Mačka, newly diagnosed, very recent DKA, high glycemia on Lantus 1.5U

Hi everyone,

My vet told me about your board which I have been reading through and through, discovering the feline diabetes world as I try to understand what's happening to my cat.

Mačka, 15 yo, was diagnosed with diabetes a month ago (BG 400ish). He was living in France with my mom while I was settling in the US, but her being blind, she could not give him any treatment, so I urged her to bring him here in Portland, Oregon with me. The French vet was very relaxed about the whole situation, saying treatment could wait until he got to the US. They flew for over 20 hours and he arrived in the poorest state :'( He could barely walk, was completely dehydrated and overall very, very sick. The next day I brought him to the ER: he had ketones 1+, pancreatitis, UTI, diarrhea, vomiting, and no appetite = ketoacidosis. They kept him for 4 days and saved his life. Now he's back at home with me and I have been treating him with Marbofloxacin (5 more days to go/ 14 days) for his UTI, giving him Cerenia for the nausea, potassium (it was very low), probiotics.

Most importantly, they put him on Lantus at 1 unit x2 day. When I managed to test him, his glucose level was always above 400. When we did his first curve last week, he was at 253 AMPS though, but then went off the roof to peak at 600 in the late afternoon. Vet said to increase to 2 units 2xday. Which I did after giving him 1.5 unit for a day because i was so scared of hypoglycemia. I can't sleep at night because I fear he'll go into hypo and I won't see it because I am sleeping and he'll die. So I wake up every 3 hours to check on him and give him a treat
Anyway, I injected 2 units yesterday morning, and at PMPS he was at 151 (and pee and thirst were normal). I panicked, because I thought that with such a BG, I should not give him another 2 units or else I would cause hypoglycemia. Vet said I should go back to 1 unit and test 2 hours later: he was at 419 again. Today I decided to go for 1.5 units. Both AMPS and PMPS were at 415 and 469. I honestly do not understand what's going on.
Am I doing injections properly? In addition, he became very finicky and lost most of his appetite. The only food he will eat at the moment is the dry food m/d (and some tiki cat meat tube), which frustrates me a lot. I hope it's just caused by the antibiotics and will resume after.
It kills me to see him diminished, grumpy, not purring. I am so worried that I can't sleep and can hardly eat. I do not function anymore, stopped working to care for him and go slowly into depression. This is hard.

I would appreciate some of the members' light and knowledge to help me decipher this situation.
Thanks a lot,

Penelope

 

Hello Penelope, and welcome to the greatest place you never wanted to be. This board helped save my girl, and I hope we can do the same for you.

First thing, if you haven't already, is to read the yellow starred Sticky Notes on the top of this forum. There is a lot in there, so ask questions. We love to help here.

I am glad to hear you are home testing the blood sugar. As far as dosing, most of us use a common spreadsheet format to keep track of our blood sugar test values. The instructions on how to set up that spreadsheet are here. Once you get that set up, we'll be able to help you with dosing. We do have a couple of dosing methods we use here. Since you are still feeding dry food (or being forced to ), you would start following the Start Low Go Slow method of dosing. Since you are dealing with a kitty recently DKA, you probably wouldn't start with the starting dose listed but maybe stick to 1.5 units for a bit.

Cats that are newly diagnosed tend to have blood sugar numbers all over the place at first, as their body sees numbers lower than they are used to. One phenomenon that is very common is something we call bouncing. From the New to the Group Sticky Note:

• Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

A couple other things about dosing and Lantus. We determine how to change the Lantus dose based primarily on the low points or nadirs during the cycle (time between the shots). That means it's important to get some tests at times between the shots when the insulin is strongest. And with our dosing methods, we find it best to dose consistently, in other words, give the same dose day and night, unless the dosing method says it's time to change it. Understanding the depot is also important - there's a Sticky Note that'll help you there.

 

Hi. I only have a few minutes before I have to leave and go out, but just wanted to say great for doing home testing. It is really important after having DKA that Macka is eating plenty of food and you are giving enough insulin. Try not to skip any doses. You may have to reduce the dose so you can give the insulin twice a day.
Are you testing for ketones in the urine ? If not I would go out and buy a bottle of Ketostix from Walmart or a pharmacy and check the urine at least once a day for ketones. This is really important.
Macka may be feeling nauseated as well so ask your vet for some cerenia and ondansetron that you can give at home. Cats recovering from DKA often feel nauseated for a while. Small frequent meals and anything Macka will eat at the moment is fine.
I will post again when I get home. Hopefully others will do so as well.
ETA I see you are giving cerenia. Ondansetron acts on a different pathway so is worth trying as well.
Glad you have found us. Welcome to you both!!

