4/9 Wrigley AMPS 310; PMPS 67 - What do I do now?

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ewalker405

ewalker405

Member Since 2015
Wrigley was 310 this morning before his shot and we gave him 2 units. He ate fine this morning. This is the first day we are giving him insulin. Tonight, I just tested him twice and got 67. His morning shot was about 12 hours ago. Should I not give him a shot? He just ate about 2-2.5 ounces of wet food.
 
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How much does Wrigley weigh? Lantus has a formula for a starting dose based on weight

In the future, what we tell you to do is stall, DON'T feed and test again in about 20-30 minutes. Use that time to post and ask for help
 
ok - here are links to your previous posts: http://www.felinediabetes.com/FDMB/...nes-in-urine-help-advice.135796/#post-1400754
and http://www.felinediabetes.com/FDMB/...omorrow-couple-questions.135901/#post-1401121

There are a couple of things. First since he's just coming out of DKA it's really important to get him his shot.
SEcondly, since you can't test during the day, you probably want to at least start out with the Start Low Go Slow method, which doesn't start with the weight-based formula. That goes with the Tight Regulation Protocol.

Is he eating only canned low carb food now?

Do you know if he was getting Lantus at the vet's as well as the fast-acting insulin they were giving him?
 
At 9.5 lbs, the starting dose would be only 1 unit twice a day, but the fact he recently had ketones means it's more important that he gets insulin every 12 hours, even if you have to feed a higher carb food to keep him in safe numbers.

Let's see what Julie has to say...she's been around more cats coming out of DKA than I have

Have you tested for ketones since you got him home?
 
ok.

Does that mean he's on day 9 of Lantus?

Can you be off schedule for tomorrow?

One option is to wait now without feeding him (we call that stalling) and as soon as he is over 150 you could go ahead and shoot the full dose. If you didn't have DKA so recently I'd suggest decreasing the dose to 0.5u, in accordance with the SLGS method.

Let me see if I can get other opinions on him.
 
Just tested him again and he was 85. He is only on day 4. We took him to the vet Monday and that was the first time he was on insulin. Today is our first day of doing it at home.
 
ok - I'm waiting to hear back and hoping I can catch someone else with experience. Things are more tricky post-DKA and i never had personal experience with that for punkin. So he's rising though, and that's good.

Your basic options with this situation is to skip the shot (not good so close to DKA), reduce the dose, wait for the blood sugar to rise, or give the full dose.

When you have more experience you'll want to give the full dose into normal numbers (50-120), but you're not ready for that yet.

julie & punkin (ga) said:
Can you be off schedule for tomorrow?
Click to expand...
 
Not all night. Probably only be able to monitor him another 4 hours or so.

What does be off schedule for tomorrow mean? My wife and I both work too far from home and can't come home during the day. We are gone from 7:30 to 5:30 CST.
 
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I mean as we stall tonight (it's now 47 minutes since you originally posted, so I assume past your shot time), it's getting later and you want close to 12 hrs between shots. This puts you an hour late in the morning.

But you can't shoot a low number and not monitor tonight - i have no way of knowing if 4 hrs is long enough to monitor or not. On a normal cycle it probably would be.

Can you get another test and post it? Let's see if he's risen more.
 
Did the vet advise you about testing at home for ketones? If not, you want to get Ketostix at any drugstore (they are for people) and test his urine twice a day for the next few weeks to make sure the ketones stay gone, and to catch things immediately if they return.

Do you have high carb cat food at home? Any gravy cat food? or Karo syrup/honey/maple syrup if you need it?
 
The vet didnt' tell us to monitor ketones. I have read about it online and collecting the urine seems really difficult. I don't know how we would do that. When we took him in, his ketones were really low and they just put suspect DKA on all his paperwork. I am not positive that he had it if that matters.

Would ketones make him show low numbers?

We don't have karo but were getting some soon at the grocery store. We do have high carb dry food and some temptation treats. We also have some maple syrup.
 
Since it is later than we want, is it safest to skip this shot and do in the morning at like 6:30 or 7:00?
 
Here are some Urine Testing Tips

If there's even a slight chance he had ketones, it's better that you check for them. You may want to call your vet and clarify if he had them or not. It can make a difference in how we'd suggest you treat him.

You can also get blood meters that will measure both glucose and ketones, but the strips for them are kind of expensive
 
For testing for ketones, you can make a second temporary litter box. Put a box lid (like from a case of copy paper) into a plastic garbage bag. Add some washed gravel (aquarium gravel is one option) and shut him and the box in a room when he eats. He should go before long and then you just tip the box to one side and you can test the urine. There is also a blood ketone/glucose meter called Novamax and you can do it all in a blood test if you prefer.

ketones would not show low numbers. They typically develop with high numbers but not always. They can appear at lower numbers too.

You have a couple of options:

It's important to give him enough insulin. One choice is to give dry food and either 2u or 1.5u.

No - i don't think you should skip tonight. I'd probably give him dry food and 1.5u, then see where he is in the morning.

It's up to you, but skipping isn't a good choice when he just had ketones recently.
 
By the way, when I said "see where he is in the morning", I don't mean don't test til then. I mean decide what do to about morning in the morning.

