6/9 Henry AMPS=361 Ketones=1.6 +5 298 +8 301 PMPS=304 Ketones=2.3 :(

John & Henry

John & Henry

Member Since 2022
Old thead
Hi All,

Well after a great day yesterday with Ketones being only .3, we're going back in the other direction today with the Ketones being 1.6 @ AMPS and 2.3 @ PMPS, despite him eating a solid 4 cans of food per day and drinking plenty of water. BG seems to not be bouncing, but the insulin isn't really taking it down much either :(

No vomits, no lethargy. Going to try to get in a 12 hour curve for the vet today, despite Christy (my wife) now also being very sick with covid :( so seems like the whole family is hurting around here these days besides the dog ... The paxlovid seems to be helping me somewhat so that's a plus.
 
Hi John, I am sorry Christy now has Covid. That’s bad luck.
If he doesn’t come back down to low blues or greens this cycle (pm cycle) I would increase the dose to 1.5 units tomorrow amps.
I am glad he is not lethargic and is eating well.
 
Ugh, AMPS Ketones were 3.3 today :banghead: I'm doing the curve for the vet today's. Everything else is the same. He's eating clean Everything I give him. He's even tried to steal some of the dogs foodo_O

There has been two different occasions now where the Lantus was left out of the fridge for 12 hours :arghh: Should I ask the vet for a new Rx? Maybe that's the problem?
 
We've had people leave their Lantus out of the fridge before. With the pens, people don't keep it in the fridge and it's good for 28 days. The worst you might do is lower the length of time it'll be good for. I think this Lantus should be OK given the length of time you've had it.

With TR you could even increase tonight if you don't see green today. And even if you do see green, I'd still increase at least tomorrow. Those ketones are telling you he needs more insulin.
 
3.3 is certainly high but if he is eating well and not lethargic that is good to hear, I would definitely monitor that situation closely

@Suzanne & Darcy was it Darcy who's ketones jumped around for a while until he got more regulated?
 
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@John & Henry - any updates? Wondering how things are going after the ketones we’re at 3.3 (didn’t see any entries for today on the spreadsheet; hoping that’s just from dealing with Covid and nothing more).

Hope you’re feeling better as well.
 
JL and Chip said:
@John & Henry - any updates? Wondering how things are going after the ketones we’re at 3.3 (didn’t see any entries for today on the spreadsheet; hoping that’s just from dealing with Covid and nothing more).

Hope you’re feeling better as well.
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Hi,

Thanks for checking in. Yes, both the wife and I have been sooo sick. I have been barely managing to get BGs, but hadn't taken the time to get them in the SS. Luckily the meter logs the date and time, so I just went through and entered them all. Yeah, that 3.3 ketones really gave me a scare. Luckily his ketones tonight were back down to .5 Strangely his PMPS tonight was 348, but was up at +3 to 393. That's the highest BG I've ever registered for him and to get that reading at +3 is just really confusing. All I can think is the fancy feast I gave him must have been much higher carbs than I thought, or the shot didn't make it into him somehow.

His hunger level is just through the roof. I've been giving him 4-5 cans every day (along with the freeze dried treats recommended by @Roxana & Henry) and he eats every last drop and begs for more. He's drinking quite well and no lethargy, but he also hasn't been grooming himself for the last several days either. The extreme hunger and lack of grooming feels just like before prior to when he stopped eating and went into DKA. Yesterday mornings numbers (when I happened to be doing the curve for the vet) were the best he's had in several days! I haven't sent it into her yet, so I think I'm going to redo it again today, because it's really not representative of what his numbers have been running.

Any thoughts on why his BG went up almost 50 points 3 hours after his shot?

edit: I just realized it was actually Friskies Shreds with Chicken and Gravy he ate and not the Fancy Feast when the BG went up 45 at +3 PMPS. Trying to figure out the carbs has been so confusing because the catfooddb.com link I just posted above says:

Guaranteed Analysis
Carbs: (est)
3.0%

Dry Matter Analysis (The manufacturer's published guaranteed analysis values normalized for moisture content.)
Carbs: (est)
17%

and then under the Calorie Breakdown pie chart is says 16.6% Calories From Carb.

So which is it? 3% 17% or 16.6%? Either way, I feel like this must be the culprit (Which is just great since this is the first can out of a whole case I just got! /sigh)
 
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there are a few possible explanations

  • sometimes, with Lantus/insulin glargine you get what is called an in-active cycle where it almost feels like the insulin isn't doing much of anything at all
  • could be a bigger bump from the food than you thought because more carbs than you thought like you said (what FF did you feed?)
  • and like you said, maybe it was a fur shot
that's all I can think of atm, sorry to hear you guys are so ill I hope you feel better soon!
 
Hi John, I am sorry you and your wife have been so unwell. It must have been hard trying to look after Henry.
It is very possible he is bouncing from a lower than normal number on the PM cycle yesterday as you didn’t get any tests in that cycle. Or he could be bouncing from the run of blues yesterday am cycle.
I am very glad the ketones have come down.
I don’t think we can increase the dose just yet as he could well be bouncing and now that the ketones are down, that takes the pressure off that for now. please keep testing for the ketones as you have been doing. Can you try and get at least one BG test in every cycle please. I know it’s hard when you are sick.
I don’t think it is worth doing a curve today if he is bouncing.
I don’t know why he is so hungry but it’s better than not wanting to eat.
 
