03/24 Baby G AMPS 300 PMPS 293 +2 288

babyg

babyg

Member Since 2019
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Good morning, everyone

Going to be leaving soon for the vet appointment. If you guys can think of anything additional I should ask or have them check for, please feel free to let me know. So far I'm thinking bloodwork and urinalysis.
Wish us luck!
 
We just got back. They did ultrasound, urinalysis, and bloodwork. I've been crying and upset. Pretty sure she has a UTI because her urine looked darker and cloudy, so vet gave me Clavamox to give her starting tonight. Vet thinks she got the UTI from the diabetes. She also has cataracts. I noticed about a year or two ago that her one eye was getting cloudy, took her to the vet, and was told it was a cataract but it was unrelated to diabetes and was in a spot where it wouldn't affect her vision. I guess that all progressed since then. The vet told me to keep her on 2.5 units but I was like no, that I think her numbers are too high still, so she said if I want to do the 2.75 or 3 to go ahead and just monitor her like I usually do. As far as the eating, vet said to give her Mirtazapine every 72 hours but she doesn't need the other stuff (Ondansetron or Gabapentin). She knew nothing about slippery elm. She doesn't like the Dr. Elsey's because it's grain free. She still prefers the DM or said to maybe do half and half of the two. They'll have some results tomorrow and the rest some time next week. I'm just very emotional right now. If anyone can tell me anything about cataracts or UTIs, I'd like to hear, and will be doing some reading up on those.
 
babyg said:
We just got back. They did ultrasound, urinalysis, and bloodwork. I've been crying and upset. Pretty sure she has a UTI because her urine looked darker and cloudy, so vet gave me Clavamox to give her starting tonight. Vet thinks she got the UTI from the diabetes. She also has cataracts. I noticed about a year or two ago that her one eye was getting cloudy, took her to the vet, and was told it was a cataract but it was unrelated to diabetes and was in a spot where it wouldn't affect her vision. I guess that all progressed since then. The vet told me to keep her on 2.5 units but I was like no, that I think her numbers are too high still, so she said if I want to do the 2.75 or 3 to go ahead and just monitor her like I usually do. As far as the eating, vet said to give her Mirtazapine every 72 hours but she doesn't need the other stuff (Ondansetron or Gabapentin). She knew nothing about slippery elm. She doesn't like the Dr. Elsey's because it's grain free. She still prefers the DM or said to maybe do half and half of the two. They'll have some results tomorrow and the rest some time next week. I'm just very emotional right now. If anyone can tell me anything about cataracts or UTIs, I'd like to hear, and will be doing some reading up on those.
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Did the ultrasound come back clear?

As far as UTI and cataracts, I'm not fluid in either really.

Its pretty common though in diabetic cats, and Clavamox is a good broad spectrum abx, so make sure you complete the full course of meds prescribed.
 
Did the vet also run a culture & sensitivity test? Were you seeing signs of UTI (straining, crying out, peeing outside LB, blood in urine)? UTIs are painful, did the vet prescribe anything to help with that? You may want to consider getting a probiotic to give her, since the antibiotics can cause diarrhea so a probiotic will help replace good gut bacteria that is often wiped out by the antibiotics.
 
She's still not the most reliable at eating, but I'm not happy with her numbers and she's been on 2.5 for a week now. She's been on 2.75 and 3 before in the past. Would you guys still do the .25 increase to 2.75? Vet had said I could do either; she initially recommended staying on the 2.5 but I was complaining about her numbers on it lol.
 
Christie & Maverick said:
Did the vet also run a culture & sensitivity test? Were you seeing signs of UTI (straining, crying out, peeing outside LB, blood in urine)? UTIs are painful, did the vet prescribe anything to help with that? You may want to consider getting a probiotic to give her, since the antibiotics can cause diarrhea so a probiotic will help replace good gut bacteria that is often wiped out by the antibiotics.
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Only UTI-related thing she was doing was peeing outside the box. None of those other symptoms. The vet had mentioned the Clavamox may cause diarrhea, but hopefully she'll be okay since I don't remember her getting diarrhea on that before and I'm pretty sure she's had it in the past. She gets Fortiflora every day due to the chronic pancreatitis.
 
Do you think you could run a curve tomorrow? I suspect 2.75u is fine, but there were 3 days without midcycle tests, so it would be good to confirm with a curve before increasing.
 
