? Alex:3/6: AMPS 187, +2 127, +4 111, +5 119

Suzanne & Darcy said:
A single layer of a gelatin capsule will completely prevent him from tasting it if you pill it into his mouth (by hand or with a piller.) But if there’s a risk he will chomp down on it, he could be foaming at the mouth. Some pill wraps are things like cream cheese, liverwurst, pill pockets of course. I don’t know if that will work. Maybe you should wait until tomorrow?
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The doctor says that’s what the doctor said… He said the bigger issue right now is the avoiding DKA
 
alexMama said:
The doctor says that’s what the doctor said… He said the bigger issue right now is the avoiding DKA
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I understand. But his ketones are still under 1. I am very worried about DKA, too, with the 500s. But he seems to be holding his own for now. I am sure that is why the vet recommended the higher insulin dose and he can see that you are monitoring him carefully. Hang in there little Alex! You are a strong cat who can recover and stabilize! Oh Maria, I am so grieved by this. I am going to say some more prayers for Alex tonight. We just need to get him through the weekend I really do believe he can be stabilized and get better!
 
i’m at the grocery store right now picking up some baby food as that was recommended… Meat only baby food by either Gerber or Beechnut… To try to get him to eat something. They say the Gerber ones have cornstarch which I can read that they do and might slightly affect his blood glucose levels. have you tried these? My local store has only the Gerber, but I’d have to drive 15 minutes away and would not get back just in time for the 7 PM shot and all of that.
 
alexMama said:
i’m at the grocery store right now picking up some baby food as that was recommended… Meat only baby food by either Gerber or Beechnut… To try to get him to eat something. They say the Gerber ones have cornstarch which I can read that they do and might slightly affect his blood glucose levels. have you tried these? My local store has only the Gerber, but I’d have to drive 15 minutes away and would not get back just in time for the 7 PM shot and all of that.
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I have used Gerber, yes. Many many times. If you look up the overall carb content of Gerber it’s very low. Get some ham if they have it. It’s a magic bullet with many cats.
 
Beech nut may be slightly lower in carbs. At this point it is very important that he eats.

Do you have Forti Flora at home to sprinkle on top of food lightly? Do you have parmesan cheese finely grated sprinkles? Do you have any of the freeze dried chicken treats like Pure Bites that can be finely ground and sprinkled on top of food lightly — that one is extremely palatable to most cats.
 
Suzanne & Darcy said:
I have used Gerber, yes. Many many times. If you look up the overall carb content of Gerber it’s very low. Get some ham if they have it. It’s a magic bullet with many cats.
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and of course, the ham one was the one that I totally did not get! I’ll run back and grab some in the morning… I got the turkey and the beef.. I was able to mix some water in it to make it a little bit smoother and syringe feed him some… his ketones are down to .7 which is good. And I just took him to his litter box and got him to pee again so that’s also good.
So the vet called me again after i sent him a video of Alex tonight walking..He talked to my husband and I for a good 20 mins.. His plan is pretty aggressive to get this diabetes under control..
2.5 tonight
3.0 Tomorrow AM
3.5 Tomorrow PM
4.0 Sunday AM if numbers aren’t going down
He said he would not usually be this aggressive with the average patient but he said most of his people don’t do the amount of monitoring I’m doing..so as long as I’m willing to closely monitor , which I am, then he wants me to check in each day with updates and follow this plan.
 
alexMama said:
Ketones down to.7 at 7pm and down to .5 at 9pm!!!! Yay!!
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How much food did you syringe?

Food is almost like medication when it comes to ketones! It's great that they're coming down....now we just need him to eat on his own!

Come on Lil' Alex! Chow down for your mama! (and Suzanne and me too)

(and don't worry about the tiny amount of cornstarch in the Gerbers....for some reason, most cats don't seem to like the Beechnut as much as they like the Gerbers anyway)
 
He is .3 Ketones at 11:15pm, BG down to 431. He is not wanting to eat, but i did get him to go pee again after giving him water in the tub which for some reason always works!!! So I’m carrying him up and down stairs to bathroom to drink from our tub, then i put him in litter box, and he pees.. but he isn’t going there on his own.. gave him more Gerber baby food with water mixed in, but had to force it..,
 
