? 24/12: MITTENS - Novolin N, Small Ketones

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MrWorfMen's Mom said:
I'll stay for the early part of this cycle and then see who is around to help if need be depending on what Mitten's numbers look like. If I need to stay up, I'll just load myself in caffeine! LOL!
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People here are just too incredibly nice. I knew there were people out there who care about their cat's as much as we do ours, but I didn't realize there was a group of people who care so much for the well being of a cat they've never met before. Everybody here is so amazing
 
Heather & Dan

THIS IS IMPORTANT INFO
If per chance you should feel any wetness on Mitten's fur suggesting the insulin did NOT go into her, DO NOT give another shot. You never know if some did get in and giving another shot could result in a larger dose than planned which could make Mittens' BG drop too low. We call them furshots and I'm sure most if not all of us have done them at least once. It happens but there is nothing we can do but wait till the next shot is due.
 
When you can spare a moment, (like you can do that at all right now) can you provide a summary of what cat foods you have there for Mittens that she will eat or should I say that you have been feeding her? I want to look at the carb content to see which might be optimal for Mittens right now. :)
 
Just remember if you give 0.25u and you don't see much movement, you don't have to stick with it. Shooting Novolin N, you can vary the dose depending on the PS and what the dose did the previous cycle.

I would suggest that we don't get too married to a dose right now. Try the 0.25u and see what it does and then decide for the next 8 hour shot. Sometimes N can have a longer duration than 8 hours so that's what we need to be very cognizant of.
 
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Thanks Marje. We knocked the dose down tonight because they are starting the TID dosing, the difficulties getting food into Mittens and precious little data. We'll see what she does this cycle and then decide how to proceed. I presume the dose will have to be raised based on last night's cycle but we have to find a happy medium here right now because Heather and Dan are being stretched to the limit and we don't have a lot of folks around to help because of the holidays.

Have a Very Merry Christmas! :D
 
Marje is spot on, which is another reason novolin-N is kind of a nice insulin to use with ketones. You can adjust doses much faster than in lantus due to it being an in-and-out insulin. Since the duration can be up to a few hours longer than 8 hours, there is some overlap in the 8 hour cycles. That is a good thing as it helps bring down higher PS numbers. However, you'll need at least 2 cycles (16 hours) to really see what effect the dose will have on the numbers. I would consider holding the dose for 2 cycles then evaluating and so on.
 
Thanks Meya. These poor folks have had to learn so much in the last couple of days that it hurts my head to even think about it. We will plan on holding the dose for 2 cycles and evaluating. I'm expecting the +1.5 reading for the 0.25u dose tonight any time now. Last night Mittens dropped 150 points at this point in the cycle on a dose of 0.5u so it will be interesting to see what the lower dose does tonight.
 
Just did a glucose test about 15 minutes ago. +1.5 -306. I think I wrote that right. That means it stayed almost exactly the same, is that normal? I didn't feel any wetness on her fur, but do you think I may have missed? I felt good about it when I did it like I thought I got it in good. I read the tips for giving her the shot and it mentioned fur shots so I've been trying to keep that in mind.
 
Thanks Heather. I did expect at least a bit of movement. Have you fed her anymore since you gave her the shot and before you took the reading? If so what and how much?

ETA - you may have given a fur shot and not noticed because it's such a tiny bit of fluid. Then again it could just be the dose is not doing much for her. We'll have to just wait and see what she does from here.
 
For anyone following, here is an updated summary as of +1.5 post shot

Summary data
Fed 7.5oz at 10:00pm EST
PMPS - 305 immediately following feeding
Insulin given 10:30pm EST 0.25u Novolin N
+1.5 - 306
 
No. She still won't eat on her own so what she gets is being syringed into her. She's still behaving like she's interested but nauseated. The extra food tonight was probably a product of lots of practice at getting food into her. :(
 
Woodsywife said:
Is Mittens eating better?
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Don't have the full details but Heather let us know that Mittens had a 10ml feed and a 7.5ml feed. I think those are a bit larger than some of the previous feeds. Heather had better success getting the potassium supplement into little Mittens tonight (go Heather! :cool:); keeping fingers and paws crossed it might ease the nausea a little.


Mogs
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I fed her 7.5 oz of Fancy Feast classic right after I did the +1.5 glucose test

MrWorfMen's Mom said:
can you provide a summary of what cat foods you have there for Mittens
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We have been giving her Fancy Feast classic (do you need the specific flavors?) mostly with some BeachNut Classics baby food (chicken and broth & turkey and broth) from time to time. We also have a few cans of Fancy Feast gravy lovers that I was advised to have around but she hasn't had any of that.