Christie & Maverick said:
Do you think you could run a curve tomorrow? I suspect 2.75u is fine, but there were 3 days without midcycle tests, so it would be good to confirm with a curve before increasing.
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I did her midcycle tests at night, though not many. I work my second job all day tomorrow so couldn't do a curve any sooner than tomorrow night unless I do one tonight. I'm already exhausted so what does it matter, lol. I'm just worried to keep her in high numbers longer than necessary, especially if they may have caused a UTI or cataracts.
 
I personally feel like her consistently best numbers for the longest period of time were on the 3. It's tough. I haven't seen anything good on the 2.5 recently that couldn't have been explained away as being because she didn't eat well enough.
 
I understand, I appreciate there is a lot going on and it can feel overwhelming. The question of whether caregivers need to increase the dose comes up often enough, and when asking yourself that question, you need to be able to answer how low is this dose taking her. That’s why I mentioned some days where we didn’t really see how the cycle was going, it wasn’t a criticism :). Nadir checks both am/pm cycles particularly over several days provide valuable information to determining how low she is going and whether you should increase.

Do you think you can check mid cycle tonight and tomorrow’s am cycle even though you can’t run a curve since you are working?
 
You're fine, I didnt take it as a criticism or a bad thing. :) I just normally cant get daytime checks because I work. The time I was doing that was an exception. Most of my checks will be at night. I'm trying to get her time moved up so I can get at least a +2 in the morning.
I can do the curve tonight, I have coffee. I just feel ancy to get her numbers better and tbh even 1 more cycle on crappy numbers makes me wanna :arghh:.
 
Going by the data though, I dont think I've ever seen anything alarming on 2.75. The 3 I've had a couple moments I wasnt thrilled, though most of the time it's been good.
 
Vet thinks a good nadir is 150 to about 200. I'd agree with that just because she needs a cushion with the pancreatitis unpredictability and my working. We'll see if we get anything like that tonight but I doubt it. :coffee::(
 
Sometimes how they were previously on a dose isn’t always the same next time on the dose, although I hear what you are saying. For the days you were able to get some tests during the am cycle, those days sure don’t appear to reflect much movement, fairly flattish, so it would be hard for me to argue that some low green number occurred on the days you weren’t able to do am mid cycle tests. And apart from those dose changes on March 15-17, which btw nadirs were still over 150, you’ve got some data since March 12th on what 2.5u is doing.

ok now that I’ve talked myself through that ;), I think I’d be ok if it were my cat to increase to 2.75u, but I always like to increase on a cycle when I can monitor a little more closely if I need to.

oh and good grief, please don’t do a curve in the pm, that’s not at all what I was suggesting, a girl needs her sleep!
 
Incidentally I don’t know if the vet mentioned it, but we have often found here that UTIs can cause elevated BG levels, so something to watch for as the antibiotics hopefully clear up the infection, the BG levels may become improved.

And perhaps more importantly, if you aren’t checking regularly for ketones, it would be something I’d suggest doing with infection in the mix.
 
She already got the 2.5, unfortunately. :( But I'll definitely get more data tonight.
Christie & Maverick said:
ok now that I’ve talked myself through that ;), I think I’d be ok if it were my cat to increase to 2.75u, but I always like to increase on a cycle when I can monitor a little more closely if I need to.
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I'm the same way about timing my increases with when I can be around to watch. I think as long as she eats good tonight and her preshot isn't unusually low for her, I can feel relatively comfortable putting her to 2.75 tomorrow morning. Back in the day when I didn't use calipers, she probably got quarterly dose increases and decreases on a regular basis just because of how inconsistent syringes can be! :rolleyes: So I'm not too worried.
That's the one thing that I guess bothers me some about the SLGS method, if I can be honest, is that while I like it and agree with it a lot, I've never seen the sense of starting all over with doses one's proven to suck. True, a cat may react a bit differently to the same dose as their needs change, and I've seen that to a degree with her, but what's the point of gathering data if one's never going to use it. o_O What about know thy cat. I've seen that the 2 and the 2.5 suck. The 2.75 is mediocre. It's when we get to 3 on up that we start to get something decent. I'm not very good at reading patterns and spreadsheets but that's what I've noticed personally. I think SLGS is excellent to strictly follow if a cat is going into completely unknown territory, but if they've treaded these waters before, I kind of think it's being repetitive to a fault. But that's just my feelings and take on it, and I'm not always right when figuring out her dose. To be even more honest, what I feel like doing is giving her the 2.75 tomorrow morning since I'll be at work but I want her to have something decent in her, and then tomorrow night doing 3 and holding that for the 7 days. I'll be home with her all tomorrow night and Sunday and can watch like a hawk. Now of course all this depends on her eating. :rolleyes: I gave her Mirtazapine just now, plus her Clavamox, so hopefully my girl will be feeling better! :cat:
 
