4/5-6 Fred update PMPS 528, +2 470, +5 350, +11 199 AMPS 186 (advice needed)

Purrberry

Purrberry

Member Since 2020
https://www.felinediabetes.com/FDMB...2-5-355-pmps-229-2-474-amps-583-3-572.245752/

Hi everyone,

@Wendy&Neko
@PerfumedCatMom
@Lisa & Oberon
@Butters & Lyla

Thank you for your responses yesterday.

An update on Fred and advice is appreciated. If he does not eat, do I give him his full amount of insulin? Vet visit?

I woke at 2 am and went to find Fred as per our usual routine. He ALWAYS greets me and comes up for a treat and usually a test. However, he didn’t move off the couch, and I could tell right away he was off. He didn’t want to stir, so I carried him upstairs to see him in the light and test him. He let me test and was 350. But he was lethargic and swishy tailed, and didn’t want his treat, which is unheard of. He finally ate one, and slunk back downstairs. He wanted away from me. Of course, I was now very worried, as this has never happened. About 10 minutes later, I hear him throwing up downstairs. So now I'm really in a panic, worrying about DKA.
I had purchased a NovaMax ketone reader for an emergency when I traveled, and I had actually tried to use it yesterday when I saw Fred's numbers so high. But I was screwing it up, somehow, so I couldn't get it to work. So, I relied on the urine tests. Now, with adrenaline going (and my poor husband wide awake at this point as well) I was determined to use it. With my husband's help, we got a ketone reading of .4. I actually didn't even know if that was good or bad, but I finally read enough to know it was "ok". So although I knew he was nauseous, etc, he really just wanted to be left alone.

I let him be until about 7:45 AM. At that time, he did come off the couch and greet me when I walked in, but I can still see he's not normal. He came up, had some water and a +11 test....199. Ketone was .2 (He hadn't eaten since 11 PM the night before) I let him have a few pieces of dry food because I wanted something in him. He then more eagerly ate a couple of PureBites and drank more water. I'm kind of holding right now to see if he keeps those bits of food down. He is due for breakfast and insulin in 30 minutes, but I can see he's not really interested in food.

Thoughts on what's going on? Pancreatitis flare? I knew something was up with those terribly high numbers yesterday. He gets SO stressed going to the vet that I don't know if that causes more harm than good. I do not, however, know how to do fluids on my own, and though I have Cernia, I just can't get it in him. :(

I guess I will see if he'll eat...
 
On the blood meter, anything under 2.4 is not DKA. 2.4 and over could potentially be DKA and a call to the vet is a good idea. So Fred's ketones are fine right now. Maybe pancreatitis? Hopefully someone with more experience with that will chime in here.
 
Purrberry said:
Thank you! For some reason, I couldn't find that bottom line info last night, so now it's in the vault.

Well, Fred ate, so I shot. :nailbiting: Here's hoping it stays down.
Click to expand...

Expanding on that a bit... in the study that determined that number, cats under 2.4 were never in DKA. Cats over 2.4 were sometimes in DKA, and the probability of DKA increased with increasing ketone numbers. So anything over 2.4 should get checked out, and I'd suggest that anything getting close to that needs monitoring. But with numbers well below 1 I think you're ok for now. For a while when Oberon was stuck in high BG numbers I made it a habit to check ketones at preshot times, just to keep tabs on it. The meter I use needs just a tiny amount of blood, and I'm often able to do BG and ketones on the same drop.
 
Hi Kathleen, I’m glad Fred ate something and you were able to give him his shot. I’m not familiar with what happens to kitties with structural changes to kidneys, but it could be that he’s nauseous or generally feeling crummy from high numbers. Do you have slippery elm bark powder or an anti nausea med like Cerenia on hand?
 
How is Fred doing now? Everything staying down? Maybe just an upset tummy and it has passed....I hope?

I think I'd be trying to figure out if he is (or was) in any pain. Was he sitting in meatloaf position looking unwell? Here is a lot of excellent information on how to judge pain/feline pain scales.

Does he have a history of pancreatitis? It doesn't say in your signature. When Butters gets a flare, she gets nauseous and may vomit as her first symptoms. She then want to eat but won't due to nausea, and will instead stare at her food and maybe smack or lick her lips. And she will meatloaf and look very unwell. I keep pain meds (buprenorphine & gabapentin), anti-nausea (cerenia & ondansetron, which can be used together) and an appetite stimulant (cyproheptadine ) on hand for her so I can treat any symptoms that crop up. as all you can do is treat the symptoms. I don't have things to do subQ at home, either, though I should probably keep that on hand also.

AMPS is looking so much better though. I kinda wonder if it was a tummy bug or something and it has passed? If it continues, you may want to consider taking him to the vet.

Keep us posted.
 
Hello everyone,

Thank you for all the info and suggestions above! I'm always on the lookout for pain in either of my cats, as I know how well they hide it. I always pay special attention to demeanor and "meatloafing"...some who know me well *might* say I get a bit obsessed with how my cats are feeling. ;-) (My Sadie is 16 months post SRT for nasal lymphoma) The same with nausea.

As I type this, Fred is sleeping in his pod, still lethargic and "dopey", but I hope feeling better in the tummy department. I guess I got my wish, for when I tested Fred at +2, he was down to 101! I know it's from eating less overnight, but I wanted to slow the drop and perhaps save the bounce. I gave him a bit of his old 18% carb dry food (Instinct Ultimate Protein Duck) and he was VERY happy to see that again! With that, I was able to trick him into eating a Cerenia. I was very glad to get that in him. I was then due to leave for the day, but I was so worried about him dropping too low that I ended up canceling my appointment, and turning the car around. When I returned home, I tested him at +4, and he was at 119.

Thanks to everything Sadie has been through, as well as now Fred, I have a nice little stock of meds. The two that are now getting a fair bit of use are the gabapentin and Cerenia. Bupe makes Fred crrraaaaazzzzy excited, but I may see if I can have some of that on hand as well.

I'm so hoping it was a transient tummy thing, but I also fear pancreatitis. We have a suspicion that he may have had a "mild" flare early-mid February, as his fPLI was an eensy bit elevated, and he was having these same kinds of symptoms. I'm wondering if his glucose rising so quickly and significantly yesterday, with seemingly no cause, was the warning sign of what is happening today. But pancreatitis was never really confirmed back then, so I didn't put it in my signature. It does seem a likely culprit, though. :-( I haven't given him any gabapentin as of yet, as last time, the Cerenia really helped the most. He doesn't so much meatloaf as "New York City Public Library Stone Lion"...paws not tucked under but out in front, and head up. Then, at other times last night and today, he'll stretch out on his back with legs up. I always associate that with "I'm chill" feeling, so he's a little hard to read.

In addition to his raw breakfast and the bit of old dry I gave him, he's only nibbled a tiny bit on the Young Again/Dr. Elsey's mix he now gets. He's definitely not very hungry.

I have my mobile vet coming tomorrow at 2:30 PM. I was so freaked out last night that I don't want to take any chances. I'd also like to get him some fluids if they feel it's warranted.

For those that battle pancreatitis flares, how long would you say they generally last?

Thank you all again!
 
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