 

Hi again Penelope, I am so sorry your Macka has been through DKA. The French vet was wrong to have just left him until he got to you. Your current vet sounds much better and great he told you about this board.
As I mentioned above, it is really important when a kitty is recovering from DKA that he gets enough insulin and enough food and any infection is being treated. It sounds like you are doing everything right.
Have you looked at a few different foods to tempt him? You can also give him some higher carb food as well if that is all he will eat. At the moment, the most important thing is he does eat. Food is like a medicine with DKA.
Wendy suggested giving 1.5 units twice a day and I agree. Test before every shot to see it is safe to give the insulin and then test during the cycle to see how low the insulin is taking Macka. As Wendy said the dose is based in the nadir so getting those tests in tells us good information. When increasing or decreasing a dose, we recommend you go up or down in 1/4 unit increments so as not to miss the best dose.
How is his hydration? Are his gums slippery and wet, or tacky and sticky?
If you lift up his scruff, does it drop down quickly or slowly?
Will he let you add some warm water, about a teaspoon to each of his meals to start with, do you think? It is also important he is getting enough fluids.
If you are testing the Blood Sugars before shots and during the cycles, you will be in control and even if he drops low, you will be able to bring him up higher with some high carb food and/or honey.
When you go out to buy the Ketostix, to test for ketones, also have a look for some higher carb food. Gravy foods or ones with rice in them will be higher carb. The MD dry is around 17% carbs which is medium/high so if you are swapping over to lower carb food, just be aware that the blood sugar levels will probably drop with the lower carb food. Low carb food is best for diabetic kitties but when a kitty is recovering from DKA the most important thing is to make sure he is eating, so if it is only high carb he will eat, that is OK. Once he is better, it can be changed over to low carb.
Keep asking lots of questions. I'm sure you have been very worried and stressed but you have come to the best place for help and support
@AliceMeowliss&Cassandra has recently been nursing her kitty through DKA and she might like to add something

 

Penelope, I would also put ‘very recent DKA ‘ in your subject line to alert people.

 

Hi @Wendy&Neko and @Bron and Sheba,

Thank you so much for your quick replies and your kindness.
It's been a rollercoaster here and I feel so distressed/exhausted/helpless. I keep an eye on Macka at all times and interpret every little muscle twitch, every lip smacking, and always fear the worst: it drives me insane. I wake up 3-4 times at night to check on him, give me a treat (one drop of tiki cat tuna mousse), just to make sure he will be hungry enough in the morning.

I have been testing ketones every day since he was released from the ER clinic and so far, he hasn't had any, or maybe traces, although it's hard to tell because the strip stays pretty pale. On the other hand, the glucose strip turns out always very brown.
Are you saying that as long as he's eating, he's not going to go into ketoacidosis? I will buy some gravy food today. I've been trying to give him low carb wet foods, and sometimes he accepts it, but I have to go after him and beg him to eat, put some dry food on top of it to make it more appealing etc... He used so be such a big eater (former fat cat). He eats smaller portions now, is it ok with insulin? How much does he need to eat per meal to NOT be in danger? I read that I had to starve him during the day so he could eat at insulin times, but you're saying that it's ok to feed him smaller portions throughout the day: what's the best way to go?

He has 2 shots a day, at 8am and 8pm. I have been very regular, never missed a shot. He is the one not being regular.
This morning, at AMPS he was at 547 on 1.5 units If I understand well, I should stick to this dose for 6 cycles? If so, I have to until Sunday morning because we will be away for 1 night and we have a caregiver that will come and give the pm and am shots and I do not want her to give a higher dose without us being around. Do you confirm it's safer?

Is the insulin having any effect since he has the same numbers with or without it?
Also, with such high numbers on insulin is he at risk of complications, or even death?

regarding the syringes, it's been more difficult to give him his shots since we bought the Walgreens ones (we asked for longer ones though). He even complains and I don't want to hurt him. Do you have any brand recommendation?

I have to go back to work and will not always be able to test during the day (if he allows me, he is very very grumpy). I will do my best.

