New to Forum - Diabetic Kitty Comes Home Today

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Kelley and Merlin, Oct 17, 2020.

  1. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Hi everyone,

    My name is Kelley and I live in the suburbs of Houston, Texas. I have a 12.5 year old kitty, Merlin, who I adopted about 11 years ago. He was recently diagnosed with feline diabetes (I took him to the vet because I was concerned about his behavior and weight loss) but he has now ended up in the vet's office (before my Lantus order arrived from Chewy's) after starting to vomit clear liquid on Wednesday night. He spent Thursday and Friday at the vet's office and I pick him up this afternoon.

    His bs when he arrived at the vet on Thursday morning was 459. He has been on IV fluid for SEVERE dehydration, IV antibiotics to prevent any diabetic-related infection, anti-nausea medication, and another type of insulin (can't remember the name) for the last two days. He has bounced back a little. He ate a little on Thursday night. He only had one insulin dose on Thursday but it brought his bs down to the low 300s. On Friday he received two doses of insulin and his bs is now in the 170s. I believe this morning's dose of insulin brought it down to the 160s. However, the vet said he didn't eat last night.

    The vet wants him to come home this afternoon as there will not be anyone in their office on Sunday. I'm so nervous. I've ordered an Alpha Trak glucometer, but I have a human glucometer here at home. It reads low (it read 303 before I took him in on Thursday morning, when his bs was really 459). I need to try to get him to eat (vet said let him eat anything he wants), continue his antibiotics (orally), monitor his glucose with the human glucometer, and give him insulin (for the very first time tonight). I will take him back to the vet on Monday for them to check him again.

    He is down to 7.5 pounds (he's normally about an 11 pound cat). He's lost 2 pounds just in the last two weeks.

    I'm super stressed and scared. I love him so much and can't stand the thought of losing him.

    I'd appreciate any advice anyone may have to offer.

    Thank you.
    Kelley
     
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  2. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Kelley,

    Welcome to yourself and Merlin. I'm glad you've found us and we'll do all we can to help you two. :)

    On a bit of a fly-past so excuse the brusqueness of this reply. I just wanted to get the info to you ASAP - particularly about meds to help with eating (see below).

    First up, the human glucometer is fine for testing. Check that you have a good supply of strips in the house. (FYI, the normal cat BG reference range on human meters is 50-120mg/dL.)

    My understanding is that you're due to pick up Merlin today. If they're not automatically offered, I suggest asking the vets for the following:

    1. Anti-nausea tablets (Cerenia and/or ondansetron).

    2. Appetite stimulant.

    These meds should hopefully help you help Merlin eat enough while you're nursing him at home. The anti-nausea meds are doubly important here because oral antibiotics can sometimes upset the digestive system.

    I suggest that you ask the vet for guidance on what to do about dosing if Merlin hasn't eaten too well (e.g. how much to give as a token dose in such circumstances).

    Also I suggest asking the vet about whether any problem with pancreatitis or ketones/diabetic ketoacidosis may have caused Merlin's symptoms (the latter is a serious [ETA] but treatable complication of diabetes). If pancreatitis were to prove to be the issue then the vet should also send you home with pain meds for Merlin (e.g. buprenorphine) - see IDEXX Pancreatitis Guidelines for more info if you need it.

    Secondary to the anti-nausea meds, here are some tips to encourage food intake:

    Persuading Your Cat to Eat (see the list of baby foods on this page - sometimes kitties will eat some of this food when they won't accept anything else).

    Also, in case you haven't seen the following post in the FAQ section, it includes suggestions for higher carb food options that can be used to raise BG numbers if needed:

    Hypo toolkit

    If you haven't already got any at home, I suggest grabbing some urine ketone test strips when you're out and about today (always wise to test for ketones as a precaution, especially in the early days of treatment!).


    Again sorry for brisk tone. Please keep posting for help because different members are here at different times. :)

    Hope to catch up with you later. Keep safe while you're out and about.


    Mogs
    .
     
    Last edited: Oct 17, 2020
  3. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Welcome from me too. Let us know what you find out from your vet once settled at home. Tge great thing about the FDMB is there’s help almost 24 hours.
     
  4. Aleluia Grugru & Minnie

    Aleluia Grugru & Minnie Well-Known Member

    Joined:
    Dec 21, 2019
    Mogs already gave you great advice and I just wanted to say welcome! :bighug::bighug::bighug:

    anti nausea meds is a must. Merlin won’t eat if he’s nauseated. Minnie has IBD so I’m all too familiar with that struggle :( but on ondansetron twice a day she does very well. Make sure they send you home with the meds Mogs mentioned.

    as for food, I’d also try baby food. I’ve had some luck with Minnie even when she won’t eat anything else. Gerber is a good brand. Turkey or chicken are my to gos. Just make sure it has no onions or any condiments

    let us know how he does at home!
     
  5. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Don’t forget to get ham Gerbers too. My go to. You need the 2nds meat only and not the ones with vegetables.
     
  6. Aleluia Grugru & Minnie

    Aleluia Grugru & Minnie Well-Known Member

    Joined:
    Dec 21, 2019
    I haven’t tried ham. I’ve done beef before. She loves all of them so I’ll try it next time! :)
     
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  7. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I’ve had two cats that would not eat the chicken before. Veal was a hit until they stopped making it.
     
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  8. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    WELCOME Kelly and Merlin. We ALL know the feeling. We've all been there. Lucky for us we found FDMB.
    Its natural to be nervous and scared when a loved one is sick. I think the questions Mogs has asked are very important. Please answer them the best you can. ok? I think for you to get better acquainted with how this board works you may want to check this link out:
    New? How You Can Help Us Help You!

