Grayson 3/6-7 MODERATE ketones back 1.5 wks later

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Grayson & Lu

Grayson & Lu

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Good morning all!

Due to some meetings, I've been tweaking Grayson's schedule the past couple of days. I forgot how much he dislikes me getting up and him not getting food immediately! I was putting a PowerPoint together, and he was assisting - walking on the keyboard, and blocking my view of the screen! Such a thoughtful helper!!!

I remembered how much better he is w/ Sub Q fluids when his face is in a bowl, so I gave him a little food and it was enough to distract him for the 4 minutes of fluids. SUCCESS!!! Couldn't get a ketone test, but did the fluids as there's no tellin' if I'll have time later in the day.

So yesterday was HUGE for Gray - he got into the yellows for more than one cycle; actually at least 3x w/ both the AMPS and PMPS! I'm guessing he likes that little extra in his syringe! I would love to go REALLY wild and up it a little more, but my schedule dictates a couple more days before that's viable - cuz I gotta be around to see it, right?!!!

SO... on to today:
+9 302
+11 369
Fed 1/2 can FF; Sub Qs 100 mL
+11.4 AMPS - shot 2.2

Here's hoping we'll see some more yellows today, and everyone else sees good numbers too!

Lu-Ann
 
Re: Grayson 3/6

PMPS was at +13.25 324. I was expecting 400... I'll take it!

One more day of busy, busy, busy; then I can increase him a little more and see how he does! There might be something green in my future, at this rate! :-D Wouldn't THAT be nice???!!!
 
Re: Grayson 3/6

PM+6 243

Caught him in the litter box in the nick of time... YIKES! Moderate ketones again. Guess it's fluids before bed... and a vet visit again tomorrow? !@#$% Did I mention how sharp those darn needles are???
 
Re: Grayson 3/6 MODERATE ketones back 1.5 wks later

OH NO~!!

Luann
I am so sorry
Good luck at the vet today I will be praying for you both!
 
Re: Grayson 3/6 MODERATE ketones back 1.5 wks later

Darn! He has been doing so well. Is there a chance he has some low grade infection that keeps popping up?
 
it didn't seem like it. His appetite is good. Last night after fluids he ate TWO cans of FF - the second w/ gravy. AMPS just now 316 - which is GREAT for him. Still trying to get a ketone test...

AMPS 316 shot 2.5 (increase from 2.2)
 
FINALLY got a pee test! Came back "SMALL" ketones - much better than last night, but still a solid "SMALL". Will wait a few hours before the fluids to give the insulin a good chance to kick into his system.

Anyone know a policy on the timing of SubQs?
 
My vet always said to wait two hours after or before fluids to give insulin and to be certain to give them in different places....ie..the insulin in the flank and the fluids in the scruff etc.

I followed that protocal, but am not sure it made much difference. With Kitty, unlike Grayson, the fluids dropped her BGs considerably, so I always gave fluids after her nadir-- or around +7.
 
Oh no! SO sorry to hear about grayson with ketones again. Hope it comes down soon!!! Did you got to vet today? How is he doing now?
 
Just picked up more fluids and spoke w/ the vet. She looked at my numbers and said to up him to 3.5 units (he's at 2.5 currently). Will still have to do in .25 or .5 increments, but that's what I was wanting/planning to do anyways. Both times he was in, there was no sign of infection. We ran one course of Clavamox, but didn't seem to make any impact. His appetite is good. He looks good. Just pees to a pretty rose color on the ketone scale. Argh!!!

BTW: he LOVES the FF w/ gravy! Probably thinks, "Dang, she's been holding out on me!!!"
 
Maybe I missed it somewhere, but is there a reason that you fed the FF with gravy?

I am glad you are going to increase, but even happier that you are going to do it slowly!
 
It looks like you are feeding HC food the past couple of days when you give sub-q fluids?

Carl
 
kse said:
Maybe I missed it somewhere, but is there a reason that you fed the FF with gravy?

I am glad you are going to increase, but even happier that you are going to do it slowly!
Click to expand...

