3/3 Simon PMPS 145 +3 79 OTJ trial delayed

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Georgia and Simon (GA)

Georgia and Simon (GA)

Member Since 2010
I am taking Simon to the vet for a check-up today. The vet is going to check his urine and weight and also I want to talk to him about a dental in the near future. I am pretty sure he is going to say that Simon doesn't really need to be on insulin since his numbers are so good, but I will bring info with me on the tight regulation protocol. I'm also going to ask lots of questions about the dental procedure and what drugs they use. I'll post later about what the vet says. Question: I know I read somewhere about making sure the vet gives fluids during the dental procedure -- is that correct?

Another question: I am wondering what I should be doing about the insulin now that Simon has been at the .10 dose for quite a while and seems to be pretty consistently in the greens and low blues. I also am still using the original lantus I got so I'm not sure if it has lost any of its potency (over 3 months). I'm going to get a prescription today from the vet to get a new vial. That might cause his numbers to drop a little more. Should I be thinking about doing an OTJ trial soon?

Thanks for your help! Simon's vet visit isn't until late this afternoon so I won't be back until the early evening. I'll post when I get home.

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Re: 3/3 Simon AMPS 106 Vet Visit Today & questions

No advice on the vet visit - can't wait to hear how it goes. Stay strong. Don't pull a Karrie LOL.

I keep thinking every day you and Simon are going to be told today is the day to try going OTJ. I'm starting a new catridge this morning to see if it helps Maverick's numbers. I've been using it two months.

Good luck at the vets.
 
Re: 3/3 Simon AMPS 106 Vet Visit Today & questions

Hi, I use the vial Lantus, and my Vet said it's okay for four months, but I am going to get one sooner as I keep getting too many bubbles. You will get different opinions. Maggie's numbers are good, so it can't be too bad yet. The Pharmacist will tell you it's good only for a month.
 
Re: 3/3 Simon AMPS 106 Vet Visit Today & questions

No advice here but lots of luck with the vet and with trying to figure out if Simon should go on an OTJ trial. Fingers and paws crossed that he can go for it.
 
Re: 3/3 Simon AMPS 106 Vet Visit Today & questions

Here's the dental info that we've passed along in the past. Note that fluids aren't necessary but a catheter should be put in just in case fluids are needed.

1) X-rays: either before or the day of the procedure. Also x-rays after to make sure there are no tooth fragments left after an extraction.
2) Bloodwork: prior to the dental to rule out anything that would prevent the procedure
3) Pre-anesthesia sedation/induction: Ketamine (some has been recalled), propofol, valium. Induction should be with an IV drug vs. a gas.
4) Anesthesia: Sevo or Isoflurane (these should not be used for induction, however)
5) Cardiac monitor: pulse oximeter or cardiac monitor
6) IV catheter for fluid access
7) Post-procedure antibiotics if necessary. (See Dr. Lisa’s commentary)
8 ) Pain meds: administered post-procedure and to take home: Buprenex, no metacam due to the potential for renal failure. A fentanyl patch may be excessive for the purpose of this kind of pain management.
9) Blood pressure monitoring (Doppler or Cardell monitor)
10) Warming: make sure there is a means of circulating warmth vs. one warm spot. The latter can cause burns.

This is a link to info my vet has on-line about dental procedures.
 
Re: 3/3 Simon AMPS 106 Vet Visit Today & questions

Good morning! I am so happy about Simon's numbers, and like Karrie, I'm waiting for the day you and Simon can do an OTJ trial... but it's all about patience, right?

Good luck with Simon's check-up. Can't wait to hear how he does!
 
Re: 3/3 Simon AMPS 106 Vet Visit Today & questions

You already have the dental procedure post, which is good-
Bring a copy of your SS to the vet and a copy of the protocol we are using...This way you have written explanation of what, and is effective. we are using..
Also, No Covenia shot after dental if needed (antibiotic) it is not recommended-- some cats had problems from it(lasts 2 weeks)--
Get Clavamox if there is a need to clear infection from any bad teeth.
Hoping you have any easy positive vet visit today-Simon has been doing great..You're doing a very good job!!
 
Re: 3/3 Simon AMPS 106 Vet Visit Today & questions

Karrie, I was thinking about your experience at the vet and hoping that I can stay strong. I think Simon's new vet is pretty easy to talk to so I hope I don't crumble and turn into a yes sir, no sir person.

Ann, I also heard that the lantus in the vial can last up to 6 months although I think I definitely am going to try a new vial just to see if Simon's numbers come down a little in the AM.

Violet and Iorwen, thanks for all your support and paws crossed!

Sienne, your info on the dental is wonderful -- I am going to take your post with me today.
 
