5/31 Henry's DKA recovery

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John, cats asking for food, and sniffing it or just taking a little and walking away sounds typical of nausea in cats. I would be inclined to ring the vet today and ask for some ondansetron. The sooner He ry starts eating more the better. I found it was very good for Sheba when she got nausea with pancreatitis.
 
FrostD said:
You said it had food in it if I recall correctly, but if it has been clear I do wonder about a possible ulcer/excess stomach acid
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Yes, it's almost always had food in it (although not 100% of the time. Maybe 85%). He hasn't vomited since he's been home from the hospital and strangely the frequency had decreased significantly over the past 6 months.

this site is run entirely on donations, the fundraising page can be found here if you're interested
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Oh nice, I was wondering if there was a way to donate. Thanks for the link, I'll definitely hit it up.

John, cats asking for food, and sniffing it or just taking a little and walking away sounds typical of nausea in cats. I would be inclined to ring the vet today and ask for some ondansetron. The sooner He ry starts eating more the better. I found it was very good for Sheba when she got nausea with pancreatitis.
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Interesting, she did mention possible pancreatitis which she gave him pain meds for. I'll call and ask about the ondansetron.
 
Quick update. 311 BG @ PMPS. Ketones up to .9 eating hasn't been great and haven't seen him drink at all today or last night despite trying to coax him into doing so. Wife did her first pokey shoot tonight in preperation for me leaving on Thursday, hopefully she'll be able to hone her skills over the next few days. Henry is super chill with the process at this point so that's good. Will talk to vet tomorrow about Ondansetron. What about an apatite stimulant too? Should I ask about that?
 
John & Henry said:
What about an apatite stimulant too? Should I ask about that?
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Yes you could ask about an appetite stimulant. Always make sure you give the antinausea medication first before you give the appetite stimulant.
Try and get Henry to eat a bit more. What about the chicken with the water added? It is really important he eats and eats well to keep those ketones away.
 
Hi John. I'm an old time member, and have been following Henry as my kitty J.D. was also a DKA survivor soon after he was diagnosed diabetic and lived another 9 happy years. I just wanted to second the starting of ondansetron. My current non-diabetic kitty Ginger, has times were she acts hungry and follows me to the kitchen and cries for food, but them will sometimes sniff it and walk away or only eat a few bites. I worry because she's 18 and needs all the calories she can get. I give her ondansetron when this happens, and if needed afterwards an appetite stimulant. After a few days, she's eating normally again.
 
Dyana said:
Hi John. I'm an old time member, and have been following Henry as my kitty J.D. was also a DKA survivor soon after he was diagnosed diabetic and lived another 9 happy years. I just wanted to second the starting of ondansetron. My current non-diabetic kitty Ginger, has times were she acts hungry and follows me to the kitchen and cries for food, but them will sometimes sniff it and walk away or only eat a few bites. I worry because she's 18 and needs all the calories she can get. I give her ondansetron when this happens, and if needed afterwards an appetite stimulant. After a few days, she's eating normally again.
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Thanks for the reply Dyana, that makes me feel hopeful. Just got off the phone with the vet and his doctor is off today :( she should be there tomorrow. Good news through, he ate all his food this morning and drank a whole bunch more chicken water! He seems to be in pretty good spirits. He was sitting loaf style a bunch yesterday which I read on here can mean he's in pain (never realized that before). I wonder if giving the buprenorphine may be a bad idea since apparently it can cause nausea. I haven't given him any today and he's been acting pretty well, so maybe I'll just hold off on giving it to him. No "loafing" today so far.

Today's numbers are about the same, BG 313 @ AMPS, Ketones still .9
 
Glad to hear Henry's well. Lately I have been able to put the raw freeze dried stella and chewy morsels and add extra water to them (he got bored of the purebites in water of course) for more liquid . He likes the turkey most since it is softer and then the salmon, rabbit is on 3rd place and 4 )chicken is a bit more dry and it's just ok. the duck he says no thanks. https://www.chewy.com/stella-chewys-tummy-ticklin-turkey/dp/129990. Of course your Henry may have other preferences but a lot of cats here like these morsels.
You can order the 3.5 oz bag which is 10-11 dollars and see if he likes it. I also sprinkle on top of the wet canned fancy feast or wellness pate which he not a fan anymore but he's ok with the morsels on (as long as I rotate lol). They are raw freeze dried, basically no carbs. Weruva has a ton of low carb options and today I went to Petco and got some more individual cans to see if he will like any. They also have more liquid.
 
