? Ketones 1.2 Emergency Vet wait

Cooked chicken warmed up for the same reaction of oh that looks yum, ew. He kicked his lips but won't eat. Syringed a little more of the Tiki cat, probably 8-10 mls. It's staying down at least?
 
I know. I've been up every two hours trying to get food into him, after staying up til midnight doing the same. I'm exhausted.

I don't even live in a super small place but our vet situation is garbage.
 
Sarah & Charlie-cat said:
Cooked chicken warmed up for the same reaction of oh that looks yum, ew. He kicked his lips but won't eat. Syringed a little more of the Tiki cat, probably 8-10 mls. It's staying down at least?
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It definitely sounds like nausea. I would check with theER that they definitely gave the cerenia injection. And maybe ask if they give ondansetron injections. He could have another cerenia injection after 24 hours.
You might have to syringe feed more often..
Like every few hours. ASSIST/ syringe feeding
 
I gave him his .25u dose of insulin, not the planned increase to .5. He's currently hiding under the bed with a bowl of chicken. I'll get up in two hours and see if he's eaten, check his numbers and call the ER vet again.

There's another practice across town that may be open today. They used to have 24/7 hours, I took Charlie there when he pulled the AC vent out of the window and cooked himself (he didn't have heat stroke, but he did hurt his leg trying to get out of that room ...he was isolated from the other cats when he was new). I can call them too but I left that practice like 2 years ago because they're expensive and not great
 
Sarah & Charlie-cat said:
I gave him his .25u dose of insulin, not the planned increase to .5. He's currently hiding under the bed with a bowl of chicken. I'll get up in two hours and see if he's eaten, check his numbers and call the ER vet again.

There's another practice across town that may be open today. They used to have 24/7 hours, I took Charlie there when he pulled the AC vent out of the window and cooked himself (he didn't have heat stroke, but he did hurt his leg trying to get out of that room ...he was isolated from the other cats when he was new). I can call them too but I left that practice like 2 years ago because they're expensive and not great
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Good plan. I’m heading to bed but @Bandit's Mom is going to be around for you now. I hope things improve very soon
I’d check the BG a few times this cycle if he’s not eating much.
 
Hi @Bandit's Mom (and anyone else whose playing along in will Charlie eat)

+3 update .25u (didn't increase to .5 because he hadn't eaten)

BG 306 (down from 317)
Ketones 1.0

Didn't eat warm shredded chicken. Got another 10ml of thinned Tiki cat mousse in via syringe. Which was a fight.

So, back we go to the ER vet.

(I think one reason this freaks me out so much is the old vet didn't tell us if he had ketones but from what I've read, he had symptoms of DKA and I don't want to do that to him again)
 
Along with asking for the anti-nausea and anti-emetic drugs, you can do subq fluids at home. Ask the vet for some. It is simple to do (assuming the cat will stay still).
You may also want to ask the vet for a couple of cans of AD. It's very smooth and easy to syringe. In general, cats like the taste.
I loved your "throw down" comment.
 
Gerbers baby food all meat (2nds) often was appealing to my cats when they refused to eat their food. It’s also easy to syringe.
 
I bought some recently for our other kitty Harold when he was sick and they now have cornstarch in them! That used to be my absolute go to. I nurses another kitty, Pumpkin, through surgery on her face and a pulled tooth, with that. But when I saw corn starch I said nope for Charlie.

The Tiki Mousse is pretty easy to add liquid to and syringe. The second batch was a bit too water but it worked. I haven't gotten the whole thing in him yet. He's currently doing what we call, charging the mom battery, laying on me purring. I'm going to have breakfast myself and go back to the ER vet. If he's not eating on his own still...and I am supposed to be three hours away tomorrow for a site visit. I'll be gone like 6:30-4ish
 
It’s always had cornstarch in it but never bothered my cats. The other brand whose name escapes me does not have it but my cats didn’t like it as well.
 