    We are a dedicated group of cat lovers that want nothing but the best for any person that finds this forum. Theres also a ton of information here at your fingertips, with good people to help you navigate it all. Youve landed in a safe place for Merlin.
    WELCOME TO OUR FAMILY:bighug:

    This is the best darn site on this planet to learn everything you need to know about feline diabetes
    jeanne
     
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  9. Gill & Mac (UK)

    Gill & Mac (UK) Member

    Joined:
    Aug 19, 2020
    Welcome Kelley
    I know this is so overwhelming especially seeing as poor Merlin has been so poorly but take a few seconds just to take a breath and relax - you can do this!
    You did well by Merlin by getting him to the vets and you have found the best site in the world for getting both advice and support.
    You will be there for Merlin and everyone will be here for you.
    Never be scared to ask any question you are concerned about even if you think it is daft (I've asked plenty!) No - one on here will ever make you feel silly.
    Sending hugs to you both
    Gill:bighug::bighug:
     
  10. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    HI KELLEY... So sorry about the diagnosis, but glad you found us! I know how scary and overwhelming it feels in the beginning... be we've got your back. And remember it's not a death sentence! They can live long healthy lives with diabetes. My cat was diagnosed 4.5 years ago. He should be feeling better soon.
     
  11. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Did the vet mention ketones at all. It would be worth while asking if any ketones were present in the blood or urine. If there were they can be monitored at home a steps taken to prevent them recurring
     
  12. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Hi everyone, Thank you for the warm welcome. It's been crazy since I picked Merlin up yesterday. While he ate some on Friday which was encouraging to the vet, he hasn't eaten since.

    So, when I picked Merlin up yesterday, the vet said his bs number in the afternoon was 60 and to NOT give insulin last night. However, because my Alpha Trak glucometer won't be here for a couple more days, she said to test him again when I get home so we can get a second idea for what he would show on a human glucometer knowing the animal glucometer read 60. I did get some anti-nausea meds in case he started throwing up again. So we came home with Prozinc, Clavamox, and some Metoclopramide. I was told to hold the Prozinc and Clavamox last night.

    Well, when I got home and tested him, he was 141 on the human glucometer . I retested two hours later and his bs had gone up to 191. When I initially took him to the vet on Thursday morning my human glucometer was about 150 points lower than the animal glucometer (I got 303 at home and the vet got 458 when he arrived), so the vet started questioning if the tech wrote the number (60) down correctly in the office that afternoon. She suggested we go to the ER for a spot glucose check to determine if he needed insulin last night.

    We loaded back up in the car and my dad drove us to the ER. We didn't make it to the end of the street and my lap felt warm. He had peed all over me. He has been so pumped full of IV fluid for two days and also had subcutaneous fluid administered before he came home.

    The ER vet was amazing. Merlin's bs was 323. He was concerned about Merlin's breathing and a nasal discharge and wondered about pneumonia. He did a free x-ray and a free test for ketones and both were normal. They administered a half dose of insulin and a dose of the Clavamox. He also gave an appetite stimulant called Mirtazapine. I'm supposed to take Merlin back mid-day today for a check. I'm supposed to hold insulin this morning if he hasn't eaten - which he hasn't. He's still acting lethargic. He took a couple of licks of tuna juice about 30 minutes ago. I also got a syringe of baby food (turkey) in him about 20 minutes ago. He just turns his head away from anything I offer him. That is all he has eaten since Friday. He hasn't drank any water since we've been home either.

    Something else I'm wondering about it a vet he saw a month ago said he had severe tooth decay (probably would lose a couple of teeth). However, it hadn't stopped him from eating and the ER notes say everything looked normal for teeth and gums.

    I just took his bs again (5:45am) on the human glucometer and it is reading 229. So, I'm thinking his bs must be around 350-380.

    I'm at a complete loss. I don't know why he won't eat or what to do about it. I'm scared that I'm just going to watch him starve to death.
     
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  13. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Kelley,

    Glad to hear back from you. I've been worrying about how things were going.

    My but ye have had quite the time! I've seen your post and I'll reply properly shortly - just need to give my kitty some medicine. I just wanted to let you know that, from what you describe, Merlin sounds like he may still be feeling nauseated. There are more suitable meds. More in a little while. In the meantime, could you let me know whether the first vets or the ER vets told you why they thought Merlin became lethargic and inappetent in the first place (e.g. pancreatitis, constipation, other)???

    Hang in there!

    :bighug:


    Mogs
    .
     
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  14. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Hi Kelly,
    It sounds to me like you have differing vets opinions. When was Merlin's last dental?

    Oh Mogs is here I will defer to her. I just didnt want you to feel alone. :bighug:
     
  15. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Hi Mogs, Neither really said. I know the vet (our normal vet) did blood work on Thursday and all organs were ok. I don't know if she said it or I suspected it, but I thought at one time he might be in ketoacidosis. It was weird, he was eating and acting normal on Wednesday and then that night started throwing up clear liquid literally all over the house. When I woke up that morning and saw what had happened during the night, I immediately took him to our regular vet and that is who he was with until yesterday afternoon.

    I need to give you some back information that I forgot yesterday in the stress of it all. He was diagnosed several weeks ago by a vet closer to my home and prescribed Lantus. At that time, I had taken him in due to weight loss, sneezing, and looking a little wobbly but he was still acting and eating fine. I chose this closer vet due to the pandemic and ease of getting there. After the diagnosis, I immediately ordered very low/zero carb food and he's been eating that ever since. I also immediately ordered his Lantus on Chewy.com, but it took over a week for me to realize that Chewy was calling the vet's office and the vet would not confirm the prescription for shipping. I checked with Walgreen's and couldn't get it there. This new vet then finally told me they don't confirm their prescriptions via phone/fax for liability reasons and mailed me a copy of the prescription. When it arrived, I placed the order again with Chewy's, but this time had to mail them the original prescription before they would ship. So that was another week I was waiting. I actually just cancelled that order on Friday (it was going to ship out that day) because Merlin was already at our old vet's office and they had started ProZinc.