Roxana & Henry said:
Glad to hear Henry's well. Lately I have been able to put the raw freeze dried stella and chewy morsels and add extra water to them (he got bored of the purebites in water of course) for more liquid . He likes the turkey most since it is softer and then the salmon, rabbit is on 3rd place and 4 )chicken is a bit more dry and it's just ok. the duck he says no thanks. https://www.chewy.com/stella-chewys-tummy-ticklin-turkey/dp/129990. Of course your Henry may have other preferences but a lot of cats here like these morsels.
You can order the 3.5 oz bag which is 10-11 dollars and see if he likes it. I also sprinkle on top of the wet canned fancy feast or wellness pate which he not a fan anymore but he's ok with the morsels on (as long as I rotate lol). They are raw freeze dried, basically no carbs. Weruva has a ton of low carb options and today I went to Petco and got some more individual cans to see if he will like any. They also have more liquid.
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I've been reading about this Stella and chewy morsels, I'm going to pick some up, thanks for the recommendation. I see a lot of people here use fancy feast, so I got a bunch of those yesterday and Henry has been absolutely devouring them. Eating almost every every little bit :). I saw you gave him some broth, but it only worked for a short time? I'm guessing you made it yourself? I went looking for broth and while the store had a huge selection, they all had either high sodium or onions :( Maybe I should pick up a whole chicken and make some. I'll look up this Weruva brand too.

My Henry seems to be doing much better yesterday and today. Pretty active (for a 12 yo cat anyway), eating basically everything I give him, water uptake could be better but I've noticed his water bowl has went down a bit, so he must be drinking some, unless it's just from evaporation.

AMPS was low @ 148. I'll be monitoring him closely over the next few hours.
 
John & Henry said:
I've been reading about this Stella and chewy morsels, I'm going to pick some up, thanks for the recommendation. I see a lot of people here use fancy feast, so I got a bunch of those yesterday and Henry has been absolutely devouring them. Eating almost every every little bit :). I saw you gave him some broth, but it only worked for a short time? I'm guessing you made it yourself? I went looking for broth and while the store had a huge selection, they all had either high sodium or onions :( Maybe I should pick up a whole chicken and make some. I'll look up this Weruva brand too.

My Henry seems to be doing much better yesterday and today. Pretty active (for a 12 yo cat anyway), eating basically everything I give him, water uptake could be better but I've noticed his water bowl has went down a bit, so he must be drinking some, unless it's just from evaporation.

AMPS was low @ 148. I'll be monitoring him closely over the next few hours.
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Glad he likes Fancy Feast pates. My Henry only likes the beef, the chopped grill and the flaked FF can, but I do limit them because as expected, he got bored of the FF quickly so I have to rotate and they tend to be high in phosphorus which in time is hard on the kidneys for senior kitties .I rotate with some wellness pates and Weruva. I definitely do not make the broth myself but probably I should. I buy a human chicken can generally organic and make sure it has only chicken breast and water. also the purebites but he got tired of all of that so I will try to limit to once or twice a week and hope that will work for him. Glad to hear your Henry is doing so well and that Lantus is working for him.
 
You have no idea how happy I am to see these numbers on his spreadsheet. With post-DKA cats it is often a slog to get them into lower numbers and keep ketones down but he's doing fantastic in that regard.
 
FrostD said:
You have no idea how happy I am to see these numbers on his spreadsheet. With post-DKA cats it is often a slog to get them into lower numbers and keep ketones down but he's doing fantastic in that regard.
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So happy to hear you say that. Fingers crossed it keeps going well. I also hope when he sees his vet tomorrow she doesn't give me too much grief over not exclusively feeding him the pro plan DM Rx diet. He doesn't seem to care much for it and I've been really trying to get him to eat as much as possible. Maybe I shouldn't even mention it?
 
John & Henry said:
So happy to hear you say that. Fingers crossed it keeps going well. I also hope when he sees his vet tomorrow she doesn't give me too much grief over not exclusively feeding him the pro plan DM Rx diet. He doesn't seem to care much for it and I've been really trying to get him to eat as much as possible. Maybe I shouldn't even mention it?
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Either don’t mention the food or just say he won’t eat it. She can’t argue with that.
You have 134 in the am cycle in yellow square……?
 
there is no reason for a cat to eat Purina proplan DM, just remember that. It's not even that low carb -- the savory selects is 10% and the pate is 5%

there is no magic formula or something, in fact the quality of the ingredients is suspect and the fat is higher than the protein. There are much much better options for a diabetic feline.

