? Dosing Advice Prozinc 1

Was bear diagnosed with full blown DKA? If so and you can manage it financially AND your vet clinic can handle treatment having him in hospital is probably best. DKA has to be treated aggressively with fast acting insulin to pull down BG, fluids to keep electrolytes balanced (potassium supplementation is often neeed) and constant monitoring of a variety of signs. He HAS TO eat. He needs whatever meds keep nausea at bay and increase his appetite. This can mean 3+ days in hospital and he’d still need a lot of attention at home afterward.
 
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Lora, I apologize if my post above seemed too curt or clinical. I wanted to get the info out before doing the morning routine with my three. :) My experience with Teasel's two bouts of DKA tells me that it's best done in a veterinary intensive care setting with 24 hour care. My clinic has a 24/7 ER ICU in it with vets on duty around the clock. Teasel was very ill and it was actually a relief for me to know he was getting the kind of care I couldn't manage at home. I visited him every day though. You already have your hands full so I'd recommend leaving Bear in hospital IF your clinic/vet/staff has experience treating DKA. Bear will likely need more than just Cerenia and fluids to get him over the hump. Yes, the stress of a hospital stay will affect BG but they should be using R insulin (fast acting) at the start to get BG down ASAP. The switch to his regular insulin would be done over time if he proves to be able to eat on his own, his electrolyte profile stabilizes, ketones disappear and he can stay well hydrated. They should do a trial off IV before he comes home to see if he keeps up his hydration level on his own.

Re Cerenia: it's a great med for nausea and vomiting but might not be the best for nausea alone or in all circumstances. I learned about using ondansetron (brand name Zofran) here on FDMB. When I asked about it for Teasel the vet said they used to use it but Cerenia was now the drug of choice. I asked for a prescription of ondansetron to try and they gave it to me. FDMB members have even used Cerenia WITH ondansetron for a kitty's bad nausea because they target different brain receptors. I gave Teasel ondansetron for several days after he came home. I filled the prescription at my human pharmacy (even the generic is $$$ here in Canada).

Re appetite stimulant: mirtazapine is often used but can make many kitties act strange - agitation, yowling, etc. Cyproheptadine is a human antihistamine that can work well but needs more frequent dosing. I asked for that too when Teasel was ill because mirtazapine didn't seem to help when I gave it just before his hospitalization. I used cypro too after he came home.

When Teasel came home I gave antinausea meds and appetite meds for several days, gradually weaning of the appy med as he ate better on his own. I kept up the antinausea med a bit longer. I gave sub Q fluids here at home three times but stopped because he was eating all of his soupy wet food meals. It took weeks for him to feel back to his version of normal.
 
Here's a compilation of DKA advice I pulled from various FDMB posts that helped me once Teasel was home. I think much or most of it came from @Meya14 who rarely posts anymore but is very knowledgeable about DKA. This might be helpful to you:
 

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@MrWorfMen's Mom @Kris & Teasel @Djamila @Rachel

So first let me tell everyone Bear has improved some. He is taking more steps before he lays down. His tail is more swishy, and irritated is way better than I don't care about anything. He is also lapping the gravy from FF and he ate some baby food on his own. Bear has always loved ham. :)

Last night just got to me too much. There are so many questions I might have to go back and address them in different posts. Here's to the questions I remember. The Vet didn't say Bear has Ketoacisdosis, his papers from the Hospital say Differential Diagnosis: Ketoacidosis. Does that men he has it or not? Differential is a form of the word different?

No I haven't checked his ketone levels again, I will make it a priority do do that asap.

Funds are limited for us. I had to quit my job once my mother starting leaving the stove on, the front door wide open, forgetting to eat, sticking a steel knife in the toaster to fish out the bread etc.

I am a bit recharged this morning but after last night I know I will have to make it a priority to catch some more sleep when I can, 4hrs max and less the last 4 days is making me wonky.
 
