3/12 Max, AMPS 460--need HELP

[Mindy & Max]

Okay, so we screwed up his shot yesterday morning and it was 2 hrs late. So I held dinner an hour late last night and gave the pm shot at +11. His BG was 526 at that time. At +3, he was over 600--all the meter said was "HI". His behavior was completely normal, actually he looked better than he did the night before. He came and cuddled with me on the couch and was purring.

Peed in a couple of spots in the house overnight. He's been routinely peeing on rugs lately (we have laminate floors everywhere but the bedrooms), but they're all in the wash, so this time it was on bare floor. That's new for him.

Again this morning he was acting normal, waiting on the half-wall by where the food is put out. He let me test him, and ate like normal.

I have no idea why his numbers spiked so high last night. I could not check for ketones as I don't have any strips--pharmacy didn't have any when I was there the other day.

I know there are a lot of numbers I don't have on his sheet...but is it possible that his dose is too high and he's rebounding? His numbers were steady in the 300s for a few days, but now they're all over the map again. And for those who haven't been following him, he is eating only low-carb canned Friskies.

I don't have internet service at home, so I won't be able to post more numbers until Monday...and I don't know what to do if his numbers continue to stay this high.

Yesterday's condo: viewtopic.php?f=9&t=8802

 

[Roni and Moonie]

He could have a urinary tract infection which would cause peeing all over the house, and high numbers--Any infection could cause numbers to rise--Very very common in feline diabetics...
Have you had him checked by vet?? Maybe you could bring in a urine sample to vet...It could be the problem..
Cat is not on a regular schedule of 12/12 shots--very important..If you are a newbie, it takes time to get them back to manageable state.
Patience & consistancy are what works here--On the upcoming holiday, I have told family I will come for dinner early, but am leaving to go home to Moonie for her shot--That's just the way we live--
Hope you find the answer today--

 

[Sienne and Gabby (GA)]

Without more mid-cycle checks, it will be hard to know if the dose is too high.What you would expect to see if this were the case would be much lower numbers at mid-cycle and a bounce up to high numbers around pre-shot time.

Roni may be right about a urinary track infection. However, if you are going to get this checked out, it's best if the vet does a cytocentesis (i.e., gets a sterile sample) in order to determine if there's any bacteria. It's also possible that there are crystals. Is Max straining at all?

Have you double checked on the carb content of Max's food? Could he have gotten in to anything that was high carb? You've mentioned having young children at home. We have a couple of kitties here who have stolen muffins, cookies, etc. Could Max be "helping" the kids with with their food?

 

[Venita]

Mindy, you raised Max from 1U to 2U after two shots because 2U is what the vet had recommended as a starting dose.

I'm no Lantus dosing expert, and I hope others chime here if I'm way off base, but I think it would make sense to start back over at 1U. Cats can show high numbers from too much insulin (a rebound effect).

Your vet, who you said didn't know Lantus and had to research it, was probably dosing based on Max's body weight. I do not think that is the preferred method here. I believe most cats here start on 1U.

As for Board coverage over the weekend, I hope some of the Lantus folks will exchange phone numbers with you. If you have questions over the weekend, you could call one or more of your phone contacts and they could post a condo for Max and get feedback from the group. I don't know who all the "go-to" people are here on Lantus so I don't want to suggest someone(s) and leave others out, so please Lantus folks, could you help Mindy set up a weekend network? (If this doesn't work out Mindy, you have my phone number and I could be the go-between for posting.)

On Roni's idea of catching a urine sample to take to the vet, I would suggest something else if there is reason to believe Max has a urinary tract problem. A sterile sample through cystocentesis, which involves the vet inserting a needle into his bladder and drawing urine out. It sounds like an ouchy, but my cats never flinch when they have it done. That is, IMO, the better way if you are looking for bacteria. However, at this time, I would be inclined to think that it is the unregulated diabetes that is causing Max's inappropriate urination.

 

[Hillary & Maui (GA)]

I already PM'd her with my phone number and the offer to post, etc. and let her know that she isn't alone. :mrgreen:

 

[PeterDevonMocha]

I'm no dosing expert either, but I know the most common strategy is start low, and go slow. Meaning start at a low dose, and hold it for X amount of days (cycles) and then either raise or lower the dose based on numbers. Mid day numbers are very important (nadir-lowest point in the kitty's cycle) because dose amounts are based off that number.

 

[Mindy & Max]

Yes, I have two phone numbers now for weekend contacts. Thank you both!

And yes, the vet was dosing based on Max's weight. She wasn't thrilled when I said people online were recommending starting at only .5 or 1 unit and then going up from there (her exact words were something about the .5 unit getting stuck in the needle and not really getting into the cat). I started at 1 unit because we couldn't be home that day and watch him.

