6/28 Henry WC. AMPS 340 Ket:1.0 +1 221 +3.75 148 +5.75 152 +7 125

John & Henry

John & Henry

Member Since 2022
Previous: https://felinediabetes.com/FDMB/thr...167-6-163-ket-0-3-8-167-10-182-11-193.265129/

Hi everyone,

When I tested ketones @ AMPS I was a little surprised to find 1.0 since his last cycle was mostly yellow. The only reason I can think why this would be is because he went about 6 hours without eating overnight and his body must be further burning off tissue to provide energy. Since he's been eating 5 cans of FF per day and seems to still be losing weight, it's got to be due to the IBD/SCL dilemma. I read that both IBD and SCL are primarily treated with steroids (in addition to chemo if SCL) which seems a little scary for a diabetic cat with problems like Henry.

Since steroids increase BG, how do you gauge how much his Lantus would need to be increased without making his BG go through the roof and thus create even more ketones and possibly cause DKA? Any idea how long after starting steroids will it take for his body to start readily absorbing nutrients again? Since he's prone to go into DKA so rapidly (less than 24 hours last time with BG >400). It seems like the only safe spot for him to start steroids would be hooked up to a continuous infusion pump where the insulin can be dynamically increased in response the steroids and subsequent rise in BG. Would immunosuppressants be better to try first? This is starting to feel like an impossible situation to treat :(
 
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John & Henry said:
When I tested ketones @ AMPS I was a little surprised to find 1.0 since his last cycle was mostly yellow.
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Numbers don’t have to be crazy high for ketones to develop.

How often do you weigh him? Are you using a baby scale?

Has he been diagnosed with IBD or SCL?

Regarding dose adjustments should he need steroids, as always the numbers will be your guide.
 
Sandy and Black Kitty said:
Numbers don’t have to be crazy high for ketones to develop.

How often do you weigh him? Are you using a baby scale?

Has he been diagnosed with IBD or SCL?

Regarding dose adjustments should he need steroids, as always the numbers will be your guide.
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He hasn't been diagnosed because he isn't well enough to undergo anesthesia to do a biopsy. My understanding is it's one or the other tho (hopefully not both).

I don't have a baby scale, but I just weighed him on my kitchen scale and it's saying only 6lbs 1oz :( He was over 7lbs when he got his FD Dx a little over a month ago, already down from his normal 9.5lbs

I get adjusting using the numbers, it just scares me that he went DKA with only 24 hours in the red last time. That doesn't allow much time for adjustment when Lantus takes 12 hours before you can re-adjust. Maybe with the R it could be done more quickly? Ugh.

edit: I just weighed him again by hold him while on my bathroom scale (our weight - my weight) and it came out to 6.8lbs. I would think the kitchen scale is probably more accurate in this situation
 
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Sandy and Black Kitty said:
How is Henry today? What’s the WCR?
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He's acting pretty well. The subQ fluids always seem to give him a bit of a boost the next day. I was surprised when I got up to take a reading in the night and he was super purry which had mostly went away since his most recent return. Appetite is ravenous as always. Still eating 5 cans of FF a day. I'm trying to only give him a half can at a time, but feed him every 2 hours or so hoping that may help increase absorption. He's going to the bathroom well. It bothers me every time I'm feeling him it's like I can feel new bony features that I hadn't noticed before. Especially on his skull.

Someone had mentioned that novel proteins can sometimes help IBD. Do you know of any brands of LC novel proteins I could try? I've also read that certain probiotics may be helpful for IBD. Any suggestions there? I plan to talk to the vet tomorrow.
 
I would think that maybe some of the Ziwi Peak foods may be novel single source proteins and also low carb. I know there are others. That’s just off the top of my head.
 
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There are some people on this Board who have cats that must be on steroids either for IBD or asthma. If it’s Prednisolone, it does raise BG to a degree. It is manageable, but does complicate things. Adjustments to insulin must be made obviously, based on the cat’s numbers. But you don’t have a diagnosis yet, just suspected IBD or something else. These are just things you can talk with your vet about as you move forward.
 
If you want to look at the spreadsheet of a cat with IBD who takes Prednisolone, it is @Katherine&Ruby. Katherine has been out of town lately and pet sitters have been taking care of Ruby, but she takes daily Pred. But this is just FYI for future reference - since I know you like to research possibilities. It’s something I would hate to see being necessary at this point for Henry with all of his difficulties. I think it’s putting the cart before the horse at this point - but I like to research possibilities too (which fortunately don’t usually turn out to be realities.). So I understand. Good night.
 
