Advice on foods and Glargine. 9 year old Sandy recovering from DKA

Liz & Sandy

Liz & Sandy

Member Since 2021
Confused about dosing. Sandy is on Glargine .25. Past couple days he’s been in green numbers and am struggling to get him above 200 with food so it’s safe to give insulin. When given previously at these numbers he has dropped below 50 few times now. He’s stayed steady in low 100’s since the afternoon, will eat small meals at a time. His BG will only numb 10-20 after meals. Then goes back to down some.
Does this mean his body is doing what it’s supposed to on it’s own?
He’s on a tiny amount of Glargine and told it’s not safe to skip any doses so I haven’t. But I’ve stalled 3 times now past few days (2 hours) to get his BG above 150 so I can give insulin. His original time of **** was 8am and 8 MPs because of the stalls I’m now on 2pm and 2am.
 
Hi Liza,
Thank you for starting the post on the Lantus forum. Here is your previous thread for continuity

https://www.felinediabetes.com/FDMB/threads/cat-recovering-from-dka.241784/

What we are trying to do is keep Sandy on some insulin while he recovers fully from the DKA he had a couple of weeks ago.
I spoke to @Wendy&Neko and @Marje and Gracie about the situation and we thought that we would try and keep Sandy on 0.25 units a bit longer. But to do that you would need to feed him some higher carb food....around 8% carbs to try and keep the BGs from dropping too far.
You also need to test the +2 to see if there is an early drop and monitor the cycles. It’s really important you do these things so that his BGs don’t drop too low.

I know he is not eating a lot. Are you still giving him some cerenia? He could still have some nausea.
Also keep giving him small frequent snacks throughout the day and night. It’s important he eats well.

You have done a great job getting him this far as I know he was very ill in hospital. And Sandy is doing well. It’s great he is needing less insulin to get into good numbers. If he was a kitty who didn’t have DKA in his history, we could reduce the dose more quickly, but we are trying to keep Sandy safe as he comes off insulin.......does that make sense?

Keep testing the ketones daily and putting the result in the SS please.

If Sandy is under 150 at preshot, stall, dont feed and post and ask for help. And test again in 20 minutes to see if he’s rising.
We will be able to lower the preshot number as you get used to shooting lower numbers.

We will have to try and get you back to a much better schedule of shooting.
Maybe @Wendy&Neko or @Marje and Gracie might have an idea of how to do that. ?? Maybe move forward instead of backwards.
Bron
 
Hi Bron,
Yes my plan is to move forward at this point with the schedule since I seem to have been stalling past few days and by his numbers today I may have to stall again tonight.
He is still on Cerenia, I have another 5 days worth but will grab more. He has lost complete interest on that food now. I scanned him and he was at 110, fed the gravy stuff he’s liking and he’s up to 157. I’m hoping it doesn’t drop too much by the time I have to give him the shot, he’s got another 5 hours to go for that so I will continue to feed him.
 
Liza Morales said:
Hi Bron,
Yes my plan is to move forward at this point with the schedule since I seem to have been stalling past few days and by his numbers today I may have to stall again tonight.
He is still on Cerenia, I have another 5 days worth but will grab more. He has lost complete interest on that food now. I scanned him and he was at 110, fed the gravy stuff he’s liking and he’s up to 157. I’m hoping it doesn’t drop too much by the time I have to give him the shot, he’s got another 5 hours to go for that so I will continue to feed him.
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He is perfectly safe surfing along in the mid blues so there is no need to feed him up to get him higher. But a good idea to keep giving him snacks of the higher low carb food we talked about ...around the 8%mark in carbs.
Make sure you don’t run out of the food!

On the Lantus page you can give the insulin if the BG is not under 150 to start with, and then gradually reduce the preshot number so you are shooting lower numbers as you gather data and see how he goes with shooting lower numbers.
Can you tell me how many hours it is now until PMPS please? I will try and make sure I am around to help you.

With the schedule, to get to a better timetable you could move forward 15 minutes each cycle. It will take a few days to get to the times you want. So tonight for example instead of shooting at +12, you would shoot at +12.25 (15 minutes later). Does that make sense?
 
