Bron and Sheba (GA)
Very Active Member
@Bandit's Mom would you be able to add this information to Mia’s SS, do you think?
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New member - Mia - Lethargic - Ketones present
- Thread starter MonicaT
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@Bron and Sheba (GA) it has been a very slow feed continuously over at least 30 min. Would it still make sense to check BG now?
Bron and Sheba (GA)
Very Active Member
A couple of things.
Are you able to give more food than that?
I would ask the vet about maybe inserting a feeding tube until she will eat on her own so that she is getting more nutrition. You could manage that at home and they are easier to use than syringe feeding.
The BGs are dropping quite low on the 2 unit dose. Unless you are able to increase the food intake or give higher carb I think you will have to reduce the dose to 1.75 units. I don’t like doing this because of the ketones but we don’t like to see the BGs go under 90 (5) when using caninsulin to be safe.
Are you able to give more food than that?
I would ask the vet about maybe inserting a feeding tube until she will eat on her own so that she is getting more nutrition. You could manage that at home and they are easier to use than syringe feeding.
The BGs are dropping quite low on the 2 unit dose. Unless you are able to increase the food intake or give higher carb I think you will have to reduce the dose to 1.75 units. I don’t like doing this because of the ketones but we don’t like to see the BGs go under 90 (5) when using caninsulin to be safe.
Yes
@Bron and Sheba (GA) I just tested, it's 15.5, up from, 14.4 almost 3 hours ago
Bron and Sheba (GA)
Very Active Member
I think you could give the insulin dose now. But I would reduce the dose to 1.75 units.. Can you do that? Then the next dose will be due 12 hours from now.
And I would syringe feed her every 2 hours if you can to try and get more food into her. So give her another syringe feed in 2 hours time.
And I would definitely ask the vet about a naso-gastric feeding tube so that you can feed her more easily.
Then hopefully we can increase the dose again once she is eating more and her BG is a bit higher….hope that makes sense.
You are doing a great job with her. It isn’t easy looking after sick kitty who won’t eat.
@Bron and Sheba (GA)
I can try increasing amount of food, the vet originally said around half a can of the recovery wet food would be enough, but have gotten several comments here and on the FB group that I have to increase that amount.
I can try increasing amount of food, the vet originally said around half a can of the recovery wet food would be enough, but have gotten several comments here and on the FB group that I have to increase that amount.
Bron and Sheba (GA)
Very Active Member
Great! Cats with ketones need to be eating an and a 1/2 times as many calories as they normally do.
The recovery food is good…just more of it.
Food is like a medicine when it comes to ketones.
@Bron and Sheba (GA) I am so unsure of what to do. Since on one hand if I lower the insulin dose now, this is not good for the ketone levels. But if I give the full 2 unit dose you are saying she is dropping too low on the BG levels
Bron and Sheba (GA)
Very Active Member
With caninsulin we always say reduce the dose if the BG drops under 90 (5). This is to be safe.
It is really a catch 22 in your case as Mia needs the insulin but the dose is dropping her low probably because she is not eating enough.
Do you have some higher carb food you could thin out to put in the syringe? we need to have her BG a bit higher so it doesn’t drop below 90.
or if she drops low you could add 1 drop of honey. I’d rather see some higher carb food if you can get it.
I’d rather see her stay with 2 units but I am concerned about the fact it drops to 3.8
If you think you can feed her more and get some higher carb food, you can stay with 2 units but you will need to monitor the Bg closely.
Hopefully the vet will insert a feeding tube and that will solve the problem.
@Bron and Sheba (GA) So I gave her the insulin 05.46. tested her BG now at 07.53 and it was 7.9.
Taking her to the vet now in 30 min.
So I will be talking to the vet about the following:
Feeding tube
Anti nausea medication (ondansetron)
Electrolytes test?
Potassium levels?
Change of insulin I understand should be put off until after ketone levels are dow
Anything else I should ask about or check etc once at the vet?
Taking her to the vet now in 30 min.
So I will be talking to the vet about the following:
Feeding tube
Anti nausea medication (ondansetron)
Electrolytes test?
Potassium levels?
Change of insulin I understand should be put off until after ketone levels are dow
Anything else I should ask about or check etc once at the vet?
Bron and Sheba (GA)
Very Active Member
That sounds good
Bron and Sheba (GA)
Very Active Member
Any news Monica?
Hi @Bron and Sheba (GA) ! So sorry for not giving any updates yesterday.
So at the vet yesterday we spent around 4 hours there where she received fluids through IV, anti nausea medicine, motillium as she hasn't been pooping for 3 days and an appetite stimulant. I also asked for tests to check electrolytes, where it showed she was low on everything, including potassium which I have understood is important to check?
So we gave her a rehydration sachet with potassium at the vet as that is the only thing we were able to find on a Sunday. Today we will be buying higher dosage of potassium and start her on that. Are there any dose recommendations? Our vet said 50mg per day.
