving insulin. Obviously that is all more complicated with a cat and home treatment. I hope Tawny starts feeling better soon.
 
Re: 12/3 TawnyER Clinic Advises... / I Need FDMB Input Pls

We have paws crossed that Tawny feels better soon. Wish we could offer more help. Sending lots of snowflakes from our foot of fresh powder. :YMHUG:
 
Re: 12/3 TawnyER Clinic Advises... / I Need FDMB Input Pls

I have trusted the people here at FDMB since 2008 when Tinkerbell was 1st dx'd & FDMB has been my lifeline ever since, as many old timers well know, & it hasn't always been just about cats...

So I trust you now...

Came back from barn, internet crashed, had to reboot everything, that's what took me so long to get back...

Gave Tawny full 2.75u dose, will go syringe feed some more as soon as I post this...hadn't fed for about 3 hrs so should be close to a fairly true # - pmps 205, blood ketones back up to 6.2.

Sienne and Gabby said:
Desi --

Will she eat HC?
Click to expand...

Sienne, that's all I have been giving her all day, mushed up or liquidated Friskies Beef & Salmon HC 19%, I don't know the calories. Thank you for the adamant advice about the dose, btw, I gave the full dose.

Dyana,
Dyana said:
I agree with Sienne, too.

I was hoping if you're going to work tomorrow, that you could take her with you, with LC, HC, feeding syringes, fluids, insulin, R insulin, the works, and have access to help here if you need it. But, I guess that's not possible, the internet access and posting, the no? experience with R or giving fluids. I'm just guessing you don't know enough about them, yet.
Click to expand...

The take her w/me (I will), LC, HC, Lantus, feeding syringes, computer & access is is possible at work & will be done tomorrow. The rest I am clueless on at this point. Also diner girl used to vet tech, i think it was on-job training, dunno how much she knows about fluids or R but am fixin' to find out in the mornin' & get lessons if possible.

Dyana said:
I wish you lived closer. We could trade shifts. I work 12 hours and then do 12 hours of cat care, and then visa a versa.
Click to expand...
Boy wouldn't that be a good plan!

Dyana said:
All I can do is give you hugs and keep Tawny in my prayers and well wishes.
Click to expand...
Thank you. To everyone again actually.

Dyana said:
Don't mark my words on this, but I think when a cat is in the hospital because of ketones, they give them R insulin to get the numbers down and also at the same time have them on a dextrose drip, and everything is monitored pretty much constantly.
Click to expand...
I believe they did this the 2 times Tawny went to ER, yes.

Karrie:
Karrie and Maverick said:
She has to eat. They are wrong. When you syringe feed, you syringe feed a food that she doesn't eat daily - not one that she would normally eat or that you would want her to continue eating on her own. This is to avoid food aversion. You feed the one with the highest calories....
Click to expand...
Good, the HC 19% she has been getting force fed all day she has never had b4.

Karrie and Maverick said:
This forum knows diabetes and DKA. You don't want her back in emergency. You have two prescriptions... food and insulin. You have the diabetes experts here with you. They help thousands of cats over the years.... the ER hospital doesn't get that kind of experience.
Click to expand...
Yes, saving me again, this forum.

Karrie and Maverick said:
I have wondered why you aren't using R and Violet was with Garland to keep her DKA from returning.
Click to expand...
I have wondered this myself, vets seem to think I don't need to. As you say above, obviously, they are wrong.

Gonna go get some more food into Tawny now, and then maybe a little into me...bbl...thank you all...please keep an eye on us.
 
Re: 12/3 TawnyER Clinic Advises... / I Need FDMB Input Pls

Desi --

I am inexperienced with using R. I know how to use it in principle but not in practice. Please PM Sandy/Black Kitty and Libby/Lucy. They can walk you through how to use R. You do not need a prescription to get R.

I would encourage you to throw a polite hissy fit about getting fluids for Tawny. You can't keep bringing her to the ER because they are not giving you the tools to manage her ketones.

