11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47/+3.5 80/+5 87

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JuJu09

JuJu09

Member Since 2014
Yesterday

WCR-GOOD
Ketone Neg 11/9 (Need to test today!)

I'm a little late waking up today, due to working late last night. Ava just told me JuJu was on the back porch chirping (chuffing?) At the birds flying in and out of the trees. We don't want him to get any birdies but I like that he's interested. Ava gave JuJu the 0.1u. We're most definitely hoping for some good (not plumiting) greens today :mrgreen:

We decided were going to take KiKi and JuJu since we're transitioning to a new family vet. That way we can monitor JuJu and they can get the low down on him, too. Plus, the scratching at the ears is annoying me. He's finally looking good and improving by the day, so I don't want something else for him to deal with. KiKi acts like she wants to eat but can only lick a little. She seemed to have a little drool this morning. Off to get her fixed up :smile:

Hope everyone has a great day :cool:
 
Re: 11/11 JuJu AMPS 198

Is he scratching at both ears or just one? I'm wondering if you're using neosporin if that's bothering him. Once in a while we see a kitty that seems to not do well with it.

good luck at the new vet and nice start for Juju today!
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49

I forgot to ask the new vet if they take care credit, so I called ahead to make sure. They do, which is great but they can't see us till 3:30 because they only have one doc today.

+2 49

Feed him some LC with gravy and a drop of honey. Sloooooow down, son!
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49

mmmm under 50 requires a dose reduction for Juju. I'll chat with some others and get back to you about tonight.

recheck him in 20ish minutes.
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47

He crawled under the bed but I kept giving him little amounts of HC with a drop of honey. He came back up a bit but just went back under the bed.
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47

matt, are you ok handling the under 50's on your own today, or do you need someone to stay with you? I know you've done it a couple of times already, but sometimes people still need someone.

my biggest concern is that this is only +2 - you may have to do this for a while. Don't relent until he's safely over 50, staying there for at least an hour after you stop giving high carbs, and he's past the nadir of the Lantus.

You've got the directions for handling low numbers - they are also on the "Shooting & Handling Low Numbers" sticky above.
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47

Oh, no neo on the ears. I think his blankie that was with him in the hospital could've got fleas/mites and brought them home. We're throwing it away.
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47

Keep doing the same thing until he's above 50 and then let's see if we can get him to surf on LC. As Julie said, we will discuss dose and get back to you but I'm thinking we need to stop insulin and see what his numbers do.

Is he eating well, drinking, and have you been test ketones?
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47

Eating like a horse, haven't seen him drinking much but we have been adding water to his food. We need to get a Ketone test today (11/9 was the last one).
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47/+3.5 80

My apologies Julie, I missed your post. Yes, I'm comfortable handling the low numbers. We have been at this for a week, and with all the help we have received from LL, we're learning the proper steps.

Looks like I over carbed him but he was likely going to bounce anyways.

Here's my thinking. Junior spent most of the week in the hospital with BG> 400. This past week he bounced a bit but he was holding between:

250-350 on <0.1u for 3 cycles.

178-198 on <0.1u for 1 cycle

He seems to hold steady on <0.1u. What if we run that again for 3 cycles? Then do double that for a cycle to get his PS number a little lower for next cycle. Then back to <0.1u for 3 cycles again to see if he surfs that number? That's unconventional but ECID.

That would give him 3 cycles to adjust to lower numbers. To far outside the box?
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47/+3.5 80

With a 36, I'm not comfortable with that, personally ;-) ;-)

What I would propose is to try the drop. But I'd like some of the others to also offer some thoughts to you. He's not mostly green like we would like to see a kitty starting a trial. Although because he is eating, my concerns for DKA are much less. AND some kitties can "bounce off the insulin" and he might be doing that which would mean we'd stop it and see if he flattens out in green.

Think about the drop and let's see what some of the others think.

Good job with the numbers. Please let us know how KiKi is and I hope Ava is better today.
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47/+3.5 80

No dosing advice here but I know what I would do and I am testing a lot. I'm a chicken when it comes to the 30's. Again no advice here but you can always go back up if needed and there is no time table for it. Good luck with whatever you decide to do. I hope that Kiki is okay as well.
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47/+3.5 80

ok, i'm one of the others with thoughts...

i'm going to suggest something i don't think i've ever suggested to a caregiver regarding a dosing decision in the 8+ years i've been involved with this Insulin Support Group.

my suggestion is to talk to your vet with juju's spreadsheet in hand.

get your vet's input.

your vet has hands on experience with your cat.

