? Ravan not doing well?

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JoyBee&Ravan

JoyBee&Ravan

Member Since 2018
He feels cold.Laying next to heat vent. I just gave him ringers (warmed it up first) he acted agitated. Tried to get up. When he did he was wobbly. This is frightening me. It does NOT feel good?
 
He's very nauseous smacking his lips I gave him Slippery elm a while ago but this time it doesn't seem to help! I'm not sure if I should try to syringe feed him? His bg went up again to 486!
 
Ravan's bg up to 544 ! What's going on ? I increased the dose to 1.25 & bg went up higher than ever before? Can someone HELP?
 
Is he eating? How is he acting? The higher readings may be due to his not feeling well. Any inflammation or infection can raise bg’s Significantly. Have you gotten a ketone test today?
 
Missed him when he peed so no ketone test i'll try to watch for it tonight What do i do if it does show ketones?
 
Sharon, He ate early morning about a tablespoon & again at 5;30 & noon. He's nauseous now Doesn't want to eat . I gave about a tablespoon baby food with some vitamins & B 12 in a syringe 30 mins ago He acts Cold Laying against the heat vent. Just wants to sleep?
 
If the number is high, he’d need a vet. To prevent them, he needs food, fluid and his insulin. If there’s an infection he would need antibiotics as well. Do you think he has a fever?
 
No fever. What do yu mean a vet Is this an emergency? What will a vet do? I'd need to bring him to emergency clinic. Now you have me scared to death!
 
Only if he has a high ketone reading. He’s been negative all along, so he’s probably ok on that front. You gave fluids and you’re assist feeding and gave him his shot.
 
High BG’s can make them feel bad. Let’s hope his numbers come down and he feels better! I do still worry that he’s not eating normally though. He needs those calories. How is Peggy Sue? Is she eating better?
 
Sharon I need to understand this clearly. If I check his ketones tonight at say 3am & they are in the mid range do I need to get to the emergency clinic? Is he dying? what would they do if his Ketones are high?
 
Ketones can turn into DKA -Diabetic KetoAcidosis. I don’t have any experience with it, just what I’ve read here, but it can be life threatening and very expensive to treat. That’s why we harp on testing. The earlier you catch it, the easier it is to treat. @Kris & Teasel kitty had it, so she can tell you more.
 
Calm down and breathe

He hasn't had ketones yet, so hopefully it won't be a problem

Yes, it's important to check, especially with him running so high, but unless he's above "trace", you're pretty much doing everything you can.

If he's higher than "trace" ketones, he'll need to go to the vet. They'll probably put him on IV fluids, use a rapid acting insulin and monitor his bloodwork for electrolyte imbalances and treat as necessary
 
Yay for negative ketones!!! I know you’re worried about high bg, but do try to get some sleep tonight.
 
JoyBee said:
Chris got any thoughts why his bg isn't coming down with the increased dose?
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Yes as I explained earlier, New Dose Wonkiness

We don't know why it happens, but it's quite common for the first cycle or two after an increase for the numbers to actually go up instead of down like you think they would.

It's also possible that there's something else going on with Ravan that we don't know about that's causing him not to eat and act like he doesn't feel well.
 
He's not feeling well and could have some inflammatory thing like pancreatitis going on. That can raise his BG overall. It's really important to focus on BG trends - overall too high/too low/too many ups and downs. etc. instead of individual numbers. It's also almost impossible to explain an individual number unless you know for sure that a cat got into some high carb kibble (as an example).

Maybe my story will help you understand how important it is to be proactive:

My cat had a bout of DKA two months after diagnosis. He was started on Lantus and I was following the vet thing of dose the same for a week, do a curve, wait for vet instructions for next dose. We were getting nowhere - his curves were high and flat or showed minimal response to the low dose of Lantus he was on. She suggested 48 hours with no shots, planning to do a restart to see if it would trigger a better response. He got very ill instead - no appetite, extreme lethargy, some vomiting. I whisked him to the clinic and he was in DKA. It took three days in the ER ICU being given fast acting insulin, fluids to rebalance his electrolytes, etc. to get him through it. That stay was very, very expensive - $2700. He recovered but it took weeks for him to get back to normal. Did I blame my vet? No, I didn't. She's a great vet and better informed about FD than most but not aware of all the nuances of dosing, monitoring and kitty idiosyncrasies that we know here.

