Please Help Cat Tested positive with moderate ketones

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Lu-ann, I am thinking that sounds about right so I dont over do it.

Sandy, when he was not diabetic, he was 13 pounds and looked great. Now he's turning into a skinny minnie he lost weight in the hospital last week ... he was 11 pounds last month now hes down to a little over 9.
 
Black Kittys ideal weight is 11lbs and a few oz. after his second go round with ketones he was down to 7.4lbs.

I'll be up for your +6, that will be midnight eastern, correct?

Something I want to pass along to you is the information on Handling Low Numbers Print it out and keep it handy. You have the tools you need -- strips, HC food, karo.
The document tells you when and how to use those the various tools should the need arise..

see you at +6 :cool:
 
If I was getting a lump bigger than 1/2 tennis ball, I would stop. Sounds like he's got a big enough frame to carry 75mL.

If he doesnt' have his face in a food bowl, I sit at the diningroom table with him on my lap. I'm R handed, so he's facing to the left. My left hand scruffing him (he's SO not used to that!) :o and I guide the needle in. I continue to scruff if he's wiggling (if face in food bowl, I just hold the needle in the position).

I've got them running wide open, so it takes about 4 minutes. I've slowed it down a couple of times as I didn't want to overwhelm him.

The biggest thing is to keep him from wiggling and the needle from spraying all over your diningroom! :o
 
just wanting to add, try warming the fluids before putting them in.

Turn bag upside down in bucket or sink of HOT water- keep line and all connections OUT of water- prop or tie so bag doesn't slip and get connections wet.

I leave mine soak for about 10 mins, then empty bucket, re-fill with HOT water and wait another 10 mins +/-. Make sure to run clod water out of line until hot water from fluid bag runs out- I test on my hand skin...cats are normally higher temp than us, so if I get fluids to where it is just comfortable on my hand skin, cats seem happy ( I have 3 getting fluids right now)

Anyway, your sweetie might find it more agreeable if the water is warm. Also, if you can use each needle only once as they tend to get burrs after one use and are pinchy if used again. Giving bits of chicken or low carb no sugar treat when you give fluids will help make it more fun for kitty, too.

Good luck- you are doing a great job!
 
I'm gonna call it a night,
I hope Sasha continues to eat.

Make sure and get a +10 and post the number, that way you will know if he is going up or down at PS time.

Keep in mind that under these circumstances it's better to have a bit more insulin on board and just feed as much HC as needed to prop up numbers.

In terms of calories, you want to aim for 1.5 times the amount needed to maintain ideal wight,
the formula to calculate calories for a 12 lb cat is -[13.6 X 12 pounds] + 70 = 233 and 1.5 times that is 349.5. So that is the total dally calorie goal to strive for.

If you are unsure about the AMPS and shooting, make sure you post for assistance.

I'll look in tomorrow :cool:
 
Tara....just wanted to add a few things about giving fluids.

First...here is a really good website that has lots of little hints that help:
Sub-Qs

Second...since you don't have any idea if his heart has any issues, I would either give him 75 mls twice a day or 100mls once a day. However..be sure he has absorbed ALL his fluids before giving him more. You can also weigh him...if his weight is up whe he hasn't been eating a normal amount, it's probably fluids that haven't absorbed. So be careful...you can overhydrate him and that's not good.

IF the vet thinks he has pancreatitis, I'd ask for some buprenex for pain. Pancreatitis is very painful. The best way to diagnose itmismwith a specFPL test but that costs money.

Hope you get some rest tonight and he improved.
 
Great info all -

Tara, be sure to stay on top of the ketones. I tested Grayson earlier today and he was at TRACE. Just got home after a late late late night at the office w/ a deadline, and he's up to MODERATE. Just gave him fluids and will feed him some higher carb food, as he's famished right now! Vet in the am.
 
Tara, please post your 6:00am test result, so we can help you with the insulin amount. And let us know how Sasha is doing.
 
Hi everyone! Thank you again for all the great advice. So I gave sasha his shot last night at 6 PM preshot he was 346. At 9 PM at 345, at 12 Am was 343.