We were able to test her urine for ketones at the vet as she started peeing alot after so many hours of fluids. And the colour was the lowest on the chart! So this was a big win yesterday.
After getting home from the vet, she went straight to her water bowl and drank by herself, and we also put out her old wet food and even even ate a little from it by herself, again first time eating by herself since Wednesday last week. I was so happy
Still fed her recovery Royal canin by syringe rest of the day as she wasn't eating enough by herself. But even syringe feeding was easier yesterday and she was licking it up voluntarily. Throughout the rest of the evening she went over to the water bowl several times and ate a couple of times from the regular wet food.
Her walking also had improved after the visit to the vet and she wasn't as wobbly as she has been last days. We also got lactate fluids to give at home subcutaneous, which we did yesterday evening.
She has also had her first poop since Tuesday/Wednesday last week.
This was the longest we have had her on IV fluids, do you think this is what made the biggest difference? Or was it the potassium? As the anti nausea and appetite stimulant she has gotten several times before without affect.
However when we tested her BG levels before insulin it was the highest it has been til now, and also it was showing that ketones were present.
Adding info on BG testing, eating etc from yesterday:
06.10.24 5:46 insulin @40uml 0.05ml
06.10.24 7:53 blood glucose 7.9
06.10.24 7:53 temp 37
06.10.24 8:30 wet food 12ml
06.10.24 9:00 antibiotic day 2
06.10.24 9:34 blood glucose 4.3
06.10.24 10:00 motillium
06.10.24 10:55 blood glucose 3.3
06.10.24 10:59 received glucose
06.10.24 11:15 blood glucose 9.4
06.10.24 11:45 electrolytes /potassium 1/2 sachet
06.10.24 12:10 blood glucose 10.7
06.10.24 12:25 wet food 9ml
06.10.24 13:30 appetite stimulant 1/8
06.10.24 14:30
first interest in eating and drinking
06.10.24 14:30 wet food 15ml
06.10.24 15:05 blood glucose 12.1
06.10.24 16:40 wet food 15ml
06.10.24 17:36 blood glucose 11.2
06.10.24 17:45 wet food 6ml
06.10.24 18:00 insulin @40uml 0.05ml
06.10.24 19:45 royal canin sterilized 1ts
06.10.24 20:00 wet food 9ml
06.10.24 21:15 subcutaneous fluids kiwi size
20:45 pooped like a champ
06.10.24 21:30 ate by herself 3ml
06.10.24 21:35 antibiotics day 2
06.10.24 21:35 motillium 1/2 tablet
06.10.24 22:35 blood glucose 3.5
06.10.24 22:23 drank by herself
06.10.24 22:42 drank by herself
06.10.24 22:50 wet food 12ml
06.10.24 23:56 blood glucose 7.3
06.10.24 3:40 wet food 10ml
06.10.24 5:57 blood glucose 19.5
06.10.24 6:05 wet food 12ml
06.10.24 6:15 insulin 0.05
So at the vet yesterday we spent around 4 hours there where she received fluids through IV, anti nausea medicine, motillium as she hasn't been pooping for 3 days and an appetite stimulant. I also asked for tests to check electrolytes, where it showed she was low on everything, including potassium which I have understood is important to check?
So we gave her a rehydration sachet with potassium at the vet as that is the only thing we were able to find on a Sunday. Today we will be buying higher dosage of potassium and start her on that. Are there any dose recommendations? Our vet said 50mg per day.
We were able to test her urine for ketones at the vet as she started peeing alot after so many hours of fluids. And the colour was the lowest on the chart! So this was a big win yesterday.
After getting home from the vet, she went straight to her water bowl and drank by herself, and we also put out her old wet food and even even ate a little from it by herself, again first time eating by herself since Wednesday last week. I was so happy
Still fed her recovery Royal canin by syringe rest of the day as she wasn't eating enough by herself. But even syringe feeding was easier yesterday and she was licking it up voluntarily. Throughout the rest of the evening she went over to the water bowl several times and ate a couple of times from the regular wet food.
Her walking also had improved after the visit to the vet and she wasn't as wobbly as she has been last days. We also got lactate fluids to give at home subcutaneous, which we did yesterday evening.
She has also had her first poop since Tuesday/Wednesday last week.
This was the longest we have had her on IV fluids, do you think this is what made the biggest difference? Or was it the potassium? As the anti nausea and appetite stimulant she has gotten several times before without affect.
However when we tested her BG levels before insulin it was the highest it has been til now, and also it was showing that ketones were present.