your vet has very recently pulled your cat through a couple of serious conditions (DKA & HL).

your vet knows your cat.


given the same circumstances (insulin & currently eating), i know what i would do (have done ~ she passed in sept.) with my own diabetic kitty... i would withhold insulin, continue testing, made sure she ate well (syringed food if necessary) and tested her urine for ketones twice a day. i would stay up night and day if i had to. i'd do whatever it took.

if i chose that path i would be fully aware of the risk i was taking (developing ketones and/or HL) AND be willing and aware of the possible need to dump my plan at a moment's notice (juju will be leading this dance).

make no mistake about it... withholding insulin is a risk. unfortunately, it's come down to there also being a risk involved when shooting insulin. that's why i'd probably look to my vet for guidance because this is kind of like a damned if you do and damned if you don't situation. any help or insight into my cat would be appreciated.

this is not a problem we normally see in this group. the members who have been offering you advice are laypersons. experienced to various degrees, yes... but their guess (myself included) as to which way to go is a bit of a crapshoot. personally, i won't do crapshoots when it comes to other people's cats.


just my thoughts. i don't envy you having to make this decision.
good luck!
~ jill



ETA: thought i should come back to explain my reasoning for withholding insulin first...
i'd want to see if kitty was done with insulin. it's the easiest to rule out before trying to have to figure out a different dosing and/or feeding plan in order to safely get insulin into the cat.
i've always subsribed to the KISS method. :mrgreen:
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47/+3.5 80

We've been at the vet for a couple hours. I have to go to my bowling league, so I'll be back later around 9pm to further discuss our options.

KiKi has ulcers on her tongue. She did eat a bit of canned before we left for the vet. The vet advised us to syringe feed her.

I did show the vet the SS. She wants us to skip tonight and get a fasting BG in the am. She's hopeful JuJu could already be in remission.

I'll be back later, just didn't want to leave you hanging all night.
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47/+3.5 80

JuJu09 said:
KiKi has ulcers on her tongue. She did eat a bit of canned before we left for the vet. The vet advised us to syringe feed her.
Click to expand...
if you have a blender or food processor...
trying blending kiki's food until it's very smooth and almost "fluffy". she might go for it and it's easier than syringe feeding.
just an idea.

JuJu09 said:
I did show the vet the SS. She wants us to skip tonight and get a fasting BG in the am. She's hopeful JuJu could already be in remission.
Click to expand...
i think that's what we're all hoping! :mrgreen:
just remember, juju's numbers may be high both tonight and tomorrow morning. i fully expect to see him bounce off that 36. it might take a couple days/a few cycles before we'd see what he could do on his own... without insulin.

have fun bowling!
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47/+3.5 80/+

I'm glad Jill posted. She was one of the others I was hoping would give some input. For any other cat with never a whisper of DKA, I would have also suggested stopping the insulin. It was just my concern for suggesting that and having him show symptoms. I'm glad your vet gave you her thoughts on it.

Enjoy the night off and I hope we soon see a sea of green with no insulin!
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47/+3.5 80/+

Fingers and paws crossed that Juju is done with insulin.
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47/+3.5 80

You've gotten tons of excellent feedback about JuJu, so I'm just adding some prayers that all goes well!!!

JuJu09 said:
KiKi has ulcers on her tongue. She did eat a bit of canned before we left for the vet. The vet advised us to syringe feed her.
Click to expand...

For KiKi....I don't know if a vet would go for this or not. I personally get mouth ulcers fairly regularly - currently have one on the side of my tongue. To say it is incredibly painful is an understatement (I've even taken percocet for my ulcers, and it barely takes the edge off sometimes - it can be that bad). I wonder if your vetty would give you some Bupe for KiKi - she'd be more inclined to eat if that ulcer pain is gone, or at least reduced. Just a thought...something to ask about. I sympathize, little KiKi...I hope you heal up fast!
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47/+3.5 80/+

Ketone Neg 11/11 8:34pm

Thank you all for the positive vines and well wishes. :-D

I didn't mention that both kitties did get blood drawn. We should get the results tomorrow. The main reason for JuJu was to check his liver values. With as well as he's been eating, I'm confident that his liver is properly healing. I think the doc said KiKi could have mouth ulcers from kidney disease, so that's the main reason she wanted to get her blood.

KiKi has started Orbax do help fend off any infection. I also appreciate the tip about using a blender/food processor.