Took his preshot BG this morning at 6 AM it was 308. he didnt want to eat over night. .
He was very thirsty this morning. Hopped up on the bathroom sink, even though there is always fresh water in his bowl. Gave him a little water, didnt want him to throw up. He wasnt very interested in his wet food, no matter what I did. I tried to sprinkle parmesan cheese on it, threw some of his freeze dried treats crumbled up, even bonito flakes. The only way I could get him to eat anything was to give him the dry Hills DM. He ate some of that. I am not sure if I did the right thing by giving him dry kibble, even though all of these vets push it on me, but it was my last resort to get him to eat.

I gave him 2 units at 6 AM. at 7 AM he was still thirsty, hopping up on the sink again. I gave him 100 ml of fluids under his skin. He wasnt happy about it, but I got it in there. I am not sure if giving him Sub-q fluids dilutes the insulin being they are both placed under his skin...but he needed fluids because his litter box was full.

Got a keytone test, he is testing moderate.

Not sure where to go from here.... all of your support, advice and encouragement is priceless.. hugs to you and yours..

Lu-Ann, I am routing for Grayson. Please let me know how he's doing.
 
Fluids often cause BG to go lower, and it looks like Sasha's BG is very high and flat, needing more insulin.
 
Thanks for asking. He just tested with "SMALL" ketones - better - but a solid "SMALL". Our shooting schedule had to change for some meetings I have this week, so I had to give him the insulin sooner rather than waiting and doing SubQs first. Will give him a couple of hours and then do the fluids.

Last night I gave him some higher carb food w/ gravy. It was his 2nd can, and both were licked clean. This morning he was 316, so it appears not to have been an issue. Just very important to get food into him. I also upped his dose .25 (which was gonna be the plan anyways for tomorrow).

Tara - any changes this morning?
 
Tara... Just a few extra pointers about giving fluids. It helps to freeze the needles....it sort of numbs the area when you insert the needle. If your vet gave you 18 g needles, these are like harpoons. If Sasha will sit still for just a little longer, you could ask for 20 g needles. When you insert the needle, be sure the bevel is up. Sending healing thoughts for Sasha today. Please update us when you can and be sure you get a mid cycle test so we can see if he is going lower.

Thank you.
 
I just got online today and saw this thread. My Garland is a ketone prone cat and gets them about every 6 weeks (YIKES) So I know how you feel

When Garland gets ketones we do sub-Q, start raising her insulin pretty quickly if she has high numbers and I let her eat whatever she wants. We would do 100ml a day for about a week. I hope everything is okay this morning.
 
Just checking in from tbp, and sending lots of eating
smiley-eatdrink022.gif
vines to Sasha.
Insulin, food, and fluids are all needed for fighting those ketones.
 
Hi Tara,

As Marje said, getting a mid cycle test is important to see how the insulin is working. Also, please try to get a ketone test at every opportunity.

As far as food....dry food is not ideal, but when a cat refuses to eat, that trumps everything. If dry is all she will eat, give her dry food. It sounds like you have tried a lot of different ideas to get her to eat wet food, it would not hurt to try HC wet (gravy) food...many cats love it. Another thing you could try is oregano...some cats love it and will eat if you sprinkle some on the wet food. You could also try finger feeding her, or assist feeding with an oral syringe....whatever you need to do to get food into her! She needs food, insulin, fluids and antibiotics.

Please keep us updated on test results and how she is eating....and please post before shot time so we can help with dose. I'm agreeing with those who are saying she needs more insulin, but it's important to take how she's eating into consideration when deciding how much insulin to give.
 
Hi everyone! Sasha is eating his dry kibble, wont touch the HC canned that I gave him. Even after the 100mls of subq 's , he's very thirsty. Thankfully he is keeping his food down. I took his BG at 12 PM it was 362... clearly I didnt give him enough insulin...Ketones are moderate to high. I am taking him back to the vet at 3:45 today as he is atleast nice enought to let me post date a check. The problem with him is that he is against home testing - I'm still going to do it any way and he's really pushing this dry prescription food on me (which isnt going to happen either). I will keep you all posted when I get home. His PM shot is at 6 PM. so I could use some pointers.

