Am I dosing correctly ?

Oh that’s ok , life gets busy and we all have things going on :) I appreciate you getting back when you’re able . Do you rescue or TNR? I hope your kitty with the heart issues is ok .

Max’s recent blood work showed his liver and kidney levels being good . I have not used the Terbinafine yet no . I am honestly a bit freaked out after I read somebody’s 3 cats all had major reactions to it . However others have used it and said there cats are fine. I’m so on the fence and unsure . The dermatologist is limited on treatment options for max with his fiv and diabetes and I don’t want to resort to steroids .
He has started his reactine and waiting on culture results to start the antibiotics . I may try the terbinafine on a day when I’m home and can monitor him . He’s supposed to be on it for 15 days
 
Katie & Max said:
At what pre shot number for Max would we skip a dose
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Well it kind of depends on whether you will be home. But you’ve already shot a 94 and a 97 and the cycles were decent. You also skipped with a 92 and that gave him a pink preshot in the 300s next morning. So I would try to at least give some insulin if he’s in the 90s. Before I recommend a dose if he’s lower, I would like to see how some of these cycles in the 90s go. There could be some instances where a dose of .25 is given- as opposed to a complete skip.
 
Hey Suzanne.
He is good . He is starting his antibiotcs and and terbinafine this morning. He has a staff infecfion. His numbers may start to lower if the infection starts healing up .
With his number being so low after a skip last night do you think she should give .75 again or .50?
 
What kind of antibiotics? They did a culture, right? And it came back as staph? That was the reason for the delay?

I feel like you made the right choice of .75 units today since his AMPS was pretty much the same as yesterday. He really is doing great! But I feel confident because I know you will be watching him closely today. If he needs another reduction it will probably be evident today. I will check back in on his spreadsheet later today.
 
Hey Suzanne . I am at work . My mom is testing today . He usually gets 1 snack 3+ in but only when we are home . When we’re both at work he doesn’t get one untill we can get the automatic feeder going . He always gets a snack +3 hours in the pm cycle before my Mom goes to bed though . We are working on the automatic feeder rite now and learning how to use it and teaching him to use it when the beep goes off without the other cats figuring it out . He only gets 1/4 pound of food a day and with his meds he needs a full belly at dose time so we’re trying to figure out portion control to give him the 2 snacks a day with out gaining his extra weight back also .
 
Yes a culture was done and it came back as a staff infection . They want him on a month of clavaseptin .

she just tested now and I will ask her to test when she gets home in a couple hours too . Mom accidently slept in so he got his shot 2 hours late this morning . It can be hard balancing life and Max’s needs sometimes ;) he is the best though so we try
 
She could have given him a teaspoon of food when she tested and got the 77 and then the 67 — before she left for work, right? If he’s in green then he surely needs small amounts of food - a teaspoon or two - before or at nadir time. I understand about the automatic feeder and other cats - that’s a problem. It sounds complicated with your work schedules. Fortunately it doesn’t look like he will drop too low since he was only at 67 at +6 and that’s probably his nadir for today. I am proud of your mom for testing. With the morning shot being two hours late, I would not shoot at his regular time tonight but would only shoot 1.5 hours after his usual shot time. Then in the morning I would shoot one hour late and the next day 30 minutes late and the next day on time. So you would be moving back to his regular shot time by 30 minutes a day. If he should happen to be really high at PMPS time then maybe ot would be okay to shoot — but I can’t see that happening.
 
Okay . Thats perfect schedule . I will let my mom know . Im sort of expecting his pmps to be around what it was this morning . If it is should she give .75 again ?
 
Okay. I think if you shoot .75 tonight— based on his previous numbers— he will be fine as long as you (or mom) can feed and monitor him (and give snacks at +2 or +3) then go ahead. Otherwise I would try a .5 dose.
 
Katie, what kind of work do you do? You do such a great job with Max, and I am impressed how you and your mom are really trying to work as a team to help Max.
 
Okay she is going to give .75 and feed at +3 . If his number is pretty low I will try and get her to set an alarm for mid cycle . We are so shocked his numbers are getting so low and insulin is so low . I think that’s why she is more willing to test because she sees the improvement ! Thank you so much !

