8/12 Tashie UPDATE + Insulin Question + ANGRY!!!

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BorisV

BorisV

Member Since 2013
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=102047

Hi all! Bern here .... up waiting from a call from the E.R. Just as an FYI - and, thank you Carl for posting! I just wanted to take a minute to address the quote below for "educational" purposes.

Drinking excessive water or no water
Excessive urination
Diminished activity
Not eating for 12 hours or more
Vomiting
Lethargy or depression
Weakness
Dehydration
Ketone odor on the breath (may smell like nail-polish remover or fruit)
Click to expand...

She had urinated a lot yesterday - that really wasn't a "trigger" for me as she was running HIGH and she urinates more when she is in higher numbers
She was pretty perky - in fact, a half hour prior to going to the E.R. she toddled downstairs looking for FOOD - this was about 45 minutes before pre shot
She ate VERY well yesterday! FF Salmon, FF Chopped Grill, some turkey and then some FF Chicken - this was all between 7AM and 5PM
No vomiting
Did not seem depressed - or weak

I cleaned litter boxes at 11 AM and noted on my SS - NEGATIVE for ketones. Since she has urinated more yesterday, I did the boxes again around 6:30/6:45PM and had another "opportunity" to use the urine stick - it turned MAROON! I was shocked to say the least and ran to get the NovaMax blood ketone meter which registered HIGH.

Called the E.R. got "call ahead seating" ..... it was 15 minutes prior to shot time - gave her insulin shot ......... grabbed the insulin, her meds, food and out the door we went.

****VERY interesting note - you all know I have been fighting my vet over the AlphaTrak meter ---- well, in discussing Nataschia's BG numbers, I found myself explaining that we use a human glucose meter and was going to try to "translate" a bit when the vet stopped me and said THEY USE A HUMAN METER THERE****

Meeting with an internal medicine specialist this morning. Will update as I can.

B
 
Re: 8/12 Tashie UPDATE

Sending tons of vines to Tashie and big hugs to you, Bern. Did you use a fresh urine sample when you tested for ketones? Interesting about the meter. :roll: :lol:
Liz
 
Re: 8/12 Tashie UPDATE

Hope Tashie is better real soon and gets to come home ASAP. We'll need to send the KTSS crew in to get the vetty smell off her so Boris doesn't tell her she can't come back in the house! ;-)
 
Re: 8/12 Tashie UPDATE

****VERY interesting note - you all know I have been fighting my vet over the AlphaTrak meter ---- well, in discussing Nataschia's BG numbers, I found myself explaining that we use a human glucose meter and was going to try to "translate" a bit when the vet stopped me and said THEY USE A HUMAN METER THERE****
Click to expand...

You know, I will bet a big reason for that is "cost". An ER is more likely to need and use a BG meter than a regular vet clinic. They are probably looking for just a quick "yes/no" answer. Either the cat is or isn't in high or low numbers. They also would be burning thru a bunch of strips if they are treating DKA or a hypo. And they know that a human meter is plenty good enough to use. Just like we do :-D
 
Re: 8/12 Tashie UPDATE

Hi bern,

Just checking in on you & Tashi & chiming in with everyone else that Tashi has a QUICK recovery & can be back home with the bean asap!!! :YMHUG: Keep us posted!
 
Re: 8/12 Tashie UPDATE

Just came home from seeing my baby - she wouldn't EAT for them but she did a little for me. I was only allowed 10 minutes with her as they wanted to get her back on the IV. She has needles taped to BOTH a back & front leg but I unwrapped her from the blankie & popped her down on the floor, she did a BIG back leg stretch and then proceeded to toddle all around the room - big blue eyes - looking at me as if to say "Hey, mum, have you come to spring me out of this joint"?
Tashie is NOT eating for them, they are having to syringe but .............she did eat some for ME! She is not acting sick, and is alert. They will be doing tests on her today - should have some results late this afternoon.

Hope you can see the photo of her I attached .....it's a heart breaker!

IMG_0753_zps667ed6b0.jpg
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Re: 8/12 Tashie UPDATE

Oh poor girl! At least they used "pink" on her back leg though. Hoping she is able to come home soon and you get a good update after the tests.
 
