? 01/16 Eddie AMPS 337 +3 306 AMPS 387 +3 301 Time to reassess @ PMPS and +3??)

Good morning,
Yesterday was difficult with such high numbers, intermittent diarrhea and copious urination.

I'm thinking we might have to reassess?

Eddie is drinking a lot of water. His AMPS 337 suggests a reassessment of 6u is in order and Wendy, Melissa and Bhooma agree we should hold the does until the full cycle, which I think is tonight.

If the numbers are still high and I suspect they will be, will I be going to 6.5u tomorrow?

Feeling a little down this morning. Have been pretty tired, although getting sleep last night did help.

Thank you @FrostD @Bandit's Mom and @Wendy&Neko

 

Is the excessive thirst and urination only on days when his numbers are high?

 

Hi Bhooma, yes, I believe it’s been increasing over the last 4-5 days. It’s been excessive over the last 3 days to be sure.

 

When was the last time his labs were done and how are his kidneys?

 

Ok, so, he's still in the magenta zone +3 306. I cannot account for the sustained bounce. It recalls November 25 2021 when we dropped the dose and then increased in only a couple cycles.

I started to use Boulardii today and hopefully that will make a difference. I know Bhooma is probably sleeping and would appreciate any thoughts towards the issue of dose increase or not. I've noticed his big H2O consumption is at night and not during the day but that also follows him getting Prednisolone at 4 hours prior to PMPS.
The compounding pharmacy is making up half doses of Prednisolone (.625) that I can give BiD instead of the one dose. Hopefully that will also help with insulin resistance.
I've attached earlier his latest blood panel. His kidneys are ok according to the report.
I think we are just in a really active cycle, like waters in an inlet churning up because of cross-currents and rip tides (for those familiar with the sea).

I just need further advice on insulin.

Thank you. @FrostD and @Wendy&Neko

Sorry to be such a squeaky wheel.

 

What days did you give the rice water?
When was the last time you gave it?

 

It might take another day or so for the rice water effects to really clear out, which is what I assume JL might be getting at.

I would not increase at night, I would wait for morning cycle

 

Rice water (sorry I should have put this in notes in SS): evening of the 14th and morning of the 15th. So, the 437 AMPS on the 15th might have been in response to that. I gave a little on the 15th but woke up to the carb-facts of rice. Somehow I was only in terms of cat food re: LC, MC and HC.

So, he hasn't had rice water for 24 hours

 

is it safe to say, then, that if he's in magenta-land (or high yellow), an increase is ok.
That rice-water is deadly. Thanks, Melissa.

 

That's my vote

 

I’ll defer to the others, but I wouldn’t rush an increase just yet. I’m not convinced that it’s a failed reduction (you had nice blues on the 5th cycle of 6u, before the rice water, for example) rather than some carb loading effect. It can take time for carbs to clear their system, and yes, more than 24 hours in my experience. I used to joke that all I had to do was wave high carb food under Chip’s nose to see an elevated BG.

But hey, every cat is different. And that’s just my two cents…

 

Previous thread for continuity
https://www.felinediabetes.com/FDMB...364-4-284-pmps-331-2-268.257885/#post-2901428

 

My thought is even with those blues, you had a lot of room down to reduction point. So even if this stuff clears out of his system, I don't think he'd be in the danger zone. Back of my mind is those antibodies as well

 

So given the variables (IAA, SRT, ECID, and ricewater and PMPS tonight) there is room for small increase. IF it comes to an increase, and I’ll defer to Wendy as well, would it be AMPS (tomorrow) it tonight AND, IF an increase how much? .5u?

 

Oh you know what I take it back, he still has runway to clear the bounce. This is 5th cycle, not sure what I was looking at . I'd hold 6U through tomorrow, reevaluate Tuesday morning

 

Thanks, I usually put at top of thread but slipped by me.

 

Oh, you're right. I just looked back, too. i think it was the drop on the same day from 6.5u to 6.0 and I was looking at the PMPS column.

 

Ok, @ PMPS 23 have 387. I will continue with 6u and will reassess @ AMPS to determine if we've come out of the bounce.

Any thoughts appreciated @Bandit's Mom @Wendy&Neko and @FrostD ...

So, where do we go from here?

 

See what he does tonight and tomorrow. Sorry I don't have much else to add! No knowing what he might do

 

So @ +3 301, We'e on the cusp of magenta and yellow zone. Thinking we'd better start with rethinking at AMPS.

Do you read it this way, Bhoooma? @Bandit's Mom ?

The only thing I get out of this is a night of sleep, which I'd willingly sacrifice if we could get out of the high numbers.

Don't know yet how Wendy is reading this....

 

Looks like he needs an increase, but I would wait for Wendy's go-ahead to do.
Not sure how long the rice water can elevate numbers.

 

I know, I'm kind of waiting to see how he goes but also to hear from Wendy. Nothing yet!! Thanks, Bhooma. I'll tag her again here @Wendy&Neko

 

I was out of town today, back now. I would see how he does tomorrow AM and re-evaluate for the PM.

On the labs, there are some early signs of potential kidney issues. Not sure why they thought a urine protein/creatinine ratio should be done based on just trace urine protein. Neko's got to level 3 before we tested for it (and got a positive for proteinuria result). His specific gravity is down there which could be a warning sign and would definitely keep an eye on his HCT.

 

I too looked at the labs last night, but didn't post since I'm still figuring out my way around CKD as well.

Bandit had a bout of PU/PD (even in lower numbers) last July but her labs didn't show a progression in kidney disease but possibly an infection. A course of antibotics did not make any difference to the PU/PD. However, labs done 2 months later showed that her CKD had progressed from Stage 2 to Stage 3 and we had to start her on fluids.

This website has a ton of info on CKD:
http://felinecrf.org/how_bad_is_it.htm
http://felinecrf.org/anaemia.htm

 

Thank you for this. I'll have a closer look.

 

Thank you, Wendy. I think we are going to have to increase today. He's still high: AMPS 328