3/20 amps 238 +6 360 just increased dose - advice?

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babbie & otto

Member Since 2015
hey. Just increased Otto's dose to 3.25 yesterday and pmps went up to 484 then this amps was low now going up at nadir. Scared he will be super high again tonight increasing his dehydration. We bouncing? Yesterday at vet after Otto had gotten into some oatmeal the day before and he had 3 liters of fluid but still dehydrated enough to keep him up last nite dry heaving. Still not feeling great today from the dehydration. On Feline's Pride raw but had been on ff. Im at a loss!
 
Prior condo (don't forget to put the link to the prior day's post...just makes it easier for us to quickly go back and look at what's been going on)

Without tests on the PM cycle, we just can't know if today's numbers might be a bounce, but I doubt it.

There's something we call "New Dose Wonkiness" that happens a lot when we first increase doses too, which may explain some of what's going on, but I have to wonder if there's something else going on with Otto since he's dry heaving.

Has he pooped? Did your vet give him anything for nausea?
 
Sorry, not good at links? past 2 days - He got into dry oatmeal,glucose goes up, I can tell he's severely dehydrated, go to vet, x rays reveal packed belly (maybe chipmunk remains),3 liters fluids, nausea shot, antibiotic just in case - then the next day an enema which went well. . Then dry heaves last night. Increased the dose but not expecting an increased glucose level at +6. Just not used to that. My vet read the info on Feline's Pride and wasn't happy with some of their info. I think he thinks that s the problem. For now, we are going back to FF. PMPS - 525!!!! My vet wants me to add 1U just for tonite but I know you guys would say no.
 
"their website had some misinformation, specifically regarding cat's gi tracts being too short to be susceptible to bacterial infections and processing plants are prone to contamination in their equipment."
 
BTW - you could put Otto's name in the subject line!

Some vets just don't like people giving raw food. Neko's main vet doesn't support it, her acupuncture vet does. More dry food has been recalled due to salmonella poisoning than raw food.

Even though Otto was high at PMPS last night it is still important to get a before bed test. That yellow this morning and the bounce makes me think he got lower last night. For what it's worth, Neko's first reduction (below 50), she started her cycle at and AMPS of 430 and she has earned reductions from as high as a preshot of 470.
 
Because your cat is ketone prone, and you have attempted a reduction to rule out overdose, I would be increasing by 0.5 as fast as you can. Likely, that 5U wasn't too much, but rather, not enough. Continue to increase until you see them improving. Some cats have co-conditions that cause them to need more (I'm guessing the depo), some just need more for no reason (Max's dose hovers between 4-7U and he's got no co-conditions).

Also, you may want to ask your vet to draw a potassium level if this hasn't been done (I can't remember from your last thread). Low potassium can slow down and weaken the GI track, and lead to constipation, nausea and vomiting. If he's dehydrated, add water to all his food to make it soupy to increase the fluids. Dehydration can falsely elevate BS tests and make it harder for the insulin to get into his body.
 
you're sweet to keep watching us! Ive been in a panic and out of town with a capable girl at home and the vet is my ex-husband who takes all my calls and texts. Last nt he wanted to me to give an extra 1U but I holdout. I think today may have gotten better. Ill update the ss and tell me what you think. He was low on potassium and gets it now 2xday. I was traveling all day yesterday and couldn't log on.
This sounds silly probably but I was thinking when he gets .50 increase he seems to go up instead of a .25??????
 
That's very convenient to have a friend as a vet! I'd ask him to redraw the potassium level when you get back home. Also, more subQ fluids might help if he's not drinking potassium can be added to the fluids if he's still low.

Is he eating ok on his own? There are some high cal wet foods available if he's not eating as much. I wouldn't worry so much about finding the lowest carb food until he feels a little better and is eating well. Any food that you start if he has nausea, he's not going to want to eat later.
 
the potassium is maple flavored and he is eating with no problem. Eats non stop. The nausea is gone and vet will come by if he needs them. My big question the past few days was what triggered all this? The vet thought there was an underlying problem (like the raw) but the his labs have been good, no ketones since Jan 21! Im out of the country and feel I have abandoned my baby but Im with my daughter on spring break and couldn't abandon her either.
 
Insulin and ketones can make the potassium really low. That's what probably led to the constipation/nausea. When potassium is low, muscles are unable to contract and become flacid. This includes the muscles of the intestines. Sometimes, oral potassium isn't absorbed efficiently for whatever reason, and supplements have to be increased. Labs should be drawn regularly when on potassium anyway, because elevated levels aren't good either.

It's great that he's eating well and no ketones and nausea is gone! Adding water to food will help dehydration, and getting sugars lower will definitely help. On your spreadsheet, it does look like the insulin is doing something. That is, your numbers at +4 to +7 have been lower than the preshot for a lot of the days. That's good. He's been at the dose for 6 cycles, so you can increase when you feel comfortable doing that.

Don't feel bad about taking some you time. It's a balance having a cat that needs daily care, and yet being able to do the things that are important to you. I've missed all my vacations this year, cause I was too afraid to leave. But now I found a boarding vet that will provide care. It sounds like you have a good system.

I'd continue to increase by the 0.5U. Sometimes, the day after the increase, blood sugars are a little random. That's why the 6 cycles is important, especially with the depot insulin. 0.25 increases is too low at this point with the history, dehydration, and such high sugars. Your dose is probably above the 5U you were at before and the sooner you get him there, the better. Once you start seeing better numbers (more yellows), then 0.25 increases might be better.
 
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dang, you're knowledgable! Thank you for the encouraging words. Its been tough! I lost my dog, cat and father in 3 years and this guy means the world to me. I don't want to hurt him or screw this up! Everyone loves this cat - he's just different, thank you again!
 
I agree with Meya14 about increasing asap. From last Wednesday's post:

I would also increase by 0.5u tonight. His nadirs are mostly over 300.

Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
You do want to stay on the dose increases and not wait too long on any dose - re-evaluate every 6 cycles. You dropped his dose significantly when you started here and it's possible that he needs more - you don't want him staying in high numbers any longer than necessary to be confident about the dose increases.

Glad you got him to the vet and figured out what was going on. Poor little guy.

Enjoy your trip with your daughter! How fun!
 
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