Suzanne & Darcy said:
I would think that maybe some of the Ziwi Peak foods may be novel single source proteins and also low carb. I know there are others. That’s just off the too of my head.
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Yes, I was just looking at those on Chewy. Too bad you gotta buy a whole case @ $100, just to find out he doesn't like it. I wonder if they might sell it at pet smart. I think I'll make an excursion tomorrow. Chewy has lots of options for rabbit, venison and lamb (not sure if lamb is considered "novel" -- although Henry's never had it before so I guess it's novel to him. Problem is none of these brands list their carb counts. I found someone else on the board had listed that the ziwi peak's venison was only ~3%. Maybe I should just go to a butcher and see if they have any of these meats and use some of those mix-in cat nutrients.

Suzanne & Darcy said:
There are some people on this Board who have cats that must be on steroids either for IBD or asthma. If it’s Prednisolone, it does raise BG to a degree. It is manageable, but does complicate things. Adjustments to insulin must be made obviously, based on the cat’s numbers. But you don’t have a diagnosis yet, just suspected IBD or something else. These are just things you can talk with your vet about as you move forward.
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Yeah, she already mentioned prednisone after his liver biopsy, but not being ideal for a diabetic. Since they can't do a biopsy I'm not sure how they'd even formally diagnose it. I will say after looking at the symptoms and thinking back, for several years before the DKA, he had always been a "pukey" cat -- happening 2-4 times per week but rarely diarrhea. Whether it's SCL, IBD or something else, he's not absorbing nutrients.

Suzanne & Darcy said:
If you want to look at the spreadsheet of a cat with IBD who takes Prednisolone, it is @Katherine&Ruby. Katherine has been out of town lately and pet sitters have been taking care of Ruby, but she takes daily Pred. But this is just FYI for future reference - since I know you like to research possibilities. It’s something I would hate to see being necessary at this point for Henry with all of his difficulties. I think it’s putting the cart before the horse at this point - but I like to research possibilities too (which fortunately don’t usually turn out to be realities.). So I understand. Good night.
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Yes, I'm just trying to research possibilities for when I talk to the vet so I'm better informed. I'm very interested to check out her SS. Have a good night Suzanne.

Suzanne & Darcy said:
Visbiome is the probiotic most recommended for IBD and SCL.
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Awesome. Thank you for the info. Even if it turned out he doesn't have IBD, a good probiotic probably wouldn't hurt anyway.
 
Been following your threads but so much going on dont want to muddy up thread. John you are doing awesome. Henry is a lucky boy to have you:bighug::bighug: but do make sure you are caring for you its hard enough for any of us with just the fd...its a lot more on you're plate!

Ok chewy...if you order something say a case of food. Henry doesnt like it...call them up tell them they will refund your money. They may or may not ask you to return product if they do it will be their expense. Most of time they will ask you to just donate what wasnt used. Admittedly I've never had a whole case of something like this. But I've ordered in past and they are super great to make sure you're baby is happy.;)
 
Rainbow Conti said:
Been following your threads but so much going on dont want to muddy up thread. John you are doing awesome. Henry is a lucky boy to have you:bighug::bighug: but do make sure you are caring for you its hard enough for any of us with just the fd...its a lot more on you're plate!

Ok chewy...if you order something say a case of food. Henry doesn't like it...call them up tell them they will refund your money. They may or may not ask you to return product if they do it will be their expense. Most of time they will ask you to just donate what wasn't used. Admittedly I've never had a whole case of something like this. But I've ordered in past and they are super great to make sure you're baby is happy.
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Awww, Thank you :bighug: Luckily the last few days have been much better than the first few and I've been able to get some decent ZzzZz's. Numbers starting to look better and not sweating the ketones as much. I've heard chewy has amazing customer service and I've been meaning to start using them. Looks like this may be the time for that. Thanks for the tip!
 
If you want to try a novel protein that would mean a protein he’s never eaten before such as venison, lamb, or duck. Rabbit is another one but kind of low in calories. I feed one of my cats Prinal frozen raw venison as she has skin allergies.
 
Suzanne & Darcy said:
I would think that maybe some of the Ziwi Peak foods may be novel single source proteins and also low carb. I know there are others. That’s just off the too of my head.
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Not sure where you are in Oregon, but if you're anywhere near a Mud Bay they have Ziwipeak. Looks like they have quite a few branches in the Portland area, 1 in Salem and a couple in Bend. That way you could try a few cans first to see if he likes them, then order the case from chewy.
 
