New here! BGC questions

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Luxe

Luxe

Member Since 2020
Hello! First off let me say how thankful i am that i've found this community. I have an 8 year old male cat named oj who was diagnosed DKA about 3 weeks ago. He stayed at an emergency vet for almost 3 full days but when i picked him up i wasnt really given much information at all. His release papers told me i should be giving him a high fiber dry food diet only which i've seen a lot of conflicting info on that on my searches online And i was told to only get ketone urine sticks and i should be doing a BLC every 3-6 months. He's on 1unit on lantus twice a day. i got the ketosticks and he's been negative for ketones. But he's always hungry and not gaining the weight he lost so i decided to buy a glucometer for cats and try to do a curve today. I should also add he has a bad tooth that they cant remove until his numbers get regulated and he puts the weight back on and the dry food seems to bother his mouth so i've been doing mostly wet. I've been giving him wellness core and orijen as those are good quality high protein. so back to the curve. He's on a 1030/1030 routine as thats what works best with my schedule and nobody else feels comfortable giving him his injections. So his first numbers this morning after eating but before shot were 468. His next tests at 2hr intervals were 402, then a big dip to 265 and his most recent was all the way up to 611 at his 6:30 reading. I was told he seemed hungry so he was given about quarter cup boiled chicken (he's being fussy with food today) at 430 Would that have raised the number all the way up that high?? I still have 2 more readings to do but seeing it go up that much made me worried. I've also read conflicting info on strict 2x a day feedings and also doing a few small meals so im also not sure on whats right to do there as he lost 4-5 lbs and i want him to get back to his healthy weight. I just want to do whats right for him and get him back to his old self so any feedback or help is much appreciated. Thank you so much in advance
 
WELCOME TO FDMB! We are glad you found us. Boy you and your extra sweet kitty have been through it! Well We here to help you figure out the best path for you BOTH to get this diabetes under control.
If there arent any pressing issues at the moment please take a few minuets and read this page:
New? How You Can Help Us Help You!
This page contains two very important features you will need for communicating everything diabetic. Your signature /profile will appear at the bottom of ALL your posts it should list all of your (insert kitties name here) particulars as they pertain to diabetes management.

Reading further down the page theres a link to set up your spreadsheet. This is your single most important way to track just how the insulin you are using affects your cats body. IF you have trouble setting either of them up PLEASE ASK We have two very good people .
to assist you.

WELCOME TO OUR FAMILY:bighug:

Youve landed in a safe place to learn everything you need to know about feline diabetes and beyond!;)
We look forward to getting to know you and your kitty .
jeanne
I need to start dinner but I'm sure there will be others, to come greet you. :)

ACK I just realized your kitties name is OJ! MY BAD! TY Nan
 
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Hello and welcome to you and oj!!!!

DKA is a rough intro to feline diabetes, so glad he made it through! Sounds like you didn't get great after-care advice, but you are figuring things out on your own. There are other folks around here with DKA experience that can help, too.

Luxe said:
Would that have raised the number all the way up that high?? I still have 2 more readings to do but seeing it go up that much made me worried.
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Well, there are lots of reasons why the BG could be rising. I tend to doubt it was the chicken, unless it came with a side of mashed potatoes and gravy (carbs being the usual culprit), but you never know. Unfortunately, it's not always as simple as "food goes in, BG goes up" or even "insulin goes in, BG goes down." The cat's body gets a say as well-- sometimes the BG starts going up because of a counterreaction to a previous low, for example. It's hard to say what exactly is happening here from one day's data. I'm not sure from what you say-- is this glucose curve being done at the vet's or at your home?

Luxe said:
I've also read conflicting info on strict 2x a day feedings and also doing a few small meals so im also not sure on whats right to do there as he lost 4-5 lbs and i want him to get back to his healthy weight.
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Most diabetic cats seem to do well grazing on multiple meals per day. You definitely do not want to under-feed so soon after a DKA, nor do you want to under-feed him while he's underweight. An unregulated diabetic can't properly utilize the calories he's eating, so you'll likely have to feed a bit extra until he's got the diabetes under control-- that's OK!

Ah, I see Jeanne has posted with some helpful info, so I'll stop here. Welcome again!
 
