3/3 Eeyore AMPS 453 +5 519 Still High!

[Melanie and Eeyore]

Previous posthttp://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=114686

My my what a long week it was last week. I was home in Colorado caring for my mom in the hospital who went in to have her kidney removed for a suspected malignant tumor and ended up having a full Radical Nephroureterectomy because they found a different type of cancer actually stemming from the transitional cells of the kidney. She is recovering well however, and was able to go home last night.

Alas, I am back home myself and was glad to see my furry children. I am dismayed over Eeyore's numbers in my absence. Today I was really hoping to see some good numbers during nadir time frame and I don't know how optimistic I am after seeing his +5 at 519. I will be checking him each hour for the afternoon to see what is going on. Now that I have some more time on my hands, I will read more of the links some of you have posted for me about the depot, how long to wait before increasing a dose, and about high numbers.

Should I be checking Eeyore's ketones? If so, is that something where I can buy the test strips at the pharmacy or store?

 

[Melanie and Eeyore]

Re: 3/3 Eeyore AMPS 453 +5 519

I have checked Eeyore again now at +6 and he is even higher 554.

I hope these high numbers don't mean Eeyore is going into Kidney failure I wish there was something I could do! I just feel helpless

 

[Chris & China (GA)]

Hi Melanie. Sorry to hear about all you've been going through with your mother, but good that she's home and doing well! I bet you're happy to be home too! Nothing's the same as home!

It's always frustrating and scary when our kitties numbers aren't where we want them, but remember, this is a marathon, not a sprint and it may just take time to find a dose that works well for Eeyore without taking him too low.

Yes, it's important for you to test for ketones, especially with these higher numbers. You can get them at any pharmacy that has diabetes supplies...places like WalMart will have them too.

Here are some Urine Testing Tips. If you get any more than a trace, it's an emergency and you should get him to a vet. If it's a trace or less, we may be able to help you treat him at home, but it's important for you to know if he's producing them.

Adding water to his wet food (making it into a little "gravy") can help get some extra water in him too. The more water, the better it is to keep his kidneys healthy and if he does have any ketones in his urine, the extra water will help flush them out of his body.

You don't have a number in the U column of your spreadsheet today. Did you give another .75 this morning?

Hang in there! You're doing great testing, and we'll help you along the way. You really don't need to test every hour. It'll probably just make him grumpy and give him sore ears. When they're high, you can take a little break from testing so much but it's more important for you to test for the ketones. Every 2-3 hours is more than enough unless he goes low.

Eeyore is still very new to this and it's going to take some time! We all want our kitties cured "yesterday". Unfortunately, it just doesn't work that way. :sad:

 

[julie & punkin (ga)]

no, it absolutely doesn't mean kidney failure. it means we don't have Eeyore to the right dose yet.

I've asked a couple of others about thoughts on Eeyore's dose for tonight. Did you give 0.75u this morning?

Chris is absolutely right about checking for ketones. They can occur at lower BGs but whenever we see a lot of high BGs it's a good idea to be checking regularly.



I want to add an encouraging word about your mom - my father-in-law turned 81 yesterday and he is celebrating 34 years since his kidney transplant. He played his violin in a Symphonic concert yesterday. Sending all my best healing wishes to your mom!

 

[Melanie and Eeyore]

Thank you Chris and Julie for your support!

Yes I did give him 0.75 units this morning! I forgot to put that in, whoops! (Red eye flights will do that) I will get some urine test strips this evening. I've added some water to his wet food because I do feel like I have noticed him drinking less.(Granted I have only observed him today, since I've been back!) I guess I will just stick it out for several cycles with the 0.75 dose, I know it probably hasn't been long enough yet for it to work. I do wonder though, I spent some time today looking at others charts to see how they handled things and there were times where the insulin was increased almost every other day, so I'm just trying to figure out how to know. I will follow the protocol of 3-5 days for now, I just started getting anxious when his numbers were in the black!

Thank you for the encouraging words Julie, I too actually only have 1 kidney so I know its possible to have a healthy life! We just had a curve ball thrown at us when we realized it was a different cancer that caused things and myself, being a nurse applying to PA school, I over analyze medical situations close to home and think the worst right away!

 

[julie & punkin (ga)]

that's because your mother is so important! :YMHUG:

Sometimes we "fast-track" kitties that are having sustained high numbers. Eeyore's been a little puzzling because we've got those 2 low numbers in there, but i think our earlier conversations agreed that those were probably wonky test strips - maybe too much blood or not enough blood, or simply bad strips.

Here is the reference that you're talking about - increasing every 4-6 cycles if there are sustained high numbers:

http://www.tillydiabetes.net/en_6_protocol2.htm

Most cats need to have their dose increased. Do it in 0.25 IU or 0.5 IU steps (0.25 IU if the cat is getting a low dose and/or relatively low BGs, 0.5 IU if the cat is getting a higher dose and/or relatively high BGs). Hold each dose for 5-7 days. However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU. Alternatively, if the cat is continuously producing moderately elevated BGs (nadir always >=200 mg/dl), increase the dose every 2-3 days by 0.25 IU ( if the cat is getting a low dose) or 0.5 IU (if the cat is getting a higher dose). From this point onward test for ketones once per week, or more often if the nadirs are still >=200 mg/dl.

Eeyore's lowest BG reading (and good job getting enough tests) since 2/26 was 269. If he were mine, I'd increase by the 0.5u option that is offered above, so his new dose would be 1.25u tonight. Technically it is in the 200's, but so many of the cycles since then were basically all over 300, that's what i'd do.

Usually, the protocol does suggest holding doses for 6-10 cycles, depending on the range. But Eeyore's got some ugly numbers and it looks like he needs more insulin sooner rather than later. What do you think about that?

 

[Marje and Gracie]

Melanie

Prayers for your mom. I truly hope she recuperated fully. How lucky for her to have you there with her during her surgery.

I agree with Julie that I would increase by 0.5u and give him four cycles to see what he does. We have often advised new caregivers to keep increasing every four cycles until they see some yellow and then slow it down. We might need to do that with Eeyore but let's take it a step at a time for now. Sometimes they just need more insulin

 

[Melanie and Eeyore]

I agree. I gave him 1.25! Fingers crossed! Also, my husband picked up some urine test strips on his way home from work so ill work on getting a Ketone reading. Thank you ladies!