8/13 Samba - ketones 0.9 mmol/L - PMPS 172 +1 203 +2 195 +3 164 +4 218

[Sarah Mc]

http://www.felinediabetes.com/FDMB/...ps-334-1-353-2-266-3-198-7-63-7-5-101.182165/

Good morning,
Samba's blood ketone reading at AMPS was 0.8mmol/L, which is in the cautionary range (0.6-1.5mmol/L)... the instructions say "may need medical attention". Should I be concerned? He has always had results in the normal range so far (0.0-0.6mmol/L).

What can be done to help the situation from home? Should I add water to his food? Also, at what point should I be alerting the vet, and what would be the next steps if he was throwing ketones? Thanks so much

 

[Kris & Teasel]

http://www.felinediabetes.com/FDMB/...ps-334-1-353-2-266-3-198-7-63-7-5-101.182165/

Good morning,
Samba's blood ketone reading at AMPS was 0.8mmol/L, which is in the cautionary range (0.6-1.5mmol/L)... the instructions say "may need medical attention". Should I be concerned? He has always had results in the normal range so far (0.0-0.6mmol/L).

What can be done to help the situation from home? Should I add water to his food? Also, at what point should I be alerting the vet, and what would be the next steps if he was throwing ketones? Thanks so much

Add water to his food to make it soupy. If he won't eat it that way syringe water into him. He has to eat and he needs insulin - both key in nipping this in the bud, along with hydration.

Test for ketones a couple of times today and if they go down, great. If they stay the same call your vet for advice. If they go up take him to the (a) vet ASAP. This can go south very quickly. Early treatment is important.

 

[Sarah Mc]

Add water to his food to make it soupy. If he won't eat it that way syringe water into him. He has to eat and he needs insulin - both key in nipping this in the bud, along with hydration.

Test for ketones a couple of times today and if they go down, great. If they stay the same call your vet for advice. If they go up take him to the (a) vet ASAP. This can go south very quickly. Early treatment is important.

Kris, thanks so much for your helpful reply... I added water to his food, and he gobbled it up, thankfully. However, his ketones did go up to 0.9... I am going to feed and test again one more time and then take him to an emergency vet. Is there a certain treatment I should ask for or will they know what to do? What can I expect in terms of cost, treatment, time spent there?

 

[Sarah Mc]

@Yong and @Sandy and Black Kitty, there are a few emergency vets in the Baltimore area... is there one that you would recommend?

(I won't wait too long for a reply since we gotta go soon, but I figured I'd try asking in case you're online)

Thanks!!

 

[Chubba (GA)]

I have no experience. Just sending prayers and .
Good luck. Hope all goes well!

 

[Kris & Teasel]

Kris, thanks so much for your helpful reply... I added water to his food, and he gobbled it up, thankfully. However, his ketones did go up to 0.9... I am going to feed and test again one more time and then take him to an emergency vet. Is there a certain treatment I should ask for or will they know what to do? What can I expect in terms of cost, treatment, time spent there?

Your kitty is obviously still feeling normal. As far as those ketone numbers, I generally pay attention to the words "negative" or "trace" on my strips. If yours say "needs attention" then it's worth paying to go to an ER vet to have him checked. Tell/show them how you measure ketones and ask for their opinion. They might want to give IV fluids to flush them out. Early treatment is much better/cheaper than treatment of a very sick kitty. When my guy had his bout in March of 2016 he was very ill and his 3 day treatment in the ER ICU came in at $2700 CAD.

ETA: Don't let them slough it off as unimportant. Their status can change quickly.

 

[Tuxedo Mom]

What brand of blood ketone meter are you using?

This has been discussed before with Ketone meters:

"It's different for cats than humans. From http://www.felinediabetes.com/FDMB/...oacidosis-dka-and-blood-ketone-meters.135952/


When do ketones show up on a blood ketone meter such as the Nova Max Plus or Precision Xtra Blood & Ketone meters?

The latest published research/studies in cats indicate ketones will begin to show up at readings of 2.4 and 2.55 on a blood ketone meter:

Measurement of ketones - Weingart_J VET Diagn Invest-2012(1).pdf
Measuring ketones - JSAP_Zeugswetter - 2012.pdf"

http://www.felinediabetes.com/FDMB/threads/phoebes-question-on-night-feedings.176785/#post-1946459 Post +10

You could post a separate thread asking for information on ketone meter readings for kitties compared to people. There are a number of members who have used the blood ketone meters.