After this bout she suggested I try ProZinc insulin. I switched and he was on it for about 9 months. The first 4 months I was doing weekly curves for my vet, reading a lot on FDMB but not yet following the methods here. The weekly curves weren't very informative - almost always high BG, etc. One morning I finally did a pre shot test and he was very low. If I'd given a full dose on that number it could have been disastrous but it wasn't. I made the decision then and there to take it into my own hands and try the "FDMB Way". By testing the way we recommend and doing those other daily spot checks I learned quickly why my vet's methods weren't working: my cat is extremely bouncy and reactive, a very small dose change can have a big effect and if he bounces up high he can get stuck up there for days on end. That's why the weekly curves always looked high and flat.

After 9 months on ProZinc I learned it wasn't the insulin for Teasel. He bounced incessantly. I made the decision myself to put him on Lantus again to see if the FDMB methods would allow me to make it work better. In Canada we can buy Lantus and Levemir over the counter so I didn't ask my vet in advance, although I told her later. She knew my cat wasn't following any rules and she trusted me to learn enough to do it properly. Teasel was on Lantus for 7 months and it did flatten our his numbers quite a bit. He was still bouncy and unpredictable but there was a definite improvement. However, it didn't seem to agree with him - he was sometimes lethargic, sometimes grumpy. I decided to change to Levemir on my own and told my vet afterward. He's now been on Levemir for 6 months and is doing well. He feels better even though he's still bouncy and unpredictable.

So what are the takeaways?
  • when something doesn't work you have to try something different
  • arm yourself with as much knowledge and help from FDMB as possible to get you and your kitty moving forward
  • bite the bullet and do what's needed to figure things out - testing more, etc.
  • start from a good baseline: vet check, health issues addressed, proper meds on board, so you have at least a good chance of improvement
  • trust the data on your spreadsheet to tell you what's working and what isn't
  • trust the advice of these good people on FDMB.
I hope this helps a little ... :)
 
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I appreciate all the info Kris. The thing most confusing to me is it seemed he was doing better 2wks ago on the lower dose
When it dropped to the lower levels (safe Levels) I got frightened & either didn't give a shot or lowered the dose. (My Vet said if he stays 200-300 that's fine Older cats do very well at those numbers. )So I felt safe when Ravans bg was at 200-300
Now people tell me it's ok to shoot at 100 or just lower the dose at 68! I'm so worried about the Hypoglyc. I get too scared! How long is it safe for him to be in 400-500 one day ? Several days? a month? You said your cats bg was almost always high. How high? Was it in the 400's like Ravan? For how long?
It's very difficult for me to understand you saying ,"She's a great Vet" If she's not well informed about Diabetes dosing & treatment I wouldn't think she was good for my cat at all.
Have you ever listened to Dr. Karen Becker DVM on You Tube? I see so many people getting their pets Vaccinated every year! She explains very clearly why you should NOT do that. (Cancer is one big reason)
No Kibble in my house EVER. Cats were raised on Raw meat diet.

The more info I have the better I can handle all this. I get stressed out when I don't know.

9:30am 425 it's come down slowly 119pt from 9:30pm 544 Is it safe for me to go out? Can He crash & drop to 50 from 425?

He's eating again! a tbls at 9am another at 9:45am I need to know how many ounces he needs a day?
 
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JoyBee said:
It'd very difficult for me to understand you saying ,"She's a great Vet" If she's not well informed about Diabetes dosing & treatment I wouldn't think she was good for my cat at all.
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She is a great vet - kind, compassionate, caring, knowledgeable and experienced in treating all the usual things. The best thing is that she listens, is willing to learn and will work collaboratively with me. She's a general practitioner, though, not a specialist.

My cat is a complicated diabetic in terms of his insulin responses. Vets don't see that many cases of FD and many of the ones they do see are more predictable in their response to insulin. If you were an "uncomplicated" human diabetic (if such a thing exists) your general practitioner/family doctor could likely take care of you adequately. If your case is more complicated you'd probably be referred to an endocrinologist/diabetes specialist. Even then, you'd be expected to learn about your own particular manifestation of diabetes and what to do when issues arise.

