? 7-19-17-Jones - I think I have lost step with the pred/diabetes dance. Dose increase?

[Tracey&Jones (GA)]

I need some dose advice.
Recap:

• Effective July 1st, we upped Jones' prednisolone dosage from 1.25mg BID to 2.5 mg BID.
• On the 1.25mg dose I think he was pretty well regulated. We went up in insulin dose then back down again over a six week period with a few bobbles.
• On the new 2.5mg BID dose, I am increasing the dose but it seems I can't seem to get ahead of the curve and he is spending way too much time in the yellows for my liking.
• Outside of that, he seems ok. Still not gaining weight (with these high numbers not surprising) but is stable. I actually ended up reducing the metronidazole back down to 1/2 tab BID with the S boulardii as he was constipated on the tab and a half approach.
• The weight gain issue: I have been thinking about that. Before all his other issues, he was never a fat cat. He was free fed dry food for the 10 years I had him before this (didn't know better) and he never ate too much or gained a ton of weight. In fact, in the lower BG's area, I can feed him some higher carb foods and not affect his BG's too much. Not sure where I am going with this but something that is in my head.

Conclusion: I think I need to be a little more aggressive with my dose increase. I was thinking of going 0.1 U this weekend while I can monitor vs. just losing the drops. Any thoughts or suggestions?

 

[Yong & Maury GA]

I can't say anything since I don't understand the doses he's currently getting but I hope whatever you decide to try, he will get back in the blues for you, Tracey

 

[Tracey&Jones (GA)]

he's currently getting

LOL - Literally - he is getting drops of insulin. It is like the line before the zero line on the syringe but it all is where the rubber piece lies - on the line, below line, above the line....

It has been micro-dosing to the finest!

 

[rhiannon and shadow (GA)]

my suggestion is to test your syringe so you know if anything is coming out or not.

When I was trying to give just one drop, I figured out that I wasn't getting any insulin at all because of my syringes. I had to back track to figure out how much would get one drop actually in the cat.

You can take an old syringe..... load your current dose.... hold the syringe needle pointed up and twist the plunger instead of pushing.
That way if anything comes out you can count drops. one drop is when it rolls down the needle.

 

[Tracey&Jones (GA)]

I figured out that I wasn't getting any insulin at all because of my syringes

Yeah, I hit that too. So I draw more and then check to see if I have 0.1 u then gently roll so I can see the drops coming out and count how many drops are coming out. Then I eyeball it to the lines on the syringe to see if it looks consistent to previous doses.

And I have learned to keep the syringe suppressed fully until withdrawn as if you release before withdrawal then you still have your drop in the syringe.

ETA: I will take your suggestion and take count see if he is getting what I think he is getting.

 

[Tracey&Jones (GA)]

He is feeling like crap. He is drinking and peeing up a storm and eating like crazy but looks skinner.

I am going to return to giving the cerenia daily. As with kathy and TITI I am seeing a pattern with the cerenia being given and lower numbers.

I am so lost right now.

@Wendy&Neko - any advice?

 

[rhiannon and shadow (GA)]

I just sat and read back a few months of history to see what's going on.
Your situation sounds a lot like where I was with Shadow when she had possible ibd/lymphoma.
You've got meds going, food issues and changes happening often enough to not know what's helping.

the two things I had extra were clay to help with the diarrhea and ondansetron for the nausea. I used both ondansetron and cerenia.


I also did a trial of using gengraff ( modified cyclosporin) in lieu of prednisolone but in hindsite, I didn't give it long enough as I got
impatient wanting her to feel better.

So sending hugs...
and patience....

It's hard while you are in the middle of it all, it's only looking back at your charts that you see where things help or don't.

 

[Wendy&Neko]

I would go with the larger increase to 0.1 as you suggest. If it's too much you can reduce. If not, go to 0.25 units next. You do want to stay on top of the yellows.

 

[Tracey&Jones (GA)]

You've got meds going, food issues and changes happening often enough to not know what's helping.

Yeah, I am my own worse enemy it seems. Like you said, you try everything and maybe it works, maybe it doesn't, maybe I didn't give it enough time. That is why I got referred to a IM vet. I am trying to stay to what he says but then you just know your cat and know it isn't right. I have a phone update call with him to do- just waiting for the call back and I will let him know I added back the cerenia and why. It works for him so may as well let it be.

Maybe DH is right. If he is doing good just leave well enough alone. Though I think the homemade food (TC Feline recipe with added B complex) seems to work better for him but I still mix it with the Merrick he is willing to eat. And the bone broth is a huge hit with everyone so I will continue with that daily.

I just sat and read back a few months of history to see what's going on.

Thank you for that by the way.

 

[Tracey&Jones (GA)]

0.1 as you suggest. If it's too much you can reduce.

Yep, too much. Should of kept my patience pants on.

I will be going back down the drop scale this evening as he went below 70 (an adjusted number we had due to the pred being a factor) Will be testing in another 5 mins to see if he is still coming up on his own without food.

I really wish I could get a lower AMPS so it isn't such a deep dive. That said it is nice to see greens again though I am missing my work out!