Thank you and you said it! We noticed he had been losing weight so we took him to the vet and after a quick exam they concluded his bad tooth was probably causing him to not eat and in turn the weight loss. They made an appointment for a week later and when they were doing the bloodwork to make sure he could get anesthesia is when they realized he actually had a lot more serious stuff going on and we transferred him to an emergency vet. They did an xray while he was there but nobody has given me any results any of the times i've asked. They were doing them to check liver and pancreas i was told. So im left to assume there was nothing out of the norm or they would have hopefully told me the results. His curve im doing at home. I had read that was the best option and less stressful so his numbers would be more accurate. thank you for the information regarding feeding. He's so thin it makes me sad to look at him and he's always hungry im assuming from being unregulated but the weights not going back on. He also throws up a light yellow-y liquid if he goes without food for too long. He's only thrown up on the days we've tried to keep him on the two meals. The days we give him more because of the hunger cries he doesnt. He was diagnosed 11/9/20 and since then he's only gained back a pound. I wish i had started checking his blood sooner because now i only have today to go off of which i know isnt a lot. But on the plus side i'll take the negative ketone tests. I'll also make sure to update my signature and start filing out the chart.
 
Luxe said:
Thank you and you said it! We noticed he had been losing weight so we took him to the vet and after a quick exam they concluded his bad tooth was probably causing him to not eat and in turn the weight loss. They made an appointment for a week later and when they were doing the bloodwork to make sure he could get anesthesia is when they realized he actually had a lot more serious stuff going on and we transferred him to an emergency vet. They did an xray while he was there but nobody has given me any results any of the times i've asked. They were doing them to check liver and pancreas i was told. So im left to assume there was nothing out of the norm or they would have hopefully told me the results. His curve im doing at home. I had read that was the best option and less stressful so his numbers would be more accurate. thank you for the information regarding feeding. He's so thin it makes me sad to look at him and he's always hungry im assuming from being unregulated but the weights not going back on. He also throws up a light yellow-y liquid if he goes without food for too long. He's only thrown up on the days we've tried to keep him on the two meals. The days we give him more because of the hunger cries he doesnt. He was diagnosed 11/9/20 and since then he's only gained back a pound. I wish i had started checking his blood sooner because now i only have today to go off of which i know isnt a lot. But on the plus side i'll take the negative ketone tests. I'll also make sure to update my signature and start filing out the chart.
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Morning Luxe. You have a right for the labs from that emergency Vet. YOU PAID FOR THEM. I would get on the phone and insist on getting what you paid for.
Also YES feed poor Oj You dont want to over feed him to make sure he eats at shot time but thats easy. 2 more snacks in between meals should be fine. (try to make them as low carb as possible.
 
I went to give him his am dose this morning and he's not eating at all. Glucose is really high though(508) so im going to reach out to the dr to see if i should still give him a shot. Im not sure if it would Drop it to a normal level with no food or if it would then take it too low. His lowest number with the curve yesterday was 265 but he for the most part stayed in the 400-500 range :'(
 
You don't want to skip shots three weeks after a DKA if you can possibly help it. When was his last ketones test?

Try tempting him with his favorite foods (don't worry about things like carbs right now, you just want to get him eating something). Lantus takes a couple hours to take effect, so if he is showing any interest in eating at all you have a while to get a meal into him (and he's really really high right now, which lowers the risk of hypo).

C'mon OJ, food is good!
 
Thank you. I just did a ketone test last night and it came up trace for the first time since i brought him home. I last tested on the 19th and it was negative then. We opened 5 different cans and even a little dry and boiled chicken and nothing. He Threw up, drank a lot of water and licked a little gravy off one of the foods But that was it. I did still give him a shot but im on hold now with the vets. its so weird, up until yesterday he was really starting to be back to his old self personality wise so i thought we were on good track until i did that curve last night and noticed how high the numbers were going and only once dipped below 300
 
Luxe said:
I went to give him his am dose this morning and he's not eating at all. Glucose is really high though(508) so im going to reach out to the dr to see if i should still give him a shot. Im not sure if it would Drop it to a normal level with no food or if it would then take it too low. His lowest number with the curve yesterday was 265 but he for the most part stayed in the 400-500 range :'(
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Please call the vet this doesnt sound good
 
Hi Luxe,

Luxe said:
licked a little gravy off one of the foods
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This behaviour is common when a cat is nauseated. Have a look at the following to see whether there are any other things you have observed:

Nausea symptoms

Nausea is a common issue in cats having ketone issues. It can be treated with ondansetron and Cerenia, possibly with additional support from an appetite stimulant, so I recommend you let the vet know about any nausea-related behaviours OJ may be exhibiting.

