10/27/19 Elmo....AMPS 561...+7 HI. PMPS HI, Dosecrease to 1.25

Hiya Beth! It really sucks to see those blacks and HIs on Elmo's spreadsheet. I really do think it's time for an increase. The lowest he's been is that 283 on the 25th. I really hope he can start coming down soon. I doubt those high numbers feel good. :(
 
How much longer for the TID ABs? Are they pills?

Looks like he need an increase, but want to make sure his ABs are sugar free.
 
Beth

Did you get a PMPS last night and forgot to enter it? I’m also wondering if he’s getting something with sugar in it or any contraband because his numbers have so drastically changed in a short time.

Normally, with these numbers, we would suggest a 0.5u increase; he’s only seen one yellow; however, if he’s on antibiotics and has been on them for a few days, we might expect the BG to start resolving a bit.
 
Wendy&Neko said:
How much longer for the TID ABs? Are they pills?

Looks like he need an increase, but want to make sure his ABs are sugar free.
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Thank you , Wendy ❤️ His ABs are exact same he has been on for the two week course so nothing new there . Started the pulsing of same ABs (pills) on Friday . Vet has him on 50 mg once a day 3x a week . All is the same ...same food , same ABs , no infection in his mouth . Has me stumped .
 
Marje and Gracie said:
Beth

Did you get a PMPS last night and forgot to enter it? I’m also wondering if he’s getting something with sugar in it or any contraband because his numbers have so drastically changed in a short time.

Normally, with these numbers, we would suggest a 0.5u increase; he’s only seen one yellow; however, if he’s on antibiotics and has been on them for a few days, we might expect the BG to start resolving a bit.
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Thank you , Marje, for weighing in ❤️ He ended a two week run of Amoxicillin (pill) 100 2x a day for mouth infection on 10/22.....started the pulsing ( same ABs) on 10/25 .... no change of food ... no change of meds ... all exactly the same . Had a bout of vomiting on 10/20 but resolved by next day . I am stumped .
 
Depending on how much and what contraband, it can take up to three days to completely clear. Neko took about 18 hours, but had a working pancreas.
 
Thinking if he got hold of lunch meat or bacon ( both cured with sugar) ...we are very careful but those are both possibilities...if that then would I increase or wait ? I'm always careful ab checking the floor . I know he couldn't have gotten into anything today for sure .
 
Beth 73 said:
Thinking if he got hold of lunch meat or bacon ( both cured with sugar) ...we are very careful but those are both possibilities...if that then would I increase or wait ? I'm always careful ab checking the floor . I know he couldn't have gotten into anything today for sure .
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He’d have to be eating lunch meat or bacon a lot to keep his numbers up this long, IMHO. I would not wait to increase with his history of DKA and infection even though it’s been a while and he’s on antibiotics.
 
Marje and Gracie said:
He’d have to be eating lunch meat or bacon a lot to keep his numbers up this long, IMHO. I would not wait to increase with his history of DKA and infection even though it’s been a while and he’s on antibiotics.
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Marje, so you would advise an increase of .25 or .50 ? And start tomorrow AM ? Hesitant to start on PM shot ..Think I would rather try a .25 increase and see how he does ...
 
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Beth --

I don't remember what the mouth infection was all about. Was this for an infected tooth or an abscess? Given what Elmo's numbers look like, it doesn't seem like the antibiotics are doing their job. Would dental X-rays be warranted?

I think you need to increase by 0.5u. With the history of DKA, the high numbers are worrisome. They are telling you the infection isn't. under control. I'd think about getting Elmo to the vet.
 
Sienne and Gabby (GA) said:
Beth --

I don't remember what the mouth infection was all about. Was this for an infected tooth or an abscess? Given what Elmo's numbers look like, it doesn't seem like the antibiotics are doing their job. Would dental X-rays be warranted?

I think you need to increase by 0.5u. With the history of DKA, the high numbers are worrisome. They are telling you the infection isn't. under control. I'd think about getting Elmo to the vet.
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Thank you, Sienne.....Vet does home visits and has determined Elmo cannot undergo any dental procedures due to aging kidneys. The infection was at front of his mouth and is easily observable and is currently no longer inflamed . We are pulsing ABs now to hopefully keep infection at bay as that is all there is to be done considering Elmo’s kidneys . If inflammation flares we go back to a twice a day 10 day course which took care of last infection. At his age and stage it is the only course of action we are left with.
 
While I tend to agree with Sienne that he needs more than a 0.25u increase, you hold the syringe.

Obviously giving a dose increase warrants close monitoring. It needs to be your decision. We can offer our input but, ultimately, you have to be comfortable.
 
Marje and Gracie said:
While I tend to agree with Sienne that he needs more than a 0.25u increase, you hold the syringe.

Obviously giving a dose increase warrants close monitoring. It needs to be your decision. We can offer our input but, ultimately, you have to be comfortable.
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Thank you, Marje... I’d like to at least give the .25 a try...a month ago (9/20) it was the dose that helped. Also if you have any wisdom when it comes to pulsing ABs please share .... seems from 2 vets I consult it can be customized and no iron clad “ this is how it’s done”.... I am increasing to 4x a week for now ... I am walking a fine line with him due to age,kidneys,thyroid as well. It is a constant balancing act but worth it ❤️
 
carfurby said:
Good luck with the increase. I hope it brings Elmo's numbers down. Glad his mouth no longer looks inflamed. Sending prayers.
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Thanks, Carla❤️ Wanting and needing those prayers ❤️ Tomorrow early we are having our sweet office kitty, BC , put to sleep due to failing kidneys . Need your prayers for that as well :bighug:
 
PS....he is on 4x a week low dose AB as maintenance from now on ... i have option of switching from amoxicillin to clindamycin ( excuse sp) if I see amoxicillin is not working . His system ie stomach tolerates the amoxicillin so sticking with that for now .
 
Just seeing this now. Sorry to see Elmo still in those high numbers. Hopefully the dose increase will get him back to business.

(((HUGS))) for you and scritches for BC. They are never with us long enough. :bighug::bighug::bighug::bighug:
 
Good luck with Elmo's dosecrease Beth. I'm so sorry you have to say goodbye to BC. Sending comfort and hugs to you at this very sad time. :bighug::bighug::bighug::bighug::bighug:
 
MrWorfMen's Mom said:
Just seeing this now. Sorry to see Elmo still in those high numbers. Hopefully the dose increase will get him back to business.

(((HUGS))) for you and scritches for BC. They are never with us long enough. :bighug::bighug::bighug::bighug:
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Thanks, Linda ❤️ No, they aren't ...second one in last few months ... this stinks ...
 
Beth 73 said:
Thanks, Carla❤️ Wanting and needing those prayers ❤️ Tomorrow early we are having our sweet office kitty, BC , put to sleep due to failing kidneys . Need your prayers for that as well :bighug:
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So sorry... :( :( :( :(

Hope the dosecrease helps. Elmo, come down off the rafters, nothing to see up there.
 
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