5/2 Latte AMPS-450, PMPS-314, +3.5-420 trace ketones

These numbers are unbelievable and becoming VERY unsettling:
PMPS- 302 (Increase from s2 to 2, pred @ +1)
+2.5- 278
+7- 508 (you dont even wanna know what her receck was to make sure that # was right)
*only 1/3 jar baby food and few bites of kibble on cycle,no food OR water over night*
AMPS- 450 (opened new cartridge)

Yesterday:
viewtopic.php?f=9&t=13406

Doubt she went lower between +2.5 and +7 last night, based on her behavior, lack of eating AND drinking. Possibly infection related, but still...that 508 is ridiculous. She has never been that high when unwell with infections or other things. Im beginning to feel these high numbers are becoming serious now.

To make matters better, I stepped in pee this a.m. Apparently she decided (or couldnt make it to her box) to pee on the floor/throw rug, just 3-4 feet from LB. So now Im wondering if this a/b is doing a darn thing. Im aware it could be the wrong one because we dont have a c/s. Typically, after a day on a/b she stops this behavior. This is day 2. Her side is completely soaked after spending a good deal of time last night cleaning her up from another accident. Now we get to do it again this a.m. At least last night she purred while I did it (in between growls and moans). So I think she knows Im trying to help and may even appreciate it a little.

Im going to get a +1 in a moment here and then give pred. I didnt want to give it on this number. Any later, however, it will just *theoretically* make her end cycle higher. She ate a few licks of food when I put it down after shot, but I have yet to push it. Maybe after her pred. She does need to start eating, as I understand high numbers like this and not eating/drinking are part of the recipe for ketones...right?

After her +1 and some persuading to eat, I will come back to continue discussion with JOJO about the "R".....

Re: 5/2 Latte AMPS-450, +1-393

Have you or will you be able to check for ketones? I hope she will eat a little for you now...
I am sending you healing vines and lots of hugs Carolyn....that's all I can do since I have no suggestions but I will be praying you both...
:YMHUG: .

Re: 5/2 Latte AMPS-450, +1-393

jojo and bunny said:

okay well anyways i looked at SS. oh boy.

Click to expand...

:lol: That made me chuckle! Her ss really does make sense and follow SOME patterns. You just have to be married to it, in order to understand.

jojo and bunny said:

okay if you want to use 0.1 of R i strongly suggest to not shoot it until you get your +4 number in a cycle. no giving it at PS like others do, you have a cat that can drop like a whole whole bunch there before +4 from a high number and R at PS would be a disaster if she is having one of those no downward movement at all cycles. would have to be used only on the cycles where the +4 number shows that cycle is a bust and then you could use R to save the cycle. would give it at +6 of 'bad cycles' at first just to be sure L action is over. there is no rule that says R must be given at PS, but there is a rule that you do not want the basal and bolus insulin nadir'ing at same time.

Click to expand...

Those were pretty much my fleeting thoughts. I can usually tell by +2 or +3 whats going to go down. Though she often throws curve balls, AND there are things to consider - like how much and when she last ate kibble, when I gave the pred, what her previous cycle was like, is she eating, vomiting, etc. I would want to weigh those in before considering a drop of "R". But yes, +4 or +6 would be when I would know for sure if she could be helped by it. Giving at +6 yesterday would have been great. Giving it when I caught her 500 last night would have been great. Had I caught the uprising last night sooner, even earlier. I think earlier in a pm cycle (+2) would be okay. I find it strange that even when giving the pred 2x/day, she still shows higher numbers at night and has the potential to drop like a rock in the a.m. cycle. What is it with the pred and giving it at night that she is more vulnerable to it causing high numbers???

jojo and bunny said:

and as always after giving that first 0.1 unit of R hourly testing has to be done first handful of times you use it to learn what her R cycle is like. there is no way to use bolus insulin successfully without thorough knowledge of it's effect and full cycle -onset/nadir/duration- in your cat.

Click to expand...

Not a problem with the testing. I would also only give it if I was going to be home. Carolyn/Spot made it very clear about how it works differently in every cat. Since Latte is extra sensitive to any /all medications I give her, I do expect that she will need to be very closely monitored when/if I were to give it.

jojo and bunny said:

it is powerful stuff and i do insist on those that wish to attempt it one ask me first if it should even be attempted in your cat (there are tons of cats that R is absolutely wrong and dangerous to use!) and two start at 0.1 units and three- do bunch of full R curves (that means from R+1 unit numbers start back up and R cycle is over and done with). four-have a well stocked hypo tool box in same house that has R in it.

Click to expand...

