3/23/12 Max PMPS 395 For information only.

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max&emmasmommie

max&emmasmommie

Member Since 2012
Link to post in Lantus (Relaxed) http://www.felinediabetes.com/FDMB/viewtopic.php?f=32&t=66887

Hello Everyone,

***3:12 a.m on March 23, 12 Still hoping for an answer -- will keep testing and posting new results. I am encouraging him to eat to keep his BG from dropping too much and creating yet another bounce. Thanks.***

We leave tomorrow (Friday) night after Max's 8:00 PM dose. I'm worried about ketones, but we are givIng him 1.75u now. Should we tell the sitter 1.5u? I'll do my best to run a full curve on him before we leave. Maybe some of you will be available at 7 or 8 PM Pacific time for a final bit of advice.

This morning, Max's BG was down 100 points from PMPS last night. He had diarrhea this morning. So, I'm wondering if 1/8 tsp of Miralax twice a day is too much. I'm skipping the pm Miralax dose. He had a very soft poo on my bed today. Obviously, he's disturbed by something.

He ate very well, went outside a lot today, and looks good. I'll appreciate any advice you may have on the dose or anything else. Thank you
 
Re: 2/22/12 Max AMPS 475 Too Much Miralax?

dale - i read your other post. if he's having diarrhea, he doesn't need miralax. that's for constipation issues. also, if he's on antibiotics, that can give him the runs. to help him get back regulated, you can try plain no sugar added yogurt or fortiflora works well to re-colonize their guts with the right bacteria. most cats like it.

glad his morning preshot was down from last night! this is a good thing!
 
Re: 2/22/12 Max PMPS 415 What Dose for Sitter?

Did you get the answer yet for what dose to tell your sitter to give? How long will you be away.? Will the sitter be able to home test ?
 
Re: 2/22/12 Max PMPS 415 What Dose for Sitter?

Did you get the answer yet for what dose to tell your sitter to give? How long will you be away.? Will the sitter be able to home test ?
 
Re: 3/23/12 Max +6.5(PM) BG: 278 Anyone? What Dose for Sitte

Hi Dale.

Just to let you know, if you want to make an addition to your thread, please use the Post Reply button and add a new post to your thread. Most people will not go back and re-read a post that they think they have already read previously, and then will not see the edits you made to your first post.

Keep posting your numbers for today, and if you don't get an answer by mid afternoon, then starting bumping your thread to the top of the page, by using the Post Reply button, and typing bump in the box.

How long are you going to be away for? Does your sitter test?
 
Re: 3/23/12 Max +6.5(PM) BG: 278 Anyone? What Dose for Sitte

Thanks for the posting tip, Dyana. See below for answers to your questions, please.

Hello Everyone,

***4:40 a.m on March 23,2012 Still hoping for an answer -- will keep testing and posting new results. One thing to consider is that he will be alone for 11 hours at a time, and he tends to eat less when he is alone. He likes someone to move his food around before he eats it. He's used to eating small amounts at a time.

Right now, I am encouraging him to eat to keep his BG from dropping too much and creating yet another bounce. He was at 278 at +6.5. Then I fed him fresh food, and he's at 337 at +8. Thanks.***

Link to Relaxed post: viewtopic.php?f=32&t=66887&p=727864#p727864

We leave tomorrow (Friday) night after Max's 8:00 PM dose. We will be gone from Friday night until April 2 in the late afternoon == 10 days. The sitter is planning to test, but I just taught her the other day. She got lucky and got blood the first time, but that may not happen each time. She won't be checking in at +6. She'll only be here at AMPS and PMPS, but I told her that if she thinks something's wrong (yet not wrong enough for a vet visit), I'll give her extra to check on him in the middle of the cycle that time.

I'm worried about ketones, but we are giving him 1.75u now. Should we tell the sitter 1.5u? I'll do my best to run a full curve on him before we leave. Maybe some of you will be available Friday at 7 or 8 PM Pacific time for a final bit of advice.

Dale
 
Re: 3/23/12 Max +6.5(PM) BG: 278 Anyone? What Dose for Sitte

Does Max have a history of ketones or DKA? If so, when was the last time he had ketones?
 
Re: 3/23/12 Max +6.5(PM) BG: 278 Anyone? What Dose for Sitte

Ketones -- no, he has never had ketones, to my knowledge. I've only been testing for them for about 2 weeks. He used to throw up. It wasn't hair balls. It was often kind of like a gel or it was his food, but more often it was a gel. I thought it was because of the CRF. He did it a lot before I started giving him renal support herbs. He has done that only once since I started him on insulin.
 
