Please help! Ketoacidosis won't eat, just diagnosed!

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Hey Wendy :)

I have around 20 strips. We lost a few last night trying to get a big enough sample.

I won't give her insulin till I have her reading. I'm not sure if I should feed her before the reading. My husband will be home any minute now, so we'll see.

(He's out buying the fancy feast)
 
Right, tested 400. Fed one oz of fancy feast purée w/water through syringe. Gave prescribed dose of insuli. Waiting on phone consult with vet.

So out of desperation I decided to try her old treats (whiskas temptations). She ate them! I only gave her two cause I'm scared for her sugar. She perked up when I shook the bag and even jumped on the bed to get some. I tried putting a treat in the wet food to trick her...no such luck. Also tried iams dry (her previous food) no luck. So she will eat the temptations. Do I let her have them, or stick with the purée and force feeding?
 
How about first we try crushing a couple and making a powder and sprinkling it on top of fancy feast and see if she will eat that. If not, just give her them.. its important she eats right now.

What kind of fancy feast did you get? The classic pates?

Wendy
 
With a BG of 400 I would start with one unit of N insulin. I would measure the BG about 4 to 5 hours after the injection. Also when you post with the BG say about how much was eaten and when
 
I am sooooo glad she's feeling better and acting a little more normal and eating the Temptations and best of all that her ketones are negative. Keep up the good work :YMHUG:
 
I'm still watching your updates.
Definitely try crumbling and sprinkling some of those treats on the food to see if she'll eat.
It may take several different cans to find the one she's interested in.
Interest in the treats is a good sign.
try other things like lunch meat ( read ingredients to avoid sugar) or the meat from a piece of fried chicken.... ( smith's has a thigh for $1 )


What is your name?
I'll figure out a time to come visit... bring you some cans of food since I know $8 won't last very long.
I can bring you some other things we use to entice kitties to eat... like fortiflora, bonita flakes, freeze dried treats.....

We can figure out what you need help with after you consult with your vet.

I also have a larger feeding syringe ( brand new in package) in case I ever needed it some day.
Perhaps your vet would give you one for free if you asked.
 
Ok, so I just checked her sugar prior to dinner and it is 171. She will willingly eat a few treats here and there. Do we give her insulin or not?
 
make sure she eats a good amount .

Normally we dont advise newbies to shoot under 200 as they dont know how the cat will behave but your kitty is prone to ketones and I dont want her shooting up again ..

So first, before you shoot, tell me

1. you have a lot of strips? At least 10.
2. do you have syrup in the house
3. are you able to test for the next 4-5hours as and when requested by us? Minimum you will need a test at +2 and maybe more after that if she drops unexpectedly.

Let me know
 
Can you provide the following information:
BG this morning. I think it wa 400
How long after BG was shot given and how much was given, When and how much cat ate
How long after first BG/shot was Evening BG.
You said evening BG was171
 
It's really important to get some insulin into Rocko tonight. However, we need to have some info please.

-- Novolin N or Novolin R
-- Time shot this morning, amount of insulin given, BG at shot time
-- Any BG readings today? Could you tell us what they were and when they were taken in relation to the shot this morning?
-- Can you get her to eat enough if she won't eat on her own
--you have supplies Wendy indicated and can you stay up to monitor?
 
Talked to the vet and she says we're out of DKA. She had me give her 1 unit of insulin (N), and I test again in two hrs.

Rocko is eating, and has almost eaten a full can of FF! She's sleeping off the insulin right now, but she's actually been a little playful. The vet is very pleased and optimistic.

Next step is to get a BG curve, which I need more strips for. I haven't done well with getting enough blood from her ears. Poor thing :( Vet said to try her lip.

This morning at around 11 it was 400. Gave 1 oz purée and 2 units insulin.
At 7 it was 171. Rocko ate 1/4 can FF. gave her 1 unit and was told to test again in 2 hrs.
Will report back then.
 
Vet said to try her lip.
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OUCH! That won't help her to eat if you poke her lip! Lips are too sensitive for poking.

You can try the paw pad if you can't get blood from the ear.

You can also aim for the vein in the ear if you really, really need to get a test. Just be expecting a big drop of blood and have a tissue ready to stop the blood after you carefully sip it up onto the test strip.
 
Oops for your vet...lips are a location for dogs, cats don't have the same capillary system in their lips plus they are very sensitive.

HUGS! EAT BABY EAT!!!!
 
