New Member - Need help with dosing

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You can move his shot 30 minutes every 24 hours or 15 minutes each cycle. Moving by more than that can act like a small increase. With him having been dka I hate to say skip though. Have you tested for ketones? If he’s high tomorrow morning from the fur shot, 300+ you could shoot an hour early tomorrow morning if you can monitor.

It does get easier once you have more data.
 
tiffmaxee said:
You can move his shot 30 minutes every 24 hours or 15 minutes each cycle. Moving by more than that can act like a small increase. With him having been dka I hate to say skip though. Have you tested for ketones? If he’s high tomorrow morning from the fur shot, 300+ you could shoot an hour early tomorrow morning if you can monitor.

It does get easier once you have more data.
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Thanks. I think I'm going to take him to my vet for the day, which will probably be best for both of us. I would be a complete mess if he was home by himself in this kind of situation.
 
tiffmaxee said:
You can move his shot 30 minutes every 24 hours or 15 minutes each cycle. Moving by more than that can act like a small increase. With him having been dka I hate to say skip though. Have you tested for ketones? If he’s high tomorrow morning from the fur shot, 300+ you could shoot an hour early tomorrow morning if you can monitor.

It does get easier once you have more data.
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His AMPS is 94. Not sure what to do.
 
tiffmaxee said:
You are home today? Sorry I just saw this. Did you test again? Did he eat?
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So I messed up again :( I ran out of AT2 strips and couldn't retest until my husband went to Walmart to get a Relion meter and strips (of course my AT2 strips arrived 30 min after he bought the relion meter lol). He usually eats breakfast around 8 am and my husband wasn't able to go to Walmart until 12:30 pm, so I just fed him and skipped the shot. I just always feel like such a POS. I keep messing up and can't seem to get it together. I guess the most important thing is Murs is still alive and still loves me regardless of my mistakes lol

Anyway, his PMPS is 108 (with AT2). I'm thinking 0.5 units but want to confirm with you first.
 
How did your vet determine he was diabetic? Did he run a fructosamine test? To get a bg that low after a skip is why I ask. It’s too low to shoot. Has he eaten? I imagine yes since it’s been 46 minutes. Can you pick up his food and test in 2 hours? I know tomorrow you are taking him to the vet. I’d get a fructosamine run there. It gives an average bg over. 2-3 weeks.
 
tiffmaxee said:
It looks like you gave .50. Test at +2 please.
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Is there a way to upload a file? I can't figure it out.

He had a fructosamine test when first diagnosed - it was 561 (range 143 - 373). I suspected diabetes due to him drinking a lot and urinating huge amounts, so I tested his urine at home and there was glucose. I took him to the vet and made sure we did a fructosamine test (as well as chem, CBC, urinalysis, T4, etc.) to confirm diabetes.

I always end up with the weirdest cats though. I still don't understand why he has diabetes as he's not overweight and hasn't had steroids. I've only had him 2.5 months though, so there's a chance he was overweight at some point while he was on the streets.
 
His bg is barely elevated. Normal on a pet meter is 68-120ish. That is a high fructosamine. Plus DKA and glucose in his urine are indicative of fd. He is a mystery.
 
What do you make of these numbers, Bron? It’s not even like he’s eating only very low lc. @Bron and Sheba (GA) He will be with the vet tomorrow as nobody can watch him. What do you suggest she give in the morning? I know we have no idea what will happen tonight but he’s pretty normal after a skip.
 
Bron and Sheba (GA) said:
Are you still testing for ketones?
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I've been doing a terrible job of stalking him to catch him while he's urinating to test his urine, and he's not obeying when I put him in the litter box lol. I ordered a blood ketone meter though, so hopefully that'll be here soon!

