10/18 Missy AMPS 306; + 3 1/2 319; + 6 304

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Maresydotes

Maresydotes

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Elaine,
Thanks for the link to that article! I am going to send it to my vet. Hopefully, she won't take it the wrong way. :o I will also be calling her for an appt to do some blood work on Missy. It also made me feel somewhat better about her dosage. Maybe I will have to increase hear bit and be able to back her down. But, I still think I need to do some blood work just to be sure there isn't something we are missing.

Despite her numbers, she doesn't seem to be feeling bad. I mentioned lethargy to Sienne, yesterday, but I am not sure that is the right terminology. She is still spending days outdoors, but inside in the late afternoon. It could be partly because of the weather change. Our weather went from summer (the whole 2 weeks of it :lol: ) to fall almost overnight and she is more of a fair weather kitty than her brother. She is alert and responsive, so maybe I shouldn't have said lethargic.

Still plan on doing the ketone testing, though. Maybe I should try that litterbox before I invest in that meter. I can just keep her in the house until she goes. Phoenix can go outside, so I know it is hers.

I am kind of anxious to get her in to the vet to rule things out or find them. When I found she had relapsed (she started
asking for more food, so I tested her) they only checked her for a UTI by culture and verified she was spilling sugar.

Thanks for the info....ready to get going!
 
Re: 10/18 Missy AMPS 306

Hello!

Is there any chance Misssy might be eating contraband while outdoors?

In our neighborhood there are folks who feed the strays (I was one of them, which is how we ended up with 4 cats). Before we took BK in, he would show up here for meals and also visit another "feeding station" about 3 blocks from here...all dry food
 
Re: 10/18 Missy AMPS 306

Sandy,
That is a good thought, but I don't think so...she is in a 6 foot chain link fence. She is just too big to get out. I don't think she really wants to. We had loose dogs next door and until we did the fence, she didn't even want to come outside. I have had to kitty-proof it for her brother,though. HE has gotten out. Just found and fixed his latest escape route last week.
But, I have wondered about bugs. She is really good at catching dragonflies, surprisingly. And she does eat them. She usually brings them to me first, but I have seen her catch them and eat them outside. And you know, they are more numerous around the time she relapsed..hmmm. I even did an Internet search on the carb content of dragonflies. :lol: (didn't find....go figure ;-) ) But there are not many around lately, so I don't know.

I hate to say, Julie and Punkin have me a bit nervous about the acro. She doesn't have any physical characteristics and she is female, but she snores a lot and her breathing is notable. But, she has been that way all her life. I will have the vet check for that, for sure.
Mares and Miss
 
Re: 10/18 Missy AMPS 306

If you're goinig to check for Acro, check for IAA (Insulin Auto Antibodies) at the same time. IAA causes insulin resistance - in some cases extreme. IAA however is self limiting which is good news, but it can be quite a battle (see BKs ss).

IMHO I would first see what's going on during the PM cycles and based on those findings adjust the dose accordingly. If the numbers indictate an increase, then you keep increasing as per the protocol until a breakthrough. Personally I don't start to worry about a high dose conditions until the dose gets north of 5u.
 
Re: 10/18 Missy AMPS 306; +3 1/2 319 Dose Question

Well,
I might have spoke too soon about the lethargy. She is upstairs sleeping and it is a beautiful, sunny fall day. I judged tested her at +3 1/2 and she is at 319. Granted she at between AMPS and now.

I think that I will take her up to 4.5 units tonight and sleep on the couch and monitor her all night long. Does that sound like a reasonable plan? I have a hypo kit. I know I don't have any info on how she handles the insulin at night, but if I watch her, do you think it will be safe enough?

Thanks for any thoughts on this. I'm scared to do it without data, but she isn't feeling herself today.

I emailed my vet about doing some blood work and also the link to the article on 'problem kitties'. I don't know if she will want to wait a few days for the Clavamox to clear her system.
 
i also don't think you would need to check on a high dose condition until she's actually getting a high dose - even according to that document that Elaine posted 5units is not reason for concern. i didn't mean to freak you out - but you were questioning why she came out of remission and that is one cause for remission ins/outs. the usual cause for coming out of remission seems to be that they have gingivitis and need a dental. if i were you, i'd do that first, even if your vet thinks her teeth are ok.

i'll just give you my 2 cents worth on what i'd do in your shoes. but i won't get excited if you do other things! ;-)

- rearrange my schedule so i can get at least a pmps +3 - that at least tells where they're headed, even if it doesn't catch the low point. most of us need to sleep more than 6 hours a night, so don't get the pm nadir on a regular basis.

- get a dental done

- wait another day so that if these high numbers are a bounce, 72 hours will have passed and her BG will hopefully come down.

after tomorrow, i'd go up .5 units - according to the protocol if the dose is above 3 units and the nadirs are over 200, you can increase by .5 every 6 cycles

personally, if i were you, i wouldn't test for the acro or iaa yet. it ran a couple hundred dollars because the blood sample had to be shipped refrigerated, and in the absence of other symptoms, she probably doesn't have either one. she could be snoring just because she's heavy.

also, missy's weight problem may be the reason she's not responding to the insulin as well as you'd like. obesity is listed as a cause for insulin resistance. i know she's losing weight, and that alone may do it, combined with increasing the dose.

btw, you can keep all of your questions in one condo - just edit the subject line of the first post and post your question. then you'll have all your advice in one spot that's linked backwards.
 
just making sure you noticed - a lot of that article was about cats who were on insulins that are shorter acting than glargine (lantus.)
 
Mares,

I am very big on obtaining as much information as possible but

I also wouldn't worry too much about the article (at least not yet and hopefully never) as it does say that even with Lantus you can go as high as 5 ot 6 u to obtain control and then head back down to 1 to 3u.

I know she went into remission super fast before and this is discouraging but perhaps it is just going to take longer this go around.

Eventually, I too will check on some of those other conditions if Pinky doesn't improve but I will just keep increasing the dose on schedule until I do.

Take care, Elaine
 
Thank you everyone!
Maybe I am over thinking things...I emailed my vet and she suggested watching and waiting as long as she is still eating, which she is. I am so glad my vet isn't just money grubbing or she'd have in the office tomorrow. That is one of the reasons I trust her so much,
I will watch and wait, maybe do the dental....that is never a bad thing, even if her teeth aren't looking bad.
I am a little stressed right now....my FIL is in end stage heart failure and was just readmitted to the hospital again today..maybe I am just a little hyper sensitive....but she was really a bit 'off' today.
I appreciate the input. Maybe I will get a little sleep tonight. ;-)
 
one thing that i've noticed - it seems like whenever punkin's BG goes into a range that he isn't accustomed to - either high or low - he gets lethargic. it could just be something like that with missy.

i'm sorry you're dealing with so much. sometimes these things can be overwhelming, especially with so many worries at once.

hugs!
 
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