? BODIE-PMPS-HIGH+8-HIGH, AMPS-729-LETHARGY

sadye claxton

sadye claxton

Member Since 2020
yesterday thread;https://www.felinediabetes.com/FDMB/threads/bodie-amps-719-pmps-high.248982/#post-2809011


Did okay most of the early day yesterday, but afternoon didn't eat his lunch and ate VERY little of his dinner. Still did 2.25u as he's SO high. Husband offered to get up for a PMPS+6 for me and slept through...so got a +8, which was still HIGH. This am, he's moving around every now and then but lethargic for him. Trying to get urine to test for ketones...I've failed BUT he goes in today at 11:30 am so going to ask the vet to test for those. .5 Cerenia given this am, he did eat some because I put some FF Classic on his chicken...low in carbs but too high Phosphorus for his kidneys BUT I figured its more important that he eats right now. My questions are:
1- If the vet continues to express she sees no sign of infection/reason for high BG after his visit today, should I try a new Lantus pen? The one we have now is from 6/2/2021 and looks fine BUT 10 days after we started using it is when his numbers went crazy. ( he did have a few highs here and there before but nothing like this)
2- Thinking of having them put a FreeStyle Libre on him for his comfort so we can run curves the next week without having to poke his ears so many times. He's always had issues with his ears-infections neededing meds often...and his ears are now beat up outside too. BUT I don't want to mess anything up reading/curve wise going from AT2 to FreeStyle for a week...???
 
sadye claxton said:
If the vet continues to express she sees no sign of infection/reason for high BG
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Get his teeth looked at as well...

sadye claxton said:
The one we have now is from 6/2/2021 and looks fine BUT 10 days after we started using it is when his numbers went crazy. ( he did have a few highs here and there before but nothing like this)
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You can usually use the pen till the last drop. If it's not an infection or some other underlying issue causing the high numbers, it's probably just glucose toxicity and he just needs more insulin to break through the bad numbers.

sadye claxton said:
BUT I don't want to mess anything up reading/curve wise going from AT2 to FreeStyle for a week...???
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You can switch from AT to a human meter/libre at any time. It won't mess anything up. Human meters read lower than pet meters. The libre doesn't always stay the full 14 days on some cats.

I am going to tag @Wendy&Neko for her advice on whether his dose can be upped by 0.5U again tomorrow.
 
Bandit's Mom said:
Get his teeth looked at as well...


You can usually use the pen till the last drop. If it's not an infection or some other underlying issue causing the high numbers, it's probably just glucose toxicity and he just needs more insulin to break through the bad numbers.


You can switch from AT to a human meter/libre at any time. It won't mess anything up. Human meters read lower than pet meters. The libre doesn't always stay the full 14 days on some cats.

I am going to tag @Wendy&Neko for her advice on whether his dose can be upped by 0.5U again tomorrow.
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thank you! Okay so I may get a Libre put on for him today for his comfort and ease of testing TR for the next few days as we try and get him regulated!! ALL of his teeth have been removed, so that's one X factor ruled out :)
 
If you are going to switch to a human meter do it ASAP as the bg will likely read a little lower. Once you do that we might even increase every 4 cycles if we don’t see improvement. If you try a libre for a couple weeks I would also get a human meter so you can double check any low readings.
 
0kay so @tiffmaxee we had the FreeStyle Libre put on today. It's loading now and I can start checking in an hour. We just got home from the vet
POST VET UPDATES:
1-She suggested upping the dose by a unit a day if needed.
2- NO KETONES! NORMAL BP!
3- Got 100ml SQ fluids, B12, ear meds ( signs of ear infection seen BUT she's not concerned that has anything to do with elevated BG
4- Suggested 100ml SQ at home for a couple weeks twice weekly IF he can tolerate it. Heard a heart murmor today that she is unsure of whether or not it's been there in previous checks
5-Kidney values need to come down, hence the fluids as tolerated
6- Possible pancreatitis flare...treating with the fluids, and Cerenia/Ondansetron ( she said I could pick one or the other to do OR both together once a day). We did not do pain meds as he's had a history of being VERY sensitive to pain meds and gabapentin to the point of almost comatose on very small amounts. She doesn't think he's in pain.