ETA However if you are unsure you could have a blood draw done at the vets to make sure.

 

[Sarah Mc]

What brand of blood ketone meter are you using?

This has been discussed before with Ketone meters:

"It's different for cats than humans. From http://www.felinediabetes.com/FDMB/...oacidosis-dka-and-blood-ketone-meters.135952/


When do ketones show up on a blood ketone meter such as the Nova Max Plus or Precision Xtra Blood & Ketone meters?

The latest published research/studies in cats indicate ketones will begin to show up at readings of 2.4 and 2.55 on a blood ketone meter:

Measurement of ketones - Weingart_J VET Diagn Invest-2012(1).pdf
Measuring ketones - JSAP_Zeugswetter - 2012.pdf"

http://www.felinediabetes.com/FDMB/threads/phoebes-question-on-night-feedings.176785/#post-1946459 Post +10

You could post a separate thread asking for information on ketone meter readings for kitties compared to people. There are a number of members who have used the blood ketone meters.


ETA However if you are unsure you could have a blood draw done at the vets to make sure.

Thank you... yeah, I was just reading some of the info about ketones in the stickies and was confused because I saw that too about readings of 2.4 or 2.55, and he is obviously well below that... he just had blood work at his vet's office yesterday, a senior wellness workup. Would they have tested for ketones then? I guess it might not matter because it sounds like a cat can be fine one moment and throwing ketones the next? I'm using the NovaMax. Thanks for all those links-I will check them out now

 

[Tuxedo Mom]

Thank you... yeah, I was just reading some of the info about ketones in the stickies and was confused because I saw that too about readings of 2.4 or 2.55, and he is obviously well below that... he just had blood work at his vet's office yesterday, a senior wellness workup. Would they have tested for ketones then? I guess it might not matter because it sounds like a cat can be fine one moment and throwing ketones the next? I'm using the NovaMax. Thanks for all those links-I will check them out now

I tried to look up some members who have used the Nova Max ( it seems to be the most popular). The few that I know of do not come on the forum very often and I am sure you would like a quick answer. The usual concerns with ketones are if they are not eating well, glucose levels are high ( although ketones can show at lower numbers too), if there is some sort of infection...or a combination of any of these. With a senior wellness they should have tested for ketones and the BW "should" have showed if there was any infection. Do you have any of the urine ketone test strips. If so try testing with that method as well. Although blood ketone testing is more accurate for current levels it can give a cross section comparison.

 

[Tuxedo Mom]

Not sure if this will help. This is a link to a S/S for one of the members whose kitty had DKA. He tested regularly at home with a blood ketone meter as well as urine test strips. You can see his test results ( usually around the AM +11 time) and read his comments.

https://docs.google.com/spreadsheets/d/1nw2ruieOxoOuIkhNn1APJWn3iTYzYj9qnob-T3xxJeU/edit#gid=5

 

[tiffmaxee]

No ketone experience here either.

 

[Yong & Maury GA]

@Yong and @Sandy and Black Kitty, there are a few emergency vets in the Baltimore area... is there one that you would recommend?

(I won't wait too long for a reply since we gotta go soon, but I figured I'd try asking in case you're online)

Thanks!!

Hi Sarah!
Not sure where in Baltimore area you are but I know there is an ER vet near Sandy and I in Catonsville. Sounds like you may not need to go though. I will tag another member, who we helped her boy clear his trace ketones at home when he wasn't showing any signs of DKA like it seems Samba is not displaying . @Meridith and Zeke I'm pretty sure Zeke never went to the Vet

 

[Meridith and Zeke]

Thanks @Yong

@Sarah Mc Zeke has shown trace once and small the last time on ketone tests. I use the strips that you dip into the urine for testing for ketones. When I see the ketones show up and he is acting normal, I start with doing the kitty stew for his food and give him lots of tuna juice (the water from a can of tuna). He loves his tuna juice and I will do a can of that every hour to 2 hours. Yep we go through a bit of tuna, but I use tuna for his treats too and will put some on his meals. When we go through the extra like on those days, we also get tuna sandwiches for lunch lol. Doing this usually clears up the ketones within 12 hours since your really flushing the system out with all the extra fluids. And I keep a close check on ketones for several days afterwards to make sure it isn't going to come right back which would be time to go to the vet.