I wouldn't even get into it with the vet unless it comes up and then just say he won't eat it, and so you're feeding other low carb options. Not sure how they could have a problem with that.
 
How is Henry’s appetite going. Is he eating well?
Good to see the ketones down to 0.3
John, if you have decided to follow the TR protocol, would you mind putting it into the SS and the signature please.
Once that is sorted out, would you like to start posting over on the Lantus page, where everyone uses Lantus or biosimilar or Levemir insulin and you will get lots of help and support?
 
Bron and Sheba (GA) said:
How is Henry’s appetite going. Is he eating well?
Good to see the ketones down to 0.3
John, if you have decided to follow the TR protocol, would you mind putting it into the SS and the signature please.
Once that is sorted out, would you like to start posting over on the Lantus page, where everyone uses Lantus or biosimilar or Levemir insulin and you will get lots of help and support?
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Yes, he's been eating very well the last few days and drinking a bunch today and last night, so that's great news in addition to the falling ketone numbers. It seems the TR protocol provides the greatest chance of achieving remission so I think that is the way to go, I'll update the ss and sig. I've been meaning to start a thread over on the Lantus page, my only reluctance right now is I am leaving tomorrow for 5 days and I thought it may be easier for my wife if she has questions to post in this thread? (It would be under this account). I've taught her how to update the spreadsheet, and we'll be in contact with each other so it may even be me posting if there are any problems. Just not sure she'd get all the customs of posting/updating the AMPS PMPS titles, new thread daily, linking the old one, etc.. I can definitely start posting over there as soon as I get back tho.
 
John & Henry said:
Yes, he's been eating very well the last few days and drinking a bunch today and last night, so that's great news in addition to the falling ketone numbers. It seems the TR protocol provides the greatest chance of achieving remission so I think that is the way to go, I'll update the ss and sig. I've been meaning to start a thread over on the Lantus page, my only reluctance right now is I am leaving tomorrow for 5 days and I thought it may be easier for my wife if she has questions to post in this thread? (It would be under this account). I've taught her how to update the spreadsheet, and we'll be in contact with each other so it may even be me posting if there are any problems. Just not sure she'd get all the customs of posting/updating the AMPS PMPS titles, new thread daily, linking the old one, etc.. I can definitely start posting over there as soon as I get back tho.
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Yes, I would stay with this page until you get back and then swap over. No rush at all. We will look after your Aussie wife ;)
 
/sigh just checked ketones and we're back up to 2.1... I was like an hour late with today's AM shot :oops: Hope that's not why..

He's been eating and drinking like a champ tho. Not looking forward to leaving him for 5 days:(
 
John & Henry said:
/sigh just checked ketones and we're back up to 2.1... I was like an hour late with today's AM shot :oops: Hope that's not why..

He's been eating and drinking like a champ tho. Not looking forward to leaving him for 5 days:(
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I am glad he is eating and drinking well. Keep those both up.
Keep an eye on the ketones and test twice a day when higher.
can you start a new thread before you leave please John as this one is getting long.
 
Hendrick Cuddleclaw said:
wait wait wait....did you mix me up with @John & Henry or do we both have wives from Down Under?
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Haha, I was going to say something, guess I was just wishing for a minute she did have that gorgeous, sophisticated accent, alas she's purebread American (on second thought I'm not sure American is a currently recognized breed. I suppose "Irish mix' would be more accurate lol)
 
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Bron and Sheba (GA) said:
John, is your wife going to be home all the time like you are during the days?
Please post the next test for ketones.
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Yep, she'll be here. Ketones were .6 & BG = 221 @ AMPS. She's struggling a bit with doing the pokey but she'll have a few more practice attempts before I leave here tonight. Henry's been a perfect gentlemen although he moves his head quite a bit.
 
Hello everyone... Christy here, Henry's reluctant favorite person while John's out of town (ie: the only person, lol). Just a quick update to say that he is eating & drinking really well. He seems to have a very good appetite & I've seen him drinking more than I have in weeks. He doesn't love to sit still for me to test him/etc, but we're getting it done ok. I think I've stuck myself more than I've stuck his ear(s). ;) Thanks for all the help you've all given to us.
 
