8/3 Salem PMPS 547, need advice on syringe feeding

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phedre

Member Since 2012
Update: 7PM

I measured Salem's BS and it was lower than earlier, which was a relief. I gave him his 1u of insulin, and then tried to get him to eat.

No dice.

I tried three different kinds of wet food, tuna, tuna water, and his dry food and he would not eat.

So I had to resort to assisted feeding. I managed to get him to eat about 4 tsp of food with the syringe and I have more standing by, but I'm not sure how much I should force on him. Any advice?



_________________


He's newly diagnosed, so I assume high readings are somewhat normal? He's not overly interested in eating though I am getting him to take a few treats. He's just kinda lying around right now.

He's not gulping down water, so I take that as a good sign, but he's definitely not himself. I'm going to do another test at noon to see how things are going then.

How concerned should I be? I'm so new to this and scared to death right now.

Ok. I've read some more info and this number being high shouldn't concern me too much I think. It's supposed to be similar to his pre-shot numbers, which I didn't get today, but when he was at the vet he had some higher numbers PS. I'll take another reading at lunchtime which will be 6h past his injection.

*deep breaths*

Any ideas on how to get him more interested in his food? I'm stumped right now.
 
Re: 8/3 two hours past injection, 586.8. I'm kinda freaking

You can try sprinkling some parmesean cheese or crumbled up freeze dried treats on top, or warming it in the microwave. Mixing in a bit of warm water can sometimes help too.
Carl
 
Re: 8/3 two hours past injection, 586.8. I'm kinda freaking

Hello and Welcome to LL, Phedre and Salem.

First of all, please remove the 911-Symbol from your subject line. The way to do this is to open your own thread/condo, scroll to the very top (i.e. your own first post), select "Edit" (button is at the top on the right hand side) and un-select the symbol. We react quite strongly to the 911-symbol, and in this case, you're right, you don't need to panic.

Now, let's see about your other concerns. Since you only joined a few days ago and haven't been able to collect a whole lot of data yet, we can't say much about Salem's insulin "personality" yet. From what little I saw on your SS, I suspect Salem is still very sensitive to lower BG numbers because he is not yet used to being in those (healthy) ranges, and he "bounces" up into higher BG numbers after going what, to him, is "low ranges" (so far, the blue number range, 100-199 mg/dL). This is something we see very, very often. Please breathe and try to relax, ok? While you're right in being unhappy that Salem is in those high numbers *at all*, you've only been treating him for a few days, it looks like. Give it a couple of weeks, and I'm sure we'll already start seeing some progress, alright? Remember, breeeeathe :mrgreen:

It *is* a good sign that he's not gulping down water. You say he's "just lying around." Is it normal behaviour for him to just be relaxing, napping, etc., or does he seem apathetic/listless/weak to you at all? Has he got any other symptoms that seem "off" to you, any changes in his normal behaviour (other than the appetite issue, which I'll get to)? Please be as clear as you can and list any symptoms you feel you're seeing in Salem. It will help us help you.

One question: Have you got ketosticks at home? They are test strips one dips into the cat's urine stream or urine sample to test for ketones. If you have not come across this term yet, let me know, and I'll follow up with info, or in the meantime have a loo at this link on ketones and their potential effects. I believe Salem has a DKA-history, yes? Staying HYDRATED and staying FED will help protect Salem from a relapse. Post-DKA kitties quite often have a little trouble with inappetance, so we need to be sure to stay on top of that.

About stimulating the appetite:
- Try warming the food. (I assume Salem is on wet food?)
- Try sprinkling the food with parmesan cheese if you have it.
- Try sprinkling the food with Fortiflora (a probiotic that can stimulate appetite) if you have it.
- Try another type of food.
- Sprinkle some freeze-dried treats (like Halo's Liv-A-Littles) on the food.
- Try hand-feeding.
- Offer any special-treat type foods: chicken meat (boiled/raw/cooked/fried in butter - whatever he'll take), a little canned tuna.

And also: We really, really need to have a good overview of Salem's history and current situation. Please set up your FDMB Profile so that we have all the relevant info - insulin treatment, DX (diagnosis) history, other health issues, food, etc. - in one place and don't have to ask you questions each time.

Anything else, right now?
Jane
 
Re: 8/3 two hours past injection, 586.8. I'm kinda freaking

I have some parmesan, I'll try that at lunchtime. I'm also going to try and pick up a few different cans of food, like fancy feast pate (Canada's Classic) and see if he likes that. Maybe a can of tuna to see if he'll eat that, but my cat's never been big on fish flavours (I'm allergic, so he didn't have it for many years).

Sorry for all my newbie questions. This is all so overwhelming!
 
Re: 8/3 two hours past injection, 586.8. I'm kinda freaking

Here's the link to your post from yesterday: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=76297&p=825287#p825287

What you're seeing is a bounce. Salem was in blue numbers last evening. In all likelihood, your cat isn't used to being in good numbers. As a result, his body overreacts and his liver panics, releasing a stored form of glucose along with counterregulatory hormones. These cause numbers to spike. It can take up to 72 hours for the bounce to clear.

