Stoney Updates/Questions

I see you had a lower AMPS originally. The procedure for doing a stall when you have a lower than expected preshot number is to
(1) Do not feed any food
(2) wait for thirty minutes
(3) Retest to see if the number is rising on its own without the influence of food.
(4) You can continue to stall without feeding for another thirty minutes or just go ahead and decide about whether you will skip the shot or shoot a reduced dose.

He must have dropped into lower numbers last night with a 116 AMPS. I wonder how low he went?

This is a good reason to wait longer before increasing the dose. He is having lower nadirs on the 2 unit dose than we can actually see on the spreadsheet.
 
Another housekeeping matter (sorry) would you please put both the 116 and the 319 in the AMPS cell for this morning and indicate how many minutes were between those two readings. Let’s say it was 30 minutes… it would be stacked in the cell like this:

116
319 +30
 
Suzanne & Darcy said:
I see you had a lower AMPS originally. The procedure for doing a stall when you have a lower than expected preshot number is to
(1) Do not feed any food
(2) wait for thirty minutes
(3) Retest to see if the number is rising on its own without the influence of food.
(4) You can continue to stall without feeding for another thirty minutes or just go ahead and decide about whether you will skip the shot or shoot a reduced dose.

He must have dropped into lower numbers last night with a 116 AMPS. I wonder how low he went?

This is a good reason to wait longer before increasing the dose. He is having lower nadirs on the 2 unit dose than we can actually see on the spreadsheet.
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You got it. I just wanted to make sure we are still on the right track. He’s eating normally, actually begging for food, so I have been giving to him. He’s not acting how he was when he was first diagnosed with DKA. I’ll be testing in about 10 minutes!

I also wonder how low he went. I was happy with the 116 this morning but knew he needed a shot. He was also begging for food at that point. 😩 it’s so hard to stall with 2 other cats wanting their breakfast too, but I understand the reasoning for it. Just don’t want to get too far off schedule, especially since daylight savings is coming up! I need my husband to shoot while I hold his face and comfort him. If we go any later than our usual schedule, it’ll be just me in the evenings. Husband has class. 😖
 
Let’s see where he is in the morning. If he is lower again then you may want to just shoot a slightly reduced dose. What is your shot time and time zone?
 
Suzanne & Darcy said:
Let’s see where he is in the morning. If he is lower again then you may want to just shoot a slightly reduced dose. What is your shot time and time zone?
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Hi Suzanne, not sure how I completely missed this! Our shot time is 5:30am and 5:30pm, central standard. He has not been lower. This morning at AMPS he was at 284 and stayed in the high 200’s all day. Considering moving to 2.25u in the am since he has been on 2 for 4 cycles. We are able to monitor him today, we finally have a rest day! I also have a hypo kit on the ready if necessary.
 
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Suzanne & Darcy said:
I’m glad you did the increase this morning. I’m hoping to see blues again soon.
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+9 he is 304 and ketones are 1.4. I think the small snacks and water are helping the ketones. Fingers crossed. I’m really trying hard to get those down. He’s doing well, I’m sure there will be an adjustment period to the new dose. When he was in he hospital I remember them telling me that they put him all the way up to 3 units at one point! Let’s hope we don’t have to get that high!
 
Stoney is still sitting high after the increase. We just got a 383 @ PMPS. I suspect a dental infection. Sometimes he eats with his head sideways and drops food. I thought this was because of the change in texture of his food, but a little google led me down a scary rabbit hole. He does have tartar on 2 back teeth. He is seeing the vet that initially diagnosed him with diabetes first thing tomorrow morning as his other vet (hospital/vet) is not available. I am urging my husband to advocate for him as I can’t be there!
 
McKenzie LaPray said:
Stoney is still sitting high after the increase. We just got a 383 @ PMPS. I suspect a dental infection. Sometimes he eats with his head sideways and drops food. I thought this was because of the change in texture of his food, but a little google led me down a scary rabbit hole. He does have tartar on 2 back teeth. He is seeing the vet that initially diagnosed him with diabetes first thing tomorrow morning as his other vet (hospital/vet) is not available. I am urging my husband to advocate for him as I can’t be there!
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Oh I am sorry you can’t be there. It really does sound like you should schedule a dental cleaning and they can look carefully at his teeth. Sometimes you can’t tell without a dental x-ray. Unfortunately, many vets don’t want to do a dental until the cat is regulated, but they’re never going to get regulated with bad teeth. 😔
 
Suzanne & Darcy said:
Oh I am sorry you can’t be there. It really does sound like you should schedule a dental cleaning and they can look carefully at his teeth. Sometimes you can’t tell without a dental x-ray. Unfortunately, many vets don’t want to do a dental until the cat is regulated, but they’re never going to get regulated with bad teeth. 😔
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I am hoping that they can x-ray tomorrow and then schedule a cleaning for sometime this week. This has been a rough month. 😕
 
Suzanne & Darcy said:
Oh I am sorry you can’t be there. It really does sound like you should schedule a dental cleaning and they can look carefully at his teeth. Sometimes you can’t tell without a dental x-ray. Unfortunately, many vets don’t want to do a dental until the cat is regulated, but they’re never going to get regulated with bad teeth. 😔
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His ketones are going up and I have been trying to get him to eat. I can smell them on his breath. The only thing he is wanting right now is a high carb food but I am taking what I can get. I think we may be taking him back to the ER tonight. I don’t know how much of this we can afford and I am getting nervous.
 
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Update: we are leaving the emergency vet now. He is not technically in DKA. He is elevated, his BG was 413. We requested sub q fluids, anti nausea meds, and more Mirataz. They did administer covenia, for precaution. Vet advised to increase his dose, which we may do tomorrow morning to 2.75u per MPM and nadirs of 200+. He also said we only need to test ketones twice a week. 🙄 I love this vet, but there some advice I am just not taking, and that’s some of it. He looked at his teeth and saw nothing to worry about but we are still going to take him in for his dental exam at his regular vet in the morning. I want a second opinion based on the way he has been eating his foods. I’m hoping the sub q fluids will really flush this out of his system.
 
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Update #2: Vet appointment this morning showed no sign of dental issues. She said there is some tartar but not enough that warrants a dental cleaning.
 
Update #3: Anti nausea meds definitely kicked in this morning. Mirataz too. He was crying for food and when my husband set down the other cats food, he darted towards it and may or may not have snacked on theirs. It’s the same food so it doesn’t matter! Hoping with his appetite back we can get the ketones down with snacks. He is also scheduled for sub q fluids tonight to flush them out.
 
My sweet, sweet boy, satisfied with a full belly and his insulin 🩷☺️ I love him so much.
IMG_1327.jpeg
 
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