I work in residential youth care . It’s 24 hour shifts for 3-4 days in a row but can change weekly so fluctuates a lot . I also work in a vets office very part time but helps with all my rescues with weird ailments lol

my mom is retired from government job but works full time at Walmart now :(
 
Your work sounds really demanding.

That’s a beautiful story about Max. I do rescue too and pretty much have my hands full all the time with feral trapping and kittens, etc.

He is doing really well, and I have high hopes for him. It sounds like a good plan for tonight — as long as your mom will be able to set an alarm and wake up to test/feed Max if necessary.
 
I love that you do that ! There are so many cats in need. I wish more people were educated in spaying and neutering.

I’m really hoping for the best with Max too . Hoping this infection clears and his BG stabilizates . It would be so nice to get him into remission one day .
 
I hope Max will be able to tolerate the Clavaseptin (what we call Clavamox here in the states). It can be so hard on the GI tract. I have some cats that do fine on it though— and some who can’t tolerate it. The vet should be able to come up with an alternative drug that will still be effective against staphylococcus if he can’t
 
Max was on clava for 6 weeks a few years ago for these skin issues and then 10 days a few months ago . I’m a bit frustrated the regular vet and dermatologist suggested it again because I don’t personally think it’s ever made a difference for him .

last night was good . His numbers are higher this morning but it’s difficult to get my mom to test all through out the day
 
And it does seem like they might try a different antibiotic to see if it makes any difference. I would like to see the culture and sensitivity report where the laboratory lists different antibiotics that the staphylococcus is sensitive to. It’s almost always more than one antibiotic and frequently mentions an antibiotic or two that should not be used. Meanwhile, of course, you are paying for all this and they keep trying the same drug.
 
My mom didn’t test him mid cycle today but I will be home tomorrow and can .

how do I upload a file ? When I click on upload file it tells me I don’t have permission
 
Katie & Max said:
My mom didn’t test him mid cycle today but I will be home tomorrow and can .

how do I upload a file ? When I click on upload file it tells me I don’t have permission
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Yes. That method doesn’t work. I either take screenshots of stuff or take a photos or use the copy function on my phone and then “copy and paste” them into the thread.
 
I can’t figure out how to send it . I tried copying but doesn’t seem to paste anything when I try . That’s so weird
 
I just got home from work , tested max . He was 227 which was really weird … I still gave him a little tiki snack and then walked into the kitchen and saw he ate through almost 1/4 Loaf of bread ….. what is this going to do with dosing later if he is still high ?
 
Hey Suzanne . Max has been to low to give insulin to for 24 hours now. We have been testing and giving snacks .
Does this mean there is a chance he could be going into remission ? Or I’m wondering if the infection and medication are causing this .
I’m not really sure what to do with these low numbers or what this could mean for him
He is 65 rite now . The dose I skipped on this morning was 72. I’m reading up on the guidelines . Should I be considering micro dosing ?
 
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Katie & Max said:
Hey Suzanne . Max has been to low to give insulin to for 24 hours now. We have been testing and giving snacks .
Does this mean there is a chance he could be going into remission ? Or I’m wondering if the infection and medication are causing this .
I’m not really sure what to do with these low numbers or what this could mean for him
He is 65 rite now . The dose I skipped on this morning was 72. I’m reading up on the guidelines . Should I be considering micro dosing ?
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Let me look at his spreadsheet to see if I can see what might be going on.
 
You are doing great. Just keep testing so we can document what’s going on. Hopefully he will stay in the greens! Maybe the an are helping clear an infection that was causing him to have high blood glucose. Let’s keep checking and make sure.
 
Suzanne & Darcy said:
You are doing great. Just keep testing so we can document what’s going on. Hopefully he will stay in the greens! Maybe the an are helping clear an infection that was causing him to have high blood glucose. Let’s keep checking and make sure.
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I am back at work now untill Thursday . My mom will be at work during the day but I will make sure she gets tests done when she is home . It starts to get nerve racking so low but he is acting totally normal. Without insulin is he at risk of ketones ?
 
Katie & Max said:
I am back at work now untill Thursday . My mom will be at work during the day but I will make sure she gets tests done when she is home . It starts to get nerve racking so low but he is acting totally normal. Without insulin is he at risk of ketones ?
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Have your mom test at the usual preshot times and when she gets home and before she goes to bed then. Can she do that? Is she the one giving him his medication? I would not worry about ketones because he is in green numbers and doesn’t appear to need insulin at this time. Those green numbers are very normal numbers for a cat and with him not receiving any insulin right now, he will not hypo. How did he seem to you when you were at home? Thank you for getting all those tests while you were home.
 
