Risky Update -- need your thoughts

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MarthaPaige

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Since Risky came from hospital his BG has been high. Hospital used R insulin and his numbers stayed around 300. Since he has been home they have been running around 500. 11:15 p.m. last night he tested 532; during the night he was 480; at 8:45 this morning he was 490. At 9:00 a.m. I gave him 2.5 units and he tested for a trace of ketones. Remember when he came home from the hospital yesterday there were no ketones present. He is alert, seems to feel good and is eating and drinking. He is eating mostly Tuna with a mix of dry Purina DM and Science Diet. I can't get him to eat FF or Purina DM by itself. He is taking 1.5 tablets of Batril daily. I have a call in to the vet. One thing that concerns me is his insulin. Since the vet had the insulin and it was not in my care, did they leave it out of the fridge? We are on vacation and the vets in this area do not use Prz so it might be hard to find a source if I needed to get another bottle. Suggestions??????
 
I definitely would check with the vet about how the insulin was cared for. What dose of R plus ProZinc was he getting? I wouldn't want to lower his overall dose once he gets home and R is out of the picture. What dose did the vet suggest?

Others are experts on sub Q fluids but I wonder if they would be a good idea. I think, as long as you can't get him off the dry, he will need to have more insulin. I would suggest upping the dose. I was for 4 units in the beginning and could still see that as possible dose until he starts eating wet lo carb. I wouldn't go directly up to that dose, but would certainly consider 3 units at his next shot. Be sure to get some mid cycle numbers and watch those ketones carefully.

I hope Kim and Nancy will jump in. They are the resident experts on DKA.
 
If there is a Cotsco in the area, some of them carry ProZinc but you need a Rx from your vet to be called in. If they don't have it in stock, they can get it the next day with overnight delivery. Not all Cotscos carry PZ though, call first and check to see if they can get it.
The high numbers are typical after DKA, but the trace ketones are a little worrying combined with the high numbers, just keep a close check on the ketones.
How is his appetite? Is he eating and drinking well? No vomiting? If he starts not eating well or vomiting combined with high numbers, I would get him back to vet to be rechecked.
 
Sue---he never got Prozinc in the vet hospital...only R. So last night was his first dose of Prozinc since coming home. She gave 2 units last night, up from the 1.5 she was giving before the ER. This morning she increased to 2.5 units. It took Kitty 3 days to respond to Prozinc after DKA.

I agree with Angela--the high numbers are to be expected after a ketonic experience, but the trace ketones are concerning.

Also, as I stated in the other thread---I think fluids are in line for this morning.

Definitely call the ER and see how the Prozinc was stored.
 
Angela&Henry said:
If there is a Cotsco in the area, some of them carry ProZinc but you need a Rx from your vet to be called in. If they don't have it in stock, they can get it the next day with overnight delivery. Not all Cotscos carry PZ though, call first and check to see if they can get it.
The high numbers are typical after DKA, but the trace ketones are a little worrying combined with the high numbers, just keep a close check on the ketones.
How is his appetite? Is he eating and drinking well? No vomiting? If he starts not eating well or vomiting combined with high numbers, I would get him back to vet to be rechecked.
Click to expand...

Unfortunately no Costco near. I have a call in to the vet but you know they will say that it was kept in the fridge. His appetite is good and he is drinking well... peeing a lot. No vomiting. Just checked ketones again and it shows a trace.
 
I would not wait around for the vet to call me back......I would take him in. Trace ketones are nothing to play around with after being ketonic. They were negative yesterday and now have now tested trace on two test. At the least he needs fluids---I think.

Nancy normally is around in the mornings--hopefully she will check in shortly and give some feedback.
 
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