Thank you for referring me to the spreadsheet, I will look into it right now!
Have a great day,
Penelope and Mačka

 

You have some great advice that’s been given already, what sounds like a decent vet, and a lot of good skills already in place. So here is what I want to add for now.

I stayed up almost all the time for about 5-6 weeks post-DKA, nursing Alice. A good dose of Lantus and all the usually LC wet food she had fattened her back up and made a world of difference. She was never overweight so she got as much as she wanted.

Also you are asking about his numbers being all over the place, take a look at Alice’s spreadsheet linked in my signature and you will see that she was all over the place too. That can be normal at first.
The best way to answer “is this dose safe” is for you to get any tests in the middle of the day, preferably between 4-7 hours after the shot is given, when insulin activity may be at its peak (we call this the nadir). If you have to work one day, that’s okay. Try the next time you have a chance. Any extra data to add to your spreadsheet will allow us to look and see what’s going on and give better advice.

I know you must be exhausted; I was too, and sick with worry.

I want to share with you, Alice in the hospital during DKA crisis, and now, less than 3 months later. Please know there is hope. Also, I promise you will eventually get chances to sleep more.

 

Hi @AliceMeowliss&Cassandra ,

What a beautiful little kitty! Yes, Macka was looking that sick too and is already regaining weight. His fur looks better as well.
I can see that Alice's numbers were indeed erratic at first, and got more even with time. It gives me hope.

By looking at my new spreadsheet, it looks like Macka's nadir happens (sometimes) at around +10 or so. Could this be possible?

 

I forgot to mention that yes, I give Macka a lot of water, and he drinks happily, all day. I do not think he is dehydrated right now. He also gets some Potassium supplements.

 

Just dropping in to say hello and welcome to you and your handsome fellow.

 

Welcome to you and Macka. In time you will find a routine and things will settle.

You say you like the longer syringes. Definitely want ones with 1/2 unit marks. Length of needle is a personal choice, no right or wrong one. Where you shoot insulin is also a choice. My Olive has no scruff and with long hair it's a hard spot for us. I shoot in the side with short needle while she is eating. It is said using side or flank insulin is better absorbed but I don't know how that's determined. It just works for her and me.

Numbers being all over the place. Yes they can be for any number of reasons. If you look at Olive's 2018 spreadsheet you will see many things. At first being stuck and glucoses not changing. Switched insulins. Diagnosed with high dose condition, then pancreatitis that lasted 6 weeks. Lately a few interruptions causing big reduced doses. Even now it seems the slightest change can upset her.

Life happens and it will be okay as long as we try to minimise interruptions.

Auto feeders are great. Ones where you set the times or a microchip one kitty can access themself. You can freeze portions of food so when it's melts when it's time to be eaten.

You do need to take care of you too. I understand stand how anxious you with Macka just being as sick as he was. With glucoses being high getting your sleep is important. Believe me you will lose enough later but for better reason.

Keep breathing everything will fall into place.

 

Lantus is a depot insulin. Meaning it has to build up a reservoir which usually takes 7 days. It's to early to say when Macka nadir is. With Lantus it is usually +5-7 hrs after shot. Some cats do fall outside of that though.

Since you have given 1.5 for a couple of days, I think keeping that dose for the 7 days, others chime in here please, is a good start.

Make sure you get a test right before each shot and try to get one at the +5, +6, or +7 time after shot. Scatter times and days, the more data the more power you have to help.

 

Hi @Olive & Paula ,

Thank you very much for your insights. I did not know about the "depot" dimension. I will then keep it 1.5 for a few more days.
I just went for Macka's +5 blood test and could not get a sufficient drop. Then I looked at his ears with a torch and poor thing, it's all bruised and red of all the pinches I did. It broke my heart and I could not try another time. I'll try again at +7.

 

Hey Penelope, Welcome to the group

To help with bruising some of us gently massage the area we pricked while we are using a cotton swab or Kleenex to stop the blood flow in order to prevent scarring and bruising. You can also use neosporin AB with pain relief to ease any irritation Macka might be feeling in his ears.

It will get easier

 

Like Wendy said, this is the best place you never wanted to be!

The front end of the learning curve is HUGE. It's overwhelming. There's so much to learn! That's the down side. The upside is that within a surprisingly short time, it will all become routine.

First, you need to take a deep breath and be calm for Macka. The calmer you are about testing and shooting the easier it will be for your kitty. They sense our anxiety.