Mom can do the regular pre shot tests and evening but she is not home till 1 hour before pre shot so day time tests are not likely .
Yes she gives him his medications daily.
He seemed like himself . Not lethargic , still chasing us constantly for food . Going into the yard with my mom. The only thing I noticed is he seems more hungry . He is always wanting food but he actually knocked the lid off the pan to get into some rice and then chewed through the bread … the bread part isn’t unusual really he will chew through things if he can but the rice was . His poops are a bit runny rite now but I’m thinking that’s the medication
 
Hi Katie. How are you? How is Max doing? How’s it going with the meds? I checked his spreadsheet and I am really pleased. I think Max is going into remission. You’ve already completed the first five days of the OTJ Trial (which is 14 days before we can officially declare him OTJ.). I am attaching the instructions here. Mostly it’s just important to keep doing what you are doing already— the testing to verify that he’s staying in the greens.

Here are the OTJ trial instructions:
• Start the trial on the next green pre shot.
• If he/she is green at your normal test times, no need to test further until the next "PS" time; just feed small meals and go about your day. If he/she is blue at your normal "PS", feed a small meal and test again after about 3 or 4 hours. If his/her number is lower 3-4 hours after a meal, then the pancreas is working!
• Post every day so we can monitor your progress and see if any tweaks are needed. He/she may have a sporadic blue number. Don't panic but post before you decide whether to shoot so we can have a discussion.
• After 14 days of no insulin, we have a party!!
Sometimes the trial doesn't work the first time and we have to give a little more support in the form of resuming insulin. It's not the end of the world if that happens; we just give him/her the support needed. Our goal is a strong remission and it's better to take our time to get that than to rush into remission just to have it fail later on.

Once he/she is through the trial successfully, you enter a new phase. Your cat is still diabetic but has now become diet-controlled. Continue feeding low carb food in the manner successful for your kitty. If you decide to change his/her feeding schedule, let your meter be your guide to the best times to feed. Avoid medications with sugar in them and steroid medications unless they are medically essential. Continue testing blood glucose weekly for the first month and then monthly forever. It's a good idea to weigh him/her monthly. Weight should remain stable. If he/she seems "off" or sick, or is showing signs of diabetes (excessive drinking, eating, urinating, weight loss), testhis/her blood glucose right away. Keep the teeth and gums clean and healthy; dental issues can bring a cat out of remission. If you see rising blood glucose numbers, it's time for a visit to the vet!
 
Hey Suzanne ,

thank you for attaching the instructions . I have forwarded them onto my mom . We are about 9 days in now.

Max seems to be well ! His energy level is healthy, he is playing and eating and drinking like normal . Still scratching and licking a lot though . His skin infection hasn’t seemed to change at all .

his Terbinafine is done in a few days . Still a few weeks left of the Clavaseptin so we will see how his numbers are once the medication changes .

My mom and I are so greatfull to all your help working with us to get Max to this point . Thank you so much !
 
Only five more days to go! I am sorry about his paw though. I hope they can figure out what’s going on — or that they can recommend a treatment that will work!
 
Oh my goodness! Is today day 14??!!! And Max is officially “off the juice”. CONGRATULATIONS TO KATIE AND MAX. I LOVE IT WHEN THIS HAPPENS TO OUR KITTIES. :otj:

See how he even had some 40s in there. That’s perfectly normal. People often don’t believe me when I tell them that some 40s can be normal for a cat. Of course with insulin we won’t let them when they’re on insulin!

Anyway, be sure to test him periodically to make sure his numbers don’t creep up. He is still diabetic but is now considered a diet-controlled diabetic. I know you will keep feeding him low carb food.
I am very happy for you and your mom and Max! I would love it if you would let me know how his paw is doing and if you get it resolved.
It’s been a pleasure helping you, Katie!
 
Hey Suzanne,

We are so excited !! I am so happy for him and he has been so active lately ! We were worried about the blue but he lowered after eating so that was good :)

There is no way we could have gotten to this point without your help and guidance. Thank you so so very much !

We are hoping for the best and will definitely keep you updated on how he is doing !

Thank you again !
 
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