10/12 Garland AMPS 269 PMPS 260 Test Results

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Violet and Garland

Violet and Garland

Member Since 2011
yesterday high Ketones

Well Im sure im being paranoid, but Garland seems a little "off" today. She didnt come yelling for her food at 5am like she usually does when my hubs gets up.... And then I gave her a small piece of deli meat as her shot treat and she left a little corner of it. Usually she will lick the floor until every possible drop of flavor is gone. But like I said, im sure im being paranoid bc of yesterday. She ate breakfast this morning as usual.... She looks fine and normal, etc...


We get the results back from yesterdays blood work sometime today. Fingers crossed for good news.... The doctor mentioned raising my dose .5 as a starter. So far ive only raised it .25 last night. Any thoughts?
 
Re: 10/12 Garland AMPS 269

No advice here. I just want to stop by to see how Garland is doing after yesterday's scare. I hope all the blood work comes back OK.
 
Re: 10/12 Garland AMPS 269

Hi Violet and Garland,

Of course it is natural for you to look closely at everything Garland does. It is not paranoia! I hope the bloodwork comes back OK and that the vet can get your girl back on track. I cannot help you with dosing because your situation is over my head, but I want to send my support and Rusty wants to send Garland some beautiful vines to help her feel better and better.

Lots of :YMHUG: :YMHUG: :YMHUG: s to you and Garland,

Ella & Rusty
 
Re: 10/12 Garland AMPS 269

Good luck with the BW results today. With all that you've been through with Garland, and little "paranoia" is a good thing...it'll keep her safe! I mean, what a great catch yesterday with the ketones. Since she was acting fine, you never would have known that trouble was brewing if you weren't on top of it like you were. You certainly saved both of you by acting so fast yesterday.

I'm sure someone will be along with dosing thoughts...

Have a great day!

Amy
 
Re: 10/12 Garland AMPS 269

Better AMPS today that's for sure. Paws crossed that she's fine and bloodwork all comes back normal. Please Garland.....

Hugs Violet!
 
Re: 10/12 Garland AMPS 269

Sorry- no dosing thoughts either but I'm so glad that Garland is doing well and seems to be nearly normal! That was totally a great catch by you!
 
Re: 10/12 Garland AMPS 269

Hi Violet,
What's the ketone reading today?

Violet and Garland said:
The doctor mentioned raising my dose .5 as a starter. So far ive only raised it .25 last night. Any thoughts?
Click to expand...
I'm inclined to recommend using a touch of R to bring the numbers down in between Lantus increases, to give the shed time to adjust. just my $0.02.
Either way, you must monitor very closely.
Has Garland ever had a dental?
 
Re: 10/12 Garland AMPS 269

Hope the BW is good and Garland feels good today. Perfectly normal to watch every whisker for a sign of a problem.
Liz
 
Re: 10/12 Garland AMPS 269

Sandy and Black Kitty said:
Hi Violet,
What's the ketone reading today?

Violet and Garland said:
The doctor mentioned raising my dose .5 as a starter. So far ive only raised it .25 last night. Any thoughts?
Click to expand...
I'm inclined to recommend using a touch of R to bring the numbers down in between Lantus increases, to give the shed time to adjust. just my $0.02.
Either way, you must monitor very closely.
Has Garland ever had a dental?
Click to expand...

I havent been able to get a ketone reading today, i used my last four strips yesterday for the meter. Ill try to catch her in the box.

Garland had a dental cleaning in 2007

I can do the R if you want. i gave her the lantus almost 2 hours ago...
 
Re: 10/12 Garland AMPS 269

You should monitor for ketones at least a couple times per day right now.
Continue to add water to her food as well - very important.
See how the rest of this cycle goes and depending on the numbers maybe a TOR at PM shot
eta - any redness in her gums? bad breath?
 