Jill, this was actually our first trip to this vet. We haven't been able to find one we like, and she was highly recommend by a couple friends. The doc tried to push the Purina DM on me for Junior. "It's the best diet for diabetic cats because it's high pro/low carb." I told her I appreciate the suggestion but I feel like he's doing well on his current food, It actually has a lower carb %. She also said that my "curves" may not be accurate because of how much he's eating and when. I feel like the LC doesn't really affect his BG much. It's the HC that makes him wonky. She said he's supposed to be fed only twice a day, once before each shot. I let her know that I have been feeding JuJu a fairly consistent amount of food, at the same times each day.
PS 2oz
+2 1oz
+4 1oz
+ 6 1oz

Because he's underweight we've been allowing him to eat a lot. I feel like he's doing well with his current feeding schedule. I also mentioned that he only gets the HC when he's <50 before the nadir. She also tried to push the AlphaTrax. She said she would give it to us at her cost, very nice of her. I told her that the price of the monitor isn't the problem. It's the $1 strips that just aren't practical for us.

Marje, I honestly agree with your suggestion of trying a drop. I feel like we should try to get him surfing in the low blue/high green before removing insulin altogether. The doc and Ava, however, agree with Jill. I expressed to the doc about the reoccurrence of DKA. She said we will see where he's at in a day or two and can easily put him back on a micro dose if he's getting too high. So, I'm going to listen to the doc and give it a try.

The doc was really nice and she listened to our (mainly me, I think I'm a pro already :cool:) input. Despite not necessarily agreeing with some of what she said, I do like her. I think we have finally found a good vet.

KISS?

Ava is feeling much better today. We didn't have time to get her back to the chiro today, so she's going in the am.

+12 154

I feel like it would be perfect for a "drop" of insulin. I think he would surf in the low blues and maybe hit green at nadir. Then again, maybe he brings himself down? We'll see...
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47/+3.5 80/+

hurray for negative ketones!!! :mrgreen:

She said he's supposed to be fed only twice a day, once before each shot.
Click to expand...
that's old school only in that it's the norm when using older insulins. with the older insulins you had to get food on board when giving a shot. feeding smaller meals does seem to help most cats, but otoh, we've seen some do just fine being fed twice a day.

Because he's underweight we've been allowing him to eat a lot. I feel like he's doing well with his current feeding schedule.
Click to expand...
"if it ain't broke, don't fix it." just keep an eye on his weight. once he reaches his ideal weight you might have to start cutting back a little. and then you might not. see how it goes.

I expressed to the doc about the reoccurrence of DKA.
Click to expand...
here's the thing about ketones...
the recipe for ketones includes 3 key ingredients: poor or no appetite + infection or systemic stressor + an inadequate supply of insulin. all 3 ingredients have to be present for ketones to develop. in ju-ju's case... he's eating and eating well so the ketone recipe is missing a key ingredient. that's why i think you have a little leeway here to see what he can do without exogenous insulin. i suspect your vet feels the same.

that said, i would continue to check for ketones... twice a day if at all possible. if by some chance ketones do begin to develop you want to catch them immediately. it's a lot easier to get rid of trace ketones than medium or large... easier on kitty... and definitely easier on your wallet.

i'm glad you like your vet. it makes a world of difference to be able to rely on a vet you like and can build a good working relationship with.

KISS?
Click to expand...
Keep It Simple Stupid/Silly --- the last word depends on your audience. :mrgreen:


happy to hear ava is feeling better! a +12 of 154 following that drop to 36 isn't bad. it'll be very interesting to see where juju will be at in the morning...
 
Re: 11/11 JuJu AMPS 198/+1 142/+2 49/+2.5 36/+3 47/+3.5 80/+

KISS= keep it simple, stupid" although it's just an acronym and Jill wasnt directing it at you ...it's the "keep it simple" principle she likes :-D

I think you and Ava are doing great by discussing and deciding together. I find having a partner to bounce things off of is a blessing. Mike and I also don't always agree but we brainstorm and usually take the more conservative approach which is what you and Ava did. Just remember as Jill said, if he's bouncing off the insulin that he doesn't need, numbers could stay high for up to a few days just like they did when you reduced from 0.25u to 0.1u. Try to be patient and stay on top of the ketone tests. Any sign of Inappetence, lethargy, etc....call the vet.

You've learned a lot fast and the vet should have been impressed with what you know. I hope JuJus liver values are normal.

When you said KiKi had mouth ulcers, I wondered if she has CKD. It can be very common due to the acid they produce. When you get her labs, I'd be happy to look at them. I've had four CKD kitties and I help members here decipher labs. Just let me know. I hope she feels better soon and I'm glad Ava does.

Think green, JuJu. :mrgreen:
 
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