Thanks for the advice. I was uneasy about sticking her lip. I got the ear vein once but aiming is hard.
Will try the paw pad next.
 
here are the best ear spots....
ear_web1_zps0bf45a17.jpg

I have even better luck just a tiny bit higher than the sweet spots.....

The other part is are you freehand poking with a lancet or do you have a lancing device?
In the beginning, you have to use a higher setting.... and need a larger gauge lance. The ones for humans are usually too fine a gauge.
 
That pic helped a lot! One stick got enough blood.

8pm it's at 264.
She is still grazing at the fancy feast and has eaten most of the can now. Her 1 unit of insulin was 2 hrs ago and her readout then was 171.
 
7/22 11 am AMPS 400 2U 7 pm PMPS 171 1U +2 264 Novolin N insulin

Another test at +4 would be good.

No we do not want to give her any additional insulin tonight. Next dose would be tomorrow morning.

How early are you up to give the insulin?
 
Would you help out my feeble, forgetful memory and put some information in your user control panel please? I can't remember where you live and searching through 75 posts in this thread, I could not find it easily.

Would you please provide us with some more information and put this in your user control panel? It helps us to help you better. This will take about 5 minutes of your time.

Think of this as having some very useful information at our finger tips for those that are replying to your posts. One reason we like to see this information in your signature is because if there is ever an emergency situation like a possible hypoglycemic episode, we don’t have to ask a lot of questions like what meter you are using to give you the best advice. Doing this signature update is totally optional, but it does help us to help you better.

If you are willing to do this, would you please do those updates when you get a chance? Thanks.

Go to the upper left corner of your screen and click on the words, User Control Panel
On the next screen, a row of tabs is presented. Select the Profile tab
On the next screen, there are a number of choices along the left hand side. Select Edit Profile.
Go down to the location field and enter your country, state/province, and city if you are willing to share that info.
Click on submit to save this change.

Still in the User Control Panel, Profile tab, this time select Edit Signature from the left hand list of options.
A free form text box appears.

We like to see information like your first name, your cats name age and sex, the diagnosis date for the diabetes like this (DX 4/30/13), what meter you are using for testing, what insulin you are using , what you are feeding (wet or dry, what brands/style of food), any complicating health issues your cat may have, any additional medications your cat is receiving. If you are using a pet specific meter like an Alphatrak or Ipet, please change the font size on that text from Normal to Large (using the drop down arrow list in the middle of the editing commands)

Click on submit to save this information. Now, this will appear at the end of every post you make. You can update the info when you need to.

There is an additional document you can create to provide even more information about your cat. This is also optional to create this google document and link it into your signature. The profile is in addition to the synopsis info in your signature. See this link on the how to's of profile creation. http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=79123 This can wait until a bit later.
Click to expand...
 
Morning Shannyn,

I think you could take down the 911 now. That way, if you need it again, it won't already be up and will more likely to catch attention.

You can also start a new post with new questions.
Or you can share your testing information for the day.
We tend to speak in
preshot numbers where you test, and feed and shoot at the same time. ( so amps is morning shot, and pmps is evening shot)
Then when you get a test.... say two hours later after the shot.... it's a +2 ( there are 12 hours in each cycle)
 
Morning! (how do I take the 911 down?)

So tested at 10am, 535, gave her 1/4 can of FF which isn't finished yet. Do I give her 2 U now?
 
She is much more responsive, still weak but less listless. She left the room on her own power this morning and visited with the other cats a few mins. She is also starting to care about her hygiene again. She's much more active even at 535 for a reading before food. (though she did graze a bit at the old dish right before taking it.)
 
to take the 911 down... go back to the first post you made.... click edit .... there is a row of post icons at the top.... you can change it to none.... or to a question mark...(candles and rainbow means they are gone)


Weren't you giving 1 unit? Or did I miss the change in dose?
 
Will do.

Her prescription is for 2 U, but the vet told me if she wasn't eating or if her sugar was lower, to use 1 U. Last night since the reading was 171, the vet said to go with 1 U.
 
I am home and do have that, yes.
her amps this morning is 535. She's eating at a slow pace. I haven't given her shot yet.
 
I asked someone to come advise.

and I am sending you my cell phone # by pm.... I have to go work for a few hours.... but it's flexible so you can call if you have an emergency and no one is around....
 
I think it's going to be a bit before someone else can come.
But I know how important it is to get some insulin in her with her high numbers and recent ketoacidosis.