Looking at Macka's spreadsheet, I have a few observations. It's very important that you get a test before every shot. It's the only way to know for sure that your cat's BG (blood glucose) numbers are in a range where it's safe for you to give a shot. That said, Lantus dosing is based on the lowest number in the cycle. If your cat follows the "rules" (most refuse to), you will see a slight movement in numbers at +2 or +3 (this is called "onset") and the lowest number in the cycle would be at +6 ("nadir"). The tricky thing with nadirs is that they move around. In addition, some cats routinely have an early nadir and some have a late nadir. Inevitably, as soon as you think you can predict what your kitty will do, he'll change it up. They do not want us to become complacent!!

In addition to reading the sticky notes and asking questions, it may be helpful to look at spreadsheet. It will give you a sense of how similar and how different each of our cats is. In fact, one of the expressions you'll see is EICD ("every cat is different").

Let us know how we can help. (And kudos to your vet for sending you to us!!)

 

Hi @AmandaE and @Sienne and Gabby (GA) ,

Thank you for all your kind words.
I just took Macka's BG at +9 and it was an alarming 560. I am panicking, should I increase the dose to 2U?
He looks very lethargic.

Thank you

 

Hi Penelope, Sienna has given you good advice. I know it is very stressful seeing those high numbers but try to remain calm if you can. You are doing a great job looking after him and I am so glad you are testing daily for ketones!
Have you tested for ketones today? If you can put the results of the ketone tests in the remarks column of the SS that would be very helpful as well as putting it in the thread.
Looking at Macka's SS he could be bouncing from the blue number a couple of days ago (Bounces can last for up to 6 cycles), or he could need more insulin, or it might be from higher carb food, if you have given him any.
What food has he had in the last 12-14 hours?
Also increases should go up in 1/4 unit increments so IF you did increase, you should go up to 1.75 units.
Are you able to monitor the blood sugar levels if you increased the dose? Have you been able to get some higher carb food yet?
How is Macka' appetite? Sorry for all the questions.
I am concerned he is lethargic. @Sienne and Gabby (GA) what do you think of increasing the dose to 1.75 units because of the high BSLs and lethargy........I'm just wondering if he could be bouncing from the 151 2 days ago.

 

Don’t panic! You’re doing fine! Like the others said before stay at 1.5u, trust me, patience is one of the hardest parts starting out

It’s really important to hold the same dose for a week so that Macka can build his Lantus depot. Consistency is key

I’ll tag @Bron and Sheba as I think she’s online right now and has experience offering advice for kitties that have suffered through DKA, especially if Macka is feeling lethargic.

 

Oh my I am so sorry Mačka is not feeling well. I was reading your first post earlier and I hate so bad she had to take that airplane ride not feeling well. By any chance are you using the Alpha Trak or a human meter? I'm not able to offer you any advice except for a hug and assurance that you in good hands with the regulars here on this board. They are a Godsend for newbies!

 

sorry @Bron and Sheba you were Quicker than me at responding thanks for supporting

 

No problem! Thanks for tagging me!

 

Hi all,

I use Alpha Track 2 for pets.
Ketones are negative today as well. When I say lethargic, I mean that he's basically laying on the ground, not doing much. I can see he's very tired. He is also a little weak from the back legs. I attribute it to the high BG, but could it be something else? He's taking antibiotics for a UTI and is almost done with them.

He's had chicken with broth this morning, and a few kibbles (1/4 of a scoop?) m/d to pass the medicines and accept the insulin shot. I also gave him tuna water at 1pm. That's it. He drinks a lot and is not dehydrated from what I can see.

Thanks!

 

Regarding the bouncing, if we have to wait 6 cycles, then the 7th cycle should be tomorrow evening. Should I then change the dose tomorrow or wait 3 more days? Are these high numbers killing him slowly??

 

When you have time could you set up your signature please. It will show up at the bottom of all your posts in pale rioting and will tell everyone your information so we won't have to keep asking you questions. To do the signature, go to the top right of this page and click on your username. Choose signature, then tell us yours and Mackas name, date of diagnosis, DKA and any other health problems, type of insulin, type of meter, food fed, method you are going to use ( when you decide), medications then save. Done! Thanks.
That's good he is negative ketones. The high B S level could be making him feel lethargic. The weakness in the back legs is probably diabetic neuropathy which is very common and it should go away when the BSLevels go back to normal. There is also medications that can help with that called Zobaline for cats which can be bought from lifelink.
Try and get him to eat more during the cycles if you can. The food intake has a really important role in stopping the ketones from forming.