Re: 10/12 Garland AMPS 269

Violet, hoping everything goes well today with the results from the vet. You are using the Precision Xtra to check ketones? I buy in bulk, so if it is this mete I can send you some strips. The ketone reading is very important this morning, I know you just have urine but that is an indicator.

Once again you made a great save!! Garland is one lucky kitty to have such a good bean! My thoughts and good wishes are with you.
Nancy
 
Re: 10/12 Garland AMPS 269

Nancy and Payne said:
Violet, hoping everything goes well today with the results from the vet. You are using the Precision Xtra to check ketones? I buy in bulk, so if it is this mete I can send you some strips. The ketone reading is very important this morning, I know you just have urine but that is an indicator.

Once again you made a great save!! Garland is one lucky kitty to have such a good bean! My thoughts and good wishes are with you.
Nancy
Click to expand...
:) Thank you. No, its a Nova Max. You can only buy the strips online and they are EXPENSIVE :o :shock: @-) Around $50-$60 for a box of 10 (before shipping)
 
Re: 10/12 Garland AMPS 269

Sandy and Black Kitty said:
You should monitor for ketones at least a couple times per day right now.
Continue to add water to her food as well - very important.
See how the rest of this cycle goes and depending on the numbers maybe a TOR at PM shot
eta - any redness in her gums? bad breath?
Click to expand...

Im trying to get a Ketone test, buts its really hard with the kids and everything going on to catch her in the litter box. Any tricks?

No redness and her breath smells like normal kitty breath
 
Re: 10/12 Garland AMPS 269 +4 235

Hi again, Violet,
Have you priced the ketone strips for the Nova Max at American Diabetes Wholesale? One of the specials includes the Nova Max Plus meter kit (which includes 2 ketone strips) in addition to a box of 10 ketone strips for $37.90. So that's 12 strips for $37.90 and you get a back-up meter, too. Here's the link to their website.

http://www.americandiabeteswholesal...e-ketone-meter-kit_3400.htm?source=SiteSearch

Hope this helps. Continuing to send healing thoughts to Garland.

Ella & Rusty
 
Re: 10/12 Garland AMPS 269 +4 235

Thanks Ella :)

So i got a strip under her, she for sure has ketones. The color looked to be the "moderate" one on the color chart :cry:
 
Re: 10/12 Garland AMPS 269 +4 235

I'd let her eat as much as she wants also - just pick up before your shot times if you plan on using R so its not a food spiked number. I think you are going to need R to get her numbers down. But there is the overlap that Sienne talked about so I guess this is why you give it at the same time as shot time?
 
Re: 10/12 Garland AMPS 269 +4 235

Violet, how many cats do you have? You may want to look at the Tidy Cat's Breeze litterbox. The urine passes through the pellets and absorbs into a pad in the bottom tray, but you can just skip the pad and use the bottom tray for collecting urine for tests. The website has a $10 off coupon, and I know the pet stores and walmart both sell them. Added bonus? Almost zero litter tracked anywhere in the house! Worth its weight in gold for that alone!!
 
Re: 10/12 Garland AMPS 269 +4 235 TEST RESULTS ARE IN

TEST RESULTS:

The bloodwork all came back normal. Liver values and blood count looks awesome (yay!)

Urinalysis- Ketones were at a +1 with a urine concentration of 1052 (normal is around 1035) So he said its a trace to moderate amount of ketones

Basically what he said is happening is since her diabetes is out of control with such high numbers, she is eating and drinking enough, but is losing hydration with the frequent urination. So this causes the urine to be concentrated as well as ketones to develop. He was surprised I even caught this as early as I did


TREATMENT:

He wants me to continue to raise her insulin to get her numbers down. He recommended a 4.5 tonight and then keep raising as needed. (So I will need help from you experts on dosing)

He also wants me to come in tomorrow and he will give me fluids. He wants me to give her 200cc of SQ fluids every other day (1 liter total)
 
Re: 10/12 Garland AMPS 269 +4 235 -->> Test Results Are In

I'll defer to Sandy on this but raising Lantus the way your vet is suggesting may not be the best method. Using R makes more sense to me.