Yes I’m glad his staying in those numbers just worried about him dropping like he has when the numbers have been lower. Once I see 75 I start feeding again to get the number back up and then I’m up all night again trying to keep him above 80.
He’s got another 3 hours to go. And ok yea that makes sense will push shots by 15 minutes.
He just ate some of that food but I had to crush some temptations and mix it in. Do you think that’s ok?
Any good treats you suggest that are good? he loves temptations and I don’t give it to him very often so I think that’s why he ate just now. but I don’t want to keep doing that if it’s going to do harm.
 
He’s got another hour to go for shot. Just scanned he is at 150 at the moment. He is sleeping, I tried to wake him up with food, smelled it not interested went back to sleep. Think it’s going to be another stall and sleepless night tonight again ☹️
 
Ok but his BG is heading back down? If BG continues going down and is low at time of shot do I feed then? I fed @+10 he only ate about 1 tablespoon so I won’t feed again. I’m pushing the shot 15 out like you said so he’s got another 15-20 minutes to go. I’ll recheck where he’s at
 
He is at 135, so will stall and check in 20 minutes. No food right now correct? I’m a little confused as yesterday I was feeding to get him up and then I gave shot
 
Liza Morales said:
I know I will give shot with food but should I stall after feeding at that time to see what he goes up to?
Click to expand...
No. You don’t feed for the two hours before the preshot because we don’t want the preshot BG to be food influenced.
Once you have tested and decided to shoot, you feed, then shoot the dose. Then you can feed whenever you want and need to.
So what we want you to do is test the BG at PMPS. If the BG is over 150 I think you will be Ok to shoot.
Then you feed the higher low carb food we talked about.....the 8 to 10% food that he will eat. Then you give the dose and test at +2 to see what the BG is. I would give some food at + 2. I will be watching and will then tell you how to move forward. Your job is to make sure you answer me so I can tell you :). Are you happy with that?
 
Do you think you will be able to test overnight and keep in touch?
If yes...and I understand if you are too tired to do it....then go ahead and shoot
But first give him a good meal of the higher carb food before you give the dose.
And I would test at + 1 as well as +2 as we are shooting lower than normal. And feed him a small snack at +1 and +2.

Let me know what you have decided to do. I will be waiting to hear back from you.:)
 
Bron and Sheba (GA) said:
Do you think you will be able to test overnight and keep in touch?
If yes...and I understand if you are too tired to do it....then go ahead and shoot
But first give him a good meal of the higher carb food before you give the dose.
And I would test at + 1 as well as +2 as we are shooting lower than normal. And feed him a small snack at +1 and +2.

Let me know what you have decided to do. I will be waiting to hear back from you.:)
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Ok will do that now. It’s 3 am here, and I’ve just had a coke and donut to help keep me awake . Setting my alarms regardless just in case. I may go to sleep around 5-6 am again when my husband gets up. He knows to scan and wake me up right away if numbers drop. But think I’m good for next couple of hours. Will post his numbers as I go
 
Ok. Let me know how he eats and please post the +1 and +2 on this thread and tell me how much he ate each time if you don’t mind.
That will take us up to 5 am and we will be able to see if you can safely have a sleep.
When you husband gets up, does he have to leave the house or does he work at home?
 
Bron and Sheba (GA) said:
Ok. Let me know how he eats and please post the +1 and +2 on this thread and tell me how much he ate each time if you don’t mind.
That will take us up to 5 am and we will be able to see if you can safely have a sleep.
When you husband gets up, does he have to leave the house or does he work at home?
Click to expand...
Bron and Sheba (GA) said:
Ok. Let me know how he eats and please post the +1 and +2 on this thread and tell me how much he ate each time if you don’t mind.
That will take us up to 5 am and we will be able to see if you can safely have a sleep.
When you husband gets up, does he have to leave the house or does he work
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He ate and I gave shot. He wouldn’t eat the 8% food. He had some of the Friskies chicken with gravy that’s 13 % food. Still only about 2 tablespoons, he went pee I tested for ketones and it’s negative. Will test in about 40 minutes which will be the +1 mark and will give snack.
My husband doesn’t leave until 10am which is when I’ll get up if it’s a weekday. Weekends we are both home.
 
