? 04/24 Shmee AMPS 409 :(

[Amanda & Shmee]

Previous condo: http://www.felinediabetes.com/FDMB/...77-2-207-vacation-dosing.194550/#post-2176860

Good morning,

For context, see yesterdays condo for vacation dosing and the concerned email from the vet. I leave tomorrow morning and come back Saturday. Shmee had one of the highest numbers he has ever had this morning. It is making me wish I would have done the increase per TR.. but we kept him on 4.5 since I will be out of state this week and thought it would be better for DH not to do the increase. My vet already expressed concern with his high numbers coming back.. I can only imagine how she will feel to see the 409. He is eating well today, and was already running around and playing, so at least he seems to feel fine. I wish I would have gotten a +10 when I woke up this morning, to see if the pill pockets made him shoot up or if he was already high. Maybe if his numbers continue to stay this high then I will have DH increase to 4.75 while I am away. I already did the colored liquid in a syringe so he can have an example (thanks for that suggestion @Gill & George!), so I was thinking of doing another syringe example of 4.75 in case he needs to increase. I would store this away in a cabinet so he wouldn't get confused.

What do you think? He works at home like I do so he can test often. Maybe I should wait to see how he does today.. I wish I felt better about leaving tomorrow....

 

[Amanda & Shmee]

Oh yes also - there was a suggestion yesterday to have a "no shot" number for DH. He is calling me any time there is a number under 100, but I also have a page written out with instructions just in case he cannot get a hold of me. As for a "no shot" number - the lowest I have ever shot him was 157. Do you think his "no shot" number should be anything under 150? At first I was thinking anything under 100?

 

[Gill & George]

What do you think? He works at home like I do so he can test often. Maybe I should wait to see how he does today.. I wish I felt better about leaving tomorrow....

The answer to this question is dependent on how confident you are on DH's ability/motivation to test shoot and monitor Shmee, and of course if he feels up to it.

If this was me and my DH I would take the dose up, he is as committed as I am to keeping George safe and healthy and confident in testing and how to manage low numbers.
However, if I was leaving him with my friend I'd be reticent to take the dose up because she is not available to monitor and keep him safe.

I agree with your vet I don't like the way his numbers are creeping up. If you are confident and DH feels confident, then why not take Schmee up to 4.75u tonight, leave DH with syringe for that. And you and DH reassess the dose on 4/27, taking him up to 5u in the pm cycle if the numbers warrant it. (as per TR)

The no shoot number of 150 sounds reasonable, given that the lowest you have shot is 157. As you are able to be in contact with him you can guide him if Shmee were to throw a low PS

 

[Amanda & Shmee]

The answer to this question is dependent on how confident you are on DH's ability/motivation to test shoot and monitor Shmee, and of course if he feels up to it.

If this was me and my DH I would take the dose up, he is as committed as I am to keeping George safe and healthy and confident in testing and how to manage low numbers.
However, if I was leaving him with my friend I'd be reticent to take the dose up because she is not available to monitor and keep him safe.

I agree with your vet I don't like the way his numbers are creeping up. If you are confident and DH feels confident, then why not take Schmee up to 4.75u tonight, leave DH with syringe for that. And you and DH reassess the dose on 4/27, taking him up to 5u in the pm cycle if the numbers warrant it. (as per TR)

The no shoot number of 150 sounds reasonable, given that the lowest you have shot is 157. As you are able to be in contact with him you can guide him if Shmee were to throw a low PS

Sounds good - depending on his numbers today (trying to get a full curve) then I will most likely increase tonight after talking to DH. He is good with testing, and wants to do what is best for Shmee. I said that is an increase. He knows where the HC food is and the honey, and can test more. I still don't know for sure, I have to have a conversation with him later. The vet is concerned with his high numbers, but she is also concerned with his "high" amount of Lantus. I hope increasing to 4.75 will be ok for DH.... I would feel terrible if something went wrong. But I really cant get around another increase with his numbers being so high..... I am really hoping the dental work when I get back home will help him to regulate better.

 

[Wendy&Neko]

What flavour of pull pockets are you using? Both chicken and salmon have corn syrup listed in the ingredients. However, the dog ones that are allergy free duck flavour are safer for diabetics. They are larger, so just break off a oiece and mole it around the pill.

Just to allay the vet's concerns about earlier greens, it is quite common to get temporary nicer numbers. Neko saw her first green ant 3.75 units, but didn't earn a reduction until 8.75 units. Course, she was a little complicated with a couple high dose conditions, but I have seen that pattern elsewhere. Cats need however much insulin they need. We don't start thinking about high dose conditions until 6 units, and that's only if they have a clean bill of health regarding the teeth. Needing a dental can make a huge difference.

Nice to see him ditch the red for those low yellows.

 

[Amanda & Shmee]

What flavour of pull pockets are you using? Both chicken and salmon have corn syrup listed in the ingredients. However, the dog ones that are allergy free duck flavour are safer for diabetics. They are larger, so just break off a oiece and mole it around the pill.