Re: 8/12 Tashie UPDATE

Just came home from seeing my baby - she wouldn't EAT for them but she did a little for me. I was only allowed 10 minutes with her as they wanted to get her back on the IV. She has needles taped to BOTH a back & front leg but I unwrapped her from the blankie & popped her down on the floor, she did a BIG back leg stretch and then proceeded to toddle all around the room - big blue eyes - looking at me as if to say "Hey, mum, have you come to spring me out of this joint"?
Tashie is NOT eating for them, they are having to syringe but .............she did eat some for ME! She is not acting sick, and is alert. They will be doing tests on her today - should have some results late this afternoon.

Hope you can see the photo of her I attached .....it's a heart breaker!

IMG_0753_zps667ed6b0.jpg
[/url][/img]
 
Re: 8/12 Tashie UPDATE ***Photo***

poor little baby!!!!! I hope she's home soon!!! Did they tell you how long they think she'll be in the joint??
 
Re: 8/12 Tashie UPDATE ***Photo***

I'd be interested if they have any idea why she started to develop ketones. I hope they'll have more information for you as the lab work is finished.
 
Re: 8/12 Tashie UPDATE ***Photo***

Poor Tashie! Sending healing vines and grat of you to have checked again. if she is alert and active that is a big plus.

On the human meter, the primary studies done on using Lantus for cats at the University of Queensland were done using a human meter!
 
Re: 8/12 Tashie UPDATE ***Photo***

Lots of GEt Well Soon Vines for TAshie!! I'm curious like Sienne too.

Hopefully they did a full blood panel and some urine too...sounds like you really need some answers and can hopefully get her back on track very soon.

:YMHUG:
 
Re: 8/12 Tashie UPDATE ***Photo***

Sending lots and lots of "get well" vines and prayers for Tashie.. and "break her out of the joint" vines. :-D Bless her sweet little heart. I hope they have some good answers for you, soon. Munch that food Tashie!
 
Re: 8/12 Tashie UPDATE ***Photo***

We're also sending along tons of healing and feel better prayers for sweet Tashie!!
 
Re: 8/12 Tashie UPDATE ***Photo***

Oh poor Tashie, sending healing vines to you both. She sure is a cutie with her pink bandage
 
Re: 8/12 Tashie UPDATE ***Photo***

Hi Bern--
I hope Tashie's feeling better and the ketones are gone or on their way out! I took a look at your pictures--Tashie could surely be a sister to Grumpy cat and I am in love with Bo! What kind of cat is he?
 
Re: 8/12 Tashie UPDATE ***Photo***

I hope Tashies ketones are zero tomorrow and you can bring her home to recuperate.

Also hoping they find out why?
 
Re: 8/13 Tashie UPDATE ***Photo***

Hi All! Thanks SO very much for all the kinds words, prayers and "vines" ...... much appreciated and it means a lot. Sorry I went AWOL last night, just completely beat and actually got to bed around 9:30 and slept pretty well for the first time in a long, long time.....probably helped a little by the 2 "adult beverages" that I indulged in! (just wine, not whiskey!)

This is the information I have so far:

Spoke with the "Internal Medicine" specialist - DVM, Diplomate, ACVIM (?)

They did the ultra sound & chest X-Ray. She said it was nothing "dire" but Tashie has a small cyst on her chest and a few tiny cysts on her kidneys - nothing to do anything about now but to keep an eye on.

Because her Creatinine level has climbed a bit, she most likely is in early stages of Kidney failure.

There was a small amount of blood in her gall bladder?

They still have her on "R" insulin and NOT the Lantus. I asked about the ketones, she said that they want to get her under 200 to test for that - she is coming down but not there yet.

She actually looked at my SS and mentioned the "Somogyi" and feels Tashie's diet needs to change to a higher carb (?) ......... I'm VERY confused about this as from the get go it's been ALL LOW CARB.....and my "normal" (?) vet wanted her on that darned canned DM that is only 2%. Also, what strange timing as I was just asking about medium carb food, huh? I am not sold on the higher carb - think it needs to be DIFFERENT food, lower in phosphorus for the kidneys but maybe a little higher carb when she has active cycles?