Laurie and Mr Tinkles said:
Re: Please Help Cat Tested positive with moderate ketones
by Laurie and Mr Tinkles » Wed Mar 07, 2012 6:24 pm

BTW...feed Sasha whatever he will eat...don't worry about feeding dry food if you have to. It more important to get the food in than to worry about eliminating dry food right now, ok? Also, the fact that you are feeding HC food and the high numbers is part of the reason increasing by so much *may* be ok. We would normally not suggest such a large dose increase at once. Now is not the time to worry about feeding a good diet....get the food and insulin into the cat. The ketones are the worry....don't worry about the HC boosting the numbers.

PS from Jill....you can expect that it will probably take between 6-8 hours at best for those fluids to be absorbed.
Click to expand...

Over the past 24 hours, I've been watching and sometimes commenting on Sasha & Tara's post on Health entitled "Please Help Cat Tested positive with moderate ketones". I'm assuming that they suggest the higher carb food to offset the insulin increase - which appears to be a larger dose faster than I'm totally comfortable with. Otherwise, it's the philosophy of getting ANY kind of food into him if he's not eating... one of those symptoms of DKA's onset.

Fortunately, Grayson is usually happy to eat, which was the basis for my decision NOT to hit the ER vet 2 weeks ago. He just finished his dinner and had his shot... a slight increase, but one of his lowest pre-shots yet. Hoping this explains my decision w/ the food. And although he rode higher numbers today, he's still lower than he was.

Tuesday night
PMPS 324 Shot 2.2u
+6 243
MODERATE ketones
SubQs 100 mL
1 can FF w/ gravy
+7 356

Wednesday
AMPS 316 Shot 2.5u
SMALL ketones
+1.5 381
+2 310
SubQs 100 mL
1 can FF w/ gravy
+6.5 337
PMPS 307 Shot 2.6u
 
Well, the theory is that you need to increase the insulin to ward off the ketones. The "formula" is not enough insulin and not enough food and an infection combine to give you ketones. So many people will increase the dose, and use higher carb food to avoid the BG going too low in the middle. Insurance against "too-low" nadirs. If you look at Lydia and Sid's threads you can see a great example of how that can help. Sid was getting green nadirs that left no room for going lower and remaining safe, so Lydia needed to "feed the curve" to keep the numbers propped up whenever she saw ketones, because giving Sid bigger doses was necessary (especially on the occasions where she was also using "R" insulin combined with Prozinc.

I don't think you did any harm by giving the higher carb food, but in Grayson's case, it may not have been as critical unless you saw really low numbers mid-cycle. The fluids have also been noted to lower BGs during the cycle they are given or in the cycle just after with some kitties. Kim saw that often with Kitty after giving fluids. (They seemed to have that effect on Bob too, although I didn't test often enough mid-cycle when I was treating him since all my vet cared about was preshots and I didn't know any better at the time).

Carl
 
Well, I KNOW I've been lucky NOT to have to worry about low numbers, but then we were "at IHOP" with flat-as-a-pancake numbers for what seemed like weeks, barely moving 30 points up or down! I'm finally starting to see a curve, albeit gentle, but when the ketones popped up, all attention went to them, and the numbers didn't seem to matter as much.

How safe is it to make a 1.0 unit jump? I did NOT feel comfortable with that much at once... heck, 3 weeks ago we were at .2u!!! I was freaked enough about jumping back to 1u, and here I am at 2.6u and supposed to take the leap! Call me guarded! But I know if I do a sizeable increase I'm supposed to throw in some high carbs. Don't know that there's a magic formula though...
 
Lu-Ann,
I personally wouldn't advise anyone to increase in 1u increments. I might do it with my own cat, but wouldn't tell someone else I thought it was a good idea. I'm more of a .25 or .5 at a time sort of dose adviser. And yes, it would be logical to assume that if you increased a large bit at one time, you'd expect to see a good decrease in BG mid-cycle, so using meal timing or carbs to offset that is an easy way to do so. It's a level of comfort thing for the person holding the needle. I myself would wait to see what the numbers do before changing the carb content of the food. It would be riskier, but it would be my decision on my cat, not something I would suggest someone else try. Bottom line, you have to do what you feel comfortable doing, and then just test, test, test, so that you can see the results of any changes in diet or insulin amounts.