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Hendrick Cuddleclaw said:
there are a few possible explanations

  • sometimes, with Lantus/insulin glargine you get what is called an in-active cycle where it almost feels like the insulin isn't doing much of anything at all
  • could be a bigger bump from the food than you thought because more carbs than you thought like you said (what FF did you feed?)
  • and like you said, maybe it was a fur shot
that's all I can think of atm, sorry to hear you guys are so ill I hope you feel better soon!
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Hmmm, hadn't heard about the "in-active cycle" thing. I'll have to look into that.

I just updated my last post, because the food was actually Friskies and it appears to have a whole lot more carbs than I thought.

Thanks for the reply Hendrick :)
 
Bron and Sheba (GA) said:
Hi John, I am sorry you and your wife have been so unwell. It must have been hard trying to look after Henry.
It is very possible he is bouncing from a lower than normal number on the PM cycle yesterday as you didn’t get any tests in that cycle. Or he could be bouncing from the run of blues yesterday am cycle.
I am very glad the ketones have come down.
I don’t think we can increase the dose just yet as he could well be bouncing and now that the ketones are down, that takes the pressure off that for now. please keep testing for the ketones as you have been doing. Can you try and get at least one test in every cycle please. I know it’s hard when you are sick.
I don’t think it is worth doing a curve today if he is bouncing.
I don’t know why he is so hungry but it’s better than not wanting to eat.
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OK, I'll hold off on the dose increase and doing the curve today. Yes, I'm definitely more happy with him wanting to eat than not wanting to eat, but the begging is relentless and he licks the bowl clean of every last bit I give him. I only have 2 ketone strips left, but ordered more last week. I'll track them and see when they're due in (hopefully today).

Thank you Bron!
 
John I just reread my previous post and added ‘BG’ into a spot where it said …can you try and get a test in each cycle …..it followed straight after I was talking about ketones but I actually meant can you get at least one BG test in each cycle…I hope I am making sense!
 
Bron and Sheba (GA) said:
John I just reread my previous post and added ‘BG’ into a spot where it said …can you try and get a test in each cycle …..it followed straight after I was talking about ketones but I actually meant can you get at least one BG test in each cycle…I hope I am making sense!
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Gotcha. I'll be more vigilant about that. I (unintentionally) slept for like 12 hours that night, so that's why I missed it (I usually have insomnia, so that was like the longest I've slept... maybe ever?). I'm finally starting to feel better, so getting a few in every cycle shouldn't be a problem. Just tested again (+4) and we're down 11 points to 382.
 
John & Henry said:
edit: I just realized it was actually Friskies Shreds with Chicken and Gravy he ate and not the Fancy Feast when the BG went up 45 at +3 PMPS. Trying to figure out the carbs has been so confusing because the catfooddb.com link I just posted above says:

Guaranteed Analysis
Carbs: (est)
3.0%

Dry Matter Analysis (The manufacturer's published guaranteed analysis values normalized for moisture content.)
Carbs: (est)
17%

and then under the Calorie Breakdown pie chart is says 16.6% Calories From Carb.

So which is it? 3% 17% or 16.6%? Either way, I feel like this must be the culprit (Which is just great since this is the first can out of a whole case I just got! /sigh)
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Yep, carb percentages can certainly be confusing. There are several ways to calculate it and it’s not an exact science at that. The ranges you see mentioned on FDMB are based on the types of calculations used in Dr Lisa Pierson’s food chart. She explains it better than I could. The table is located here: https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

For more info about cat food, nutrition, health, etc., check out her website at www.catinfo.org

A couple generalities:
- ignore guaranteed analysis, it’s not particularly helpful
- anything “in gravy” is likely higher carb (due to the thickeners)

I think the Friskies you fed is around 13% carbs per the food chart.

Glad to hear you’re on the mend.
 
John & Henry said:
Ugh, AMPS Ketones were 3.3 today :banghead: I'm doing the curve for the vet today's. Everything else is the same. He's eating clean Everything I give him. He's even tried to steal some of the dogs foodo_O

There has been two different occasions now where the Lantus was left out of the fridge for 12 hours :arghh: Should I ask the vet for a new Rx? Maybe that's the problem?
Click to expand...
I somehow also managed to forget the insulin out of the fridge two times for 12 hours. I was the same as you omg. But realized what Wendy said and moved on. Scary at first and you are definitely not the only one. Sleep deprivation will do that to you. I now trained myself to put it back in the fridge immediately after I draw the insulin into the syringe.

As the carbs are concerned, it is so annoying to have to figure out/calculate carbs isn't it? So now I get mostly Weruva and Wellness, they are all listing carbs based on ME values on their direct websites. And phosphorus. They both have many options with low, medium and even high carbs. You can buy at petco individual cans to try and see what your Henry may like and they have variety packs as well. Glad he is eating, that is better than not eating. Wishing you and your wife quick recovery. Hang in there:bighug::cat:
 
Since you are following TR, you have plenty of room to increase by 0.25 units anytime. With TR, we hold doses with blue nadirs from 6-10 cycles, today was cycle 13. Bouncing is no reason not to increase. Even if following SLGS (which you are not), you would increase tomorrow. Given how sick you've been, you've done a fabulous job testing. :bighug:
 
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