1/2-3 Hadley - Post-Low#'s Dose Advice?

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Laura and Harley (GA)

Member Since 2011
Happy New Year! ...and what a way to start 2012.

Hope everyone's holidays were happy. It's been crazy busy here as usual. Harley and Princess have both required nursing care for the last few weeks. Prior to the holidays Harley's appetite and weight started to decline fast. He's now on cyproheptadine along with his other meds. to keep him eating and to try to regain weight. I thought I might have to make some hard decisions right before Christmas, but he is still with me and is looking and feeling better. But he won't eat without the cypro. He turned at least 14 yesterday, for which I am very grateful. He's my Tucker, my Gandalf, and my Tom. I hope he will see 15 next year but nothing is certain and I'm just taking one day at a time now. His regulation is spotty at best because I'm giving him some dry Purina DM (junky food that he loves) sprinkled on his FF to keep him eating. Even with the cypro and the prednisolone he is very thin.

On the good news front, Hadley had a much needed dental on December 27 and had his upper left canine extracted. It was broken at the tip enough to expose the pulp and there was a neck lesion below the gumline. He and Harley are now a matched set of Fangless-Shui brothers. He did just fine with the anesthesia and was ready to come home 3 hours after the procedure. He ate normally for 3 days and was on buprenex for pain. But Friday night he vomited his entire evening snack long after eating as it was only partially digested. Same thing Saturday and Sunday nights. Since the vets were closed and I have a small arsonnal of meds. I tried some of Harley's Zantac, Anzemet (for nausea) and 50 ccs of SubQ fluids to keep him comfortable and hydrated. I tried one more dose of bupe, just in case he was in pain, but it didn't make a difference. He vomited again anyway, so I'm thinking the issue is GI related or food related. But I haven't changed anything with his food and he's not on any Abx. And so far he only vomits at night or overnight when he gets food and his BGs are on the rise. confused_cat

His BGs were in the 300s for the first few days after the dental so I held him at 1.5u. Yesterday he ate breakfast like normal and at lunch wouldn't eat. His +6 was 57, and at +7 he was 47 so I fed LC and he rose from there. So I reduced to 1.25u last night and held it this morning even though he was 366 for AMPS (clearly he's bouncing). At +6 today I caught him at 45 and retested thinking it was a mistake and got 39. He's 63 now at +6.5 and I'll keep watching him because we are near nadir and the 1 tsp Karo that I added to his 9Lives Turkey & Giblets for lunch will wear off soon. Joy, my first official hypo (taking breaks as I type to test and feed, of course ;-) .)

I'm confused about what to shoot tonight though. Usually I'd shoot the bounce and then reduce but am not brave enough to do it on a fellow who may vomit on me when his BGs are on the rise again. Clearly he's sensitive to the insulin after yesterday and today.

I'm perplexed...would appreciate thoughts on dose - Hadley's SS link is in my signature.

Thanks!



P.S. I will call my vet to morrow to discuss why the heck he could be vomiting. I hate to even think the "P" word, but it is very possible...
 
Re: 1/2 Hadley - Post-Hypo Dose Advice?

AMPS=366
+6= 45 / retest=39, fed 9Lives T&G with 1 tsp Karo
+6.5=63
+7=70
+7.5=63
+8=65
+8.5=72
+9-let him rest
+10=102

So far so good, a nice surf. I hope the syrup wears off in time for PMPS. I'm contemplating 1u for tonight - if he's shootable.
 
Re: 1/2 Hadley - Post-Hypo Dose Advice?

I'm just going to throw this out there...It was my first thought when I read your post...I wonder if that bad tooth was hindering him from going OTJ and now that it's gone....fingers and paws crossed. :thumbup
 
Re: 1/2 Hadley - Post-Hypo Dose Advice?

Marcy & Klinger said:
I'm just going to throw this out there...It was my first thought when I read your post...I wonder if that bad tooth was hindering him from going OTJ and now that it's gone....fingers and paws crossed. :thumbup

That thought had crossed my mind too, Marcy. GMTA :-D :-D

Hope your boys are doing OK today. Gotta check your SS...
 
Re: 1/2 Hadley - Post-Hypo Dose Advice?

First, yes, 1u seems like a good dose - unless he doesn't rise much above 100 - then maybe .8u. That may allow the shed to deplete some more, but you may need to up his dose after a few cycles and/or he stops vomiting and keeps all his food down.

The dental may be allowing infection to clear up or pain to subside (or both) so he needs less insulin. Did he get ABs before or after the dental? (I re-read and see he didn't, so that might be a concern). If not he probably needs them as bacteria can get into the blood stream with the dental. That can cause septicemia which could be causing the nausea. This would not be a good thing, so you might want to get him to the vet.

FWIW, I would not consider his lows as a hypo. They are low BGs, no doubt about it, but witih Lev (and probably lantus) the action is so gentle that they barely seem to notice they are in low BGs. Jeddie, and more so, Beau, had BGs in the 30s with no symptoms and just a little bouncing afterwards. Of course, it's always good to lower the dose on anything under 50.

Happy (belated) birthday Harley! So sorry he is not doing well. I hope he rallies. I know you are doing everything you can for him.
 
Re: 1/2 Hadley - Post-Low#'s Dose Advice?

...and PMPS is 112. Trying to make up my mind what to shoot. 1u is ballsy, .8u is conservative.

