? 6/20 Dak Advice on Adjusting Dak's Dose

Jeremy & Kate

Jeremy & Kate

Member
It has been a daily struggle with Dak so far, fighting his blood ketone levels (they are listed in the SS), IBD and trying to get his diabetes somewhat regulated. He is currently on a high carb wet food (Hills D/D Duck pate), since it seems to keep his inflammation from IBD at bay (our assumption based on how he looks physically and him eating his full meals). We have been upping his dose by 0.5 units every 3 days, but are a little confused on when the next time to increase his dose due to us having a furshot on 6/19. Should we stick to the increase every 3 days (if his values warrent the increase) or is there a protocol/guideline that if you have a fur shot you have to hold the current dose for X amount of days before adjusting?

We have been giving Dak sub-q fluids twice a day to help battle the ketones and giving him at least 1.5 to 2 times his recommended calories for his ideal weight (ideal weight is 13 lbs but he is under 10 lbs due to multiple ER visits due to DKA conditions but going into full DKA).
 
How many mls are you giving of the sub Q fluids twice each day. Would you mind putting the amount each time into the remarks column please? Thanks. I am talking to others about dose.
 
Jeremy & Kate said:
Should we stick to the increase every 3 days (if his values warrent the increase) or is there a protocol/guideline that if you have a fur shot you have to hold the current dose for X amount of days before adjusting?
Click to expand...
If you do a fur shot, the count of 3 days starts again. But with high ketones in the picture that can change. I’m still waiting to hear back. Sorry.
 
I am very concerned the ketones are hi again.
Did the vets check thoroughly to see any infections.
How is he today?
Eating? Alert?

ETA…I see in the remarks column you say he is getting lethargic. You might need to think about going back to the vets/ER
 
Have you asked the vet about ondansetron which is another antinausea medication that is often better for nausea than cerenia.
I would ask if you can have some ondansetron. Be firm and push back if they say no.
What is the dose of cerenia you are giving?
I would give an antinausea medication routinely at the moment and don’t wait until he’s not eating. He’s obviously nauseated which is common with ketones as he’ll need the antinausea for a while I would think.
Would appreciate an update when you can.
 
His appetite started decreasing yesterday around lunchtime (would only eat a little at a time). We stopped feeding him D/D duck pate completely last night, as he would not touch it. We decided to go ahead and give him whatever food that he would eat. He ate a large amount of Friskies and Ziwi Peak pate, plus some YA zero mature overnight. He seemed to be in a better mood today and ate his food pretty easily until dinner time. Thinking that his cerenia had worn off and we went ahead and gave him more.

We have a follow up appointment with the internal medicine specialist on Tuesday morning, so we are trying to get him to that appointment. Dak is currently on 1/2 a tablet (16 MG tablet) of cerenia a day. The last time Dak may have been checked for an infection was over a week ago.
 
Very happy to get an update. I have been worried about Dak.
I’m glad you gave him whatever he will eat at this point as eating something trumps everything. I see the ketones went back down but are up again tonight. And a fur shot… that was bad luck. Keep the food up if you can.
I would ask the vet about getting some ondansetron tablets as it is better for nausea than cerenia. The vet will need to give you a script for the ondansetron and you get it at the human pharmacy. Ondansetron can be given three times a day and can be given in conjunction with cerenia as they work on different pathways in the body. In the meantime keep the cerenia going every 24 hours. Don’t wait to see if he’ll eat first. Ketones makes cats nauseated and you know how hard it is to eat when you feel sick.
I would also ask the vet to do another blood test to check the white cell count for infection. Something is causing the ketones to hang around. Have they checked his teeth and urine?
We recently had a cat who had very high ketones and it was caused by infected teeth. He was given antibiotics and the ketones reduced but as soon as the antibiotics stopped the ketones went up again. He was put on a combination of two antibiotics and the difference in the ketones was quite marked. He had to stay on the meds until he could have a dental.
Your vet needs to get to the bottom of what is causing the ketones and treat it.
You are doing a great job with Dak. I know how hard it is for you .
 
Good to see Dak's ketones are coming down (as are his BG numbers) and the new food is agreeing with him more. You are doing a great job.
 
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