Just to allay the vet's concerns about earlier greens, it is quite common to get temporary nicer numbers. Neko saw her first green ant 3.75 units, but didn't earn a reduction until 8.75 units. Course, she was a little complicated with a couple high dose conditions, but I have seen that pattern elsewhere. Cats need however much insulin they need. We don't start thinking about high dose conditions until 6 units, and that's only if they have a clean bill of health regarding the teeth. Needing a dental can make a huge difference.

Nice to see him ditch the red for those low yellows.

We did try the duck pill pockets from a suggestion on here but he refused to eat them , so I tried poached chicken, then cheese, and both of those did not last / he wouldn't eat the whole pill, so I had to switch back to the chicken pill pockets just the other day, to ensure he was getting the Denamarin down. The pills are too big to go down his throat, and the pill maker suggests it with food to ensure it gets digested. I wish I can come up with a better solution... I have to work on that when I get back.

Thank you for putting me more at ease about the vets concerns. I just emailed her and said I am increasing tonight... so I am curious as to what her reaction to that will be.

 

[Wendy&Neko]

The duck pill pockets are rather smelly. Thankfully my crew liked them.

ETA: rolling the PP in crushed freeze dried chicken dust may help entice.

 

[Stacy & Asia]

We did try the duck pill pockets from a suggestion on here but he refused to eat them , so I tried poached chicken, then cheese, and both of those did not last / he wouldn't eat the whole pill, so I had to switch back to the chicken pill pockets just the other day, to ensure he was getting the Denamarin down. The pills are too big to go down his throat, and the pill maker suggests it with food to ensure it gets digested. I wish I can come up with a better solution... I have to work on that when I get back.

Thank you for putting me more at ease about the vets concerns. I just emailed her and said I am increasing tonight... so I am curious as to what her reaction to that will be.

Just some things that have worked over here if you haven’t tried them. American cheese (kraft slices) can be molded like pill pockets, I’ve used that alone or American cheese and then rolled in Parmesan (we named them Toki truffles after our cheese loving civvie Toki), also stinky cheese like Gorgonzola. Cream cheese has been a hit with Asia recently, a little messier, but same idea as the pill pocket. Also liverwurst, it’s pretty smelly and it’s like a pate you can mold around the pill. I don’t use that currently, but that was the go to for cat meds when I was growing up, mine always loved it.

Sorry his numbers are creeping up, but it’s awesome DH can be there and look after him while you are gone. Who knows, maybe he will become a pro FD cat dad while you are away!

 

[Amanda & Shmee]

Just some things that have worked over here if you haven’t tried them. American cheese (kraft slices) can be molded like pill pockets, I’ve used that alone or American cheese and then rolled in Parmesan (we named them Toki truffles after our cheese loving civvie Toki), also stinky cheese like Gorgonzola. Cream cheese has been a hit with Asia recently, a little messier, but same idea as the pill pocket. Also liverwurst, it’s pretty smelly and it’s like a pate you can mold around the pill. I don’t use that currently, but that was the go to for cat meds when I was growing up, mine always loved it.

Sorry his numbers are creeping up, but it’s awesome DH can be there and look after him while you are gone. Who knows, maybe he will become a pro FD cat dad while you are away!

These are all great suggestions, I will have to try American cheese and liverwurst (never would have thought of that). I have tried cheddar cheese and cream cheese, and once he figured out there were pills in there he was done.

And as for DH, I really hope all goes well.. I am nervous and really don’t want to leave but I’m hopeful all will go smoothly. I hope I don’t regret moving him up to 4.75 but it really seems like he needs it.

 

[Tracey&Jones (GA)]

I would stick to what you know. I would use the 150. At least with that you know what he would do.

You never feel good about leaving but I have found I ended up losing some stress while gone - which is good for you.

Good luck to DH. He can always post here if he has questions.

 

[Amanda & Shmee]

I would stick to what you know. I would use the 150. At least with that you know what he would do.

You never feel good about leaving but I have found I ended up losing some stress while gone - which is good for you.

Yes I really hope this relieves some stress. My gma is sick and I haven't seen her in years so I am happy I get the chance to go see her.
As for the no shot number at 150 - I honestly don't really know how to handle if he calls me for this. If the number is between 100-150 I was thinking to try and get him to eat a little more, test again in 20 mins, and then give him the shot if he has gone up? And if he is below 100 (I doubt it but never know), should I tell him to skip the shot entirely? Or give a half dose?

 

[Wendy&Neko]

If he is between 100 1nd 150, I would have him wait, but do not feed. Then test again in 20 minutes. Otherwise you don't know if the number is rising due to food, or natural end of the cycle. A half dose is an option for lower numbers, but only if he's willing to monitor. It's only a few days you will be away. Shmee will be fine if you go the cautious route.

 

[Bobbie And Bubba]

That AMBG looks out of place with the rest of the cycle. Wondering, did you retest? Whenever there is a odd ball high or low number, I always retest to make sure it's not a wonky number. However, there is room for improvement and if DG will be diligent with testing while you are gone then taking him up looks like a good idea.