Elmo PMPS 133.....

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Critter Mom said:
If it were me I wouldn't fanny around with the Vetsulin/U100 + conversion chart stuff; I'd move straight to the request for the new insulin. (Ask me some time about when I reached this stage with Saoirse and forked out nearly £100(!!) for a Vetpen which only got used twice. :banghead: )


Mogs
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Totally with you...been at this vet practice for +15 years but mostly saw his associate, a lovely younger vet who was easy to communicate with...sadly she left this summer not long after she diagnosed Elmo..was there for his DKA hospital stay in a grand way. He is a caring vet who goes the extra mile but is next to impossible to communicate with...a very highly intelligent man with zero communication skills. I am preparing on how to finagle him into agreeing to this. I may be overthinking nothing but want to be prepared. Happily his wife, an RN, manages the office and is easy to talk to. I have already moved my tabby brothers to another vet but didn't want to disrupt Elmo's care at this time.
 
MrWorfMen's Mom said:
Yes the snow is beautiful to look at! I've been using that beauty as my excuse for procrastinating at cleaning it up this morning but alas I really need to go get my butt in gear! Right now I'd probably have a hard time getting out of my driveway even with four wheel drive and snow tires! :arghh:
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And still, I'm green with jealousy :D
 
MrWorfMen's Mom said:
Maybe if you threaten the vet with dropping Elmo off the next time he requires a PJ party so he can get a taste of what you've been going through!:smuggrin:
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Ohhhhh, now that's good. Bless his heart tho,probably all I'd get is a blank stare. A real flat liner ! But great especially with cats. Does not overcharge but will not give up on an animal. Has kept kitties brought in for euthanasia for insane reasons and he takes the money and the cat, care for them and then keeps or adopts them out. Huge heart but small mouth:):(
 
Beth 73 said:
Totally with you...been at this vet practice for +15 years but mostly saw his associate, a lovely younger vet who was easy to communicate with...sadly she left this summer not long after she diagnosed Elmo..was there for his DKA hospital stay in a grand way. He is a caring vet who goes the extra mile but is next to impossible to communicate with...a very highly intelligent man with zero communication skills. I am preparing on how to finagle him into agreeing to this. I may be overthinking nothing but want to be prepared. Happily his wife, an RN, manages the office and is easy to talk to. I have already moved my tabby brothers to another vet but didn't want to disrupt Elmo's care at this time.
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Maybe he's on the spectrum?
 
Beth 73 said:
He is a caring vet who goes the extra mile but is next to impossible to communicate with...a very highly intelligent man with zero communication skills. I am preparing on how to finagle him into agreeing to this. I may be overthinking nothing but want to be prepared.
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Maybe print out some of the posts on this thread and the previous one which cover the reasons why a gentle, longer-acting insulin would benefit Elmo. Maybe use a yellow highlighter to emphasis the key reasons and use that for yourself as an aide-mémoire to help you keep on point during your discussion with the vet?

I've also attached a PDF of the Roomp-Rand published, peer-reviewed study on the management of feline diabetics with long-acting insulins. It covers the use of Lantus and Levemir to achieve better regulation of blood glucose levels. (about as legitimate a reference as one could hope for.)


Mogs
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Mogs, I can get a bit carried away when dealing with unreasonable people who think everything is black and white and they know it all.

As you know my little sugar is a diehard kibble addict that I have been trying to convert to wet food since I adopted her a 10 weeks old. Needless to say, I have kicked myself often enough for not being more assertive about the change in her younger days, but the last straw was when I felt beat up here with every one telling me ALL cats can be converted over. I seriously thought about offering to pay her travel costs to any sugar Mamma who thought she could convert my girl with instructions not to return her until she was TOTALLY converted. The one caveat to that plan was that I couldn't live without my sugar for any length of time so I thought better of making the offer for fear someone might take me up on it and I might never get her back knowing how stubborn she is! :woot:

You, my friend, could never fit the profile of anyone deserving of my wrath so no worries!:bighug:
 
Morning summary: AMPS 141...+1.5..123( gave 1t 5 snack plus thyroid meds).......,+2....119( 1/2 5 carb1/2 8 carb snack).....+2.5..126( gave 1/2 t 5 carb).......+3....128( 1t 5 carb snack).....+3.5..131( tried no snack).....+ 4...125( 1 t 1/2 5 carb 1/2 8 carb........will check again within the hour then test again at + 7.5 and +10....
 
