2.5 U and still in high 500s at +4

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Hi Alayna,

Frankie might be in the middle of a bounce. It's possible he might have dropped to an unfamiliar number during the night. Only other thing I can suggest is that his body might still be adjusting to the Prozinc but that's pure speculation on my part because I've not used that insulin.

You can't give any insulin until his next dose is due.

Tuesday's a long time to wait to check Frankie's ketone status, especially if he's bouncing up to such high numbers. Purely for safety, is there any way you could you or a friend/family member could get out to Walmart or a local pharmacy for ketone test strips and check him ASAP?

How is Frankie eating? Are you still assist feeding?


Mogs
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Critter Mom said:
Hi Alayna,

Frankie might be in the middle of a bounce. It's possible he might have dropped to an unfamiliar number during the night. Only other thing I can suggest is that his body might still be adjusting to the Prozinc but that's pure speculation on my part because I've not used Prozinc.

You can't give any insulin until his next dose is due.

Tuesday's a long time to wait to check Frankie's ketone status, especially if he's bouncing up to such high numbers. Purely for safety, is there any way you could you or a friend/family member could get out to Walmart or a local pharmacy for ketone test strips and check him ASAP?

How is Frankie eating? Are you still assist feeding?


Mogs
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Okay, I was thinking maybe I had made an error by giving him only 0.5 U last night when he was around 270. That might have been the case, but I was so worried about giving him more since I couldn't stay up.

This morning he ate a little more than 1/8 cup of dry food on his own, and I supplemented the rest of his calories with some syringe feeding. I did give him his appetite stimulant an hour beforehand.

I can run and get him some strips tomorrow if he's still looking bad.

I'm waiting for my vet to call back, she was in surgery when I called, and I'll see what she says and report it here.

Thank you for your response! It could be the switch to Prozinc too, his numbers dropped pretty fast on Vetsulin.
 
alayna said:
I can run and get him some strips tomorrow if he's still looking bad.
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I can't recommend strongly enough that you grab the ketone strips tomorrow, Alayna, and include checking for ketones as part of Frankie's standard daily routine. They can build up very quickly and get to problem levels before any clinical signs appear.

I'm glad to hear you're managing to keep Frankie eating. It can take a little while for post-DKA kitties to start eating normally again. It's great that you're such a dab hand with the syringe feeding. (((Frankie)))


Mogs
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Critter Mom said:
I can't recommend strongly enough that you grab the ketone strips tomorrow, Alayna, and include checking for ketones as part of Frankie's standard daily routine. They can build up very quickly and get to problem levels before any clinical signs appear.

I'm glad to hear you're managing to keep Frankie eating. It can take a little while for post-DKA kitties to start eating normally again. It's great that you're such a dab hand with the syringe feeding. (((Frankie)))


Mogs
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It makes me feel so much better to hear you say that about DKA kitties not eating right for a while, honestly I was starting to feel like it wasn't expected that he wasn't eating, and that he was just going to be sick forever. But yes I will get those strips as soon as I can!
 
The dry food could be making the numbers higher too, but he needs to eat so nothing to do about that. You may see the numbers drop once he’s off of it again. Last thing I’ll say is, feline diabetes is a marathon not a sprint. I keep reminding myself of that every day when Minnie’s numbers don’t improve as fast as I’d like them too.
 
alayna said:
Spreadsheet in signature, and here. Looks like he went up from his +2. When, if ever, should I give him more insulin? Recent DKA. I know I didn't give a fur shot. Urine test strips for ketones should be coming in on Tuesday.
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It would be helpful to also post the thread about his DKA hospitalization at the beginning of new ones so new members commenting know the history. Like @Deb & Wink yesterday :cat:
 
Critter Mom said:
I can't recommend strongly enough that you grab the ketone strips tomorrow, Alayna, and include checking for ketones as part of Frankie's standard daily routine. They can build up very quickly and get to problem levels before any clinical signs appear.

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I actually just ran out and got him some ketone strips, I'll check every 30 minutes for urine in his tray. I didn't like how he was laying all goopy on the rug, lol

Aleluia Grugru & Minnie said:
It would be helpful to also post the thread about his DKA hospitalization at the beginning of new ones so new members commenting know the history. Like @Deb & Wink yesterday :cat:
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Aw beans, yeah I should have done that. I'll add it now. :-)
 
alayna said:
I was starting to feel like it wasn't expected that he wasn't eating,
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I think a lot of vets don't realise how big an issue feline nausea can be, especially for kitties recovering from DKA or experiencing a pancreatitis flare. So many times here we see kitties have problems eating after discharge from the vet clinic or hospital (some leading to relapses) because they get sent home without any supportive meds (anti-nausea, appy stimulant). The cat might never need them, but having the meds to hand if it does can make the world of difference to the recovery process. It is far easier to help a nauseated cat keep eating, albeit with the need for meds, than trying to get a completely inappetent cat eating again from a standing start. Needless to say, appetite issues are an even bigger issue for feline diabetics.

