12/30: Cliff notes--pm dosing question

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MiCo

MiCo

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previous thread: http://www.felinediabetes.com/FDMB/...f-care-bringing-him-home.170434/#post-1856206

Good morning! We made it through the night. Cliff seems relaxed. Eating a little, but not back to normal appetite yet. Hoping meds kick in soon to help with that.
  • BG 502 at 8A
  • Gave cyproheptadine dose at 8:30a
  • Fed/shot at 9A, 4 units
    • He ate ok. Better than yesterday.
Will be monitoring him today, but hopefully less pokes! Next cerenia due at noon. (First at-home dose for that. He got injection yesterday.)
 
Good morning Michele! Sorry I didn't chime in much last night...I had a wicked headache and when I checked in, I saw Kris was there with you...so I knew you were in the best hands!

I'm so glad to hear that Cliff is eating some. Have you tried forti-flora? My cats gobble up food with that on it...just a thought for the eating.

So what was the final word from the vet? Were they able to figure out what's going on? They said no DKA right...but he does have ketones? Just trying to get a better picture of what's up.
 
Rachel said:
Have you tried forti-flora? My cats gobble up food with that on it...just a thought for the eating.

So what was the final word from the vet? Were they able to figure out what's going on? They said no DKA right...but he does have ketones? Just trying to get a better picture of what's up.
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Sorry, trying to catch a few winks. didnt sleep much at all between 2a-6a bc Dave is sick now. :( I really need some cumulative hrs of sleep.

Anyways, thx for the forti-flora tip. I will check that out.

In terms of final word, still waiting on some bloodwork. When I called this am, they did not have, but I will check again later.

yes to ketones (they did a urine dip test) but no dka. The way it was explained to me was that he's ketonic, but not adicotic. No acidosis, which takes in to account other factors/symptoms-such as electrolyte and potassium levels (which I know were checked yesterday...)
 
Can you continue to take ketone tests at home, daily if possible? You want to catch any increase in ketones when he is not eating well.

I think the PetSmart vet clinics sometimes have forti flora; your vet might have some. Otherwise, on the internet.
 
Sue and Oliver (GA) said:
Can you continue to take ketone tests at home, daily if possible? You want to catch any increase in ketones when he is not eating well.

I think the PetSmart vet clinics sometimes have forti flora; your vet might have some. Otherwise, on the internet.
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Thanks! I don't see a problem in continuing to check his blood ketones at home, however I've lost a little faith in the meter/results. I do have a baseline #, & if he goes higher than that I would know it's time to take him somewhere.

I tried a urine stick today, in litter, right after he peed, and it said neg/trace. So I dunno? :/
 
Oh, and he's high and flat today after 4 units this am:
Amps= 502
+3=480
+5=503

He's eating treats and the pill pockets/pills. Gave cerenia at noon/+3.

He finished a whole plate this am (1.5 ounces) over the course of a few hours and I've given him another that he's nibbling at. Earlier he ate about (0.75oz) I know it's not enough, but some better than nothing. I've left the kibble out and been pushing the treats after pokes and when he'll take them.
 
He is likely to be high with the higher carb food. But I'd plan to shoot enough insulin for those high ranges until you find out and get the right treatment for any possible infection, and until he starts to eat regularly again. Once you are there and can take away the high carb, see how much he drops and adapt.

I'd be encouraged by your ketone urine test at home.
 
  • We picked up a bunch of friskies classic pates, and he enjoyed the ocean/tuna one just now. Abt 0.625 oz.
  • We have to go back to the vet this afternoon to have a tech remove this IV catheter thing that they left in his arm last night "in case of emergency"
He seems so content right now. He gets very lovey when I sequester him in the bedroom with me. :) gonna try to stay positive. Hope this vet visit is in/out stress free, and then I'm really going to try and have a nice night/Caturday with him tomorrow. I've been letting myself get very stressed abt all this... But at the end of the day, I'm spending 1on1 time with my favorite buddy.
 
MiCo said:
  • We picked up a bunch of friskies classic pates, and he enjoyed the ocean/tuna one just now. Abt 0.625 oz.
  • We have to go back to the vet this afternoon to have a tech remove this IV catheter thing that they left in his arm last night "in case of emergency"
He seems so content right now. He gets very lovey when I sequester him in the bedroom with me. :) gonna try to stay positive. Hope this vet visit is in/out stress free, and then I'm really going to try and have a nice night/Caturday with him tomorrow. I've been letting myself get very stressed abt all this... But at the end of the day, I'm spending 1on1 time with my favorite buddy.
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All this is very stressful, Michele. I'm glad you have some quiet cuddle time with Cliff tonight and tomorrow. :bighug:
 
What a stressful, awful time! I'm glad Cliff is feeling better, and hope you have a restful snuggly weekend!
 