So do you think it is potentially a good idea to try this, with close monitoring? She has recently begun an increase in her pred from 5mg to 10mg (dose split 2x/day). She also has this 'undiagnosed' UTI at the moment (any chance you could answer my questions about this in health? Same questions asked in my condo last night). Would it be worth FIRST, continuing to increase her Lantus? Do you think I will just continue to see lower numbers in a.m. cycle, and higher in pm even if I increased the Lantus? I just brought her up to 2U last night (and new cart this a.m.). How quickly can I increase again, if need be? If Im lucky, the soonest I could get my hands on some R AND be able to fully be able to monitor would be next weekend (fri-sun). Until then, Im kind of strapped to work. Im pretty nervous about it, as Latte and I kinda fumble on our own with Lantus dose already. She has so much going on, there seems to be no 'protocol' other than her own unique one.

BTW- I think one major concern with using the R, when talking with carolyn/spot, was her inability to eat on demand, and the always potential to vomit. If she were not able, or willing to eat after giving the R, or if she vomited (vomiting drops her), how dangerous would that be?

Thanks for taking the time to stop by and look at her ss. You be one BRAVE woman! :mrgreen: And, thank you for the input. It is very much valued and appreciated.

Re: 5/2 Latte AMPS-450, +1-393, +2-337

Hi Carolyn and lots of hugs to you and Latte. That's about all we can offer, but they come from the heart. Hope your day is more encouraging.

Ella & Stu (who will stop off later with a bowl of chicken broth)

Re: 5/2 Latte AMPS-450, +1-393, +2-337, +3-374

I might just go cry now.
I dont see any way of getting her out of these high numbers.
Of all the things she has going on that could take her...now I get to worry about complications from the FD?!?!
I CAN check ketones, but I dont want to. There is NOTHING I could do about it, if she developed them. I dont wanna know.

Re: 5/2 Latte AMPS-450, +1-393, +2-337, +3-374

This is one cycle. And there is something you can do for ketones -- you could give a bit more fluids. And, this may be the pred. Deep breath.

Re: 5/2 Latte AMPS-450, +1-393, +2-337, +3-374

Carolyn,
I was forever upset about Shadoe's high numbers, and now with Oliver's. We all know how much damage those high numbers can cause if allowed to continue. I was always like come on, come on, come on, come down already! Thanks goodness for R now.

Now, with some great help and guidance from Carolyn and jojo, I am attempting to put R to good use in bringing them both down from those higher danger numbers.

I also started with .1uR because gives a good yank down in the numbers once you are at a suitable dose for your kitty. I don't need as much for Shadoe, but Oliver seems to need more. Shadoe's numbers usually reflect the R around +2, but Oliver takes longer, close to +3. Still, you can tell the pull and it's a big relief to get out of Black and Red and even those Pink numbers!

It would be totally worth it to have on hand for those crazy 508's Latte decides to throw your way; it's such a relief to know you have another tool that can bring that number down quickly and then be gone from her system.

I sure hope that lousy number is a thing of the past in very short time.

As for testing for ketones, it's better to test and see a negative than to have another 'what if' additional worry at the back of your mind. Best to test and be done with it.

Re: 5/2 Latte AMPS-450, +1-393, +2-337, +3-374

No advice, just (((hugs))) (((Carolyn))) (((Latte))).

Re: 5/2 Latte AMPS-450, +1-393, +2-337, +3-374

Just sending you HUGS for support sure hope Latte can turn around for you :YMHUG: :YMHUG: :YMHUG: :YMHUG: :YMHUG:

Re: 5/2 Latte AMPS-450, +1-393, +2-337, +3-374

Sorry about my little fit.
And yes,I am thrilled with this +6...172....BUT...wtheck. There is one of her curve balls! What if I had R'd that +3?!? And, I dont even know how fast her drop went because silly me (who almost threw the meter out the window after the last test), went back to bed. I know she got up and ate kibble maybe around +4. knowing her, Im sure the drop was fast, tho. That is just going to set her up for another bounce. @-)

Could someone just wish her to stay put right there. 172...beautiful number...forever???? :roll:

Re: 5/2 Latte AMPS-450, +1-393, +2-337, +3-374, +6-172!

Hellloooo blue.

Like I said, it's one cycle. I think you need to stop looking at one tree and look at the forest. I know it's hard. You do an incredible job of juggling everything Latte -- her chronic medical problems, her acute medical problems, her meds, her moods, her incontinence... Yeesh, if I get sick will you come and take care of me?

You need to do some care-taking of yourself, too. Things like sleep would be good. I even wonder if you're eating like a normal person.