Carl
 
carlinsc said:
Bottom line, you have to do what you feel comfortable doing, and then just test, test, test, so that you can see the results of any changes in diet or insulin amounts.
Click to expand...

Thanks for saying that... a friend at work really crushed my spirit this week, when she commented that I'm REALLY taking it a little too far with all the testing! The irony is, that she hasn't seen Grayson since right after he was dx. If anyone saw him and didn't know about the FD, they'd think he was pretty normal! I feel like I need to stay on top of his numbers and especially his ketones, so that I can pre-empt something.... like DKA - that's really not in my budget! I'm sure when his numbers get a little more consistent, I'll feel more comfortable letting up on the tests some.
 
Lu-Ann,
Try to not get crushed when people say that. Your friend has probably never had a sugarcat, I'm guessing. In some ways, people who never have to experience what you and Grayson have been through are lucky, but in some ways, they really aren't. Dealing with this will change you forever, and months from now, you'll see all of this as a blessing (at least I do). Plenty of people look at me like I'm crazy when I start rambling about FD. Let 'em. They don't "get it", but I don't care. Importantly, you see Grayson, before, during and after he was diagnosed. So you know beyond any doubt that all you have done since the day he was diagnosed has been a great thing. For him, and for you. Your friend doesn't understand that, and may never understand. But that's her loss.

Carl
 
Grayson & Lu said:
kse said:
Maybe I missed it somewhere, but is there a reason that you fed the FF with gravy?

I am glad you are going to increase, but even happier that you are going to do it slowly!
Click to expand...

Laurie and Mr Tinkles said:
Re: Please Help Cat Tested positive with moderate ketones
by Laurie and Mr Tinkles » Wed Mar 07, 2012 6:24 pm

BTW...feed Sasha whatever he will eat...don't worry about feeding dry food if you have to. It more important to get the food in than to worry about eliminating dry food right now, ok? Also, the fact that you are feeding HC food and the high numbers is part of the reason increasing by so much *may* be ok. We would normally not suggest such a large dose increase at once. Now is not the time to worry about feeding a good diet....get the food and insulin into the cat. The ketones are the worry....don't worry about the HC boosting the numbers.

PS from Jill....you can expect that it will probably take between 6-8 hours at best for those fluids to be absorbed.
Click to expand...

Over the past 24 hours, I've been watching and sometimes commenting on Sasha & Tara's post on Health entitled "Please Help Cat Tested positive with moderate ketones". I'm assuming that they suggest the higher carb food to offset the insulin increase - which appears to be a larger dose faster than I'm totally comfortable with. Otherwise, it's the philosophy of getting ANY kind of food into him if he's not eating... one of those symptoms of DKA's onset.

Fortunately, Grayson is usually happy to eat, which was the basis for my decision NOT to hit the ER vet 2 weeks ago. He just finished his dinner and had his shot... a slight increase, but one of his lowest pre-shots yet. Hoping this explains my decision w/ the food. And although he rode higher numbers today, he's still lower than he was.

Tuesday night
PMPS 324 Shot 2.2u
+6 243
MODERATE ketones
SubQs 100 mL
1 can FF w/ gravy
+7 356

Wednesday
AMPS 316 Shot 2.5u
SMALL ketones
+1.5 381
+2 310
SubQs 100 mL
1 can FF w/ gravy
+6.5 337
PMPS 307 Shot 2.6u
Click to expand...

Please note that this cat was refusing to eat...that was the basis for the suggestion to allow him to eat whatever he would eat. The advice to increase by a full unit was given by the VET, not by me/us. She asked for our feedback on that recommendation. That advice is specific to Tara/Sasha's situation, and should not be interpreted to be for Grayson or any other cat.
 
LU, I agree with carl. They just don't get it! SOme of my own family members don't even get it. But they don't have that special bond that i have with my kitty and i think that is a blessing. Just cherish each day you have with you sweet grayson and the special bond that you have. Forgive the ones who don't understand because they probably would never get it until they had to deal with it themselves. SOme people have even told me it is a worthless cause and just put him to sleep. I get a sick feeling in my stomach when they say that and feel sorry that they are so clueless on what love is really about in life.

