09/04 Eddie AMPS 463 +2.5 493 PMPS 367 +2.5 427 +6.25 362

@ 2.5 493. This can't be NDW as we are on 5th cycle of 15u and he's still way too high in the red zone with only occasional drops to the 300s.

I'm not sure what to do beyond increasing to the original Lantus dose (16u) tonight.

Please share your thoughts here. Getting quite worried about this extended stay in the red zone even before the switch to Levemir.

And, now for the first time ever, Eddie's ketone test is above 0. It's 0.3. He's never even registered on the meter before.

@Wendy&Neko @FrostD @Rainbow Conti
 
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Yikes. This is way out of my league but I'm here sending healing vibes and love! I agree it's been too long for ndw...and way too long so high.

:bighug::bighug::bighug::bighug:
 
Rainbow Conti said:
Yikes. This is way out of my league but I'm here sending healing vibes and love! I agree it's been too long for ndw...and way too long so high.

:bighug::bighug::bighug::bighug:
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Yes, I'm freaking out here a bit. I also have to take Blue to his dental surgery on Tuesday (it's a 4.5 hour drive and I have to stay overnight at destination as he goes in at 9:00 am). I have a pet sitter but she shoots only and doesn't test.
 
Next, tonight is cycle six on this dose, you can increase tomorrow.

Weren’t Eddie’s teeth a bit of an issue? I wonder if the vet would suggest a short course of antibiotics to help his mouth out. Needing a dental are on of the biggest issues for numbers going off. I agree that something seems off lately. You see red in his mouth?
 
Wendy&Neko said:
First, ketone levels are normal. Getting close to 2.6 is when you call the vet. How is his appetite?
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His appetite is good. His enthusiasm for food has not waned. I've never had a problem with ketones for either Eddie or Blue and so when it registered in positive numbers I got a jolt.
 
Wendy&Neko said:
Next, tonight is cycle six on this dose, you can increase tomorrow.

Weren’t Eddie’s teeth a bit of an issue? I wonder if the vet would suggest a short course of antibiotics to help his mouth out. Needing a dental are on of the biggest issues for numbers going off. I agree that something seems off lately. You see red in his mouth?
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Yes, tonight is cycle six. If things continue like this, I will definitely increase tomorrow to 16u. He should be ok with that while I'm gone Tuesday morning until Wednesday night.

Eddie does need dental. He is the one though for whom sedation is precarious. He will also need an anesthesiologist (and the use of gas. There are 3 sedatives that send him either in the opposite direction (paradox effect) or threaten his breathing) for sure.

Long weekend: there are no vets available to ask for antibiotics. I do, however, have Clavamox (a new prescription) for Blue and might just start Eddie on it. I will probably get another prescription for Blue from the specialist. I know the vets will give me hell if I do that but what other option do I have on a Sunday and a long weekend?

Thanks for getting back to me. What with preparing to travel and to include work preparation (thesis defence Thursday, have to read, etc.), prepare for the pet sitter and cleaning the house, I'm feeling a bit of pressure. :eek::cat::cat:

At least Blue is in the blue zone.
 
Wendy&Neko said:
Not sure I'd give just any antibiotics for inflamed mouth, if that's what he has. Kidney cats who cannot have anaesthesia but need a dental, will sometimes go on a pulsed dose of antibiotics. More here: https://felinecrf.org/dental_problems.htm#antibiotics Maybe you should schecule a vet appointment when you get back.
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Eddie's not a kidney cat. Just acro and DM. Blue is on Clavamox, prescribed to address the abscessing he had earlier and the decision to keep him on antibiotics until the surgery.
Once I'm back I will get Eddie in for a consult. He's the one who really needs an anesthesiologist for dental work (or anything else requiring sedation).
 
Any signs of a UTI? They don’t always let us know in obvious ways, so just wondering if you’ve seen any changes in his litter box or other habits, since UTIs can affect BG too.
 
Wendy&Neko said:
I know that. But like kidney cats, there may be reasons he cannot undergo procedures requiring anaesthesia, even with an anesthesiologist. The pulse dosing of antibiotics maybe a solution for him too.
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Oh, I see. I will make an appointment for later this week and ask about that...
 
JL and Chip said:
Any signs of a UTI? They don’t always let us know in obvious ways, so just wondering if you’ve seen any changes in his litter box or other habits, since UTIs can affect BG too.
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Hi JL, actually his kittybox action has been pretty consistent; nothing out of the ordinary.
 
You can't use the same test times as you did with Eddie on Lantus. With a cat on Levemir, it's a better indication of how a cat is doing on a dose to get a test after onset. Which in most cats on Levemir, means at least +3 or later. With Neko it meant after +4. By +2.5 the insulin dose has not yet started to take effect. I would expect numbers to still be rising by +2.5.
 
Wendy&Neko said:
You can't use the same test times as you did with Eddie on Lantus. With a cat on Levemir, it's a better indication of how a cat is doing on a dose to get a test after onset. Which in most cats on Levemir, means at least +3 or later. With Neko it meant after +4. By +2.5 the insulin dose has not yet started to take effect. I would expect numbers to still be rising by +2.5.
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I guess at times I just do what I have the capacity to do with having to stagger times for two different cats. Anyway, here is +6.25 362, which suggests that if he went lower between +2.5 and 6.25, it wasn't significantly so.

I don't know if you'll get this before AMPS but will increase to 16u

Maybe between now and AMPS @Bandit's Mom might be around to advise?
 
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Wendy&Neko said:
You can't use the same test times as you did with Eddie on Lantus. With a cat on Levemir, it's a better indication of how a cat is doing on a dose to get a test after onset. Which in most cats on Levemir, means at least +3 or later. With Neko it meant after +4. By +2.5 the insulin dose has not yet started to take effect. I would expect numbers to still be rising by +2.5.
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Ok, I got a +4 and will try to keep that schedule for Eddie and the regular one with Blue.
 
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