    Merlin seemed to actually be doing well with the diet change until Wednesday night. I'm not sure what happened that night. He's been a different cat ever since. He was so incredibly dehydrated from the vomiting. I still don't know what caused the vomiting and if the blood sugar is completely out of control due to that episode or if it was happening prior to that while I was trying to get the Lantus and just finally showed itself on Wednesday night.

    It seems that none of the vets can find any other problems with him other than severe tooth decay (by the new vet) which oddly the regular vet and ER are not finding.
     
  16. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Back to you, Kelley. Reading...


    Mogs
    .
     
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  17. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Does this mean that your vet gave him Prozinc while he was at the office, prior to getting that 60 on the AlphaTrak yesterday?

    Did they tell you what dose they gave?
     
  18. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Yes, they gave him 2 units of ProZinc yesterday morning around 7am. Then got the reading of 60 around mid-day I think. They started his ProZinc on Thursday (only got one dose of 2 units) and I believe it brought him down from 458 to lower 300s if I remember correctly. Then he got two doses on Thursday (and I think he came down to 170s on the first and 160s on the second). Then he got the morning dose on Friday and they got a reading of 60. He did eat Thursday night also because the vet was so happy to come in and see that he had eaten his food during the night. The only unassisted eating he has done since Wednesday was on Thursday night.
     
  19. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    I'm wondering if the reading of 60 yesterday was really 160 and they wrote it wrong.
     
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  20. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    I'm annoyed with the vet for not double checking such a drastic change, but it still doesn't help the current situation of refusal to eat.
     
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  21. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Hard to say... 60 is pretty low on an animal meter, but even 160 they might give the "no insulin" advice.

    Couple more questions: what food are you feeding, and did they assist-feed the same food at the vet's office or use their own?

    And, related to some of the earlier discussion, do you know if they did a pancreatitis test?

    Right now, he's on Prozinc (well, sort of), Clavamox (sort of), mirtazapine, and metoclopramide, but no pain meds, correct?
     
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  22. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Have you tried offering him some of his old favorite foods? When a diabetic cat won't eat, we temporarily throw the low-carbs rules out the window. It sounds like there's some serious nausea going on, so this probably won't work, but is worth a try anyway, just in case. Sometimes, even a temporary bout of nausea can cause cats to develop food aversions to the food they were eating at the time, so that they refuse it even after the nausea has resolved.
     
  23. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    HISTORY

    ------------------------------------------------------------------------------------------------------
    Vet A - Clinical Signs at Presentation
    (Late September/early October):
    * Sneezing.
    * Unexplained weight loss.
    * Looking a bit wobbly (possible neuropathy?).
    * Appetite normal.

    Vet A Dx: Diabetes, severe tooth decay.
    Vet A Rx: Lantus.

    Actions Taken:
    * Successful switch to low carb food - clinical signs (appetite, energy levels) good until Wednesday 14 October.
    * Start of insulin treatment delayed (not received due to logistical/bureaucracy problems with vet/supplier). Order cancelled.

    ------------------------------------------------------------------------------------------------------
    Vet B - Clinical Signs at Presentation (Thursday 15 October AM):
    * Protracted vomiting - clear liquid (started night 14 October), severely dehydrated.
    * Severely lethargic.
    * BG spot check - 459 Alphatrak (on low carb diet, prior to start of insulin treatment).

    Findings:
    * Blood work - all organ function normal.
    * No mention of any tooth decay.
    * No mention of whether Merlin in DKA [Sounds like treatment for DKA - Mogs]
    * No mention of root cause of nausea to Kelley.

    Actions Taken:
    * Hospitalised (Thursday 15 to afternoon of 17 Oct inclusive).
    * IV fluids.
    * Prozinc started.
    * Additional type of insulin given (possibly rapid-acting?).
    * Antibiotics (prophylactic).
    * Anti-nausea medication - only time Merlin ate unassisted was Thursday night.
    * Sub-q fluids before discharge.

    Vet B Rx at time of discharge: Prozinc, Clavamox, Metoclopramide (prescribed for nausea or constipation? Useless for cat nausea.)

    ------------------------------------------------------------------------------------------------------
    Home: Merlin not eating or drinking. Poor overall clinical signs.

    ------------------------------------------------------------------------------------------------------
    ER Vet - Clinical Signs at Presentation (Saturday night):
    * Nauseated.
    * Inappetent.
    * Lethargic.
    * Nasal discharge - ER vet worried about pneumonia.
    * BG 323 (Alphatrak)

    Actions taken:
    * X-ray - All normal.
    * Ketone test - NEGATIVE.
    * Examination of teeth/gums - all looks normal.
    * Med adminisration: Mirtazapine administered for appetite, 1/2 dose Prozinc, Clavamox.

    Current Clinical Signs (Home - Sunday AM, prior to ER follow-up):
    * Lethargic.
    * Inappetent.
    * Not drinking.
    * Small amount of food via syringe Sunday AM, first since Friday.
    * Signs of nausea (turns head away from food, licked some tuna juice).
    * Rapid weight loss - 2lb dropped in last two weeks.
    * Wide swings in BG (e.g. 60 - 323)

    ------------------------------------------------------------------------------------------------------


    Mogs
    .
     
    Last edited: Oct 19, 2020
    Reason for edit: Formatting.
  24. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    ER just called. We are heading back so they can do another glucose check, give insulin and more subcutaneous fluid.
     
  25. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Do you have mobile internet access, Kelley?


    Mogs
    .
     