Woodsywife said:
Is Mittens eating better?
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Not really, she won't even take any licks from a plate anymore. She hadn't much before but at least she was giving it a try. Now all she does it smell it and walk away. What makes me think she's still somewhat interested is because when I open a can and am mixing it on a plate with a little water she often comes into the kitchen just like she always used to when she heard a can of food open. She doesn't stand there staring and meowing waiting for me to set it down like she used to though, she just comes in there and sits there and then will smell the food and walk away. I don't know if she actually wants some or if it's just a strong habit from before.

And while she still struggles to get away, tonight I have found it slightly easier to feed her, only very slightly though. It's tough because there's always some that I spill or she'll move at the perfect time for me to squirt my hand and miss her mouth entirely or I'll get it in there and she'll like start licking and some will fly out of her mouth. That's why I've been averaging getting 7.5mL out of my attempts of 10mL

I just did another glucose test +2.5 -263
 
Thanks for the reading and the food details. I have a kibble addicted cat & not sure if different flavours are different carb counts offhand so if you could give us a run down of flavours it would be helpful. Mittens has only dropped 40 points which is still pretty slow movement. I'd try to get some more fluids and food into her. Any luck getting a ketone test? Is Mitten peeing at all?

I am going to go take a quick siesta and will be back for the +4 reading. I'm setting an alarm or two for 2:30 am so post your next reading which I believe should be due around that time ( I may be off by 15 minutes or so!) :bighug::bighug::bighug::bighug::bighug: that I wish I could deliver in person!
 
For anyone following, here is an updated summary as of +2.5 post shot

Summary data
Fed 7.5oz at 10:00pm EST
PMPS - 305 immediately following feeding
Insulin given 10:30pm EST 0.25u Novolin N
+1.5 - 306
Fed 7.5 oz. right after +1.5 reading taken
+2.5 - 263
 
Oh glad to see you Dyana. I overslept. Looks like not too active a cycle which is fine. It's all good data. Another gentle drop. So next test will be due about 04:30am or so (just over an hour from now). Great to get more food into Mittens. Is that still you Heather or is that Dan now? Just wondering if you've had any luck checking ketones. Is Mittens peeing at all?
 
For anyone following, here is an updated summary as of +4 post shot

Summary data
Fed 7.5oz at 10:00pm EST
PMPS - 305 immediately following feeding
Insulin given 10:30pm EST 0.25u Novolin N
+1.5 - 306
Fed 7.5 oz. right after +1.5 reading taken
+2.5 - 263
+4 - 228
Being fed again right after +4.
 
MrWorfMen's Mom said:
Is that still you Heather or is that Dan now?
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It's still Heather for a while, Dan is awake now too though. I fed mittens another 7.5mL of food about an hour ago, he woke up while I was feeding her.

MrWorfMen's Mom said:
Just wondering if you've had any luck checking ketones. Is Mittens peeing at all?
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I think she's only used the liter box once today, we didn't see her use it so we didn't get a chance to test it. I'm worried that she hasn't used the liter box hardly at all today, I tried to give her some water with the syringe earlier. I should probably start doing that as well every time I feed her, I'll start doing that next time.
 
For anyone following, here is an updated summary as of +5 post shot

Summary data
Fed 7.5oz at 10:00pm EST
PMPS - 305 immediately following feeding
Insulin given 10:30pm EST 0.25u Novolin N
+1.5 - 306
Fed 7.5 oz. right after +1.5 reading taken
+2.5 - 263
+4 - 228
Fed another 7.5 oz. between +4/+5
No ketone check yet. May have peed only once today. More fluids to be given by syringe..
 
Ok Heather I'm here again. It's very important we get fluids into Mittens so try syringing some or do you want to give her the SubQ fluids from the vet now that Dan is awake and before you go get some rest? I think she needs the SubQ fluids to flush the ketones and make sure she stays hydrated. This would be a good time before the next shot is due around 6:30am. The next couple of hours are going to be busy.

Roughly how long does it take for you/Dan to syringe feed Mittens the 7.5oz to 10oz 0f food?
 
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I just checked my email and I got this email from DCIN:

Hi heather,

I thought I would send you some good news this Christmas Eve! You've been approved for assistance & we will be sending you out a package with some insulin, syringes & a testing kit.

As soon as I get the tracking number I will let you know.

Merry Christmas!!!

~Jennifer

That is very good news, what wonderful people, I'm so glad I sent that application in.