So Bear's BG of 330 this morning is food influenced. He lapped that baby food and gravy from a plate I left down between 9AM &10AM I tested him at 10:50. I gave him 2 syringes of Baby food and shot at 11:05.
 
Bear & Lora said:
@MrWorfMen's Mom @Kris & Teasel @Djamila @Rachel

So first let me tell everyone Bear has improved some. He is taking more steps before he lays down. His tail is more swishy, and irritated is way better than I don't care about anything. He is also lapping the gravy from FF and he ate some baby food on his own. Bear has always loved ham. :)

Last night just got to me too much. There are so many questions I might have to go back and address them in different posts. Here's to the questions I remember. The Vet didn't say Bear has Ketoacisdosis, his papers from the Hospital say Differential Diagnosis: Ketoacidosis. Does that men he has it or not? Differential is a form of the word different?

No I haven't checked his ketone levels again, I will make it a priority do do that asap.

Funds are limited for us. I had to quit my job once my mother starting leaving the stove on, the front door wide open, forgetting to eat, sticking a steel knife in the toaster to fish out the bread etc.

I am a bit recharged this morning but after last night I know I will have to make it a priority to catch some more sleep when I can, 4hrs max and less the last 4 days is making me wonky.
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I have all Bear's lab work but I have to say it is mostly Greek to Me. Most all of it is initials, spelling some of the words out sure would make things easier. My son asked me to take a pic of them and send, he looks at labs all day. He later said Bear's Kidneys are great and his liver too. The only issues Bear had when the Vet went over them with me were; ketones, stress induced BG, and slight elevation in white blood cells.
 
Glad to hear Bear is a little more active and eating some on his own. That is definitely encouraging. An elevated WBC could indicate an infection. If you could plot in the lab values on the LAB worksheet in Bear's spreadsheet, then we can compare his Aug tests to his current. I'm still wondering if he could have a urinary track infection...they are really common in unregulated diabetics.

Differential diagnosis is medical lingo for suspected diagnosis and sometimes there is one possibility and sometimes more.
Keep offering Bear any food he will eat and make sure he stays well hydrated. Grabbing his scruff and then letting go to see if it settles immediately or takes a moment is one indicator. You can also check his gums to see if they are sticky. If he needs more fluids, you can syringe some being careful to do so slowly so he doesn't aspirate the fluid and of course you can also do the SubQ fluids as per vets instructions.

If Bear continues to take more food in today, then I wonder if his insulin should be increased back up to 2u tonight. Lets see what this cycle looks like and I am setting an alarm to come check on you at shot time tonight. Can you check Bear at +4 today? It will just help to fill in some data on the Spreadsheet.
 
Hey Lora, Just saw that 60. Bear is still safe but need to keep his BG up. Try feeding him some baby food with a bit of honey or karo to up the carbs in it if he won't eat on his own. Kibble is also fine. Just need to keep him surfing and not dropping more.
 
MrWorfMen's Mom said:
Glad to hear Bear is a little more active and eating some on his own. That is definitely encouraging. An elevated WBC could indicate an infection. If you could plot in the lab values on the LAB worksheet in Bear's spreadsheet, then we can compare his Aug tests to his current. I'm still wondering if he could have a urinary track infection...they are really common in unregulated diabetics.

Differential diagnosis is medical lingo for suspected diagnosis and sometimes there is one possibility and sometimes more.
Keep offering Bear any food he will eat and make sure he stays well hydrated. Grabbing his scruff and then letting go to see if it settles immediately or takes a moment is one indicator. You can also check his gums to see if they are sticky. If he needs more fluids, you can syringe some being careful to do so slowly so he doesn't aspirate the fluid and of course you can also do the SubQ fluids as per vets instructions.