 

[Marje and Gracie]

Thanks @Yong

@Sarah Mc Zeke has shown trace once and small the last time on ketone tests. I use the strips that you dip into the urine for testing for ketones. When I see the ketones show up and he is acting normal, I start with doing the kitty stew for his food and give him lots of tuna juice (the water from a can of tuna). He loves his tuna juice and I will do a can of that every hour to 2 hours. Yep we go through a bit of tuna, but I use tuna for his treats too and will put some on his meals. When we go through the extra like on those days, we also get tuna sandwiches for lunch lol. Doing this usually clears up the ketones within 12 hours since your really flushing the system out with all the extra fluids. And I keep a close check on ketones for several days afterwards to make sure it isn't going to come right back which would be time to go to the vet.

Be sure you check on the ingredients list of tuna, not just the front that says "canned in water". If the ingredient list says "vegetable broth" you should not give him that brand. Vegetable broth contains onions which cats should not have. You also don't know what else they are putting in it. Find a brand that is just tuna and water although most add salt unless you buy low sodium.

Sarah...Mary Ann's suggestion to test with a urine ketone strip is good. The blood ketone meters are more real time as it does take time to show the ketones in urine. The numbers she gave for ketones in cats are accurate but the urine t st strips will give you comfort level, too.

In the US, the labs do not always check for blood ketones. Depends on the labs and the tests they are doing. They do usually test for ketones if a urine sample is provided. I have found that the labs don't always indicate if there is infection present. You would hope to see it in the CBC with the WBC, neutrophils, lymphocytes, etc but low grade infections might not have triggered an immune response.

Insofar as his dose, the reason you are seeing him not hold 2.25u is you've stepped back from his testing at night and he's dropping fast. He was headed down at a pretty good clip last night when you stopped testing at +3 and so he just kept falling. Luckily, you caught it. But on 8/10, a bit more monitoring that night would have probably kept him from dropping into a reduction number. No criticisms...just observations. We don't want him earning too many Reductions too quickly. He's still really bouncy.

I know it's hard between your schedule and wanting to have a life I know you are doing the very best you can for your boy.

 

[Sarah Mc]

Thank you so much for all of your posts... I am always amazed by the overpouring of support that is given by the members of this forum. It is truly incredible how quickly others will come to your aid on here, and we are so blessed to have found this place.
I am battling a bad headache that won't go away, so I've been taking a break from my screen, but I've been reading all of the info and keeping a close eye on Samba. We did not end up doing the ER today because his ketone reading went down, but this definitely woke me up, and I feel more confident now in knowing how I should proceed if he reads high in the future. Be back soon after my head feels better

 

[Meridith and Zeke]

If the ingredient list says "vegetable broth" you should not give him that brand.

Thank you, I did not know that! Also, I knew dogs couldn't have onions, didn't know cats couldn't either. Right now he is getting purely fancy feist treats but have been looking at getting him a different treat. Now I will know better what to look for.

Learning everyday!

 

[Marje and Gracie]

Thank you, I did not know that! Also, I knew dogs couldn't have onions, didn't know cats couldn't either. Right now he is getting purely fancy feist treats but have been looking at getting him a different treat. Now I will know better what to look for.

Learning everyday!

You're welcome!!

 

[Sandy and Black Kitty]

Hi there

I'm glad you are monitoring for ketones - very important since they can quickly develop to life threatening levels.

Any underlying infection/inflammation?

Regarding emergency vets, I use the one on Catonsville-it is minutes from home. There are others that may be closer to you. Nows the time to identify one near you, in the event you need to act quickly.

 

[Meridith and Zeke]

@Marje and Gracie after what u said, checked out the tuna Isle. None of the ones available were free of vegetable broth but found canned salmon (boneless skinless) was just the water and salmon so gonna see if he likes that broth for the next time I have to flush his ketones.