3:30am PST update :
Checked BG at 2am : 302, Ketones up to .6 from .5 earlier
Took him to litter box and he peed again.
BG at 3am: 270… yellows!! Yay!
Ketones down to .3
Fed him a sauce dish of turkey/gravy Gerber baby food via dropper and got all of it into him. He’s didnt fight me too much.
He’s still weak and back legs notably weak.
But happy to see yellows nonetheless. testing hourly to monitor up until 7am AMPS..
Sick husband, sick kitty.. No fun! 😴😴
 
alexMama said:
and of course, the ham one was the one that I totally did not get! I’ll run back and grab some in the morning… I got the turkey and the beef.. I was able to mix some water in it to make it a little bit smoother and syringe feed him some… his ketones are down to .7 which is good. And I just took him to his litter box and got him to pee again so that’s also good.
So the vet called me again after i sent him a video of Alex tonight walking..He talked to my husband and I for a good 20 mins.. His plan is pretty aggressive to get this diabetes under control..
2.5 tonight
3.0 Tomorrow AM
3.5 Tomorrow PM
4.0 Sunday AM if numbers aren’t going down
He said he would not usually be this aggressive with the average patient but he said most of his people don’t do the amount of monitoring I’m doing..so as long as I’m willing to closely monitor , which I am, then he wants me to check in each day with updates and follow this plan.
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Do you have easy access (close by) to an emergency vet 24/7?
 
5:30am update: BG 255, Ketones .4
Got him to drink more water and syringe and spoon fed a tiny bit of food as well.. Still not eating on his own. Back legs still really weak. He feels like a rag doll.. so light and flimsy.. 🥹
 
we left the prozinc out last night on accident and it’s saying online that I can still give it to him… Because it’s not super warm temperatures. He’s at 2:05 this morning so it’s still going down which is not his usual norm… We are very cautious about how much to give him and are thinking to give and likely more between one and two somewhere thoughts? him definitely not the 3.0 that the vet recommended this morning..
I think we need to be very cautious since his BG has continued to drop since 3:30am.
1-2.0 somewhere… thoughts???
 
Hooray for a yellow AMPS.
We have had members leave their insulin out of the refrigerator for that long of a time and it was still viable. If you give him his dose this morning, you should be able to see if it’s still working. Do not give the dose if you see any floating particles in the insulin, but otherwise it should be safe.
 
Is your vet open today. I am very uncomfortable with him being floppy and weak. Is he any better now that he’s in the yellow numbers? The weakness could mean he needs something we are unaware of … supplemental potassium? Anything. We don’t know and have not got any recent bloodwork on him since they opted not to do any the other night.

How is his respiratory rate this morning? Is he eating?
 
Suzanne & Darcy said:
Is your vet open today. I am very uncomfortable with him being floppy and weak. Is he any better now that he’s in the yellow numbers? The weakness could mean he needs something we are unaware of … supplemental potassium? Anything. We don’t know and have not got any recent bloodwork on him since they opted not to do any the other night.

How is his respiratory rate this morning? Is he eating?
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I have not given him his dose yet as we are waiting to see if he’s still dropping at 8 AM. I’m putting a call into the vet as well and they are there all day today. He did actually eat on his own for the first time in a couple of days this morning. He liked the chicken and gravy baby food by Gerber. He ate a good amount of it and now I just made up a little soup with water and the baby food to get some more hydration in him.
We will wait 15 more minutes to see what his blood glucose level is and then call the vet to decide what to do. We’re not used to seeing his numbers continue to drop between these hours, so are very cautious.

Respiratory rate is normal between 24 and 28 on average. He’s definitely perked up a bit.
The vet does not open until 9 AM so not able to get dosing advice until then. I don’t wanna wait that long, but not sure what to do.
 
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Try 100’s!! 165 at 2 PM today… .2 on the ketones… He’s still pretty lethargic but did get up on his own and go drink water which is great. I’ve had to prompt food and feed with syringe when Feeding him when I left the house with my son and husband in charge. This is usually his low point in the cycle so I am expecting it to go up from here but happy to see that he’s down in the 100s. I am so glad we did not Do anything more than 1.5 this morning.
 