Also, a dental in 2007 is too long. Her teeth may be part of the problem.
 
Re: 10/12 Garland AMPS 269 +4 235 -->> Test Results Are In

Sienne and Gabby said:
I'll defer to Sandy on this but raising Lantus the way your vet is suggesting may not be the best method. Using R makes more sense to me.

Also, a dental in 2007 is too long. Her teeth may be part of the problem.
Click to expand...

Teeth? Why? Her dental was only 4 years ago. Do people do cat dentals more frequently than that? The only reason I even took her in for that one, is bc Connick needed one (he had swollen gums from plaque) and I figured, might as well get them both done, while I was at it.
 
Re: 10/12 Garland AMPS 269 +4 235 -->> Test Results Are In

That is great! but I disagree about the ketones .... high numbers can push ketones out but to do that they need to be in the 500-600's sometimes 400's for awhile and you haven't been seeing that. I agree with the SQ fluids but I wouldn't give 200ml at one time, ask if you can split into two 100ml? High amounts of SQ fluids are hard on the heart.

I don't know L but I agree she needs more insulin now but she needs to come out of moderate because that is a danger zone for a cat that has just been DKA .... I understand this place and most vets don't, they seem surprised when it happens BUT we don't want it to happen. Didn't someone come and do SQ for you before?
IMHO you need to figure out where to put the R in before tonight .... you said she was off just a little, do you still think that?
 
Re: 10/12 Garland AMPS 269 +4 235 -->> Test Results Are In

Violet:

Nancy is right...it is better to give a smaller amount of squids more frequently....100mls/day then to give a higher amount EOD. The vets usually charge alot of money for one bag of fluid...sometimes as much as $18/1000 mls. I know you will not need to use them that often and so it doesn't make sense to buy a case of 12 BUT I would just contact Walgreens or one of the local pharmacies and see if they can sell it for less. I pay $20/year for a Walgreen's prescription card and then my squids are $22/case of 12. That is a huge savings. They may be willing to break up a case.....I have absolutely no idea.

I know you have your hands full.....wish I lived nearby and I'd just give you several bags.

Keeping you all in our prayers.
 
Re: 10/12 Garland AMPS 269 +4 235 +7 229-->> Test Results Ar

Can you guys do a crash course on R and explain why its better than her vets method - especially just for right away to help avoid DKA? It's a lot to take in. Also do you thing 200mls of fluid at one time is a good idea? I've never dealt with DKA.
 
Re: 10/12 Garland AMPS 269 +4 235 +7 229-->> Test Results Ar

Praying for Garland's recovery and hope you will find the right dose!
 
Re: 10/12 Garland AMPS 269 +4 235 +7 229-->> Test Results Ar

I will do whatever you guys think is best. I asked the Dr if giving 200cc at one time was too much at once, he said no. But i was a little wary about it. He said he will have me come up there and show me how, give me the fluids and supplies (1 liter) for $41 //// Marjorie-- what is a squid?

Is an increase of .25 a lot to do tonight after the increase last night? Just curious.. isnt it only a drop? would it cause a big drop in her numbers or something? (LOL Im still learning)

I can do the R, but last time the .25 of R did nothing for her. Was it too small a dose?

As far as Garland, she seems fine. I would say maybe not as "loud" today... and maybe not quite as hungry as usual. But I also think I am over sensitive to the amount of food she takes in ever since the FHL. I watch her food intake like a hawk and get nervous if its decreased at all. But she was rolling around on the bed earlier, she meowed at me, she ate lunch. So yea, shes a little quiet today, but shes not acting sick or anything....
 
Re: 10/12 Garland AMPS 269 +4 235 +7 229-->> Test Results Ar

I would hold the Lantus dose at 4.25 for at least 4 cycles.
If Garlands PMPS is pink tonight I would use a touch of R.
BG 300-350 ~ 0.1u
BG 350+ ~ 0.25u.

