3/8 Sasha AMPS 393 ketone and R help, please

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Good morning Tara...you are doing fantastic and I'm so happy to see Sasha's BG coming down. It's great you got the R last night.

I'm here to help you with the fluids. He absolutely needs the fluids but you CAN give too much. If you give too much you can overload his circulatory system. So it's important that we assess and make sure he's ready for more.

Since he's thin, you should be able to feel him all over and tell if any part of him feels squishy. Fluids like to gravitate to the lowest point so be sure you feel under his front legs, around his chest, etc. it is unlikely the fluids will still be up where you put them last but just check. Also check his front legs .....fluids can also find channels down the front legs...the leg would feel squishy and appear swollen....even down into the paw.

If you have any type of baby scale or a digital scale that registers in tenths, you can also check his weight. If you only have a human scale, then weigh yourself and then hold him and calculate the difference. Fluids will cause the weight to go up faster than just eating a lot of calories will. Think of how a persons weight can change when they feel bloated. I think it's a good idea to keep track of his weight so you can weigh him every time before you give fluids.

Be sure you move the site around where you are inserting the needle but keep it opposite of where you put the insulin. If you had a chance to look at the link I posted on your health condo, you'll see there is a large area in which you can inject fluids. Think of Sasha having a saddle on...anywhere in that area.

So please check him over, weigh him, and let me know what you find...then we can talk about when to give fluids again, ok. Sasha is very lucky to have you.
 
Morning!! ~O) ~O) Wow, you have been busy!! Looks like you are getting some great advice here!!

Garland was in the hospital for a week with DKA and ended up with a feeding tube. Im so happy to hear sasha is eating!! That is a big step! When Garland gets ketones she always stops eating her LC food. So during her ketone weeks she eats HC FF Gravy Lovers. Then once shes feeling better I start weaning her back to the LC stuff. Its always so important they eat something, anything

Ive used R several times too. And SQ fluids. When I was using them all this is how I would do it.

830am Lantus/R

2pm 100ml-200ml SQ fluids. Sometimes she would get 200ml every other day instead of 100 ml a day. (Vet recommended that) The thing is the previous fluids must be absorbed first.

I wanted to seperate them so the fluids didnt flush the R out.

Ive noticed what really gets Garland out of the ketones is the insulin increase. The lantus experts here helped me get her to the dose she needed based on her numbers. You are in great hands! Let me know if there is anything I can do to help!
 
Marjorie, I checked him, there are no bulges at all. Thank you again!

Violet, Thank you -these are good tips> I was afraid the SubQ would interfere with the R too! I am using Ketostix right now.
 
Great..if he has absorbed the fluid, then I would take Violets suggestion and wait until after the R has worked (approximately 4 hours) and go from there. We also have to watch his BG because fluids can drop it so we'll want to be sure he is not getting fluids at a time that his BG is super low....but gotta get fluids in him. Gotta run! BBL.
 
UPDATE: Just got off the phone with the animal hospital he was in last week. The vet didnt speak to me upon discharging him, I just got in touch with the vet, wanted to know specifically why he was taking Baytril, I thought it was a precaution. Vet just told me now that he infect does have an infection in his kidneys. I have been giving him the Baytril everyday...

Gave him 100ml subq at 11:30 AM , +5 BG was 311
 
Just to be clear, this is a kidney infection and not a urinary tract infection? Kidney infections take longer to get cleared out. You're looking at 4 - 6 weeks of antibiotic treatment. There are usually repeat vet appointments and possibly ultrasounds depending on how your vet handles these.

When you spoke with the vet, did you tell him that Sasha is showing large ketones?
 
I just called the vet back to be clear, she's busy so her vet tech spoke to me and said yes it is a kidney infection. The vet is going to call me back. I did tell her about the large ketones...the attitude in that hospital is no money, no help... last week when Sasha was in there they basically told me ("nicely") either I come up with the money or they can just put my baby to sleep.
 