If Bear continues to take more food in today, then I wonder if his insulin should be increased back up to 2u tonight. Lets see what this cycle looks like and I am setting an alarm to come check on you at shot time tonight. Can you check Bear at +4 today? It will just help to fill in some data on the Spreadsheet.
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I need an estimate on his calories. I know he isn't getting enough at this point. I decided to syringe feed him more balanced food (Pate's) versus empty calories (Gravys). His +2 was 60. I knew that baby food wasn't high enough in calories but hadn't realized the Pate food would work in the syringe. If I could get his calories up with some nutrition meant for a cat I think we could up his insulin. Really, really good news is his Ketones have went down to moderate #40 (Relion Ketone Test). My hopes have risen!

I will need some advise on calories, plus balancing the insulin with his needed food load.

You know I have felt so helpless watching his appetite come and go since I started monitoring his BG. I would much rather have Bear eat on his own but until he does and (he allows me to syringe feed him), I feel much better knowing he can get what he needs and not make this situation worse (more ketones).

As far as the Lab work put on his SS. I was trying to do that yesterday but am too unfamiliar with the medical terminology (Initials). I put some on there of Aug 14th. I can take a pic or scan them to my computer and post it on this thread or send it to someone who knows what's what and can enter his labs. I have no problem with giving my User & Pass.
 
MrWorfMen's Mom said:
Glad to hear Bear is a little more active and eating some on his own. That is definitely encouraging. An elevated WBC could indicate an infection. If you could plot in the lab values on the LAB worksheet in Bear's spreadsheet, then we can compare his Aug tests to his current. I'm still wondering if he could have a urinary track infection...they are really common in unregulated diabetics.

Differential diagnosis is medical lingo for suspected diagnosis and sometimes there is one possibility and sometimes more.
Keep offering Bear any food he will eat and make sure he stays well hydrated. Grabbing his scruff and then letting go to see if it settles immediately or takes a moment is one indicator. You can also check his gums to see if they are sticky. If he needs more fluids, you can syringe some being careful to do so slowly so he doesn't aspirate the fluid and of course you can also do the SubQ fluids as per vets instructions.

If Bear continues to take more food in today, then I wonder if his insulin should be increased back up to 2u tonight. Lets see what this cycle looks like and I am setting an alarm to come check on you at shot time tonight. Can you check Bear at +4 today? It will just help to fill in some data on the Spreadsheet.
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Oh and by the way I did syringe fed Bear 0.5oz after his 60BG and I will test at +4.
 
MrWorfMen's Mom said:
Hey Lora, Just saw that 60. Bear is still safe but need to keep his BG up. Try feeding him some baby food with a bit of honey or karo to up the carbs in it if he won't eat on his own. Kibble is also fine. Just need to keep him surfing and not dropping more.
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Thank you Linda, I appreciate you with all my heart! I don't know how to send hugs on here but I would send you some. :)
 
With that 60 @ +2 I'd test again 20 minutes after the feeding just to make sure he's staying up or rising a bit. Don't wait till +4.

Yeah for the ketones being down but we want them down to trace or none. Progress but still a little ways to go.

As for calories, I'd aim to get a minimum of 200 calories into him everyday and hopefully 250 or even a bit more. There is some special cat food you can get from the vet that is high cal, and easily watered down for syringing. Might be something to consider. Or get some kitten foods which are usually higher calorie.

If you post the labs we can have a peak.
 
MrWorfMen's Mom said:
With that 60 @ +2 I'd test again 20 minutes after the feeding just to make sure he's staying up or rising a bit. Don't wait till +4.

Yeah for the ketones being down but we want them down to trace or none. Progress but still a little ways to go.

As for calories, I'd aim to get a minimum of 200 calories into him everyday and hopefully 250 a bit more. There is some special cat food you can get from the vet that is high cal, and easily watered down for syringing. Might be something to consider. Or get some kitten foods which are usually higher calorie.

If you post the labs we can have a peak.
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Ok, going to test now.
 
MrWorfMen's Mom said:
With that 60 @ +2 I'd test again 20 minutes after the feeding just to make sure he's staying up or rising a bit. Don't wait till +4.