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They're gonna hold him today and overnight and give him fluids and see if they can get his BG down and get him to eat. He and Harold are in some very strange competition to see who is the most expensive, most beloved by mom. The four girls are no trouble at all
 
Sending lots of prayers for Charlie, you must be so exhausted. Try and get some sleep. He's so adorable . :bighug::bighug::bighug::bighug:♥
I know when you can please keep us updated :bighug:
 
Update: he's going to get fluids to see if they can correct his electrolytes and maybe help flush some glucose. They wanted to try a short acting insulin as well temporarily to see if they could get him under the renal threshold. Maybe an appetite stimulant if that doesn't help.

His blood work did show low platelets. Which is what he's on steroids for in the first place.

He seemed fairly ok. But if I wasn't going to be able to turn him around on my own today, I would have been up **** creek having to leave before the vets open tomorrow morning for a work thing. The work thing is a research project that I'll get a stipend for this summer, which is gonna help pay the vet bill, lololol. They want him to be transferred to our new vet in the am. So my poor hubs is gonna have to get up early to make that happen.
 
Update:
Husband had to transfer Charlie from ER vet to normal vet yesterday morning. I picked him up from the normal vet yesterday and spent 45-60 minutes talking to Dr. A. She went over all his labs with me (no one has ever done that for me). His blood work suggested an infection of unknown source, his urine pH was a little up, glucose in his urine as expected, low level of ketones. She seemed happy I was testing those and knew that as a currently unregulated diabetic kitty he was at risk for developing ketoacidosis. No UTI tho, so that's good. I would have been flummoxed if he got one switching from dry to wet food.

She remains adamant that he does not have a clotting disorder from her smears. I am inclined to believe her. I swear some days his ear pokes clot before I can get the strip to it and BG and ketone from the same poke? Nope, he's clotting up already... So we're going to keep working off the pred. She seemed irked her colleague, Dr. K, who I haven't met, told us to go back up to the full dose we had been doing.

He's on Cerenia and Mitzaprine (sp) and he yowled his hunger at me all night and from 5-7 before his shot. He's on amoxicillin as well.

Based on his curve, I was going to go up to .5 u, but Tonya, mother of Adam the sugar cat suggested staying at .25 as clearing the infection up should also help his numbers and don't want to tank him. I'm a little worried about not raising it as he's basically not dropping below 200 at any point in the day and that's gotta be hard on his poor kidneys. But I gave .25 since my day is back to back crazy busy today. Dissertation defense and faculty Senate...crazy busy but actually it's all just sitting around until I get to talk for 5 minutes.

Anyway, she said she didn't think we'd get him evened out by mid-April, which I so wanted because I'll be traveling for work. But she was game to get a Libre 3 and burner phone set up, so hoping to try that out in a couple weeks so we can troubleshoot shoot before I leave. I also need to reach out to the pet sitting partner of an acquaintance who said they were willing to learn to do ear sticks.

The new vet receptionist also diagnosed him as very pretty and told me how much she wanted to pet him.

And I just have to chuckle a bit. Our other boi, Harold, was very sick when we first got him, so many vet visits, and has gotten bit by someone in the gang twice recently, so many more get visits, and he has a fan club at the old vet (and online in Cat Squad) and Charlie was like if I can't kill you, hold my beer and watch me get a fan club. Bois! All of girls, while being bonkers in their own way, are pretty healthy and no trouble (except when Widget eats **** she shouldn't, but now we just don't have things like tinsel or herbs).
 
Sarah & Charlie-cat said:
And I just have to chuckle a bit. Our other boi, Harold, was very sick when we first got him, so many vet visits, and has gotten bit by someone in the gang twice recently, so many more get visits, and he has a fan club at the old vet (and online in Cat Squad) and Charlie was like if I can't kill you, hold my beer and watch me get a fan club. Bois!
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That is too funny!!
So glad Charlie is home now. :bighug:
 
Sarah & Charlie-cat said:
Based on his curve, I was going to go up to .5 u, but Tonya, mother of Adam the sugar cat suggested staying at .25 as clearing the infection up should also help his numbers and don't want to tank him. I'm a little worried about not raising it as he's basically not dropping below 200 at any point in the day and that's gotta be hard on his poor kidneys. But I gave .25 since my day is back to back crazy busy today. Dissertation defense and faculty Senate...crazy busy but actually it's all just sitting around until I get to talk for 5 minutes.
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I’m glad Charlie is back home. That is great news. It sounds as it your vet is lovely!

