11/29 PurrFace UPDATE PMPS 315 +3/257 +6/249 +8.75/354

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Frosty

Member Since 2012
11/29/13 RECAP
AMPS 278
+1.5/280
+3.5/238
+5.5/247
+7.5/314
PMPS 315

Just got home with PurrFace. He is so much better and alert. The ER vet said his last BG reading there was 100. He was in the 290 range but dropped when they stopped the insulin drip at 6 a.m. it started to drop some. She said the insulin they use is an instant type and once they stop the drip it's used up within an hour. He wouldn't eat for they there so that was her main concern. She said if he eats it would be OK to start his insulin again but decrease his dose from the 2.25U BID to 1.8U BID. It's going to be hard to dial in a 1.8U dose. I'm guessing that's a f1.5U in our terminology.

When he got home he went straight to his cat lounger and gave it a good scratching and then over to where he gets feed. He ate 1/2 can of a 3oz can of FF. poor guy hasn't eaten since yesterday morning AMPS. And then he only ate about 2tsps. Since he just ate I'll about 2-1/2 hours before testing him.

It just dawned nome that their low BG threshold isn't as high as it sounded. They said they use a human test meter that allows them to program it for cats or dogs. My guess is it's an AlphaTrac. If it is a 150 reading would be about a 120 on our Relion Micro. When we arrived at the ER yesterday our meter had him at a 34 and theirs had him in the low 60s I believe.

Thank you all for your reassuring and calming support. It is greatly appreciated.
PurrFace's Condo
 
Re: 11/29 PurrFace UPDATE

Yay, he's home!!!
It just dawned nome that their low BG threshold isn't as high as it sounded. They said they use a human test meter that allows them to program it for cats or dogs. My guess is it's an AlphaTrac. If it is a 150 reading would be about a 120 on our Relion Micro. When we arrived at the ER yesterday our meter had him at a 34 and theirs had him in the low 60s I believe.

Ha, I just mentioned something along those lines in yesterday's condo. :-)

Sending feel-better vines,
Carl
 
Re: 11/29 PurrFace UPDATE

Oh John,
I just checked on the board and saw PurrFace was in the ER. My best prayers for him and you and Donna. I know he'll get better and better now that he's home with his precious family. I'm keeping you all in the white light and sending tons of "be wonderful" vines to all of you. Keep getting stronger and stronger sweet little PurrFace, eat up those fuds!!!!!!!!
be well, safe, and healthy
xoxo mary and ollie
 
Re: 11/29 PurrFace UPDATE

Just going to throw this out there....

If Purrface had not dropped into the thirties, but say maybe to the upper 40s yesterday, that would be the 3rd time under 50, so he would have gotten a reduction, right? So down to 2.0u?

And if had dropped to 38 and NOT required a trip to the emergency room, it is possible that someone would have suggested a reduction regardless of how many times he'd gone below 50? And maybe even a .5u reduction?

Given the measures that it took to get him up yesterday, and given that he may be a bit more "sensitive" to insulin short-term, does anyone thing that maybe 1.5u makes sense today? Or am I being overly cautious?

Carl
 
Re: 11/29 PurrFace UPDATE

I've heard that when they have a symptomatic hypo that they will often be extra sensitive to insulin. I don't know if PurrFace had a symptomatic hypo though. I think, as long as John and Donna are home to watch him, that the 1.75 (or 1.80) dose will be fine to try.

I'm so glad he's home. :YMHUG: Sending eating vines to PurrFace.
 
Re: 11/29 PurrFace UPDATE

I'm so glad to hear that PurrFace is doing so much better. Sending tons of healing vines, and wonderful appy vibes for him. I hope you're having a good day so far. :-D
 
Re: 11/29 PurrFace UPDATE

After reading Carl's thoughts I decided to start him back on insulin at 1.5U. I'd much rather error on the side of caution and I can always increase it if needed. He just ate 1.5oz of 5% FF so I gave him his AM shot. I'll probably be hairless and without fingernails between now and when I test him again.
 
Re: 11/29 PurrFace UPDATE AMPS 278

The most I would have suggested would have been 1.75u. I think 1.5u is fine.

It looks to me like you have been using the 3 drops into the 40 - 50 range before reducing. Given this experience and it can sometimes be easy to forget to take the reduction, I'd encourage you to return to the modification that's used here (one drop below 50). If you want to shave, that may be OK (unless there's a drop below 40) but please take Dyana's information into account. For a kitty that's dropped into low numbers for a while, there may be some unexpected sensitivity to insulin. Frankly, I'm surprised PurrFace's numbers aren't higher today.

What %-carb are you feeding? It may also be that manipulating the food will help to level PurrFace out.
 
