1/2/25 Raven Dose Increase AMPS 455 +3 383 +6 365 +9 434

SophieFRA

SophieFRA

Member
Hi all,

Against my internist’s pre-holiday advice but in line with recommendations in this group I increased Raven’s dose by 0.25 to 2.75 given his high numbers due to pancreatitis/surgery/and higher carb food he is eating. I am encouraged to see that this brought is BG down back into the high 300s, after 400s yesterday and mid 500s the day before.

I just called the internist front desk to relay a gazillion questions and concerns, including
- his Ketones, which this morning were at 1.0 again after a high of 1.4 yesterday)
- his insulin dosing
- the fact that he’s peeing constantly and small amounts with blood spotted in urin twice yesterday and once today (this could be afternath of having a urinary catheter until Monday - flagged for ER and they told me to bring him in if he stops peeing)
- the fact that he’s no longer purring
- and to ask a bunch of questions about his medication, food, feeding schedule.

Front desk rep was very nice and said she’d relay and doctor would call me back. I’m worried about my little man - especially the fact that he’s not purring when I pet him anymore (which he did even at the ER at times). But I’m hoping he wil be feeling better with his BG numbers improving.

yesterday’s post
https://felinediabetes.com/FDMB/thr...9-465-pmps-445-4-464-ketones-on-meter.297074/

Spreadsheet: https://docs.google.com/spreadsheets/d/1pw2gozDXz_UhGSs897ptj3iAeUPqD-dGnxrcCwXgfWg/edit

Thank you for your advice!
@Wendy&Neko @Bandit's Mom @Bron and Sheba (GA) @Margaret (and Pearl)
 
Fingers crossed for a gentle drop to better numbers. And lower ketones. :bighug:. How is his appetite today?
 
Wendy&Neko said:
I wonder if he needs pain medication and that's why he's not purring? It's a key part of treating pancreatitis, and I've heard from humans who have had pancreatitis that it is very painful. A Primer On Pancreatitis
Click to expand...
I’ve been wondering that as well. The vet gave me gabapentin to give as needed. But they stopped giving it and said he did not seem painful (based on pressing sites in question). I don’t know what to make of it. Will ask vet about pain meds if she calls back herself.
 
SophieFRA said:
Thanks so much. Will check it out. Just measured his ketones and got 0.5. Yes!!!! So relieved. Of course possible that it’s an off reading. But I have only 5 ketone meter strips left (more coming tomorrow) so I want to conserve them.

And BG is at 365 at +6.

Thank you all especially @Wendy&Neko for dosing advice. Still waiting for call from vet.
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Hi all, so it looks like he dropped quite steeply (to mid-300s) from the dose increase and then bounced back to mid-400s. No reason not to continue with current dose right @Wendy&Neko?

Heard back from internist via front desk and she said it’s fine to break up the feedings and feed lunch (which I did today at around 11). She also said if I test a lot she’d be ok with me increasing dose to up to 3u (will of course only do that if warranted after several cycles following SLGS).

She (and my primary vet who called me to check in - she’s the best) also said it’s fine to give 50mg of gabapentin am and pm if I think he’s in pain and agreed that blood clots in urine are not too concerning (unless they persist into next week or he stops producing pee) and likely due to catheter.

A couple of commente relayed via front desk from internist I found problematic. She apparently said she is not worried about Raven’s BG being too high (only too low) and that there’s no number at which she’d say I need to bring him into ER (unless there are other symptoms) and she apparently said that human meters are totally unreliable and that the 560 I referenced from my meter doesn’t mean anything. I did order an aphatrak so I can crossreference with vets. I should get it on Sunday. I think this will be helpful.

Btw it looks like ketones were only tested on 12-23 at which point they were present (no number/blood strip based) and on 12-26 at which point they were not present.

This afternoon around 4 Raven was at 0.9 ketones. Up from earlier in the day but slightly better than yesterday. He did purr a bit earlier. I put his box bed into his crate as a hiding spot and that made him happier. He also groomed a bit.
 
I'd carry on with this dose. Glad to hear the vet OK'ed the gaba for pain if needed. Glad to hear about the purr and grooming.

Human meters are not unreliable. When I started here, the pet meters were not a thing yet and even the vets used human meters. Our dosing methods were developed with using human meters, including TR which has been published in a peer reviewed journal. At some point Abbott started marketing heavily to vets. Sigh. Some people placate the vets with the odd curve or comparison with a human meter, but continue to save money using the human BG meters.

With ketones present, with SLGS we can change the "rules" a bit. But keep monitoring as you have been and let's wait to see what happens when the 2.75 unit depot gets established.
 
Wendy&Neko said:
I'd carry on with this dose. Glad to hear the vet OK'ed the gaba for pain if needed. Glad to hear about the purr and grooming.

Human meters are not unreliable. When I started here, the pet meters were not a thing yet and even the vets used human meters. Our dosing methods were developed with using human meters, including TR which has been published in a peer reviewed journal. At some point Abbott started marketing heavily to vets. Sigh. Some people placate the vets with the odd curve or comparison with a human meter, but continue to save money using the human BG meters.

With ketones present, with SLGS we can change the "rules" a bit. But keep monitoring as you have been and let's wait to see what happens when the 2.75 unit depot gets established.
Click to expand...
Thanks so much for your response. It’s very helpful and all makes sense to me. Will use alphatrak just to cross reference and to have numbers that vets understand.
 
I totally agree with everything Wendy said about the human meters.
Vets are happy to put on freestyle libre monitors on cats which are human meters and seem to except this numbers.
Sending loads of healing vines.
 
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