12/10 Oberon AMPS 412, +2 348, +4 319, +6 327, +9 340, PMPS 368, +2 364, +4 327, +5.5 343

Lisa & Oberon

Lisa & Oberon

Member Since 2020
Yesterday: sky high all day https://www.felinediabetes.com/FDMB...-390-6-330-9-382-pmps-411-3-407-5-409.239770/

Wendy&Neko said:
You are now seeing fully what the 5.0 unit dose can do, the 5.5 unit depot is gone. He could still be bouncing from the long streak of green on the 6th. If you don't see bounce clearing tomorrow, I might think about whether this is a failed reduction. It may mean time to go to under 50 for reduction point. Or maybe not. Up to Oberon. :cat: Tonight might be the high before the low.
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I think he cleared that bounce on 12/8 when he dropped down to the blue/green border. But I've been wondering if he might need a bump up.

He was over 400 this morning, so we're starting off with 0.25 U of R along with the 5 U Lantus. But I think it's time to break out the calipers so I have better dose accuracy... I've been giving such high doses that I haven't been bothering with it. Caliper calibration will be my project for the day.
 
Interesting to see that the 0.25 units got you down the 100 points today.
Lisa & Oberon said:
I think he cleared that bounce on 12/8 when he dropped down to the blue/green border.
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Possible, but it also had some influence from the larger depot, meaning he's probably not hitting greens on 5 units alone. But he could also be saving it for tomorrow. The good thing is you get so slow down the testing today.
 
Wendy&Neko said:
Interesting to see that the 0.25 units got you down the 100 points today.

Possible, but it also had some influence from the larger depot, meaning he's probably not hitting greens on 5 units alone. But he could also be saving it for tomorrow. The good thing is you get so slow down the testing today.
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Yeah, it looks like I can definitely bring the R scale down. I'll stick to 0.25 U if over 400 for now. Or should I use 350 or even 300 as my cutoff?

Do you think I should think about increasing the Lantus dose tonight, or give it another cycle or two to see how low he goes at this dose if/when this bounce clears?

I went back through his records from Sept, and the internist actually mentioned that he could use a dental cleaning but it wasn't urgent. She wanted to wait until other stuff (ketones, figuring out IAA/acro) had settled down. Maybe it's time to do that now. The ER hospital has a dental department (though no one board certified for dental; I'd have to go further away for that).
 
I'd try another experiment at 0.25 unit R, to see if there is consistency, then decide if you need to change it.

I'd also wait on the Lantus increase, just in case. Never trust an IAA cat!

For the dental, you want to make sure they'll take x-rays before starting the procedure. Neko had things below the gum line that even the dental specialist couldn't see by naked eye. Sometimes you can find a regular vet who specializes in dentals, even though not certified they have lots of experience. The thing a specialist gives you is probably extra help monitoring during anaesthesia. Since Neko had a heart murmur, that part was important to me.
 
368 at PMPS; I think I'm going to try another 0.25 U of R. I'll be up long enough to monitor (and can stay up later if he really dives).
 
Wendy&Neko said:
For the dental, you want to make sure they'll take x-rays before starting the procedure. Neko had things below the gum line that even the dental specialist couldn't see by naked eye. Sometimes you can find a regular vet who specializes in dentals, even though not certified they have lots of experience. The thing a specialist gives you is probably extra help monitoring during anaesthesia. Since Neko had a heart murmur, that part was important to me.
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Yeah, I definitely want them to do x-rays. My other concern is renal function; all his numbers were fine in late September but the ultrasound showed he was missing a kidney and the other was slightly hypertrophied, suggesting possible renal disease. Wondering if we ought to do bloodwork before putting him under, just to make sure all's well. (I've also been wondering just in general how often we should be doing a routine senior panel, given everything he's had going on. Every 3 months or so? If so he's about due.)
 
Any vet will want blood work done within the last three months before considering anaesthesia. So yes, renal function will be checked before a dental. I did b/w every 6 months for the longest time. It got more frequent when we were trying to control phosphorus, potassium levels for CKD, and after she started chemo.

Some vet clinics have discounts on pet dentals during February (pet dental month). Might have to book them now if you want to take advantage of that.
 
Lisa & Oberon said:
I went back through his records from Sept, and the internist actually mentioned that he could use a dental cleaning but it wasn't urgent. She wanted to wait until other stuff (ketones, figuring out IAA/acro) had settled down.
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IMHO for a diabetic kitty anything that can cause even a low grade infection is best addressed sooner rather than later. Infection raises BG
 
Sandy and Black Kitty said:
IMHO for a diabetic kitty anything that can cause even a low grade infection is best addressed sooner rather than later. Infection raises BG
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Yeah, I'm starting to think I should get moving on this soon. I'm just nervous about it. (At least this recommendation wasn't as bad as the one from my regular vet in July. He wanted to wait for the pancreatitis to clear up before starting him on insulin...)
 
Only down about 40 points at +4. Not much R effect this time around.

Also, he's seemed a little bit off this evening (starting before PMPS). Nothing I can pinpoint, just a little down. Appetite is normal or maybe just slightly lower than usual. Heart rate and breathing rate are normal. Ketones 0.5. But he's looking like maybe he doesn't feel well. For a while just now he was sitting by my laptop as usual but instead of lying down he looked like he was ready to fall asleep sitting up. Checked the feline grimace scale and he was showing some of the signs of possible pain (ears slightly back, eyes squinting a little). Now he's sacked out on the table as usual. I'm wondering if either he isn't used to these high numbers any more and has a headache or something, or alternatively that something else is bothering him and that's why his BG has been high. Don't think there's much to be done at the moment, but I'll keep an eye on him.
 
Earlier tonight
 

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Back up a bit at +5.5, and I'm heading off to bed. He seems better now, so maybe it was just me reading too much into his behavior. I'll still keep an eye on him.
 
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