Hi Christy! Lovely to meet you.
It’s great you can take over from John while he is away.
Are you going to be testing for ketones as well while he is away? I can see a 0.3 ketones in the SS…was that you?:)
Are you able to get at least one test in during the PM cycles please? We like to see what is happening at night as well as the day cycle.
I’m sure Henry is happy to have you look after him…he’s a very lucky boy!
If you are concerned at all about anything, just post and ask.
Bron
 
Bron and Sheba (GA) said:
Hi Christy! Lovely to meet you.
It’s great you can take over from John while he is away.
Are you going to be testing for ketones as well while he is away? I can see a 0.3 ketones in the SS…was that you?:)
Are you able to get at least one test in during the PM cycles please? We like to see what is happening at night as well as the day cycle.
I’m sure Henry is happy to have you look after him…he’s a very lucky boy!
If you are concerned at all about anything, just post and ask.
Bron
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John recommended that I test his Ketones 1x per day unless it's 1.9 or above, then check it twice... which hasn't happened until today. During the AM cycles he had 2.1 and now it's PM cycle and it's up to 2.7. :/ Anything specific I should do?

He's been eating quite a bit today, but did once throw up a bunch of what he'd just eaten. Seems to be drinking a good amount of water. John gets back tomorrow evening... which I'm sure Henry will be happy about. He is getting a bit more surly with me with every day & his dirty looks are at legendary levels. lol
 
John & Henry said:
John recommended that I test his Ketones 1x per day unless it's 1.9 or above, then check it twice... which hasn't happened until today. During the AM cycles he had 2.1 and now it's PM cycle and it's up to 2.7. :/ Anything specific I should do?

He's been eating quite a bit today, but did once throw up a bunch of what he'd just eaten. Seems to be drinking a good amount of water. John gets back tomorrow evening... which I'm sure Henry will be happy about. He is getting a bit more surly with me with every day & his dirty looks are at legendary levels. lol
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That’s a concern it is 2.7
How does he seem?
is he lethargic.?
I think I would ring the vet and tell him that the ketones are 2.7 and see what he says. Above 2.4 is of concern.
Is the SS up to date? I see there are no pm tests in during the cycles. Are you able to test during the pm cycle? It’s important that you do at this point with the ketones up at 2.7
I think it would be a good idea to increase the dose on insulin up to 1.25 units. But I would need you to be testing during this pm cycle.
Do you think you could measure 1.25 Units in the syringe?
 
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He doesn't seem any more lethargic than he has been in the last week or so. I've updated the SS; hopefully correctly. Maybe I'm not sure what you mean by "PM cycle". I tested him just after his 1st shot and then 8 hours after his 1st shot. He's due for the next shot in about 2 hours. I can try to measure 1.25 units and see if that helps...
 
Do you think you could get a couple of BG tests in during the cycle tonight which is called the PM cycle..that’s the one you will be doing in 2 hours time? As well as the preshot BG test? Where it says PMPS..that is the start of the pm cycle….does that make sense?
Please keep in contact as I am concerned about those ketones.
Do you you think you could test for ketones again ?
Is he eating plenty of food for you? It’s important he does eat really well, especially seeing the ketones have increased.
Yes please, give the 1.25units at the next dose.
 
Hi,

This is John. Christy called me in the middle of the night last night, very worried about Henry. I called the vet and let them know about the high ketone numbers. They didn't seem too concerned so long as he was still eating and drinking well. I'm not sure the tech I was talking to really understood the relevance of the number because she kept saying "check the manual for your meter and it'll tell you the "normal range"" and of course we know there is no "normal range" for ketones (the normal range is 0) but I wasn't going to argue with her about that. His normal doctor won't be in til Wednesday but she did check with one of the doctors there in the ER and he apparently didn't seem too concerned either so long as he was eating/drinking, and wasn't lethargic. She told me he's eating and drinking well. Not sure why she didn't update the PMPS last night. I'm sure she took it. She said that it's been getting increasingly difficult to get his BG (he's not being an ideal patient and trying to escape the pokeys). She said she was going to slightly increase the insulin last night and I told her she could give it 2 hours early since his BG had been so high all day. She's really frustrated with him and he can turn into a bit of a bastard when I'm not there apparently. He's normally not one to try and escape the house when someone opens the door, but apparently he has been trying, so he's probably stressed I'm not there. I'm getting on the plane in a few hours and I'll be home tonight, so hopefully that will help. Thank you all for your help and concerns.
 