I'd like to get @Sienne and Gabby (GA) input re the possible bouncing and increasing the dose first before deciding. Is that ok with you?
Re the high numbers. I know it is really hard seeing them but low numbers are much more dangerous. They can kill in a minute. That is why we always test. We say 'better a high number for a day than a low number for a minute'. High numbers can take their toll over time but short term he should be fine. I do understand. My Sheba had very high numbers when she fell out of remission (this was before I had found this forum) and I spent days and weeks stressed out worrying about her.
But in saying that we do want to get Macka's BS levels down because of the DKA and getting enough insulin and concern about ketones..YOUR main job is to make sure he is getting enough food and fluids and testing for ketones every day and giving the insulin. And you are doing really well. Hopefully Sienna will see the tag soon. How long til the next shot?

 

Hi @Bron and Sheba ,

Thank you for the advice. I just updated my signature.
regarding the food intake, are you saying that I should feed him also in between shots (he would thank you for that)? Should he eat more that 2 meals a day, should I give him many little snacks? Is the snack Tiki cat mousse (9 calories per tube) ok? Please let me know as I really wonder what to do here.

 

Great signature thanks! So helpful.
Yes absolutely feed him inbetween the shots. For example feed him Preshot and then +3(3 hours after shot), +5(5 hours after shot ) and +7. Some feed three times during the cycle and some people feed 2 times during the cycles and some people free feed. Just take up the food for the two hours before the Preshot so that the BSLevel is not food influenced. Also feed during the night time cycle.
Tiki cat food is usually suitable. Not sure what carbs are in the mouse though.

 

With a recently DKA, you want to get lots of calories in him. Feed the poor boy! I believe the mousse is low carb. Some people here have grazers, and they just leave food out.

 

@Wendy&Neko what do you think about increasing the dose to 1.75 units. Macka is lethargic and in high numbers, no ketones today though, but unsure if that is a bounce or just high numbers?

 

@Penelope and Mačka looks like Wendy and Sienne are not online anymore and it must be near shot time. I think probably leave the dose at 1.5 units for tonight and hopefully we will see if he comes off the bounce before the next shot. (if indeed he is bouncing). How does that sound? But get him to eat all you can.

 

Hey @Bron and Sheba ,
Yes, I just gave him 1.5 units. He had a good Fancy Feast chicken can that he actually liked a little more than others. Now he's in catnip paradise. I need to sleep tonight because I have a long working day tomorrow. It's scary to leave him alone for a full day, thankfully I have a camera. Let's hope his next reading will be better.

I am so thankful to have found you people, you are the best.
Have a good night.

 

I’m glad he ate. If you are working tomorrow it may not be wise to raise the dose if you can’t monitor. Let’s see what the BSLevels do. Is there anyone who can feed him during the day while you are at work.?
Try and get another ketone test in before you leave for work if you can.

 

Just popping by, it looks like you have some good support and plans in place for Mačka!
-I agree, feed him all the time he will eat except for those two hours before shot time.
-if you are working tomorrow and no one can monitor him, it may not be good to start a dose increase. Maybe you could see what the numbers are like tomorrow and revisit an increase for tomorrow night?

I know this is so overwhelming-feeling at first! So much. That’s why you just need to breathe. I felt really bad for my girl when she had a lot of high numbers. My baby was sick and I did not want that at all. But you are in the process of doing what needs to be done. Someone reminded me once, FD is a marathon, not a sprint. That can be frustrating sometimes, too. Then there will be moments where you see improvement that will give you great joy again. Just keep going.

Mačka is in wonderful hands with you and everyone here as well.

 

Could you update the spreadsheet with the latest test data? As long as ketones remain negative, and he’s eating well, we can wait a bit on the increase. Those blacks will make him lethargic.

Many of us got automatic feeders to help make sure kitty gets food when they need it if we are away during the day, the Petsafe 5 is a popular model. A less accurate option is to freeze some cat food, part water with cat food. You leave the frozen food out and it melts and is available for later.

If you aren’t sure of the ketone strip status, try it on yourself.