Post-DKA kitties need both adequate calories and adequate insulin to keep ketones at bay. The little bit of anti-nausea/appy stimulant support can help a great deal during the recovery period. Adequate fluid intake is also important, so it's a good idea to monitor just how much OJ is drinking each day.

The other pillar for DKA is infection/inflammation/other systemic stressor. If OJ's still got the problem tooth then that would make him that little bit more vulnerable on the ketone front. If you are getting him in to see the vet, I suggest asking the vet to check for other common issues such as pancreatitis and urinary tract infection.

Another common cause of inappetence is constipation, so if OJ's not been as 'regular' as he should be then that's another thing to ask the vet to check.


Mogs
.
 
Thanks all. Im waiting for the vet who originally saw him to call back. He's definitely drinking a ton. Im wondering if maybe his insulin dose has been too small with the 1 unit twice a day. The only difference i've made is when i got him they gave me a small vial with about a weeks worth of lantus as well as some pre dosed shots. I switched him to the lantus pen because it was way cheaper. But its the same product so that shouldnt have any impact right? When they did a urinalysis on the 9th when he was diagnosed they didnt say there were any indicators of uti. They said his ketones were very high which they were and his blood showed elevated stuff with the liver. I was told they were going to do an ultrasound and they never did. The 3 days he was at the vet iriginally i only actually spoke to his vet once. And still havent gotten info regarding the xray results or why they changed their mind on the ultrasound. It was already all paid for and they refunded me 1,800$ at pick up so i was like wait what didnt they do?? These were his original blood and urinalysist results
 

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The
Critter Mom said:
Hi Luxe,


This behaviour is common when a cat is nauseated. Have a look at the following to see whether there are any other things you have observed:

Nausea symptoms

Nausea is a common issue in cats having ketone issues. It can be treated with ondansetron and Cerenia, possibly with additional support from an appetite stimulant, so I recommend you let the vet know about any nausea-related behaviours OJ may be exhibiting.

Post-DKA kitties need both adequate calories and adequate insulin to keep ketones at bay. The little bit of anti-nausea/appy stimulant support can help a great deal during the recovery period. Adequate fluid intake is also important, so it's a good idea to monitor just how much OJ is drinking each day.

The other pillar for DKA is infection/inflammation/other systemic stressor. If OJ's still got the problem tooth then that would make him that little bit more vulnerable on the ketone front. If you are getting him in to see the vet, I suggest asking the vet to check for other common issues such as pancreatitis and urinary tract infection.

Another common cause of inappetence is constipation, so if OJ's not been as 'regular' as he should be then that's another thing to ask the vet to check.


Mogs
.
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Are you interested in setting up a Signature and spreadsheet? That link in my first post has every thing you need to do so and IF you have any problems with either we will get you help, to get them done.
 
Signature i think i set up right. I dont have access to his numbers right now as i went straight from work to the vet and we're still here. They did not give me any info on the blood in urine. The emergency vet that he originally stayed at for 3 days when first diagnosed wont return my calls today. So i ended up bringing him to his regular vet. They're injecting fluids, told me to up his insulin from 1 unit twice a day to 2 units twice a day. And are giving him a pain med injection to help with his tooth so he hopefully will eat more readily. Even when he had a more normal appetite the last week or so it was clearly bothering him. Only eating on one side of the mouth, pawing at his mouth a lot after. Im hoping he eats something for me tonight. I was told to watch his blood glucose. If he doesnt eat later but its still high to still give him a dose. And was advised if his ketones go from trace to the next level that he should go somewhere that can give him overnight care
 
Are they doing a ketones test at the vet? Usually they can test blood, so they don't have to get a urine sample (you can buy a blood ketone meter yourself as well-- the strips are quite expensive, but you don't use as many as for blood glucose so it's not the worst solution).
 
Sorry, didn't mean to distract with the talk of blood ketone meters, the main thing is that you want to make sure that he's being evaluated for ketones while he's there, and get them treated if they're present.

The pain meds may help his eating if that's the issue (it certainly sounds like it's an issue, at least). Did they give you any anti-nausea meds? I agree with Mogs, it sounds like he might have some nausea as well.

