Charlie update. Trace ketones saw yellow today! +8 283

[EllieKozak]

Hello friends. So Charlie had his GI panel done yesterday and tested trace ketones yesterday and today. Hoping the results of the GI come back quick and with some answers. He is having worse stools, still not quite diarrhea but when I say stinks.....that's the understatement of the year. Hes been on metro for 4 days now (7 doses so far of 50mg), also the forti flora and neither is helping. I don't know if its because of the amount of food he eats (6 cans daily). He gained 0.2 of an ounce, which surprised me because he feels smaller and more frail than ever. He has no muscle mass anymore either. Started pancreazyme yesterday too. He has such severe gas too and his tummy is making all kinds of gurgling sounds almost constantly. I showed his doctor the spreadsheet from over the weekend and she was somewhat satisfied with his numbers (as far as keeping him from the ER), but she said not to give the R sub q and that it should only be given IV or IM. Has anyone else heard this? On a good note, we are currently in the yellow range! Lets hope this trend continues! Oh, and I started him on 4 units of lantus today

 

[Sandy and Black Kitty]

Hi there

Been watching for an update.
Glad you increased the Lantus.

I showed his doctor the spreadsheet from over the weekend and she was somewhat satisfied with his numbers (as far as keeping him from the ER), but she said not to give the R sub q and that it should only be given IV or IM. Has anyone else heard this?

Can't say that I have. I'm curious to know why she believes R should only be given IV or IM. Did she explain? Did she provide you with some sort of strategy?

Fingers crossed for some answers to the GI mystery -He has been checked for Giardia, right? (just popped into my head)

 

[Sienne and Gabby (GA)]

In part, giving the R either IM or IV is not something that we do because of safety issues. I know R can be given in an IV line for a cat that's hospitalized but, in that case, there is pretty constant monitoring and usually there's a dextrose drip in place because the cat is in DKA and aggressive intervention is needed. The biggest difference with IM vs. sub-q is that the action is faster with an IM shot. You don't have as much control if onset and nadir come quickly. We tend to do what is safest since none of us are vets and there is a great deal of variability with regard to how much monitoring that people will do. R has the capability of being very dangerous if not used appropriately and if careful monitoring isn't possible. We have a very healthy respect for the benefits and risks inherent in it's use.

Frankly, I think you are fine to use it sub-q. The biggest difference is that it's onset takes a little longer which means you would have more time to respond if numbers start to tank.

 

[julie & punkin (ga)]

i don't want to criticize your vet, but is this the same vet that wanted to you only use 2u of Lantus and not to let his body get used to a second insulin? I've seen many cats come through this support group who had ketones, and giving it subq is what they all do. It works. I also used it subq with punkin, and there are several current posters who use R as needed, not to deal with ketones but to bring down high numbers in cats that bounce. For those of us with cats who have had high dose conditions, it can be an essential tool.

I'm glad you've increased him to 4u. He needs what he needs - and he may need even more than this. You're doing a great job of monitoring, but keep in mind that before you increase, you really want to get a couple of tests in that pm cycle. If you had that, we'd be re-evaluating every 4 cycles and looking to see if he needed to have an increase.

The goal is to get him between 68-160AT, that's the normal range of a non-diabetic cat. That's the range where his pancreas can heal and begin putting out his own insulin again, if at all possible.

Sandy's got a good idea there - has Charlie stool been checked to see what's there? punkin had c. difficile, which was really hard to get rid of. He had 40 days of antibiotics to get it under control. If he hasn't had a stool sample analysis done, that's where i would start.

 

[Deborah & Shasta]

Good job, Ellie & Charlie! YELLOW is a HUGE difference from what you were posting this weekend. Great job monitoring, too. Happy Hump Day!

 

[EllieKozak]

Thank you for the boost of confidence. I feel confused about his vet. I feel like I'm learning more about his diabetes and how to treat him here thru the great advice of you guys. I swear he would of been hospitalized last weekend without you. The sub q was/is working for him. The 4 u seems to be helping too. I don't know why she'd tell me to give it im. When he was at the end tail of the dka I understood the reasoning behind the im because his numbers were sky high but now it's just for that extra boost he needs. I feel funny gping against her advice but I'm gonna do what works for my cat. She has been excellent to me and I know she loves Charlie. Working with her daily I know he is on her mind she is constantly reading stuff about diabetics etc. Let's face it, Charlie's not your "classic diabetic". The whole GI thing is getting bad. I think he has a constant tummy ache. I just want to save my cat. Thanks again for all you do! Sent several fecals all negative :/

 

[Deborah & Shasta]

I feel confused about his vet. I feel like I'm learning more about his diabetes and how to treat him here thru the great advice of you guys.

I think many of us feel the same way...or have felt the same way at one time or another. The original vet that diagnosed Shasta's diabetes retired about a year into her diagnosis. The lady vet who took over his clinic asked me if I was a nurse or a vet tech. "Ummm....no, I'm a public high school chorus teacher." "Oh, really? You just know so much about feline diabetes. I thought, for certain, you were in the medical field." ohmygod_smile Thank heavens for FDMB! I'm really excited for the positive updates and numbers on Charlie! Sending more positive vines and healthy juju y'alls way!!!