I can’t see where Tonya mother of Adam said to stay at 0.25 u. Was it here?
With ketones in the picture I would have increased to dose to 0.5 units.
If he doesn’t drop into blues today, I would increase the dose to 0.5 units.

Try and feed him as much as he will eat as food will help combat any ketones. Lots of snacks as well as the two main meals.
I’m glad he is on the cerenia,..give that before the appetite stimulant. Keep giving the cerenia for a while to make sure he eats well.
Also don’t skip any doses of insulin…as insulin also keeps ketones at bay.
Test daily for ketones and pop the results into the remarks column of the SS please so we can see easily. Thanks!
If he will tolerate it, put a teaspoon of warm water into all the snacks to increase fluid intake.
Try and get as many tests in during BOTH the cycles so we can see how low the dose is taking him.

Do you have some higher carb foods in case you need them and some honey or Karo.?
 
So glad Charlie is home and that you had a good experience with Dr. A. who seems to really be with it.

I hear you about university work. It's great but when you're dealing with sugar bois, things can get stressful. :cat::eek::bighug::bighug::bighug:
 
Today's numbers are just going up?
AMPS 243, +5 308, +10 338. Last night PMPS 294, +3.5 ( I was so tired I couldn't make it to 4) was 250. I am so confused again.
 
Sarah & Charlie-cat said:
Today's numbers are just going up?
AMPS 243, +5 308, +10 338. Last night PMPS 294, +3.5 ( I was so tired I couldn't make it to 4) was 250. I am so confused again.
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Did you read my post 74 about looking after him now that he is at home again?
You need to give it time for the depot to fill with the increased dose. We don't know what happened at the hospital as far as the dose and the BGs are concerned.
Its possible he may have gone down further last night and be bouncing a bit today.
Have you tested for ketones today?
 
I know I need to let the depot fill back up but it's hard to watch his numbers go up all day and not down. Twitchiest liver this side of the Mississippi, apparently.

I haven't tested for ketones today. I can in a little bit. He's currently laying on me and purring. But that never lasts all that long. Recharge the battery and back to being an independent boy.
 
Updated his spreadsheet. 0.8 on the blood ketone meter. Planning to syringe him more food in about another hour (it's 8:10 pm central US time, so at 9:10).

I did also find another biggish hairball under the bed. Looked fairly fresh, probably his, but the median coat color in our crew is medium grey. He thinks brushing is murder, but he's clearly grooming more than he was.

Gonna go get him his quilt and tell him I love him. And pill the other cat and check his surgical wound healing
 
I know how hard it is to see high numbers.
Just hang in there and try and catch up on your sleep. You will be no good to him if you get sick!
 
Yikes, I just caught up on your and Charlie's saga. Hope you're getting some sleep. Minnie dragged me through this situation early in our diabetes journey. Multiple visits to the ER with DKA. I remember being so grateful for Bron's advice at the time, especially the adding water to her food - it's standard practice now.

Just want to echo what others have said - I always have ondansetron, cerenia and mirataz on hand. The sniffing food and walking away is a sign, especially from the kitty buffet. I use the sub-lingual ondansetron because I'm not great at pilling so I just have to get it in her mouth and keep it clamped shut. I get them at Costco for $13 a box. Can't remember if anyone's mentioned it, but they can have both cerenia and ondansetron which work differently.

Have you tried beef liver powder sprinkled on the food? It's a new discovery for me and she loves it. I feel like a waiter with the 'fresh ground pepper' mill.

Hope things are looking up with Charlie soon (but not BG or ketones) and he eats for you. I find that the hardest thing to cope with! Hang in there.
 
I'll have to work on water in his food but he was drinking on his own today.