Has anyone suggested antibiotics, either/both for the tooth or for a possible urinary infection?
 
He was on antibiotics for his tooth for two weeks. They didnt test there but he just pee'd when i got home so i tested and its through the roof high. I feel like im at such a loss. I dont want him to keep having such massive relapses. His numbers both blood and glucose are both insanely higher than they were when he was first diagnosed. It doesnt seem like anything is helping just getting progressively worse
 
I'm going to be blunt: OJ needs immediate vet attention, and it sounds like your regular vet has no clue what to do with ketones. Not sure about the first ER vet, either, the one who isn't answering your calls right now, but at least they got him out of DKA the first time so if you can reach them they might be an option. But if it were my cat, I'd be looking for other ER clinics right now. OJ went from "trace" to "through the roof high" in 24hrs, ketones/DKA become life-threatening very rapidly at this rate.

Did they get him to eat anything, or has he eaten since he's been home?
 
Will do. Unfortunately the other emergency vets in the area closed for emergency night hours mon-thurs. the emergency vet i go to now is already out of state and my closest option since the ones around here are weekend only.
He didnt eat when he came home, acting like he wants to but he just licked at the gravy and ignored the pate
 
Sorry all, been a very busy night/afternoon with work and family issues. This kitty really has me stumped lol. I ended up keeping him last night and was going to bring him today if no improvement. When i checked his blood around 1030 last night it was low for him, 307. I still gave him the 1.5 units of lantus like the vet said if it was still out of range. When i woke up at 6am to leave for work he was following me around purring and rubbing around my legs and crying for food. I gave him just two spoons of wet because i wanted him to be hungry for a shot when i came home on lunch break. Well, when i came home from break i caught him going in the box so i rushed to get a ketone stick out and made it before he finished his business. It was negative for ketones! His blood sugar was high(700) but he apparently at some point in the morning a couple hrs before i got home stole an entire boiled chicken breast off the counter and ate it. So im thinking it was that high because of the large meal and no shot?? The emergency vet emailed me today, i guess a phone call would be too much of a hassle and they told me to up him to 2units twice a day so i gave him the 2. Im going to check his blood when i get home in about half an hour. Could his ketones have gone up so high because he was that dehydrated?? I mean i was overthrilled to see them negative today and he's acting like he did prediabetes but he also did this a couple weeks ago and had that huge relapse yesterday. Im hoping now that his insulin is upped he'll regulate himself better. Should i also be doing weekly visits at the vet in the meantime until he gets more regulated? Nobody ever mentioned follow ups except every 3-6months for a curve to be performed. I also happened to look at the food list on here. A lot of the foods i was getting were high protein/fiber as i was told but turns out the carbs were pretty high. So i just got all new food today incase i was actually on the wrong track with the food and that was an issue
 
Luxe said:
It was negative for ketones!
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:woot:!!!!

Luxe said:
stole an entire boiled chicken breast off the counter and ate it.
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Also :woot:!!!! Food is medicine for ketones, just as much as insulin is, and the fact that he's hungry enough to play kitchen counter pirate is an amazingly good sign!

I wonder if the pain meds for the tooth are what turned him around, getting him eating again, removing the stress of pain, etc.? Whatever it was, yay for OJ!!!!!

As long as he isn't throwing ketones or having other issues, you should be able to manage FD at home for the most part, without having to keep going back to the vet for curves. The only thing about that, though, is that if your vet won't take care of that bad tooth before he's regulated, you're going to have to keep the vet in the loop about how he's doing, so that you can get that tooth (and any others that are less visible) out asap.

In the meantime, though, hooray for clearing the ketones on his own!!! What a champ!
 
Luxe said:
I also happened to look at the food list on here. A lot of the foods i was getting were high protein/fiber as i was told but turns out the carbs were pretty high. So i just got all new food today incase i was actually on the wrong track with the food and that was an issue
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Fyi, you'll want to be very careful about switching the food over right now, especially since you've upped the insulin dose. If he's used to getting carbs, removing them could cause his insulin needs to plummet. So, while you're quite correct that you do want to switch him to low-carb food, you want to do it gradually, and while monitoring BG closely. I don't know if you get days off around the Thanksgiving holiday, but if you do and are home for a few days, it coudl be a great time to do the switch!

The boiled chicken breast he 'liberated' :rolleyes: should be very low carb, so probably not the cause of his zooming up to 700 today. One possibility is that he went lower after the 307, and the 700 is a reaction to that (a 'bounce').
 
