9/16 Toby AMS=459 Ketones? Need Help!!

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Peg and Toby

Peg and Toby

Member Since 2014
I don't know if Toby's ketones are back haven't got urine test to confirm it but his breath smells like acetone this Morning. He is eating and drinking good this morning. Will have to wait till I can get a urine sample to confirm it. Probably with the bounce and the fur shot he got to high. Got a good shot this morning gave 4.25 units. AMS are 459. Will let you know how we make out. Peg and Toby
 
Re: 9/16 Toby AMS=459 Ketones?

Don't know what to do every time Toby's bg goes low and then goes high again it knocks the crap right out of him. His legs are weak again and you can tell he's not feeling good again. This is what happened last time. When he was on the PZI his bg was
high but he never got ketones . Do you think this is the right insulin for him? He does get lower numbers for a day then goes back up. He seems to feel better when he in the high 200's and low 300's. Just don't know what to do. Just don't know how much
more I can spend in Vet. bills . It's his last day on antibiotics. It kills me to think about losing him but don't want to make him suffer. Peg and Toby
 
Hi Peg-

I'm sorry Toby is feeling crappy again. Unfortunately I don't have any ketone experience, and I have to head out the door very shortly, but I'm bumping your post up so hopefully folks with ideas about whether this is the right insulin and the ketones will see it soon. In the meantime...sending tons of hugs and prayers....
 
IT's 9.00 am just took Toby's bg and it was 354 down from 459 also got a few drops of pee. He was almost done when I caught him. I had enough to soak the stick and it said neg. Do you think just getting the last end of the urine is enough for a test?
Hoping when his bg comes down his legs will get stronger. It did this the last time his bg went so high . There is so much stress with diabetes. Never know how the day will go . Peg and Toby
 
I don't know much about ketones, but if the stick was soaked, I don't think it would matter if it was the last of it.

Looking at Toby's spreadsheet, I definitely think he is bouncing from the lower numbers. It's normal, but frustrating. His body just doesn't recognize that those lower numbers are okay. The more time he spends in lower numbers, the more his body will recognize them and not freak out. The wild swings in the BG can make them feel yucky when they go back up so high. Again, frustrating, but normal.

Come on down Toby! Nothing to see up there!!

~Suzanne
 
I'm so glad Toby's BGs are coming down and his ketone test was negative. I would imagine bouncing can make a kitty feel kind of yucky, but hopefully once his body gets used to lower numbers the bouncing will stop and he'll feel better and better.

FD is definitely stressful, but you are not alone...we're here to help you in any and all ways!
 
Re: 9/16 Toby AMS=459 +3=354+6=284

Toby's bg is going down he seems to be feeling better. His legs are stronger. When his bg was high this morning he walked
like a drunk person. Now that it has come down he's weak but walking normal. Probably due to the fur shot last night and going
lower than he was used to yesterday. I will have to learn not to panic every time something happens. Thanks for putting up with me. Peg and Toby
 
We're a family here, Peg, and we understand how you feel. Please don't feel like we're "putting up with you"...it is our pleasure to offer both moral and technical support!
 
Hi there :cool:

Glad to hear the most recent ketone test was negative however his breath smelling of acetone has me concerned. Please re-check at your earliest opportunity.
If you are not already doing so add as much water to his food as he will tolerate

I want to caution you not to make the mistake of thinking Toby is out of the woods based on one test.
I recommend testing a minimum of 2x per day for a kitty battling ketones - if you can test more often all the better. They are sneaky.
If you are having difficulty catching him at the litter box, consider getting a BG meter that also checks for ketones in the blood.
it gives you an earlier warning being that if ketones are present they can be detected in the blood sooner than the urine.
The name of the meter escapes me - I'm sure someone will come along with the details for you, if you don't already have them.

My Black Kitty went into DKA twice early on - he was one sick kitty. It took a lot of work but eventually we got the ketones behind him.
If you look at his ss from May -July 2008, you will see how quickly negative ketones can develop into large.
Below is an example of a 24 hour period beginning 06/22/2008 at PM+1:
On 06/25/2008 he was hospitalized - for the second time, just about 1 month after the first DKA episode.