Hi John. Thanks for the update. I hope Henry’s ketones will come down. My cat was prone to high ketones, but he did okay with them as long as he was eating well and not vomiting and was not lethargic. Those were the warning signs. A few times when he seemed “off” and didn’t want to eat his usual amount, I took him to the vet and his white count was elevated so we started him on antibiotics. He never went into DKA again. Please ask your wife to update his spreadsheet and post here if she has ANY concerns!
 
John & Henry said:
She said she was going to slightly increase the insulin last night and I told her she could give it 2 hours early since his BG had been so high all day.
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It is not a good idea to shoot early or late, Henry will benefit the most from being as consistent as possible with the dosing and when the dose is given. Shooting early can cause issues with overlapping the previous dose, and also now the next shot will be two hours late. Just best to pick a shot time and try to stay with it and be as consistent as possible with it.

What is the increase? 1.25?

[edit] I know it's hard to see those high BG numbers all day and it feels like "oh no, poor Henry he needs his insulin shot! Let's not wait, he clearly needs it now look at these numbers!" but you must resist the temptation. Shooting early will not help him get regulated, quite the opposite in fact. But I totally sympathize with the urge to go ahead and give insulin when you see such high numbers all day.
 
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Hendrick Cuddleclaw said:
It is not a good idea to shoot early or late, Henry will benefit the most from being as consistent as possible with the dosing and when the dose is given. Shooting early can cause issues with overlapping the previous dose, and also now the next shot will be two hours late. Just best to pick a shot time and try to stay with it and be as consistent as possible with it.

What is the increase? 1.25?
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Kyle, the increase was to be to 1.25 units yes, per Bron’s suggestion.
 
Hendrick Cuddleclaw said:
It is not a good idea to shoot early or late, Henry will benefit the most from being as consistent as possible with the dosing and when the dose is given. Shooting early can cause issues with overlapping the previous dose, and also now the next shot will be two hours late. Just best to pick a shot time and try to stay with it and be as consistent as possible with it.

What is the increase? 1.25?

[edit] I know it's hard to see those high BG numbers all day and it feels like "oh no, poor Henry he needs his insulin shot! Let's not wait, he clearly needs it now look at these numbers!" but you must resist the temptation. Shooting early will not help him get regulated, quite the opposite in fact. But I totally sympathize with the urge to go ahead and give insulin when you see such high numbers all day.
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Yes, I knew it wasn't ideal, but the high ketones really worried me and i was half asleep when she called. With the BG being so consistently high all day it made me question if there was a problem with the previous shot (like maybe she shot through the skin) and he didn't get much/any insulin). My layman's understanding is the ketones develop if there isn't enough insulin to get the glucose into the cells so it was my attempt to stop anymore ketones being produced. But point taken tho, I'll be sure that doesn't happen again. Thanks for all the support everyone.

Edit: about the increase... she has no idea about how to use the calipers to measure the shot (well, neither do I to be honest), so I told her to eye ball it as best as possible. Just pull it back a little behind the mark. She should be up soon, I'll call her hopefully she'll be able to do a BG soon. Would it be better to do the next shot on his normal schedule or 12 hours from the last one and keep on that pattern (ie, the one that was 2 hours early)?
 
we don't mean to come down on you for it, just trying to help. Sorry if it came off as shaking a finger! We have all been there, feeling helpless and wanting to do something to make our fur buddies feel better.

it is good that his appetite has remained strong that is great to hear. When Hendrick was DKA, the very very first sign that something was wrong was when he seemed very excited and hungry for one of his favorite foods and then just sniffed at it, couple licks and walked away. And then later when it got worse he just sat by the water dish kinda zoned out. Would drink a little water then sit, then drink some more.
 
Hendrick Cuddleclaw said:
When Hendrick was DKA, the very very first sign that something was wrong was when he seemed very excited and hungry for one of his favorite foods and then just sniffed at it, couple licks and walked away. And then later when it got worse he just sat by the water dish kinda zoned out. Would drink a little water then sit, then drink some more.
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Yeah, same thing happened with Henry. Do you think he should keep on the "normal" shot schedule or get the next one 12 hours from the last?
 
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