Big Hugs to you and yours!!!!
 
Tara

A couple things.....ask the vet if he would give his child insulin without testing the BG because Sasha IS your child and not hometesting would be like the vet giving his child insulin blindly. Second....Laurie is right...the best diet right now is the one he will eat and once he's feeling better, you can switch him. You are smart to not let the vet push the dry food on you that you don't want. Just tell him Sasha won't eat it. Enuff said....it's your cat.

Jill created a SS for you and I've got it posted in your signature block so we can all see it now. I sent you a PM on how to edit it so you can fill in the numbers as you get them.

Paws crossed...come on Sasha...feel better!!
 
Again, thank you so much for the spread sheet... I am so thankful to have all of you supporting me and my baby.

Ok, so we went to the vets. Why he is not flipping out about Sasha's ketone's is beyond me. The other animal hospital Sasha came out of last week suggested putting him down if I could nt come up with the money to treat him...two very different extremes.

However, I am very concerned, as he is still testing positive for moderate-high ketones. The vet just gave him another 100mls subq and told me I can do it again at home tonight "if i want" I said "doc, cant I overdo it with these fluids?" He said no. (I find that hard to believe)

he also tested Sasha's blood which was 400 at 4PM.

I am not at all comfortable feeding him dry kibble, was only giving it to him because that's all he would eat. I got a few cans of FF with GRAVY and Sasha was in heaven. I am happy to see him eating wet food.

Forgive me if I'm all over the place, havent slept much...

The vet also said to raise his insulin from 3 units PM and 2 units AM to 3 units twice a day... what do you think? I just tested him again, he is at 387. It will be time for his 6 pm shot soon.


Thanks again for all of your advice!!!
 
Hi Tara,

I don't have direct ketone experience, I "talked" to Jill...she said that for lack of a better immediate solution, she *guesses* shooting 3u will be ok as long as you monitor closely. I would try to get a nap after you shoot, get your first spot check at +3. Please post and keep us up to date on the numbers, ok?

Regarding the subQ fluids....you need to make sure that the previous fluids have been absorbed before you give more. Three hundred ml a day is a lot, but it may be warranted in this case. Jill gave that much to her cat Alex, but she is bigger than Sasha.
 
Thank you, Thank you! Just shot him now and he's eating again. :) I am definitely going to get a "cat" nap in... will post +3!!!
 
Laurie and Mr Tinkles said:
Hi Tara,

I don't have direct ketone experience, I "talked" to Jill...she said that for lack of a better immediate solution, she *guesses* shooting 3u will be ok as long as you monitor closely. I would try to get a nap after you shoot, get your first spot check at +3. Please post and keep us up to date on the numbers, ok?

Regarding the subQ fluids....you need to make sure that the previous fluids have been absorbed before you give more. Three hundred ml a day is a lot, but it may be warranted in this case. Jill gave that much to her cat Alex, but she is bigger than Sasha.
Click to expand...
hi tara. nice to *meet* you.

usually when a kitty is throwing ketones we use a combination of a basal insulin (lantus in this case) and a bolus insulin... usually R (Humulin R). i will put a call out to a couple of R users to take a look at sasha's spreadsheet. i'm sure they'll be stopping by some time tonight.

the way to get rid of ketones is increasing the insulin, making sure kitty gets enough water (in food and through sub-q administration), addressing any possible infection, and making sure kitty eats. i understand your vet's recommendation to increase the dose to 3u twice a day. it may a good idea for tonight. after all, his numbers are high and you're feeding high carb food. let's see what the other's say about incorporating the use of R for tomorrow.

make sure sasha eats. feed him whatever he'll eat. it doesn't matter what. the important thing is for him to eat.

i won't be online for several hours, but i'll check back later tonight. there are several people with eyes on this thread. ask any questions you have. we'll do our best to help. hope you can catch a nap. you have to be exhausted.


edited to add:
yes, you can over-hydrate a cat. like laurie said, please make sure the fluids given previously are completely absorbed before administering any more.
 