Thanks! Yeah im sooo happy that he's being good. I jjst got home from work, checked him and he's at 334 so switching to the 2units definitely dropped it a lot.
I think the pain meds definitely helped because he was face first in the food where he'd been only eating on one side of his mouth. Just gotta continue to check and adjust accordingly because i hate stressing him out having to bring him back and forth to the vets and im sure he hates it too lol. Once his insulin is regulated he'll stop drinking as much and urinating as much right? I think thats what was dehydrating him and caused the ketones to get so high
 
Luxe said:
Thanks! Yeah im sooo happy that he's being good. I jjst got home from work, checked him and he's at 334 so switching to the 2units definitely dropped it a lot.
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Wow, that's a big drop! When was that (how many hours since the morning shot, how many hours since you got the 7000 [edit: 700!!!! I meant to type 700!!!!])? Keep an eye on that to make sure he doesn't go too low.

So glad to hear that his appetite has returned, big time! Did they give you more doses of the pain meds? For how long will he be on them?
 
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From 11am to 5pm. I got home at 11am tested him and when i saw the numbers that high i was like whoa. Then my mom told me she had given him some canmed food about half hour before i got home and at some point in the couple hours before he got ahold of the chicken lol. When i got home around 430 he was crying and pacing the kitchen so i wanted to check his levels before i gave him something else to eat. So roughly 6hrs between the first shot and reading and the second reading. The pain meds hes on now will last for 3days. Since he wasnt eating i didnt think i'd be able to get a pill in him. But since he is now the vet said he could prescribe him the pills. So im going to ask about them on friday as they're closed tomorrow. As for how long he'll be on them im not sure. As far as his night injection goes, if its borderline 300 im wondering if i should stick with the 1unit. I was just thinking about the bounce thing mentioned earlier and maybe at 304 last night giving him the increased dose was too much. I just want to do the best for him. Its been so nice seeing him back to his old personality. And im sure its a process and takes time/trial and error to get the right insulin and the right dose to regulate. I just want it to be sooner than later so he has a better chance at remission one day
 
Luxe said:
Im wondering if maybe his insulin dose has been too small with the 1 unit twice a day. The only difference i've made is when i got him they gave me a small vial with about a weeks worth of lantus as well as some pre dosed shots. I switched him to the lantus pen because it was way cheaper. But its the same product so that shouldnt have any impact right?
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This for me is a red flag. I'm glad you are giving insulin out of a pen now. You should not use repackaged Lantus. We've had many horror stories of people using ineffective insulin. You might want to read this Sticky Note from the Lantus forum on Insulin Care. Actually, lots of good info on all the yellow starred Sticky Notes there when you have the time to read them.

At some point you may wish to see if your vet will refer you to a dental specialist vet. They are used to more complicated animals, including unregulated ones.
 
Wendy&Neko said:
This for me is a red flag. I'm glad you are giving insulin out of a pen now. You should not use repackaged Lantus. We've had many horror stories of people using ineffective insulin. You might want to read this Sticky Note from the Lantus forum on Insulin Care. Actually, lots of good info on all the yellow starred Sticky Notes there when you have the time to read them.

At some point you may wish to see if your vet will refer you to a dental specialist vet. They are used to more complicated animals, including unregulated ones.
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Thank you. When i picked him up they were sending me home with 3 days of insulin already drawn up in syringes. They told me a place to order it online that would be cheaper than an in store pharmacy. So i was like wait what if it takes a few days to get here?? So she came back eith a vial with a little bit in it and said it should last me a week or two. After about a week i noticed it was getting cloudy so i started to use the pen since it came in the mail.
And i'll look into that. He went down from about 15 lbs to 9 lbs and with his levels so bad even the emergency vet wouldn't touch it. He's only put half a pound back on in the last few weeks But we just adjusted his insulin yesterday so hoping that will keep the ketones at bay, the glucose low and he'll start to put the weight back on so i feel more than bones when i pet him
 
jt and trouble (GA) said:
Are you interested in setting up a Signature and spreadsheet? That link in my first post has every thing you need to do so and IF you have any problems with either we will get you help, to get them done.
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Can i only make a spreadsheet on a laptop or computer?? I dont own either, i just have my iphone and im embarrassingly technology illiterate for my age
 
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