 

[Sarah Mc]

@Marje and Gracie after what u said, checked out the tuna Isle. None of the ones available were free of vegetable broth but found canned salmon (boneless skinless) was just the water and salmon so gonna see if he likes that broth for the next time I have to flush his ketones.

I read in one of the older posts that Trader Joe's might have cans of Tuna with just the water

 

[Sarah Mc]

I tried to look up some members who have used the Nova Max ( it seems to be the most popular). The few that I know of do not come on the forum very often and I am sure you would like a quick answer. The usual concerns with ketones are if they are not eating well, glucose levels are high ( although ketones can show at lower numbers too), if there is some sort of infection...or a combination of any of these. With a senior wellness they should have tested for ketones and the BW "should" have showed if there was any infection. Do you have any of the urine ketone test strips. If so try testing with that method as well. Although blood ketone testing is more accurate for current levels it can give a cross section comparison.

I imagine the results of the blood work will come back sometime next week, so hopefully all looks okay... Samba is definitely still eating well, and he seems to be his normal, sweet self today. I do have some of the urine test strips that may be expired. I have to find them. I had a hard time doing that with Samba, but I will try again thank you so much...I also found that looking at the spreadsheet for Small Kitty was really helpful! Scary how quickly things can go from looking fine to very bad... I just ordered more of the NovaMax strips, and I will need to figure out something that works for the urine testing to make it more affordable. Thank you for helping us

 

[Sarah Mc]

Hi Sarah!
Not sure where in Baltimore area you are but I know there is an ER vet near Sandy and I in Catonsville. Sounds like you may not need to go though. I will tag another member, who we helped her boy clear his trace ketones at home when he wasn't showing any signs of DKA like it seems Samba is not displaying . @Meridith and Zeke I'm pretty sure Zeke never went to the Vet

Thank you so much! It looks like the one in Catonsville is 22 minutes away from me, and there are two slightly closer (15 min and 20 min away). Have you or @Sandy and Black Kitty had to go to the Catonsville one? Cost is definitely an issue for me, so just wondering what your thoughts were... We had our first appointment at Paradise yesterday, and I felt good about meeting Dr. Thacker. Also, the cost was 1/3 of what we were paying at VCA for blood work, $30 cheaper for the exam, and 1/2 the price to analyze his stool sample. I easily saved $250, so thank you both for that recommendation

 

[Sarah Mc]

Thanks @Yong

@Sarah Mc Zeke has shown trace once and small the last time on ketone tests. I use the strips that you dip into the urine for testing for ketones. When I see the ketones show up and he is acting normal, I start with doing the kitty stew for his food and give him lots of tuna juice (the water from a can of tuna). He loves his tuna juice and I will do a can of that every hour to 2 hours. Yep we go through a bit of tuna, but I use tuna for his treats too and will put some on his meals. When we go through the extra like on those days, we also get tuna sandwiches for lunch lol. Doing this usually clears up the ketones within 12 hours since your really flushing the system out with all the extra fluids. And I keep a close check on ketones for several days afterwards to make sure it isn't going to come right back which would be time to go to the vet.

Meridith, this specific info was extremely helpful, and I will be looking for tuna cans that don't have the vegetable broth... I mentioned earlier I read on another post that you can get them at Trader Joe's. I will let you know where I find them. Thank you so much

 

[tiffmaxee]

Meridith, this specific info was extremely helpful, and I will be looking for tuna cans that don't have the vegetable broth... I mentioned earlier I read on another post that you can get them at Trader Joe's. I will let you know where I find them. Thank you so much

I just happen to have a can of Trader Joe's low salt tuna. The ingredients listed are solid white tuna, water, salt and that's it.

 

[Sarah Mc]

Be sure you check on the ingredients list of tuna, not just the front that says "canned in water". If the ingredient list says "vegetable broth" you should not give him that brand. Vegetable broth contains onions which cats should not have. You also don't know what else they are putting in it. Find a brand that is just tuna and water although most add salt unless you buy low sodium.

Sarah...Mary Ann's suggestion to test with a urine ketone strip is good. The blood ketone meters are more real time as it does take time to show the ketones in urine. The numbers she gave for ketones in cats are accurate but the urine t st strips will give you comfort level, too.