Re: 3/23/12 Max AMPS 429 Anyone? What Dose for Sitter?

Hi,

Ketones -- no, he has never had ketones, to my knowledge. I've only been testing for them for about 2 weeks. He used to throw up. It wasn't hair balls. It was often kind of like a gel or it was his food, but more often it was a gel. I thought it was because of the CRF. He did it a lot before I started giving him renal support herbs. He has done that only once since I started him on insulin.

He's eating well this morning.
 
Re: 3/23/12 Max +6.5(PM) BG: 278 Anyone? What Dose for Sitte

hi dale!

this is a tricky situation and i'm not sure we've got a good answer for you. the concern is that he's bouncy, he got into the 50's on the 2.0, and in theory his bounce from that should've cleared by today, but he's still nearly 500 this morning. you're saying that testing is iffy and he's going to be alone all day for 10-11 days. he's also got diarrhea and is on AB's - if he does have an infection and it clears, he made need less insulin. but if his dose is dropped significantly, then he may stay too high for the next 11 days.

if he does have an infection and this antibiotic doesn't clear it up, if he doesn't eat normally while you're gone, and he sits in high numbers - that's the recipe for ketones.

it's hard to make a recommendation with those factors that anyone can be relatively certain will keep him safe.

is there any possibility of taking him along with you? we've learned that punkin can go pretty much everywhere with us. you would be amazed how portable cats can be.

is boarding him at the vet's a possibility?
 
Re: 3/23/12 Max +6.5(PM) BG: 278 Anyone? What Dose for Sitte

hello dale. nice to meet you! someone asked for more eyes on this thread... so here i am. :-D

juie's right. this is a very tricky situation. you'll be gone for 10 days. you have a sitter who may or may not be able to test at shot times. max will be alone most of the time. while he doesn't have a history of ketones, he bounces so hard that remaining in high numbers could become a problem. there's a poo situation which has not quite been resolved yet. the antibiotics could be causing diarrhea at the moment, but when those are finished he may become constipated again. constipated kitties often vomit and refuse to eat. as it is, you've mentioned he eats less when you're away and wants his food "moved around". no one will be there to do it for him. add CKD into the mix. if he doesn't eat enough, CKD kitties often vomit. as you see, there's much more to consider when leaving him home alone than just an insulin dose.

i've thought real hard about this... weighing every possible scenario. i'm sorry. i'm not comfortable suggesting a dose which will guarantee his safety over the next 10 days. there are too many unknowns/variables involved. even the suggestion to drop the dose to 1u bid is iffy at best.

whenever i offer suggestions or advice i try to put myself in the situation. given the circumstances, the best advice i can offer is to suggest either taking him with you or boarding him at the vets or another pet care facility where all his issues would be monitored. imho, he needs more supervision than what a sitter can offer coming in twice a day to administer shots. this probably isn't what you wanted to hear, but none of us has a crystal ball available to see how he'll react over the next 10 days. i would hate to suggest a dose and have you come home to find out it wasn't right and max in worse shape than when you left.

just my thoughts...
 
Re: 3/23/12 Max +4 418 What Dose for Sitter?

Thanks Jill and Julie,

I agree with you. I wouldn't feel comfortable giving advice in this situation either. It's very tricky. I can't bank on him never having ketones. I doubt he'll drop low like that again as I think it was due to the infection and the constipation, but . . . This is a terrible time for me to leave.

We are flying out of the country. So, we can't take him.

Boarding: he'd be in an unfamiliar environment which would make his condition possibly worse. I can't trust any vet I know to give him the right amount of insulin.

The worst part is that no one will be there at night. Even worse, Max's shot time would have to be moved back to 6 o'clock from where it is now at 8 o'clock -- tonight at 6 pm. Impossible. The vet's office closes at 6 p.m. every night. So, for $1,650.00 I have a 50% chance he will be hypogylcemic or have ketoacidosis while no one is there.

There is another vet many miles away, that I have never used before, that proposed to board him for $1,150, but I didn't get the details on how often they would test him, and they want a $200 exam to even consider it. It's too late now to try that.

I think I'll offer my sitter a good deal to stay here and hope she says yes.

Thank you all for your attempt to help.

