4/26 RK - AMPS HI, ketones 3.0 +2 440 +4 300 PMPS HI, ketones 3.2 +3.25 529 +6.5 328 +8.5 425

Yesterday’s post

Morning update:

• RK’s ketones continue to nudge higher and are now at 3.0. Not great, but also not the worst we’ve seen and we’re learning that the ketones tend to track with BG. I’m hoping she decides to break out of these high numbers today.
  
• I’m still pushing fluids, including subQ, as well as ondansetron, mirtaz, and her antibiotics. I have one final Cerenia injection that I’m holding back for if/when she really needs it. Should I be giving that consistently even though she’s not vomiting? If so, I can probably get more from the vet.
• She dived into a can of FF pate this morning and ate voraciously for a few minutes. She only ate 1/4 to 1/3 of the can but it was good to see her want to eat something. She has canned and dry available at all times but really doesn’t seem to eat much other than what’s freshly opened. Oh, and she’s decided that Temptations are a delightful treat after the BG/ketone tests so will willingly eat those.
  
• I’m still supplementing calories by syringe feeding C/N and liquid recovery food. I haven’t ruled out a feeding tube but we’re navigating the syringe feedings ok and she does eat some on her own, so it’s wait and see for now.
• Given that her BG was HI again at AMPS, I added a drop of R. Hopefully that was a good call.

Have a great day, everyone.

 

I hope that pesky bounce breaks today.
As you say the ketones have been worse and they do seem to track with the BG.
It’s good she is eating some food on her own. Those high BGs must make her feel yuk though, poor dear.
Next time the bounce breaks, maybe if you could feed some higher carb food to slow any drop, we might be able to prevent a bounce from bouncing too high.
I am glad she is enjoying the temptations. I remember one DKA kitty we had who would only eat temptations for days, but at least she was eating.
With the cerenia, if you think the ondansetron is holding the nausea, you could keep the cerenia for if it is needed later. I think the clavomax is most likely affecting her appetite somewhat but it’s important she finishes the course.
It sounds as if you have everything pretty much under control. I think you are doing an amazing job with RK. She is a lucky girl to have you.
And I think giving the R was a good call.

 

The new drop size of R seems to be better, not dropping her as fast.

Cerenia targets a different nausea receptor than ondansetron, though I found ondansetron better overall for nausea. At one point, Neko ended up on both as Cerenia seemed to help a bit more. But I was giving pills. I also think I was underdosing the onda, as that was before the latest guidelines on dosing came out.

Does a Temptation crushed on food make it more palatable? Or freeze dried meat? Or Fortiflora? Using that one as a flavor enhancer, not probiotic.

 

I tried the crushed Temptations on food; worked the first time but got the side-eye the second time. Also found out that she DOES. NOT. LIKE. Hydracare. Well ok then. I have another older rescue cat who will stalk me and nearly knock the Hydracare bowl out of my hands if I don’t set it down quickly enough. Go figure. Cats are such interesting and opinionated little creatures.

RK’s feeling a bit more dehydrated tonight. I’m not surprised, I suppose, given how much time she’s spent in the blacks. Appetite is down, but I gave her mirtaz earlier so hopefully that will spark something. Otherwise I’m just trying to keep up with fluids and get as much food into her as possible to keep the ketones at bay.

I think she’s definitely improved from where she was at diagnosis —I no longer steel myself when I go to find her in anticipation that she might have “left” us—but I don’t think we’re out of the woods just yet. We’ll be finishing the antibiotics soon and I’m concerned that there’s a risk of backsliding. If we can string together a few good (or at least not terrible) days, I might see if the vet can do some quick preliminary dental work under mild sedation to address the most glaring issues, then go back when she’s stronger to do a more thorough job. Crazy idea, perhaps, but I question whether it might’ve a necessary evil. She’s already had a block of teeth come out while I was syringe feeding and I know she has additional loose teeth that are about to fall out. Not only must it hurt like crazy, but it’s such a reservoir for infection.

Onward we go.

 

She has certainly got a good bounce going there.
She still getting subQ fluids?
At least the ketones are not climbing up as high.
Poor girl with all those teeth issues. I wonder if the vet might keep her on a maintainable dose of antibiotics until she can have something done.
I’ll be interested to see what AMPS is.

 

Yes on subQ fluids. I’m thinking she’ll be on them for the foreseeable future.