This particular doctor is ONLY there today (Monday) this week and I will get another tomorrow. This will ALSO be an internal medicine doctor so I'll be curious to see what he/she says. I will be going to see her tomorrow as I asked as I feel it is good for Tashie to stretch her leggies and also if she will just have a few licks of food for me - don't want her to start getting weird about eating again - I will also take "her" bowl. The doctor agrees.

I have ASKED then to feed her EVERY three hours - I am going to stay on top of that. ***after I left she did start to eat some on her own

The doctor was on the fence about adding an antibiotic to her IV and I sort of begged her to - I said that it's not like Tashie has been on a lot of antibiotics, to the best of my recollection, the June hospital stay was the only time - so it's not like she's been overloaded and it will become inefficient. Again, we have to WAIT for the urine culture - but, IF she does have a UTI or something - let's get going on that, yeah?



I will be going sometime today and hope to get more details and even some information "on paper" as, so far, all has been verbal. Actually, just took a second to call and check on her so here is more of an update:

Tashie did "really well" over night. She is eating and still on "R" insulin, she is in the 300's Tech said that she can TELL Tashie is feeling better as she was petting her and then when she stopped, Tashie "hissed" at her .......Hummm, that's odd, Tashie is not a "hisser"? Hope she has the right cat :?
They are going to do some blood work this morning and also check ketones. I can visit her around 1PM and hopefully get to chat with the Internist on today - warned that they have a "busy" day ....humm, at $800 a day, they'd BETTER take time for me! Yep! $800 a day + 350 for blood tests, $75 for urine tests, $350 for X-Ray, $500 ultra sound ........Cha Ching!


Just a "Bern" note - SO, the THREE things that cause ketones are:
1. Not enough Insulin / 2. Not enough food / 3. Infection - am I right?
Well, she obviously is getting enough insulin as the day before she went down to 56
She has been eating like a piglet - even on Sunday, the day this happened she ate VERY WELL
So that leaves infection, right? SO that is what I am pushing for an antibiotic. Agree?

Promise I'll keep updating! And, yesterday someone asked me if I was going to LEAVE THE BOARD - as, when this happened before I panicked and left for a while. NO! I am here to stay! You guys have been beyond great to me, and you'll never know how much I appreciate all of your support. My goal is to one day be able to do the same (got a LOT to learn) but I'm starting to connect the dots!
I'm also hoping that we can get some insightful information on this ketone issue that may help others going forward. I will be pushing to get as much information as possible and ALL paperwork I can get my hands on.

Until this afternoon........
B

Oh, PS: Kat, Boris is a "Blue Exotic" - a short haired Persian. I got Bo & Tash from the same breeder and at the same time. He's been a bit "down" yesterday & today so I started him on a little ProBiotic in hopes to perk him up - missing his sis! Boris is the "protector" and has an amazing personality and is VERY sensitive - he also THINKS I gave birth to him :-D
 
Re: 8/12 Tashie UPDATE ***Photo***

Bern --

"Enough" insulin is relative. There are cats whose numbers are in the 200s (or lower) and can have ketones. Because this is a metabolic/physiologic process, for a cat that's prone to ketones what constitutes enough insulin may not always be reflected in the BG numbers.

Also, it's not just infection that can be related to ketones developing. It can be an inflammation. Problems like pancreatitis or dental issues are inflammations. Basically, anything that stresses the cat's system can be a factor since stress releases stress hormones which raise BG.

Finally, putting Tashis on any old antibiotic, especially if she has a UTI isn't always a good strategy. I'm sure they took a sterile urine sample and are running a culture and sensitivity. This latter procedure which takes a couple of days will tell you IF there's a UTI and if so, which bacteria are present. The C & S allows the vet to select an antibiotic that is specific for that bacteria.

I would ask the vet if Tashie's electrolytes values were off. And if so, how are those levels now.
 