Liz & Minnie said:
Not sure where you are in Oregon, but if you're anywhere near a Mud Bay they have Ziwipeak. Looks like they have quite a few branches in the Portland area, 1 in Salem and a couple in Bend. That way you could try a few cans first to see if he likes them, then order the case from chewy.
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Oh, great idea. Seems I'm not quite accustom to living in a "big city" (portland) since I didn't even think about specialty pet stores. Thanks for the tip Liz, I'll hit them up tomorrow!
 
tiffmaxee said:
If you want to try a novel protein that would mean a protein he’s never eaten before such as venison, lamb, or duck. Rabbit is another one but kind of low in calories. I feed one of my cats Prinal frozen raw venison as she has skin allergies.
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Gotcha. I wasn't sure if it was a certain category or novel to him. He's basically only ever had chicken, turkey and beef so that should leave a lot of possibilities.
 
No idea why it was so low at PMPS. It just kept getting lower throughout last cycle. I wasn't sure whether to shoot it or not, but I did. Now we're down to 68 :( I'll be monitoring closely. Already fed some 18% food.

edit: probably going to get a bounce out of this now
 
John & Henry said:
No idea why it was so low at PMPS. It just kept getting lower throughout last cycle. I wasn't sure whether to shoot it or not, but I did. Now we're down to 68 :( I'll be monitoring closely. Already fed some 18% food.

edit: probably going to get a bounce out of this now
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If you are unsure about anything John, always post and ask. He has been dropping lower all cycle and coming off the bounce in the am cycle. When you first shoot a lower than normal preshot it is a good idea to get a +1 and a +2 so you have an idea of where the cycle is going.
 
Bron and Sheba (GA) said:
If you are unsure about anything John, always post and ask. He has been dropping lower all cycle and coming off the bounce in the am cycle. When you first shoot a lower than normal preshot it is a good idea to get a +1 and a +2 so you have an idea of where the cycle is going.
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Well, I was pretty sure & got the +2. I figured the Lantus wouldn't show anything before +2. It looked like we bottomed out at AMPS +11 and figured by the time the Lantus kicked in it would be fine. Would you have delayed at PMPS?
 
John & Henry said:
Well, I was pretty sure & got the +2. I figured the Lantus wouldn't show anything before +2. It looked like we bottomed out at AMPS +11 and figured by the time the Lantus kicked in it would be fine. Would you have delayed at PMPS?
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No I would have given the dose as you did.
Getting a +1 when you have shot a lower than normal preshot can tell you if you are most likely to have an active cycle, as can a +2.
Usually at +1 you see a food bump. If you don’t, then the BG could well drop further early on.
With a +2, if it is the same or lower than the preshot then you are most likely to have an active cycle with the BGs dropping lower.
 
The libre just reported we're on the upswing now. His 18% probably just kicked in, so hopefully he's good. Will keep monitoring tho
 
Better I would say. I think feeding him every 2-3 hours helps. He just started getting back in his chair today instead of just laying behind the door. Also, I guess he's mad at me because he's avoided my lap the last few days (his favorite spot) and has actually been sitting on my wife instead (he never does this unless I'm gone >3 days). He's probably mad about all the pokes. Cats! I'm trying to save your life little buddy, geesh.
 
John & Henry said:
Better I would say. I think feeding him every 2-3 hours helps. He just started getting back in his chair today instead of just laying behind the door. Also, I guess he's mad at me because he's avoided my lap the last few days (his favorite spot) and has actually been sitting on my wife instead (he never does this unless I'm gone >3 days). He's probably mad about all the pokes. Cats! I'm trying to save your life little buddy, geesh.
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Better is great news. I’m liking the 0.2 ketones.
What is the carb % you have been feeding (in general)?
 
John & Henry said:
Better I would say. I think feeding him every 2-3 hours helps. He just started getting back in his chair today instead of just laying behind the door. Also, I guess he's mad at me because he's avoided my lap the last few days (his favorite spot) and has actually been sitting on my wife instead (he never does this unless I'm gone >3 days). He's probably mad about all the pokes. Cats! I'm trying to save your life little buddy, geesh.
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Not really funny, but, "sitting on my wife instead" made me laugh. Henry is not a traitor, just a smart boy!
I look forward to the day you can back off on so much testing. At this point, Henry likely thinks you are nuts, with a slew of new disorders, and his mom is the sane one!
Great to hear he isn't still waiting on the front door rug, ready to leave home!
 