So if you can stall for a little bit and wait, do so.... ( next shot time is 12 hours from when you shoot)
If you can't wait then I would say shoot the 1 unit and play it safe.
Continue getting tests so you can collect data and observe how she reacts to the insulin. Data is good to have .... and you need to know how she responds.



ETA: i'm off to work so if you need me, you'll have to call for the next 4 hours.
 
Shannyn

I'm sorry...Rhiannon did contact me but I wasn't available and just saw her message now.

I'm glad you gave her some insulin. I would suggest calling your vet today and getting her input on what you should shoot....in other words, a sliding scale. Most of us us the longer lasting insulins that are dosed on the nadir or lowest number but Novolin N is dosed primarily on the preshot (but you need to be aware of the nadir) so if you get a higher PS, you give a higher dose. This is especially important considering her DKA history.

Do you think your vet would help you with that over the phone?
 
HI, thanks.

My vet is out for the day. Tested at +2 491. Giving 1 U to complete her morning dose.

My husband is going to take over for the afternoon. He'll be posting on here if he needs any help. Should we test again in 2 hrs, or let it go longer? If it's still this high in a few hrs, should we give her more?
 
I would test in a couple hours but I have no idea on the dosing. I don't know if this Humulin N Primer has been linked for you before but I think it will be helpful. Novolin N and Humulin N are the same insulin...just a different name.

You do need to find out what her nadir (lowest BG in the cycle) is so you can see how low the dose is getting her. But I would be hesitant to continue to add more insulin during the cycle without a knowledgable person or your vet to guide you. In other words, now that you've given 1u twice at separate times today within a few hours, I don't think Id give another 1u dose before 12 hours without someone to guide you.

I know you can dose this insulin every 8 hours if need be but I would be more comfortable if someone else was here to help you that was familiar with the insulin. Even though it is not a depot insulin like Lantus or levemir, I do think you can see some carryover and overlap between shots. IMHO, I think it is safest for you to shoot only every 12 hours unless an experienced person with this insulin or your vet advises otherwise.
 
Please keep this same post for now. So we can look back at the post history and what has already been said.

If it's still this high in a few hrs, should we give her more?
Click to expand...

You have overlapping doses going now with the shots of N insulin at two different times this morning. I would not give her any more insulin for now, not unless your vet advises that.

Because of the DKA, I highly recommend and strongly urge you to get at least 1 ketone test a day.

Next shot should not be until at least 8 hours after your last shot, preferably 12 hours.

I'd definitely suggest another BG test sooner than 2 hours. A +3 if you can, if anyone is there to get it.

Please tell me how may hours it has been since your last insulin shot.

7/22 11 am AMPS 400 2U 7 pm PMPS 171 1U +2 264 Novolin N insulin

7/23
AMPS 10 am 535 1/4 can FF no shot yet
+2 491 gave 1U


I'd like to see her eat at least 1/2 can of FF before you give the insulin. She needs to eat at least 30-45 minutes before you give the shot. Test, feed, wait 30-45 minutes from when she started to eat, test again. If high enough, shoot the insulin. Never shoot the N if she is below 200. If below 200, stall, no food, test again in 20-30 minutes to see if the number is rising.

My vet is out for the day
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No emergency contact number? No other vet in the same office? What do they advise you to do in a case of emergency?

ETA: Please add DKA to your signature. So we know Rocko is ketone prone.
 
That would be great if she could start the process of getting a prescription for one of the longer lasting insulins.
 
Would it then be ok for a member here to send some insulin to her? If she had that prescription in hand for Lantus or Levimir I mean.
 
HI, sorry I was gone for a day. I'm going to be gone this weekend too. My hubby will be taking care of Rocko.

Rocko is doing wonderfully. She is eating a whole can at meals and is even starting to wander out to be with the other cats now.

Her sugar was in the 500's this morning before food. We gave her 2 U after a can. We're running very low on strips so we can't check till dinnertime.

Is there a cheaper way to get strips? My hubby went to buy them today and they were $40. (we can't do that).

Anyway, my hubby will post on here if he's not sure of something or if there's a problem. I will be back Sunday.

*hugs* thank you all for your support!

(I will add DKA to my sig now)
 
Maybe switch meters to the Walmart relion - check the shopping links above but the strips are cheap depending on which one you get. Or you could try ebay - just watch the expiry dates and choose a reputable vendor..

Wendy
 
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