? - 08/02 Eddie AMPS 434 (update threshold HHS) | Feline Diabetes Message Board - FDMB

? 08/02 Eddie AMPS 434 (update threshold HHS)

Jodey&Eddie&Blue

Jodey&Eddie&Blue

Member since 2021
Hello
I don't have a complete record for yesterday but at PMPS (Aug 1), he clocked in at 373 and at PM +8 335.

Now we are in the red zone and he wouldn't eat this morning so I had to syringe feed to give insulin (6u increased last night).

Please tell me we aren't going to end up at the clinic like last week where he went in and had a hypo on Friday morning of 30 and then 48.

I know it's a full moon and all but I sure could use a break...

@Wendy&Neko
 
Ok, this is what we have. I just spoke with the vet who is working closely now with the IM vet: they are thinking Eddie might be dealing with a threshold (he hasn't reached the high BG end as yet) Hyperosmolar hyperglycemic state (HHS), i.e. blood glucose (sugar) levels are too high for a long period, leading to severe dehydration. Eddie isn't in DKA either but they are going to treat as-if: i.e. with R insulin and check BG every hour and try to stabilize BG and maintain hydration. They think it might be a function of the tail-end of SRT with these BG crazy swings. So, a loading dose to begin and CRI with R, then switch back to Levemir.

I know it's a very serious condition and I asked about that--pretty sensitive to these issues after Blue--and she feels confident that we will have a good outcome.

Please do send whatever feels right for his recovery. OMG.
 
I am on a ferry, so will be brief.

Eddie’s Levemir dose was lowered too much. He is hyperglycaemic. Surprised he got dehydrated so fast, but maybe the heat on top of it?

No such thing as “tail end SRT”. The BG is high because his dose is too low. It went low on the 27th because some tumour cells died. He needed less insulin, but the reduction was too big. He bounced after the lows.

R and fluids will do the trick in the short term, but R on top of Levemir would be a better solution. No Levemir given means the depot will deplete and you’ll have to wait longer to get the Lev dose back on track.

For Eddie’s sake, it was good you retained earlier. :bighug:
 
Wendy&Neko said:
I am on a ferry, so will be brief.

Eddie’s Levemir dose was lowered too much. He is hyperglycaemic. Surprised he got dehydrated so fast, but maybe the heat on top of it?

No such thing as “tail end SRT”. The BG is high because his dose is too low. It went low on the 27th because some tumour cells died. He needed less insulin, but the reduction was too big. He bounced after the lows.

R and fluids will do the trick in the short term, but R on top of Levemir would be a better solution. No Levemir given means the depot will deplete and you’ll have to wait longer to get the Lev dose back on track.

For Eddie’s sake, it was good you retained earlier. :bighug:
Click to expand...
Yes, I totally agree with what you are saying. Not sure if you'll get to read this sooner rather than later. They are starting out with R with the intention to use both R and Levemir so, yes, it will be R on top of Levemir. Just spoke with the vet and she feels he's doing exceptionally well already. They don't want him to drop too much or too fast and gave an initial injection and then are treating with infusion. She thought it very positive that even as we are beginning this "aggressive therapy" that his high BG is not as high as the standard diagnosis for HHS which is 600. Oh, and, in addition to his lower numbers (around 162), he's eating again, with some enthusiasm.
Eddie is resilient and a fighter and I've got faith he will come back. They are going to continue this intensive approach for 24-36 hours (which again will be R + Levemir). The clinic vet said she is working very closely with the IM vet and he is very involved, I think, in part because of Blue.

He wrote this to me when I told him what had happened with Blue (below). He really had a deep affection for Blue, who has touched so many people:

"My sincere condolences with the loss of Blue. What a loss it is.
Blue, the majestic sweet and brave cat, I am so very very sorry. He was dealt some bad cards in his life but he was a winner, he won with finding you as his loving supportive owner and he won with his handsome personality inspired attitude with which he faced his challenges.
Your news truly saddens me and I would like to express my heartfelt condolences again, as I cannot begin to imagine the gap he leaves behind in your heart."

He also feels strongly about Eddie so I've got faith here, as well.
 
What a lovely sentiment about Blue. He sounds like a really special kitty.

Good news it's R + Lev. Any chance you can get details on R dose and when it's given? That plus any BG numbers they take might help us figure out a better Lev dose when he's home. The nice thing about using R, is that you can get lower numbers and it's in and out in about 4-5 hours. Using it plus Lev means you don't have to worry so much about larger Lev depots if they are doing down the dosing scale at a fair clip.
 
Wendy&Neko said:
What a lovely sentiment about Blue. He sounds like a really special kitty.

Good news it's R + Lev. Any chance you can get details on R dose and when it's given? That plus any BG numbers they take might help us figure out a better Lev dose when he's home. The nice thing about using R, is that you can get lower numbers and it's in and out in about 4-5 hours. Using it plus Lev means you don't have to worry so much about larger Lev depots if they are doing down the dosing scale at a fair clip.
Click to expand...
I’ll be able to get details once they’ve had a few hours to test. I do know they stared with only 1u R. More to come.
 
Jodey&Eddie&Blue said:
I do know they stared with only 1u R.
Click to expand...
Neko's R dose never got above 0.5 units. ECID on R dose kitties. We had one kitty on 30 units Levemir who also needed no more than 0.5 units. Too much R causes a rapid drop, setting off a bounce. But we've also seen kitties who needed multiple units of R. Thankfully Eddie's being well monitored.
 
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