Bron and Sheba (GA) said:
John, I would stay up and get a +5 and a +6 as he is still fairly low and you have fed high carb food and when that wears off he could drop again.
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Ugh. I didn't see this comment before I hit the hay, and you jinxed me! The libre alarm went off about 10 minutes after +5, nova read 37 :( 2ml syrup and 18% food later and libre is saying we're back to 138. Continuing to monitor. Gave more FF

Tina Marie (GA) and Jan said:
Not really funny, but, "sitting on my wife instead" made me laugh. Henry is not a traitor, just a smart boy!
I look forward to the day you can back off on so much testing. At this point, Henry likely thinks you are nuts, with a slew of new disorders, and his mom is the sane one!
Great to hear he isn't still waiting on the front door rug, ready to leave home!
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Ahh, me too on less testing. The poor guys ears. He seems pretty content while I'm doing it and never protests, but yeah, I'm sure he'd call social services on me or get me 5150'd if he know how to dial the phone.

Sandy and Black Kitty said:
Keeping in mind right now he needs as many calories and as much insulin as possible I’m wondering if feeding slightly higher carbs might be better…:

Have you considered a programable timed feeder? It was a lifesaver for us.
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I was actually thinking about getting a feeder earlier. I've bought a few over the years, but I've never really had one that worked well, but it's probably been about 5 years since my last attempt, I should probably look into it again.
 
John & Henry said:
I'm going to try and find him some venison, lamb or rabbit tomorrow. (Low carb of course)
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Some low carb options:
Koha has Rabbit, Duck
Ziwipeak has Lamb, Venison, Rabbit & Lamb

Both those have NZ green mussel in them if seafood is a suspected issue.

There are other options, you do need to check the ingredients though, some that are called "Rabbit" or whatever, also have other proteins like chicken in them.

I have Cinna on budesonide and Koha Rabbit for suspected IBD and he's doing really well with that.
 
John & Henry said:
I was actually thinking about getting a feeder earlier. I've bought a few over the years, but I've never really had one that worked well, but it's probably been about 5 years since my last attempt, I should probably look into it again.
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This is the one I use.

We have a cottage out back where my office was; I worked from home thank goodnesses. When we took BK in off the streets the cottage became “BK Central “.
Since he was FIV+ and we had other indoor/outdoor kitties in the house keeping him in the cottage was the best option.

However after about 6 weeks of sleeping on the futon in my office (because I was terrified he would bottom out on the overnights) I was burning out. The programmable timed feeder allowed me to sleep in my bed once again knowing that food would be made available. It was a lifesaver.
 
Sandy and Black Kitty said:
A couple questions-
What are your shot times?
Do you have food with a carb % in the 5-9 range?
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2am/pm. Don't have any in that range, beside I think DM pate is like 8% You think FF doesn't have enough carbs? I was actually just getting ready to go to a specialty pet food store and hopefully has the ziki peak and Koha. Should I try to find something in the 5-9 range?
 
Sandy and Black Kitty said:
This is the one I use.

We have a cottage out back where my office was; I worked from home thank goodnesses. When we took BK in off the streets the cottage became “BK Central “.
Since he was FIV+ and we had other indoor/outdoor kitties in the house keeping him in the cottage was the best option.

However after about 6 weeks of sleeping on the futon in my office (because I was terrified he would bottom out on the overnights) I was burning out. The programmable timed feeder allowed me to sleep in my bed once again knowing that food would be made available. It was a lifesaver.
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Yeah, I could see how that could burn you out quick. I'll probably pick up one of those feeder, thanks for the link. Easier than trying to always be here every 2 hours or getting up every 2 hours at night.
 
Diane Tyler's Mom said:
Checking in on Henry
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He's doing pretty well. We had that little non symptomatic hypo bump last night. I think the more frequent feeding schedule is helping. He was actually sleeping on me this morning instead of behind the front door. The libre is a real life saver sometimes. Makes my phone go crazy if he gets too low.
 
John & Henry said:
He's doing pretty well. We had that little non symptomatic hypo bump last night. I think the more frequent feeding schedule is helping. He was actually sleeping on me this morning instead of behind the front door. The libre is a real life saver sometimes. Makes my phone go crazy if he gets too low.
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I'm so happy to hear this John. Yes feeding the smaller meals more frequently seems to be helping. Give him kisses for me :bighug::bighug::bighug::bighug:
Tell him it's from his Auntie Diane :cat:
 
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