Chloe 19

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I'm still pushing and advocating for the meter. It is ONE step. The strips will require more work on your end and consistency.

Glad she is coming home though!

Just remember having a solid plan and following through is essential for Chloe's health. Ask the vet any questions you may have.
 
It's raining and I got lost on the way home from the hospital (no light pollution here). We finally made it home and Chloe ran straight under the bed. They put her on 2.5 units of Prozinc.
 
srk4cats said:
It's raining and I got lost on the way home from the hospital (no light pollution here). We finally made it home and Chloe ran straight under the bed. They put her on 2.5 units of Prozinc.
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PLEASE PLEASE PLEASE monitor her VERY close!
1.5 units dropped her under 100 for her next preshot on a yellow the night before.
Getting a +3 or +4 each cycle will give you an idea if she's going to drop too low. You might need to increase her food in order to continue the 2.5 units. If she won't eat enough, increase the carb level of the food.
 
I'm sure I sound like a broken record right now, but what is your plan for testing for Ketones, BG, and feeding and shooting?

You REALLY need a plan if you have intentions of keeping Chloe alive and healthy!

I prefer to write down what I need to do. I have this on top of my shoe box which is where I keep testing supplies.
example:
1. Test BG
2. Feed
3. Shoot (if necessary and while she is eating)

You should create something similar.

Then you should create another note of-- >If Ketone test is positive what should I do: And write any special instructions.
 
We’re all very worried about that large increase in dose. At least give her the safety cushion of higher carb food. Roberta, we really want the best outcome for Chloe. Did the vet give you an at-home action plan since this is her third bout of DKA? This doesn’t have to happen again ... :(
 
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Kris & Teasel said:
We’re all very worried about that high increase in dose. At least give her the safety cushion of higher carb food. Roberta, we really want the best outcome for Chloe. Did the vet give you an at-home action plan since this is her third bout of DKA? This doesn’t have to happen again ... :(
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Chloe tested at 519 this morning and I'm very concerned that she might bounce and have a hypo with such a high dose. I think I'll take off a few hours of work this morning to monitor her, but I have to be at work by noon. I also have to give her Clavamox. The vet also said to follow up in a week, so I emailed my regular vet the 2018 spreadsheet and said I'll call when they open to make an appointment for next week.
 
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I just went over her labs (this time I had the foresight to ask for them). They did curves and the glucose levels ranged from the four hundreds to 600's. She's eating well. I went ahead and gave her the 2.5 units.
 
srk4cats said:
I just went over her labs (this time I had the foresight to ask for them). They did curves and the glucose levels ranged from the four hundreds to 600's. She's eating well. I went ahead and gave her the 2.5 units.
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Please test her at +2, Roberta. If she's going to dive it could show as a big drop (100+ points) at +2.
 
She's still in sky high numbers and based on a comparison with what she did on much lower doses before this recent hospital stay, I'm concerned that she's bouncing up into the stratosphere at 2.5 u. Extra monitoring is crucial. I know you have to go to work this afternoon but I suggest you test her the minute you get in the door after work and aim for at least 2 evening tests.
 
My stress level is through the roof! I met with the principal today and am having my observation next Tuesday. The last one I had was horrible, so I have to really plan this one out well. Anyway, I too am bothered by such high numbers and I haven't seen her pee. She's eating and drinking a lot. I made an appointment with her regular vet for next Thursday. We have Thursday and Friday off for the Fiesta de los Vaqueros (rodeo). I was told not to change her dose unless I check in with the vet first. I have to go to work tomorrow from 7:30 - 3:00 and I don't usually get home until 4. I can do a half curve on Saturday, but I have to be at a workshop at 12:30 pm. I fully expect to return home one day to find her dead and am thinking about euthanasia, but trying to hold out.
 
srk4cats said:
thinking about euthanasia, but trying to hold out.
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I don't think that's necessary.

As for the dose, if she is in the 200s I would be worried giving 2.5 units. Chloe was very sick at the vet and I think she gets stress elevated BG from going there.
So, you absolutely can decide what dose to give her. She is your cat. If you feel like she will go too low, you can reduce or feed higher carb food.
I know how stressful it is to leave and not know what you'll come home to... You hold the syringe. Getting some more +2, +4, and +6 numbers will help you decide if she needs less insulin or higher carb food on the lower preshots.
 
I just want to point out I had to walk away from my laptop before responding, as I was a little upset.
I really don't even know where to begin.

Roberta, I'm sorry you are under stress at work. In my opinion if you can't take care of Chloe the way she needs and deserves then you need to find someone who can and will. It is not fair to her, but under no circumstance do you need to euthanize her. <------- That is my opinion. She just needs consistent care and this is something you can do-you just need to put in the effort.
But, I promise you is doable.