Re: 11/29 PurrFace UPDATE AMPS 278

Donna & John, so happy to hear Purrface is home and doing so much better!
You guys continue in my thoughts & Prayers ;-)
 
Re: 11/29 PurrFace UPDATE AMPS 278

They said they use a human test meter that allows them to program it for cats or dogs.
I think you are probably right that they are using an AT but it's not a human meter that allows them to program it for dogs/cats. It's actually made for animals. Perhaps they were just oversimplifying it because they did not know you are as savvy as you are about meters.

I also think that the 1.75u dose is reasonable but if you have already shot f1.5u or something along there, I'd just leave him and see where he goes. If he stays really high and flat and it doesn't look like a bounce, you can increase after four cycles but since his depot needs to refill and he could be bouncing, etc, it would be best to hold the dose for six cycles. We can play that all by ear. I would watch him for insulin sensitivity but even more so, I would watch him because sometimes giving R can allow the lantus/levemir door to open and for that insulin to kick in. I doubt it will happen in this scenario because of the depot drain but never say never.

I did look at his labs and noted that the increased creatinine could possibly be attributable to a kidney infection and you should ask the vet. You PMd me that they gave him two doses of baytril and did not send any home with you. This makes absolutely no sense to me. One doesn't start an A/B, give two doses, and stop unless it's making the kitty really ill. Two doses would do nothing for a kidney infection....if there is one....because that usually requires 4-6 weeks on baytril. But I would never give baytril without a definitive diagnosis. Baytril given at too high of a dose "can" cause blindness so you have to be sure what you are dealing with and then prescribe the correct amount. Using it carefully, I've never had any issues. Gus had to take it twice for long courses due to kidney infections (which are not uncommon in CKD cats).

I also agree on a couple other points:
1. you might want to just start shaving doses when he goes below 50 once and see how he handles that kind of a reduction

2. if he does not do well with the lower dose, it is probably a very good idea to take a good look at his feeding and perhaps feed him just a little higher LOW carb food to manage the curve and flatten it out, as Sienne suggests. That would allow you to get more insulin in him safely.

Sending many healing thoughts and prayers. Please let us know how we can help.

Will you still take him into your vet?
 
Re: 11/29 PurrFace UPDATE AMPS 278

It's wonderful to hear PurrFace is home and looking like he feels better!!

With as hard as it was to get him back up, I would have taken the reduction to 1.5 too.

Sending extra healing vines for PF and hope he does well on the new dose!
 
Re: 11/29 PurrFace UPDATE AMPS 278

Morning John ~O) ~O) ~O)

It is wonderful to read that PurrFace is back home, and eating well. Good luck with the dosing. I too would think that the 1.75 dose would be OK, but also understand the desire for the 1.5. Sometimes it is best to go on the side of safety. One can always up the dose if numbers do not improve. I too am surprised that he isn't higher than he is this morning. Wishing you much luck!

I too am a bit curious on eh kidney infection issue. For sure a call ton the vet.

Enjoy your day today John. I hope all goes well. Welcome home PurrFace!
 
Re: 11/29 PurrFace UPDATE AMPS 278

So happy to read PurrFace is home and eating!
 

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Re: 11/29 PurrFace UPDATE AMPS 278 +1.5/280 +3.5/238 +5.5/24

Thank you all. Your support, well wishes and prayers are very much appreciated and helpful. As you can see he is surfing the yellow zone since his shot 3-1/2 hours ago. He is doing fine, up moving around, renewing his membership in the CPC, bright eyed and alert. He is tired though but not just worn out like he was yesterday. We are taking him to his regular vet on Monday. They were closed today and never open on a weekend. We don't have an appointment but the Dr. always fits him in. They all love PurrFace. He even had the techs and vets at the ER saying how lovable and gentle he was with them while they were treating him.

Thank you all again.
 
Re: 11/29 PurrFace UPDATE AMPS 278 +1.5/280 +3.5/238 +5.5/24

I'm so glad that PF is looking brighter. :-D
We've been keeping him (and you and Donna) in our thoughts ♥
 
Re: 11/29 PurrFace UPDATE+1.5/280 +3.5/238 +5.5/247 +7.5/314

John & Donna
Very happy to hear PurrFace is home with you and has been eating again. They come around so much quicker in their own familiar environment. You are all in my prayers as PF continues to improve :YMHUG:
 
Re: 11/29 PurrFace UPDATE PMPS 315

Piling on the vines for Purrface. There really is no place like home to help him feel better, especially with the care of his most excellent beans.
 
Re: 11/29 PurrFace UPDATE PMPS 315

John and Donna
I missed that he had to go to the ER yesterday.
So sorry he was unwell, but I am glad he's home and doing better now.
I am sending tons of healing vines to PurrFace.
 
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