Christie & Maverick said:
Incidentally I don’t know if the vet mentioned it, but we have often found here that UTIs can cause elevated BG levels, so something to watch for as the antibiotics hopefully clear up the infection, the BG levels may become improved.

And perhaps more importantly, if you aren’t checking regularly for ketones, it would be something I’d suggest doing with infection in the mix.
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The vet didn't mention it but now that you've said that, it makes sense, thanks. I checked for ketones this morning and will continue to check until the infection is cleared and her BGs improve. :)
 
What I'm still upset about is that all those years vets kept her at sucky numbers. I used to ask them "should we increase her dose? should we increase her dose?" I was terrified to take anything into my own hands and change it myself because if something bad happened to her I'd never forgive myself. It wasn't until last year with the chronic pancreatitis diagnosis that I started talking to my brother, who used to have a diabetic dog, and going on here more, that I started dabbling in changing the dose myself. And now I'm disgusted with how her numbers were before and wish I'd have changed things sooner.
But I still don't like green! lol My petrified heart can't take that. :nailbiting:
 
Thanks @Christie & Maverick for all the good advice and for "listening" lol. I appreciate it, especially with all this craziness going on and my nerves getting shot. It helps to be able to talk to others about what's going on. If only these furballs knew what they put us through. :rolleyes:
 
babyg said:
True, a cat may react a bit differently to the same dose as their needs change, and I've seen that to a degree with her, but what's the point of gathering data if one's never going to use it. o_O What about know thy cat. I think SLGS is excellent to strictly follow if a cat is going into completely unknown territory, but if they've treaded these waters before, I kind of think it's being repetitive to a fault.
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I totally agree! And since you brought up one of my favorite topics, here's my view (and actually technically spelled out in the SLGS guideline). The guideline actually does say, "Keep in mind these are general guidelines, and they should be personalized to your own cat's response to insulin." and "let experience, data collected, knowledge of your cat, and availability to monitor help in making the best decisions for your cat."

Absolutely and 100% agree with Know Thy Cat . And SLGS is flexible in that once a caregiver feels they have a good understanding of how insulin and carbs affect their cat, they can choose to personalize. To me, as long as a caregiver knows their cat's response to insulin and carbs well (inside, outside, forward and backward) with lots of data where they can answer:
1) How much of a food bump does kitty usually get after their main meal?
2) How easy is it to bring your kitty up when the numbers are lower? What carbs does it take, how carb sensitive is he/she?
3) do you feel you have a good idea of when your kitty onsets, nadirs and how much duration they get on a certain dose?
4) have a specific reason for needing to modify the general guideline,

and then as long as the caregiver understands that there are safeguards built into the guideline so straying from them may involve taking on additional risks and responsibilities to keep their cat safe, well there is nothing that says you can't personalize. The only caveat to that in my mind is that you don't want to be mixing and matching between TR and SLGS, but perhaps that's a lesson for another day :bookworm:
 
Thanks! Yes, I saw that too in the guidelines and I think that was part of why I'd get confused when I'd get a bit of "push-back" from others whenever I'd try to do something not technically correct, though I understand their side of it too and I like to hear all opinions regardless. There were just things that didn't make sense to me based on the data I had already procured. But I also don't 100% always trust myself that I know what I'm doing so I definitely appreciate and like having an extra set of eyes on her spreadsheet because if anyone ever sees me doing something reckless or dumb, definitely feel free to call me out on it so I can correct it right away. It's all about her and wanting her to be healthy and safe.
 
Sounds like you have the right mindset, and honestly it can happen sometimes where people won’t always agree with you, let alone each other, and that’s ok. But the good thing about this forum is people do want to offer insight based on their experience but ultimately you get to weigh out what you think is best for your cat. On that note, give 2.75u the old college try before you go too quickly up to 3u :)
 
Lol thanks! :bighug:
Now time to get a +2 :) shes been gobbling food down surprisingly well since her shot/meds
 
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