What would you like to do tonight? You could also wait until he's over 150 and shoot then.

After you shoot you should get a +1 (test in an hour) and repost here. I'll watch for you.
 
We gave him some of the high carb dry food. He didn't eat a ton of it, but moderate amount. He also ate a little more wet food. I gave him a shot about 10 min ago. It was 1.5 (possibly could have been closer to 1.25). I will test him a couple more times tonight to monitor him.

This is really frustrating and draining. I am just constantly worried about him and always feel drained. I want to do what is best for him though. Thank you for the help.
 
I hear you when you say that this is really hard and draining. Just keep taking it one step at a time. It does get easier.

As for getting pee for keytone testing, my cat wouldn't let me near him in the litterbox. One day I finally lost my cool. I picked him up, plopped him into the litterbox, and told him, "You are going to pee on this stick right now!" I lifted his tail, stuck the stick under it, and he peed. I think he was so in shock by my "Second Grade Teacher Manner" that he obeyed. It was hilarious.
 
Starting out is really hard, Eric. It gets infinitely easier once you get things in balance and you learn a little more. Hang in there - and hang in here. People will teach you what you need to know to help Wrigley.

Everyone's been through it and people are very generous with helping new members.

I'll watch for you and help you if you need anything. Please post when you get new tests in.
 
+1 he was at 63. Is that expected? Good/Bad?
I am terrible at getting blood from his ear. I tried his paws and it seems to hurt him. I put some vasoline on it to help bead it up some. I am doing the inside of his ear.
 
It's not bad, but it's a bit low. Can you give him some of the canned food (about 1-2 tsp) and add maple syrup to it, maybe 1/2 tsp.

Recheck him in an hour.
 
By the way, he'll develop more capillaries as you poke. It's probably nothing you're doing wrong, it's just that there aren't as many capillaries there in the beginning. As you poke, it stimulates the capillaries to grow and in a couple of weeks you'll get blood at every poke.

Are you heating up his ear with a little rice sock before you poke? take a small sock (or hankie, or piece of cloth) and add 1/2 cup or so of uncooked rice to it. Nuke it til it's warm but won't burn him and hold it against his ear for a minute or so before you try poking. This thread "Shooting & Testing Tips" has other ideas that might help you.
 
I am heating up his ear with a washrag in a ziplock bag. He ate a little bit more food with a little maple syrup on it but didn't want to eat much. He has ate quite a bit of food tonight compared to what he has been eating the last week or so.
 
Just had to poke him a bunch of times to get blood. It is 43 now though. That seems bad. What should I do?
 
Give him a tsp or two of his wet food with a couple of drops of syrup on it. Then test again in 1/2 hour. How long past shot time is it?
 
Is he eating?

Looks like that 1.5U might have been a bit too much insulin tonight. Or he could still be feeling some of the depot from the 2.0U dose he's been getting the last couple of days. Tomorrow before you shoot, post and ask for advice on the dose.
 
He is eating it.

He ate a couple tsp of wet food with maple syrup on it and 3 temptation treats.
 
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Ok good. Recheck 30 min after last test.

If he keeps going down you may need to take your glucometer and maple dyrup with you and head for the vet. How far away is one?
 
How quick can food bring up his numbers? I am going to test again in about 20 min. I wish I could get blood easier. His ears barely bleed.
 
poor little guy. that will get better but it does take a couple of weeks. I used a flashlight against the inside of the ear and poked from the outside where I could see the capillaries through punkin's skin.

How quickly depends on the cat. I found it took 30 minutes from eating the high carbs for it to really show up. Can you go ahead and test 30 minutes after he ate/the last test? I'm concerned about waiting longer when he was at 43 with the last test.
 
Just tested him again. He is at 76 now so that is good! He is about 3.75 hours from shot. If I go to bed soon should I set an alarm to test again during night? how long from now should I test if I should?

Got blood pretty easy with a flashlight on the inside and poking from outside.

Thanks
 
I would test again in an hour. Blood sugar can wobble around as the food carbs wear off. He's still early in the cycle.

You want to see him stay like this for 1.5 hours after you've given him food. It's important to understand he might drop again tonight after the food wears off.

Just to encourage you. ..this is not typical for the first week. you're getting baptism under fire.

I'll look for you in an hour. And I'll get the official guidelines for you on handling low numbers.
 
By the way, the website updates in a few minutes from now. it can be hard to post for a couple of minutes when that hsppens. Just 5 min or so.
 
Just tested him again and he was 99. It seems to be going good. Do you think I will be good to sleep and get up around 6:15?

I am also curious about the morning. We didn't give him his shot until 8:25 tonight and the latest we can leave the house in the morning is 7:30. Also, what dose do we use? Nobody will be able to be with him tomorrow between 7:30 AM and 5:30 PM.
 
Yes i think you're ok for tonight. You can always just leave him extra of his regular low carb food for insurance if you want.

For morning, it's really hard to say. If he hadn't had ketones I'd say skip it. especially since I'm not sure about this dose - it might be too high.

I've asked some others to watch for you in the morning. You might check him about 7am and post asking for help. Start a new thread and put "help now" in the subject line.
 
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