Nice 'n' steady; you're looking after Elmo so well, Beth! :bighug:

Maybe skip the +10 and do the +11 instead so that you'll have a guide as to whether Elmo's rising at PMPS (same as yesterday). No food after +10 (unless something weird happens and food is needed).


Mogs
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Beth 73 said:
Morning summary: AMPS 141...+1.5..123( gave 1t 5 snack plus thyroid meds).......,+2....119( 1/2 5 carb1/2 8 carb snack).....+2.5..126( gave 1/2 t 5 carb).......+3....128( 1t 5 carb snack).....+3.5..131( tried no snack).....+ 4...125( 1 t 1/2 5 carb 1/2 8 carb........will check again within the hour then test again at + 7.5 and +10....
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Looks good!
 
Elmo is having a very nice & peaceful cycle today. Yeah ELMO!

For your pleasure ladies, I invite you all to join me by my Lagoon of Tranquility! Almost as beautiful in the winter as it is in summer! The waterfall isn't showing well in the picture due to winter configuration to keep my fishies safe but the sound of it in the silence of the snow is just short of heaven to me!

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MrWorfMen's Mom said:
Elmo is having a very nice & peaceful cycle today. Yeah ELMO!

For your pleasure ladies, I invite you all to join me by my Lagoon of Tranquility! Almost as beautiful in the winter as it is in summer! The waterfall isn't showing well in the picture due to winter configuration to keep my fishies safe but the sound of it in the silence of the snow is just short of heaven to me!

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This is beautiful, Linda! Remind me: where are you in Canada?
 
Praying for you , Kris and Mogs, as you help Sasha's Momma....mercy .....also FYI vet appointment set for Wednesday ...wants to research the L insulins ( had only used vetsulin, prozinc and novolin)....used the word "crashed" multiple times....again, praying success and rising BGs over Sashi....I know the situation all too well
 
Beth 73 said:
Praying for you , Kris and Mogs, as you help Sasha's Momma....mercy .....also FYI vet appointment set for Wednesday ...wants to research the L insulins ( had only used vetsulin, prozinc and novolin)....used the word "crashed" multiple times....again, praying success and rising BGs over Sashi....I know the situation all too well
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It's been a busy few days for the Royal Mounted Kitty Cavalry!
 
Kris & Teasel said:
where are you in Canada
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Kris, I'm in Etobicoke, a western suburb of Toronto. A tad warmer here than in your neck of the woods so we often get that heavy wet snow rather than the fluffy fun stuff and the clean up today is proving to be brutal! I need to go tackle the pile up left by the road plow! It was hard knocking down those little statues. They were so cute but also rather heavy!
 
MrWorfMen's Mom said:
Kris, I'm in Etobicoke, a western suburb of Toronto. A tad warmer here than in your neck of the woods so we often get that heavy wet snow rather than the fluffy fun stuff and the clean up today is proving to be brutal! I need to go tackle the pile up left by the road plow! It was hard knocking down those little statues. They were so cute but also rather heavy!
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Yes, I know Etobicoke. I agree that Ottawa is a tad colder. Isn't it the coldest nation's capital in the world or is that Moscow? Still snowing relentlessly here.
 
How much of this white crap do you have? They say we got 17cm but I'm sure I cleaned up more than that. Which reminds me...the bottom of my driveway and road access still need clearing. I'd better get at it before dark!
 