As far as I know, Max is not straining to urinate. If anything, he's letting go because his bladder is just too full--it's always a large amount when he goes, and it generally only happens overnight (not during the day). He is still drinking water like a fish (understandably). He actually peed in the carrier on the way home from the "learn to shoot insulin" appointment last weekend. He yowled at me a few times when we were nearly home, and then I found the blanket wet when I let him out. I think it's happening because he just can't hold it. We used to use non-clumping litter, but the "accidents" around the house were happening more towards the end of the week, and when I looked, sure enough the boxes were full and very wet. I switched to clumping in hopes of keeping it clean enough for him, but he's still not happy about it--he's peed on the floor in front of the box at least twice that I know of.

I doubt Max has been helping my daughter with her food (my son isn't on solids yet, so I know it's not him!). We usually only let her have food at the table, Max isn't big on table food unless it's yogurt, but both my cats are trained to stay off the tables and counters (well, at least when we're home and looking!). And we have a 90-lb australian shepherd/collie mix that is pretty much on top of any crumb that might fall when Casey is at the table. The cat we lost to a fatty liver trained us to not leave any food, particularly carbs, on the counter as he was quite a piggy and would steal whatever he could get. The only food left out at this point is produce, and I know the cats aren't nibbling on that. Hmmm...tho now that I think about it, Casey's been eating Rice Krispies in the morning and so has DH. I'll have to make sure they're not dropping any.

 

[Venita]

I wanted to share the pic of Max that Mindy sent to me. Isn't he a sweetheart??

Mindy, OK like you don't have enough to do, but Dr. Lisa, our resident vet here, recommends one more box than there is cat (a cats, 3 boxes), unscented clumping litter, and box cleaning twice a day. (I only do once.) If the floor peeing is happening at night, is it possible to put Max and his box into a small bathroom at nights so that there is less space to look for messes and maybe more of a chance he will make it into the box?

As for food scraps, I know some people have had trouble with their cats getting into the kitchen sink where used food plates/bowls are left while folks are gone for the day or asleep at night. If you and DH don't do dishes or load them into the dishwasher before leaving/sleeping, maybe get a piece of plywood cut to size that you can use to cover the sink so no errant diabetic kitties help themselves to scraps.

 

[Jen and Oreo (GA)]

Mindy,

I haven't visted you yet, so "hi" :smile:

I only read part of your second post as some of what your vet (who admitedly doesn't know much about FD) said irritated me. Hilary is a great resource! Please call her over the weekend :smile:

I think you need to start over at 1U, hold it for 5-7 days, get some mid-cycle checks when you can and then the more experienced can help you get sweet Max on a dose that works for him!

You can do this and so happy to see you made the decision to try. As for what Venita was saying about the plywood, I have a huge cutting board that I can place over the sink when DH and I are too lazy to do dishes before bed.

 

[Mindy & Max]

Thanks for posting the pic, Venita!

Thanks for the suggestions on covering the sink. We aren't the best at getting the dishes done, but I've warned DH there will be consequences to pay if he leaves dirty/wet dishes in the sink until we get Max in better order. DH is known for leaving pots full of "soaking" water in the sink, and with as much as Max is drinking, I don't want him getting into something scummy because the big water dish got too low. I will have to ride DH harder about making sure the trap is cleaned out--never crossed my mind that he might be eating leftover food from there.

Hmmm...and now that I think about it, the dog recently hasn't been eating all his food. The cats have never gone near his bowl, but I suppose it's possible they're getting their carb fix from there while we're gone. I'll also start making sure we don't leave any food in there.

As for the boxes...At this point I'm struggling to get the boxes scooped out once a day. Once I get that in order, I'll aim for twice. Space is limited, adding a third could be done, but it might be a challenge. As for putting one and Max in a bathroom, well, that would mean we can't use the bathroom as it is our only one, plus the boxes are in the basement rather than the main floor (small children, remember). I didn't see unscented litter when I was looking the other day (my own personal preference), but I did switch from Tidy Cats non-clumping, to Tidy Cats clumping, in hopes the scent was the same/similar (and I got lucky and it was on sale).

I should be able to keep a closer eye on Max this weekend--we have less happening than last weekend. I am definitely tempted to back down to 1U and see what happens.

Oh, and this was posted on another thread about Max:

Dale
Joined: Mon Dec 28, 2009 4:07 pm
Location: northeast Oklahoma
Member since: 0- 0-2005

Re: FD Max in MI needs new home

New postby Dale » Fri Mar 12, 2010 11:39 am
Might I add that with a steroid-induced diabetic, IF they are going to come OTJ hometesting is a necessity because you don't know when that steroid is going to completely konk out and leave the body. With my two it took between 4-6 months. And when that happens you MIGHT see high numbers during one preshot and a low number the next preshot. That's what both Scrappy and Fang did when they came off the juice. I kept thinking I was giving them too much insulin cause it was lasting +12 and the insulin I used wasn't supposed to last that long (PZI). Once I just stopped the insulin his numbers leveled out and they were back to normal cats.
FWIW.