Remind me, did your vets give you an Rx for anti-nausea meds?


Mogs
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Critter Mom said:
Remind me, did your vets give you an Rx for anti-nausea meds?
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They gave me 4 Cerenia tabs, and told me to use it only if he started vomiting. I tried using it once prophylactically before a meal to not much results... not sure if it's technically classed as an anti-nausea. (Not to mention the foaming at the mouth from the bitterness gave me a heart attack, WHY did the vet not counsel me on that :nailbiting:) Haven't used them since. I also got some cyproheptadine which I try to give him an hour before meals. He's actually acting hungry now, too bad I don't want to feed him yet!
 
alayna said:
He's actually acting hungry now, too bad I don't want to feed him yet!
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Meanie! :p

alayna said:
They gave me 4 Cerenia tabs, and told me to use it only if he started vomiting. I tried using it once prophylactically before a meal to not much results...
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I can't comment on what to expect from Cerenia tablets, as it's only available as an injectable over here (24-. I've found the injectable to provide quite limited benefit compared to pilled ondansetron. An effective dose of ondansetron can take 24-48 hours before the anti-nausea benefit becomes really evident (and it can take a little bit of trial and error titrating up to an effective dose for a particular kitty). I've found it works really well. My best suggestion to you is to keep a little daily journal of how Frankie behaves when food is set out for him, particularly any that are listed in the following:

Nausea Symptom Checklist

A cat can be badly nauseated and not vomit at all. From reports we see here some vets don't seem to acknowledge this, or maybe they think that because Cerenia and ondansetron are classed as anti-emetics that they should only be prescribed when vomiting is an issue. Experts at IDEXX would disagree:

IDEXX Pancreatitis Treatment Guidelines (see section covering treatments for nausea control - they're equally applicable for DKA-related nausea)

If Frankie does display nausea-related behaviours then perhaps your daily log plus the IDEXX document might help you to argue the case with your vets for an Rx for additional anti-nausea support for him. If nausea is present then appy stimulants alone don't tend to help much (or the kitty may end up developing food aversions).


Mogs
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419 PMPS and negative for ketones. I guess he did drop some from from the 2.5 units. My vet prescribed 3 units of Prozinc BID and over the phone today she really encouraged me to stick to that, so I think I'm gonna go ahead and give him the full 3 units and try not to freak out. He's eating dry food now but I'm positive I'll have to supplement calories with syringe feeding wet as usual.
 
alayna said:
419 PMPS and negative for ketones. I guess he did drop some from from the 2.5 units. My vet prescribed 3 units of Prozinc BID and over the phone today she really encouraged me to stick to that, so I think I'm gonna go ahead and give him the full 3 units and try not to freak out. He's eating dry food now but I'm positive I'll have to supplement calories with syringe feeding wet as usual.
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With the DKA episode, your vet is trying to keep the insulin dose a bit higher. That is ok, especially since Frankie is eating dry food, which is higher in carbs, and keeps the BG levels higher generally.
 
alayna said:
They gave me 4 Cerenia tabs, and told me to use it only if he started vomiting. I tried using it once prophylactically before a meal to not much results... not sure if it's technically classed as an anti-nausea. (Not to mention the foaming at the mouth from the bitterness gave me a heart attack, WHY did the vet not counsel me on that :nailbiting:) Haven't used them since. I also got some cyproheptadine which I try to give him an hour before meals. He's actually acting hungry now, too bad I don't want to feed him yet!
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Cerenia never worked for Minnie and you can only give it to them 5 days straight and 3 days off. I needed something I could give to her daily and ondansetron worked great.

about the foaming at the mouth, you need to stick the pill all the way into the back of their throat. If he’s foaming it’s because it didn’t go in deep enough and now it’s in his mouth melting and he can taste it. One thing I do is wrap the pill in a super thin layer of pill pocket so when I stick it in even if accidentally it gets in her mouth it won’t melt right away and she won’t taste it before she spits it out, which she’ll do if it doesn’t go in far enough. So, I push it all the way in now to the point where she bites my finger trying to close her mouth and that’s when I know it’s gone in. Sure enough once I remove my fingers she closes her mouth and it’s gone, swallowed. I hope this makes sense. Tricky to describe it
 
Btw, I hate pilling and now that she’s on ondansetron twice a day it keeps her from being nauseated so I can just mixed it in her food (still wrapped in the pill pocket so the flavor is disguised) and she eats it up without even noting. Obviously that only works if cat is eating. The idea is to have them on it all the time so they’re always covered and don’t get nauseated at all.
 
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