Re: 3/3 Simon AMPS 106 Vet Visit Today & questions

Georgia -

We've been doing a little backchannel chatting about Simon. Providing Simon gets a clean bill of health today (i.e., no infections, etc.), rather than buying new Lantus, what would you think about starting an OTJ trial? Simon's numbers have been in the normal range for a while. Moving his PM feeding to +8 may help to bring the AMPS number down but the numbers are still pretty darn good!

The instructions for an OTJ trial (according to Libby!) are as follows:
  • Test at your normal AMPS and PMPS times. Feed multiple small meals throughout the day as much as possible (small meals are less likely to overwhelm a newly functioning pancreas).
  • If he is green at your normal test times, no need to test further until the next "PS" time, just feed small meals and go about your day. If he is blue, feed a small meal and test again after about 3 hours. If his number is lower 3-4 hours after a meal, then his pancreas is working!
  • Sometimes the trial doesn't work the first time and we have to give a little more support in the form of resuming insulin. It's not the end of the world if that happens, we just give him the support he needs. Our goal is a strong remission and it's better to take our time to get that than to rush into remission just to have it fail later on.
 
Re: 3/3 Simon AMPS 106 Vet Visit Today & questions

Good morning guys .. good luck with the vet visit today .. I bet your vet is going to be so impressed with Simon .. mocha can't wait to get to another OTJ party!! Have a great day guys!
 
Re: 3/3 Simon AMPS 106 Vet Visit Today & questions

Just a hello and a good-luck for the vetty visit. Simon is looking great! Today seems to be the day to start new insulin vials/cartridges. Rusty got a new cart. today too.

Ella & Rusty
 
Re: 3/3 Simon AMPS 106 Vet Visit Today & questions

WOOOOOOHOOOOO This is so exciting. I'm so excited for you guys. But I was nervous as heck. Can't wait!
 
Re: 3/3 Simon AMPS 106 OTJ trial questions

OMG!! I am very excited that Simon may be ready for the OTJ trial (unless there are any issues that I find out today at the vet). I am also very scared thinking about it and I have butterflies in my stomach.

If everything checks out ok today, do I start the trial tomorrow and give him the regular PM shot tonight? The only problem I may have is that if he is blue in the AM which is pretty typical for him, it is going to be hard to get a +3 shot to see if the numbers are going down. I can get a +2 before I leave for work but that might show a food spike. I can also do either a +5, +6, or +7 because I can usually get away from work during those hours for a few minutes. What do y'all suggest?
 
Re: 3/3 Simon AMPS 106 OTJ Trial questions

WOOHOO!!!! THIS IS FANTASTIC!!!


go, dude, go!

best of results at the vet...and we are rooting for you!!
 
Re: 3/3 Simon AMPS 106 OTJ Trial questions

How about starting at his first green pre-shot. Even though his AMPS is most often blue, it's a "normal" BG number (i.e., below 120).

Also, I'd try giving him his last snack in the PM an hour earlier and see if that effects your AMPS.
 
Re: 3/3 Simon AMPS 106 +7 82 OTJ Trial questions

Sienne, thanks for clarifying. I think I will feed Simon about 1/2 of what I usually give him in the AM and then test him before I go to work if his AM number is blue. I'll then feed him the rest of the food at +2. I'll also start giving him his last snack at +7 instead of +8. That will really shake him up when the automatic feeder goes off early tonight!
 
Re: 3/3 Simon PMPS 145 Back from Vet

Simon and I are finally home from the vet. The PMPS is high I'm sure because I had to test him immediately after we got home to make sure I gave him his insulin in time.

I love Simon's new vet! He spent over an hour with me talking to me about everything. I brought all the literature on the Protocol and he was very interested in reading everything. He said he has heard about it but has not had clients that have been doing it. He is taking the literature home to read tonight. He also is in total agreement with the low carb, canned food, frequent small meal feedings. He was very impressed with Simon's spreadsheet and thinks Simon is doing great and ready to do the OTJ trial.

I went ahead and had a urinalysis and blood work done because Simon definitely needs a dental. I saw his gums and they look pretty bad. I won't know the results of the bloodwork until tomorrow and the urinalysis will come back on Mon. What I really liked is that the vet did both of the tests in the exam room with me right there. I never have had a vet let me be right there. They always took my cats back to another room to do the tests. I'll post the results once I get them back. Simon does have an allergic ear infection so I have to do the dreaded drops in his ear for the next 14 days!

I asked the vet all the questions about how they do the dental. Everything checked out with him except he doesn't do an x-ray. He doesn't use the pain meds that are not recommended and usually uses bupe. He has 2 other people in the room with him during the procedure so Simon will be constantly monitored. I will probably schedule the dental sometime the end of this month.