Re: 8/12 Tashie UPDATE + Insulin Question

A PS: to the post above. I was wondering if it's POSSIBLE that Lantus may be "too harsh" for Tashie - any thoughts on switching her to Levemir?

Lantus attaches to the "fat" .......? She doesn't have much of that!

Just thinking out loud .......any thoughts out there?
 
Re: 8/12 Tashie UPDATE + Insulin Question

Lantus and Lev are very similar with respect to being gentle. Some cats do better on Lev. Marje's Gracie is one who has done better. Barb's Checkers is doing about the same. There's no way to really predict if one will be better than the other. One thing to consider, though, is that onset and nadir are later with Lev. If you want to get tests around nadir, that may be a consideration. It's one of the reasons I've stuck with Lantus. Given Gabby's tendency to dive early, Lantus is better for my being around and/or awake to test.
 
I COULD SCREAM! I TOOK 12 CANS OF FOOD, A SMALL BLENDER & CHICKEN BROTH (IN CASE THEY HAS TO SYRINGE FEED) SHE ATE WET FOR ME YESTERDAY AND WAS TOLD SHE WAS EATING ON HER OWN. JUST GOT OFF THE PHONE WITH TODAY'S INTERNAL MED DOCTOR AND HE MENTIONED DRY DM. THEY HAVE GIVEN HER DRY DM! I SPECIFICALLY ASKED THEN NOT TO GIVE DRY!

WHAT THE HECK! AND HE'S TELLING ME HE WANTS ME TO HAVE THE DRY DOWN FOR HER TO BE ABLE TO GRAZE!

SHE WAS KETONE FREE THIS MORNING - THEY WILL DO ANOTHER CHECK LATE THIS AFTERNOON. I AM GOING AT 1:00 TO SEE HER.

THEY ARE GOING TO PUT HER BACK ON LANTUS TONIGHT - THE .5U THAT SHE WAS ON. HOWEVER, WE KNOW THAT SHE WON'T GET IN GOOD NUMBERS AS THE DM IS SO HIGH IN CARBS!

NOW WHAT! I WANT TO SLIT MY WRISTS!

****I'VE ALSO BEEN THINKING ..... I THINK THESE KETONES OCCUR WHEN SHE GOES LOW AND BOUNCES REALLY HARD. I THINK IF SHE IS LESS THAN 350 AT P.S. I NEED TO GIVE HER A HIGHER CARB FOOD THAT DAY SO SHE DOESN'T DIVE - EVEN IF IT KEEPS HER AROUND 150 - 200 OR SO AND SHE NEVER EARNS A DOSE DECREASE - SEEMS LIKE, IN TASHIE'S CASE, THIS MIGHT KEEP HER "SAFER"........THOUGHTS?
 
Hi guys .. I don't have any advice for you as far as what's going on with Tashie, but I am keeping you guys in my thoughts and prayers that she recovers and is home SOON!!!
 
If, for some reason, she was not absorbing food properly, she might be breaking down fat for calories.

Maybe take them a printout of the Cat Info food chart ... and circle in red the carb counts on what they are feeding vs some of the other options such as Evo Cat and Kitten (8% calories from carbohydrates) or Wellness Core (11% calories from carbohydrates)
 
Sending tons of vines for Tashie and you and Boris. (((Bern))) Tashie can also graze on wet food, just put a little extra water on it and it will be fine to set out.
Liz
 
Just checking in to see how Tashie doing,Im sure.it Dr Lisa's chart thats what we all use. Sending vibes for a good recovery and for you not to stress real hard on this. I leave down a ice cube of cat food Lucky will.eat it slower.good luck
 
Re: 8/12 Tashie UPDATE + Insulin Question

BorisV said:
... any thoughts on switching her to Levemir? ...
Click to expand...
Hi Bern--I posed this exact question when Gobbles was, I believe, about 3 months into his dx. And was told to give it more time. Thankfully, I took that advice. Who knows? If I would of switched him to Levemir, he may not have gone OTJ. If I were you, I'd give the Lantus more time...
 