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I just wish he would perk up more.. He has no energy.. I did get one Churru down him!! He just wants to sleep.. He’s had a rough month!!! I hope he will be his normal self soon!! No purring… sad!😔
 

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alexMama said:
I just wish he would perk up more.. He has no energy.. I did get one Churru down him!! He just wants to sleep.. He’s had a rough month!!! I hope he will be his normal self soon!! No purring… sad!😔
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Oh I am so sad about this, but I still feel optimistic that this is a rough patch he can get over. But it hurts my heart to hear and see this. Keep up the amazing work you are doing to help Alex.
 
well, dang it! Back up to 475 now an hour before shot. Ketones are still low at .4. The plan is to stick to the 1.5 dose at this point. thoughts?? He did perk up and walked around back yard with my son a little. I also gave him about 4 teaspoons full of the baby Gerber food with water soup mix.
 
Over 600, Hi on monitor!! Both at PMPs and 9:15 pm. Dang it!!!!!!!
fed him a Churru and more baby food with water mixed in.. So frustrated!!! I’m sticking with 1.5 units as it worked to drop him this AM to 165 at Nadir
His body is panicking likely at that low 165 and is flooding him with sugar. I’m battling that response with his food and hydration. This is one heck of a battle! He is definitely getting back his spunk and level of normal behavior… So that’s good, but these huge swings are so hard on his heart!!!! 🥹🥹🥹
 
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I would go to 2 units. It’s a higher dose, but it shouldn’t be too high that you can’t manage the lows that may come (meaning giving high carb IF he dropped below 50.)

Isn’t there tapioca starch in the churu? I read they are quite high carb, but it could depend upon the flavor. Chewy has some listed as “15-20 percent” carbs (which is vague.)
 
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Suzanne & Darcy said:
Regarding Churu — the Tiki Cat Stix are a better choice as they don’t contain Tapioca Starch. Here are the ingredients for the chicken one:
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ok will look for those… My info I found shows only 1-2.5 % carb content in his churru’s.
My primary concern about going to 2.0 is that we really want to avoid a crash because his heart may not be able to withstand it. As long as his ketones are staying Level which they are… Currently .6, then he is managing these higher numbers and body is not going into crisis mode other than creating more sugar. The heavy swings coming from the higher insulin doses are the Hardest on his heart.
He’s already at 468 right now, so he’s come down from 579 in last hour and I’m giving his shot now..so his body seems to be doing its job to normalize. 🙏🏻🙏🏻
 
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5pm update: Last bg was 461 at 4pm.
He is drinking water on his own, going to bathroom on his own and when i take him to box, but still not eating much on his own, even with cerenea.
He is really struggling with back left leg, but both back legs, starting to walk on his hocks now more., not able to sit up on edge of litter box like he always has..
Still having to feed him baby food soup (meat with water mixed) via dropper filled..

Hoping we are making some progress with 300 and 400’s… and hoping we will continue to go down.
 
9::30pm update: 592 and .8 ketones.
Gave plenty of water and hand fed gerber baby food with water, a whole sauce dish full… trying to drop those ketones and help insulin work!!
Gonna be a long night.
exhausted…
 
alexMama said:
5pm update: Last bg was 461 at 4pm.
He is drinking water on his own, going to bathroom on his own and when i take him to box, but still not eating much on his own, even with cerenea.
He is really struggling with back left leg, but both back legs, starting to walk on his hocks now more., not able to sit up on edge of litter box like he always has..
Still having to feed him baby food soup (meat with water mixed) via dropper filled..

Hoping we are making some progress with 300 and 400’s… and hoping we will continue to go down.
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Some of that is encouraging — other parts just hurt my heart. I know I am repeating myself, but I would encourage you to try 4 mg. Ondansetron every 8 or 12 hours.

Cardiologist today?

Edit: It’s now nearly his shot time and I am still thinking of you and Alex! I haven’t heard from you yet.
 
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Please let me know how everything is going when you can. I know it’s a super busy time. I will worry (more) if you don’t update. Hugs!!!

Edit: I just looked again at his spreadsheet. Paws crossed and prayers for Alex today.
 
Suzanne & Darcy said:
Please let me know how everything is going when you can. I know it’s a super busy time. I will worry (more) if you don’t update. Hugs!!!