I want to encourage you in the strongest possible way to get pre-shot tests. It's the only way you will know if giving an injection is safe. In addition, Lantus dosing is based on the lowest number in the cycle -- the nadir. For this reason, you will want to get at least one spot check during the AM and PM cycles.

I would try some different brands of food. Fancy Feast Classics (also pate style) are often a favorite. Crushing freeze dried chicken over the food can help. Some cats like parmesan cheese. If you can find bonito (or tuna) flakes, many cats like these, as well.

If Salem has pancreatitis, this is a painful condition. He may need pain medication. Many vets will prescribe buprenophine to help with the pain.

Does Salem act like he's nauseous? If so, an anti-nausea medication like ondansatron or maropitant may help. Alternatively, famotidine (Pepsid) may help if Salem has an acid stomach and that's what's effecting his eating.
 
Re: 8/3 two hours past injection, 586.8. I'm kinda freaking

phedre said:
I have some parmesan, I'll try that at lunchtime. I'm also going to try and pick up a few different cans of food, like fancy feast pate (Canada's Classic) and see if he likes that. Maybe a can of tuna to see if he'll eat that, but my cat's never been big on fish flavours (I'm allergic, so he didn't have it for many years).

Sorry for all my newbie questions. This is all so overwhelming!
Click to expand...

Great plan on getting other foods, FF pate is good, all our cats love it. Good luck with that. And remember there are those other tricks you can try, and even if all those don't work, there are meds to stimulate appetite, and lots of great minds here to help you think of what to try next.

As for being sorry - NO NEED, EVER, TO BE SORRY FOR ASKING QUESTIONS. Asking questions saves lives and educates caregivers to help take better care of their kitties. You are doing great, reaching out and asking for advice. Well done!

Anything else, right now?
May I ask what your testing plan is, i.e. how often do you and can you test?

Any progress on setting up your PROFILE?
Jane
 
Re: 8/3 two hours past injection, 586.8. I'm kinda freaking

Jane said:
Hello and Welcome to LL, Phedre and Salem.

First of all, please remove the 911-Symbol from your subject line.
Click to expand...

Done. Sorry! I'm still learning about all this!

Now, let's see about your other concerns. Since you only joined a few days ago and haven't been able to collect a whole lot of data yet, we can't say much about Salem's insulin "personality" yet. From what little I saw on your SS, I suspect Salem is still very sensitive to lower BG numbers because he is not yet used to being in those (healthy) ranges, and he "bounces" up into higher BG numbers after going what, to him, is "low ranges" (so far, the blue number range, 100-199 mg/dL). This is something we see very, very often. Please breathe and try to relax, ok? While you're right in being unhappy that Salem is in those high numbers *at all*, you've only been treating him for a few days, it looks like. Give it a couple of weeks, and I'm sure we'll already start seeing some progress, alright? Remember, breeeeathe :mrgreen:
Click to expand...

You're right. The vet mentioned this too, and told me specifically to "not turn into one of those clients where we want to take your glucometer away". She's supportive of home testing, but doesn't want me hung up on numbers. I'm guessing from what I'm reading here, they're likely to vary a lot in the first week so I'm going to try not to panic.

It *is* a good sign that he's not gulping down water. You say he's "just lying around." Is it normal behaviour for him to just be relaxing, napping, etc., or does he seem apathetic/listless/weak to you at all? Has he got any other symptoms that seem "off" to you, any changes in his normal behaviour (other than the appetite issue, which I'll get to)? Please be as clear as you can and list any symptoms you feel you're seeing in Salem. It will help us help you.
Click to expand...

He's actually up on his favourite chair now, having a snooze. That made me happy! He had some weakness in his hind legs but his jump to the chair was fine, so he's looking better. He doesn't seem as off as he did this morning, when I'm guessing his BS was higher. He's a bit perkier now! I'm guessing the insulin is kicking in.

I went and pet him and spoke to him just now, and he looked up and purred, seems alert. I'm feeling much better now.

One question: Have you got ketosticks at home? They are test strips one dips into the cat's urine stream or urine sample to test for ketones. If you have not come across this term yet, let me know, and I'll follow up with info, or in the meantime have a loo at this link on ketones and their potential effects.
Click to expand...

I do. I also have a special litter box with gravel in it for when we need to test. He had DKA up til yesterday when I brought him home. The vet told me that I had to keep an eye on it if he's not eating and is drinking too much, but that he won't go DKA from one day of not eating, so I'm not going to freak out TOO much.

About stimulating the appetite:
- Try warming the food. (I assume Salem is on wet food?)
- Try sprinkling the food with parmesan cheese if you have it.
- Try sprinkling the food with Fortiflora (a probiotic that can stimulate appetite) if you have it.
- Try another type of food.
- Sprinkle some freeze-dried treats (like Halo's Liv-A-Littles) on the food.
- Try hand-feeding.
- Offer any special-treat type foods: chicken meat (boiled/raw/cooked/fried in butter - whatever he'll take), a little canned tuna.
Click to expand...

