Ketones

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doombuggy

doombuggy

Member Since 2011
So Cedric is coming off his DKA & acute pancreatitis. So today, I checked his ketones and the stick came up between moderate and lower large. He is eating almost up to normal and drinking water. I need to update his spreadsheets for today, but he was:

295 amps, 1.5 units (raised from 1.25 on Sunday am)
254 +2
257 pmps, 1.5 units
273 +4
Ketone check was at about plus 2.75
He had some diarrea about 15 minutes ago, and that is probably because he ate some of his brother's food which had Miralax in it; Cedric had a regular stool yesterday and an enema last thursday.

Thoughts? I had another $200 bill at the vet today, and I am about at my limit - we are now around $4700 and I am about out of funds here.
I am exausted. Off to bed and will stop by in the morning to read your thoughts. He had another full panel blood test this am, so I expect to hear back from vet tomorrow. If his BG is over 250 tomorrow amps, I plan on raising his dose to 1.75.
 
A little confused which SS to use and which insulin you are giving.. However a few suggestions aside from going back to the vet since it doesn't sound like he has cleared the DKA.

1. You need to try and get more fluids and food into him. See if you can flush at least some of the ketones out

2. I suspect he isn't well regulated and getting him there would help a lot. This means
A) mid cycle tests (day if you can, night otherwise ), and a before bed, and spot checks... More at weekends. Try and find out what the nadir is, and base dose changes on it.
B) follow the tight regulation protocol so you aren't sticking to the same dose too long if it isn't working.


Wendy
 
As someone who fights ketones and have finally been successful, it is insulin, fluids, water in food and making
sure kitty eats and eats! getting regulated is important but getting enough insulin is the most important. Sometimes
if the ketones start going up you can add R (regular insulin) to the mix with the theory of always having
enough in the system, that is important. Test daily and if you can, get a blood meter for ketones, good luck.
Nancy and Payne
 
He went back on Lantus insulin after being diet controlled this past february, as stated in my signature.
I convinced the vet to switch to Levemir in May, as stated in my signature, as the Lantus was not lasting the whole 12 hours.
I had started a new spreadsheet, but was asked to keep using the old, so both sheets are updated, usually daily, but it has been pretty hectic since he went to the hospital on Sat 7/20. the sheets have been updated with my data, but I wouold like to get the chance to put in the hospital data as well.
I work 7 days a week.
He got fluids yesterday morning.
Will see if i can catch him in the litter box before I go to work (live alone). Cannot miss work or call out from 2nd job, as I am faced with a $4700 vet bill now. That would wipe out 1/3 of my savings account.
As you have figured, I am at my wits end with this situation.
 
Well to make it easier I wouldnt bother updating both sheets -since the "lantus" https://spreadsheets.google.com/pub...4KdE8yVWlQWEdnQXNZMGFGeDdWbFk2dVE&output=htmlone has all the data in it, i would just use it and add a coloured line may 21 saying "switched to levemir" in big and bold. And update your signature to remove the levemir one and just put "Cedric SS" for the SS name. Save you updating two sheets!

7 days a week work week? yuk! Poor you. Are you on shifts or something? We can work that and see if we can get him regulated.

First I would try and get a before bed test no matter what as that will provide more data. And then a mid cycle test whenever you are home in the middle of the day .

Because I think if you can get a couple more tests a day for the next few days we will get a better picture of whats going on with him and be able to recommend or know how well this new dose is working. I am thinking a dose change every 3-5 days depending on his nadirs. Lets get him better regulated.

And keep me updated so I can watch whats going on..

What do you think?

Wendy
 
Another thought is to reduce the carb% in your foods.Some of the friskies and weruva are up at 10% and many average 8% or 9%. You might have some success bringing it down under 4% - whether different flavours or even trying fancy feast pates instead. Some cats are more carb sensitive than others and it might bring him down more.

Check this food sheet (column C % calories from carbs) : http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf
 
His ketones are down tonight. They were less in the blood & urine test from yesterday.
I think the Denamarin takes his appatite away.

was a bit caught up with the feral cat catching tonight - still waiting to hear back from the catcher if she got more than 1. I am the "payer" but 2 is going to be my limit, since Cedric's bills are around $4700 and are not done - another blood/urine test next week...

Yes, I work 7 days a week. Weekdays 8am to 5pm, weekends usually somewhere around 10ish to about 5ish, the shifts at walt disney world change. On Sundays it's been 8:45 to 2:45. The only way I am going to get a nadir is if I stay home from work - I can't afford to do that on the weekends at this point, since I am faced with this giant bill. He needs to go in again on Monday, and the appt they have is 10:40am, so I could get a reading on him when I bring him back home....

Thanks for the support, it's been a very difficult road for me the past week & 1/2....
 
Cats nadirs do vary, and even a few tests during the cycle will tell us a lot .. Even if its not slap bang in the centre of the cycle. What time do you normally shoot?

Can I suggest you test before you head out in the morning and again when you get home? As well as preshot. And one before bed?
 
I can't find the strips for ketones yet down here, so I don't know about that. My Holly has a tendency to dehydrate - adding a couple of teaspoons of water to her food along with a teaspoon or so of pumpkin (or any pureed yellow squash) has helped her immensely. She's had two enemas in the past three weeks and is now regular with a pink nose. She's not out of the woods yet, but this has been a BIG help. Hope this helps.
 
An idea for you that might be worth a shot - check with local high schools for a student interested in becoming a vet or vet tech. Offer experience working with a feline diabetic to help get into college. Must have good grades and references from teachers.

Teach this person and maybe he or she could get some mid-day tests for you.
 
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