Klinger update

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Marcy & Klinger (GA)

Marcy & Klinger (GA)

Member Since 2010
Good morning,
Klinger seems to be feeling a little bit better. He's still eating, which is awesome. His eating habits have changed a little...he's still a grazer, but he's finishing all of his food and in less time. I'm speculating that he likes this food better; his numbers are super high so he's starving; something else is going on (because I worry over everything now). He did vomit last night, but he ate like a champ right after and this morning. Could it be because the FF Elegant Medley's are almost 1/2 the fat than what's in FF Classics - although EM is double in carbs? These are the things I'm speculating about. Every once in a while I see him dry heave, but nothing comes out and he'll still eat. What's that about? I did a search and came across an old blog from 2007 of a cat that was dry heaving and it turned out to be lung cancer...so yes, I'm now freaking out about that. :roll:
We did pick up another two bags of fluids, bup, and Cerenia to have on hand in case he gets another bout of p-titis. He now lays there when getting his fluids. I think he's figured out that they make him feel better.
Just wanted to check in...
Wishing everyone a happy and health New Year.
Marcy & Klinger
 
I don't think recovering from pancreatitis is causing his high BGs. There have been a lot of dose changes and skipped shots recently and that is not going to help. Even with all the changes, 1.25U had a very good cycle on the 15th & 16th, then 1U actually had a cycle which is ideal on the 18th. Although I realize he may not have been eating much then, so 1.25U is possibly a good dose. You're not going to find that out unless you drop below it and systematically work back up. Levemir just doesn't work well with constant dose changes.

With everything that's been going on for him & Radar I know you're doing the best you can, so please don't be upset with me. I know how it is when you're trying to get through their illness - you may not even realize that many changes have happened because you're trying to figure things out day by day.

It's good that he's eating and feeling better for sure, so you are definitely doing something right!!

((((((Marcy))))))
 
Thanks, ((((Vicky))))). No, I'm not upset with your comments. I have been making a ton of dose changes...when we were in the thick of the p-titis episode I was reducing his dose or skipping based on how much he was(n't) eating. Then when he started eating on his own again and eating higher carb food, I figured he needed more insulin to compensate and then I freaked out thinking that he was getting to much insulin and I would change it again. :oops: where is that banging your head against the wall smilie when you need it! ohmygod_smile this one will have to do.

Ok. So...do we start over at 1.00 unit? I just hate to see him in those high numbers, so I react with more insulin....I need to mellow out. :lol:
 
:lol:

As long as he's eating fine, it's probably safe to stay at 1U for a little while, probably at least 5 days though to get all these changes worked out of his system. Then let's re-evaluate his cycle with a curve and see if he needs more.
 
Ugh...5 DAYS...torture for me :lol: I'm going to have to check in every day for you to reel me back in from reacting to his numbers.

I'll reduce him tonight and sit on my hands and maybe tie my hands behind my back...I think there's a jacket made just for this purpose...to bad I don't have one of those handy.....5 days... nailbite_smile :smile:
 
Here are today's numbers:
AMPS 295 (vomited over night) 1.5 units (4th cycle)
+2 258
finished his 9% carb breakfast and started in on his 2nd can of 11% carbs can - ate about 1/4.
+4 305 - tested and went out to do errands. He was on our bed when I left. Came back an hour later and he was in the basement.
+9 186 - he's back up on the main level. He finished his 11% carb can.

Based on these numbers, are we sure we should drop down to 1 unit? He hasn't seen yellow or blue in so long...this is when I drive myself crazy... @-)

Tested for ketones and I can't tell if it's trace or negative. I usually test him in the basement, but since he's been hanging out in our bedroom (as the get well room) we added another lb. The lighting is definitely different. It looks like the color is falling between the two -neg and trace. I'll definitely catch him the next time he goes to make sure it's not getting any worse. The outer edge looked neg, but the center had a slight twinge of pale pink.
 
Hi Marcy,
I would hope it's just a trick of the light. I had that happen before when looking at ketone strips. It's best to look at them in natural light, but of course, it's getting dark now. There is not much difference between the tan that's normal on them and the pinkish trace.

If you can, give him some fluids tonight, that would be good if there are trace ketones. No more than 100ml. I suppose you could run out and get one of those Precision Extra meters which also test blood for ketones. At least try to get another urine test. Giving fluids will make him need to pee!

His BGs aren't too bad, especially not that +9. Ketones can happen even with lower numbers though, so just because he's been higher doesn't mean he's going to get ketones. How is he acting? When was the last time he was weighed and how did that compare to the most recent he was weighed before that? The equation for ketones is infection + not enough insulin + not eating. He appears to be getting enough insulin though and you say he is eating. A +9 of 186 is good! That is below renal threshold. He is probably OK.