Yes, I've put out a few varieties to tempt his tastebuds: the MD from the vet, and a can of Friskies Chef's Dinner. I'm also going to pick up a can of FF pate (classics) on the way home and see if that interests him. I did put some of his freeze dried chicken breast treats on his food, and he ate a bit of that. I've been giving freeze dried chicken breast as treats for a long time now, so that wasn't new for him.

I did try hand feeding, but that was a no go. I'll pick up some chicken and see if that or some parmesan will tempt him later. I may have a block of that in the fridge.

And also: We really, really need to have a good overview of Salem's history and current situation. Please set up your FDMB Profile so that we have all the relevant info - insulin treatment, DX (diagnosis) history, other health issues, food, etc. - in one place and don't have to ask you questions each time.
Click to expand...

I'm going to do that right now.

Anything else, right now?
Jane
Click to expand...

Got a case of Sanity handy? :-D
 
Re: 8/3 two hours past injection, 586.8. I'm kinda freaking

(((Phedre)))

You're funny
I actually ordered an extra case of sanity, since I myself was running low - when it arrives, I'll send some on to you!

Off you go to set up your Profile and read, read, read, k?

Please take to heart what Sienne reminded you of: It is VERY IMPORTANT to get pre-shot BG tests, to keep Salem safe (and to amass data). Mid-cycle tests are needed to find Salem's nadir (lowest BG of cycle, highest insulin action), so that we can give you safe and accurate dosing advice (because Lantus dosing is based on the LOWEST BG, not on pre-shots). You can start TONIGHT, by testing Salem before his eveing injection, and entering the BG into the SS as the PMPS (pm/evening pre-shot). The more BG readings you get and enetr into your SS, the better we will al be able to help - and that's waht we want most!

For the sake of LL-Maintenance: Would you please alter the thread title one more time, to read as follows: 8/3 Salem (+2) 587 - Need feedback. We like to keep to one format throughout LL, so we can get to the condos that need attention in order of urgency. First the date, then the cat's name, then the BG, and then any requests for help/advice. :mrgreen:

Jane
 
Re: 8/3 two hours past injection, 586.8. I'm kinda freaking

His profile is up.

I'll be coming home at lunchtime to do a nadir test, and will test again at 6PM.

Now to try and concentrate on work.
 
Re: 8/3 two hours past injection, 586.8. I'm kinda freaking

GREAT!! To help us out a bit more, you could add a comment to the "We Hometest" question, letting us know how frequently you will be able to test on weekdays/weekends. Lots of folks here work full-time and can't test a lot during the day. It helps to know the specific situation so we know how much we can ask you to test.
Before you go to work, please still change the thread title (see above post), k?
See you at (+6)!
Jane
 
Re: 8/3 two hours past injection, 586.8. I'm kinda freaking

hello and welcome to the group!
sienne asked me to stop by to post cheryl/winnie's list of appetite enticers:

Here are some things you can do do entice your cat to eat:

-sometimes in order to get a cat to eat you even have to resort to dry it is more important that they eat. there are a couple low carb / grain free brands -- EVO and wellness core.

-making a buffet to give him choices
- heating food

sprinkle food with :
- forta flora -- a probiotic you can get at vets or online. is very smelly and cats love the taste of it.
- parm. cheese
- smashed crumbles of dry food
- bonito tuna flakes
- halo chicken treats -- crumble into dust over food -- my Wolfie loves this stuff.
- poor a little water from tuna in water over food ( I use low sodium/no sodium added as other kinds in water has veg. broth in it and I assume that means onions, which are toxic to cats-- check labels)
-powdered oregano. yep sounds weird . but some cats like it and it will entice them to eat.

other ideas of foods to offer your kitty to stim appy:
- trader joe tuna for cats
-baby food -- beechnut turkey and broth or chicken and broth. they have no onions or other additives. some babyfoods have onions . please read labels if you can't find beechnut.
- kentucky fried chicken
- deli turkey /chicken
- plain cooked ( boiled or baked ) chicken breast
-canned chicken for people (watch the label that their are no onions)
- chicken broth -- low sodium

If enticements don't work, you should consider:
-assist feeding ( syringe or make little meatballs and place in mouth)
-and/or talking to your vet about appetite stimulents ( mirtazapine or cyproheptidine)




i'm glad you have some ketostix to check his urine for ketones. you'll want to try getting a test every day until numbers come down and salem's eating normally.