The R thing, sit down with your vet and bring Latte's SS. Raise these questions. Bring the answers back here. I don't know how much experience with R your vet has other than in an emergency situation. Based on the dose suggestion that was made, I'd say not much. You know the people here will brainstorm with you.

Re: 5/2 Latte AMPS-450, +1-393, +2-337, +3-374, +6-172!

Yay! Blue! (((Carolyn & Latte))) :YMHUG:

Re: 5/2 Latte AMPS-450, +1-393, +2-337, +3-374, +6-172!

From your thread on Health:

So I only have 5 days of the orbax and then they want to recheck same day or next day after last dose.

1. 5 days on the a/b does not seem long enough. though we dont know if its the right one, so maybe thats all we should do?

2. How long does the a/b need to clear in order to get valid test results back?

This is my (inexpert) understanding: I believe you need to wait at least 72 hours after the last dose for the a/b to clear. If an infection has been properly identified, you should reculture after 5 - 7 days of treatment to make sure the a/b is working. Culture again one week after the end of treatment to make sure the infection is still clear.

You may need to consider that she has pyelonephritis (kidney infection). Very suspicious in a renal kitty with recurrent infections on steroids. The urine cultures may come back negative, as the bacteria are burrowed deep in the kidneys. Diagnosis would have to be based on other clinical signs, such as fever, pain in the abdomen, elevated WBC count, or possibly as you are seeing here, elevated BG's? If pyelonephritis is suspected, long term antibiotic treatment is needed. If the culture comes back positive one week after the end of tx, you need to go back on for 4 -6 weeks.

http://books.google.ca/books?id=_aS...e&q=the feline patient pyelonephritis&f=false

Have you looked into starting pain meds for the UTI?

Re: 5/2 Latte AMPS-450, +1-393, +2-337, +3-374, +6-172,+9-273

+9-273
Yup, up she goes again. I knew it wouldnt last long. At this point, I probably could throw the meter out the window. Really not interested to see her PMPS or anything beyond that for that matter.

Gayle- Thank you for the encouragement. Im guessing if I take the R route, it will be a lot of figuring out on my own. there is not much information on the board of its use (unless you could guide me to some) in a safe manner. Quite frankly it scares me. But the consequences of these steady high numbers has already shown its ugly head with the UTI...and will only continue to make things worse in her already fragile state. Im not sure which option scares me more at this point.

Linda- She has had a kidney infection before. I would place bets this is a plain ol ugly UTI (at this point). The constant presence of sugar in her urine, along with the pred,and the history of UTI's/kidney disease makes that a given. Again, if I cant get her out of these numbers I dont doubt it could manifest into a kidney infection. I dont know for sure, but I really dont see how an a/b is very helpful if the source of the infection is constantly pumped into her urinary tract.

I work a dbl tomorrow, but hope to catch up with the vet and see if Thursday would be better to do a recheck, depending on how she does the next 24-48hrs. This way she would have had 5 days of the a/b and off for 48hrs. Obviously if things go downhill in those 48hrs I would have to get her in and do what needs to be done. She has peed less today,and in more volume. So far, no urinating self or dribbling from what I can tell. I will try to take this as a good sign.

Sienne - Nope, sleep has not been the most doable thing with my work schedule the past few weeks. I had hoped to catch up on more this weekend, but Latte's care has taken a big chunk of that away. And thats okay. She is worth it and I will survive...but it does make it harder to make it through each day. Im eating ok. Maybe not so well this weekend. But over the last few weeks I knew I had to have quick, healthy foods on hand. So I prepared. Never drank so much OJ in my life! :lol:

Re: 5/2 Latte AMPS-450, +1-393, +2-337, +3-374, +6-172,+9-273

I forgot to address the pain meds:
She does NOT do well on the bupe. She gets skittish and very difficult to do meds. Remember I have to try and wash her rear a few times each day. I really dont want to make things worse for her. that is why I have not given it.

Re: 5/2 Latte AMPS-450, +1-393, +2-337, +3-374, +6-172,+9-273

believe it or not, i have not yet gone to sleep since i was in your condo last night. it is sunday, vet's closed and everyone seems to be having crises. so i am next to incoherent at this point but just a few quick things, will do more after sleep.