You are doing a great job with grayson and he knows that too! Take it day by day! LOL
 
Oh, wow - let the internet go out and you miss a lot - sounds like you have your hands full!

Sounds like you're on top of things. I mainly wanted to echo what Carl said about not letting others crush your spirit. You KNOW what you're doing is the right thing to do. I have friends/family members who don't get it and I know they never will. So, I just don't talk to them about it. But, you know, it was the same thing raising my kids. I can only think of a few people who generally agreed with my thoughts on child-rearing, so if they were older I'd let them talk, smile politely and do as I thought best.

I will say I am very close to this young man at church and he asks regularly about Hershey. A few weeks ago, he said, "I'll pray for him. I've never prayed for a cat before but I'll pray for Hershey." :smile:

Take care -

Libby (and Hershey, too!)
 
Interestingly enough, tonight as I left my meeting and headed to grab dinner, the co-worker called to appologize! She said she had heard what she'd said, and realized that we were in different places where our pets are concerned. I told her that I had already concluded that I just wouldn't share his challenges with her, but that I understood where she was coming from too. It's hard to compare apples to apples when one is not an apple. So, it turned out to be a good thing, and she said she'd try to be more supportive. Keep in mind, her first concern following the diagnosis, was my health & sanity. This past two weeks was rough, and both were compromised! She saw it in my face (I suck at poker!) that I was really stressing out over the situation... which was actually worrying about him, not focusing on work, therefore not getting things accomplished on schedule, the frustration associated with that, and the day-to-day things... taking the time to cook, clean, shop, etc. And making sure the other pets managed to get some attention!

Anyways, it's good to have friends that you can share your issues with - whether in person or on the cat board! And it's even better to have people who understand, have been there, and would do it all over again, if need be. Thanks to all for the support and well-wishes for my boy. He really DOES look like a happy, healthy cat! A far cry from 2 months ago!

Lu-Ann

...and LIbby - Grayson is on the prayer list at church as well! ;-)
 
So is Sneakers- on our prayer list, too.

First thing i did was send out an email :lol: . I get asked how she is doing and they understand when i need to go home and test. Of course, we are doctor and nurse heavy0 just about one or the other in every family, so they know about diabetes for a human.
 
hmjohnston said:
First thing i did was send out an email :lol: . I get asked how she is doing and they understand when i need to go home and test. Of course, we are doctor and nurse heavy0 just about one or the other in every family, so they know about diabetes for a human.
Click to expand...

It's so great to have the support of friends/family/co-workers - and how valuable to our mental health - particularly on those days when we're stressed or have hit a roller coaster. It's important to let people know what we're going through... you never know when it will help someone else!

I'm one of those people at work that doesn't have a back-up currently (it's a matter of timing to train someone). Everyone is already stretched, so I feel bad asking them to stay late or come in after hours... and since I can be a control freak, it's usually easier/faster for me to "just do it". However, that really puts me in a bind when I have something come up. It would've been good if I could've just focused on Grayson, the ketones, and maybe kept up w/ day-to-day things at home this past week... but I don't always have the luxury to do that. I am, however, VERY fortunately that supervisors are flexible, as they know I'll stay til all hours to get the job done, when push comes to shove. And if I hadn't been so distracted, I could have, in theory, worked from home. I brought stuff home, but never got to it. Good plan, anyways!

I can't imagine going through FD alone, or without at least the personal support of friends. When my coworker told me she'd lost 2 cats that had FD, I could't believe I never heard word one about it! How difficult that had to have been for her. I wish she'd have said something - cuz I probably at that time, would've done at least a base level of research to see if there was anything I could help her with. Anyways, I'm not always good at asking for help myself, and sometimes not thoughtful enough to realize something is going on with someone, but I'd like to think if I could, I would have done SOMETHING to make her life a little easier. Likewise, this board has been invaluable - whatever the hour, to getting immediate feedback when necessary, or random banter when that's in order. What a godsend! Thanks to everyone for whatever your contribution is!
 
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