It all comes down to:
  • expectations - are they reasonable?
  • responsibility - are you willing to learn/look after as much as you can on your own?
These are the same criteria we have to use for our own health issues.

If you go look at my spreadsheet and look at the tabs, you'll see one for a link to 2016 and another for 2017. You can see Teasel's numbers all the way back to August 2016 when I started the FDMB methods.

And just to finish up: I, personally, have a rare genetic medical condition for which I've been a guinea pig in many clinical trials of various treatments. My doctor for that is a specialist researcher and very knowledgeable. However, he listens to me, respects what I have to say and I've taught HIM a few things about my condition that he didn't know. I've had to make myself very educated on my condition and I definitely know far more about it than any doctor is likely to know if he/she is not a specialist researcher in this particular area. I accept that willingly because it's in my own best interest. I look at Teasel's diabetes treatment the same way.
 
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I read a LOT so If I'm given info I can work with I'll be OK.I'm not too good with the computer so sometimes i ask a lot of questions when i can't find answers.
My Vet ,when I offered info I thought was helpful, told me , "Quit reading stuff on the Internet! We know what we're doing!" They are NOT perfect. They can make mistakes. I wish my guy was as open & willing to learn as your DVM ! I understand now why you like her.

I've tried for many years to find a Vet like what you describe but so far no luck out here.

How do I discover how many ounces Ravan should be eating each day. For some reason no one seems to want to answer that question?

Thanks again for all your help.
 
JoyBee said:
How do I discover how many ounces Ravan should be eating each day. For some reason no one seems to want to answer that question?
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There's no easy answer. I like the simplest one: if your kitty is eating well - ie., no signs of nausea, etc. - let him eat as much as he wants in several small meals a day if he's the typical starving diabetic. Let him graze if that's his preference. Once his BG is better controlled the excessive hunger should lessen and then you gauge his body condition. If he looks a bit "fluffy" cut back a bit on his rations. If he needs a bit more flesh, increase a bit. You can get on the bathroom scale while holding him then subtract your own weight to get an approximate weight for him. A digital baby scale works really well but it's an extra expense.
 
Going forward: I think you'll see progress and learn more if you can spend a bit of quiet time reading the yellow information stickies on the Lantus forum. They tell you everything you need to know about this insulin and how to use it best. I'd print them out and put them in a binder so you can scribble on them, underline things, jot questions to ask, etc.

We all understand the high anxiety and stress that comes with treating FD. What helps every one of us is learning as much as we can, trusting the good advice given by experienced people on the forums and working really hard to keep our emotions in check. Clear thinking and extreme worry can't exist in the same mental space. ;)
 
I have learned to quit reading ANYTHING besides what is on here, when we are reading way to much info from a million places it gets so overwhelming we don’t even remember what we read and where it came from.
As for eating, I just make sure bella is eating, I measure it at all, I say did he eat, does he look ok, is he feeling ok and of course check in his BG, I used to be obsessed with checking it all the time but then he got to where he just looked at me with that look, we have to remember they are cats and not just a number, BG numbers, calorie numbers numbers, number numbers, we have to relax and sometimes just sit back relax and watch how they are feeling, does that make since, you are going to drive yourself insane, I’m only saying this to you because I don’t want to to be so upset all the time, does this make since what I’m trying to say, I only go by what is on here, Bella’s numbers if you will look sometimes could not even register they were so high, I just wanted to die, I got on here and only here and look at them now, I trusted these people and we are doing so so much better, I do keep in contact with my vet when needed and send him copy of spreadsheet, he wants 1x a month. Please relax and it will be ok
 
Thanks Kris & Bellasmom! Lots of good info.
Ravan does NOT have excessive Hunger! He's only eating small amounts. (Not like he is starving.) That's what concerned me. I thought with high #'s he would be eating a lot. That's why I asked how many ounces? I want to know if I need to syringe feed to make up for what he's not eating.

I said I read a lot to let you know i am looking to educate myself about this. I do read the stickies & have been reading some of the posts also.