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  26. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Possible factors fuelling inappetence (not an exhaustive list - just common issues):
    ----------------------------------------------------------------------------------------------------------

    * Possible upper respiratory tract infection (cats won't eat if they can't smell the food properly).

    * Check for constipation (if a kitty's backed up then that needs to be sorted before good anti-nausea meds will work. Metoclopramide helps with gut motility but is USELESS for cat nausea).

    * Possible DKA earlier in week (can take a kitty some time to get back to eating normally so effective anti-nausea and appetite stimulant meds may be needed for some time to ensure adequate calorie intake, aid consistent insulin dosing, and thus prevent possible relapse).

    * Possible pancreatitis flare?

    * Other infection?


    Stuff to ask ER vet for:
    -------------------------------

    * Advice on what you might be able to do at home re the nasal discharge (to help Merlin smell things better).

    * Check for pancreatitis.

    If the ER vets didn't already rule out pancreatitis, I recommend asking them to do a Snap fPL test (it's not included in standard blood panels). It works like a pregnancy test and they can get an immediate yes/no/unclear result. If the result is unclear they can then order a Spec fPL test (needs to be sent to a lab).

    * Another check for ketones, also for any possible urinary tract problems (glucose in urine can give rise to UTIs in not-yet-regulated feline diabetics).

    * Cerenia injection for nausea (fastest way to get some anti-nausea benefit - tablets take longer to work - and may also have anti-inflammatory benefit).

    * Vitamin B12 injection (can help with GI issues and appetite, and give a bit of a general boost).

    * Ondansetron or Cerenia tablets to take home for nausea (IDEXX Labs concluded metoclopramide doesn't work well as an anti-nausea treatment in cats).

    * Ask about famotidine for stomach acid (can build up when a kitty has been fasting too long - dealing with any excess acid can help the anti-nausea meds to work better).

    * Appetite stimulant for home administration.

    * If pancreatitis is in play, pain relief for home administration (usually sublingual buprenorphine). Anti-nausea and appy stimulant meds don't help as much if pain isn't managed.

    * Advice on food and insulin dosing (no shot limit, what size dose to give if Merlin's not eating properly).

    Note: The wide ranging BGs you're seeing may be in part due to Merlin being underweight (body's energy stores not what they should be). It might be an idea to discuss with the ER vet whether feeding a slightly higher carb food for the time being might help with insulin administration. (Technically, the right food for Merlin just now is the one he can manage to eat.) [ETA] Because feeding a slightly higher carb food temporarily may better support regular, safe administration of adequate insulin it could possibly help Merlin to regain weight more easily.

    ------------------------------------------------------------

    I hope you're able to pick this up on your way to the ER. I'm sorry I couldn't get it to you quicker.


    Mogs
    .
     
    Last edited: Oct 18, 2020
  27. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    The ER kept him overnight. They said it is a guarded prognosis. They did some bloodwork and his electrolytes are off and that could be part of the reason he isn't eating. They will keep him on IV fluids and his meds until 7:30 in the morning, then I have to take him back to his normal vet. This ER vet today will syringe feed him, the one last night told me he didn't like to do that. I had to fill out a DNR. It breaks my heart, but if he slips away peacefully, I cant stand the thought of them hurting his little body trying to bring him back for a life that may not have a lot of quality to it.
     
  28. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    In my heart, I think it might have been DKA earlier this week.
     
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  29. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Food is critical medicine in a possible DKA, so I'm very happy to hear that the ER vet is going to syringe feed (as for last night's vet.. :banghead:).

    Don't lose hope. Even if he's in or on the edge of DKA, with proper treatment many cats can pull through. He's in the best possible place right now to give him a fighting chance.

    :bighug: :bighug: :bighug:
     
  30. Gill & Mac (UK)

    Gill & Mac (UK) Member

    Joined:
    Aug 19, 2020
    "Like" does not seem right when I press it for messages such as these - just know that it really means that I'm thinking of you both and keeping everything crossed.
    (((Kelley)) (((Merlin)))
    Gill
     
  31. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    (((Kelley and Merlin)))

    I'm hoping that the fluids and meds plus the syringe feeding will give Merlin the boost he needs. As Nan says above, if it is DKA then while it is true that cats can be really ill for a little while - especially during the hospitalisation stage - with correction of the electrolyte balance, insulin and assist feeding to restore regular metabolic processes, plus the right supportive treatments during convalescence many cats go on to make a full recovery.

    I, too, am glad that the ER vet looking after Merlin has chosen to assist feed. If it is DKA then aggressive food and insulin treatment is key to restoring normal metabolism. As a general fact of their biology, cats shouldn't be fasted for very long.

    By way of general information, sometimes in addition to nausea support a kitty with temporary eating difficulties might benefit from a feeding tube for a short while. They can and do save lives (easier, more reliable food, insulin, med and water administration - and they're not as scary in real life as they sound in theory!). Here's more information from a vet-authored site which might help you and give you some ideas about what to ask the vets:

    catinfo.org - Feeding Tubes

    When speaking to your own vet again (Vet B above) I suggest printing off the IDEXX guidelines for pancreatitis treatment before you go because the section on anti-nausea and appetite stimulant meds has all the information you need about the right general treatments for cat nausea - and from an authoritative source. I'm worried because that vet sent you home last time with metoclopramide for nausea and it's not really effective in cats. By way of a real-world example, our very caring and well-intentioned vet prescribed metoclopramide for my Saoirse to treat severe nausea and it wasn't worth a light (according to IDEXX cats don't have many of the receptors it works on). Two members here told me about ondansetron so I went back to the vet and pushed for the Rx (2mg every 12 hours for a 10lb cat). It was a little slow to work initially but within 48 hours she was able to eat much more readily - for the first time in weeks!! That plus an appetite stimulant saved her life. It's not fun, and we all wish it didn't happen at all, but sometimes it can be necessary to push a bit with the vets in order to get the right treatments in place for a kitty.

