7/17 Henry WC. AMPS 400+ +3 387 +6 386 +9 400+ PMPS 436 Ket: 1.7

[John & Henry]

Previous : https://felinediabetes.com/FDMB/thr...-3-5-206-6-226-8-216-pmps-302-ket-0-3.265882/

Well, I thought Henry had been doing pretty good yesterday and today until I just checked his ketones @ PMPS and we're at 1.7 Reminds me of some song lyrics "when life looks like easy street there is danger at your door". His PMPS BG is also the highest BG reading I've seen in nearly 2 weeks. It rarely reads over 400 on the novamax, and last time there was a large run of over 400 on the nova meter was when he had his last DKA hospitalization.

My wife and I both noticed that he looked like he had gained a little weight, he started puring on my lap yesterday (and today) which he hadn't been doing hardly at all since the hospitalizations. He's started hanging out in his normal places more often (although not as much as before). He even played with his favorite toy (the plastic wrappers that come on the top of jars/bottles) a couple times. So I thought everything was going swimmingly. He drank like a fish yesterday.

His appetite has been good, only rejecting the enzymed food once or twice. I've been alternating between the laced food and giving him the pills because the pills are so much easier for both of us. He gets so riled up when I open a can of food, but then he has to wait the 20 minutes for the zymes to incubate and when he doesn't get it immediately he'll start looking for anything to eat and then after the 20 minutes sometimes he'll just turn his nose up to the food. Anyway, his stool was very light colored today (meaning the enzymes aren't doing their job)

So I know I've asked about upping the Lantus and Wendy suggested that may be a good idea, but then (of course) his BG took a dip and I held off on upping his dose. Maybe next cycle would be a good time to go back to 1.75uL ?

I'm considering giving the subQ fluids due to the high ketones, but he's still eating and acting fine, I'm not sure if it might be better to just save them? Hopefully he'll be able to get in for an appointment with the vet this week and we'll be able to get more fluids.

I know it's only been two days since I've weighed him, but I was disappointed to see he's only coming in at 5lbs 8oz. I guess a lot of the variation in weight could probably be due to the last time he went to the bathroom, how much water he's drank, how much he's eaten, so I know I can't really draw firm conclusions. Just strange he can lose almost half a pound in 2 days

 

[FrostD]

With TR, you hold for 10 cycles when you see green. It's been more than that, and he's earned bounces and not shown any green. I would increase.

We try to avoid increasing on bounce-breaking cycles, because they tend to have a little extra downward momentum anyway. So in a normal situation, we'd wait for this bounce to clear, then increase in the next cycle (assuming no surprises). In Henry's case, I think you personally have to weigh the ketones against possible low numbers and decide what is right for you. 1.7 isn't bad, but we know it can change quickly.

I can't really answer the fluids question unfortunately. I worry about interfering with electrolyte balance if he's not dehydrated and otherwise eating and drinking well. Did they give you saline or lactated ringer's?

 

[John & Henry]

With TR, you hold for 10 cycles when you see green. It's been more than that, and he's earned bounces and not shown any green. I would increase.

We try to avoid increasing on bounce-breaking cycles, because they tend to have a little extra downward momentum anyway. So in a normal situation, we'd wait for this bounce to clear, then increase in the next cycle (assuming no surprises). In Henry's case, I think you personally have to weigh the ketones against possible low numbers and decide what is right for you. 1.7 isn't bad, but we know it can change quickly.

I can't really answer the fluids question unfortunately. I worry about interfering with electrolyte balance if he's not dehydrated and otherwise eating and drinking well. Did they give you saline or lactated ringer's?

I'm always around him, and he's got the libre to alert me to any hypos before they happen so I think an increase would make sense for next cycle. I know generally having ketones at 1.7 isn't too bad, but at his last DKA he was only at 1.9 ~12 hours before he was hospitalized (with BG in the 400s).

So the fluids are actually an electrolyte solution (Isolyte S pH 7.4). I looked it up and it looks real similar to the lactated ringers:

The vet said this would help keep the pH of his blood from getting too low due to the ketones and provide potassium which he has been deficient in. Its work amazingly well to "bring him back" when he starts acting weird/stops eating. I have little doubt I would have made 3 more trips to the ER without it. For the first 9 nights I used it, the next morning would be the only time I'd get any purs out of him.

edit: I just weighed him again after a couple meals and he's coming in at 5lbs 14oz now, so I guess he may not have lost much, if any weight.

​

 

[Diane Tyler's Mom GA]

@John & Henry
Hi John Is everything ok with Henry, I don't see your SS updated and am worried