When I was young I worked "better "under stress! Now it's a whole new world! I guess I'm depressed. Spend a lot of time crying. I Hate it. Trying to control my emotions makes me feel like everything inside is waiting to Explode!

I'll work on it. I can see no one likes when I get a Panic attack!
 
JoyBee said:
Thanks Kris & Bellasmom! Lots of good info.
Ravan does NOT have excessive Hunger! He's only eating small amounts. (Not like he is starving.) That's what concerned me. I thought with high #'s he would be eating a lot. That's why I asked how many ounces? I want to know if I need to syringe feed to make up for what he's not eating.

I said I read a lot to let you know i am looking to educate myself about this. I do read the stickies & have been reading some of the posts also.

When I was young I worked "better "under stress! Now it's a whole new world! I guess I'm depressed. Spend a lot of time crying. I Hate it. Trying to control my emotions makes me feel like everything inside is waiting to Explode!

I'll work on it. I can see no one likes when I get a Panic attack!
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We don’t want anyone having a panic attack, if he’s always ate only a small amount at a time then just offer it maybe a cpl more time a day, he’s doing what he has always done in eating right?
I did to when I was younger, the more the better for me, not so much anymore, I really had to work on it, it was driving me :confused::eek:o_O, so I now have camomile tea and I take more long hot baths, bella seems a lot more relaxed as well, :)

And I meant in previous message that I do not measure it
 
JoyBee said:
Ravan does NOT have excessive Hunger! He's only eating small amounts. (Not like he is starving.) That's what concerned me. I thought with high #'s he would be eating a lot. That's why I asked how many ounces? I want to know if I need to syringe feed to make up for what he's not eating.
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If this is different from his normal pattern when he feels well it's a clear sign he's under the weather. One very common problem in diabetic cats is pancreatitis. I can't say with certainty that's what it is but it shows as a variety of "feeling icky" signs: nausea (lip licking, trying to eat and walking away), sometimes vomiting, abdominal discomfort (not moving much, sitting hunched in the "kitty meatloaf" position, sometimes a tenderness reaction if you press gently on his tummy).

What might a vet do if pancreatitis is suspected?
  • an in office "SnapfL" test which gives a yes/no answer
  • a blood test to send off for the "SpecfL" test that gives precise levels of pancreatic enzymes, etc. to know the degree of inflammation (expensive and doesn't change the treatment plan)
  • treatment with antinausa/anti inflammatory med like Cerenia (can work well)
  • pain meds because this is a very painful condition - eg. the opioid buprenorphine (can really help)
  • sometimes sub Q fluids in clinic or for you to do at home
  • if needed - stronger antinausea med like ondansetron (human med for chemotherapy)
  • if needed - appetite stimulant meds like mirtazapine (can work well but sometimes causes odd behaviours like yowling, etc.) or cyproheptadine (a human antihistamine that can help with fewer side effects).
I'm sure you won't welcome seeing a list of meds like this but the gentler homeopathic or natural route doesn't always work. It can come down to a choice between staying with what's not proving to be effective enough or getting a kitty better ASAP.
 
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4:30 pm bg 98 Dropped 327 pts in 7hrs?? Will bg continue to drop?? Do you feel it's normal for a huge drop like this?

Ravan doesn't want to eat, Walking a little wobbly, Ketones, No Vomiting, does not exhibit pain when I rub or press his belly.

My appt is for Thurs with the Vet. Soonest they can see me ( even though I told them i was very concerned)

Urinating OK, BM normal I'm going to give Ringers sub Q & slippery elm, Within the next hour.

I explained on another post that my cat Jai died because I gave him Buprenorphine. He went into respiratory failure.(The web site warns not to give it to cat with breathing problems but the vet told me to give it to him before i had read the warning. ) I have legitimate reasons for not wanting to use most Pharmaceuticals.
 
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I do understand really, cause I just changed vets like Saturday. She is wobbly?? You said ketones, she is showing them or no? Can you not get her to eat anything?
 
Did you see the Huge Drop? 425 to 98

No Ketones Doesn't want to eat, I'll syringe feed in a while.

I'm concerned about this Huge bg drop?
 
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