    Did the ER vets tell you whether they did a ketone test or pancreatitis test?

    Sending prayers for the ER to work some medical magic for Merlin. Anything we can do to help and support you, just let us know. We're here for the two of you.

    :bighug:


    Mogs
    .
     
    Last edited: Oct 19, 2020
    Reason for edit: Grammar.
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  32. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    Kelley, trying to compare human and pet glucometers is like trying to compare apples and sandals. Both glucometers work and are fine.
    Before a company saw a market for poet-specific glucometers, all vets used a human glucometer.

    This is what we know:
    The lower the numbers are, the closer they are to each other. The higher the numbers are, the further apart they are. With high numbers, it really does not matter. High is high on any glucometer. It's the low numbers that you want to watch.

    The "take action" number on an AlphaTrak is 68.
    The "take action" number on a human glucometer is 50.

    See? The numbers are not all that far apart.

    I hope all goes well with your little one.
     
  33. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I'm tagging member @Sienne and Gabby (GA) to ask whether she can give you more advice if she's online. (Gabby had DKA, pancreatitis and hepatic lipidosis at time of her diagnosis but came through with the right treatment.)


    Mogs
    .
     
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  34. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    (((((Kelly and Merlin))))) sigh
    Praying he pulls through.
     
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  35. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    If Merlin's electrolytes are off, there's a good chance this is DKA and the ER is the best place your kitty can be. They will do repeat tests including for potassium, sodium, and bicarbonate. They want to avoid metabolic acidosis. Often the combination of an infection or inflammation plus not enough insulin plus not enough food tips the scales toward DKA. Generally, there ER will keep your kitty on a combination of a longer acting and short acting insulin, a dextrose drip (it provides nutrition and and offsets any potential problems with BG levels dropping), and fluids which help to dilute the ketones and counter the dehydration caused by DKA.

    Hopefully, the ER has a Snap fPLI which is a rapid test for pancreatitis. If pancreatitis is present, you'll likely be sent home with a medication to manage pain (buprenorphine is what many cats are prescribed and I would vote strongly against any of the non steroidal antiinflammatories such as Metacam because they can cause kidney failure), an anti-nausea medication (Cerenia or ondansetron) and an appetite stimulant (e.g., mirtazepine). I may have missed whether someone linked our Primer on Pancreatitis.

    I haven't a clue why you were given metoclopramide. It's typically used for GI motility problems and isn't really a preferred medication for nausea.

    Once Merlin is home, the key is keeping him eating. Frankly, while low carb is ideal, the best food is a food he'll eat.

    Please keep us updated on how Merlin is doing.
     
    Last edited: Oct 18, 2020
  36. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
  37. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Hi everyone,

    I haven't had a chance to read everyone's posts yet. The ER has spent almost 24 hours now treating him for low potassium with potassium paste, syringe feeding, and IV fluids. My regular vet called them yesterday afternoon and I will be picking Merlin up in an hour and a half and taking him straight to her office. I am anticipating him staying, but I'm not sure. I called the ER around 5:00pm yesterday for an update and they said he was doing "very good." He was purring and loving on them. I doubt that he was eating on his own though. After reading about hypokalemia, it describes Merlin perfectly. Acting a little drunk and wobbly, not picking his head up, no appetite, following a severe vomiting episode. I think this may be the treatment he needed. I'm hopeful with a few more days of potassium supplementation (and from what I'm reading, possibly the permanent need for potassium supplementation) he will improve and start eating on his own. At that point, I can start learning how to care for him at home by monitoring his bs and giving him insulin. I feel emotionally exhausted. I feel asleep early last night or I would have logged on and provided an update. I just wanted to thank everyone for their support and all of the helpful information. I will be back on later this morning with an update and try to respond to everyone.

    Kelley
     
  38. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    rest well,;) we'll be here.:bighug:
     
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  39. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    I am reading through the above posts and see your comments about feeding tubes, Mogs. I was thinking about this yesterday. I plan to ask my vet this morning about this should he not start eating on his own. Thank you!

    The ER did a ketone test the first time he was there and all looked good. I don't know if a pancreatitis test was done though. I will ask.
     
  40. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Best wishes and prayers being sent. Lets hope this gets sorted soon.:bighug:
     
  41. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I'm so happy to read your update, Kelley! I need Kleenex...

    (((Kelley)))


    Mogs
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  42. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    PS: I'm very glad you managed to get some rest last night. With Merlin being looked after in the hospital, getting some sleep was the best thing you could have done to help him. You need to look after you so that you can look after him. :)

    :bighug:


    Mogs
    .
     
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  43. Gill & Mac (UK)

    Gill & Mac (UK) Member

    Joined:
    Aug 19, 2020
    Keeping everything crossed & thinking of you both Kelley
    :bighug::bighug:
     
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  44. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Hi everyone, Merlin continues to do well. I am picking him up in about an hour. I wanted to share these with you. They are the notes from his ER discharge this morning. I do bs testing and insulin for the first time on my own tonight at 9:00pm central time. I'm nervous! I'll be back on a bit later.