Yeah for the ketones being down but we want them down to trace or none. Progress but still a little ways to go.

As for calories, I'd aim to get a minimum of 200 calories into him everyday and hopefully 250 or even a bit more. There is some special cat food you can get from the vet that is high cal, and easily watered down for syringing. Might be something to consider. Or get some kitten foods which are usually higher calorie.

If you post the labs we can have a peak.
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Bear 244 BG
 
Ok then! Now you can wait a bit. Just want to confirm...did you add any honey or karo into the food cause that will boost BG but it also won't last that long.
This is the food I was mentioning for syringe feeding and higher calories.

cn_can_dog_cat.png
 
Oh good. But, the next time you get a considerably lower number like that, it would be a good idea to retest immediately to ensure it wasn't just a bad strip. Could have been right but also could have been a fluke. It happens. And with Bear being a little unpredictable right now, better to double check so we are sure the data is solid. :bighug:
 
MrWorfMen's Mom said:
Oh good. But, the next time you get a considerably lower number like that, it would be a good idea to retest immediately to ensure it wasn't just a bad strip. Could have been right but also could have been a fluke. It happens. And with Bear being a little unpredictable right now, better to double check so we are sure the data is solid. :bighug:
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Ok, I will absolutely retest to make sure it isn't a screw up. :)

I'm going to try to load Bear's lab records.
 
On quick glance, nothing sticks out except for the tests that can suggest infection of some sort. Noticed vet made mention of possible pancreatitis but I don't see any testing for it. There is a snap test they can quickly do in the vet's office but all vets don't necessarily have it although I'd expect the ER would. On the other hand, with no signs of abdominal tenderness etc. she probably took that off the list of possibilities.

I think the "ua" under "Treatment/Diagnostics" stands for urinalysis but I don't see those results. Is there another page? If you want me to plug in the lab numbers on your spreadsheet I can do it for you. Let me know and I'll send you my email via PM. You don't have to give me your password. You just give me permission to edit. Once the numbers are plugged in, then you take my permission back off.
 
Pearl 9-30-18 (3).jpg
Pearl 9-30-18 (3).jpg

MrWorfMen's Mom said:
On quick glance, nothing sticks out except for the tests that can suggest infection of some sort. Noticed vet made mention of possible pancreatitis but I don't see any testing for it. There is a snap test they can quickly do in the vet's office but all vets don't necessarily have it although I'd expect the ER would. On the other hand, with no signs of abdominal tenderness etc. she probably took that off the list of possibilities.

I think the "ua" under "Treatment/Diagnostics" stands for urinalysis but I don't see those results. Is there another page? If you want me to plug in the lab numbers on your spreadsheet I can do it for you. Let me know and I'll send you my email via PM. You don't have to give me your password. You just give me permission to edit. Once the numbers are plugged in, then you take my permission back off.
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The Vet pointed out a figure on the lab results and said it ruled out Pancreatitis.

Yes, I would appreciate & love your help putting the labs on.
 
Usually with active pancreatitis, the amylase and lipase would be elevated so she must have used that make that judgement call. His values look fine. I'll send you a PM.
 
@MrWorfMen's Mom

So on the days Bear was eating well, he was up to 5oz of canned food, pate & flaked, mostly fish because when at the store I was looking for a variety to feed him. They only had in the lower carb (no sauceor gravy) Turkey & giblets the rest were fish. I will try to get some of that Purina Critical Nutrition tomorrow so Bear's calories can be upped (I won't have to syringe 5oz daily) that will be easier on Bear for sure. He was also eating with that 5 oz of wet around 12 Freeze Dried Chicken.

Today we are only up to 1.5 ounces syringe fed.
 
He really needs more calories in whether you have to syringe feed or he's eating on his own. The Critical nutrition is easily made into a slurry for use with a syringe if need be. This is why nursing a cat with DKA is so intense. It requires a lot of time and effort to make sure they are taking in enough calories and staying hydrated. If he's still not eating or interested at all, he likely needs more than just the Cerenia.
 
