2/15/13 George AMPS 426

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Girlface

Girlface

Member Since 2013
Update on George. Still on 2 units of Lantus every 12 hours. We saw an internist at Georgia Veterinary Specialists on Tuesday at the recommendation of both the behaviorist and our regular veterinarian, as his polyuria is very bad. His thyroid is at the low end of normal, and an ultrasound shows evidence of mild pancreatitis, and moderate to severe pyelonephritis (kidney infection) in the left kidney. However, a urine culture showed no growth of bacteria. Blood pressure was normal. The internist is recommending a 3 week treatment of Clavamox. They also want to start buspirone, a medication for behavior, in the hopes it will help the behavior aspect of his polyuria. Blood glucose levels are still high despite insulin and diet.

Sigh.
 
Morning Whitney ~O) Welcome to LL.
I was going back and reading your previous posts to catch up on where you are...

I wonder if you've gotten some syringes ( half unit markings) so you can be ready to do your next dose adjustments when it is time.
Have you been reading up on all the sticky's at the top of the lantus board?
New to Lantus has lots of info you should read thru
and click on the links... there are pictures of syringes for the half unit markings.

and print yourself a copy of "symptoms and how to treat hypoglycemia" down at the very bottom just in case of internet outages...

It is possible that the jump in dosage was too much at once and that one of the advisors here may want to help you adjust that.
As you settle in to Lantusland , you may start discovering that your vet might not be experienced with Lantus and not giving you the
best advise. Many of the vets out there aren't. And when they go thru vet school, there isn't a lot of time spent on diabetes ( especially
feline). Your vet is suspect since he advised you to go up in whole units. That is done with other insulins, (and with canines) but not with Lantus.

There is far more experience and wisdom here and the people here will become far more involved helping you to help George. Ask questions
as you have them... Put a question mark or "question " in your subject line and post daily. There will be some of us tracking you
and the one's who advise scan thru the subject lines to see who needs help sooner than later.
George's infection may be keeping his numbers up and the increase in whole units could also be influencing his bg as well.

Keep testing and getting data ( and keep your ss updated)
Hopefully the Clavamox will address his infection and get him feeling better.
Reading other condo's will also help you learn.
I read everything here when I first got here. I was determined to get my cat feeling better and pushing for remission... I was lucky
to get to remission and I couldn't have done it without this site and the community here.
Most vets are only seeking regulation.

It would help others if you could add a line to your signature at the bottom corner that you are on the Alpha trak meter...
Most of us are using a human meter.

did George catch you a mouse?

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Hi Whitney,welcome to LL! I'll echo Rhiannon and recommend that you read through all of the stickies at the top of the forum; there's a lot of useful information there, and if you have any questions, just ask! There are some really great advice givers, and there is typically always someone online who can help you.

Regulation can take some time, and the best thing you can do is collect as much data as possible. If you have a free day, it might be a good idea to do a curve. As you know, PS testing is critical, but it's a good idea to collect more data about George's cycle. I usually try to get a +3, and more importantly, a +6 to record Kismet's nadir. I have found that a good method is to test at +5, +6, and +7 to see when kitty's numbers hit their lowest point, and when they start to go up. Curves are necessary when trying to determine the appropriate dose for you kitty. If you need help, one of the great advice givers can guide you through the process.

I read in your profile that you don't use Binky's food chart. Dr. Pierson has compiled a more recent list that lists all the nutritional facts for most commercial and specialty cat food. You can find it here: viewtopic.php?f=28&t=79683&p=861766#p861766. I suggest that you save a copy for future reference.

I hope George feels better soon and you are able to get his polyuria under control.

Courtney and Kismet
 
Pylonephritis is hard to diagnose. It's great that the vet did an ultrasound! You might want to do some reading -- 3 weeks is a rather short course of antibiotics for treating a kidney infection. Usually, a course of 4 - 6 weeks is needed.

Buspirone (Buspar) is often used to treat inappropriate elimination. There are other meds that are used as well.

I know I'm being a bit of a broken record but getting PM tests is really important. You don't know whether George's numbers are dropping at night and he's bouncing into higher numbers as a result. Lantus dosing is based on the lowest pointin the cycle and you don't have very many tests during the cycle to guide your dosing decisions. I don't feel comfortable commenting on dose without some spot checks in addition to your pre-shot tests.
 
http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf
The above list is what I used to choose the food we feed George, which is why we're using the Authority-Chicken. It's a 3% chicken. I updated my spreadsheet with all my current values. I will try to get a spot check before I go to bed tonight. I think the plan is to see how he's doing in 3 weeks, at which point we may continue the Clavamox.

I will make sure to read all the hyperlinks. I have not gotten any syringes as of yet. Pharmacy school never waits.
 
I'm concerned that your vet has him on clavamox and, as Sienne said, three weeks is not enough.

My oldest cat has had a few bouts of pyelonephritis. It is not uncommon for no bacteria to show up in the urine. That's why the ultrasound is so important. The best treatment for it is 4-6 weeks on baytril.

I also agree with Sienne that we need to see some nighttime checks in order to see where he's going with his BG at night.
 
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