One of my other cats has a very long list of medical conditions, and he never makes medical sense lol. He's 16 years old now though and is doing pretty well overall! Strange cats always seem to find me, and we figure it out together. Murs is definitely my kind of cat with all of his health issues and just not making much sense lol. He may just cause me to lose my mind though haha
 
tiffmaxee said:
Becca, how many cats do you have?
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Including Murs, I have 6 cats, and they all have special needs. I think it's safe to say he's a foster fail lol. He's seriously the sweetest boy, so I still hoped he would find a wonderful home, but then he got diabetes and was hospitalized for DKA. I kept saying, "He's too adoptable for me to keep. I only keep the unadoptable cats." He just kept getting new health issues and has officially made himself unadoptable, so I've told him he now qualifies and gets to stay. Hopefully, his medical issues will end here lololol
 
It’s not good to skip with DKA in the recent past, and we especially when we don’t know what the status of ketones is.
Are they going to monitor him at the vet?
Will he be fed at the vet and do you think he will eat at the vets?
 
Bron and Sheba (GA) said:
It’s not good to skip with DKA in the recent past, and we especially when we don’t know what the status of ketones is.
Are they going to monitor him at the vet?
Will he be fed at the vet and do you think he will eat at the vets?
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Yes, I'm doing medical boarding, so they'll be monitoring him, checking his BG, giving insulin (if needed), feeding him, etc. He ate really well there when he was hospitalized after the first two nights, so I'm sure he'll eat there again. He loves food lol
 
Becca and Murs said:
Yes, I'm doing medical boarding, so they'll be monitoring him, checking his BG, giving insulin (if needed), feeding him, etc. He ate really well there when he was hospitalized after the first two nights, so I'm sure he'll eat there again. He loves food lol
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How long until the AMPS is due?
I’ll be around for the next8 hours off and on so I’d rather see the AMPS before committing to a dose.
Can you post the AMPS?
 
My husband picked him up from the vet (for medical boarding) because I wouldn't be able to pick up him up until pretty late (I'm still at work). Anyway, I just talked to the receptionist and she's going to have the vet call me back. They skipped his AM shot and his BG has been pretty low all day - like around 99ish. My husband tested him at 3 and 5, and it was 80. He's going to feed him and retest in 20 minutes. I had the vet test for ketones, and there aren't any. He also sent out a fructosamine test. Is there a chance Murs just isn't actually diabetic?
 
Becca and Murs said:
Is there a chance Murs just isn't actually diabetic?
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If he had DKA, he was diabetic. He was not started on insulin for 3 days when first diagnosed, despite high blood glucose levels and that was enough to cause the DKA. He should have been started on insulin the first day.
But he’s responding well to the insulin now.
I don’t agree with skipping insulin doses with post DKA cats and I’m surprised the vet is.
A reduced dose would have been better than a skip, especially when he was going to be at the vet and could be monitored closely.
A fructosamine test is good to confirm diagnosis but once you are home testing, it does not tell you as much as all your hometesting BGs do. The fructosamine test just gives an average of the BG from the past few weeks. The BG could be really high and really low and it would just look average….or on a good range.
If you can fill in the days BGs from the vet and your husband for us to see that would be helpful. I’m glad there were no ketones.
 
Bron and Sheba (GA) said:
If he had DKA, he was diabetic. He was not started on insulin for 3 days when first diagnosed, despite high blood glucose levels and that was enough to cause the DKA. He should have been started on insulin the first day.
But he’s responding well to the insulin now.
I don’t agree with skipping insulin doses with post DKA cats and I’m surprised the vet is.
A reduced dose would have been better than a skip, especially when he was going to be at the vet and could be monitored closely.
A fructosamine test is good to confirm diagnosis but once you are home testing, it does not tell you as much as all your hometesting BGs do. The fructosamine test just gives an average of the BG from the past few weeks. The BG could be really high and really low and it would just look average….or on a good range.
If you can fill in the days BGs from the vet and your husband for us to see that would be helpful. I’m glad there were no ketones.
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I'm honestly furious they didn't give him insulin and I'm still waiting on a call back. I worked 14 and a half hours today, and the whole point of me paying for medical boarding was for them to give insulin and monitor.

His PMPS is 80 and I'm honestly about to have a mental breakdown because he's too low to shoot, but I can't skip.
 
If you had not been told about DKA I would think he’s not diabetic. I seriously wonder if a mistake could have been made. His BG is in normal range despite a skipped shot this morning. I don’t see how you can give insulin with BG that low on a pet meter. I know cats that have been DKA should not skip. It’s not my area of experience but something seems off to me.

