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Ann & Liz

Ann & Liz

Member Since 2016
We have had Lila checked and vet says to starve till tomorrow and no insulin. Reintroduce food tomorrow am and inject again from PM. Any ideas on some food that will be gentle on her gut and not be too much for her diabetes until we start insulin again. ? She seems reasonably OK considering everything. There is a trace of ketones.
 
Ann & Liz said:
We have had Lila checked and vet says to starve till tomorrow and no insulin. Reintroduce food tomorrow am and inject again from PM. Any ideas on some food that will be gentle on her gut and not be too much for her diabetes until we start insulin again. ? She seems reasonably OK considering everything. There is a trace of ketones.
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I'm not a vet but I would be very worried about withholding food and insulin from a cat that is showing trace ketones. No food + no insulin + dehydration (?) + trace ketones is a scary mix.
 
I don't know that I agree with what the vet has said about no food til tomorrow and no insulin tonight if Lila has a trace of ketones in her urine.
I will tag @Meya14 as she knows a lot about ketones and DKA.
Are you giving Lila any fluids to drink?
 
Pumpkin is good for diarrhoea. Plain canned pumpkin with nothing added or make your own by just boiling some pumpkin then mashing it and freeze in small portions nothing added to it either. Try 1/2 to a teaspoon with meals.
 
I would get a second opinion on Lila. I am most concerned that she is not to eat and not to get insulin with that trace of ketones in her urine. In the meantime I would make sure she is getting plenty of fluids to drink. Maybe try giving her some chicken broth ....no added salt.
I would also check her urine twice a day for ketones.
Ketones in the urine can develop into ketoacidosis (DKA) very quickly and can be life threatening.
 
Yes we were a bit worried about vets plan. Lila is drinking herself, but not excessively. As have no pumpkin right now does anyone know if scrambled egg would be an idea.? Will test bg very regularly and ketones too and will consider injecting as usual this pm ( in about 3 hours) then? But will of course need to feed too if we inject. Unfortunately our brilliant vet has just returned to Australia and her replacement now on holiday for a week. And it's bank holiday too! Although no blood tests at vets, she has no temperature and all signs are ok. He thought her gut felt a bit thickened but no tumours palpated at least.
 
Hi, I'm sorry I did not get back to you. I live in Australia and have just woken up.
How is Lila? Just looked at her SS and it looks like you fed her and gave her some insulin. That's good.
Scrambled egg is a good food and should have been ok for her. Plain steamed chicken and its juice would be good to give also.
Has she had any more diarrhoea?
 
Hi there! I don't really think that your vet is on point with her recommendation. I think she is assuming a simple upset stomach or something. However, ketones themselves can cause nausea and can cause cats to stop eating. The longer you let her go with no food and not enough insulin, the worse this nausea will get. It will be harder to get her back eating if you wait a day, and it's possible for ketones to go from trace to very high in that time, which could be an emergency.

Please, feed your cat anything she will eat on her own (even dry food, even nothing but treats). If she won't eat anything on her own, then you may consider starting to syringe feed. Then she definitely needs the insulin as well. You may have to be extra vigilant with testing tonight, but try to give as close to your normal dose as you can. Since caninsulin is a shorter acting insulin than lantus, it's possible that your cat is not getting good enough coverage with it or the peak is too strong and makes it hard to regulate. It's possible while you are dealing with the ketones to switch to every 8 hour dosing at lower doses which might help reduce the swings and help clear the ketones.

If you can get ketones strips and test her urine so you know where she's at, that'd be great.
 
Thank you for replies, - quick update. Yes have ketone strips tested about 12 hours ago and were negative again thankfully but will keep regular testing. Lila has not had diarrhea for approx 15 hours now. Her appetite is reduced but it us extremely hot weather here at present. Bg is high will look at giving a more normal shot depending on how she eats breakfast soon. Good idea on 8 hour reduced shots. Will post again when have more idea how she is today.
 
Update bg Hi this morning. Eating fairly well now. So have given 1.2 insulin.
 
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That swinging from very high to low numbers frequently is concerning to me. It isn't good control (risk of complicatons like DKA) and it puts your cat at more risk for severe episodes of hypoglycemia. Have you discussed other insulin options with your vet that might keep her sugars more stable?
 
Meya14 said:
That swinging from very high to low numbers frequently is concerning to me. It isn't good control (risk of complicatons like DKA) and it puts your cat at more risk for severe episodes of hypoglycemia. Have you discussed other insulin options with your vet that might keep her sugars more stable?
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We were hoping before this last issue that Lila's readings were becoming more settled with lower pre shots etc. Unfortunately the vet we have been working with has left to return to Australia and the one who is taking over is on holiday till next week. So will discuss situation when she is back. Do you think we were nearing regulation in the last few weeks possibly? We have been able to reduce the dose over the months from 1.5 so we were hoping that her own insulin was kicking in slowly? Lila is eating normally now and we shall be injecting her regular 1.2 dose. Will check ketones later.
 
The last few weeks on your SS, she was getting good numbers at the nadirs, however shooting back up at preshots. This probably leaves her at about 30% of the time in very high numbers. This is a LOT of time to spend in bad numbers, even if 70% of the day she is better. It looks like this particular insulin's action is having too short of a duration for your cat. Duration is somewhat dose dependent with lente insulins like caninsulin, however, because it's dropping the numbers quite a bit, it might not be safe to raise her dose much more than where you are at. I'd consider either trying every 8 hour dosing or move to a depot insulin like lantus or levemir.
 
Meya14 said:
The last few weeks on your SS, she was getting good numbers at the nadirs, however shooting back up at preshots. This probably leaves her at about 30% of the time in very high numbers. This is a LOT of time to spend in bad numbers, even if 70% of the day she is better. It looks like this particular insulin's action is having too short of a duration for your cat. Duration is somewhat dose dependent with lente insulins like caninsulin, however, because it's dropping the numbers quite a bit, it might not be safe to raise her dose much more than where you are at. I'd consider either trying every 8 hour dosing or move to a depot insulin like lantus or levemir.
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Thank you, the 8 hour dosing sounds like a possibility and will def mention a different insulin go the vet soon.
 
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