You may have noticed, on BKs ss, that I was giving a second insulin - R (short for Humulin R). It's a powerful fast acting insulin with early onset and short duration.
It's a tool you should add to your arsenal. We can guide you on how to safely use it.
Fur shots happen but for a kitty battling ketones they can tip the scales in the wrong direction. A bottle of R in the fridge can help reduce the fallout from a fur shot and get a ketone prone kitty safely to the next L shot time.
You don't need a prescription (in most states) and it's not as expensive as the L although I'm not sure of the cost these days (back in our day it was about $35).
It's not fragile like L and it lasts forever. Call your pharmacy and make sure they have it on hand before you make a trip to purchase.

This is an 'intensive care" situation requiring close BG monitoring around the clock, which you are doing. Well done!
it''s also a battle - take no prisoners :cool:
We will do all we can to help you fight.
 

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Sandy and Black Kitty said:
You don't need a prescription (in most states) and it's not as expensive as the L although I'm not sure of the cost these days (back in our day it was about $35).
Click to expand...

FYI, Walmart sells a R insulin for about $35.
 
that must've been a very scary morning, peg. Amy's right - we all get it. these little furry ones are so precious -they are family. and of course you want to protect him.

Sandy suggestion of using R is a possibility. It's a faster acting insulin that is in and out in about 4 hours. We can teach you how to use it - it is in addition to the L insulin and is used to bring down the high numbers.

What do you think of doing that?
 
Toby does pretty good and then he will walk off side ways like a drunk person. His legs were fine yesterday. He did it before
we went up on his insulin . Do you think where he got the fur shot and bounced last night that it made his legs weak? He tested neg. for ketones tonight. His breath doesn't smell like acetone. He is eating, drinking , Peed just twice today. Seems to be weak in one leg more than the other. It's his back legs. I know the diabetes makes their legs weak. Got a good shot this morning and tonight . Now as I was posting he just jumped on the couch. Seems weaker some time more than others. He went
down in the yellow today even being so high last night. Maybe the bounce won't last as long this time. Do you think I need r insulin ? Peg and Toby
 
are you giving him Zobaline? That's methylated B vitamins and it can make a huge difference in leg weakness. Here's one link to it - but i don't know anything about this website, i just picked it because it had some explanations in it. Many people give it and it can reverse neuropathy. Even cats that have begun walking down on their hocks can rise back up on their toes after being on it for a while if the damage hasn't been too great.

http://www.ilifelink.com/zobaline-for_diabetic_cats-3_mg_x_60_tablets.html

The choice to use a bolus (supplemental) insulin is up to you. We don't encourage everyone because most people can get their cats under fairly good control without it. But sometimes when ketones are in the picture, or with a cat that has a high dose condition (mine and Sandy's, for example), it can be very helpful.

It looks to me like Toby is getting close to a good dose. The nadirs yesterday in the 150ish range are good. If you don't see something lower than that by tomorrow afternoon, you could increase his dose by 0.25u tomorrow night. In Toby's case, I'd go with the 6 cycles mentioned below rather than the 10 cycles, because of the ketone issue.

from the Tight Reg Protocol
Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...
 
I,ve got vitamin b 12 injections from the vet. to give once a week. Don't know if that is the same thing. His legs came right back when we went up to 4.0 units from the 1.5 when we started. Just got weak when he got the fur shot last night. He feeling better just tried to catch a fly. Glad you think we are almost at the right dose. Peg and Toby
 
vit B12 injections are great - my vet gives them to all her senior kitties. i could see punkin perk up with them.

the Zobaline is different from B-12 though. That's other vit Bs, and each does something different. They are really easy to give - i'd give them a try and i think you'll find his legs get stronger.
 
Hi there :cool:

I want to make sure you understand what I see as the best use of R for Tobys circumstances at this point in time:

Sandy and Black Kitty said:
It's a tool you should add to your arsenal. We can guide you on how to safely use it.
Fur shots happen but for a kitty battling ketones they can tip the scales in the wrong direction. A bottle of R in the fridge can help reduce the fallout from a fur shot and get a ketone prone kitty safely to the next L shot time.
Click to expand...
After the furshot last night a shot or two of R over the course of the PM cycle could have kept Toby out of the "HI" zone.

You never know when a furshot will happen - I've given plenty - even back to back :roll:
For a kitty that is not flirting with ketones a furshots impact is usually sorted out in the next couple cycles I'd say don't worry, it's just one shot, he'll get back on track.

However Toby is flirting with ketones and a fushot could put him at risk.

If you can manage the cost, it's well worth it just for your peace of mind
Think of it as insurance - you may never use it but it's a good thing to have - just in case.
A $35 investment just may save you a (potential $2k) visit to the ER. (I've been there - twice)
 
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