i was told salem was diagnosed with pancreatitis. here's a very good informational piece on pancreatitis written by jojo/bunny which you might find helpful:

chronic pancreatitis (or does my cat have a pepcid deficiency?)
Posted by: jojo and bunny(GA) and Y (IP Logged)
Date: December 13, 2007 10:26PM

things are going great. diabetic fluffy is nicely regulated. and then one day...just seems "off". BG numbers are higher. not eating much. maybe vomits later that night. hunched up in the 'meatloaf' position. lethargic. what is going on? you listen to the freely dispensed pepcid advice off board and after a couple of days fluffy seems to snap out of it. pepcid rocks! and recommend it to the next person on board that posts about their diabetic cat being "off".
however a few weeks/months later fluffy goes through the same episode. and again. and again. some of the episodes are worse than others. that last attack was bad and you got scared and fluffy was hauled off to vet for some basic blood work. yet nothing really abnormal on the results. is this just a normal part of being a diabetic cat? does your cat have a basic pepcid deficiency??? no.

it is estimated that AT LEAST 30% of all diabetic cats have what is known as Chronic Pancreatitis (CP). makes sense, the pancreas is the weak link with diabetics, in fact CP could be the causative factor on why fluffy became diabetic in the first place. simply put the pancreas has 2 types of basic functions the production of metabolic hormones (like the one everyone knows about, insulin) and the production of digestive enzymes. with pancreatitis it is the production of those digestive enzymes that is out of whack. when the pancreas 'misfires' and activates those digestive enzymes too early, the pancreas actually starts to digest itself and then the surrounding tissue and nearby organs, and systemic inflammation and toxin production ensues. there is a close link between CP with IBD and Cholangiohepatitis, (all three together collectively known as Triaditis).
so what now?

the best diagnostic test available is the fPLI (feline pancreatic lipase immunoreactivity ) [www.vetmed.wsu.edu] not perfect but far better than the options we had in the recent past.
it is far better to have a diagnosis (always) because then you and your vet can form a plan better than just pepcid. SQ fluids and pain management top the list. CP flare ups ARE painful...look carefully at how your cat is acting, it is not easy to tell when a cat is in pain, they hide it well. it is not just nausea that is keeping fluffy hunkered down under the chair, it is pain.

possible tools your vet might have you use:
~SQ fluids
~ pain meds
~ anti-nausea meds (hey look pepcid falls in this category)
~ antioxidants (vitamin E ~water-dispersible form preferred and vitamin C ~non-acidic Ester-C form preferred)
~ liver support (milk thistle, denosyl, or marin)
~ vit b-12 injections(especially if bowel involved)
~ pancreatic digestive enzymes (to 'predigest' food, however some controversy in vet med on whether or not to use these)
~ antibiotics if indicated
~ steroids if needed
~ appetite stimulants if needed (and if liver not involved, some of these are contraindicated with liver issues)
can all be used to help the cat through the flare up. your vet can work up a treatment plan for managing your cat's CP flare up attacks.

the veterinary community is still undecided on the issue of fat content of food and whether or not it is something to be considered in feline CP. it is very much an issue in human or canine CP, however felines are very unique in how they utilize the fats (and protein) in their diets. anecdotally, some owners find that lowering the fat content (to about 35% or less) of their CP diabetic cat's diet even though it means they have to raise the carbs helps. ECID, you would have to experiment on that yourself. just a reminder on the topic of food..as a CP flare up begins cats will eat less in the days leading up to it and often not eat at all when the attack is in full force, know that it does not take many days of reduced calorie intake to make hepatic lipadosis possibly rear its ugly head, especially in a liver already compromised.

cats that are simply diabetic with no other condition going on should not need pepcid ever...if you are reaching for the pepcid again, maybe reach for the phone and call your vet instead and discuss the possibility that your diabetic cat might be one in that 30%.



hope this helps...
 
Re: 8/3 two hours past injection, 586.8. I'm kinda freaking

No advice from me, but I wanted to welcome you to LL! Hope you have a great day!
 
Re: 8/3 Salem (+2) 587 - Need feedback

You are in AMAZING hands with this group!!!!!!!!! I'm in Ottawa also - out in Rockland. I found this group last year when Maverick was diagnosed and have met some people I consider great friends here. The lantus group is a family. I'll leave the diabetes advice to them.

I had a horrid experience with vets in Ottawa- I went through four of them before I found the perfect one. I'll PM you where we went and if you get any pushback at all from your vet you have that option. You will save a fortune also.

You have to get food into Salem. With DKA as you are finding out - you need lots of calories. Until you get Salem regulated you will probably need to assist feed him. Was he a kibble cat before diagnosis? Maverick wouldn't eat any of the wet food and needed assist feeding to convert him. He loved the Walmart Special Kitty Turkey and Giblet and the Chicken formulas. They also didn't spike his blood glucose like the fancy feast or Presidents Choice brands. Plus they are only 52 cents a can.

There is a Yahoo group dedicated to assist feeding. I would like you to join it so you can read the article they will automatically link to once you join. How to safely syringe feed your cat. You can do this with a syringe, finger feeding, feeding on a baby spoon - what ever works. But in Salem's case its critical that you start now. I can stop by and help if you feel you need it but I think you'll get the hang of it from the articles and the Yahoo Feline Assisted Feeding groups help. http://pets.groups.yahoo.com/group/Feline-Assisted-Feeding/.