Yep its very stressful when this happens! I went thgthgriugh Gypsy refusing to eat and I was sick from stress. Hopefully this weekend can be relaxing and snuggly!
 
Back from vet. Spoke to the on-call vet (not my regular) who said his fructosamine test came back at 725! That's up from 633 when he was diagnosed 10/29. I must have looked discouraged, because the vet told me not to be discouraged. :(

I just feel like we've spent the last two months giving insulin and increasing doses. Changed his diet. We only ever skipped these two recents doses this week because he stopped eating. I am discouraged!!

The vet suggested 5units tonight. Says the fructosamine results tell her he needs more insulin. Thoughts on 5u? Is that too much? He was getting 4u prior, and as high as 4.5 before Christmas. Still not eating as much as he should. Turned up nose at plate just now. :(

I'm also hoping to give pm dose at +11, cuz otherwise I'll be up all night testing thru nadir. We really got off schedule yesterday, and with the vet asking me to wait to dose this am until we talked. Hindsight, but I should've given him something earlier this am.

Edited to add one more question--do you think I can give him the appetite stimulant and HR earlier? It says to dose every 12hrs, but I was hoping to give before test/feed/shoot I hopes that he will eat a little.

Thanks for feedback!
 
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MiCo said:
Back from vet. Spoke to the on-call vet (not my regular) who said his fructosamine test came back at 725! That's up from 633 when he was diagnosed 10/29. I must have looked discouraged, because the vet told me not to be discouraged. :(

I just feel like we've spent the last two months giving insulin and increasing doses. Changed his diet. We only ever skipped these two recents doses this week because he stopped eating. I am discouraged!!

The vet suggested 5units tonight. Says the fructosamine results tell her he needs more insulin. Thoughts on 5u? Is that too much? He was getting 4u prior, and as high as 4.5 before Christmas. Still not eating as much as he should. Turned up nose at plate just now. :(

I'm also hoping to give pm dose at +11, cuz otherwise I'll be up all night testing thru nadir. We really got off schedule yesterday, and with the vet asking me to wait to dose this am until we talked. Hindsight, but I should've given him something earlier this am.

Edited to add one more question--do you think I can give him the appetite stimulant and HR earlier? It says to dose every 12hrs, but I was hoping to give before test/feed/shoot I hopes that he will eat a little.

Thanks for feedback!
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I'd increase gradually to 5 u (if you even get there) over the next few cycles, starting at 4.25 u. You don't have to hold more than a few cycles if you aren't seeing downward movement.

Did the vet have anything to say about when the meds should kick in to help his appetite? It's really only been one day. How much earlier would it be? An hour or two shouldn't be a problem.

Don't worry about the fructosamine test. Your SS data give a better picture.
 
Kris & Teasel said:
I'd increase gradually to 5 u (if you even get there) over the next few cycles, starting at 4.25 u. You don't have to hold more than a few cycles if you aren't seeing downward movement.

Did the vet have anything to say about when the meds should kick in to help his appetite? It's really only been one day. How much earlier would it be? An hour or two shouldn't be a problem.

Don't worry about the fructosamine test. Your SS data give a better picture.
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You are right, it's only been one day! And he only got first dose of app stimulant last night at 8:30. I'm going to increase dose to 1/2 tablet tonight (per vet instruction) and dose 1hr early (to hopefully help with appetite tonight.)

I will probably dose 4.25 insulin tonight. Was thinking 4.5, but he dropped the other day on 4.25. There are a lot of moving targets the past two days... I'm not comfortable with jump from 4-5, MY regular vet last said hold at 4 units for a while. Ok, 4.25, just talked myself into it, thanks!!
 
Cliff was begging for dry food, so moved everything up a little:
  • At 7:30est gave appetite stimulant
    • increased from 1/4 to 1/2 tab, per vet, since he tolerated first two doses well
  • Test/feed/shoot
    • PMPS BG=432
    • Fed 1/2 3oz can and he ate a little more than 1/2 serving. With treats on top. (LC food, freeze dried treats)
    • 4.25 units at 7:47 est
Ok, let's do good work tonight, Cliffy. Momma has a movie, a book, and a new card playing app on her iPad! :)
 
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