Is the Elegent Medleys the 11% carb food? I fed that to Gandalf during Pancreatitis because it is low fat but I remember it being higher in carbs. There are other lower fat canned foods which aren't so high in carbs. The mantra on the board about food has always been below 10% kcal from carbs. That could also be a factor in his higher BGs. Even something like 9 Lives is lower in fat than Wellness or other "premium" foods. I usually look for less than 5% guaranteed analysis on the can to consider a food lower in fat. No one is convinced that fat is a factor in pancreatitis though. I continued to feed Gandalf Wellness and he didn't flare in the last 6 months.

Hope this helps ease your mind a little. Otherwise you should take him in to the ER, if there is possibility of ketones. They can test for ketones and you'll know for sure one way or the other.

If you're concerned about lowering the dose because of the ketone uncertainty, stay with the 1.5U dose for now. The important thing is to not change the dose so much. if the 1.5U is too much, he would eventually have a low number.

Keep us updated.
Vicky
 
Thanks, Vicky. His PMPS is 470. I think I'll stick with the 1.5 tonight just in case. I gave him 50 ml at AM +10, right after I ketone test. I'll give him another 50 ml in a few hours. He's eating fine, preening, interested in what Radar's doing, peeing, and pooping.
Thanks for your support. I'll definitely take him into the ER if his ketone numbers are higher. I don't want to mess around with that!! Hopefully it was just the lighting.
The trouble with the food is finding something he'll eat. I used Friskies to assist feed him, so I don't think he'll want to touch the stuff now. He still won't eat his FF Classics and to tell you the truth, I'm a little freaked out by the possibility it was something in the food that set him off.
Thanks again!!!

ETA: I forgot to answer your question about his weight. He was 19.5 when we brought him in to the ER two weeks ago. When I brought him in on 11/30, he was 20 lbs, but that also included a blanket. I would say that was roughly the same. I'll have to get him on the scale tonight and see if he's lost weight. I would imagine the reduction of fat intake in his diet would cause him to lose some weight. I'll keep you posted.
 
Marcy, nice update on your Klinger boy. I have been trying to catch up with everyone. So glad he seems to be doing better. And my, what progress you have made giving fluids! You make it sound so easy now!

Good advice from Vicky as usual on everything. :)
 
Marcy, it;s good that he is eating more and seem to be doing well.

Just a couple of comments on numbers, dose, food and "dry heaves":

The food is probably adding to the higher numbers - so I would not reduce the dose right now. You need to work the insulin around his other issues and if feeding a lower fat food that is higher in carbs is helping him heal from the p-titis then you give insulin to compensate. I always think of the diabetes as being "flexible" and needing to managed around other issues that are not flexible. You certainly don't want him in the 400s.

Are you sure he is having dry heaves and not coughing? I always find it impossible to tell a cough from a sneeze in a cat, but I don't think I have ever seen dry heaves. Maybe a single retch if something is stuck in their throat. How is the air in your home? Is it dry? Maybe a humidifier would help him?

Hope there are no ketones. Fluids will help.
 
Thanks everyone. I didn't get another opportunity to test ketones last night and I was worried I wouldn't be able to get a test in before going into work this morning (I thought I was on vacation...hmmm). I gave him another 50 ml this morning and he used the lb just a few minutes before I had to leave. :-D I took the strip to a few different lamps/light sources and this time they all looked negative. I think last night was the bathroom light playing tricks. I'll continue to monitor Klinger for ketones.

Pamela - giving fluids is very easy now - kinda like how hometesting became after so many times. :-D I now hang the bag on the curtain rod in my bedroom, Klinger's laying on the bed, and we just go for it. It does take a little longer since he's not on the floor, but at least he's comfortable this way. It helps for me to see the level on the bag too. ;-)

Shelia - The air is pretty dry here. I'll pick up a humidifier and see if that helps him. Great idea!

Well, I just got pulled away because Klinger came up from the basement and he and Radar decided to have a little hissing/sneak attack from under the bed episode. :roll: :lol:

I did manage to get another ketone test in and it now looks like it falls between the neg and trace again. He's also in the 400s today. This is the third day on 1.50. Should I stay on the dose or increase tonight? He did have some good numbers yesterday, but I think that's because he vomited overnight...bing, bong.. what to do???
 
