Grayson 2/27

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Grayson & Lu

Grayson & Lu

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Good afternoon - my how time does fly!

Despite the fact that I've been pouring insulin into Grayson, he's still staying flat. Now maybe it's because of the ketone scare, slight sniffles, or maybe something else. He's acting normal, although his eyes are glassy-looking. Friday evening, after having seen the vet in the AM, we upped him from .6u BID to .75u without much impact. Saturday morning I went to 1, and since then 1.2 Yesterday, he got three shots totalling 3.4 units (caught him before reaching 400 by +9.5 and +8. Mind you, he's had some higher carb food to offset the insulin, but he's still not having much of a range.

Being more comfortable in Excel than googledocs, I started playing with his SS and extracted the high & low of each cycle (regardless of the length of the cycle). I also calculated the range (diff betw high & low). Lately it's been hanging around 40 or so... REALLY FLAT!

I left a message for my vet a short while ago. See if we need to do anything - like some R to get it to do a quick drop? Or maybe something else? His ketone test about an hour ago came back between NONE and TRACE, so I'll give him another SubQ flush in a little while when he has his face in the bowl (1/2 can FF mid-meal), To look at him, you'd think he was just a normal cat... but to know all he's been through this past few days and weeks, all you can say is "hang on!" - it's gonna be a bumpy ride!

AMPS 373 (+10)
SHOT 1.2u
fed 1 can FF
+2 344
fed 1/2 can FF
+4 335
+5.3 356 MAYBE this is a food spike??? Apparently. 20 points up, half a can...
+6.5 344

Where to go from here??? Wait til +12? Shoot before it goes to 400+?

Any thoughts?
 
Hi LuAnn, I'm on my cell ph so pls forgive any errors.

I think most members will tell you to wait to shoot until the end of cycle and then from there u determine a dose that will give Grayson the duration he needs. I cannot pull your SS from the phone, well I can but it doesn't show the entire table, so I cannot comment on the dose or give any advice about it.

I think if you wait, you can clearly see what his cycle will be on the dose you give him than seeing it skewered because of possible overlap, regardless of how little overlap that may be.

Just my two cents.
 
Hi Lisa -

If it hadn't been for the ketone issue, and the fact that he was "on the edge of a cliff" as Nancy said, I felt like the higher dose, AND keeping his numbers down, were crucial to keeping him from going DKA. Otherwise, I'd be right with you. I commented that his eyes were a little glassy - I'm thinking from the higher dose - and Kim warned me that that was one of the things that Kitty had before she went DKA.... so I continue to sit on the edge of my seat (fortunately, NOT a cliff), and ponder why I'm having an upset stomach - surely it couldn't be stress-related!!! ;-)

Lu-Ann
 
Jsut a thought...where are you shooting?
can you find a different spot tonight and try that
he has been so flat, I am thinking to stick to the 1.2
but shoot on his side or somewhere different
 
I usually alternate between both sides of his scruff and his R hip. He had a matted pc of fur there that got trimmed off, so I thought it was a good area to not get a "fur shot'. Since starting SubQ fluids, I've done more in the hip to keep some distance from the SubQs (also shooting at different times too).

Any other ideas? I can't decide if it's too much or too little insulin - but SOMETHING has to bring him out of these flat numbers. It's just going on too long!

Still waiting to hear from the vet... will probably pester again, in case she didn't get the message earlier.... Patience - not one of my strong suits!
 
As long as the ketones are negative--he will not go DKA. But, the probable reason they are negative to trace is due to the therapy you are giving. Remember...too little insulin, ketones, and Infection are 3 of the major culprits of DKA. I would not reduce the dose any, with the ketones in the picture. In fact, there is a thought process, that would say to shoot more insulin and use your other tools--honey, high carb foods etc to combat any low numbers (I am not recommending that--I have no experience there). Insulin is paramont for him in the battle against the ketones.

Did they do a urinalysis when you took him to the vet Friday? If so, any signs of UTI? Did they do bloodwork? Were the white blood cells elevated?

I would recommend going to the search engine on the site and searching Violet and Garland. Garland went DKA and has had numerous scares since-- with moderate ketone levels. There is A LOT of information on how she treated Garland at home with the higher levels. It is very informative and a lot of the members on the board, that have DKA and Ketone experience, coached her through the battle. Garland is on Lantus, so you need to consider that, but the protocal is the same.
 
Okay, I just read your post above mine...you must have posted while I was typing.

In my opinion, if ketones are in play, you cannot decrease the dose. The numbers are important...BUT, ketones are your main enemy. Ginny's Alex went DKA with numbers in the 200s (I think--it was lower than normal numbers)-- but, he was getting very little insulin. You NEED insulin to fight ketones.

It is not necessary to have High BGs to go into DKA.
 
Sorry - got distracted w/ a phone call... coworker checking since she didn't see me today and knew I signed out as "vet emergency" on Friday.

Finally talked to the vet this afternoon. Told her he's still flat - barely moved 40 points today - although much of that lack of movement may be attributed to the little piggie eating his weight in FF!

RECAP:
AMPS 373 (+10)
SHOT 1.2u
fed 1 can FF
+2 344
fed 1/2 can FF
+4 335
+5.3 356 MAYBE this is a food spike??? Apparently. 20 points up, half a can...sounds about right.
+6.5 344
+7 338
100 mL SubQs
fed 1 can FF (to entertain him during SubQs)
+8.5 Ketone test: betw NEGATIVE & TRACE... WOO HOO!!!
+9 329 - LOWEST number - but still not very low.
+9.75 360... spoke w/ vet. Recommended increase to 1.6u.
PMPS @ +10: I conservatively shot 1.4 this time...a week ago I was shooting .4u - will up to 1.6 in the am.
Fed 1 can FF
+1 Ketone test: TRACE
+1 380
+2.5 309... WOO HOO!!!! We might actually break the 300 mark today!!!

How low will he go???? And how long can I hold him off from YET ANOTHER can of food???!!!
:smile:
 
Payne is an eater!! and being on pred daily, well if she could will the cabinets open ..... and use a can
opener! :mrgreen: but an unregulated kitty is always hungry and needs the food. I had a weird cat once who would only eat raw turkey meat, which the vet said would kill her young ..... she lived to 19 :) so I thought about raw or lightly poached chicken, turkey meat, chicken giblets, pure protein.

So now Payne munches on a variety of pure protein snacks, plus a freeze dried chicken she will do flips for but I save as a treat. At her worst she was 7 lbs. and now she is a portly 15 .... I am very happy. Even with the pred. her BG #'s are in the low 200's not great but not bad for a cat who should have died 4X.

And yes, ketones are the important component in DKA. Three times that Payne went DKA her BG #'s were in the 200's but her eyes got glassy, it is a sign.

Nancy and Payne .....
 
WOO HOO!!! We FINALLY broke 300!!!
+4 297!!! Happy Dance! Happy Dance!!! dancing_cat dancing_cat

My Paulo would probably do well on a raw poultry diet. He loves chicken, but I expect while he was in-cinto, he had a LOT of birdie! His mom Nicki had an absolute FIT the first time she was inside and saw a feather toy on a wand. Beat the ever-livin snot out of it!!! VERY memorable! For a while Paulo even had me cooking chicken & California Vegetable Medley for him regularly - quite ironic as I barely cook for myself!

I'm watching his ketones EVERY time he heads to the box - probably will until every ketostick comes back negative for 2 weeks!!! And then some more, just in case! And I am continuing fluids - picking up another bag tomorrow.

My only big concern right now is his eyes. I'm not real comfortable w/ the glassyness...
 
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