Adding info on BG testing, eating etc from yesterday:
06.10.24 5:46 insulin @40uml 0.05ml
06.10.24 7:53 blood glucose 7.9
06.10.24 7:53 temp 37
06.10.24 8:30 wet food 12ml
06.10.24 9:00 antibiotic day 2
06.10.24 9:34 blood glucose 4.3
06.10.24 10:00 motillium
06.10.24 10:55 blood glucose 3.3
06.10.24 10:59 received glucose
06.10.24 11:15 blood glucose 9.4
06.10.24 11:45 electrolytes /potassium 1/2 sachet
06.10.24 12:10 blood glucose 10.7
06.10.24 12:25 wet food 9ml
06.10.24 13:30 appetite stimulant 1/8
06.10.24 14:30
first interest in eating and drinking
06.10.24 14:30 wet food 15ml
06.10.24 15:05 blood glucose 12.1
06.10.24 16:40 wet food 15ml
06.10.24 17:36 blood glucose 11.2
06.10.24 17:45 wet food 6ml
06.10.24 18:00 insulin @40uml 0.05ml
06.10.24 19:45 royal canin sterilized 1ts
06.10.24 20:00 wet food 9ml
06.10.24 21:15 subcutaneous fluids kiwi size
20:45 pooped like a champ
06.10.24 21:30 ate by herself 3ml
06.10.24 21:35 antibiotics day 2
06.10.24 21:35 motillium 1/2 tablet
06.10.24 22:35 blood glucose 3.5
06.10.24 22:23 drank by herself
06.10.24 22:42 drank by herself
06.10.24 22:50 wet food 12ml
06.10.24 23:56 blood glucose 7.3
06.10.24 3:40 wet food 10ml
06.10.24 5:57 blood glucose 19.5
06.10.24 6:05 wet food 12ml
06.10.24 6:15 insulin 0.05
Bron and Sheba (GA)
Very Active Member
Hi @Bron and Sheba (GA) ! So sorry for not giving any updates yesterday.
So at the vet yesterday we spent around 4 hours there where she received fluids through IV, anti nausea medicine, motillium as she hasn't been pooping for 3 days and an appetite stimulant. I also asked for tests to check electrolytes, where it showed she was low on everything, including potassium which I have understood is important to check?
So we gave her a rehydration sachet with potassium at the vet as that is the only thing we were able to find on a Sunday. Today we will be buying higher dosage of potassium and start her on that. Are there any dose recommendations? Our vet said 50mg per day.
We were able to test her urine for ketones at the vet as she started peeing alot after so many hours of fluids. And the colour was the lowest on the chart! So this was a big win yesterday.
After getting home from the vet, she went straight to her water bowl and drank by herself, and we also put out her old wet food and even even ate a little from it by herself, again first time eating by herself since Wednesday last week. I was so happy
Still fed her recovery Royal canin by syringe rest of the day as she wasn't eating enough by herself. But even syringe feeding was easier yesterday and she was licking it up voluntarily. Throughout the rest of the evening she went over to the water bowl several times and ate a couple of times from the regular wet food.
Her walking also had improved after the visit to the vet and she wasn't as wobbly as she has been last days. We also got lactate fluids to give at home subcutaneous, which we did yesterday evening.
She has also had her first poop since Tuesday/Wednesday last week.
This was the longest we have had her on IV fluids, do you think this is what made the biggest difference? Or was it the potassium? As the anti nausea and appetite stimulant she has gotten several times before without affect.
However when we tested her BG levels before insulin it was the highest it has been til now, and also it was showing that ketones were present.
Adding info on BG testing, eating etc from yesterday:
06.10.24 5:46 insulin @40uml 0.05ml
06.10.24 7:53 blood glucose 7.9
06.10.24 7:53 temp 37
06.10.24 8:30 wet food 12ml
06.10.24 9:00 antibiotic day 2
06.10.24 9:34 blood glucose 4.3
06.10.24 10:00 motillium
06.10.24 10:55 blood glucose 3.3
06.10.24 10:59 received glucose
06.10.24 11:15 blood glucose 9.4
06.10.24 11:45 electrolytes /potassium 1/2 sachet
06.10.24 12:10 blood glucose 10.7
06.10.24 12:25 wet food 9ml
06.10.24 13:30 appetite stimulant 1/8
06.10.24 14:30
first interest in eating and drinking
06.10.24 14:30 wet food 15ml
06.10.24 15:05 blood glucose 12.1
06.10.24 16:40 wet food 15ml
06.10.24 17:36 blood glucose 11.2
06.10.24 17:45 wet food 6ml
06.10.24 18:00 insulin @40uml 0.05ml
06.10.24 19:45 royal canin sterilized 1ts
06.10.24 20:00 wet food 9ml
06.10.24 21:15 subcutaneous fluids kiwi size
20:45 pooped like a champ
06.10.24 21:30 ate by herself 3ml
06.10.24 21:35 antibiotics day 2
06.10.24 21:35 motillium 1/2 tablet
06.10.24 22:35 blood glucose 3.5
06.10.24 22:23 drank by herself
06.10.24 22:42 drank by herself
06.10.24 22:50 wet food 12ml
06.10.24 23:56 blood glucose 7.3
06.10.24 3:40 wet food 10ml
06.10.24 5:57 blood glucose 19.5
06.10.24 6:05 wet food 12ml
06.10.24 6:15 insulin 0.05
I’m very glad to see this update.
