numbers keep climbing & I missed a dose

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DiabeticMom

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Hi again,
The numbers are going up again. This morning 460! And I just slept through her 9 am shot. She sleeps on my bed and was up and down all night. She broke into a small bowl of dry food I had high in a cabinet but didn't eat it all. I was surprised that she ate less than 1/2. Maybe I caught her in time. She's ravenous again like at the beginning.
I posted yesterday and got replies as confused as I am to what is happening.
I have been giving 1 unit and at one point put it up to 1.25, then back to 1 to see if rebounding. I took +6 and she was 236.

It is now Sat at 11:20 and all vets are off except an emergency hospital, which I don't want to do if possible. I actually was between vets and had 2, nice people but not very impressive with diabetes. I was told by a vet tech to give her the regular amt and the vet will call on Monday.

Chongs eating but more lethargic today.

I'm going to have to give her a shot and give her one tonight at 11:30 pm, then back it down. But should it be 1 unit or higher? Is something else going on?

I dreamed of death all not. Hope it's fear and not reality.

Thanks for immediate help.

Barb & Chong
 
Breathe everything is going to be okay.
Go ahead & give insulin. Yes you will be off schedule, but it's easy to get back on track. Everyone here will help you with advice how to do that.
So for right now test, feed, shot.
I would go ahead with your current dose. 1 unit.

Are you testing for ketones? If not get some test strips from Walmart & start testing.

Go ahead & take down the 911 icon, but don't delete your post.
 
The dry food can cause those numbers to skyrocket. What brand of food is the dry?

I think a vet visit on Monday might be a good idea. There may be something besides just the diabetes that is going on that could be causing higher numbers. You said lethargic, but is she showing any signs of being in pain? Cats are masters at hiding pain, but the stress from being in pain can raise the numbers too. Or any type of infection.

Is she using the litter box like normal? No evidence of having problems urinating or any constipation?

The reason I would not increase is because like I said in yesterday's thread, up until 4 days ago, it looks on your spreadsheet that 1u was working okay. If something else is causing the higher numbers, then upping the dose is just going to hide what is going on, but not "fix" it.

I'd definitely talk to the vet today and let him know what her numbers were a week ago on 1u, and ask what could cause the lack of response since. Her insulin needs wouldn't just increase significantly for no good reason.

Carl
 
Hi Barb -

We've all got our eyes on you, but Jenn has given you good advice. Test, feed shoot. and most importantly, BREATHE! We've all done it - Chong will be fine.
 
I read your post yesterday, but I am not totally caught up with Chong. I am going to look at your SS and read your recent posts and see if I can be of any help. I have dealt with most all of it, unfortunately....ketones, pancreatits, kidneys, and unresponsive numbers!

Like Carl said-- the dry will sky rocket the numbers.

Jenn asked, and I think I saw you said yesterday that you were checking for ketones and they were negative-- is that correct? If you are not....I would start there.

Any evidence of infections...urinary, respiratory etc?
 
Hi,
Thanks everyone. I tested ketones within the last week and she was negative. I'd have to look back at when it was.

Littlebox has been in use. Its clumping so it looks like peeing smaller amounts more often.

She does have pancreatitis and I have been giving her a homeopathic formula for that. To my knowledge, the only way to find out aobut pancreatitis is with ultrasound which is how we did find out but I don't know what we can do to check to see if the homeopathic formula is working.

I gave her 1 unit insulin then food a few minutes later. She ate about 1/3+ small can FF Chicken Feast Classic. No grooming after. Haning out on chair. Starring a bit but she responds well if I call her.

Since St. Pats day I have gone to free feeding (she was at 97-a week ago!, but unstable) since I'm out of the house and she's 16. Only leaving out 1 can FF classic. With the numbers going up I've tried to go back to morning & evening, but having a hard time with it. I have also given her a little chicken from my dinner, something very rare in her life. I wish I had given her a little FF classic before I went to bed last night, maybe that would have kept her from prowling cabinets and finding dm dry.

I will check again for ketones. Are there any strips to check for UTIs?

Anything else I should do?

I have left messages for the old vet and the new vet. I have kind of lost my faith in vets but I will run her into whoever answers first with an appt. One vet is off Monday with no coverage, so I guess the newer vet.

When should I test again? Is there anything else I can do or should watch for?

THANK YOU

Barb & Chong
 
You need to check for ketones more often. They can come on really quick. When Kitty's numbers are High, I test daily. I am not aware of any urine strips that detect infections--- I think you need a urine culture to be run by a lab. But, the small amounts of urine in the litterbox would be enough to make me suspicious of a urinary infection. Unrinary tract infections are very common in diabetic cats, due to increase urination.

I would test in a couple of hours and see if the onset of the insulin has started.

Pancreatitis is hard to detect by lab test, but there is a test run by Idexx that is ...maybe called a FPL that is used to dx Ptitis. For what it is worth, if she is having a Ptitis flare up -- that is enough to create the high numbers, low appetite and just overall feeling bad. When Kitty has a Ptitis flare up, I give 1/4 Pepcid bid, sub q fluids-- very important to keep the pancreas hydrated, and Bupe for pain.

I think you have two strong possibilities going on --Ptits flare up and/or a UTI. Both can create what you are seeing. But, the dry food is a BIG culprit of high numbers--but, the food alone would not make her feel bad.

My Kitty has been DKA-- it started with an untreated UTI-- she was negative for Ketones on Saturday and was in the moderate range on Sunday and DKA. Please test for ketones!
 