MrWorfMen's Mom said:
He really needs more calories in whether you have to syringe feed or he's eating on his own. The Critical nutrition is easily made into a slurry for use with a syringe if need be. This is why nursing a cat with DKA is so intense. It requires a lot of time and effort to make sure they are taking in enough calories and staying hydrated. If he's still not eating or interested at all, he likely needs more than just the Cerenia.
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Yep, you are right on all accounts. I will call and leave a message in the morning to the Vet. Bear needs something else....
 
Just tested Bear's ketones. He is in the small range #15. YES! He seems to be on the rebound. I'm so glad those da** things are leaving his body.
 
Labs are all posted and I marked anything elevated in red for easy viewing. It appears your lab is using some different scales to what was put on the template so I changed those for the values that were tested.
 
Saw the 269 and dosing of 1.5u. Good decision! Wondering if you want to try to back Bear's shot time up a bit again or is the later time working better with your Mom's other caregivers? Just thinking that you could, pre-shot allowing of course, shoot a half or even an hour earlier tomorrow morning if you want to get back to your previous shot time. Unless you have any questions/concerns, I'm gonna sign off soon and head for LALALA land soon!
 
MrWorfMen's Mom said:
Saw the 269 and dosing of 1.5u. Good decision! Wondering if you want to try to back Bear's shot time up a bit again or is the later time working better with your Mom's other caregivers? Just thinking that you could, pre-shot allowing of course, shoot a half or even an hour earlier tomorrow morning if you want to get back to your previous shot time. Unless you have any questions/concerns, I'm gonna sign off soon and head for LALALA land soon!
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Yes, I need to work it back eventually to 9AM, so an hour earlier tomorrow at 10AM would be good. I would like to be able to test Bear at night without losing most of my sleep time. :)
 
I always preferred doing dose increases or shooting earlier to get back on schedule in the mornings so if there was any extra monitoring needed, it happened on a day cycle. Looks like you managed to get considerably more food into Bear today. That is great and is probably helping keep those ketones down. I hope you get some sleep tonight.
 
Hi Lora! I'm so glad to hear that Bear's ketones are reducing! You're doing a great job of nursing him, and Linda has made some great suggestions about food and labs and all. @MrWorfMen's Mom, I was skimming a bit since I wasn't on at all yesterday and am trying to get caught up. Are you thinking the 60 was maybe an error? I saw your suggestion to increase the dose and I'm inclined to agree, but that 60 worries me a bit since we aren't sure if it was an error or lack of food, or a "real" 60. Maybe wait through this morning's cycle and see what shows up?
 
@Djamila I was nothing short of shocked with that 60 and agree it could have been lack of food, a wonky strip or "real". I had initially thought if any of you were around we might consider upping the dose last night although I was never keen on dose increases for night cycles and in this case, a little less so, but at that point we didn't yet know ketones had gone down and I didn't think it prudent to keep holding at 1.5u.
Bear was pretty flat last night up to +3 but I'm not sure I want to assume he stayed that way. I tend to agree that perhaps we should wait, keep him at 1.5u and see what's up. The other thing is that Lora was going to shoot an hour earlier this AM to start working back to her preferred shot time, so while there is no depot to worry about, it's still a shortened cycle so holding for now seems prudent. Lora got a lot more food into Bear yesterday so fingers crossed he starts feeling better and eating at least some on his own.
 
@MrWorfMen's Mom @Djamila

Hello ladies,
Well I slept through two alarms this morning. Argg! First I need to let you know I retested Bear's Ketones and I was wrong yesterday, he was still in the moderate range. Apparently I have a harder time differentiating between Peach colors. I will retest him soon.