"What is it with the pred and giving it at night that she is more vulnerable to it causing high numbers???"
because at night the body releases it's own "pred-like hormones" so you're getting some double action. if she is on once a day pred you might want to switch it to morning dosing. if twice a day, well just remember how it plays into cycle.

okay you have correct thought pattern about the R. remember it is just a tool, one that might be useful during this infection not something that is going to be used every day forever. i see what she did today, was why i said last night +3/+4, like would have to test the +3 if went way up give the 0.1 R if flat pink wait until +4 and see if any change and if no droppage, then use it. see what i'm saying? and yes INDEED everything it also dependent on how she is feeling and eating and what she is eating and meds and all those other factors. a lot to think about at once.
since she is not an eat on command cat you wold be wise if you choose to do this to have karo in house. R action is so short you can ward off any problems of a 0.1 R dose with some karo on gums.

so she never had first C&S? then yes keep vet appt and get one. don't even know if orbax works on this UTI and if there is a UTI so don't want to stop AB for 2 days and then get C&S, not when she is so very symptomatic and uncomfortable. with her low USG, high numbers, increased pred dose, and symptoms this is one time that i would say UTI is more on table than sterile cystitis. need that C&S to know what is target AB. the orbax might be totally useless for all we know at this point and wasting time. and then still have to wait for C&S results a few days so vet as soon as you can for the cysto.
has she ever had tramadol? or have you ever tried tiny dose of bupe? besides infection pain could also be driving up those numbers. 508 with a cat with multiple health issues and very possible infection and not eating makes me nervous. any chance you can p/u the R before next weekend? any drugstore has it with no Rx needed.


dang, you just typed this while i was typing~
"I work a dbl tomorrow, but hope to catch up with the vet and see if Thursday would be better to do a recheck, depending on how she does the next 24-48hrs. This way she would have had 5 days of the a/b and off for 48hrs. Obviously if things go downhill in those 48hrs I would have to get her in and do what needs to be done. "

yeah that 48 hours off is what i am worried about, what i was typing about above (and hopefully making sense, lol. like in perfect world i would go for C&S monday morning). but you are the one there with her, if you think she looks brighter, follow your gut, you know her best.

i have to crash now, i know i did not get to all your questions but can't type anymore.

Re: 5/2 Latte AMPS-450, PMPS-314

Can not give you advise but sending you low number vibes and hugs

Re: 5/2 Latte AMPS-450, PMPS-314

I got a ketone test and it was different than any one Ive seen. The middle seemed to appear as the light pink "trace". The outside of the square appeared to be the tan color (no ketones). I got it mid stream, also a second one that i placed on her pee pad. They both came out the same. I think I got these strips in maybe Jan? It says unopened they expire in Sept 2010. Do they expire sooner if opened(they have been stored with cover on all this time)?

I also read that steroids can give a false positive reading. Is this true?

She ate a little between 7am and8am. She ate a little more, I think around 8:30am. At 9:30 and 10:30 am she ate some kibble (actually a lot). She ate maybe 1/4 3 oz can wet around 1pm. I gave her a little baby food (little less than 1/2 jar) about pmps +1 (7pm). She doesnt really eat much until midnight or so...if she eats on the pm cycle.

Her +1.5 (shortly after baby food) was 323 ...I think? not much different than pmps. I already gave the pred, so that should be kicking in about now.

Should I give her some fluids? She had 50ml this a.m. She drank a lot this a.m., but nothing since.

I guess she is acting normal. Sleeping under the piano, got up to pee a bit ago,sat in the hall, now in the bathroom (little early for that spot). She was purring after her shot and happy for skritches.

If she has ketones and needs emergency medical assistance, I cannot provide that for her. This has been one of my biggest fears through out the FD experience. what more can I do for her at home. Should I call the family I work for and ask if I can stay home tomorrow and try to get her in tomorrow? Otherwise I work a dbl and wont be around much at all.

Im kinda scared.

Re: 5/2 Latte AMPS-450, PMPS-314 I think we have trace ketones

I do think the strips expire sooner once the container is opened. Also, if there was any blood in Latte's urine, it may effect the test. And you are correct, steroids can cause a false positive.

What can give false positives in urine tests (from a site on human diabetes, but much of this probably applies -- except the diet part).

1. Special diets (low carb, high protein) as discussed previously.
2. Dehydration that can cause ketones to concentrate in the urine.
3. Medications, for example:-
Glucocorticoids (steroids) such as Prednisone - a potent medication used to treat many inflammatory conditions including rheumatoid arthritis.
Levodopa (Sinemet or Larodopa) - used for the for the management of Parkinson's disease.
Phenazopyridine (Pyridium, Geridium, Pyridiate, or Urogesic) - used for urinary tract infections.
Valproic acid ( Depakote, Depakon, or Depakene) - used for the treatment of convulsions, migraines and bipolar disorder.
Vitamin C (ascorbic acid), when taken in large amounts.
Inositol - part of the vitamin B-complex.
Metformin - oral diabetic medication.
Methionine - an essential sulphur-bearing amino acid, potentially beneficial in liver detoxification and in neutralising toxins.
Captopril and other free sulfhydryl drugs.
Other factors that may affect test results:-