    Kelley

    1 of 3.jpg 2 of 3.jpg 3 of 3.jpg
     
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  45. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Refuse to leave till they give you appetite stimulants and anti-nausea meds (and I don't mean metoclopramide... ;) )!!! :D

    Keep safe while you're out, Kelley. We'll be here to help when you get back. Merlin's coming home! Yay!!!! :woot:


    Mogs
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    Last edited: Oct 19, 2020
  46. Gill & Mac (UK)

    Gill & Mac (UK) Member

    Joined:
    Aug 19, 2020
    How wonderful that Merlin is coming home and doing well after all those horrible hours you had after you had to sign the DNR.
    So happy for you both Kelley.
    Now I need a Kleenex like @Critter Mom earlier - pass one over Mogs !
    Gill :bighug::bighug:
     
  47. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    WELCOME HOME MERLIN! :bighug:
     
  48. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Happy to oblige...
    [​IMG]


    Mogs
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  49. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Hi everyone, just a quick update before Merlin and I go to bed. His bs was 61 when I picked him up from the vet at 4:30. We came home and I spent a long time just lovin' on him! He is eating well. I first tried some Fancy Feast low carb tuna and mackerel wet food. He took a few bites, but I think he doesn't like it that much. Then he found a couple of dog kibbles on the floor and ate that (first time ever!) so I gave him a little of his usual dry food and he gobbled it up! Then he ate about a quarter can of the urgent care wet food and right before his insulin I gave him about a half jar of turkey baby food. This was all over about 5 hours. I'm literally just feeding him small amounts of anything right now. I took his blood sugar at 8:30 and it was 174. Then he ate the turkey baby food and I gave him his potassium paste, antibiotic, and 1 unit of ProZinc. He's super alert and following me all over the house. Now he and I are getting ready for bed. It's been a long week. We will check in again tomorrow!

    Kelley
     
  50. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    What a wonderful update, Kelley! I'm so happy for you both. It's great to hear he's eating so well. :)

    Wishing you both a peaceful and refreshing night's sleep.


    Mogs
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  51. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Good morning! Merlin and I are up. It is 7:15am here. I hoped to keep him on a 9 and 9 schedule because it works perfectly for my schedule. However, I just took his glucose to see how it was doing. It was 174 last night at 8:30pm so my vet said 1 unit of ProZinc. This morning it is 351. I'm not how sure this meter is when it gets this high, he could be higher. In the past, this meter matches the vet's meter at low numbers but could be 150 points low once his bs is high. Is it safe to have him wait until 9:00am to get insulin or should I feed him now and get some insulin in him? Getting nervous...

    Is it normal to be so high in the morning? I wonder if he should have had 2 units last night instead.
     
  52. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Good morning!

    It's OK to wait until 9am to shoot-- the high numbers aren't going to hurt him until then.

    The high numbers could be due to not enough insulin, but they could also be a reaction to the low (61) he had at the vet yesterday. Assuming that's a pet meter, that's below our usual 'take action' (feed high carb) number of 68, so his body could be reacting to that, dumping sugars into the blood as a defense mechanism. We call this kind of thing a 'bounce', it's so common in newly diagnosed cats it's actually unusual when they don't do it at first. So it's nothing to worry about.

    I'll leave the dosing suggestions for the Prozinc folks. One thing, we usually try to have the pre-shot BG reading as free of food influence as possible (usually trying to keep a 2hr window). Merlin is a special case right now, if he's willing to eat we don't want to withhold food just to follow that rule, so I'd say if he's hungry now feed him even though it's (just) inside the two-hour window. I'm mostly just mentioning this so that you know, and (if you can) try to avoid feeding him close to the pre-shot BG reading so we can get a clear picture of where he is then.

    And finally, big welcome home for Merlin! What a trouper!
     
  53. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Morning, Kelly!

    Hope yourself and Merlin feel better for the sleep. :)

    A higher reading in the morning may be affected by 'dawn phenomenon' and also Merlin's BG may have dropped to a safe but unfamiliarly low level overnight, in which case the body reacts by dumping too much sugar into the bloodstream to compensate (bouncing). As you accumulate BG readings it will help you to learn Merlin's 'style' of response to his Prozinc.

    I can't help on the dosing side of things 'cause I've not used Prozinc, but it's OK for a cat to be in higher numbers at the beginning of the cycle. Regulation will take some time, so don't panic if you see numbers in the higher range.

    IMPORTANT: Please do not give any insulin now. You need to wait until Merlin's normal shot time of 9am.


    Mogs
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  54. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I'm so happy your Merlin is home with you. :cat:


    Mogs
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  55. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
  56. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Thank you all! He is eating now. I actually kept him in a very large crate near my bed last night with a litter box and bedding because I was afraid if he threw up it would be someplace I wouldn't see right away. He did good all night. Because he was crated, I know he hasn't eaten since last night.

    I went ahead and gave him a 2oz packet of food at 7:45am because he acted so ravenous. The food is Purely Fancy Feast Natural White Meat Chicken and Shredded Beef Entrée in a Delicate Broth at 50 calories per packet. The packet says feed a whole packet for every 2-2.5 lb of body weight each day. That would be 3-4 packets, so I'm confused how I would do that when most of what I read says only feed twice a day at insulin time. How do I make sure he is getting enough calories? He seems to have ate a little less than half and drank all of the liquid in it. He just came back and is eating some more as I am typing this, but has stopped again. It looks like a TINY bit more is gone now.

    The 351 was prior to eating. I will wait and give the insulin at 9:00.

    This is my first day back to work since I joined this forum (I'm working from home due to the pandemic). I have sooooo many questions. I will be here at my computer all day and will definitely be reading through all of the information here.

    Should I just leave this food out and available to him for the day but not give him more until tonight's insulin feeding?

    Thank you all again!
    Kelley
     
  57. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Most of us feed more than twice a day. I feed four times a day. I leave the food out. My cats are all grazers. Just no food 2 hours prior to the preshot test so the number is not food influenced.
     
  58. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Ok, this is bad. I just gave him 2 units and think I went through the fur completely because his fur was wet.
     
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  59. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Has this happened to all of you at some point?
     