Have you purchased the Ketone testing kit? The one that tests for ketones and BG together? If you haven't seen her pee, or been able to catch it THIS is yet another reason why you need the ketone testing
 
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Sometimes I dig deep for the energy to take care of Chuck.
Making a plan and sticking to it can help. Eventually it will become normal and easier to do.
 
srk4cats said:
Easy for you to say at age 28. I don't have that kind of energy anymore.
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If only you knew. It's not easy for me--not at all. I'm tired--both emotionally and psychically. Some days I am only home for a few hours between class and work. I generally work nights and go to school during the day. I stress between homework and work. Sometimes when I'm home all I want is sleep, but I can't sleep. Gracie needs to eat, her BG checked, her litter box changed. Then I have homework and studying, and at some point I need to clean and cook. I live on my own. Nobody is there to cook for me, do my laundry, wash my dishes or pay my bills.

I understand your energy level isn't what it used to be, and I don't and would never fault you for that.

I hope Chloe continues to make positive progress.
 
Could you please give me an example of your plan? Mine is: get up, test, and feed. I think I'll stop waiting for her to finish eating before giving her the shot because that could be up to an hour. As soon as she sees the syringe, she runs to the bedroom and jumps on the bed. I give her the shot and she goes back to the kitchen to eat some more. She just gave me some urine-- outside the box in a corner of the kitchen. Negative for ketones. I'm going to have to set up a litter box there (with no litter). She pees (mostly) on an old shopping bag that's been there (who has time for housekeeping?). So, instead of covering the litter box with plastic wrap, maybe you should try plastic shopping bags. She called me and made sure I was watching. She's such a good kitty.
 
Here's is my schedule. I work full time, I'm a lot older than Teenuh ;), and I also do this all on my own:
4:30am test/feed/shoot and go back to bed - it's all done in about 10 minutes. I don't wait for him to eat, just let him take a few bites so I know he's willing to eat
6:30am get up and ready for work
7:30am out the door test and leave for work
4:30pm home from work, test/feed/shoot as soon as I walk in the door. Then if I have plans for the evening I still have plenty of time to go out and do other things.
7:30-8:30 - another test to see how he's doing.
9:00 bedtime - I'm not really in bed by this time, but I try really hard since sleep is important!

Hope that helps. Waking up early for the test/feed/shoot in the morning has really helped since it allows me to get a +3 before I leave and know that Sam is safe before I leave for the day. It took some getting used to, but it's made a huge difference in my ability to care for him well.
 
Djamila said:
Here's is my schedule. I work full time, I'm a lot older than Teenuh ;), and I also do this all on my own:
4:30am test/feed/shoot and go back to bed - it's all done in about 10 minutes. I don't wait for him to eat, just let him take a few bites so I know he's willing to eat
6:30am get up and ready for work
7:30am out the door test and leave for work
4:30pm home from work, test/feed/shoot as soon as I walk in the door. Then if I have plans for the evening I still have plenty of time to go out and do other things.
7:30-8:30 - another test to see how he's doing.
9:00 bedtime - I'm not really in bed by this time, but I try really hard since sleep is important!

Hope that helps. Waking up early for the test/feed/shoot in the morning has really helped since it allows me to get a +3 before I leave and know that Sam is safe before I leave for the day. It took some getting used to, but it's made a huge difference in my ability to care for him well.
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4:30 am is a bit early for me. I get up at 5:30 and it's still pitch black outside. Usually Chloe is yowling for food, so I do the test before I even make coffee. I only have 1-1/2 hours to get ready for work. If I can hold out to the Spring equinox, it won't be so bad, and during the summers here, you can't go outside after 7 am because it's too hot.
 
Getting a test before you leave at +1.5 can help see where she's going too. If she's already lower than her preshot you could give her an extra snack.
What time do you get home on a normal day?
Getting a test right after you get home, even if it's +10 or +11 can see if she has a big rise toward the end of the cycle or if she's surfing.
At night, getting a +3 or +4 can help you decide if she needs an extra snack or if the dose needs to be adjusted.
Setting an alarm for +6 or +7 can really help decide how she's doing on a dose.
It doesn't have to be every night. But. If she's got a yellow preshot it's a good idea to make sure you get the +3 and if that number is the same or lower than preshot- make sure you get the +6 or +7.
I've spent many nights on the couch worried about hypo or steering.
It takes some effort and you might get a little less sleep but keeping Chloe safe is worth it.
Feeding a medium carb or higher than her usual carb food can help you keep her on the 2.5 units. She needs the insulin to keep Ketones at bay so this might be the only way to keep her on a high enough dose to prevent ketones.
If the food keeps her in high numbers, it can still trigger Ketones. So finding that balance is the hard part. Once you find that balance, you can relax a bit knowing she's staying in safe numbers while getting enough insulin.
 