BTW...feed Sasha whatever he will eat...don't worry about feeding dry food if you have to. It more important to get the food in than to worry about eliminating dry food right now, ok? Also, the fact that you are feeding HC food and the high numbers is part of the reason increasing by so much *may* be ok. We would normally not suggest such a large dose increase at once. Now is not the time to worry about feeding a good diet....get the food and insulin into the cat. The ketones are the worry....don't worry about the HC boosting the numbers.

PS from Jill....you can expect that it will probably take between 6-8 hours at best for those fluids to be absorbed.
 
Ok, I am taking in all of this great advice, thank you. Can you imagine this vet told me the fluids are absorbed in 45 minutes?! Hmph! Crazy!!!

Question... would it hurt him or help him to put a little pedialyte in his drinking water for electrolytes?
Thanks again!
 
Tara, I hope you were able to get a little nap.
Please let us know what Sasha's +3 test is when you get it. When you increase insulin doses like that, it is especially important to get extra tests in.

You are getting some of the most experienced Lantus folks here helping you. I have been here a long time, and I have seen a lot, a very lot, of cats (and their people) helped here on the FDMB, and become healthy diabetic cats.
Right now, with moderate to high ketones it is very serious that we get your cat better a.s.a.p.
I hope you will continue to listen to us. I know it's hard to trust people you don't even know, on the internet.
When you have some extra time, take a look at my profile. I didn't do a very good job of writing it, but I wrote it when I first started posting on this forum. My cat had been hospitalized for 8 1/2 days with DKA, and I was so scared, back then. I have been posting daily since. I wish you the best of luck with Sasha.

I will be up for your AMPS shot, so please post that test number, so I can help you in the morning.
 
Hi! I am humbled by all of your thoughts and words and actions. I have the R! Gave him 3 units of Lantus at 6 PM , 4.5 hours later he is at 424. He ate 3 cans of HC wet food in the past 4 Hours... Last can was about a half hour ago....
 
Marjorie- I am giving him Lactated Ringers, those have electrolytes? That would be great.

Dyana- Thank you. I will be staying on this site for sure. I was praying yesterday morning when I didnt know what to do, and my prayers led me here.
 
welcome, Tara and Sasha! My Lucy had DKA and was hospitalized for 6 days. I was so scared, but she fought hard and pulled through (that was in 2007, and she is still going strong!).

It sounds like Sasha is eating well, so that is a big hurdle cleared. Later he'll have to switch back to lower carb, but for now it's best to eat whatever.
 
Tara....lactated ringers does have electrolytes. What I want to be sure is you do not have the LRS that has dextrose. Could you please check the bag? Thank you!
 
Libby, Thank God he is eating like a pig!!! I am so glad for that and happy Libby is doing so well!

Marjorie- no dextrose in the bag!
 
Ok, so I am officially in Lantus Land!!! Thank you all so much for everything.I am very grateful and without all of you angels, I doubt he wouldve made it through the past 24 hours. Your knowledge, support, kindness and advice have Sasha and I in the right direction. I am very grateful, Sasha is truly my baby. I will wake up early and check back about the R dosing. Hugs to you and your babies!!!!

Tara and Sasha
 
Here's a good trick to get the urine easily :

- Fill the litter box almost completely, so that there is litter almost flush to the edge of the litter box. That way, when your cat goes inside and gets in position to urinate, you still have plenty of space to place a small "container" under him (I use a tiny espresso cup).

- Place his litter box close to where you are planning to spend couple of hours (near your desk if you want to stay at the computer or near the couch if you want to watch tv). It has to be somewhere you can reach in less than 5 seconds!

- Have your little cup, ladle or any small container next to you the whole time

- When your cat goes into his litter, wait until he starts to urinate (not after the first drop cuz he can still stop peeing and just get out of the litter box!, but after like 2 or 3 seconds of urinating, he wont stop!), and quietly grab the cup and place it under him to take a sample.

- The fact that the litter is filled will definately make things easier since there's almost no chance you'll touch him. He'll probably just look at you with that nasty look, but it will only be 2 seconds of confusion in his life!

All that procedure was invented for my nervous cat that really wants no one to be close to her when she's doing her business. And that technique never failed!

Good luck !
 
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