Second thing I need you to consider is Bear's appetite hasn't even come close to recovering and it takes me 25 minutes to syringe feed him, (I have to get more syringes and some bigger ones), so if his BG goes low I would have to resort to honey (which he despises) and then try to quickly fill a small syringe which is only 3CC's.

Bear hardly ever hits blue range, yellow and then green seems to be his drops. I know hypo isn't like a code blue, get the electric paddles, but I have only been testing Bear for eight days and this trial by fire has me feeling like a whipped puppy. I want Bear in the blue and green, (blue is a nice color) but Bear's BG likes to play hop scotch with blue.

I also have to get syringes with more lines, so we can do some gradual increases when needed. I can hardly find the .5 on these needles.

Leaving my house during the day is like scheduling a visit with the president.

Please take these things under consideration when contemplating dosing amounts.

Tomorrow I will be gone all afternoon, ultra sound & wound care center.

Bear's BG was 370 and since I overslept and am behind on my day I shot him 1.5U and then fed him.

Please don't think I under value either of you. Your kindness, thoughts, knowledge and experience are invaluable to Bear and I. XOXO
 
@MrWorfMen's Mom @Djamila

Do people ever do different dosage amounts in the AM & PM?

What was the name of that pill/herb that helps with neuropathy? Things have been moving so fast I forgot.

Linda Bear is walking on his pads (backfeet) like he is tip toeing. It looks as if he is walking on something disgusting and doesn't want to put his feet fully down in the nastiness. His gait is choppy(not smooth & inline) with him raising his back hips higher. Does that fit neuropathy?
 
Bear & Lora said:
Please take these things under consideration when contemplating dosing amounts.
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ABSOLUTELY! While Bear is the "star" of this show, you are the producer and therefore just as important if not more so. We have to take your schedule, responsibilities and ability to keep up to all this into consideration. You have the final word and anything we suggest is just that....suggestions not orders.

While not what we hoped to hear, it's good to know the ketones are still up. You need a really good light to read those strips because it is hard to differentiate the colours.

Bear & Lora said:
Bear hardly ever hits blue range, yellow and then green seems to be his drops. I know hypo isn't like a code blue, get the electric paddles, but I have only been testing Bear for eight days and this trial by fire has me feeling like a whipped puppy. I want Bear in the blue and green, (blue is a nice color) but Bear's BG likes to play hop scotch with blue.
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Yes he does have a habit of jumping ranges. When he has hit blue, it's been from red and then of course the green has been following yellow. And the fact that there is intense monitoring and an inability to easily get some carbs into Bear right now, has to be a major consideration when deciding if dose increases are safe. It's a balancing act and as you say it is still early days without a lot of data on which to base decisions about what he might do. He has been somewhat erratic.

I'm glad you got some extra sleep although I'm sure and sorry that has now caused you more stress about your day's schedule.:(

If you do decide to head out today for any errands and can stop at Walmart, they should have the U100 Relion syringes. You want the 3/10cc (ml), 30 or 31gauge, 5/16th" needle with half unit markings. These however will have to be used with a conversion chart but will allow you to make tiny changes in dose. They should have a feeding syringe for babies that is larger too to make feeding a bit easier.

Not to add to your stress, but I would definitely call the vet and ask about an appetite stimulant and that hi calorie food. If you can get that it could make things a bit easier on you.

Looking for a video of cat with neuropathy for you to look at. Be back soon.
 
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Have a look at this video. It shows neuropathy quite well. It's walking on their hocks rather than on their toes.


The name of the supplement is Zobaline and you can order it online at Amazon or there specific site. Just search Zobaline and you'll get some options.
 
Yep, Bear has that and even at the video cat's worst, Bear is worse at this point. :(

Thanks Linda.

Bear's BG +2 is confusing to say the least. It is almost like he didn't get insulin today, 376BG?
 
Bear & Lora said:
Yep, Bear has that and even at the video cat's worst, Bear is worse at this point. :(

Thanks Linda.

