KitKat update, ER visit 2

[KitKat's mom]

After being discharged 8/27, he was readmitted 8/28 for DKA again. Home now so we'll see. Reviewing paperwork now with hubby and Google. It's attached if anyone cares for a boring read. Advice would be helpful but please speak stupid since I'm not yet up to speed. Thanks!

 

[Kris & Teasel]

Was the second admission because of a relapse? What is his current insulin and dosage? Are you testing BG at home? Post DKA he needs fluids, calories and a high enough insulin dose to keep ketones away. Adding extra water to all wet food meals can help with hydration. Feeding slightly higher carb food can help too.

 

[JeffJ]

The paperwork is actually quite good. I agree with Kris's suggestions as well. One critical component is having KitKat's blood glucose values over time. Then you can see trends, and we could help more.

 

[KitKat's mom]

Was the second admission because of a relapse? What is his current insulin and dosage? Are you testing BG at home? Post DKA he needs fluids, calories and a high enough insulin dose to keep ketones away. Adding extra water to all wet food meals can help with hydration. Feeding slightly higher carb food can help too.

1st admit Friday. 2nd Monday. Both DKA. He's Lantus 1 unit. No ketone test yet; we're ordering blood tester because he pees outside and it's more accurate. No food this morning. Gave nausea, antibiotic, appetite stimulant meds. Glucose 598. ER vet said to give meds time to work and I'll test again. Boiled chicken cooling on stove for backup food (he only eats fresh boiled). He was eating during night so wth?

 

[Kris & Teasel]

No ketone test yet; we're ordering blood tester

Sometimes human pharmacies carry blood ketone testers.

Boiled chicken cooling on stove for backup food (he only eats fresh boiled). He was eating during night so wth?

Is this you go to when he won't eat or is this his usual food? Many people have success with human baby food - meat in broth, no seasoning, onions, etc. - when the kitty won't eat. It can be syringed in easily. You might have to resort to syringe feeding to get calories into him.

Did they get his BG down successfully while he was in the ER?

 

[KitKat's mom]

Sometimes human pharmacies carry blood ketone testers.


Is this you go to when he won't eat or is this his usual food? Many people have success with human baby food - meat in broth, no seasoning, onions, etc. - when the kitty won't eat. It can be syringed in easily. You might have to resort to syringe feeding to get calories into him.

Did they get his BG down successfully while he was in the ER?

I've tried human from my house to Charlotte and no blood testers. He just peed and pooped covering both; normally not covering is his tale tale sign of a huge problem. When he doesn't eat, he doesn't eat. There is no go to solution. I have baby food here and will syringe feed him if he doesn't eat by 8:30. Giving appetite stimulant a chance to kick in. Seem ER had it down but it was still higher than it should be the whole time.

 

[Kris & Teasel]

I've tried human from my house to Charlotte and no blood testers. He just peed and pooped covering both; normally not covering is his tale tale sign of a huge problem. When he doesn't eat, he doesn't eat. There is no go to solution. I have baby food here and will syringe feed him if he doesn't eat by 8:30. Giving appetite stimulant a chance to kick in. Seem ER had it down but it was still higher than it should be the whole time.

Is not eating an issue with him sometimes? Yes, you'll have to syringe feed if necessary.

 

[KitKat's mom]

He just at 1/3 of chicken. Have Gerber beef and beef gravey here at the house. Do you think that's ok or do I need to send hubby to the store? He's taken the rest of this week off to help with Kit/human baby so all hands are on deck.

 

[Kris & Teasel]

He just at 1/3 of chicken. Have Gerber beef and beef gravey here at the house. Do you think that's ok or do I need to send hubby to the store? He's taken the rest of this week off to help with Kit/human baby so all hands are on deck.

Any of the all meat baby foods are OK so long as they have no seasonings, onions, garlic, etc.

 

[JeffJ]

We did the syringe feeding thing with Leo during a low spot a few months ago. It's important to ensure that enough calories are getting pushed through their little bodies. We were able to get the procedure down to:
- 1/3 to 1/2 of the food went into Leo
- 10 paper towels max

Good suggestions from Kris. I also warm up the food a bit to bring the odor out. It seems to help.

 

[Larry and Kitties]

The vet prescribed mirtazapine as need to stimulate appetite. However, the prescribed dose is to high. The mirtazapine suspension is 3.75 mg/ml and the prescribed dose is 1/2 ml one a day (24 hours).
The old dose was 3.75 mg (1/4 of 15 mg tab) every three days but that frequently results in agitating the cat. A new dosage is 1.88 mg every other day was found to stimulate appetite and not results in adverse side effects
https://www.ncbi.nlm.nih.gov/pubmed/23838205
https://www.ncbi.nlm.nih.gov/pubmed/26228539

 

[KitKat's mom]

The vet prescribed mirtazapine as need to stimulate appetite. However, the prescribed dose is to high. The mirtazapine suspension is 3.75 mg/ml and the prescribed dose is 1/2 ml one a day (24 hours).
The old dose was 3.75 mg (1/4 of 15 mg tab) every three days but that frequently results in agitating the cat. A new dosage is 1.88 mg every other day was found to stimulate appetite and not results in adverse side effects
https://www.ncbi.nlm.nih.gov/pubmed/23838205
https://www.ncbi.nlm.nih.gov/pubmed/26228539

He's on liquid mirazapine susp 3.75 mg/ml #2.50. Giving .05 (one syringe) ever 24 hours if needed.

 

[Larry and Kitties]

He's on liquid mirazapine susp 3.75 mg/ml #2.50. Giving .05 (one syringe) ever 24 hours if needed.

Yes, you stated that previously. If you give it every day that would be 5.6 mg every three days which is higher than 3.75 mg every three days and 3.75 mg every three days is too high

 

[KitKat's mom]

So that means 3.75 mg per three days is too high??? Not sure if I understand correctly. I apologize!!! Not exactly sure how you got to those numbers

 

[KitKat's mom]

Yes, you stated that previously. If you give it every day that would be 5.6 mg every three days which is higher than 3.75 mg every three days and 3.75 mg every three days is too high

I'm sorry but my husband and I are unclear what you mean. So he should have it ever other day if needed only to prevent the side effects?

 

[Larry and Kitties]

So he should have it ever other day if needed only to prevent the side effects?

Yes, I would dose that concentration ( 3.75 mg/ml) as 1/2 ml every other day maximum

 

[KitKat's mom]

Yes, I would dose that concentration ( 3.75 mg/ml) as 1/2 ml every other day maximum

Got it. Thanks!