When I first got the diabetes diagnosis it was horribly overwhelming. I had to fight vets on home testing, dosing etc. Maverick almost died in 2008 due to a vet advising us to put him on weight loss food without warning us about the dangers of cats losing weight. We spent $6000 saving him and he had a feeding tube for six weeks. The Yahoo FAF group saved his life. THe FDMB saved our sanity and at least a couple thousand dollars in the year Maverick was diabetic. I lost him suddenly in April of last year to what was most likely a blood clot. Not diabetes related but a bad heart.

Sending you a pm now. Trust this group. They are the diabetes experts - your vet isn't. They will be here night and day.
 
Re: 8/3 Salem (+2) 587 - Need feedback

It turns out she is already seeing the vet that I pm'd her about - she's the vet who diagnosed Salem. Totally made my day and I really needed a boost today. :mrgreen: She's in good hands with that vet, but especially FDMB.
 
Re: 8/3 Salem (+2) 587 - Need feedback

I have to say it made my day too. I had a very good feeling about this vet, and it's nice to see it supported by others here. I almost broke down in tears. I'm still SUPER emotional about all this, but I know it will get better.
 
Re: 8/3 Salem (+2) 587 - Need feedback

Hugs to you, Phedre. I so understand the emotional duress of this diagnosis, and the exceedingly steep learning curve that comes after it. We're here to listen to you and help you. If you feel like just venting, even if it's not FD-related, you can always send PMs (private messages) too, if you prefer. You're going to be okay!

Jane
 
Re: 8/3 Salem (+2) 587 - Need feedback

My Lizzie was diagnosed a little over a week ago, & while I have experience with feline diabetes from another cat, dealing with Lantus is new to me. I don't have much advice to offer, but I completely understand what you're going through. Hang in there, keep testing, & breathe! It'll be ok. As long as you're monitoring everything & giving lots of love, Salem will be fine. I can't say enough good things about this board. Where else can you go to get so much information, support, & love?!?!?!

I know it's pretty high in sodium, but if you put a couple drops of fish sauce (it doesn't take much), on the cat food, it might help. Whenever I cook with it, Lizzie goes nuts. I spilled some on my hand the other day & thought I washed it off, but she came up to me & started licking my hands. Couldn't get enough! You can find it in the Chinese food section at a grocery store.
 
Re: 8/3 Salem (+2) 587 - Need feedback

With DKA you don't really have the luxury of trying to get a cat to eat, don't delay trying assist feeding. It often just takes a couple mouthfulls of food to prime their eating engine and they will often eat more on their own. DKA as you know is a life and death crisis and you want to keep him out of that. Food is a critical component for any diabetic cat but more so for a cat recovering from DKA. Wellness Chicken 5.5oz can has 200 calories (AD is 160) and you can use this for finger feeding or assist feeding. I doubt Salem will eat this on his own. But you never know.

With DKA you want him to eat, so carbs is a lesser concern. The experts can advise here. So focus on assist feeding a high calorie food when you can't get him to eat enough on his own. Don't assist feed him food you do want him eating on his own - make that enjoyable.
 
Re: 8/3 Salem (+2) 587 - Need feedback

Also the first week is the most overwhelming. Its information overload and you've been thrown right into the fire. You aren't alone. It will get better. Hugs.
 
Re: 8/3 Salem (+2) 587 - Need feedback

Phedre!

Welcome to you and Salem :-D We're so glad to have you both with us and happy that we can be your partner in the journey to better health for Salem. Thanks for doing the profile.... \M/

You've gotten great info from these amazing ladies. Is your vet having you give Salem subq fluids at home? Often after a bout of DKA when kitty is first sent home and also if kitty has pancreatitis (which we don't know if Salem does), subq fluids will help immensely. If that is in your vets treatment plan for Salem, we can also help you with that if you need the help. If your vet didn't mention it, you might want to ask her about it. Subq fluids can *help* keep that nasty DKA at bay but the u deploying infection and the food and insulin issues also have to be addressed. If, at any time, you have any problems getting a urine sample, I have a blood ketone meter here that a member donated. It is brand new...I don't believe he even used it and I could send it to you. While the urine ketostix are the cheapest way to go, the blood ketone meter will p.ick up ketones sooner than they will show in urine. Unfortunately, the strips are expensive :evil: but..it works along the same lines as your glucometer.

JoJos info on pancreatitis is excellent but a few things have changed. For instance, the most up to date test is the specfPL and it is very reliable. Just in case you need to ask for it.

You'll find everyone here anxious to help and we are manned quite often 24/7 with our dear friend, Jane, in S. Africa to watch out while the rest of us catch up on our beauty sleep :-D

We like to say that FDMB is the best place you never wanted to be. :-D
 
Re: 8/3 Salem (+2) 587 - Need feedback

I'm on my way home right now with a variety of canned foods, some tuna, and parmesan cheese. I'm going to see if he's willing to take a few bites, and get his 6h bg at the same time. I also called his hospital and left a message for his vet.