However, this cycle has been flat yellow - I'm wondering if there may be action ahead. . .
get a +11 if you can
 
Re: 10/12 Garland AMPS 269 +4 235 +7 229-->> Test Results Ar

no advice, just cheering you on. garland is SO lucky to have you! that's an understatement.
 
Re: 10/12 Garland AMPS 269 +4 235 +7 229-->> Test Results Ar

Karrie and Maverick said:
Can you guys do a crash course on R and explain why its better than her vets method - especially just for right away to help avoid DKA?
Click to expand...

Lantus is slow acting, each increase requires shed remodeling and that takes time. IMHO upping the Lantus dose every 2 cycles may just create a loop of NDW, the dose never gets a chance to settle in and show it's action (or lack of action).
R is fast acting - no shed - in and out in approx. 4 hours although ECID. So a high PS can be brought down a bit by +2ish, when Lantus onset begins. Then the Lantus action takes over.

When the numbers improve - you just stop the R - no shed action to worry about with R.
 
Re: 10/12 Garland AMPS 269 +4 235 +7 229-->> Test Results Ar

Violet and Garland said:
Teeth? Why? Her dental was only 4 years ago. Do people do cat dentals more frequently than that?
Click to expand...

Gingivitis and tooth decay were BKs Achilles heel. It took 2 dentals to get it under control. The first was Dec.2008 and the next one was end of May 2009.
If you look at his ss you can see the difference it made. Also, even though he had infected gums/teeth, his WBC was always normal.
I honestly believe, in BKs case, that without addressing the dental issues he never would have made it to the falls.
 
Re: 10/12 Garland AMPS 269 +4 235 +7 229-->> Test Results Ar

The Lantus works better at lower numbers, I believe. The R is the quick and dirty way to yank the BG down to a less harmful range and allow the Lantus to work better.
The R curve is shorter; nadir close to +2, gone by +6. The Lantus does not kick in till +3 or 4, so you can think of it as a relay race.... R is the first runner, who is fast and gets a head start, then hands off to Lantus to finish off the race.

If you increase the Lantus, you are making a long lasting change that may turn into a problem later if BG drop too much, whereas the R is in, does its job, and is out.

Think of walking your dog at a certain pace. If the dog slows down, you give a yank to have him speed up, but then you fall back to the good pace for both of you. You would not want to yank the dog and keep up the faster pace because it's too fast for the dog.... he just needs a nudge to move along.
 
Re: 10/12 Garland AMPS 269 +4 235 +7 229-->> Test Results Ar

Gayle is correct -- a lower number gives the Lantus something easier for it to "grab" on to in order for it to lower numbers more easily.

Jill had commented back channel that 300 ml of squids (Violet -- squids = subcutaneous or sub-q fluids) is not excessive PROVIDING there is no underlying heart condition. If a cat has a cardiac complication, too much fluid can cause hypervolemia and result in problems like heart failure. I doubt that there's a right or wrong way with fluids if a cat is healthy. Violet's vet may also be considering that Garland can get feisty and may not sit still twice a day for fluids.

As far as dentals, Gabby needs a dental almost every year. ECID but 4 years is a long time unless you're brushing Garland's teeth daily.
 
Re: 10/12 Garland AMPS 269 +4 235 +7 229-->> Test Results Ar

WOW!! Thanks for all the info guys. Yall are experts!!