Bear's BG +2 is confusing to say the least. It is almost like he didn't get insulin today, 376BG?
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Bear could possibly reacting to the temptations treats. The second ingredient is Corn..
 
Yes those temptations are high carb are very likely influencing that +2 BG but better to get some food of any kind in him than not. Let's see if he drops a bit later. Can you get a +4 or +5, whichever works better for you today? That's when the bigger drop should be starting or peaking. If you need to wait till +6 that's OK too.

Poor Bear with the neuropathy. The good news is that once BG is regulated better and with some extra B12 support, the symptoms will subside and Bear will get back to normal. Keep in mind, that while humans experience pain with neuropathy, and it's hard to see them walking like that, it's not painful in cats.
 
Oh crap! I see when I described the syringes earlier I didn't include "with half unit markings". My bad! Sorry! Hoping you didn't go to Walmart yet. :banghead:
 
MrWorfMen's Mom said:
Yes those temptations are high carb are very likely influencing that +2 BG but better to get some food of any kind in him than not. Let's see if he drops a bit later. Can you get a +4 or +5, whichever works better for you today? That's when the bigger drop should be starting or peaking. If you need to wait till +6 that's OK too.

Poor Bear with the neuropathy. The good news is that once BG is regulated better and with some extra B12 support, the symptoms will subside and Bear will get back to normal. Keep in mind, that while humans experience pain with neuropathy, and it's hard to see them walking like that, it's not painful in cats.
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Ok, quick update the Vet prescribed an appetite stimulant and recommended Cn, En, & Om. I got some of each. She recommended a feeding tube if we can't get Bear to eat, she said syringe feeding is high stress on a cat. I syringe fed Bear 1 oz of CN when I got home, it was much harder because he is feeling better. His ketones are at small range today but I am going to have to try again latter to verify. He is using the litter box on his own and has been sneaky. Later I will move it to the middle of the room where I can see it. I am going to the pharmacy now so I can get the appetite stimulant in Bear. I would rather Bear didn't have to have a feeding tube. Talk to you soon
 
If I'm remembering right, @Kris & Teasel has some experience with a feeding tube, and as I recall she said it really wasn't bad. Hopefully she can chime in when she has a minute. I've read on the board that they are far less stressful than syringe feeding, but I haven't had experience with it myself.

Lora, I wish so much that we could be there with you and help carry some of this burden. It is exhausting, especially when everything is so new. I'm so thankful that Linda is around so much to walk with you through all of this.

Looking at today's cycle, I do think a little increase in insulin could be safe now. What would you think about a "fat 1.5u". You would draw to the 1.5u line like you've been doing, and then just a smidge more. So kind of eyeball where you think is a little more than 1.5u, but not quite 1.75u. One trick is to draw some colored water into an old syringe and use that for comparison. Then when you draw the insulin you can be sure you're being consistent even if it isn't an exact fraction.

If you've got Temptations, and if he'll eat them, then you can steer him up if you need to. Those things are crazy high in carbs and are often used to treat hypos. Please don't even worry about the carbs right now. Your biggest concern is just getting food into him, and keeping the insulin going since the insulin helps with clearing the ketones. After he's been clear of them for a little bit, then we'll start working on getting better numbers. Right now your goal is food, insulin, and any number that is safe, even if it's a little high.

It is really important that you're taking care of yourself right now too. Kind of like in an airplane when they tell you to put your oxygen mask on first. You can't take care of Bear (and your mom!) if you've exhausted yourself. So if you want to wait until tomorrow to try a little more insulin, do what you need to do. Your sleep is important.
 
Into day 4 and starting to feel a bit better finally. Dang cold medicine is supposed to be non-drowsy but I think it's actually been keeping me awake at night and the nighttime stuff says it can cause agitation so I avoided that and still wasn't sleeping well. Not taking any more of that crap! And yes, hot tea and snuggling up and napping with my furballs at every opportunity has been the name of the game. BONUS!
 
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