Sorry for any typoes - I'm on my phone.
 
Re: 8/3 Salem (+2) 587 - Need feedback

Welcome to the board! You're on the right board to get the help for Salem that he needs. What you're experiencing is extremely normal when you first begin treating your kitty. You're going to experience bouncing (higher #s for a day or 2 with insulin adjustments up or down, and then food increases/decreases may also affect his #s, too). It's all perfectly normal. With regards to Salem laying around, this too is normal. He's not feeling very good right now because of the higher #s, but with your constant care, he'll soon feel more like himself.

When I first started out, Blackie would have a few #s in the 500's and at 1 point did have a # in the 600's. But then, she was on the wrong food at the time, too. She, too, would lay around, lethargic. It was hard to watch in the beginning, however, she's much better now. Don't get too discouraged. Feel free to ask away, even if they sound like repeat questions. The more you question, the more you'll understand. Refer back to the stickies at the top to help you, also. I still do, even after all this time. You WILL get there. :-D

Try adding a couple of teaspoons (or more if you wish) of water to his meals. It'll help to add more fluid to his system.
 
Re: 8/3 Salem (+2) 587 - Need feedback

Ok I'm home and have tested him again. His blood sugar is reading at 600, which is higher than when I tested him this morning. In fact the first reading just came back as "HI".

His vet called and said just try to get him to eat anything to try and stabilize him. Should I call her with his numbers?

I put a bowl of his old food and some wellness food in front of him (chicken in gravy). He did eat some of the dry, and now he's licking at the Wellness and has eaten a few bites, so that's good news. His numbers are concerning me, especially at 6+, he should be at an alltime low shouldn't he? Or is this part of the initial bouncing?
 
Re: 8/3 Salem (+6) 600 (updated) - Need feedback

Did you give him his 1u already this morning? I'm not seeing it on your spreadsheet except for the one that you gave him last night.

If you just fed him, it could be a food spike.... I hope that someone with more experience than I have will be around to help you.

Be sure to update your spread sheet as often as possible so that those experienced can help you as quickly as possible.
 
Re: 8/3 Salem (+6) 600 (updated) - Need feedback

Ok, please put that on your spreadsheet so that others can check. What was the old food that you fed him, if you don't mind my asking?

Nevermind the previous question above. I looked at your profile, and it could be the Friskies that is making him spike like that since it has carbs, and grains. I think that the Purina MD has carbs, too. Carbs will make the BG's go higher, or high. Are you beginning the transition to wet food only or waiting? Fancy Feast is a good food to give to him, and you can try all sorts of flavors for now until his #s are better. He simply needs to eat, and if need be, get a baby syringe (plastic one), add some water to a bit of wet food and feed him that way.
 
Re: 8/3 Salem (+6) 600 (updated) - Need feedback

Here is a video of Kathy and Miss Toady - teaching others how to syringe feed if you need it:

[youtube]U6o17wH6ujk[/youtube]
 
Re: 8/3 Salem (+6) 600 (updated) - Need feedback

I just heard back from my vet, and she said not to worry *phew*

So here's how the day went:

6AM: Injection
Fed him the canned MD. He didn't eat much.
8AM: test, 586
12PM: test, 600
Fed him some of his original dry food, he ate a few bites. Gave him a can of wellness chicken in gravy as an option and he also licked at the gravy and ate a few bites of that. So he has eaten some, just not a lot.

I'll continue with his 6PM dose and do a PMPS check, and feed him whatever he'll eat tonight, probably a mix of his dry and a wet canned food. He's definitely tired, but he's not wobbly or spacy, just sleeping a bit. Probably because he's feeling like crap from the high blood sugar. He's not drowning himself in water, nor is he peeing super excessively.

Here's hoping he continues to improve.
 
Re: 8/3 Salem (+6) 600 (updated) - Need feedback

Good. He will improve, and it'll take time. Of course continue with the doses, follow the protocol, and ask questions if you need to. I've done that a lot. :lol: We all have. It sounds like a bounce from the carb foods that's giving you the high #s. Carbs will do that with my cat, Blackie, too. I hope that he likes something you've purchased for him. Just keep trying, and you'll get there. You both will. :smile: It is overwhelming in the beginning, but over time this will get easier for you both, and then it'll become part of your daily routine. You're doing great. :YMHUG:
 
Re: 8/3 Salem (+6) 600 (updated) - Need feedback

I do thank you! I'm using the lists to pick my food from low carb options, though right now I'd give him straight bread if he would eat it.

He's sleepy, but purring and happy to let me poke and prod him. I'm back at work now, worried about him, but I'll make it til I get home this evening. It'll just be a few hours.

This whole ordeal is soooo overwhelming. I'm just going to focus on his testing, injections, and getting his eating back on track. I won't freak about his numbers unless they dip into hypoglycemic territory. It's his first few days on insulin, and I'm wondering if they were giving him more at the vet than I am at home (I should call and ask to compare), as 1u is quite a conservative dose.