Kris & Teasel said:
How is Elmo? Have you called your vet? Just thought I'd dash over here to check in in the midst of Sashi's crisis. Whew!
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Elmo is great, thanks to all your great coaching, time and wisdom...I go to vet on Wednesday..told them Elmo's story and they r going to research the L insulins ( which they have never heard of) but open to it. Going to fax BG records tomorrow so vet has day to digest it all. Sounds promising :).....and as far as Sashi...oh...my...goodness....you all r amazing....I know her panic and living far from ER clinic...keeping Sashi,his mama and all of u in my heart, thots and prayers....mercy
 
MrWorfMen's Mom said:
How much of this white crap do you have? They say we got 17cm but I'm sure I cleaned up more than that. Which reminds me...the bottom of my driveway and road access still need clearing. I'd better get at it before dark!
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Not sure how much we have so far. Just glanced out my window and saw a guy riding a bicycle down the unplowed road beside me. Not the best transportation today methinks ...
 
Critter Mom said:
Seconded; and ditto.

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Dearest Mogs, please go to bed and rest. I worry about you and continue to pray for your restoration and rest. Elmo is doing wonderful...+ 11 he was 139 so it's a no shoot night again tonight...you and all Kitty Cavalry have well equipped me for which I am eternally grateful. Now put yourself first and rest your body AND your mind/emotions.You have earned it in spades:bighug::bighug::bighug::bighug::bighug:
 
Elmo update: +11 was 139......PMPS was 133.....ketones negative....appetite great....litter box good( God bless this cat that his balancing on the edge of the box all these years has paid off in easy peepee collection):)..... I'm guessing ( per Kris's former instruction) it's another no shoot night, let him eat when he wants, take a few BGs , leave little food out for overnight.....THE END .....
 
Another really smooth day for Elmo - and a very positive whole cat report! Long may ketones stay negative. :)

How were his energy levels today, Beth?

If he were mine I'd skip again tonight. If you get a chance try testing at PM+3 tonight.

Sorry I can't write much now; I'm completely and utterly exhausted; passed out a little while ago but thankfully woke again because I need to set out feeds for the Noodler. Once that's done I'm going to collapse again.

Great job looking after your boy. Thank you for coming to encourage Sashi and his mama, too.

:bighug::bighug::bighug:


Mogs
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Wow what a great start to the day! Elmo is doing great! Don't panic if numbers go into double digits... I always aimed for a low of around 85-90. As long as you're there to monitor it's good.

I have a feeling your off the juice trial will be soon. :)
 
JanetNJ said:
Wow what a great start to the day! Elmo is doing great! Don't panic if numbers go into double digits... I always aimed for a low of around 85-90. As long as you're there to monitor it's good.

I have a feeling your off the juice trial will be soon. :)
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Thank you, Janet. If not for all of u here on this board I shudder to think where Elmo would be. Many kindred spirits have been met here. What a blessing !!!
 
Elmo is looking good Beth. I'm hoping you are getting much more restful sleep on these "no shot" nights. Looks like the excitement with Sashi is under control (waiting for a last confirming test in an hour or two) so hopefully no PJ parties tonight.

Mogs, I hope you have now retired for the night. You may just be staring at a screen while doing these low number kitty watches, but we all know, the tension can be exhausting and you've had a number of these situations over the past few days which I am sure are taking their toll. Please do take care of yourself.
 
MrWorfMen's Mom said:
Mogs, I can get a bit carried away when dealing with unreasonable people who think everything is black and white and they know it all.