Liza Morales said:
He ate and I gave shot. He wouldn’t eat the 8% food. He had some of the Friskies chicken with gravy that’s 13 % food. Still only about 2 tablespoons, he went pee I tested for ketones and it’s negative. Will test in about 40 minutes which will be the +1 mark and will give snack.
My husband doesn’t leave until 10am which is when I’ll get up if it’s a weekday. Weekends we are both home.
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Well done shooting. Two tablespoons is OK
Fabulous there are no ketones.
That’s great your hubby is home til 10 am! Do you work from home?

By the way, when you have time, can you put a photo of Sandy in the avatar box?
Would love to see one. I saw a photo on the Facebook page and he is gorgeous.
 
Bron and Sheba (GA) said:
Well done shooting. Two tablespoons is OK
Fabulous there are no ketones.
That’s great your hubby is home til 10 am! Do you work from home?

By the way, when you have time, can you put a photo of Sandy in the avatar box?
Would love to see one. I saw a photo on the Facebook page and he is gorgeous.
Click to expand...
I don’t work from home. I’m a construction worker and usually leave at 6am and I don’t return until about 4pm. Told my boss can’t work right now because of this and he understands, work has been up and down also with covid so it’s working out. I’m just broke after this happened with cost of care for Sandy but that’s ok I don’t mind being broke I don’t need much . Hopefully once he is more stable I can get back at it, but probably limited hours until Sandy is really doing better.
My husband is retired military but is attending school so he leaves at 10 and is back by 12:30, does that 3 days a week. We have 5 dogs and 4 cats so he walks dogs in the am before he leaves, feeds them all. When I do have work I’m back at 4pm and I’ll take over and do afternoon walks and feedings and more play time. We’re very committed animal parents . I also have a 21 yr old daughter living home that goes to college and helps out a lot when we need, she loves animals just as much as we do.
She was helping me administer fluids into Sandy and she did it like a boss. She’s in and out with work and school so I can’t have her watch Sandy constantly and is why I asked for time off. Same with husband I just told him take care of everything while I take care of Sandy and he’s doing it.
 
What a wonderful family you sound. Your boss is very understanding...that’s good.
Sandy is very lucky to have such committed parents.
I know how expensive it must have been to get that care for Sandy.
 
Thank you! My boss really is great, I’ve been there 10 years and thankfully he loves his pets as much as I do so he is very understanding. Plus when he doesn’t have work work for me when slow I don’t complain, and grateful when I do have work. He knows I wouldn’t turn work don’t unless I really need to like now. And my husband didn’t sign up for the pets but he knows I come with the package so...lol
 
Sandy’s BG is 187 @+2. Giving him a snack now.
My husband is going to take over so I can get few hours sleep. He’s going to check every hour for the next 4 hours will wake me up if he gets under 100. He will feed again in couple of hours.
 
Liza Morales said:
Sandy’s BG is 187 @+2. Giving him a snack now.
My husband is going to take over so I can get few hours sleep. He’s going to check every hour for the next 4 hours will wake me up if he gets under 100. He will feed again in couple of hours.
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Thank you for letting me know.
Is he going to update the SS or is that your job?
 
Liza, try and get some ondansetron from the vet tomorrow if you can. It might help his appetite.
Not sure if the vet has it in the US or you need to get a script from him and get it from the pharmacy.
 
What% of carbs are you feeding now Liza ? Are you still feeding the 8-10% carbs?
Was wondering because his BGs have gotten a bit higher.
Oh I’ve just read in the remarks column of the SS that you fed him some dry food. That might account for the higher numbers.
 
Bron and Sheba (GA) said:
Liza, try and get some ondansetron from the vet tomorrow if you can. It might help his appetite.
Not sure if the vet has it in the US or you need to get a script from him and get it from the pharmacy.
Click to expand...

Usually you need an RX for ondansetron and buy it from a pharmacy as it’s a human drug. Vets often give cerenia because they have it and sell it. I used to buy it at Costco or tge local pharmacies and it really helped Max.
 
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