Hi Marcy and crew, Just stopping in to get caught up on everyone. I'm so glad that Klinger and Radar are both home and continue to do well. I don't know about you, but I now measure each day by how many of my cats are eating all their food, and how many P's are firmly in place. It's the little things that give such great joy to us kitty mommas!

For what it's worth, I'd suggest holding the 1.5u for another cycle or two at least. He's only had 6 cycles at this dose and there has been a downward trend in BGs since you started. His throwing up last night/the night before last could have affected yesterday's numbers. But then today's numbers could just be a bounce off of yesterday's good #'s that he hasn't seen in awhile. Since the threat of ketones is there I would not suggest reducing dose at this time. If he's absorbed the 50 ccs SubQ LRS from this morning, you could give another 50 ccs this evening. (I suggest checking to ensure he's absorbed this morning's dose first to be on the safe side.) The fluids will help with the ketones, keep his electrolyte balance in check and also combat any dehydration.

Regarding the food, it is possible that the Fancy Feast Elegant Medleys is causing his BGs to run a little higher. Depending on which flavors you are feeding, they run between 9 - 13% carbs, 28 - 36% fat, and 52 - 61% protein. The higher carbs. do hit the bloodstream faster because they are simpler construction and glucose does enter the bloodstream faster so you will see a more immediate spike in BGs. (This can work to your advantage if you ever have to shoot a low PS, you know he will rise more due to the food.) Both proteins and fats require more dissassembly before glucose can enter the blood stream, so there is less of a sharp spike effect but they do last longer.

I wish I could say how much the FF EM affected Harley's BGs but I wasn't really ever sure. I did notice a slight decrease in BGs when I was finally able to switch him back to FF classics a few months ago though - 6 months after he got sick. For the longest time, he just wouldn't touch them. I guess it took him 6 months to get over his food aversion. So Klinger may come around in time as well. If he likes the FF EMs, and responds well to them clinically, (no more P-titis attacks) then I suggest staying with them for now and shoot around any food wonkiness.

EDITS: To fix multiple bad spellings, mamma mia!
 
Glad to hear that Klinger is eating more and feeling better. Hopefully your boys will leave all the sickness behind in 2011!
 
Thank you Laura for that information on your experience, It's always so appreciated and very helpful!
Darlene, thanks for checking in on us.

Klinger started out great this morning. AMPS 233. Then I think he had a fur shot. ohmygod_smile ohmygod_smile ohmygod_smile ohmygod_smile ohmygod_smile I didn't feel anything, but I could smell the insulin. He acted great all day. He was a little more social and came into the living room a few times today. He still ended up in the basement late morning into early afternoon, but he likes to sleep in a box of old clothes down there. He chased Radar under the Christmas tree and then seemed to look forward to another sneak attack from under the bed from Radar. Hopefully tomorrow will bring better numbers again.

WIshing everyone a very Happy and Healthy New Year! party_cat drinking24 party_cat
 
None here either because he was 500s yesterday, which could have been a fur shot. That stinks.

Does he go back for any kind of follow up? Did they confirm pancreatitis? Sorry, but there's no mention of what's wrong on spreadsheet and I forgot...

Please check for ketones. Lack of insulin is a big factor in them and that possible fur shot yesterday isn't a good thing.
 
Happy New Year Marcy, Klinger & Radar! Glad he seems to be feeling better & hopefully those numbers come down tomorrow!
 
Hi Marcy!
I haven't been here in forever, and I was feeling a little withdrawal. How is Klinger feeling? I'm just getting on board the p'titis train myself. It looks like Charlie may have it, but we haven't tested for it yet. Is he on any pain meds for it? My understanding is that it is quite painful, and that could certainly contribute to the high numbers. I'm sure you've already considered that, but I figured I'd mention it. Wow, he's 20# :shock: He's got a pound and a half on my big guy :lol: Has he fallen in love with Radar yet? I can't imagine the stinkeye I would get from my kitties if I brought a kitten home!

By the way, I love the new pic of him!
 
Oh no Claudia! I hope Charlie isn't headed for the p-titis train. It's a horrible ride!!!!!! How's Charlie acting?

Klinger's higher numbers seems to be from the high carb food he's eating. He's finished both cans already today. That never happened when he was eating the FF Classics. He doesn't act like he's in pain. I can touch his underside without him reacting...except to go into a full body stretch. He's not meatloafing. His eyes are bright and he's no longer hanging out solely in the bedroom.

Klinger's been on 1.75 for 10 cycles with little progress except for an unexpected PMPS of 198 on 1/4. So, increasing by .25 tonight unless you see something that I'm not seeing.

