Post DKA constant high BG

Parent of Brutus

Parent of Brutus

Member
We are now 1 week post DKA, my partner and I have been doing our best to stay on top of BG readings to try to get as much info as possible. My boy’s blood sugar continues to be high which i brought up to my vet, who insists on waiting for a fructosamine test next week before upping his insulin dose.

Is this test even necessary if I am tracking his BG multiple times a day ?? And should I be pushing more about an insulin dose increase after his 400+ AMPS test this morning?

He has been eating a lot more than usual, I’m assuming because of high blood sugar and also gaining appetite back after hospitalizations.
He was 6.8 lbs at the vet last time,we don’t have a scale at home yet but I’m thinking at most he is back up to 7lbs.

Should I still be letting him eat as much as he wants during meals ? What about snacks ? He has been downing a can of chicken feast pate and asking for more after. Is there a calorie cap we should be cutting him off at ?
 
Parent of Brutus said:
Is this test even necessary if I am tracking his BG multiple times a day ?? And should I be pushing more about an insulin dose increase after his 400+ AMPS test this morning?
Click to expand...
You are right about the fructosamine test. It is a waste of money at this point. It tells you an average of Brutus’ BG for a period of a couple of weeks. You don’t need to know that. And your glucometer can give you that information. What we need to know is how LOW (nadir) the dose is taking Brutus. A fructosamine test will never tell you that.
 
You have held this dose long enough. He is ready for an increase to 1.75 units. His best nadirs have been in the upper -mid and higher blue numbers … it’s good to see some blue by the way :)

I am encouraged to see how he is doing. I would go ahead and increase and hold the dose for 7 days.
 
Parent of Brutus said:
Should I still be letting him eat as much as he wants during meals ? What about snacks ? He has been downing a can of chicken feast pate and asking for more after. Is there a calorie cap we should be cutting him off at ?
Click to expand...
If you need Brutus to gain weight after his DKA, then yes, let him eat a lot of food. Keep it low carb. You probably don’t want to feed him much after his nadir to keep from potentially shortening the duration of his insulin. Testing treatments can be given, of course, and if he’s absolutely freaking out for food, go ahead and give a very small amount as long as it’s not within two hours before a shot.
 
Parent of Brutus said:
we are testing as often as possible. it has been hard to catch him in the act. if we aren’t able to get one for him this week, will ask the vet to do that one !
Click to expand...

You don't have to go and buy this, but I wanted to let you know that this is an option... I got a blood ketone meter and it works pretty much just like a Blood Blucose Meter. I have the KetoBM one from Amazon. It takes just a tiny sample. Strips are a little pricey, but I don't have to stalk the litterbox, so it's worth it. Replacement strips are $1 each. There are other options too, if you are interested.
 
Kobe (Dean and Lesley) MO said:
You don't have to go and buy this, but I wanted to let you know that this is an option... I got a blood ketone meter and it works pretty much just like a Blood Blucose Meter. I have the KetoBM one from Amazon. It takes just a tiny sample. Strips are a little pricey, but I don't have to stalk the litterbox, so it's worth it. Replacement strips are $1 each. There are other options too, if you are interested.
Click to expand...
thank you I do think we are going to get one of these so I can be more sure about ketones !!
 
Suzanne & Darcy said:
What do you think about increasing? When have you been feeding him? What food is he eating and how many carbs is it?
Click to expand...
I personally think he would benefit from an increase, and would be willing to try it and monitor any changes. but when I asked my vet about it they just said to wait to see the results of a fructosamine test.
I want to work with them but also feel like I know more than them at this point and am nervous to step on their toes. I am also unsure how I would be able to dose out 1.75 with the needles we use currently.

We feed him 5am & 5pm one whole can of fancy feast chicken feast pâte. recently he has been downing that quickly so we have been offering him Reveal 100% chicken or fish also. I believe he is averaging about 140kcal per meal recently and i think the pate is only 3% carbs. the only other carbs he is getting are the occasional couple of Temptations treats. should we feed more carbs to help with his weight gain ?
maybe go back to offering some dry food too? it feels impossible to help him gain weight and also keep blood glucose under control.
 
Parent of Brutus said:
also unsure how I would be able to dose out 1.75 with the needles we use currently.
Click to expand...
Do you have the U-40 syringes with the half unit markings? If not, you need them. If so, then you simply take the plunger and draw it back to halfway between the 2 unit mark and the 1.5 unit mark. It’s as simple as that. You just eyeball it.

I would not recommend going beyond 1.75 units at this time. He is having some blue nadirs already. I also would not recommend waiting too much longer to do the increase because glucose toxicity can set in where the cat becomes comfortable in higher numbers and it just makes their BG more difficult to manage.
 
Parent of Brutus said:
I personally think he would benefit from an increase, and would be willing to try it and monitor any changes. but when I asked my vet about it they just said to wait to see the results of a fructosamine test.
I want to work with them but also feel like I know more than them at this point and am nervous to step on their toes. I am also unsure how I would be able to dose out 1.75 with the needles we use currently.

We feed him 5am & 5pm one whole can of fancy feast chicken feast pâte. recently he has been downing that quickly so we have been offering him Reveal 100% chicken or fish also. I believe he is averaging about 140kcal per meal recently and i think the pate is only 3% carbs. the only other carbs he is getting are the occasional couple of Temptations treats. should we feed more carbs to help with his weight gain ?
maybe go back to offering some dry food too? it feels impossible to help him gain weight and also keep blood glucose under control.
Click to expand...
Stay with low carb or his BG can become quite unpredictable. Also, his numbers will go up and he will need more insulin if he’s eating medium or high carb. My cat gained a lot of weight back while eating LC. He did eat a lot of food.
 
The 1.5 dose was held too long. It should have been held for 7 days and then he should have been increased to 1.75 holding for another 7 days and then 2, etc. increasing from 1.5 to 2 directly is not the way we do it around here when you have already had blue nadirs on the 1.5 dose. Cats are small creatures and insulin is a powerful hormone; small changes in dose can make a big difference. It will take a few cycles for us to see the impact of this dose. I hope it will work, but just test him carefully and don’t assume that if you see higher numbers one cycle that it will stay that way.
 
You must log in or register to reply here.
Back
Top