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  60. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Furshots happen, Kelley. :bighug:

    Whatever you do, DON'T give another dose of insulin. There's no way of knowing how much went in.


    Mogs
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  61. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    DO NOT give another shot! You cant know how much actually went in. This is something you just have to ride out. It happens
     
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  62. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Oh, yes! :D


    Mogs
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  63. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    oops sorry Mogs lol we cross posted
     
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  64. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Snap!!! :D


    .
     
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  65. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    Uuuhhhhh...YEP!:p
     
  66. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Oh my goodness yes!

    there's a mini-tradition over in Lantus, I think, of setting up a fur shot jar-- a dollar goes in for every fur shot, end of the year kitty (and/or caregiver!) gets a nice present. For some of us, a reeeeally nice present!
     
  67. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    hahahahaha :p
     
  68. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    I just tested his bs again and it says 361, only 10 points higher. Of course, it may be much higher on a cat meter. This one doesn't seem accurate as it gets higher. So, should I hold food until his next dose tonight? Or let him finish this plate of food as he is interested?
     
  69. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Back when I was waiting on the Lantus, I ordered U100 syringes with a 5/16 needle to hopefully avoid this. Then we switched to ProZinc and the vet gave me U40 syringes with a 1/2 needle. Is it possible to remove the shorter needles from the old syringes and put on the new U40 syringes as I use them? I may just go ahead and start drinking today...
     
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  70. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    lol I just spit my coffee all over the keyboard:D
     
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  71. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    sorry I dont know the answers to your questions but someone will. hang in there before you pour that first one:p
     
  72. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    You should always let your cat eat if he's hungry. No reason to hold food from him. You only need to hold the food 2 hours prior to the preshot test... otherwise he can eat whenever he wants.
     
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  73. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Probably the easiest thing would be to see if you can get U-40 syringes with your preferred needle length and gauge. I don't think you can swap needles out, unless your syringes are made very differently than mine.

    An alternative: you may be able to use the U-100 syringes directly. You would have to convert the dosage, however, using this conversion chart. For example, the 2.0U of prozinc drawn up in a U-40 syringe is equivalent to drawing up 5.0U on a U-100 syringe.

    Obviously, it's absolutely critical that you keep the syringes separate and always double-check which one you are using. You do not want to shoot 5.0U using a U-40 syringe!
     
  74. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Thank you. I def don't want to try to convert from the U100 to the U40. I'll just reorder some U40 syringes with the shorter needle.
     
  75. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
  76. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Sounds like a plan! Hang onto the U-100s, you may want them later. Despite the range on that conversion chart, what most people use it for is to do tiny doses (0.4, 0.2) of U-40 insulins more easily. So at some point, when Merlin is on one of those tiny doses, you may reconsider! But I agree, it's probably not something you want to deal with at the beginning of FD, when there's so much other stuff to worry about.
     
  77. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Apart from the two-hour period before each preshot check, I'd suggest you let Merlin eat as much as he wants. After all the problems he's had with appetite over the last week, it'll aid his recovery greatly to keep him eating regularly. Also, too long a fast can lead to tummy acid build-up so making sure Merlin eats a little something at least every 3 hours or thereabouts may help prevent that. Also he needs to regain weight so there's no need to restrict calories at the moment.


    Mogs
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  78. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Thank you, Mogs. :bighug:
     
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  79. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    I've added a profile picture of Merlin. It's an older pic. I caught him mid-yawn and he looks like a vampire kitty. I figured it was appropriate for Halloween. He also has a FB page if anyone would like to add him. I haven't updated it in quite a while, but there are some photos of him and our other furry family members. I adopted Merlin and a beautiful, sweet, orange kitty on the same day. The orange kitty is no longer with us. His name was King Arthur.

    Merlin's name on FB is Merlin Romanov (the second name is a whole story...) and the profile pic is the same one I used here.

    Kelley
     
  80. Gill & Mac (UK)

    Gill & Mac (UK) Member

    Joined:
    Aug 19, 2020
    Way to go Merlin ! ( & Kelley of course) glad he's getting more back to his loving self.
     
  81. Gill & Mac (UK)

    Gill & Mac (UK) Member

    Joined:
    Aug 19, 2020
    Oh yes ! Most definitely ! In fact i managed one on Saturday - the first time in ages since changing to u100 syringes so I could have a shorter needle (using a conversion chart of course). I swapped because Mac's a bit of a fidget so furshots were a little too easy to get. Eliz gave me the tip and I love the u100s so much more but it is all a matter of taste .
    It's a pain in the UK as you can only get u40s with the longer needles so u100s was the only way I could go to get shorter ones. Least outside the UK there are more u40 options.
     
    Last edited: Oct 20, 2020
  82. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    LOL Def Halloween appropriate :eek::D:bighug:
     
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  83. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    He’s so cute! So glad he’s doing so much better.
     
  84. Gill & Mac (UK)

    Gill & Mac (UK) Member

    Joined:
    Aug 19, 2020
  85. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Seems like he ended up the right place! :D

    Great photo, Kelley. :cat:


    Mogs
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  86. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    PS: Although we'd rather he didn't need to. ;)

    (((Merlin)))

    :)


    Mogs
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  87. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    Here is a thought. The 2units is dropping him to the 60s which is fine but then goes right up to the 300s. If I read correctly above the 1 unit isn't enough.

    What about giving 1.75 units? See if he stabilizes must be bit?
     
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  88. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Olive and Paula, I'm thinking the same about the 1 unit not being enough. Below is how the vet is recommending dosing him.

    I just gave his morning insulin (2 units) at 9:00am. His bs was 369. I'd like to take it a couple of times today to see how far and how fast these two units bring it down. What time intervals do y'all recommend that I test for this?