MY QUESTIONS:
1- okay to stick with my current spreadsheet even though I'm now reading via FreeStyle Libre for now? How different are these readings than his AT2?
2- I also need to get an additional glucometer?? I have the Libre on him, and the AT2...are you suggesting I grab a Relion from Walmart in addition to the two?
3- He's had 3 shots at 2.25u now ( that's 3 "cycles", I think...?)? With his sugars still SO HIGH can we think about upping the dose tonight since he's got the FreeStyle on?

THANK YOU ALL! I'M HOPING THE FLUIDS AND B12 HELP HIM TODAY !
 
Will answer some of the simpler Qs and leave the more advanced ones to Elise :)

sadye claxton said:
1- okay to stick with my current spreadsheet even though I'm now reading via FreeStyle Libre for now? How different are these readings than his AT2?
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There is a formatting change that needs to be made to the SS for the switch from pet to human meter.
I have sent you a request for edit access to your SS. It will come to the gmail account associated with the SS. Check the spam folder as well since it sometimes goes straight there! :)

sadye claxton said:
I also need to get an additional glucometer?? I have the Libre on him, and the AT2...are you suggesting I grab a Relion from Walmart in addition to the two?
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Put the AT2 away and yes, get a human glucometer as a back-up to cross-check any Libre reading that seems wonky.


sadye claxton said:
3- He's had 3 shots at 2.25u now ( that's 3 "cycles", I think...?)? With his sugars still SO HIGH can we think about upping the dose tonight since he's got the FreeStyle on?
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Yes. Each cycle is 12 hours. 2 cycles in a day. You hold the dose for at least 4 cycles since that's how long it takes for the Lantus depot to adjust. Elise will take a call on whether the dose needs to be upped faster than 6 cycles depending on the numbers you get on the Libre.
 
Bandit's Mom said:
Will answer some of the simpler Qs and leave the more advanced ones to Elise :)


There is a formatting change that needs to be made to the SS for the switch from pet to human meter.
I have sent you a request for edit access to your SS. It will come to the gmail account associated with the SS. Check the spam folder as well since it sometimes goes straight there! :)


Put the AT2 away and yes, get a human glucometer as a back-up to cross-check any Libre reading that seems wonky.



Yes. Each cycle is 12 hours. 2 cycles in a day. You hold the dose for at least 4 cycles since that's how long it takes for the Lantus depot to adjust. Elise will take a call on whether the dose needs to be upped faster than 6 cycles depending on the numbers you get on the Libre.
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GOT YOUR EMAIL AND GRANTED YOU ACCESS! THANK YOU ALL SO MUCH FOR ALL YOUR HELP SO FAR!
 
I've always heard that ear infections can cause a rise in BG. And, so can ear infection meds. Great to hear no ketones. Poor kitty is really high. Sending prayers you get to the root of the problem and Bodie comes down and feels better.
 
Summer and Susie said:
I've always heard that ear infections can cause a rise in BG. And, so can ear infection meds. Great to hear no ketones. Poor kitty is really high. Sending prayers you get to the root of the problem and Bodie comes down and feels better.
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i know just about any infection can cause a spike for sure! However, we have dealt with this constantly with him without these issues....I suppose it could be a more intense infection? The meds we used today he's had before without issue so I hope its okay
 
Made the changes to the SS. Please enter data for the Libre for today in the row dated 6/25/2021 below the blue strips that says "Switched to Freestyle Libre".
 
Bandit's Mom said:
Made the changes to the SS. Please enter data for the Libre for today in the row dated 6/25/2021 below the blue strips that says "Switched to Freestyle Libre".
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thank you!
Bandit's Mom said:
Made the changes to the SS. Please enter data for the Libre for today in the row dated 6/25/2021 below the blue strips that says "Switched to Freestyle Libre".
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DONE! Thank you...I'm so sad I just checked it and it's saying "Hi" out of range, and he's just lying there looking so lethargic and sad. He's breaking my heart but idk what else I can do for him right now
 
sadye claxton said:
DONE! Thank you...I'm so sad I just checked it and it's saying "Hi" out of range, and he's just lying there looking so lethargic and sad. He's breaking my heart but idk what else I can do for him right now
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Hang in there. We will take his dose up as safely as it is possible to do.
 