In the US, the labs do not always check for blood ketones. Depends on the labs and the tests they are doing. They do usually test for ketones if a urine sample is provided. I have found that the labs don't always indicate if there is infection present. You would hope to see it in the CBC with the WBC, neutrophils, lymphocytes, etc but low grade infections might not have triggered an immune response.

Insofar as his dose, the reason you are seeing him not hold 2.25u is you've stepped back from his testing at night and he's dropping fast. He was headed down at a pretty good clip last night when you stopped testing at +3 and so he just kept falling. Luckily, you caught it. But on 8/10, a bit more monitoring that night would have probably kept him from dropping into a reduction number. No criticisms...just observations. We don't want him earning too many Reductions too quickly. He's still really bouncy.

I know it's hard between your schedule and wanting to have a life I know you are doing them ery best you can for your boy.

Thank you, Marje... you had posted on another condo about the issues with the tuna cans, and I took note of it this morning. Your knowledge is helpful to so many... thanks for the info about the blood work. I went out last night and on 8/10, which is why I stopped testing yes, he did earn many reductions in a really short amount of time. His insulin dose has gone down a third since we moved in to our new place! I am single and 33, and I try to be social when friends want to do things so that I don't isolate myself too much, but I do often feel guilty about it when I leave for the night and find myself wanting to just stay with Samba instead and missing/worrying about him while I'm away. I knew that he'd be low when I got back last night and on the 10th and that I would have to intervene on some level. Sorry, I don't mean to be negligent... THANK YOU

 

[Marje and Gracie]

@Marje and Gracie after what u said, checked out the tuna Isle. None of the ones available were free of vegetable broth but found canned salmon (boneless skinless) was just the water and salmon so gonna see if he likes that broth for the next time I have to flush his ketones.

That's what I give my kitties for a rare treat.

 

[Sarah Mc]

Thank you, I did not know that! Also, I knew dogs couldn't have onions, didn't know cats couldn't either. Right now he is getting purely fancy feist treats but have been looking at getting him a different treat. Now I will know better what to look for.

Learning everyday!

Samba LOVES the purely Fancy Feast treats... they are the only treats that I can find that he loves. He is very meh about the freeze-dried Pure Bites, and he dislikes Orijen. Oh the things that we do for our cats

 

[Marje and Gracie]

Thank you, Marje... you had posted on another condo about the issues with the tuna cans, and I took note of it this morning. Your knowledge is helpful to so many... thanks for the info about the blood work. I went out last night and on 8/10, which is why I stopped testing yes, he did earn many reductions in a really short amount of time. His insulin dose has gone down a third since we moved in to our new place! I am single and 33, and I try to be social when friends want to do things so that I don't isolate myself too much, but I do often feel guilty about it when I leave for the night and find myself wanting to just stay with Samba instead and missing/worrying about him while I'm away. I knew that he'd be low when I got back last night and on the 10th and that I would have to intervene on some level. Sorry, I don't mean to be negligent... THANK YOU

You aren't being negligent at all. You absolutely need to have a social life!!! What I might suggest is leaving a higher carb food down for him.....maybe MC so it might help to keep him from dropping so much and you coming home to a crazy number. If the MC keeps him a bit higher than you want, it's ok.....it will wear off. Then you can enjoy being out without worrying and he won't earn those reductions so fast.

I do apologize because my intent was not for you to feel like you need to have no life. I just wanted to point out where he was dropping and earning reductions. For sanity's sake, we do have to get out and have fun esp when the CG is young and single. We just need to develop an alternative way to deal with numbers so you can have a social life.

 

[Sarah Mc]

Hi there

I'm glad you are monitoring for ketones - very important since they can quickly develop to life threatening levels.

Any underlying infection/inflammation?

Regarding emergency vets, I use the one on Catonsville-it is minutes from home. There are others that may be closer to you. Nows the time to identify one near you, in the event you need to act quickly.

Thank you... I am not aware of any infection, but lab results from yesterday have not come back yet and his first dental is scheduled on 8/23, so we shall see... I wish the closest ER to me wasn't 15 minutes away! But I did find one-thank you. Yours is 22 min away

ETA: I thanked you above for your recommendation to go to Paradise (hard to see among all the other posts). Thank you so much! We had a good first experience

 

[Barbara & Uncle (GA)]

Glad to hear Samba's ketone levels went down. You are a great mama!!!