As you know my little sugar is a diehard kibble addict that I have been trying to convert to wet food since I adopted her a 10 weeks old. Needless to say, I have kicked myself often enough for not being more assertive about the change in her younger days, but the last straw was when I felt beat up here with every one telling me ALL cats can be converted over. I seriously thought about offering to pay her travel costs to any sugar Mamma who thought she could convert my girl with instructions not to return her until she was TOTALLY converted. The one caveat to that plan was that I couldn't live without my sugar for any length of time so I thought better of making the offer for fear someone might take me up on it and I might never get her back knowing how stubborn she is! :woot:

You, my friend, could never fit the profile of anyone deserving of my wrath so no worries!:bighug:
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@MrWorfMen's Mom Thank you for that statement. I realize its been over a year since that comment was written but it fits my junior perfectly. He has been on Dry food for the last 10 years and now with his diabetes diagnosis changing his food from dry to wet has been impossible. I have spend so much on food just these last few weeks. Its only been 3 weeks since diagnosis and thank god he hasnt needed insulin since I started making sure he is eating low carb food, but let me tell you he is testing all my patience. I feel horrible but for right now I am going to give him just dry food to make sure he is getting all the calories he needs because in 3 weeks he has gone from 11.5 to 10 pounds. So once again thank you for your comment. Its helping cope with my situatin and it lets me know I am not alone in this journey of stubborn kitty food

luz and junior
 
@luz You are quite welcome. Rest assured I feel your pain and a little more because I am in Canada and I can't get the low carb dry food you can. EVO decided our market wasn't good enough for them and Young Again may or may not make it through customs and would frankly cost me an arm and a leg over time. So for now I have had to settle on a 15% carb food.....higher than ideal but the best I can do. They have to eat. There is no doubt it complicates things a bit more but it is doable. I still hold daily stand offs with my girl hoping one day her hunger will overide her brain and she will at least taste the wet food rather than trying to bury it as if it were her waste. My cat has a high dose condition to boot but we have made a lot of progress despite her fussy appetite, so chin up. You and Junior will be just fine! And if anybody tells you it's easy to transition them..... just let me know. I've got your back! :bighug:
 
MrWorfMen's Mom said:
@luz You are quite welcome. Rest assured I feel your pain and a little more because I am in Canada and I can't get the low carb dry food you can. EVO decided our market wasn't good enough for them and Young Again may or may not make it through customs and would frankly cost me an arm and a leg over time. So for now I have had to settle on a 15% carb food.....higher than ideal but the best I can do. They have to eat. There is no doubt it complicates things a bit more but it is doable. I still hold daily stand offs with my girl hoping one day her hunger will overide her brain and she will at least taste the wet food rather than trying to bury it as if it were her waste. My cat has a high dose condition to boot but we have made a lot of progress despite her fussy appetite, so chin up. You and Junior will be just fine! And if anybody tells you it's easy to transition them..... just let me know. I've got your back! :bighug:
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You are too kind. I am glad your fur baby is thriving on dry food. Will let you know if i need you to back us up. :)
 
Beth 73 said:
Thank you, Janet. If not for all of u here on this board I shudder to think where Elmo would be. Many kindred spirits have been met here. What a blessing !!!
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When is 165 I would do the 0.25, but not lose the drop. You could get him just a tad lower closer to the 85-100 range.
 
JanetNJ said:
When is 165 I would do the 0.25, but not lose the drop. You could get him just a tad lower closer to the 85-100 range.
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Hi Janet,

In theory that might work but the issue with Vetsulin is that the same dose can yank down an unexpectedly higher, slightly 'bouncy' preshot to a similar nadir range as the cat would run in on the same dose but from a lower preshot BG level.

Upping the dose, even by a fraction, may result in a faster (and possibly earlier) drop followed by the cat spending the rest of the cycle in a higher range, not a lower one (a 'tick-mark' curve).

Because of its harsher style of action Vetsulin is not really appropriate (or safe) as a tool when trying to tightly regulate a cat. And aiming for a nadir in the 80s with Vetsulin is, in my considered opinion, putting a cat at greater risk of a hypo. If the pancreas decides to sputter or if, say, the cat doesn't eat enough/exercises a little more than usual there is little or no safety buffer.


Mogs
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