4/15 Barsa PMPS 19.2 (346)

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Vintry

Vintry

Member Since 2014
Yesterday - http://www.felinediabetes.com/FDMB/threads/4-12-barsa.136091/

Vet appointment is in the evening, at 4.15. 5pm - food/shot time. BG is falling, quickly. What should I do about pm shot if bg is low then? I don't know how it's going to be but posting in advance in case I won't get a quick response. Is it ok that I'm feeding her now while the sugar is falling? I'm giving her small amounts - 10g of the usual food (not high carb) every hour. When I see 3.3 (60) then feed her higher-carb food or steer with honey, correct?

Ketones situation. Been giving her water all night hourly and all day every half an hour. Ketones are still there, still very high. But you wouldn't know it. Barsa looks very good, very bright, maybe even better than when there were just traces of ketones. All because the sugar is down and she's continuously hydrated. Weight - 3.5kg (it was 3.3kg two days ago) but I have no idea if it's because of water :)
 
I would add the latest +8 79 in your Subject Line.
It sounds like you are doing the right things of feeding her regularly and getting water in her.
You are using a human glucometer, right? I'm glad she is looking good.
Keep us posted with her numbers. I would do a +9 test.
 
Iryna:

When is the expiration on your ketone strips and are you following the directions for testing exactly? How about if you test yourself (i.e., you test your urine). It would be odd for ketones to be high and your cat to be acting normally. The strips do expire fairly quickly and can go bad if you are storing them in a humid environment. Likewise, is you are not testing exactly as they require, you can get incorrect results.
 
Can you get a blood ketone meter in the UK?
When do you have to leave for the vet?
 
I'm leaving now. It seems to be going up now, but maybe not. It could be just because of 20g of food I gave (9% carb). Anyways, I don't know what it's going to be like at PS time and the new dose is quite high so no idea how it will behave.

I'm tired of worrying about ketones. Vet won't take my Basa on a drip anyways, not until she stops eating. So I'm dong my usual thing, pumping her up with water and feeding. That seems to make it work.
 
People, I'm going to be at vets at the time of shot. What to do? Advice please. I won't be able to update the spreadsheet until I come back but I can still read your replies on the phone. If bg preshot is below 200, should I give her the 2,5unit dose? And any other scenarios? Thank you!
 
The vet visit might raise her BGs, so maybe you won't have anything to worry about. Or, the vet visit may make her go down, like they did with my J.D. at the vets. Hopefully, she'll be at something like 150 at shot time. She needs the insulin to combat those ketones. You're doing a great job. I guess you can't do a +11 and post it.
Does she have an infection that is contributing to the ketones? I would ask the vet that.
Hopefully, others will chime in.
 
Iryna

That's a tough call without us knowing what her BG is at shot time. I think it is really important that you get insulin in her if her ketones are thst high. Because of her situation, I would tend to tell you to shoot any number above 50 as long as you have lots of strips, HC food, syrup or honey, and you can get food in her. I'm glad she's feeling Perrier and is eating. You are a great mom.

It looks to me like she's coming up towards the cycle end and feeding her probably did help. If she dips back down, it's likely a Lantus second dip and its ok to shoot, as long as she is above 50, and get food in her to bring the BG back up. You are just going to have to shoot the safe green numbers and feed HC if you have to do you can keep fighting those ketones.
 
I'm back. BG climbed up to 5.9 (106) pre-shot. I went ahead and gave 2.5unit insulin shot. +2 160

So, I asked the doctor about subq fluids, he said ok, can do that. Gave her 40ml, enough for 1 day. Showed me how it's done. Same as insulin injection, under the skin with chubby 20ml syringe. So twice to make it 40ml. Easy, I can do that at home now if needed.

I cannot get fast-acting insulin. Expected. They only administer it in clinic. He can refer me to endocrinologist who can deal with that.

Blood test Basa had before to check for other health problems did not look for hyperthyroidism :( it was for liver and kidneys. So I will find out tomorrow if she has it. A bit upsetting because I thought vet did check for that before. But no, he didn't. So now it's a possibility.
 
I'm just now getting home from work. Glad you went ahead and gave the full dose - look how flat she's been tonight! and in blue, too!

It's too bad your vet refused to give a prescription for the R, but as you said, you expected it. We'll just muddle along with what you can do.

What did he say about the ketones being high but her acting normally? That is odd and unexpected.
 