 

I suspect that some of the high numbers you're seeing are due to the kibble. M/D dry food is high carb. The higher the carbs, the higher the numbers. I'd encourage you to remove the dry food from Macka's diet and stick with the lower carb. We generally don't even encourage the use of kibble if you need to bring numbers up. It takes longer for dry food to be metabolized and have an effect on numbers and it takes longer than a HC canned food to leave a cat's system. (You do want to have some HC canned food on hand. There are varieties on Dr. Lisa's list.. Many people will use Fancy Feast Gravy Lovers which is fine unless your cat is sensitive to gluten.)

If you're home during the day and can get a few spot checks, that would be great. In the evening, I'd suggest getting at the least, a before bed test every night. It's particularly important to get PM tests if you're not home during the day. The more data you collect, the easier for you and us to understand how Macka is responding to Lantus.

I would give the dose a little more time. If there's a change in ketones, I'd reconsider that statement. You don't want to increase Lantus too quickly. The dose/depot needs to stabilize otherwise you end up with wonky numbers.

 

Good morning,

This morning, his Ketones were negative again.
I fed him less, but multiple times 3 hours before PM shot, then at 1 am, and at 6:30 am (very bad sleep again). I avoided completely the m/d kibbles, but I now face a challenge when giving him his shot. He hates it and now jumps forward every time I put the needle in. It's becoming a battle with the kibbles he was at least mesmerized by them for 10 seconds.

I can't install an automatic feeder because we have another cat. I decided to come back for lunch when I work, but it's going to be an extra challenge with the traffic and leaving the workplace for an hour instead of 1/2. We'll see how it goes.

Wish me luck today, I don't know how I can go back to working with Macka in mind all day.

 

Welcome to a wonderful support group for FD! You're in the right place. I remember how overwhelming it all was at first - it takes time and patience but you'll get there. Lots of people on this forum have to leave for work - so you can read about them and how they handle their kittiehs when you have time.

For now, do your best - for it's all any of us can do. You're a good mama for helping Macka! I'll be looking forward to your new thread (that's what we call the posts, or condo) tomorrow. If you could please start a new one each day - like this 6/28 Macka AMPS ### - Recent DKA...other items you'd like to share briefly...people will see the new posts each day and will look and help you along. It's a steep learning curve here...just take it a day at a time. Sending hugs your way.

 

Did you get tests before the shots last night and today? It's really important to test before you shoot, to make sure it's safe to give insulin. If so, please update the spreadsheet. We also need that data to decide what to do next with the dose. Good to see the negative ketones.

 

Hello and welcome. You’ve all ready been given sone good advice. I just wanted to say hello and welcome and keep asking questions. That is how we all learned. And let us know how we can help you.

 

Hi all,

You're all so very kind and sweet it makes me want to cry
You've already helped me so much it's incredible.

I could not take Macka's BG this morning because I poked 5 times and could not get blood, and then he was very angry.
However, I took it at +4 and PMPS and got amazing results (for him it's already amazing): 353 and 377!!!! What a drop from yesterday.

He had 4 meals today, and ate each one without any issue. I could see he was feeling better, just by his behavior, more playful, more curious and overall better energy level. Less pee too. We all agreed we would continue with 1.5 units until Sunday and see if he stabilizes, right? I decided to stop the Cerenia today, and will also stop the Marbofloxacin tomorrow (11 days on it for the UTI), as I think it's enough for antibiotics. I read that it can cause a loss of appetite and I could definitely see the difference in his taste for foods. Would you agree?

Thank you all so much, tomorrow I'll start a new thread then

 

I would definitely continue the full course of antibiotics. It is really important that the infection is completely knocked on the head. It can cause loss of appetite but so can recovering from DKA. I would continue the cerenia until at least the antibiotics finish and then try stopping it.
Are you letting him eat while you give the shots. A lot of us shoot while they feed.
Looking good. Try and get a couple of tests in before bed if you can

 

Macka is SO CUTE! Even with his little shaved belly and paws! He looks like he’s wearing a short sleeved crop top and gloves

 

Oh pretty baby! Even that shaved belly! I want to rub it! Hehe.

I see you saying you are having trouble getting enough blood. The two tips that helped me the most are:
Warm the ear. I was sent a little rice sock I heated in the microwave. I used this a lot at first, until the capillaries started to get more used to bleeding.
Secondly, blood flows from the tip down. Anytime I need more than what has come up from the prick itself, I hold the ear below where I poked, and more beads up. In fact, this method also allows me to try not to prick as deeply or to avoid causing as much tissue damage.

Maybe these tips will help you a bit as well. Know that it takes practice, and that’s okay!