But I'm not going to freak out (or at least I'm going to TRY not to freak out), and just go with it for now. I think I'm lucky that I have a "good bleeder" who puts out blood for his tests easily, and doesn't fuss over them or even notice his injections.
 
Re: 8/3 Salem (+6) 600 (updated) - Need feedback

You are doing very, very well, Phedre. :-D Yes, it is overwhelming, but like I said, and I'm sure that others have said it, too. It'll get easier over time. We've all been where you're at right now. I used to freak out over lower #s, and debated about shooting the regular dose or not. I got over my fear rather quickly as she needed her insulin on time. :lol: I tested, though. I used to be a testaholic. :lol: Now, not so much. Right now, the main thing is to get Salem to eat. You could also try canned chicken in water and see if he'll eat some of that. Boil, or steam some chicken (I did the latter by using a piece of aluminum foil, poke holes into it, put it over a pot, and create a "bowl" by lower the bottom part a bit, and filling the bottom of the pot with a small amount of water, about 1 - 1 1/2"). Or even try some raw chicken or turkey, or cook the turkey by boiling it or steaming it, too. Raw chicken gizzards may work. Raw or cooked, doesn't matter. As long as he eats. :smile:
 
Re: 8/3 Salem (+6) 600 (updated) - Need feedback

I'm trying to normalize all of this now.

I ended up getting out from work early (2PM) so I came home and did a mass clean and reorganization of supplies and food. All the food is now tucked into a cupboard instead of in bags all over my kitchen counter (looks like a pet shop with all the varieties I have), and all his medical supplies (minus his temporary pills) are on a shelf near where I inject him. They only need to be out for a few minutes every day, so there was no reason for me to keep my table covered in everything. It made me feel calmer, and more like this can be a part of our normal routine to not have everything littered everywhere.

He has his medical shelf now, and it should make life easier.

I did have a mini heart attack when I saw him at the water bowl, but he just drank a little bit and wandered away. I'm sure I'll stop obsessing at some point, but I doubt it'll happen for a few weeks.

I'll be taking his PMPS and giving him his 1u injection at 6PM as per instructions, along with his 4PM antioxidant and 8PM antibiotic, then trying him on some Fancy Feast pate to see if that appeals to him.
 
Re: 8/3 Salem PMPS 547, need advice.

I measured Salem's BS and it was lower than earlier, which was a relief. I gave him his 1u of insulin, and then tried to get him to eat.

No dice.

I tried three different kinds of wet food, tuna, tuna water, and his dry food and he would not eat.

So I had to resort to assisted feeding. I managed to get him to eat about 4 tsp of food with the syringe and I have more standing by, but I'm not sure how much I should force on him. Any advice?
 
I'm going to leave the quantity info to Karrie. However, you want to get 1.5 times the usual amount of calories into Salem for the time being. You don't need to feed this all at once. I'd also suggest using something like the MD. You do NOT want to assist feed a food that Salem would typically like. Some cats will develop a food aversion due to the assist feeding.

I don't want to alarm you, but lethargy is a symptom of ketones. Please, get a ketone reading as often as you possibly can. I am not concerned about Salem going to the water bowl. Fluids help to flush out the ketones.
 
I'll try to do my best on the ketone test tonight. For the food, it looks like I need to try and get the full can into him. This could be challenging. I'm going to wait for someone to weigh in as I don't want to force it all on him at once, but I will probably try feeding the rest to him at around 9 PM after his last pill for the night.

ETA: In terms of ketones, his urine was clear yesterday when I took him home from the vet.
 
Zener weighed about 11 lbs and I gave him 18 syringes per day, as I recall. Maybe it wasn't that many but it was quite a few. Those are the 10 ml syringes. I followed the guidelines in Kathy's video. I gave him Wellness Chicken since he wouldn't eat that normally, it's low carb and high calorie. I added a little bit of water when I put it through the food processor. I got about 30 syringes so that I could do a bunch at a time and kept them in the fridge. The pharmacy at Target gave me 10, I bought 10 from the vet and some were ordered online. It was scary at first and a pain, but it saved his life. Thank you to Karrie for encouraging me to do it. Hugs to you Phedre.
Liz
 
Salem's at about 13lbs, a tad overweight but I'm not worried about that. He should be around 10.

I've gotten him to finish about the equivalent of two of her syringes, so I'm going to try and give him two more tonight at 9, then another two before I go to bed. That will give him 6 total tonight, which should be a good start.

If he still refuses to eat in the morning, we'll go through it again, but I'm hoping if he gets a bit regulated on his levels, his appetite will perk up.
 
Ok, he's drinking a little water now. I'm hoping he'll go pee soon!

I just did the dumbest thing... I took a big scoop of fresh litter from the bag, dumped it in a small glass bowl, then filled it with water. I used it to test the litter to see if it would react with the strips (it didn't, yay!), then had the pleasure of trying to scoop the chunk of congealed litter out of the bowl with my hands when I was done.

Let me tell you, even knowing it was water felt disgusting.