Dale
 
Re: 3/23/12 Max +6.5(PM) BG: 278 Anyone? What Dose for Sitte

Dale-
You mentioned the other day grandma was watching Emma. Is she nearby that she could check on Max often?

Just a thought.

I am really sorry there is no perfect answer. I am hope your sitter can consider house sitting, as well as watching Max. If that ends of being the case, make sure to give him/her access to FDMB so they can post any questions which may arise.

Try to enjoy your trip, Dale.
 
Re: 3/23/12 Max +4 418 Sitter stays night/Dose?

Hey everyone,

Good News: So, the sitter is going to stay the night except for Saturday nights, and she is going to come to check on him at mid-day every day. I'm still considering lowering the dose to 1u, but if she is successful in testing it would be more likely she would catch a hypo than that she would catch a fresh urine sample and find ketoacidosis.

I think I have to lower the dose to 1.5u because the syringes are not marked at .25 and .75.

Any comment?
 
Re: 3/23/12 Max +6.5(PM) BG: 278 Anyone? What Dose for Sitte

You can always (and I would recommend this regardless of the dose) set up a "demonstration" syringe using milk or a colored liquid. That gives the sitter something to compare to. (We've seen well intentioned friends shoot 5.0u vs. 0.5u because they didn't know what they were doing.) A sample syringe will make sure things are clear.

I think having the petsitter stay is a fantastic solution. It will let Max get familiar enough that testing shouldn't be a problem, she can coax him to eat, and if his insulin needs drop, she can adjust the dose.

Would you be willing to let your petsitter access your FDMB account? Or, would she set up her own account so if she needs help, we can lend a hand? If you leave her the instructions as to where to post, you know we will be more than happy to provide support, feedback, suggestions -- whatever she needs.

I'm doing some checking on dose.
 
Re: 3/23/12 Max +6.5(PM) BG: 278 Anyone? What Dose for Sitte

Hey everyone,

You are all so wonderful, and so is Mel (MommaofMuse)! I will give my sitter the user name and password so she can post here if she has questions. Thank you!

My sitter's name is Fawn, and she's the mother of cats, dogs, and horses. She's a true animal person, and I know you will like her. She is very nervous about this, and her other pet sitter friends probably have told her not to touch this one with a ten foot pole. I'm lucky that I found her, and if something happens, I know she will have done the best she could have done under the circumstances. We will be in constant contact via email, and if necessary, texting and calling.

Carolyn, Grandma is the reason for this trip. She is turning 70, and she's taking her two sons, daugther in-laws and 2 granddaughters on this trip.
 
Re: 3/23/12 Max +6.5(PM) BG: 278 Anyone? What Dose for Sitte

Dale, yay on a fantastic solution! that's the best possible one. i'm so glad you were able to figure out a good plan - you'll be able to enjoy your trip a lot more knowing that someone's watching out for your max!

if your petsitter is testing, we can help her interpret what's going on and adjust the dose if necessary. make sure she has access to your spreadsheet as well!

have a wonderful, wonderful trip! we'll help her if she posts.
 
Re: 3/23/12 Max +6.5(PM) BG: 278 Anyone? What Dose for Sitte

sorry i'm so late getting back here. having problems with my internet.

you definitely want to lower the dose to one that has a line on the syringe. 1.5u may be fine for now, but it's really important to have your sitter get some mid-cycle spot checks whenever possible because the dose may need adjusting while you're gone. it's also important for her to encourage max to eat. if he's not eating much she'll need to lower the dose even more. you also may want to give her a "no shoot" number of 150.

we'll keep an eye out for Fawn. please tell her not to hesitate to post, ok? we'll help her out as best we can.

enjoy your trip!
 
Re: 3/23/12 Max +8 391 Lowering dose to 1.5

Hi,

Thanks everyone for all your help!!!! I'm going to lower to 1.5 because it will be on the line, and it's only .25 less than where we are now. I don't like his numbers, of course, and I'm afraid to lower any more because of ketones. During the night his numbers sometimes get lower because I'm not up to move his food around. He is eating well now, and if he doesn't eat in the day because he's alone, then it will be good that I lowered it to 1.5.

I'll update the spreadsheet until we leave tonight if I can.

Fawn will be signing in as me. I appreciate any help you can give her. I might come on line a few times, too.

Hope all your kitties and droolers are doing fine, and the beans, too.

Dale
 
So sorry to hear this Dale. I hope he is ok and eats ..no more vomiting.

We all hope you have a safe trip and we'll be here to help Fawn.
 
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