I am incredulous that the vets discourage you from getting blood ketone tests. Blood tests are far more accurate and reflect the values at the moment compared to urinary ketones. It would be the same as getting urine glucose vs. BG tests. BG is telling you what the level is now.

FWIW, here's the abstract of an article on blood vs. urine ketone testing. The bold and italics at the end are mine. Share it with the vet:

Diabetes Metab. 2007 Apr;33(2):135-9. Epub 2007 Feb 21.
Correlation between urine ketones (acetoacetate) and capillary blood ketones (3-beta-hydroxybutyrate) in hyperglycaemic patients.
Taboulet P, Deconinck N, Thurel A, Haas L, Manamani J, Porcher R, Schmit C, Fontaine JP, Gautier JF.

AIMS: To facilitate the transition from urine ketones (acetoacetate) to capillary blood ketones (3-beta-hydroxybutyrate), we studied the correlation between these two tests.
METHODS: Retrospective study of all patients with blood glucose greater than or equal to 2.5 g/l on arrival in the Emergency Department. We studied the correlation between urine ketones (Clinitek 50, Bayer) and capillary blood ketones (Optium, Abbott). We then compared the relative risks (RR) of ketoacidosis and hospitalization associated with each of these tests.
RESULTS: In 33 months, 529 adult patients with both urine and blood testing for ketones were enrolled (ketoacidosis 8%, admission rate 49%). Urine ketones scored as +, ++ and +++ corresponded to median capillary blood ketone levels of 0.5 mmol/l (IQR: 0.1-0.9), 0.7 mmol/l (IQR: 0.2-1.8) and 3 mmol/l (IQR: 1.4-5.2), respectively. RRs of ketoacidosis or hospitalization associated with blood ketones greater than or equal to 3 mmol/l were higher than those associated with +++ urine ketones: 74 (95% confidence interval [CI]: 48-88) and 2.9 (95% CI: 2.5-3) versus 31 (95% CI: 18-45) and 2 (95% CI: 1.7-2.1), respectively.
CONCLUSIONS: In hyperglycaemic patients in the Emergency Department, a good correlation was observed between urine ketones and capillary blood ketones for low values, but a poor correlation was observed for high values. Either test can therefore be used to exclude ketosis, but the capillary blood ketones test is more accurate to confirm ketoacidosis.
 
Re: 12/3 Tawny pmps +2/273

Sienne and Gabby said:
Desi --

I would encourage you to throw a polite hissy fit about getting fluids for Tawny. You can't keep bringing her to the ER because they are not giving you the tools to manage her ketones.
Click to expand...

Honey, I'm fixin' to have a full blown fist-clenchin' foot-stompin' DamnYankee hissy fit, I am. Cuz I may live in Luz-Ee-Ana now, but I was born in Iowa!

Thank you for all the great data Sienne, Karrie, Marje, Dyana, everyone, and all the support today/I mean yesterday now it is. Desi

Please continue to keep eyes on us and throw that data & info & advice out there, it has made all the difference today. I will be up every couple hrs checking on Tawny and feeding her.

(P.S. Down here in Luz-Ee-Ana "DamnYankee" is one word!)
 
Des:

I don't know about in LA, but I am able to buy Lactated Ringers Soln at Walgreens with a $20 annual membership for a case for $22 of 12-1000 ml bags. I order Terumo UTW 21 g needles from
www.thrivingpets.com.

It might be worthwhile to call the pharmacy and see if you can purchase them without a script.

BTW...I thought Thelma was sending you her bags of fluids with the other stuff??

Thinking of you and Tawny...sending hugs.
 
Just be careful with the R. Don't use it without advice from someone here like Sandy or Libby. Teeny Teeny Tiny little doses can have a big effect on bg.
Wishing you well today. Tawny is in my prayers. Ketones, go away!!
 
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