I still think Chloe would do better on a long acting insulin like lantus or levemir.
Maybe you can discuss this with your regular vet again.
Chuck was really bouncy on prozinc. He would bounce from yellows.
It is strict compared to prozinc protocol but I think she would benefit from it.
You like giving the same dose each cycle. Both lantus protocols do the same dose each cycle. They have clear guidelines for when you decrease and increase.
The only hurdle you'll face is testing more. But that doesn't mean a curve every day. You'll test more often in the beginning and with dose changes.
Maybe you can do this once school lets out for summer?
My vet was a little reluctant to prescribe lantus for Chuck. They don't use it at her office. But I convinced her that with my experience and guidance/research on this forum, I could use it and keep Chuck safe. Best decision I've made since he was diagnosed. Well second to deciding that he didn't need to be put to sleep like my first vet suggested. Jerk told me he only had one or two miserable and painful months left to live, even on insulin. We sure showed him he was wrong!
 
I agree with Steph that a longer acting insulin should be tried for Chloe. And as for needing to test more often, this last round of DKA has more than proven that more testing is needed regardless. Continuing with testing only at pre-shots and an occasional mid-cycle is clearly not enough to keep Chloe (or any cat) safe, so whether you continue with Prozinc or switch to Lantus, you will need to find a way to test her more and thereby be able to match her dose to her needs. Steph has outlined a good plan for getting in more tests within the constraints you've given.

So considering that you'll need to commit to testing her more going forward anyway, I really do think that talking to your vet about Lantus would be in Chloe's best interest. Aside from hopefully being better for Chloe, I think the insulin action on Lantus will suit you better as well as it's a more stable curve (less ups and downs) which might allow you feel safer leaving her when you go to work.

I'm guessing you have spring break coming up in a few weeks. If you talk to your vet about it as soon as possilbe, you could have everything ordered and in place to begin that week when you could be home to monitor her through the switch.

Here are some links to read to learn more about how to make this work:

http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/

http://www.felinediabetes.com/FDMB/...ion-possible-with-a-full-time-job-yes.129378/
 
Djamila said:
I'm guessing you have spring break coming up in a few weeks. If you talk to your vet about it as soon as possilbe, you could have everything ordered and in place to begin that week when you could be home to monitor her through the switch.
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Oh, I forgot about spring break! That's a great idea.
 
Djamila said:
Here's is my schedule. I work full time, I'm a lot older than Teenuh ;), and I also do this all on my own:
4:30am test/feed/shoot and go back to bed - it's all done in about 10 minutes. I don't wait for him to eat, just let him take a few bites so I know he's willing to eat
6:30am get up and ready for work
7:30am out the door test and leave for work
4:30pm home from work, test/feed/shoot as soon as I walk in the door. Then if I have plans for the evening I still have plenty of time to go out and do other things.
7:30-8:30 - another test to see how he's doing.
9:00 bedtime - I'm not really in bed by this time, but I try really hard since sleep is important!

Hope that helps. Waking up early for the test/feed/shoot in the morning has really helped since it allows me to get a +3 before I leave and know that Sam is safe before I leave for the day. It took some getting used to, but it's made a huge difference in my ability to care for him well.
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@Djamila, such an early riser! Her schedule is more ideal. Mine is more all over the place and varies by week.

One thing I am consistent on is testing.

Test
Eat
Shoot
If in doubt I will post on here. I would rather be over cautious.

If I happen to be home for most of the day I try to get a few extra tests in just for data reasons. My SS is not an accurate reflection of my routine right now. She is OTJ so I don't test as frequent.

You can do it.
 
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StephG said:
I still think Chloe would do better on a long acting insulin like lantus or levemir.
Maybe you can discuss this with your regular vet again.
Chuck was really bouncy on prozinc. He would bounce from yellows.
It is strict compared to prozinc protocol but I think she would benefit from it.
You like giving the same dose each cycle. Both lantus protocols do the same dose each cycle. They have clear guidelines for when you decrease and increase.
The only hurdle you'll face is testing more. But that doesn't mean a curve every day. You'll test more often in the beginning and with dose changes.
Maybe you can do this once school lets out for summer?
My vet was a little reluctant to prescribe lantus for Chuck. They don't use it at her office. But I convinced her that with my experience and guidance/research on this forum, I could use it and keep Chuck safe. Best decision I've made since he was diagnosed. Well second to deciding that he didn't need to be put to sleep like my first vet suggested. Jerk told me he only had one or two miserable and painful months left to live, even on insulin. We sure showed him he was wrong!
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WTF! Please excuse my language, but are you kidding me?!? I'm glad you didn't put Chuck to sleep! This just goes to show that we know our animals better than a person with a fancy paper on the wall. Chuck, you have yourself a good mama!
 