    He got 2 units last night at 9:00pm. But his bs was in the mid-300s this morning. I'm wondering if it is the dawn phenomenon like Mogs said the other day. Is there a good time to test in the middle of the night to determine if that is what it is? If I tested at 1:00am or 2:00am would I see a low number if it is the dawn phenomenon?

    Vet dosing recommendation (ProZinc):

    under 100 - hold insulin
    100-175 - 1 unit (yeah there's a gap between 175-200, so I'm not sure how many units for the 175-200 range - I also worry a little about 1 unit at 100, how low would that drop him?)
    200+ - 2 units
     
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  89. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Forgive me if this has been asked and answered...Would you be interested in setting up a spread sheet? It really would expedite the best ideas and help. here just in case ;)
    FDMB SPREADSHEET INSTRUCTIONS
     
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  90. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    I do want to set up a spreadsheet. I will read this information. I opened the one on Mogs profile yesterday, got overwhelmed, and closed it. :nailbiting: I've been keeping notes on my phone that I can transfer over.
     
  91. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    I'm going to test him every two hours today to see how his bs fluctuates. He's 2 hours out and down to 131.
     
  92. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Mine's a bespoke number, Kelley. The standard FDMB sheet is much simpler. Here's an example of one of the standard sheets for another kitty:

    https://docs.google.com/spreadsheet...5WVl5oTbj9v316LvjjroBaCoY/edit#gid=1182885903

    Essentially the spreadsheet is just a grid where you record the doses you give and then fill in the BG readings you take relative to the time the dose was given (plus helpful remarks about food, meds, and so forth). All the colour coding happens automatically after you enter your BG number into a cell. Here's a helpful thread explaining further:

    Understanding the Spreadsheet Grid

    If you need any assitance getting going just give a shout out and we'll find someone to help you. :)


    Mogs
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    Last edited: Oct 21, 2020
    Reason for edit: Grammar.
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  93. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    Yeah the ss can be a little scary when you look at it the first time. However, you will be surprised of the whole picture if you print out in color every so often. It's an eye opener and you will see patterns emerging.

    Each row covers 24 hrs. Broken down into the 12 hr cycle. So you have the date, 2nd column is the meter reading at shot time. 3column is the number of units you give. The +1 is 1 hr after shot, +2 is 2 hrs after shot, etc. Until +11. After that is the meter reading at pm shot time, then dose of insulin and it starts with the +1 again.

    What helped me was at top of column where the +1 numbers are I put the time above it.

    Any time you add anything but a number you have to fill in the color manually.

    I also created more work for myself since vet wasn't techy enough to access ss. I kept daily hard copy (in excel) but used 2 rows for each day. Second row I put in meds, poops, vomits, meals so vet saw everything that goes on with her then emailed every 2 weeks. 2wks fit on page and was easier to manage through out the day for me. I can only enter numbers to ss using phone, but use my kindle daily for everything else in my life. If any major reformatting had to be done I had to use pc. So paper copy in place of 3 devices for hourly/daily use, then every couple days updated copy for vet was just easier for me.

    Look at Ollie's ss below, you will see the times I used at top.
     
  94. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Merlin's pre-shot was 189 at 8:30 tonight. I'm thinking about skipping this dose based on the ProZinc Dosing Methods page. I'm concerned because this afternoon he dipped down to 46 around 4.5 hours post shot. I've got to get this spreadsheet filled out early tomorrow morning.
     
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  95. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    :eek: :eek: :eek: :eek:

    The 2.0 dose is definitely too high. Any time he goes below 50, you need to take action to bring the numbers up-- feed a little high-carb snack, and post here for help in managing the numbers. The spreadsheet will really help folks keep an eye on what's going on as well -- that 131 today was a warning sign that he was in a dive, but it was easy to miss as a single post in what has become a pretty long thread.

    I hope you did end up skipping tonight... I'm thinking sliding scale is not going to work for Merlin, he'll probably be better off just getting a consistent (smaller) dose. (prozinc folks may have more detailed recommendations, but they'll probably need the spreadsheet to make them).

    Don't worry if he's sky-high in the morning, that's a normal reaction to the day he had today.

    This, by the way, is a very good sign of Merlin's progress!
     
  96. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Please Kelly help us help you. Your signature is an important to help us help you. TRUST ME You will be glad you set this up.
    • Click on Signature. This is where you will put information that helps us give you feedback.
      • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
      • Add any other text, such as
      • Caregiver & kitty's name (optional)
      • DX: Date
      • Name of Insulin
      • Name of your meter
      • Diet: "LC wet" or "dry food" or "combo"
      • Dosing: TR or SLGS or Custom (if applicable)
      • DKA or other recent health issue (if applicable)
      • Acro, IAA, or Cushings (if applicable)
      • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
      • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
    Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.
     
  97. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Good morning. I started uploading the info to the ss last night. I just finished. Now I'm going to try to follow JT's instructions to add it to my signature.

    Nan, I agree that 2 units seems too much. The vet said something yesterday about going to 3 and everything in me was saying nooooooo. I told her about the low number (46) yesterday afternoon. I ended up giving 1 unit before bed last night as his BS was going up and was at 229.

    I'm about to attempt adding the spreadsheet to my signature.
     
  98. Kelley and Merlin

    Kelley and Merlin Member

    Joined:
    Oct 17, 2020
    Got it linked. :joyful:

    Yes, I realize this thread is getting out of hand. I will start posting in the other forum threads. Thank you all again for the incredible support and help. :bighug:
     
    Nan & Amber (GA) and Critter Mom like this.
  99. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    WELL DONE!
     
  100. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Great job on the spreadsheet, Kelley. I see Merlin's been enjoying his Beechnut. :cat:

    (((Merlin)))


    Mogs
    .
     
    jt and trouble (GA) likes this.

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