Edit: I just looked again at his spreadsheet. Paws crossed and prayers for Alex today.
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got him his new insulin at 8:20am… I’m not sure that the Old insulin was bad but I’m not gonna take the chance because he’s just sticking up there in the 500-600’s..
He is alert and aware, and sitting here in the sunshine in his favorite spot to soak up as much sun as he can.
It’s been a constant battle to keep the ketones down… his body is trying hard to go DKA and I am just not allowing it, but not sure how much more time before I won’t be able to control it. I just keep taking him to get more water going to the bathroom and giving him the Gerber baby food and water mix. But he is so weak on his hind legs, especially his back left. So hard to watch.
I’m exhausted and have not had enough sleep but need to get him up to the cardiologist today by 12:45 PM so we’ll leave here at about 11:30 AM to head that direction as it’s about 45 minutes to an hour depending on traffic.
Going to be just getting as much fluid and food into him as I can up until we get there.
His respiratory rate is still normal, so we seem to be keeping the heart protected for the time being.
 
alexMama said:
got him his new insulin at 8:20am… I’m not sure that the Old insulin was bad but I’m not gonna take the chance because he’s just sticking up there in the 500-600’s..
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I understand this!

alexMama said:
He is alert and aware, and sitting here in the sunshine in his favorite spot to soak up as much sun as he can
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This is good to hear!

alexMama said:
It’s been a constant battle to keep the ketones down… his body is trying hard to go DKA and I am just not allowing it, but not sure how much more time before I won’t be able to control it.
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Well I haven’t seen a ketone reading over 1, so that’s good. Ketones alone don’t make a DKA. You should see my cat’s spreadsheet! He had very high ketones for a long time (way way higher than what you are seeing) and lived with it for a long time without ever having a DKA a second time. It was an infection that made him go into DKA to begin with. But I can tell you I was worried about it until he got down to about 1 and eventually lower than 1. His ketones started coming down after he started getting higher doses of insulin — even before his BG numbers came down. So I am glad you shot 2 units today. So getting enough insulin is key.

You are working hard to help prevent a DKA. Pushing the food is also important.
alexMama said:
His respiratory rate is still normal, so we seem to be keeping the heart protected for the time being
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This is a great sign that the Lasix is doing its job!

I cannot wait to hear how it goes at the cardiologist and hear about their plan. Will your husband and son (one or both) be able to go with you? Please drive safely. Do whatever you need to in order to stay awake. Make sure to write down questions ahead of time.
 
Have you ever started the Zobaline or another methylcobalamin supplement at a therepeutic dose for Alex’s hind leg weakness? I pray it’s only diabetic neuropathy, but there are other possibilities of course.
 
Suzanne & Darcy said:
Have you ever started the Zobaline or another methylcobalamin supplement at a therepeutic dose for Alex’s hind leg weakness? I pray it’s only diabetic neuropathy, but there are other possibilities of course.
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no, I have not started that it arrives on Weds, The Zobaline.
I’m printing out my chart and my questions so I don’t forget. I’ll be heading up alone. Unless i can get my son to go with me.
 
we are on the road to the cardiologist, but I am hearing the rough sounds in his chest again starting today… My son noticed it as well. That is very concerning when he’s at these high 600+ glucose numbers his ketones are down to .5 so the fluids and the food have been working and we did get a good bit of the Gerber baby food water soup mix in him. He is really down today and not feeling well clearly. When I sat him in the litter box to go potty, he just laid down in it… Not a good sign very worried.
 
alexMama said:
we are on the road to the cardiologist, but I am hearing the rough sounds in his chest again starting today… My son noticed it as well. That is very concerning when he’s at these high 600+ glucose numbers his ketones are down to .5 so the fluids and the food have been working and we did get a good bit of the Gerber baby food water soup mix in him. He is really down today and not feeling well clearly. When I sat him in the litter box to go potty, he just laid down in it… Not a good sign very worried.
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Oh no. I am so worried too.
 
Suzanne & Darcy said:
Oh no. I am so worried too.
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made it to the cardiologist and all testing is done… They did more bloodwork as well. I’m just waiting for the doctor to come in and chat with me now. Alex did fine on the car ride and drank some water and had a little bit of snack and peed! His ketones were .2 when I came into the appointment but he was still at 600+ for his glucose.
I’ll update you once I’ve got the report.
 
Well not the day i hoped for.. He’s in kidney failure.. his levels were all normal at the beginning of February but now with the furosemide, it has hurt his kidneys and he’s in acute kidney failure right now, along with heart failure, (HyperAtrophic cardiomyopathy?) which had to do with the strength of his heart muscle and not being able to pump well … I can’t remember the name of it now for sure, because I’m still in tears.
Really hard day
 
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