@tiffmaxee @Bandit's Mom... feel free to tag anyone else with good advise please....Bodie has been completely lethargic since returning from the vet and did not eat his usual afternoon snack. In anticipation for this evening's shot and dinner I'm looking for advise on dose? I see @tiffmaxee above you said increase by .5u every 6 cycles BUT maybe 4 with the FreeStyle on? If I'm waiting 4 cycles, that makes another dose of 2.25u tonight. These doses aren't touching his sugars and he's getting worse. The vet told me to bump it up by .5 to even 1 unit...I'm at a loss here. I trust all of your experience and just want to get some feedback before his 8pm please...? He may not even eat. I"m going to pick up mertazapine now too
 
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I would increase by .50 but after 4 cycles unless you see a big change. Would you change your signature to say TR? You really can’t rush things any faster than that. The infection definitely could be causing the bg to rise. Is it topical and if so does it contain a steroid? If not we’re yiu given a liquid and does it contain sugar?
Add as much water to his food as he will tolerate and eat. I would give 50 ml every day vs 100 every other but just be sure to add water to his food on the alternate days. Cerenia is every day and ondansetron 2-3 times every day. Max got ondansetron mostly.
 
I agree with Elise, try 0.5 increases every 4 cycles if you are just seeing red and black.

Ear meds are notorious for containing a steroid. Infection can also raise the BG. Some comments on other things the vet said:
sadye claxton said:
-She suggested upping the dose by a unit a day if needed.
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Nope, that's too fast.
sadye claxton said:
4- Suggested 100ml SQ at home for a couple weeks twice weekly IF he can tolerate it. Heard a heart murmor today that she is unsure of whether or not it's been there in previous checks
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OK, that's a bit worrying, but glad the vet took a listen. Neko went into heart failure when fluids became a regular thing. Keep an eye on his resting respiration rate. That's the count of complete in and out breaths per minute, while he's resting. Normal is around 20-30 a minutes. I used the timer on my phone to count. Heart issues also cause inappetance.
sadye claxton said:
6- Possible pancreatitis flare...treating with the fluids, and Cerenia/Ondansetron ( she said I could pick one or the other to do OR both together once a day). We did not do pain meds as he's had a history of being VERY sensitive to pain meds and gabapentin to the point of almost comatose on very small amounts. She doesn't think he's in pain.
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Ondansetron doesn't last a day, you can easily move it up to 3 times per day. Cerenia yes on once per day. Has he ever been on buprenorphine? Pancreatitis is very painful. Maybe take a look at this to see if you think he's in pain. Feline Pain Scale
 
Wendy&Neko said:
I agree with Elise, try 0.5 increases every 4 cycles if you are just seeing red and black.

Ear meds are notorious for containing a steroid. Infection can also raise the BG. Some comments on other things the vet said:

Nope, that's too fast.

OK, that's a bit worrying, but glad the vet took a listen. Neko went into heart failure when fluids became a regular thing. Keep an eye on his resting respiration rate. That's the count of complete in and out breaths per minute, while he's resting. Normal is around 20-30 a minutes. I used the timer on my phone to count. Heart issues also cause inappetance.

Ondansetron doesn't last a day, you can easily move it up to 3 times per day. Cerenia yes on once per day. Has he ever been on buprenorphine? Pancreatitis is very painful. Maybe take a look at this to see if you think he's in pain. Feline Pain Scale
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thank you. These ear meds we have used multiple times in the past without BG issues. I asked about pain meds for this reason. She said she didn't think he was in pain and we didn't do pain meds considering his history of EXTREME sensittivy to pain meds/sedating drugs. He can barely handle low doses of gabepentin and we almost lost him going under for a neuter and dental. I'm look at resting respiratory rate. It's closer to 35 bpm but that's been a thing for awhile and I'm watching for any increase.