1. You have not correctly stored the test strips - If you do not close the lid of the container tightly the strips can be affected by light or moisture.
2. Likewise moisture can affect strips if you remove the desiccant (usually found in a small white packet in the bottle).
3. The strips have been affected by heat because they have not been stored in a cool, dry place - NOT the refrigerator!
4. The test strips have passed their expiry date. Urine test strips usually expire 90 days after a vial of test strips is opened. One can buy foil wrapped ketone strips that last for 2-3 years. These are more expensive (they can be more than double the price) but if you are not testing frequently you may actually save money in the long run by not having to throw away expired strips.
Do not use strips at any time if the pad is discoloured.
5. When preparing to do the test you have touched the test area of the strip with your hand or put it down on a surface where it an be contaminated.
6. The urine specimen has become contaminated with bacteria, possibly from the container it was collected in.

Re: 5/2 Latte AMPS-450, PMPS-314 I think we have trace ketones

I called the UofM ER and they told me to just keep getting tests if I can. It could be the steroids, could be the stix, it could be the real thing. If the color gets darker than she needs to come in ASAP because there is nothing I can do from home. Not an option...at that point I guess I start saying my good byes...but we are not there yet, so...calm down, carolyn!

I think I WILL give her some more fluids, because I know she is constipated still, and has not had much to drink since this a.m. Maybe just 50ml. Dont want to over load her. Maybe it will help her pee some more too. Cant believe I am saying that after the last few days of urine everywhere! I will also keep testing BG to see how high she is progressing in this cycle.

My boss has little to no flexibility this week (no back up). She did say if I needed to come in a little later tomorrow I could do that. So I will call and try to get into the vet by 9am so we can get the u/a done. Im pretty limited in funds this month, so just the u/a, c/s is going to be a terrible burden. But it has to be done. I cant do any more than that.

Okay- off to give fluids, meds, and clean her butt.

Re: 5/2 Latte AMPS-450, PMPS-314 I think we have trace ketones

I'll be thinking of you and Latte, hope all goes OK and the strips are just crappy.
Thinking positive now.

Re: 5/2 Latte AMPS-450, PMPS-314 I think we have trace ketones

((Carolyn))
Sending lots and lots of hugs to you and sweet Latte.
Max and I are always watching.

Re: 5/2 Latte AMPS-450, PMPS-314 I think we have trace ketones

+3.5- 420 :cry:

Vines, snowflakes, healing thoughts, love all being sent to you and Latte. Do try to get some rest tonight, Carolyn. You are doing all you can do.

Many, many hugs,
Ella & Stu

hi carolyn. sorry latte has had a rough time. ( you too )

couple random thoughts from posts above.

1. constipation can also cause numbers to rise. So that can also be factored in.
what are you giving her for that?

2. re: fluids ---she is still getting them daily right? you mentioned something about deciding to give more fluids.
have you talked to your vet about her daily max? ( I know she has some special kidney issues)
cause w/ any UTI or idiopathic cystitis and/or constipation fluids are very helpful. ( not to mention cp)
will she drink extra if you make her a tunatini ? ( tuna juice --- no salt added best) diluted w/ water?
Unless that will make her less likely to eat her food.

3. I know we talked about R being a possible tool w/ the roid increase. I would go ahead and pick up some -- they keep it behind counter. and wait til you have a day or a night ? that you can test
dunno how much info jojo or carolyn have given you info on that. so not wanting to repeat. i am glad to see jojo here on LL . happy to help though . just buzz me
one note -- you asked about the not eating on command issue. R is in and out fast. If she is high and as long as you are there to test, i wouldn't worry about it. i know you have your own little successful concoction to help out if a problem arises. ;-)

4. assuming UTI -- whatever ab is deemed best to use make sure she is treated for no less than 3 weeks. dm + roids + glycosuria = need longer treatment. Please talk to your vet about this. I would treat Winnie anywhere from 3-4 weeks.
have you ever tried using dasquin/cosequin ? really helped winnie's idopathic cystitis and helped uti's too.

healing wishes for latte

ETA used these "tushee wipes" for winnie. non irritating cat safe , company manus such things for hospitals so they are on up and up. NOT $$ (hey on sale this week too! google for discount codes if you order from them)
check it out. maybe they can help latte.

http://www.entirelypets.com/qubawituwi30.html

also when ordering from this co. click through fdmb thingy at top of page ( rebecca just added new icon)
and then fdmb gets donation.