Anyway, that leads me to tomorrow morning. I am going to start the OTJ trial and am praying that things will go well for Simon. I am a little nervous since his number was so high tonight but at least there is an explanation. Sorry this is so long, but I had a lot to say. Thanks to everyone for your continued support and expertise. And Simon thanks you, too!!
 
Re: 3/3 Simon PMPS 145 Back from Vet

great news about the new vet! It's awesome to have a vet who will work with you. I love my vet, not because she knows a lot but because she is open minded when I come in with something and say "will you read this and tell me what you think?" I hope you have found one of those vets too. :smile:

What kind of ear drops do you have?
 
Re: 3/3 Simon PMPS 145 Back from Vet

I'm so happy to be reading your update. I'm impressed with you and your vet (so far). Great job!!!!

I can't help with the OTJ/feeding/dosing stuff but can provide high fives as you trial OTJ! The way they explained it to me - why I felt so nervous, was that with the insulin, even a drop or two I have some control of the numbers. With an OTJ trial, its all up to Simon :mrgreen:
 
Re: 3/3 Simon PMPS 145 Back from Vet

AWESOME, and way to go Simon! It is so great to have a vet that will listen, work with you, understands FD and will take into account all we do here. YAY!!!! I think I like your vet. :-D

Good luck with the dental too whenever you schedule it.

YAY! TRIAL COMING UP!!! Hooray. Mannie is so excited - that means he gets to cook again.... :cool: :-D
 
Re: 3/3 Simon PMPS 145 Back from Vet

Georgia --

What ear drops are you going to be giving Simon? Many of the drops contain steroids. If the ear meds do, in fact, contain steroids, it's very likely they will raise Simon's BG numbers. You may want to hold on the OTJ trial until you see how Simon responds to the ear meds.
 
Re: 3/3 Simon PMPS 145 Back from Vet

here is another voice wondering if the drops have steroids every time Do Lou gets ear drops for his allergy ears they have steroids so check to see what kind you have and so happy you like the new vet wonderful news
 
Re: 3/3 Simon PMPS 145 Back from Vet

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Re: 3/3 Simon PMPS 145 Back from Vet & Question

Oh dear, I didn't realize the ear drops can contain steroids. Simon seems to get alot of ear infections and he just had one a few months ago. My old vet gave him Tresaderm and I have alot of it left over. My new vet usually uses something else but he said that the Tresaderm is fine to use since I already have it in my fridge. I am trying to save a little money since this vet visit today cost me a fortune so I decided to use the Tresaderm. Does Tresaderm contain steroids? If it does, do I wait to do the OTJ trial?
 
Re: 3/3 Simon PMPS 145 Back from Vet

Yup. It's got a steroid in it. I would suggest that you keep giving Simon his insulin until you see whether he has a reaction to the steroid. I'd rather you not have a failed OTJ trial and instead, stick with your tiny dose and if Simon's numbers are the same, then do the OTJ trial. If his numbers go up, we know it's from the steroid and you can continue to give his pancreas some support until he's off the Tresaderm.
 
Re: 3/3 Simon PMPS 145 Back from Vet

Hi Georgia,
I'm sorry not to be able to answer your questions, but I think that it is great that you found such a fine vet. If you do start the OTJ trial soon, that would be fantastic, but you certainly want to start it without any issues that might skew Simon's numbers. Fingers and paws crossed that all will go well!

Ella & Rusty
 
Re: 3/3 Simon PMPS 145 Back from Vet

How great is this... GREAT! :-D
I dunno. I have only used Zymoc HC for eardrops & eardrops in general are a nightmare in our home...Baby was on Baytril her complete OTJ trial.. I agree with Sienne.. I would wait until kitty is not taking a med!
Anyway.. so hapy to hear you LOVe the vet.. like me.. not so much LOVE but they participate & agree with your plan of care.. my vet does to & has for 10 years!
Sooooooooooooo excited for Simon!!!
 
Re: 3/3 Simon PMPS 145 Delaying OTJ Trial

Dang, it figures something would get in my way of doing a trial, but I definitely don't want to have a failed OTJ because of the ear drop steroid. I'll go ahead and keep giving Simon the insulin until I see if the Tresaderm causes his bg to be elevated. Simon is not happy to hear that he can't get his party started!!
 
Re: 3/3 Simon PMPS 145 OTJ trial delayed

aw, Simon...don't worry...this is Lantus land...

the kitties can have a "Pre-Party Party!" :-D
 
Re: 3/3 Simon PMPS 145 OTJ trial delayed

yes tresaderm is what DL usually uses I have tried others but this one works really well for his ear allergies too hope it clears up Simons ears soon
 
Re: 3/3 Simon PMPS 145 OTJ trial delayed

Lots of great news for Simon today and sounds like the delay will just be a short one. I hope the tresaderm helps his ears and you can get on with the trial!!
 
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