This is interesting to me as Max has only been off the pred for just under 3 weeks now. He was on it for a month. At the time of his diagnosis, he'd only been off it for about 4 days. Definitely makes me think about backing down to 1U and seeing what happens.

 

[Sara & Magnolia]

Did the peeing problem start when you switched litter??? That could do it and wouldn't that be an easy fix?

I think I've missed a lot, but only have a couple minutes to type, have you read all the stickies? This protocol can be so confusing and overwhelming! Can you print out a copy to take home with you? Without spot checks, there's no way to know if these high numbers are rebounds, or if the dose is just too low.

I have no experience with prednisone, but I too am intrigued...

And don't be too hard on yourself. You are doing a great job! You are in the right place and you will get a lot of help from the caring folks here.

 

[Mindy & Max]

Oh how I wish the peeing problem only started with the litter! It was problematic before the switch, as the switch only happened on Tuesday. :smile:

 

[Deb & Spot]

Hi Mindy! Just dropping in to see what is going on with you guys today. I can only echo what everyone else is saying....numbers could be higher due to high carb scraps he is stealing, to large of a dose, UTI, or stress. I also suggest that you drop your insulin back down to 1u, and then make sure that you make it back to the store to get some ketone strips...with numbers this high, it's important to make sure that you are checking for ketones.
As far as the inappropriate elimination...do you remember how long ago this started? Has there been any changes in the household (beside Max's dx) that may have stressed him out? My Ralph started peeing on my carpets when I moved into my new house... That, plus a series of many other things must have pushed him over the edge (we moved from the only home he's ever known to the new house, my mom moved in with me, his best bud....my Akita, Kodi, passed away and my sister and her three kids moved in with us...all within a matter of 4 months). After three years of this, I finally decided to try him on Buspar, and he hasn't peed anywhere except in the litter box. Of course, I clean the box out daily, wash them weekly, and pulled up the carpets where he peed, lol.
And, btw, your max looks just like my Ralph!!

 

[Melanie and Smokey]

Hi Mindy,I just wanted to comment on the rug peeing, this was one of my Smokey's biggest things. No matter what the box was like, she walk right past it and pee on my bathroom rug. After a couple weeks on Lantus we went a few days with no peed on rug and knew my Smokey was doing better. It has gotten progressively better as the diabetes becomes regulated. There is hope.

 

[Kelly & Logan]

Definitely pick up the dog food! Logan will get into the dog food if we don't watch him closely. He even takes food while the one is eating.

With the rug peeing, you may end up having to buy a new rug. Some cats will continue going in the same area if they can still smell the urine. Just a thought if he continues to pee on it even after becoming better regulated.

The pred definitely makes them drink a ton of water! So coming off of that and getting better regulated should help with the peeing situation. It may not hurt to confirm that he doesn't have a UTI, though, if you don't see any improvement.

 

[carolynandlatte]

Hi Mindy,
My Latte was on a steroid for three months. She began peeing herself and getting in her LB, but peeing outside of it. A little tweaking and it got better, until the end of the three months. It started happening again, and sometimes she would get up from the spot she was laying, start walking to the LB and just lift her tail to pee on her way. It was not her typical signs of a UTI, but decided to take her in once the peeing anywhere started. Sure enough, she had a UTI (which got much worse...she was VERY sick from it), and they detected sugar in urine with a BG in the 300's.

I weened her off the pred to see what would happen (she has ibd and/or gi lymphoma). You can look at our ss for the first month and see she was on a very small dose of insulin (.25u) and gave great numbers as the pred became less and less in her system. The longer she was off the pred however, and GI symptoms got worse, the higher the BG's got again - because she was not feeling well. I think she may have also redeveloped a UTI at that point. Started her on a chemo drug that she responded very poorly to, so we had to go back to the pred...or pts. Now her numbers are yucky again.

When we lived with a dog,and latte was not feeling well from the kidney failure, one of the only things she WOULD eat is the dog's food. I noticed Kelly's logan is gravitating toward dog food right now...and possibly not feeling great. Maybe there is a correlation?

I would definately make sure there is no UTI.

Try and add another litter box (or a different one...I had to try out many). Can you keep a box next to or near where Max lays? Latte likes to lay between her water bowl and LB. easy access to the necessities of a diabetic cat on pred! :roll:

did you cut the pred out cold turkey or wean max off of it?

i would also echo what others say about maybe starting at a lower dose. our vet wanted me to start at 1u. I tried .5 first, and that almost sent her into a hypo. its quite possible, if the FD is transient from the pred max is starting to go too low and rebounding.

I hope the weekend goes okay.