Just checked her glucose again now were at +6 -284
 
Oh Heather....the best Xmas present ever!:D:D:D:D:D I'm so happy for you, Dan and Mittens. I'm going to go make a coffee and will BRB with some more info. Don't feed Mittens again right now. You may need to re-read my post #127 as I added stuff to it (hit the reply too soon:facepalm:)
 
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For anyone following, here is an updated summary as of +6 post shot

Summary data
Fed 7.5oz at 10:00pm EST
PMPS - 305 immediately following feeding
Insulin given 10:30pm EST 0.25u Novolin N
+1.5 - 306
Fed 7.5 oz. right after +1.5 reading taken
+2.5 - 263
+4 - 228
Fed another 7.5 oz. between +4/+5
No ketone check yet. May have peed only once today. More fluids to be given by syringe.
+6 - 284
 
MrWorfMen's Mom said:
Roughly how long does it take for you/Dan to syringe feed Mittens the 7.5oz to 10oz 0f food?
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It takes between 10 and 15 minutes. Yesterday it took me almost a half an hour the first time I tried to do it by myself, but I've figured out a better strategy. I'm still hoping it gets easier because I'd like to start giving her two of the syringes in one sitting to try to get more food into her at a time.

Yes now that Dan is awake I want to give her the fluids, I know she needs them. I just told Dan that we should do them, so we will very soon.
 
Ok do the SubQ fluids now. This next hour and a half is going to be busy and if the shot has to be moved out to 6:45 or 7:00am that's Ok. It's all new today and may take longer than it will tomorrow. Typing up a schedule of sorts for you, testing my cat ;) and will BRB.
 
The vet told me to give her 100mL at a time when giving fluids, does that seem like the right amount? I just like double checking the advice I get from her just in case... I just know she has drank only a very very small amount of water today
 
I'm not that familiar with SubQ amounts but that sounds reasonable to me and she definitely needs lots of fluids. Get yourselves set up and started. I'll see if Meya mentioned this in her instructions & BRB.
 
Ok so we should be aiming to get 300ml of fluids into Mittens each day. Her food slurry will contain some but the amount will depend on what you've added plus the nature of the food. Given only 7.5oz of food at a time and only peeing once, I think the 100ml is probably needed right now. So yes give what the vet told you!
 
Let me know when the fluids are done please. We need to allow enough time between the fluids and insulin and I am checking that time frame which I believe was an hour and a half. BRB
 
Ok we need an hour to an hour and a half between SubQ and insulin administration. I think we should only wait an hour this morning so here's the drill and we'll add in times once we know when the SubQ fluids are done so let me know and I'll complete the schedule. The steps will be as follows:

Complete SubQ fluids.
Test BG again.
Feed Mittens
Give insulin 30 minutes after feeding.
 
I'm trying, I cant get the needle off the line. When I was at the vet they gave her 100mL of this fluid and it was the bag they sold to me so there is an old needle on the end of the line that she told me I have to change before I can give the fluids. I cannot get this thing off, we've been trying for almost half an hour, I don't know what to do I'm getting very frustrated
 
Ok Heather. Deep breathes. Syringes fluid into Mittens now and get Dan (or vice versa) to try twisting the needle. If it won't come loose, wet a wash cloth, heat it up in microwave and hold it on where the needle meets the line to warm it up. The expansion may make it easier to remove!
 
Good morning and Merry Christmas Nan & Amber! Heather got a wonderful gift of an email from DCIN saying they are approved and insulin (Lantus), syringes and lancet are enroute. :cat::D Glad to have another set of eyes on things here!:)
 
@Nan & Amber if you pop up to post # 130 there is a summary of tonight so far. Right now those poor folks are struggling with the SUbQ equipment. Can't get the needle changed. It doesn't want to come loose. We need to get some fluids into Mittens as she only peed once yesterday which is indicative of dehydration. Next insulin shot is due at 6:30 but we may need to delay slightly to accomodate the SubQfluids if they can get the needle changed. Until then I've asked them to syringe more fluids and no more food at the moment so we can get a fasting BG before next shot. If any other questions, please let me know. I have been catching 1 hour cat naps and may be a little punchy although I think the expresso is now clicking in! :coffee::coffee::coffee::coffee::D I am going put a timetable together once we hopefully can get those SubQ fluids into Mittens. :)
'
 
Whoops, cross-posted.

Yep, I agree, fluids are a high priority. Wish I could offer some tips on that, the last time I administered them was 10 years ago when I was doing fostering, and my memory is far too shot to remember any details.
 
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