I don't have a smart litter box, so what do you do with aquamarine stones. Dump them and clean pan after every use?

This is all so new . . .

In hearing you say that hydration is so important . . . when Chong went in for the ultrasound she was upset. They got it done and then gave her subliminal (?) hydration --- the one under the skin that takes about 10 min. They also gave a free Vit B shot. The next day her numbers were great! I asked what the hydration and Vit B did to get these numbers and was told by the vet that they had nothing to do with it. I still think that is quite a coincidence and in light of what is going on, and what was said on this board I'm again thinking they had a lot to do with it. Could dehydration shoot her numbers like this? I'm not good at telling if she is dehydrated or not. She's drinking plenty of water---esp after eating. That also makes me wonder about salt content.

With the numbers I saw after the hydration, I'm wondering if I should do that instead of insulin!

THANKS AGAIN for your information and thoughts.

Barb & Chong
 
OK. I feel dumb & negligent. I meant if I went to aquamarine stones as litter all the time, not just when checking for Ketones. . .
 
I'll let someone who's done it answer the question about aquarium gravel... I used a meter to check Bob's blood for ketones so I never had the pleasure of using the dip sticks!

To answer about the hydration and fluids - administering sub-q fluids to treat dehydration can cause the numbers to drop. Kim and I have had this discussion a few times in the past months, and both of us saw that trend in our cats. Basically, it relieves a condition that causes the cat to be in pain or discomfort and feeling like crap, and when Bob got fluids, the effect was pretty immediate. When he was dehydrated, and received fluids, he'd perk up within an hour or two. The lower BGs would show up either that cycle or the next cycle.
I wouldn't use it as a substitute for insulin, but it should definitely help Chong if she's dehydrated at all. :smile:
I'm surprised your vet said that fluids and b-12 would have no effect on the numbers. If Chong needed either of those to provide relief from pain or discomfort, then that benefit would show up in her numbers. Anything that causes stress causes higher numbers, so stress relief drops them.

Depending on how long her hair is, or how loose her skin is, if you tent a good bit of her fur and then let go, it should return to place quickly. If it doesn't, that can be due to dehydration. That she is still drinking isn't odd, but you'll see her water consumption go down as her diabetes improves. And also because she's eating canned food. Cats get almost all their required water from canned food (vs. dry food). Bob rarely touches his water bowl anymore. You can also add a little water to her food if she's not opposed to mushier food. Fluids are extremely important if pancreatitus is a possibility, any way you can get them into her.

If she's visiting the litter box to pee often, but not doing much each time, that could mean a UTI is present. If she goes in and doesn't pee, that's a stronger sign, or if she decides to pee outside the box. Some cats who are having a hard time urinating will go out of the box because they associate the box with the pain of trying to pee and not being able to. I think if we were all "cat whisperers", this would be much easier to deal with. Either that or they need to learn English as a 2nd language!

Carl
 
Hi,
Thanks for the info. Your meter, does that test ketones everytime you do a BG test? What kind of meter is it? Expensive? Can I get it at Walgreens or that type of pharmacy? What about the strips? Easy to get? Expensive? Seems like a lot easier way to go than trying to stalk Chong in the litter box.

Thanks.

Barb
 
Mine is called a Nova Max Plus. It tests blood for ketones and for glucose, and there are different strips for each test. I got the meter at Walgreens for $20 if I remember correctly. I bought it only for ketone testing, since I used a Relion Micro for BG tests. The ketone strips are expensive. I think you can probably find them on ebay on a lucky day, and might be able to get them cheaper, but when I bought them, the best I ever did was $3 per strip, which is obscene IMO. And the local pharmacy I bought the meter at never had the strips, so I bought them online from Walgreens or found them on Ebay. There is another brand of meter that you can get made by Aviva I think. I'm sure that there must be others out there. The strips for all of them are very costly.

The reason I bought one was because I found it impossible to test Bob with the ketostix. He's very private in the litter box, and rather than beat myself silly trying to stalk him or use gravel or saran wrap, I just said the heck with it and bought the meter. He had been DKA once, and I felt the cost was worth knowing that the ketones were staying away. I never got a reading any higher than "trace" levels, so he was very fortunate in that the ketones never came back.

I would be happy to send you my meter, just PM me your mailing address and I can mail it out this week. Unfortunately, I don't have any strips I can send you. But the meter is yours if you want it.

Carl
 
DiabeticMom said:
Hi,
Thanks for the info. Your meter, does that test ketones everytime you do a BG test? What kind of meter is it? Expensive? Can I get it at Walgreens or that type of pharmacy? What about the strips? Easy to get? Expensive? Seems like a lot easier way to go than trying to stalk Chong in the litter box.

Thanks.

Barb
Click to expand...

Barb-
I have a nova max plus that checks both ketone and bg levels.

I got the meter for free at the Diabetic Wholesale- use the link up in the shop logo as FDMB gets a small commission. The kicker was the strips cost a bunch- 10 for $30 and the meter came with. It is a promotion they run at times.

What I would do is use the ketone strips for the majority of the time. If she had anything over a small I would test her blood- or if I couldn't catch her in the box for over 36 hours. It got so where she doesn't mind me sticking the strip under her so I hardly use the meter anymore. But, as the strips are expensive- get using a regular meter down pat so you don't ruin strips. Make sure you get plenty of blood to test.

I was worried about DKA too and catching it early and my vet was saying "it isn't a bad thing..." We are seeing a new vet on Monday.
 
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