\
 
Wendy&Neko said:
I agree with Elise, try 0.5 increases every 4 cycles if you are just seeing red and black.

Ear meds are notorious for containing a steroid. Infection can also raise the BG. Some comments on other things the vet said:

Nope, that's too fast.

OK, that's a bit worrying, but glad the vet took a listen. Neko went into heart failure when fluids became a regular thing. Keep an eye on his resting respiration rate. That's the count of complete in and out breaths per minute, while he's resting. Normal is around 20-30 a minutes. I used the timer on my phone to count. Heart issues also cause inappetance.

Ondansetron doesn't last a day, you can easily move it up to 3 times per day. Cerenia yes on once per day. Has he ever been on buprenorphine? Pancreatitis is very painful. Maybe take a look at this to see if you think he's in pain. Feline Pain Scale
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i didn't do the ondansetron this evening bc he already had cerenia today AND martazapine (spelling...appetitie stimulant) tonight and my vet tech friend said both have anti-nausea properties. Cerenia given at 8:00 am, Martazapine at 8pm...about a teaspoon of vomit between 8-10pm and not eating...should I add the Ondansetron now??
 
tiffmaxee said:
I would increase by .50 but after 4 cycles unless you see a big change. Would you change your signature to say TR? You really can’t rush things any faster than that. The infection definitely could be causing the bg to rise. Is it topical and if so does it contain a steroid? If not we’re yiu given a liquid and does it contain sugar?
Add as much water to his food as he will tolerate and eat. I would give 50 ml every day vs 100 every other but just be sure to add water to his food on the alternate days. Cerenia is every day and ondansetron 2-3 times every day. Max got ondansetron mostly.
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I'll have to look- it was applied IN his ears. We've done this med several times in the past without any issues with his BS. I will change to TR as soon as i figure out how to...I did change it on my SS. Okay, I'll add .5u tomorrow morning. Tonight we did the 2.25 again BUT I"m so worried, he took about 3 bites of dinner and is not eating even after the appetite stimulant AND we gave the 2.25 anyway
 
idk guys....he had today:
-Cerenia at 8am and DID eat- gave 2.25u- ALL HIGH readings...not even registering a number
- did NOT eat his usual lunch and tood MAYBE 3 bites of dinner-gave the 2.25 anyway along with the appeitite stimulant at 8pm which did nothing
- he's just lying there, not eating and I have given him 2.25u anyway...still registering too high to read. I'm at a loss and so sad about him right now
 
Which appetite stimulant did he get? Have you given both cerenia and ondansetron? If no ondansetron give it now.
 
Wendy&Neko said:
Ear meds are notorious for containing a steroid.
Click to expand...
sadye claxton said:
I'll have to look- it was applied IN his ears. We've done this med several times in the past without any issues with his BS.
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sadye claxton said:
using Claro- in his ears. He has had in the past without any BS issues AND it was JUST done today at 1:00 pm so it isn't what's causing the high BG readings
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Claro has mometasone furoate which is a steroid. This web page says it should not be used on cats because it has not been tested or approved on cats. Maybe it's used off-label?
https://www.petbasics.com/our-products/claro-for-dogs/
 
tiffmaxee said:
Which appetite stimulant did he get? Have you given both cerenia and ondansetron? If no ondansetron give it now.
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okay thank you-i did not give yet. He had Cerenia this am-1/2 tab, mertazapine ( topical on the ear at 8pm) and no ondansetron yet...the dose is 1/2 to one tab which is 2-4 mg- they are 4mg tabs) should i give the 1/2 tab now?
 
Wendy&Neko said:
Also, what dose of ondsetron are you giving and how much does he weigh. This med is often underdosed.
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have not given yet. It's suggested .5-1 tab. they are 4 mg tabs. He had cerenia this am and mertazapine (topical in the ear appetite stimulate ) at 8pm...looks like i should give the ondestron now too....
 
I would try 1/2 a tablet of ondansetron. It should work in about 45 minutes from my experience but sometimes takes a few doses. It can bf given every 8 hours.
 
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