I know Peter!!! I just called the other vet who is letting me post date my checks... they told me I can come in at 6:45.. this is the vet who is against home testing and treatment and all of that, and is making lightly of Sasha's ketones but I do want to get more subq fluids in case I need them because this office closes at 7PM and is closed on Sundays. Should I ask him for more antibiotics? I dont get it! He looked over the paperwork that the hospital faxed him, Sasha did have ann ultra sound last week...Why isnt he addressing the infection? I am so frustrated.....ughhhhh
 
Tara....I'm here to help you with testing after the R, since Sandy is at work and can't watch closely.

After you give the R, please start out with a test at R+1 (one hour after you gave the R) and post when you get it, ok? I'll be watching for it.
 
Others here can tell you where to get them cheaper than your vets office that charge an insane amount per bag. Edit - I realize you probably won't need more than a bag - so its probably not a big deal.
 
Good! Test again in one hour.

How is Sasha acting? Peeing, pooping, purring, playing, preening? All of those things give you some insight into how he's feeling...a cat is more than his numbers. Still eating ok? Alert?
 
R+2 333 He did eat a little after his last shot . He's preening himself, I'm still waiting for him to pee, I missed him in the litter box before. He is very tired, but he's been up all night and day with me... I think while I'm at work all day he usually sleeps which is why he's a little maniac by the time I come home...lol. But he looks good. Fur looks nice, and his eyes are bright. I just gave him his last feeding before his next Lantus shot. He is very hungry!
 
He's holding pretty steady...not rising dramatically. Let's see where he is at R+3. I'm glad to hear that he seems to feel pretty good! And hungry is good! I'm sure he is tired, but as long as he's alert and preening and acting normally, not lethargic, that's good news. How are you holding up?
 
Thanks Laurie, he looks a lot better then he did last night!!! I'm holding up. Pretty tired but that's alright. It's well worth it!
 
Hi R+4 is 331... he is due for his shot of Lantus at 6PM

I just spoke with the ER Vet, she said the one that called me before was NOT Sasha's primary treating vet, they vets there are rotational and that she was actually Sasha's vet. Any way, she says Sasha does NOT have a kidney infection, the other vet was wrong,or I misunderstood her, and that the Baytril is precautionary. She asked me about his Ketones, so I told her I dont have the money to take him in, but have been proactive at home testing him, and she started flipping out saying that its causing him stress (I know it;s not, he could care less) and that she only wants him on 2 units of Lantus and as long as he's eating the ketones will go away...blah blah blah....
This was his 5000 dollar vet, and if I said I had the $$$, she would be flipping out to take him in right away because theyve got to get started on short acting insullin right away.... I am so disgusted by this vet, but happy Sasha does not have a Kidney infection. Forgive me if I am rambling, I am pretty tired.
 
I'm sorry about the vet, Tara. It's ok to vent and ramble here...we all understand! I'm glad to hear that he doesn't have a kidney infection. I'm sure you are right that she would want him in the ER if you had the money to take him....and that's what I would suggest as well if it were possible! They have the tools to deal with large ketones much more easily than you do at home.

Have you been able to get a ketone test?
 
Thanks Laurie! I just cant believe how all of a sudden she's saying ketones are "not the end" for him and to just leave him alone and dont home test.. when last week she was telling me while Sasha was in there that if I didnt have the money to continue treatment at their hospital I should consider putting him down.


No, He hasnt gone to pee yet, he has just been sleeping. i pick him up to get his BG's and then he looks to see if Im going to give him any food (I havent for the past two hours) and then he lays down next to me again. He looks a lot better then he did yesterday though!!!
 
aggravating, but it's great news that he doesn't have a kidney infection.

my smart-aleck side wants to comment on that being a rather large mistake for the vet to make, and makes me wonder if the vet talking to you had even looked at sasha's file. either he has a kidney infection or he doesn't. it's not like it's somewhere in between.

in any case, glad he doesn't have one. the R at +6 seems to be holding down his BG numbers nicely.
 