Remember that ketones are a byproduct of fat breakdown. In and of themselves, they can happen from starvation, excessive exercise, as well as lack of glucose, and probably some other things. It does not automatically diagnosis diabetic ketoacidosis, but in a diabetic, you want to be very, very cautious.
 
@julie & punkin (ga) He just said that she's dehydrated a little (fur doesn't spring back right away when pulled). I asked him this. If ketones are this high (and they were 8mmol yesterday) is it possible they will eventually get out of the system without putting cat on IV. He said yes, that can happen. And that is the reason why he said that it's an emergency only if the cat stops eating. Because things can turn for the better, there's always a chance if she eats, drinks and there's enough insulin.

This morning I woke up and tested for ketones. I'm so used to seeing colours between pink-deep pink on the strip that I didn't even hope to see something lighter. But it showed NO ketones, absolutely negative. And BG was just perfect all day and all night :) Both me and my cat got some sleep last night, at last. Let's see if this will hold.
 
Fabulous news on the no ketones today.:) Yesterday was a lovely flat Levemir day. Paws crossed for a repeat today.
 
Glad to hear no ketones today, hope all goes well. Shame you were not able to get the R, it's a very good tool to have in your armoury, bought over the counter here in France.
 
Big bounce +3, then +5 after food. Feed is usually twice at pre-shot and then after 2-3 hours. And I cannot counteract it with short-acting insulin because I don't have access to it. You guys in America are lucky.
 
The bounce is higher with each dose increase :( I'm losing hope she will wake it now. She just can't take these high numbers. Just lays down flat with sad eyes.
 
(((Iryna)))
I know it must be hard to remain hopeful when things are so challenging on a day after day basis. But you are a fighter, and so is Barsa.
And we are all cheering you on, and praying that all will be well soon.

Do try to take good care of yourself too; I expect you must be pretty exhausted, and it's hard to remain positive when completely tired out.

Holding you both in my thoughts,

Eliz
 
The blood sugar can go higher the more dehydrated she gets, and adding fluids can sometimes lower the BS when they are necessary. Were you able to give her the fluids at home yet? I'm thinking that your good numbers yesterday had something to do with her having better hydration from the subQ at the vet.

The other thing is that high sugars do not always mean ketones. Often we see high sugars in cats with ketones, but this is because there's not enough insulin. The BS are not the cause of Ketones, but rather can be just another sign that there has not been enough insulin.

Once she gets enough insulin to prevent ketones and really start gaining weight, you may still see some high sugars, but this is due to insulin resistance or other process. Ketones can happen whether sugars are high, low, or normal depending on what's going on with the cat.

Your indicators for how she is doing should be: Ketone tests (good job on monitoring these!), weight gain/appetite, signs of dehydration (fur doesn't bounce back, dry mouth, lethargy).
 
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Thanks Eliz, I'm just experiencing a moment of weakness. It's true, I'm very exhausted. But yes, I have to recharge and stay positive.
 
I gave fluids today, Kaminox supplement, water by syringe (when sugar was really high pre-shot and right after), plus always adding water to food.
 
You are such a good caring Mom to Barsa. She is a lucky girl to have you.
It is true when you are tired everything looks bleak. Try and grab a few extra minutes of sleep here and there if you can, even lie down and just close your eyes. I know when I am really tired it is hard to even think straight, let alone be positive.
Good news no hyperthyroidism:)
Hang on in there:bighug:
You are making progress even if you can't see it. You now have the subQ fluids :) and you are fast becoming an expert on ketones and the treatment for same.
You and Barsa are in my thoughts:bighug::bighug:
 
What a fabulous day yesterday was for Barsa! I'm sure a relief for you too.

Yay for the no ketones and even for just a trace tonight. I'm looking at her spreadsheet and seeing yellow numbers overnight. Perhaps the bounce is already clearing. As you get closer to a good dose, it can help reduce the bouncing.

Hang in there - you're making progress!
 
Just an observation. It seems that a few of your other increases have resulted in a low day followed by some higher numbers. BS can be a little crazy right after a dose change (new dose wonkiness). Base the increases on the blood sugars once they stabilize after a few cycles. Keep a close eye after any dose change.

Fingers crossed for no ketones today.
 
OK, I will do. I see change now. Before, all lower doses of insulin couldn't counteract BG bounce right after feed, at all. Now, with 2.5units, I still have that problem, but insulin does lower glucose once it starts working (+4 onset I think). Maybe after 5-7 days if I increase the dose, sugar won't even bounce sky high after food like it does now. I'm just glad something IS happening and I get some sleep now, finally.
 
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