@Bron and Sheba (GA) @Wendy&Neko
 
tiffmaxee said:
I just googled this and it’s possible but very rare to develop dka with normal bg. I could not find much on this or how to treat it.
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Thank you so much! I seriously don't know what I would do without y'all, and I appreciate your help more than you know. I'm still on the edge of a mental breakdown, but your help and support makes things a lot better.
 
The meter is good news! I never was able to get near my cats while in the lb. I diagnosed Max by putting wax paper over some litter. I was fortunate he never was dka.
 
Bron and Sheba (GA) said:
Great!
Do you have any higher carb foods you can feed him if needed?
How is his appetite at the moment?
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I have prescription canned renal and urinary diets, which are higher carb. I also have prescription dry food (Glycobalance, hydrolyzed protein, renal, c/d, and SO). His appetite is great as usual. He loves eating! I'm working at least 12 hours again tomorrow (I may take Saturday or Sunday off this week), and I really just physically can't stay up late unfortunately. I feel terrible about it, but I need my job to afford all of my cats' expenses. I'll be working from home the rest of the week and most of next week, so I can monitor during the day.
 
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tiffmaxee said:
The meter is good news! I never was able to get near my cats while in the lb. I diagnosed Max by putting wax paper over some litter. I was fortunate he never was dka.
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Murs is seriously the BEST! He's so tolerant, patient, and sweet. I lucked out having him as my first diabetic cat. He rarely puts up a fight. The only thing he really hated was when I was shampooing his tail but he still let me do it. Now I'm just using the mousse, and he's much happier lol
 
Becca and Murs said:
I have prescription canned renal and urinary diets, which are higher carb. I also have prescription dry food (Glycobalance, hydrolyzed protein, renal, c/d, and SO). His appetite is great as usual. He loves eating! I'm working at least 12 hours again tomorrow (I may take Saturday or Sunday off this week), and I really just physically can't stay up late unfortunately. I feel terrible about it, but I need my job to afford all of my cats' expenses.
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Ok. I understand.
Because you can’t stay up tonight testing ……Here is what I am thinking.
If you can test for ketones with the new monitor and if it is negative I think we will have to skip the dose…although this does worry me a bit. I was going to suggest a drop of insulin but if you can’t test I would hesitate with his normal BGs and no monitoring
Also leave him plenty of food out to eat overnight…just normal low carb food. It is important he is eating really well if we are going to skip the dose.
 
Bron and Sheba (GA) said:
Ok. I understand.
Because you can’t stay up tonight testing ……Here is what I am thinking.
If you can test for ketones with the new monitor and if it is negative I think we will have to skip the dose…although this does worry me a bit. I was going to suggest a drop of insulin but if you can’t test I would hesitate with his normal BGs and no monitoring
Also leave him plenty of food out to eat overnight…just normal low carb food. It is important he is eating really well if we are going to skip the dose.
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I just tested ketones and got "LO" which I guess means negative? I'm using the nova max plus.
 
Becca and Murs said:
I just tested ketones and got "LO" which I guess means negative? I'm using the nova max plus.
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I assume that is OK too …normally the blood ketone meter gives a number.
Ok so are you ok with skipping the dose tonight?
Then tomorrow we can see what the AMPS is and if needed you can monitor the BGs because you will be home….is that right?
****Remember to feed lots of food tonight.****
Can you tell me how many hours from now your AMPS will be.?
I’m in Australia so hopefully will still be awake. It’s 1.30 pm here on Thursday.
 
Can you put in the Unit column of the SS ….”skipped as unable to monitor”…….also can you note in the remarks column that the ketones were negative please?
 
Bron and Sheba (GA) said:
I assume that is OK too …normally the blood ketone meter gives a number.
Ok so are you ok with skipping the dose tonight?
Then tomorrow we can see what the AMPS is and if needed you can monitor the BGs because you will be home….is that right?
****Remember to feed lots of food tonight.****
Can you tell me how many hours from now your AMPS will be.?
I’m in Australia so hopefully will still be awake. It’s 1.30 pm here on Thursday.
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Thanks so much! Yeah I think I'll skip tonight. I can do AMPS around 8 am/8:30 am EST. I appreciate y'all's help SO MUCH! There's no way I would be able to do this without the both of you!
 
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