Re the dosage for potassium. You will need to ask the vet for that. We don’t give dosages for potassium. It’s very important you get the dosage right so make sure you get it from the vet.
I’m glad the ketones seem to be reducing. That is very good. Can you tell me the latest result please?
And it’s good she is starting to try to eat on her own. Keep up the syringe feeding in the meantime as she needs to eat really well.
And I am pleased you are giving her some sub Q fluids. How much are you giving of that?
It’s hard to say what is making the difference. It could just be she is generally improving or it could be one of the things you have done.
Keep doing everything. The next few weeks will be full on for you making sure she is eating, drinking, getting the medications and getting the insulin.
What did the vet say about the tube feeding ?
What did the vet say about the ondansetron?
I am going to ask @Bandit's Mom to see if she can update your SS as we really need to see the information there. It’s too hard to read it just down the page with every other thing mixed up with it….although I am glad you included that.
Please keep us updated and asking questions. She still has a way to go to be out of the woods.
I am so happy to see a positive update
Bandit's Mom
Very Active Member
@MonicaT If you will send me all the test data from Day 1 via a PM, I will input it in the SS.
Bron and Sheba (GA)
Very Active Member
Thanks Bhooma
@Bron and Sheba (GA) Ok will just follow the dose recommended by the vet then, just wanted to check if you had other recommendations than what she had said.
We tested BG approx 1 hour ago, and our tester should show ketone levels too, but not sure if it's working as it should. Last night at 5am it was showing as high, 1 hour ago it didn't show. Haven't been able to get a urine sample since yesterday.
Regarding subQ fluids, we were just instructed to give approx peach sized, so not sure about the actual measurements. Will give her again in an hour or so, and at 16.30 we will go to the vet again for IV fluids for 3-4 hours.
About the tube feeding she wants to put it off until completely necessary to avoid additional stress on Mia as she said here they don't do nasal on cats, but through her throat so it will be an operation procedure. Now that Mia seems to have an appetite again, it should make a difference to the amount of food I get her to eat.
The ondansetron she for some reason didn't seem to keen on, so we were given cerenia, where we will be giving 1/8 of a 24mg pill every 24 hours.
Would you still recommend that we wait with changing the type of insulin?
We tested BG approx 1 hour ago, and our tester should show ketone levels too, but not sure if it's working as it should. Last night at 5am it was showing as high, 1 hour ago it didn't show. Haven't been able to get a urine sample since yesterday.
Regarding subQ fluids, we were just instructed to give approx peach sized, so not sure about the actual measurements. Will give her again in an hour or so, and at 16.30 we will go to the vet again for IV fluids for 3-4 hours.
About the tube feeding she wants to put it off until completely necessary to avoid additional stress on Mia as she said here they don't do nasal on cats, but through her throat so it will be an operation procedure. Now that Mia seems to have an appetite again, it should make a difference to the amount of food I get her to eat.
The ondansetron she for some reason didn't seem to keen on, so we were given cerenia, where we will be giving 1/8 of a 24mg pill every 24 hours.
Would you still recommend that we wait with changing the type of insulin?
Bron and Sheba (GA)
Very Active Member
Yes I would not change the insulin over until there have been no ketones for 2 weeks.
Just so I am understanding you correctly, are you saying you have a blood ketone meter, when you say your tester shows ketone levels too?
@Bron and Sheba (GA)
Ok, will stick to caninsulin for now then.
I am really not sure if the meter I have is actually showing ketones or if it just suggests to check for ketones based on how high the BG levels are. Tried checking the booklet but can't figure it out.
Also, today I am seeing Mia walking with her head a little strange. As if she had something wrong with her neck so she is keeping her head down and just looking up and around by moving her eyes around
Ok, will stick to caninsulin for now then.
I am really not sure if the meter I have is actually showing ketones or if it just suggests to check for ketones based on how high the BG levels are. Tried checking the booklet but can't figure it out.
Also, today I am seeing Mia walking with her head a little strange. As if she had something wrong with her neck so she is keeping her head down and just looking up and around by moving her eyes around
Bron and Sheba (GA)
Very Active Member
I think you will find it is just suggesting you check for ketones. If the BG is over a certain number the meter will tell you to check for ketones. That doesn’t mean there are any. They just want you to check.
To actually see if there are ketones you need to either check the urine or get a blood ketone meter..
That could be from the low potassium. Check with your vet.
@Bron and Sheba (GA) Oh ok, sounds like that makes sense. Will hopefully get a urine test done sometime today, either at home or at the vet.