Radar just jumped on the coffee table, found the bag of catnip and took off with it. :lol: I get the hint!
Klinger hasn't fallen in love with Radar. I do think he likes their little encounters even though they hiss at one another. It gives him something to do and he's always looking to see what Radar is up to.

Vicky, we didn't actually do the p-titis test. When we took him back to the ER the 2nd night and saw a different vet, she agreed that his symptoms definitely sounded like p-titis and we decided to treat it that way. I know, I know, I know... but between the two of them and all their ER bills and Rx's and the money we had spent for Christmas, we just had to take a chance and treat for it without getting the test done. If he didn't improve, they wanted us to bring him in for an ultra sound. So far, he's improved - antijinx.
 
There's nothing wrong with treating for p-titis without a confirmation test. I only liked having had a confirmation so that the next time he developed those symptoms I knew what to do. It still cost me to go to the vet to get the meds though 'cause of course they had to do blood tests. But it was cheaper than investigating for something else or treating for something else when it was a p-tits flare.

So you did the right thing and obviously the vet was on the ball and didn't make you do more tests before providing treatment.

Not sure how to help with him & Radar getting along. It may just take time. Maybe if you try to play with them both at the same time, or use an interactive toy and involve them both - like let Radar get it for a bit, then tease Klinger with it too so they get equal treatment. That may cause more problems though, it really would depend on their temperaments.
 
I'm glad that there hasn't been any bloodshed among the recruits :lol: Hopefully Radar will bring some spunk back to Klinger. Charlie has had a few occasions of super-high numbers combined with lethargy and vomiting bile. We will try to test next time it happens, just to confirm it, although my vet says that it's pretty likely. I've never done fluids nailbite_smile so that's completely scary for me. I'm so glad to hear that Klinger is feeling better! :-D :-D
 
Thanks Vicky! So, I went on to Janet and Binky's food charts and added up the values for a day when he used to eat FF Classics and now that eats FF Elegant Medley's Shredded to see the difference. :shock:

Protein Fat Carbs Fiber Phos Calories
Classics 173 217 13 1.8 1324 370.9
Shredded 228 133 39 .7 1073 346
difference +55 -84 +26 -1.1 -251 -24.9

Could the reduction in fat be the cause for his increase in appetite? What about the reduction in fiber? Should I add something to his food to compensate for the reduction? .7 doesn't seem like nearly enough. Does anyone know what the recommended amount of fiber is for a cat? :shock: on the amount of phosphorus! Glad it reduced a little bit, but it still seems awfully high.

Claudia - if you have to give fluids to Charlie, there were two great links in my thread - Klinger's at the ER from Vicky (& Gandalf) and Gayle (Shadoe & Oliver).
 
Marcy & Klinger said:
Thanks Vicky! So, I went on to Janet and Binky's food charts and added up the values for a day when he used to eat FF Classics and now that eats FF Elegant Medley's Shredded to see the difference. :shock:

Protein Fat Carbs Fiber Phos Calories
Classics 173 217 13 1.8 1324 370.9
Shredded 228 133 39 .7 1073 346
difference +55 -84 +26 -1.1 -251 -24.9

Could the reduction in fat be the cause for his increase in appetite? What about the reduction in fiber? Should I add something to his food to compensate for the reduction? .7 doesn't seem like nearly enough. Does anyone know what the recommended amount of fiber is for a cat? :shock: on the amount of phosphorus! Glad it reduced a little bit, but it still seems awfully high.

Claudia - if you have to give fluids to Charlie, there were two great links in my thread - Klinger's at the ER from Vicky (& Gandalf) and Gayle (and Shadow).
Click to expand...

I'm not much of a food guru, but man the carbs on that shredded stuff seem awfully high. If I remember right from when Gandalf had p-tits and I discovered Elegant Medleys were low in fat, there should be some EM varieties less than 15% kcal from carbs.

When a food cuts back on either protein or fat, one has to be increased to make up the difference, so I don't know if you can say the lack of fat makes him more hungry. He may just be feeling better and want to eat more now.
 
I'm not much of a food guru, but man the carbs on that shredded stuff seem awfully high. If I remember right from when Gandalf had p-tits and I discovered Elegant Medleys were low in fat, there should be some EM varieties less than 15% kcal from carbs.
Click to expand...

According to the "new" food list, the Shredded varieties are the least coming in at 9 - 11%. The list doesn't have the Florentine EMs and I think there's another kind...Primavera? Not on the list...

I'm going to have to start mixing in a little bit of the Classics soon. I'm running out of room in the dedicated kitty food closet. :smile:
 
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