Oh, I know, I disagree with that completely...not sure why she would say such a thing, she should know that is not the case. I would expect her to at least give you some suggestions to help you, not tell you something that is so obviously not true. What can I say? I don't like to bash vets...they have a difficult job and most of them do try to help....even when they are misguided or misinformed.
 
i think that's a smart choice - tara, i love your attitude and commitment! that's going to help sasha beat this!!!

will you be able to stay awake or use an alarm to check hourly over the next 4 hours?
 
PMPS- 348 Sandy!

Julie- Yes, I am setting my alarm every hour in case i doze off...I am tired but I used to pull all nighters all the time back in the day....but they were never worth it like this is!!!
 
Good.

So, one syringe for the lantus, and when you are done with that shot and have put away the lantus, prepare a new syringe for the R.

For the R, here is what 0.25u looks like
 

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I want to kick that vet in the teeth for you. I had a bully vet that actually made me cry the last visit with him. I wonder if you posted on the health board if someone in Yonkers or nearby can recommend a vet. Forums are an amazing thing. I spent $6000 on Maverick's surgeries and he would have died without the feline assisted feeding forum. Is there an alternative emergency hospital? You are in good hands with the advice you are getting. Just want to say I'm following along hoping for a full recovery for Sasha.
 
Karrie, I know!!! The same vet had me hysterical crying at work the other day because of the money, and now she's shrugging it off. I have asked my friends and have a few suggestions, but unfortunately dont have the $ right now. Thank you for routing for us!

Sandy- No, I just stalked him and he was pooping...lol, now he's laying back down again preening. He ate a full can of FF again.
 
I just had to check and see how you're doing. I love that you are taking the bull by the horns and doing what you have to do. I'm also glad to hear Sasha is feeling better. I know you must be exhausted.

I hope the next ketone test is better.
 
OMG!!!!!! UPDATE!!!!!! HE JUST PEED, I TOOK TWO TESTS DURING THAT TIME, BECAUSE I THOUGHT THE FIRST WAS A MISTAKE...I SWEAR HE IS IN BETWEEN SMALL AND TRACE!!!!!! I AM SOOOOOOO HAPPY...I CANT BELIEVE THIS!!! IS THIS POSSIBLE? TWO TESTS!
 
YAY!!!!! And Thank You, God!
Please keep checking every chance you get. You are doing an amazing job. I'm am so glad Sasha is eating well.
I'm sorry I was calling her, I mean him, a she. Now I know.

I may not be on for much longer tonight, but I will be here for your AMPS tomorrow morning. If you want to get a +11 (one hour before you shoot the Lantus dose in the morning - ie 5:00am), then we can compare that to the +12 and make sure he is stable and not dropping. I usually log on about 5:30am.

Are you taking tomorrow off? I would, if you can afford it. But that's just me.
 
I am absolutely taking off tomorrow!!!!!!!! I am so sooooooooooo greatful to you all. I have never in my life met a kinder bunch. I really mean it when I tell you that you have all have saved my Sasha's life. He is invaluable to me, he is my baby....I tell him every day he is priceless. And when I couldnt come up with the money yesterday I felt like I let him down, and it was awful. Then I found this website, and on it the kindest people I have EVER met in my life. You all stayed with me, I was never alone, not for a second. Your knowledge, generosity,encouragement and compassion made all the difference. I wish there was some way I could repay you all. I honestly wish I could give you all hugs in person. Words cant describe my emotions right now. I am humbled by your kindness, yet I want to shout for joy!!!

I am going to stay on this site, and in Lantus Land and I hope one day I can help someone else the way you all helped me.

I will keep on posting updates, but I really wanted to say THANK YOU FOR SAVING MY BABY'S LIFE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
 
Tara: we've been discussing back channel on his food. We want to keep him eating the higher carb food only for a few days to be sure he keeps eating. It may keep his BGs up but we can adjust the insulin to address that.
IF he starts to not eat, please let us know right away....we don't want his BG plummeting. When we feel he's stabilized, we can start talking about slowly changing him back to his regular food. Sound like a plan?
 
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