:lol: :lol: Is you CAPS key stuck in place? :lol: :lol: If you pop that key off, there should be a dial there where you should be able to turn the volume down :lol: :lol:
 
BJM said:
...some of the other options such as Evo Cat and Kitten (8% calories from carbohydrates) or Wellness Core (11% calories from carbohydrates)
Click to expand...
Bern & BJM: If it were okay to try the YA Zero Carb, I can priority mail some to Bern today and she would probably get it tomorrow....or even Express mail it and she should definitely get it tomorrow....
 
(((((((((Bern))))))))))) I'm glad that Tashie's BGs are coming down and that you will be able to take her home soon. Tess is another cat that is doing well on Lev, but not because Lantus was harsh. Theses are the gentlest insulins. Tess's nadir was very early on Lantus and then wearing off too soon. Lev just gives her a longer cycle. There can be a sting from Lantus at high doses (6u or more), but that but that is because of it's Ph not the harshness of the insulin. So can be uncomfortable when the shot is given.

Sorry you are getting so much conflicting information. She is your cat and you can do what you feel is right for her once you get her home.

p.s. yes that link was for Dr Lisa's site, it looks like there was a typo in the URL. If you want a shorter list to print out there is a tab on Tess's SS w/ the foods that are low carb and low phosphorus. Easier to print out.
 
Please bear with me I am using my voice on my voice over on feature on my phone to post as I am driving on thank you all for all the well wishes and comments soon as I have an opportunity to get to my computer later today I will make another more concise post under is a reason they gave her the dry DM food which I will explain later
 
BorisV said:
BJ: THANKS - THE LINK YOU SENT IS NOT WORKING ..... IS IT THE DR. LISA CHART?
Click to expand...
Ooops!
Yes, the chart Dr Pierson compiled.

I fixed the link.
 
TheBowHuntress said:
BJM said:
...some of the other options such as Evo Cat and Kitten (8% calories from carbohydrates) or Wellness Core (11% calories from carbohydrates)
Click to expand...
Bern & BJM: If it were okay to try the YA Zero Carb, I can priority mail some to Bern today and she would probably get it tomorrow....or even Express mail it and she should definitely get it tomorrow....
Click to expand...

Hi Kat - I just wanted to mention that I don't think Tashie would eat the YA. BErn offered to mail me her bag (which is still in her fridge). So, I believe she has some if she needs it, but Tashie probably won't eat it.

Do you feed Gobbles YA?
 
Hi Bern! I'm so sorry you are so stressed about Tashie. My vets think that the dry DM stabalizes their blood sugar (like it's a good carb). I"m thinking that specialist you saw probably does too. Hang in there!! It's tough. :YMHUG:
 
Lkldcatlady said:
...Hi Kat - I just wanted to mention that I don't think Tashie would eat the YA. BErn offered to mail me her bag (which is still in her fridge). So, I believe she has some if she needs it, but Tashie probably won't eat it.

Do you feed Gobbles YA?
Click to expand...
Oh, OK...I just thought maybe she hadn't tried it and at least if the vet has to feed dry, the YA would be a good choice...
 
Hi Bern,

What an ordeal you're going through! Just wanted you to know you & Tashi are in our thoughts & prayers - hope she's home safe soon, & you can get all this behind you.
 
Sorry guys! JUST walked through the door ....... need like a half hour go get thoughts together (and some dinner prep etc;) and I'll pop back on and tell you the latest.

KAT: Thanks for the offer of YA - been there, done that - no go. And, it's NOT about the fact that it's DRY food ......will explain more in next post - you are such sweetie for offering though REALLY appreciate your kindness.

BJ: Thanks for the food chart - as I couldn't open the link - I wasn't sure if it was "Dr. Lisa's" or not. I do have TWO copies printed out of her food charts - one stays in the car and one at home. Appreciate your suggestion though! Again, I will post again "explaining" what is going on.

****I think I need to do a NEW post with this as a link - so that things don't get too long and confusing. I know we are only supposed to do that in the morning but as this is BOTH a combo of yesterday & today, I think it's time for new - hope I'm not braking any rukes :o

Be back soon - with LOTS of info - stay tuned :-D
 
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