Ok, have given her potassium according to vet instructions. Should I be worried about kidney/renal issues? As I read that hanging with their head like that also could be a symptom of renal/kidney issues.
I think from the blood tests done tuesday and thursday, they checked. But should I ask for any additional/specific tests?
Ok, have given her potassium according to vet instructions. Should I be worried about kidney/renal issues? As I read that hanging with their head like that also could be a symptom of renal/kidney issues.
I think from the blood tests done tuesday and thursday, they checked. But should I ask for any additional/specific tests?
Bron and Sheba (GA)
Very Active Member
I would tell the vet about Mia hanging her head. As she has low potassium, that is most likely causing the issue. The vet will know if more tests are needed.
Can you add any ketone results into the remarks column of the spreadsheet please?
Can you add any ketone results into the remarks column of the spreadsheet please?
Just got home from the vet, had a 3,5 stay this time. First with lactate IV drip, but also potassium this time. Took new blood tests yesterday which showed she was extremely low on potassium. Got potassium through the IV today. Will be going back tomorrow morning for more potassium through IV.
The vet says that the low potassium is probably causing her head hanging which suddenly started this morning.
I am super worried about this evening and tonight. Because I understand now that low potassium is life threatening but also administering potassium too quick is life threatening.
I am reading all the different reasons that potassium can be low, including excessive peeing, which Mia has been doing as she has been receiving IV fluids. That is can be from too much insulin? She has been on insulin since Friday, 2 units twice daily. That it can be connected to renal/kidney issues?
The vet also increased her insulin dose for her dose at 18:00 today, which was 3 hours ago. From 2 units to 2.5 units. Her BG levels was at 20 at 17:00. It then increased to 22 when testing at 18:00 before insulin, insulin was given at 18:00 and then BG increased to 23.5 at 19:36.
I'm feeling completely lost and no idea what I should be pushing the vet to check and test, and what is unnecessary. Also scared terrified of Mia's health declining suddenly during the night.
Any advice? Anyone had the same potassium issues with their kitties?
Attaching images of the blood tests from today, on the far right you can see the results from the blood tests that were done yesterday to compare.
The vet says that the low potassium is probably causing her head hanging which suddenly started this morning.
I am super worried about this evening and tonight. Because I understand now that low potassium is life threatening but also administering potassium too quick is life threatening.
I am reading all the different reasons that potassium can be low, including excessive peeing, which Mia has been doing as she has been receiving IV fluids. That is can be from too much insulin? She has been on insulin since Friday, 2 units twice daily. That it can be connected to renal/kidney issues?
The vet also increased her insulin dose for her dose at 18:00 today, which was 3 hours ago. From 2 units to 2.5 units. Her BG levels was at 20 at 17:00. It then increased to 22 when testing at 18:00 before insulin, insulin was given at 18:00 and then BG increased to 23.5 at 19:36.
I'm feeling completely lost and no idea what I should be pushing the vet to check and test, and what is unnecessary. Also scared terrified of Mia's health declining suddenly during the night.
Any advice? Anyone had the same potassium issues with their kitties?
Attaching images of the blood tests from today, on the far right you can see the results from the blood tests that were done yesterday to compare.
Bron and Sheba (GA)
Very Active Member
I am concerned the vet increased the dose of insulin to 2.5 units as the 2 units is already reducing the BGs to lower than we like with caninsulin. Please monitor the BG closely to see she doesn’t drop too low. Do you have some honey and high carb food at home?
I’m going to tag @Wendy&Neko and @Suzanne & Darcy to see if they can comment on the disease and the potassium and the lab results.
How is she eating now? Any improvement there?
I’m going to tag @Wendy&Neko and @Suzanne & Darcy to see if they can comment on the disease and the potassium and the lab results.
How is she eating now? Any improvement there?
Last edited:
@Bron and Sheba (GA) I agree about the increase in the dose, however she told us to stick to the 2 units, and that she only increased it for that one time because it was the highest it's been. We are monitoring her closely, checked BG at 11pm and it was 2.9 so we rubbed honey on her gums and gave her a rehydration sachet we initially got for her yesterday after finding her potassium levels were extremely low as it has potassium in it. The food we are feeding her daily is recovery wet food by royal canin. Is it high carb?
Today she had been very hungry after getting back from the vet, and is drinking alot of water too. However this has me also worried, as I have read these also can be signs of kidney disease? As well as ketones/diabetes? Especially since she has low potassium too, which I know have read is a sign of kidney issues too.
Today she had been very hungry after getting back from the vet, and is drinking alot of water too. However this has me also worried, as I have read these also can be signs of kidney disease? As well as ketones/diabetes? Especially since she has low potassium too, which I know have read is a sign of kidney issues too.
Bron and Sheba (GA)
Very Active Member
Can you show me on the syringe where you draw up the insulin to please? You say 2 units and then 0.05ml which is unusual.
