Duke 6/9

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Bone Daddy

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Duke continues to ride the BG roller coaster

AMPS 297 1.5 u
+ 7 = 347

PMPS 486 1.5 u
+ 5 = 370

I am offering Duke food several times during the day or whenever he acts hungry. I know this may keep his numbers floating some, but the boy really has to eat.

Addendum to 6/8: Duke started to go keto on me when his numbers were high. I could smell them starting on his breath. I fed him all he wanted to eat with plenty of water. He's OK today, none the worse for the wear. Breath is back to being normal, which for Duke isn't really that bad. Hydration looks good, but I'm watching it closely.

Duke loves raw chicken liver. He also laps up the juice like there's no tomorrow. I've been reading up on feeding raw foods.
Does anyone here use raw foods?

H is out of town for a few days. Last night Duke hopped up on the bed settled in and had a bit of a purrfest going on. It's nice to see that Duke is still in there and is trying to get out.

Wishing everyone a nice long catnap......
 
I can't offer any advice, just moral support. It's pretty frustrating and discouraging when the numbers jump around, I've had that happen too. I started testing like crazy, trying to get more data, hoping it would help the picture become clearer. I dropped the dose down and slowly increased again....BUT Tinkles has no history of ketones, and Duke does so that complicates things. Hopefully someone with more experience will be able to help you sort it out.

I'm starting to believe the "45 days and the numbers start to settle down" theory on ProZinc. It seems to fit our situation, we are on day 44 and the numbers are starting to stabilize.

ETA: I would offer food like you are, give him all he will eat. Eating is good!
 
He probably needs more insulin if you got ketones last night. Even if they seem gone by this morning, they still may be in his bloodstream, and they can come back quickly anytime. Are you comfortable raising the dose, and keeping an eye out for unexpected lows?

When others have had ketones before, the process is different than with a non-ketone kitty. One thing I have seen people do is test more often, trying to keep the #s pretty much in blues & greens all the time. With PZI you can shoot the next dose anytime after +6 in theory (I like +8 better, but +6 is what I have been told), on a rising #. So basically you can test somewhere mid-cycle, if the # is above your no-shoot (probably 150 or 180 depending on your comfort level), you test again in maybe 15 minutes, if the #s is rising, you go ahead and shoot the next dose. When you do that though, you reduce the dose (so you get the same amount in a 24-hour period as with 2 shots, only split out over 3 shots). It can be tricky to get the timing & dosing right, but the idea is to get as much insulin into their system as you think they can tolerate, and keep the hypo kit handy.

It can be stressful, but ketones aren't something to mess around with. If you can smell them, it's a pretty high level I think, which means he may have a low level still going on. I don't have experience with ketones, and don't feel comfortable giving you a lot of dosing advice for aggressive shooting, so I'm going to see if I can round up some peeps who can help you out a little more.

There are people who feed raw, you might want to post on Health about that...

Glad he is doing better today - keep getting those fluids in him, and if nothing else I would go ahead and raise the dose by 0.25u at the next shot, and see if that gives you better #s.
 
p.s. here is a link I just saw this morning with good info & advice: viewtopic.php?f=22&t=7213

Always remember too, that if you know ketones are present above a trace level (are you testing with Ketostix? sorry I have forgotten if you are already doing that or not), you should get to the vet right away. Not to sound overly scary, but if they do get to the point of DKA, from what I understand, the majority of cats do not survive it. It can come on really quickly, so even if he seems ok at the moment, if he isn't getting enough insulin, it could go south quickly at any time.

So... I would scratch any advice I or others have given you to try lowering the dose, or even to stay at this dose. If he got ketones on this dose, it is not enough insulin, and staying here or lowering is just not an option. If you do run into rebound problems, you will probably have to shoot through it, or shoot a lower dose more often than 12/12 to keep the curve more shallow to prevent rebound.
 
p.s. just peeked at the SS - the #s the last couple days make 0 sense to me, so hopefully some others will be along who can decipher what is going on!!! it looked so promising that one day, mysterious what is going on since then :(
 
I wrote something yesterday, but I think it got lost.

I'm wondering what the +10 or +11 is before the yellow amps looks like. Also the morning +1 or +2.

Wondering if a rebound is clearing, bg is still on the downswing, and a new rebound is born. Maybe, but really not likely, but some more data might be necessary to see what's going on.

Also ... curious if the vet has done a full blood work up and a urinalysis. And looked at the teeth. Did you get Duke's full report from the old vet? Sorry if that's been discussed, but I missed it.

Think I also wondered if Duke was eating a lot more during the day, then at night. Or if he was one to get in the sink and lick plates, steal food off the counter when one's back was turned, or otherwise get into contraband food. When they get HUNGRY, they can be very sneaky, persistent, and will eat stuff that you would never expect a cat to eat.

Are you a scruff shooter or a flank shooter? Do you move the shot location around between morning and night?
 
I was wondering about increased food intake too Donna. The +10 or +11 and +1 readings will let you know if there is too much insulin. Have you noticed Duke eating more on his own lately? If he is doing better in that dept, it could be that he actually needs more insulin now to counteract the food.
 
If you're smelling ketones, don't even consider rebound. Ketones come from insulin shortage, not from high blood sugar whatever the cause.

If there's a chance of DKA, don't fool around with wondering about dose or rebound, just keep shooting as much insulin as you safely can to keep those numbers below 200, and make sure kitty eats and drinks even if you have to syringe-feed.
 
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