 

[Sarah Mc]

You aren't being negligent at all. You absolutely need to have a social life!!! What I might suggest is leaving a higher carb food down for him.....maybe MC so it might help to keep him from dropping so much and you coming home to a crazy number. If the MC keeps him a bit higher than you want, it's ok.....it will wear off. Then you can enjoy being out without worrying and he won't earn those reductions so fast.

I do apologize because my intent was not for you to feel like you need to have no life. I just wanted to point out where he was dropping and earning reductions. For sanity's sake, we do have to get out and have fun esp when the CG is young and single. We just need to develop an alternative way to deal with numbers so you can have a social life.

I had thought about leaving out some MC last night but it was after +3, and I recalled that one time that I did that and he lost duration... I will do that anyway though. I have the timed feeder, so what times/how much would you recommend (say for a situation like last night)? One tsp at +4 and one tsp at +5? I've tried to avoid feeding after +3 like we talked about, so if he's reached +3 and isn't low yet but has the potential to go low, I'm generally nervous to feed and have it mess w/ his duration. Obviously I don't really understand how it all works very well 'cause it sounds like it's okay to do that You definitely don't need to apologize for anything...you didn't make me feel bad. I love this cat, and I do know that I am trying my best. Honest feedback is what's most helpful, and it sounds like I should be trying harder to flatten him out and prevent these reductions, which makes sense... some tiny part of me was hopeful that he'd just keep earning reductions all the way to the falls but I see that we are getting stuck again. Thank you for all that you have taught us, and I know that your intentions are only ever good

 

[Meridith and Zeke]

I read in one of the older posts that Trader Joe's might have cans of Tuna with just the water

Thanks, I will look into that brand. At least I found the salmon so that way I have the liquid for when he needs the extra fluids. Just finished opening a can and giving him some of the water and I think he loves it more then the tuna water. lol

Meridith, this specific info was extremely helpful, and I will be looking for tuna cans that don't have the vegetable broth... I mentioned earlier I read on another post that you can get them at Trader Joe's. I will let you know where I find them. Thank you so much

Thanks! He loves his tuna too. And it is great for encouraging him to eat when he isn't wanting to.

I just happen to have a can of Trader Joe's low salt tuna. The ingredients listed are solid white tuna, water, salt and that's it.

Where do you buy it from?

Samba LOVES the purely Fancy Feast treats... they are the only treats that I can find that he loves. He is very meh about the freeze-dried Pure Bites, and he dislikes Orijen. Oh the things that we do for our cats

I know right!

 

[Sarah Mc]

Where do you buy it from?

It is a store with locations in the US & Canada... check it out: traderjoes.com

 

[Meridith and Zeke]

Oh ok, there is also a brand of that so didn't know it was a store too lol.

 

[Meridith and Zeke]

Dang, just did a search and there is none even semi close to me. At least I found the salmon.

 

[Sarah Mc]

Dang, just did a search and there is none even semi close to me. At least I found the salmon.

Aw darn! Well if I see it anywhere else, I will definitely let you know.

 

[Meridith and Zeke]

Thanks. I checked on Amazon and it was horribly priced on there. If I ever make it to Tulsa (which only seems to be when I am going to the Airport for some reason or other lol) will check. That is the closest to me.

 

[Sarah Mc]

Regarding adding water to Samba's food, should I start doing that all the time as a good practice? Or only when I have concerns about ketones? I assume that I should just do it all the time, but if it might lead to food refusal issues, then I guess I better save it for when it's really important...

 

[Meridith and Zeke]

Regarding adding water to Samba's food, should I start doing that all the time as a good practice? Or only when I have concerns about ketones? I assume that I should just do it all the time, but if it might lead to food refusal issues, then I guess I better save it for when it's really important...

Zeke tires of it so I only do it when he really needs it and do some coaxing if have to with the tuna (now salmon) and even sometimes some parmesan sprinkles. If your guy likes it, then do a little all the time.