You did the right thing by rubbing honey on her gums. 2.9 is too low for caninsulin. I’m glad you have gone back to 2 units.
I’ll get you to start a new thread please Monica as this one is getting too long. Keep ketones and low potassium and syringe fed in the subject line of new thread.
You did the right thing by rubbing honey on her gums. 2.9 is too low for caninsulin. I’m glad you have gone back to 2 units.
I’ll get you to start a new thread please Monica as this one is getting too long. Keep ketones and low potassium and syringe fed in the subject line of new thread.
@Bron and Sheba (GA) I will take a photo at next dosing.
What do you mean regarding a new thread? You have started a new one for me?
What do you mean regarding a new thread? You have started a new one for me?
That potassium is very low. I've had a kitty go below 3.5, but was 3.4 and she still showed some symptoms. A cat does get some potassium from food, so that fact that your kitty wasn't eating much would have made the potassium lower. I'm glad you are supplementing the K. Lactated ringers also has some potassium in it. I treated my girl with lactated ringers, potassium supplement, and anti nausea to get her eating more.
How much does your kitty weigh? I'm worried she's not getting enough calories and the Cerenia dose is too low. Royal Canin Recovery is 183 calories per can, 1/2 that is way too little. 3 mg of Cerenia oral is good for a 1.5 kg cat. Many vets underdose this, they give the same as the injected amount. 3mg injection is good for a 3 kg cat. Ondansetron can also be obtained as an injectable, if pilling is difficult. Like the others, I prefer it for nausea. Cerenia is good for vomiting.
Drinking a lot of water can also be a sign of nausea.
How much does your kitty weigh? I'm worried she's not getting enough calories and the Cerenia dose is too low. Royal Canin Recovery is 183 calories per can, 1/2 that is way too little. 3 mg of Cerenia oral is good for a 1.5 kg cat. Many vets underdose this, they give the same as the injected amount. 3mg injection is good for a 3 kg cat. Ondansetron can also be obtained as an injectable, if pilling is difficult. Like the others, I prefer it for nausea. Cerenia is good for vomiting.
Drinking a lot of water can also be a sign of nausea.
@Wendy&Neko Mia weighs 3.8kg. the cerenia tablets er have are 24mg, and we were told to give 1/8 of the tablet per 24 hours. Should I give more? Even though she is eating?
I would try giving 1/4 of a tablet - you want to stay ahead of nausea.
From the catinfo.org website - a rough approximations for how many calories she would get is:
How much is Mia eating now?
From the catinfo.org website - a rough approximations for how many calories she would get is:
or about 184 calories, almost exactly what is in a full can of Recovery. From the information in Bron's post (#24), she needs to be eating 1.5 times that when getting over DKA, so that would be 1.5 cans.
How much is Mia eating now?
Ok so 1/4 tablet every 24 hours?
She is eating approx 1 can daily, plus a couple of ts of some other wet food she likes (gourmet gold) and Dreamies treats 5-10 pieces as rewards after testing etc. We also got a high calorie paste that we are adding to her food to increase calories.
She had now been free from ketones for 2 days
She is eating approx 1 can daily, plus a couple of ts of some other wet food she likes (gourmet gold) and Dreamies treats 5-10 pieces as rewards after testing etc. We also got a high calorie paste that we are adding to her food to increase calories.
She had now been free from ketones for 2 days
Bron and Sheba (GA)
Very Active Member
Fantastic no ketones for 2 days! keep testing.
Keep up the 1 and 1/2 times the normal number of calories. How much are you having to syringe feed now?
You are doing a great job!
Just tested ketones again and was negative, so on day 3 now
Syringe feeding most of the recovery can, but not having to force her so much anymore between her teeth. Now she is mostly licking it up while I inject it in front of her mouth. And then offering her the old wet food once in a while in addition
Syringe feeding most of the recovery can, but not having to force her so much anymore between her teeth. Now she is mostly licking it up while I inject it in front of her mouth. And then offering her the old wet food once in a while in addition
Great news on the no ketones and yes, 1/4 tablet Cerenia every day.
@Wendy&Neko @Bron and Sheba (GA)
At the vet right now as Mia is getting the third IV infusion of potassium. Took new blood tests. Yesterday the potassium level had increased slightly from 2.2 to 2.4. today it is still 2.4 even after a second IV drip yesterday.
Her clinical signs are better as her head is no longer hanging. But the blood tests haven't improved.
Vet also checked other values, and RBC, HCT and HGB have all gone down further.
RBC - was 6.86 M/uL two days ago - now 5.43 M/uL
HCT - was 30.8% two days ago - now 24%
HGB - was 9.6bg/dL two days ago - now 7.2 g/uL
At the vet right now as Mia is getting the third IV infusion of potassium. Took new blood tests. Yesterday the potassium level had increased slightly from 2.2 to 2.4. today it is still 2.4 even after a second IV drip yesterday.