Do you need a script for ondansetron?

I will ask for refills on the Cerenia and mirataz to keep those on hand. The ER vet sent most of an IV bag home with us, so I just need needles and a lesson, lol.

The vet called to check on him and I was like, well he got syringe fed dinner and breakfast. We discussed me dropping him off tomorrow as I have a site visit. But the. Wouldn't you know it, he ate just fine on his own. I needed to read the directions on the Mirataz, because the vet was like just coat his ear and the directions said measure out this much, which was much more than I gave him.

Dried beef liver has come back up when I gave it as a treat, but he loves freeze dried duck liver more than maybe anything else in the universe (more than me, more than his girlfriend Olivia, more than dried shrimp, more than minnows), so I usually sprinkle some of that on his food if he's hesitating. And I have a ton of Tiki Stick, which he loves. Once he starts licking those, he'll usually eat the food underneath.

What a butt head. But his preshot number tonight was lower than his am number (257... Stupid spreadsheet won't let me edit on my phone again). I am hoping his am number looks better yet.

He definitely is more his lively self when his numbers are lower. Wrestling with Olivia (cute) and giving chase to Widget (less cute, she's like a third of his size)
 
I can't figure out how to upload a photo, otherwise I would post a couple of pictures of the stinker from this week... I had been making him a quilt as a joke, because he was always trying to lay on my hand stitching. When he was diagnosed in December, it lit a fire under me to finish it and there was some sewing and crying and crying and sewing. The pattern is heart shaped and it has lots of fabrics with birds and cats. I got it back from the quilter's on Tuesday (she quilted a bird pattern on it for me ) and he has happily curled up on it anywhere I put it since. He seems to know it's really his. My husband says it must just smell like me from handling it so much in the pressing, cutting, gluing, and stitching. He's currently laying on it across the foot of my bed and he never lays in bed... Lol, he just decided it was time to go to sleep, which means crawling up into the cat tree next to my bed for his bedtime bath routine.
 
Sarah & Charlie-cat said:
I'll have to work on water in his food but he was drinking on his own today.

Do you need a script for ondansetron?

I will ask for refills on the Cerenia and mirataz to keep those on hand. The ER vet sent most of an IV bag home with us, so I just need needles and a lesson, lol.
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Yes, you'll need a script for ondansetron. Also, the vets would never give me injectable cerenia (apparently it stings?) so I have that as tablets too but give that in a gelcap because it makes her drool horribly (again, I'm not great at pilling!). Since it's not urgent, I'd check the prices for the meds at chewy or costco, or other online pet meds. Will be much cheaper than the vet!

I'm envious of you (or anyone really) whose cat likes treats. Madam doesn't like any treat, I've tried them all...and donated to the shelter. Beef liver powder is a first. And - the quilt story, brilliant. You can drag and drop a photo into the body of a message from a laptop. I think there's a note somewhere about how uploading a file doesn't work, but drag and drop does :cat:
 
I'll have to try that next time I'm on my laptop and see if the vet will give us scripts. Neither this vet nor the previous vet seem to much want to give prescriptions unless it's something like insulin or a Libre that they don't have in stock themselves. Sigh

The vet mentioned the injectable Cerenia stings too. I've just squashed it up with a little baby food or Tiki Stick and given it in a syringe. Charlie is impossible to pill.
 
You've just reminded me I should get some duck liver treat for miss fussy pants. Neko was a huge fan too.

Drag and drop from laptop, or cut and paste should work in the text box. I've done both.

Best video for learning how to give fluids, starring Marje's civvie Gus (GA).How to Give Subcutaneous Fluids (Video) If you get needles from the vet, try to get 20 or 21 g ones, the 18g are like harpoons. Terumo thin wall were my go to's.

A favour to ask, next day you post, could you start a fresh one. This one's getting a little long.
 
Thanks for checking in... yesterday was a LONG day and I didn't manage to update my spreadsheet. No matter how often I clear the cache on it, it goes to view only on my phone.

We're doing a curve today since it's spring break and I'm home. Working, but at least at home
 
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