Thanks for the correction Sheila, I updated my thread title to be more accurate. You're right, Hadley didn't exactly hypo, in fact he was snoozing the entire time and pretty calm. Except when I broke out the food, then he was all excited. On the flip side, Harley tested at 83 at +4 and he was having a royal freak-out session. Boys... :mrgreen:

We did not do Abx before or after the dental. The vet tech told me Hadley got a short term injectible antibiotic cocktail during the procedure to combat against infection. I was very clear that he was not to get any convenia or metacam ever again. (He'd had both before in MD.) Coincidentally my vet e-mailed me this afternoon after I posted and I e-mailed back explaining the situation and about the vomiting. She hasn't responded yet but I'll call the office tomorrow and ask if Abx should be considered.

Thanks for the well wishes for Harley. They really help.
 
Re: 1/2 Hadley - Post-Low#'s Dose Advice?

Will be interested to see what happens - hope keeps his dinner down!

(and yes, boys with be boys, but also, girls will be girls :lol: )
 
Re: 1/2 Hadley - Post-Low#'s Dose Advice?

+1 is 241, and so far so good. It's later at night that the tummy wackiness seems to happen for some reason.

Ah yes, those girls can be something else too. :lol: :lol:
 
Re: 1/2 Hadley - Post-Low#'s Dose Advice?

+3=111. onset has arrived, and he is hungry...looks like I need ~O)

My vet replied and she is OK with everything I've done so far. If he is no better tonight then she's willing to consider ABs and/or a visit tomorrow.
 
Re: 1/2 Hadley - Post-Low#'s Dose Advice?

Are you still up? I see he was down to 68 an hour or so ago. Feeding regular food is the right thing unless he drops below 40 - then get out some higher carb.

Are you going to drop to .8u in the morning?
 
Re: 1/2 Hadley - Post-Low#'s Dose Advice?

Sheila & Beau & Jeddie said:
Are you still up? I see he was down to 68 an hour or so ago. Feeding regular food is the right thing unless he drops below 40 - then get out some higher carb.

Are you going to drop to .8u in the morning?

Yes, I'm still up and his +7=160. Fed regular 6% LC at the 68 so not sure if it's the food or if the bounce is beginning. I'm headed off to bed though. I'm thinking of reducing tomorrow...need to sleep on it.

Thanks for all your help today!
 
Re: 1/2 Hadley - Post-Low#'s Dose Advice?

Well, at least he seems safe for the night. And a 68 is a good nadir. Maybe hold the dose? If you keep reducing it you will lose momentum.

I think if it were me, I would wait and see if the PS is low 100s again before deciding. I might be inclined to reduce a hair of he is in the low 100s and hold the dose if he is higher than, say, 150.
 
Re: 1/2 Hadley - Post-Low#'s Dose Advice?

AMPS=369 today. I held the dose although this does seem a bit bounce-y of a number. He didn't like that 68 last night - he was doing a Harley "oh no, here we go again" routine. I wish I could bring him down more gradually. Poor fellow.

No vomit but possibly some white foam overnight Not sure if it was him or my little foam-queen, Princess.

Back to bed for 1 more hour. ( I-)
 
Re: 1/2 Hadley - Post-Low#'s Dose Advice?

I would have held the dose on that PS as well - yes, seems like a bounce. Maybe he can ease off that number so he doesn't go as low and doesn't bounce as high by tonight - then you can consider another reduction. Just remember that you have reduced quite a lot (percentage-wise) already so his shed is depleting. He may not need another reduction just yet.
 
Re: 1/2 Hadley - Post-Low#'s Dose Advice?

+6=174. Let's hope you're right Sheila and he's easing. :) If he follows the same pattern as last night's cycle, nadir could have been earlier though. He ate a whole can FF Turkey & Giblets at lunch so I don't think he'll be low for PMPS. Perhaps I may have to fatten up the dose to a 1 or a 1.1u in the near future.
 
Re: 1/2 Hadley - Post-Low#'s Dose Advice?

Yeah, if the numbers start to slide, you may have to ease up by .1u or something. I wouldn't do more than a .2u increase - and maybe in planned steps of .1u, wait 3 days, then the next .1u. You don't want to start the bouncing ball going again.
 
Re: 1/2 Hadley - Post-Low#'s Dose Advice?

And PMPS=244. :-D Sure hope the bounce is clearing...

Don't hurt me but in all honesty I think I shot 1u this morning and so I shot another 1u tonight to match. Promise I won't raise it again for at least 3 days! :lol:

And I really think the overnight foam came from Princess and not Hadley. She's barely eating today and just sitting on her cushion waiting for me to bring her food to her. Time to do the hepatitis/p-titis meds for her now too (she already gets Pepcid everyday). I swear, someday I'm going to discover their secret hidden, flare calendar. "Ok, here's the plan, Harley, you first, as soon as you are getting better, Princess will take over and then we'll pass it back and forth until Hadley goes deep for the touchdown. Mom'll never see this one coming."
 
Re: 1/2 Hadley - Post-Low#'s Dose Advice?

Looks like Hadley kept you on your toes last night. I hope he settles into the 1 unit.

Oh no, Princess...I hope she feels better soon! If/when you find that flare calendar, please share!!! :-D
 
Re: 1/2 Hadley - Post-Low#'s Dose Advice?

:YMSIGH:
Marcy & Klinger said:
Looks like Hadley kept you on your toes last night. I hope he settles into the 1 unit.

Hi Marcy, Join me in a late night capuccino - tonight's going to be a repeat performance - he's 78 at +4. :mrgreen:

Marcy & Klinger said:
Oh no, Princess...I hope she feels better soon! If/when you find that flare calendar, please share!!! :-D

LOL, I suspect Princess is selling space on the off days of the calendar to other kitties - it's always the quiet, shy ones. Have your boys been running up any long distance bills lately? :razz:
 
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