Her clinical signs are better as her head is no longer hanging. But the blood tests haven't improved.
Vet also checked other values, and RBC, HCT and HGB have all gone down further.
RBC - was 6.86 M/uL two days ago - now 5.43 M/uL
HCT - was 30.8% two days ago - now 24%
HGB - was 9.6bg/dL two days ago - now 7.2 g/uL
Bron and Sheba (GA)
Very Active Member
I can’t help you with those particular blood results as I haven’t had a lot of experience with them sorry. What does the vet say?
Wendy will be asleep atm and won’t be around for several hours.
Maybe @Sienne and Gabby (GA) or @Suzanne & Darcy can help with them.
I’m glad Mia’s head is no longer hanging
Wendy will be asleep atm and won’t be around for several hours.
Maybe @Sienne and Gabby (GA) or @Suzanne & Darcy can help with them.
I’m glad Mia’s head is no longer hanging
The vet had mentioned the possibility of her being anemic, so she is getting a shot of B12 now and we will get an iron syrup she will have to take twice a day.
She also mentioned that if the numbers drop further we will have to administer an injection to stimulate production of new red blood cells through bone marrow.
There are also plenty of possibilities to where these low numbers are coming from, which makes me even more confused. Could be from inflammation, from the DKA, or from the low potassium for example.
She also mentioned that if the numbers drop further we will have to administer an injection to stimulate production of new red blood cells through bone marrow.
There are also plenty of possibilities to where these low numbers are coming from, which makes me even more confused. Could be from inflammation, from the DKA, or from the low potassium for example.
Bron and Sheba (GA)
Very Active Member
I’m glad you have gone back to the vet and are aware of it all and getting treatment for it. I’m sure you are worried. Hang in there. The ketones have been negative for a few days and she is more interested in food and they are both big pluses!
JL and Chip
Very Active Member
Insulin dosing with a cat who has low potassium can be a balancing act. Insulin drives potassium out of the bloodstream and into the cells, meaning giving insulin shots can decrease circulating potassium (had a big problem with Charlie, who had low potassium and was also anemic). That doesn’t mean you shouldn’t give insulin—to the contrary, it’s imperative with recent DKA. But it can feel like you’re chasing your tail.
Also, anemia can alter BG readings and cause them to be artificially inflated (i.e., appear higher than they actually are). So, for example, a reading of 90 on the meter (or even lab machine) might really be 80 (I don’t know percentage it can be off, so that’s just an illustration; don’t take the numbers literally). So anyway, a normally nice BG number can give you a false sense of security, so that’s another reason to be very cautious with insulin dosing and not allow the BG to go too low.
I don’t give dosing advice, but I would want to dose the lowest amount of insulin needed to keep DKA at bay and continue pushing as much food as kitty will tolerate. We nearly crashed Charlie’s potassium with insulin and also had to navigate significant anemia. We talked about a blood transfusion at one point. And I wouldn’t focus too terribly much on kidney failure right now — the Creatinine looks good, BUN can be elevated with dehydration. You can always ask for an SDMA test if you want but I (and my IM vet) hesitated to pull any more blood than was absolutely necessary when Charlie was already anemic. I think kidneys are likely not your biggest problem right now. Low potassium notoriously causes weakness and the head hanging you describe, so I’m with Bron on suspecting that’s the root of at least some of the symptoms.
edited to add: I’m somewhat surprised they don’t want to hospitalize and keep the IV in for at least 24 hours to bring the potassium up in a slow, controlled manner, and then switch over to oral K supplement.
Also, anemia can alter BG readings and cause them to be artificially inflated (i.e., appear higher than they actually are). So, for example, a reading of 90 on the meter (or even lab machine) might really be 80 (I don’t know percentage it can be off, so that’s just an illustration; don’t take the numbers literally). So anyway, a normally nice BG number can give you a false sense of security, so that’s another reason to be very cautious with insulin dosing and not allow the BG to go too low.
I don’t give dosing advice, but I would want to dose the lowest amount of insulin needed to keep DKA at bay and continue pushing as much food as kitty will tolerate. We nearly crashed Charlie’s potassium with insulin and also had to navigate significant anemia. We talked about a blood transfusion at one point. And I wouldn’t focus too terribly much on kidney failure right now — the Creatinine looks good, BUN can be elevated with dehydration. You can always ask for an SDMA test if you want but I (and my IM vet) hesitated to pull any more blood than was absolutely necessary when Charlie was already anemic. I think kidneys are likely not your biggest problem right now. Low potassium notoriously causes weakness and the head hanging you describe, so I’m with Bron on suspecting that’s the root of at least some of the symptoms.
edited to add: I’m somewhat surprised they don’t want to hospitalize and keep the IV in for at least 24 hours to bring the potassium up in a slow, controlled manner, and then switch over to oral K supplement.