The things we do for our cats.
 
You might need to feed him every couple of hours to get as many calories in him as you can. And I would also add a little extra water to the food so you're getting water into him if you aren't giving him subqs.
 
Welcome to Lantus Land! You're doing GREAT for being so new at this. My cat Lucy is a DKA survivor too. She was diagnosed in 2007, we landed in Lantus Land in 2008, and she has been off insulin since 2009. You can do it! I understand what you mean about having to normalize things. I'm going through that now with a different sick cat, trying to figure out how to fit the new meds into a routine. You won't believe this right now, but the diabetes really does get much, much easier. Some of us are even crazy enough to bring in a second or third diabetic cat. :shock:

About the DKA, since Salem has just come out of the hospital he is going to need some extra work and attention for a little while. You need to keep him from slipping back because he may be prone to ketones for a while. Food, water, insulin are keys to keeping the ketones at bay. As others have said, be sure you are getting enough food into him, whatever it takes to do that. Water is important too, and you can help that by diluting his food as much as he will tolerate.

Insulin - Lantus is a great insulin, but it takes a while to build up in the system and it can take a while to safely work up to a dose that will do some good. A lack of sufficient insulin can allow the ketones to creep back in (or sometimes they storm back in very quickly). How much is "sufficient?" Well, each cat is different, and even the SAME cat can be different if they have an infection going on. His numbers are pretty high today. In a non ketone prone cat there isn't usually much harm in just patiently waiting for the Lantus to start working. However, with Salem having just come out of DKA, you might want to be more aggressive in trying to get the numbers down. It's hard to do that quickly with Lantus. At the vet, they most likely used a faster acting insulin, probably Humulin R. They might have used it in conjunction with Lantus, or maybe on its own. R is fast acting and is in and out of the system usually in a few hours. Humulin R can be purchased at a pharmacy without a prescription. I'm not sure about Canadian prices, but in the U.S. it is usually less than $40 for a vial that will last pretty much forever.

While bringing down numbers quickly is a good thing, you have to be careful to not let it bring him down TOO fast or TOO far. You only want to use R in small doses and with advice from someone who is experienced in helping folks use R. You would need to test quite a bit at first while you learn his response to R. You would still be giving Lantus too. The idea is to use the R to help bring the numbers down into a range in which the longer-lasting insulin (Lantus) can help hold them down. It would probably help get his numbers out of the 500s while the Lantus has a chance to build up.

If you're interested, I can help you get started. What you would want to do is give a TINY dose (we usually start with 0.1 units, just a drop of insulin) and test at +1, +2, +3, and +4 after the first shot to see what it does. For some cats that little drop of insulin does nothing, for some cats it does everything. Once we see how 0.1 unit works, then we can decide what to do from there. I'm happy to help, just say the word.
 
Ok, another two syringes down. It went a bit easier this time! It's still messy and he got a bit on himself but overall it went in his mouth and not all over the towel and me. Progress!

I'm going to give him one more dose of two syringes before I go to bed at around 10:30. I don't want to force his stomach to take in too much right now. Ideally I'd like to see him eating tomorrow, and he does seem perkier, at least he's cleaning himself where some of the food got on his fur.

As stomach churning as this all feels, it'll be worth it if he can be eating properly soon.

I have seen him sipping water off and on, not a ton like he was before, but a bit.
 
What Sienne said - get that ketone test.

The litter story made me laugh. I have never done that LOL. With Maverick I had to turn the lid on his box around until he was sniffing around it - he really had to go. I was able to get the bottom of a styrofoam cup under him and catch a bit of urine. Once he started peeing he didn't care that I was bothering him.

I hope the vet will prescribe some of the fast acting insulin. If you educate her that you will be monitoring and have a hypo kit ready she may be more up for it. Maybe someone here can give her some info that would convince the vet to do this.

Salem needs more than he did before he was recovering from DKA. 1.5xs normal. So you will be feeding lots. I would say plan on assist feeding for a week. He will eat when he's feeling better. It will get easier. It will be worth every drop of sweat. You may want to get up and do a couple over night feedings. I had to do this for a few weeks when Maverick had his feeding tube. It was worth it and I'd do it for years if I could have him back with me.

What are you assist feeding? What does he normally eat? If its wellness chicken, I'll look up Wellness Turkey to see how it compares. This way you won't be syringe feeding the food you are depending on him eating when he gets better.

Most cats can handle 30 - 40 ccs of food every 2.5-3 hours. Maverick had a PEG tube so I could tell his stomach was empty at the 2 hour mark but I chose to assist feed through the night. I knew he'd need less food as he started getting better. He had his feeding tube for ten weeks.

BBL
 
I'm currently feeding him the Fancy Feast. I will try and do ketone tests when I see him heading to the litter box.

I'll be feeding him again tonight before bed, which will give him three assisted feedings today, plus what he ate on his own. I'll definitely be keeping an eye on him! Hopefully he'll be hungry tomorrow morning. If not, it's back on the syringes.
 
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