Yep, I left the office in tears, like really ugly crying. I tried diet change for 2 weeks. He suffered and lost more weight those 2 weeks. I called and said we are coming in today to start insulin. They still tried to talk me out of it. I left shortly after. Hindsight, I wonder if he was purposefully trying to kill my cat. Gee started him on 7 units ProZinc twice a day. That's how I ended up here. FDMB saved his life!
 
StephG said:
Yep, I left the office in tears, like really ugly crying. I tried diet change for 2 weeks. He suffered and lost more weight those 2 weeks. I called and said we are coming in today to start insulin. They still tried to talk me out of it. I left shortly after. Hindsight, I wonder if he was purposefully trying to kill my cat. Gee started him on 7 units ProZinc twice a day. That's how I ended up here. FDMB saved his life!
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How many times can I say WTF today. RIDICULOUS!!!! SOOOOO glad you found FDMB! I'm glad I found it too!!
I think I ugly cried when I got the diabetes Dx over the phone, and I'm pretty sure I ugly cried at the vet when I took her there on her first hypo. It was a little dramatic.

Do you use this same vet?
 
No, the day we started insulin was the last day he was there. We started with his new vet in Jan or Feb last year. She's super awesome. She is my side kick in this marathon. She lets me run the show and she backs me up when I need her.
 
Teenuh said:
WTF! Please excuse my language, but are you kidding me?!? I'm glad you didn't put Chuck to sleep! This just goes to show that we know our animals better than a person with a fancy paper on the wall. Chuck, you have yourself a good mama!
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My first vet who diagnosed Chloe suggested the same thing. I have 2 days off at the end of next week in addition to the weekend. Tucson has a traditional parade for the rodeo. I went to the rodeo once with my school and found it upsetting. I don't like circuses either. Basically, I don't like anything.
 
My cousins do rodeo. He rides the bulls and she barrel races her horse.
She was actually just crowned Miss Teen Rodeo Pennsylvania. She's so proud and a little of a local celebrity.
I'm not a fan of the rodeo but the barrel racing doesn't bother me. The roping competition breaks my heart. Those cows must be terrified.
Some call me a "bleeding heart liberal snowflake". Ppfft, at least I have a heart.

How's Chloe doing?
 
srk4cats said:
My first vet who diagnosed Chloe suggested the same thing. I have 2 days off at the end of next week in addition to the weekend. Tucson has a traditional parade for the rodeo. I went to the rodeo once with my school and found it upsetting. I don't like circuses either. Basically, I don't like anything.
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I don't support circus'. It's probably good I don't want actual human kids. I'd never take them to zoo's either.
 
Steph, that's awesome! You're related to royalty!!!

I didn't think there were any circuses anymore. Is that just a Seattle thing? We definitely have rodeos around here though!
 
Djamila said:
Steph, that's awesome! You're related to royalty!!!

I didn't think there were any circuses anymore. Is that just a Seattle thing? We definitely have rodeos around here though!
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We had one in Sacramento a couple years ago. I didn't see one advertised this year. Perhaps they are fading out.

We have a rodeo around here too! Never been though.
 
StephG said:
My cousins do rodeo. He rides the bulls and she barrel races her horse.
She was actually just crowned Miss Teen Rodeo Pennsylvania. She's so proud and a little of a local celebrity.
I'm not a fan of the rodeo but the barrel racing doesn't bother me. The roping competition breaks my heart. Those cows must be terrified.
Some call me a "bleeding heart liberal snowflake". Ppfft, at least I have a heart.

How's Chloe doing?
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That is right!! Can we say the same about . . . Mr. (I refuse to say his name).
Steph, you are talking to a crazy animal lover. If I had the room and money I'd own a farm full of animals. My friends have chickens and I love going to see them. I'm a little animal-crazy.
 
Uh oh, she just vomited. It's food. Maybe she was eating too fast. btw, I think a circus rolled through town here a couple months ago.
 
Very likely she jut ate to fast. Gracie does that sometimes. I would recommend giving her a little smaller portion this round--just to prevent her from doing it again. This will help her slow down too.
 
Teenuh said:
Very likely she jut ate to fast. Gracie does that sometimes. I would recommend giving her a little smaller portion this round--just to prevent her from doing it again. This will help her slow down too.
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She threw up a couple hours later, too. But her numbers look great.
 
srk4cats said:
She threw up a couple hours later, too. But her numbers look great.
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Have you tested for Ketones?
I would try to get her to eat a spoonful at a time and see if she can keep it down.
If not, you can try giving her something to settle her stomach. I use regular strength pepcid, 1/4 of a 10 mg tablet.
 
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