 

[Sarah Mc]

Zeke tires of it so I only do it when he really needs it and do some coaxing if have to with the tuna (now salmon) and even sometimes some parmesan sprinkles. If your guy likes it, then do a little all the time.

Thanks!!

 

[Kris & Teasel]

Regarding adding water to Samba's food, should I start doing that all the time as a good practice? Or only when I have concerns about ketones? I assume that I should just do it all the time, but if it might lead to food refusal issues, then I guess I better save it for when it's really important...

I add it to Teasel's all the time and he's fine with it.

 

[Yong & Maury GA]

Thank you so much! It looks like the one in Catonsville is 22 minutes away from me, and there are two slightly closer (15 min and 20 min away). Have you or @Sandy and Black Kitty had to go to the Catonsville one? Cost is definitely an issue for me, so just wondering what your thoughts were... We had our first appointment at Paradise yesterday, and I felt good about meeting Dr. Thacker. Also, the cost was 1/3 of what we were paying at VCA for blood work, $30 cheaper for the exam, and 1/2 the price to analyze his stool sample. I easily saved $250, so thank you both for that recommendation

You're welcome! Last time I had to go to that ER was like over 15 years ago with my GA boy. I'm glad you liked that clinic too

 

[Marje and Gracie]

I had thought about leaving out some MC last night but it was after +3, and I recalled that one time that I did that and he lost duration... I will do that anyway though. I have the timed feeder, so what times/how much would you recommend (say for a situation like last night)? One tsp at +4 and one tsp at +5? I've tried to avoid feeding after +3 like we talked about, so if he's reached +3 and isn't low yet but has the potential to go low, I'm generally nervous to feed and have it mess w/ his duration. Obviously I don't really understand how it all works very well 'cause it sounds like it's okay to do that You definitely don't need to apologize for anything...you didn't make me feel bad. I love this cat, and I do know that I am trying my best. Honest feedback is what's most helpful, and it sounds like I should be trying harder to flatten him out and prevent these reductions, which makes sense... some tiny part of me was hopeful that he'd just keep earning reductions all the way to the falls but I see that we are getting stuck again. Thank you for all that you have taught us, and I know that your intentions are only ever good

It’s not that you can’t feed after +3. What we discussed, as I remember (but I’ve slept since then haha) was feeding at PS, +1, +2, and +3 to control the drop but it’s totally fine to leave food out or feed the curve when necessary. We try to avoid feeding after +6 unless the BG requires it but there’s no reason why you couldn’t leave him some food if you want to go out. If it clips his duration, it’s ok....it’s one cycle here and there.

I think you’ll have to experiment on how much and when but I think +4 and +5 is a good place to start. You can try a tsp and see how he does with it. You could even try on a night when you are at home so you see how it affects him and whether he might need a little more food...or less. You are correct that trying to flatten him out to prevent a reduction is the goal. The more time he can safely spend at a dose that is work for him, the more he can (hopefully) be in healing numbers. The more time he spends in healing numbers, the better the chance his little beta cells will start to work on their own.

You are doing excellent especially considering all the balls you are juggling. It’s very evident how much you love him.

 

[Sarah Mc]

It’s not that you can’t feed after +3. What we discussed, as I remember (but I’ve slept since then haha) was feeding at PS, +1, +2, and +3 to control the drop but it’s totally fine to leave food out or feed the curve when necessary. We try to avoid feeding after +6 unless the BG requires it but there’s no reason why you couldn’t leave him some food if you want to go out. If it clips his duration, it’s ok....it’s one cycle here and there.

I think you’ll have to experiment on how much and when but I think +4 and +5 is a good place to start. You can try a tsp and see how he does with it. You could even try on a night when you are at home so you see how it affects him and whether he might need a little more food...or less. You are correct that trying to flatten him out to prevent a reduction is the goal. The more time he can safely spend at a dose that is work for him, the more he can (hopefully) be in healing numbers. The more time he spends in healing numbers, the better the chance his little beta cells will start to work on their own.

You are doing excellent especially considering all the balls you are juggling. It’s very evident how much you love him.

Makes sense... thanks for explaining that again. Sometimes it takes awhile for concepts on here to click for me sounds good. I will try that and see how it goes. Thank you, Marje!