DKA episode, clearly need to change food but have ?'s

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IttyBit

Member Since 2013
Ok we seemed to have bounced back 100% from our DKA episode this wknd but we're pending blood work results today or tomorrow on liver/kidneys. Although most recently (3-6mths at most) he's not been able to be controlled he was for over a year before that. There's been no food change. Once dx'd we went Friskies/FF/Welness 10% or less, pates, no dry & only freeze dried chicken treats. He occasionally gets people food but only meat with no spices/seasoning or additives that's been cooked. But now with this ketone episode I'm starting to wonder if he doesn't need a lil bit more carbs? Like around 15-20% instead of the tradition 10% recommended.

I ask b/c when I was gestational I had a similar problem. I could keep my numbers under control with diet alone but I was getting hardly any carbs, too much protein & had high ketones. I had to add more carb, lower protein a lil & add more insulin, it was the only way I stopped spilling ketones. I also have a thyroid problem myself that was not controlled at the time. Tightly knitted in the endocrine system I know this makes controlling diabetes near impossible. We are testing thyroid on Bitty to check that! But while he wasn't eating this wknd I gave him beef n gravy friskies, his numbers actually weren't bad (180-190 but we were also chasing down the high numbers he started with). His ketones were down to trace today so I'm guessing I need to bump up some carb a lil bit with the increased insulin. I see Janet/binky list has been updated with a new one but there's no carb % on the recommended foods, where do I find that? Also I see sophisticat on there & FF but no friskies. So should I switch to sophisticat instead of friskies? I mean I assumed by price alone friskies is a tad better quality (I know none of them are great) than sophisticat but I could be wrong. Does it sound like I'm along the right lines here? I also see some beef varieties on the new list which I know is more than 10% so it kinda all makes sense.

So questions I'm asking:
1. Sound like I need to bump up carbs a lil correct? Not just 10% or below varieties?
2. Where do I find carb counts on foods flavors?
3. Is it still ok to use friskies or should I switch to the sophisticat on the list?
4. Also I only buy the classic line in FF based on carb content but should I only buy the ones listed since they are grain/plant free or is it ok to still use some of the other classic flavors?

Thanks so much! I'll also be setting up a new doc for his numbers to share & seek advice on PZI dosage this week.
 
I'm glad your moggy is feeling better :-D

I know that protein and carbohydrate requirements work a lot different for cats than for us (like a cat can 'convert' a carbohydrate if needed), but I don't know enough to really comment on that... I'm sure someone who does will be along soon enough, however. As for calculating carbs in food, you use a calculator such as this one :smile:

EDIT: Sorry if I missed it (running on very little sleep :? ) but what meter are you using to test BG?
 
Thank you! I knew it was a lil different than us as they don't need carbs like we do, but otherwise I can't explain the sporadic numbers & all the bouncing. The more insulin I gave him the higher his numbers got so we know they were bouncing up to that high. Kinda why I wonder if thyroid is involved, off thyroid throws everything off including the body's ability to break down things & maintain proper fluid/mineral/vitamin balance as well.

I'm using the relion meter which I know can be off by 20%. But with my mountain of medical bills & a brand new baby I just can't afford the one touch strips anymore :( Wish I could!
 
IttyBit said:
Thank you! I knew it was a lil different than us as they don't need carbs like we do, but otherwise I can't explain the sporadic numbers & all the bouncing. The more insulin I gave him the higher his numbers got so we know they were bouncing up to that high. Kinda why I wonder if thyroid is involved, off thyroid throws everything off including the body's ability to break down things & maintain proper fluid/mineral/vitamin balance as well.

I'm using the relion meter which I know can be off by 20%. But with my mountain of medical bills & a brand new baby I just can't afford the one touch strips anymore :( Wish I could!
Click to expand...

The Relion is a pretty good meter, the one touch may be snazzier but you shouldn't be having any problems there. Hmm. I've just looked at your other thread and that really is baffling. Is it possible that your insulin is compromised? Kitty has had some pretty big drops that correlate with the insulin usage, so it definitely seems like the shots are doing something, but it's the closest thing to an idea I can think of...
 
1) Yes, there are some kitties who work better with a slightly higher carb level. And some who work better with almost none. You have to find what works with your cat. There is a huge food list at Cat Info, in the black column on the right of the opening page. Anything with 10% or fewer calories from carbohydrates is considered low carb. I use Friskies pates, which are about 8% calories from carbohydrates .

2) Depending on the insulin, what you might have been seeing is the result of bouncing, where the body releases compensatory hormones upon detecting either a fast drop or a large drop to an unaccustomed level. These hormones release a form of stored sugar (glycogen) and elevate the glucose level. It can take about 3 days for bounces to clear.

3) what insulin are you using? Insulins like Humulin, Novolin, and Caninsulin may not last a full 12 hours, resulting in a rapid increase in glucose level when they wear off.
 
The DKA could have been triggered by an infection, or by bouncing like BJ said.

Personally I would hold the same dose and food and try and get more tests in during the day to see how its working and to check he isn't bouncing. Reduce the dose if he is bouncing - after all he could be headed into remission or not need such a high dose as before!

Do that for a few days and let us know how the results are ( i would get pre shot tests plus a couple 5-8 hours after the shot for 3 days in a row). and then if you find in fact he isn't bouncing we can look at dose and/or food.

Wendy
 
Thanks! We use PZI insulin. I'm pretty sure he was bouncing before the DKA & that's why I reduced the dose. He would get better numbers for awhile & then creep back up again. I almost wonder if maybe he's not getting reoccurring infections that keep bringing his numbers up after so long? I mean it like he literally has good numbers for a month or so & then it's all over again chasing down the dose. He has been on antibiotics for teeth/gum infections maybe that's the issue? We do need to get his teeth cleaned. The 1st day bringing him home we got his numbers down but now they're back up again :/ This is driving me nuts! I'll get a spreadsheet posted as I'm testing every 2-3hrs right now.

Also his breath still has that nail polish remover smell, does that take awhile to go away or is it only once the DKA is cleared?
 
The nail polish smell should go away if he is not producing ketones.

Maybe add extra water to his food to help flush them.

And do urine ketone testing as needed to monitor. Anything more than a trace and he needs more intensive treatment than you can give at home.
 
A spreadsheet would really help us!

Any infection can spike blood sugar - are you planning to get the teeth cleaned? Could help a bit.

Wendy
 
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