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JL and Chip
Very Active Member
It does sound unusual, doesn’t it? I’ve seen the ml reference a few times over the years, mostly from European vets, I think. I’m wondering why, unless it makes the dosing less syringe dependent (so you wouldn’t have to have a u-40 or u-100 syringe if you’re simply measuring in ml’s maybe ??). But I’d be concerned that the owner might accidentally give 0.5ml instead of 0.05ml, so there’s that…
Anyway, the math for anyone who is interested. Caninsulin is a u-40 insulin, so 40 units per ml.
2 units / 40 units/ml = 0.05ml
Ok, so do I understand this right regarding potassium? That the insulin moves potassium to "where it's needed" in her body, which causes it to not show up/show up in low levels in her blood tests? For example since we gave potassium yesterday and he head position is back to normal, it means her body has infact accepted the potassium IV, and moved it to the cells to repair the damage it had caused. So all the potassium went to this cause, making it not visible in the blood?
We are currently still on 2 units morning and evening. Should we discuss lowering the dose slightly to see if it has an affect on potassium levels? What made your Charlie get through this seeing he seems to have had a lot of the same issues? (Low potassium k anemia) And is there a general recommendation in terms of insulin doses and keeping DKA away?
Unfortunately there is no 24/7 animal hospital in Malta at the moment. This is why we are doing daily visits to the vet for the potassium IV, which has been done over 2-3 hours both yesterday and today in order to not give it too fast. At home we also give her a sachet of potassium orally, in the evening as an extra "boost".
@Sienne and Gabby (GA) @Suzanne & Darcy @Wendy&Neko Any suggestions or ideas on the blood tests above?
Also, just checked her BG levels 5 hours after her last insulin dose. First reading was 21.1, checked again and it said 18.2. Found these abnormally high compared to tests at the 5 hour mark last days. What has changed today is that she got 2ml of an iron syrup supplement as well as a B12 shot at the vet this morning. A quick Google search showed me that vitamin C can give falsely high BG results, and the first ingredient on the iron syrup supplement is vitamin C. Could this be causing the abnormally high number? And also, any idea to why the meter is showing 2 different numbers right after each other?
Also, just checked her BG levels 5 hours after her last insulin dose. First reading was 21.1, checked again and it said 18.2. Found these abnormally high compared to tests at the 5 hour mark last days. What has changed today is that she got 2ml of an iron syrup supplement as well as a B12 shot at the vet this morning. A quick Google search showed me that vitamin C can give falsely high BG results, and the first ingredient on the iron syrup supplement is vitamin C. Could this be causing the abnormally high number? And also, any idea to why the meter is showing 2 different numbers right after each other?
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Bron and Sheba (GA)
Very Active Member
If the ketone results are still showing ketones. I would not reduce the dose of insulin if at all possible. I would try feeding some higher carb food to keep the BGs up a bit more, if that makes sense.
I thought ketones had been absent for 3 days but I can see they were present yesterday (in the SS)
How is her appetite now? How much is she eating on her own.?
The difference in the two BG readings is within the normal range of meter variance. So no concerns there.
I thought ketones had been absent for 3 days but I can see they were present yesterday (in the SS)
How is her appetite now? How much is she eating on her own.?
The difference in the two BG readings is within the normal range of meter variance. So no concerns there.
I get worried whenever I see something referred to as "syrup" as that often indicates a sugar somewhere in the mix.
@Bron and Sheba (GA) not sure where you are seeing ketones being present yesterday in the SS? Last time they were present was Sunday, so for 3 days now they have not been showing when testing with the ketone strips.
She is getting royal canin recovery wet food at the moment, as well as some of her old favorite wet food, Dreamies treats and a pate as snacks. So we are still following the suggestion of feeding whatever and as much as possible due to the ketones being present 3 days ago.
Her appetite seems to vary a little from day to day, however most of her food still has to be force fed.
She is getting royal canin recovery wet food at the moment, as well as some of her old favorite wet food, Dreamies treats and a pate as snacks. So we are still following the suggestion of feeding whatever and as much as possible due to the ketones being present 3 days ago.
Her appetite seems to vary a little from day to day, however most of her food still has to be force fed.
@Wendy&Neko Yes I agree, there is sugar in it. However seeing the forum is recommending higher amount of calories at the moment, should that be ok to keep up in order to get her the iron supplement? Will have to check with the vet if there are any other iron supplement alternatives.
I think the ketones misunderstanding happened because the spreadsheet has not been updated the last two days, making the ketones incident seem more recent. Glad to hear they are still in the past.
How long do you have to give the iron supplement? If she needs it, we work the insulin dosing around an essential medication.
How long do you have to give the iron supplement? If she needs it, we work the insulin dosing around an essential medication.
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