+11 256
----------------

When I got her teeth cleaned in 2007, I almost had to force them to do it. They said she didnt need it, etc... Thats the only time shes had a dental. But she doesnt have any red gums or anything. I remember I had to keep her there all day, they sedated her and it cost close to $300. Crazy. Connick had mild gingivitis, thats what spurred the appointments

---------------

Since she has ketones is this her second attack of DKA? Or are we trying to prevent DKA? And does ketones cause them to eat less? Bc she has for sure not eaten as much today as usual
 
Re: 10/12 Garland AMPS 269 +4 235 +7 229-->> Test Results Ar

Sienne and Gabby said:
Jill had commented back channel that 300 ml of squids (Violet -- squids = subcutaneous or sub-q fluids) is not excessive PROVIDING there is no underlying heart condition.
Click to expand...
popping in between appointments...

i'd like to clarify the above statement before anybody flips out. what i said was,

obviously fluids are best given every day rather than every other day. there seems to be some concern about the amount in her condo today. IF A CAT DOES NOT HAVE A KNOWN HEART PROBLEM administering 200ml at once isn't as big a deal as people seem to making. when alex got real sick last year the vet was giving her 300ml at once. i think i even gave her 300ml at home once or twice. i was worried about it so i asked jojo if i was doing more harm than good. jojo said it wasn't uncommon to give a cat 300ml at once when sick and there were no known heart problems. it's one of those things that may be a good idea for a day or two or three... not as an on going treatment plan.

in this situation, i'd be tempted to give 200ml squids today since she didn't get any yesterday and there are trace to moderate ketones present. however, i'd drop that amount down to 100ml or even 50ml per day if garland is no longer throwing ketones... on a short term basis.

i guess what i'm trying to say is if alex had trace to moderate ketones i wouldn't hesitate to give her 200ml today since she doesn't have any apparent problems with her heart.


administering 300ml of fluids is a lot of fluids to give at once and it's not a routine practice... just wanted to clarify.
bb after work...
 
Re: 10/12 Garland AMPS 269 +4 235 +7 229-->> Test Results Ar

Sorry if I confused or misstated.

A dental is no small undertaking. It does require anesthesia and, frankly, $300 is cheap for a dental.
 
Re: 10/12 Garland AMPS 269 +4 235 +7 229-->> Test Results Ar

Sienne and Gabby said:
Sorry if I confused or misstated.

A dental is no small undertaking. It does require anesthesia and, frankly, $300 is cheap for a dental.
Click to expand...
LOL Not at all! I was just remembering when I took her in, thats all :)

PMPS 260
 
Sandy and Black Kitty said:
How is Garlands appetite?
Behavior?
Click to expand...
Appetite is a little lower than normal. But she is eating.

Behavior seems fine. Shes been a little quieter than usual today, but she may still be out of sorts from the vet and the sedation from yesterday (?)

Do ketones cause a lower appetite?
 
Glad Jill clarified because I don't have an issue with the amount (200 mls). I have an issue with the frequency. Just for stability, if you have a set amount of fluids you want the cat to have per week, it is more helpful to the kitty to give a smaller, consistent amount every day as opposed to one larger amount EOD.....and I would think esp with a DKA prone cat....a smaller amount every day makes more sense than a larger amount EOD. I like Jill's idea of giving her 200 mls today and then giving her 100 mls/day (or less) daily after that.

$41/bag is highway robbery.......just sayin'.
 
Re: 10/12 Garland AMPS 269 PMPS 260 SQ bag question

OMG!! I just remembered!!

I have a bag hanging in my closet that Pat brought me back in August. Would that still be good, or do they go bad after a while?
 
Sandy and Black Kitty said:
Make sure she is getting as many calories as possible, and plenty of water too.
shoot for 1.5 times the calories required to maintain body weight.
Click to expand...
Im putting food out there all day. As much as she wants....
 
Try and get a couple spot checks tonight, and a ketone test if possible.

If Garlands AMPS tomorrow is pink I would use a touch of R.
BG 300-350 ~ 0.1u
BG 350+ ~ 0.25u.

If you do use some R in the AM, you will need to get a +1 +2 +3 +4.
 
Has the bag been opened? Does it have an expiration date. It's probably OK if it is still sealed and within the expiration date (if there is one). If in doubt, ask a pharmacist.

Good job today Violet. Hang in there. We are all thinking good thoughts for Garland.

Ella & Rusty
 
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