4/16 Lattte AMPS-246, PMPS-398

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carolynandlatte

carolynandlatte

Very Active Member
Yesterday:
viewtopic.php?f=9&t=12059

Recap:
PMPS-327
+2-277 (pred given)
+5.5-281 (kibble)
AMPS-246
+2-216 (pred given)
+4- 283 (kibble - not much, also wet)
+7-391
+10.5-371 (little wet food)

Latte was a tad crabby this a.m. She did not eat as well on the pm cycle and had no desire to get out from under the piano this a.m. Was kind of a bummer. She did perk up later in the a.m., so that was hopeful.

I went back to the original increase of the steroid because:
1. Her vet highly recommended it, and that we stay there for at least 1 week.
2. Cheryl echoed my vet's opinion w/o me ever saying what he thought.
3. Her decreased appetite last night and hiding this a.m.

She is definately eating better. But Im still a little on edge as to if it will continue to be enough. I know I also have to factor in some of her other conditions, as the kidney disease and metabolic acidosis is quite certainly playing more of a role in her symptoms than it did in the last few years.

She has been under the piano most of the day, but up and about occassionally to see what Im doing. Bright and full of purrs when I pet her.

Question (I know its getting too close to shot time for to probably get an answer):

She cant sit in these high numbers and WILL continue in them if I do not do anything about her insulin. Would it make sense to increase it for the next 7-10 days while getting the dbl dose of pred? Of course when I taper the pred, I will have to reduce her dose and accept the messiness of it, as it sorts itself out.

Thing is, I dont know how much. She is @ 1.75u right now. I was thinking s2.0, but then saw what her numbers are doing today and think maybe a full increase to 2.o. I can monitor until monday, and drop her down if for some reason its too much (im thinking not). She was a little lower yesterday because I didnt give her all the pred I plan on giving in the upcoming week. Today is probably more representative of the numbers we will see. I have to keep in mind that I have someone coming in to shoot her most pm's this week, and will have little time to monitor. So, this is the only increase I could do- comfortably.

On the other hand, could she possibly be bouncing from the low yellow this a.m., since she has been so high since Wednesday?

I know there isnt a soul out there who likes to give us dosing advice. But seriously, if this is your cat what would you do? Let them sit in the 300-400+"s for the week? Increase a drop and hope it helps, knowing it might/probably wont? Increase the full .25 and hope its not too much...back down if need be mid week?

Any thoughts would really be appreciated.

Now...I think we are off to the big P A R T Y!!!! :mrgreen:
 
Re: 4/16 Lattte AMPS-246, +10.5-371 (DOSE HELP, pleeeeaaase!)

Hi Carolyn
I so cannot help with Latte other than to check in and see how you are doing.

Max is waiting for her at the party. He has some comfy pillows waiting for her and
when I walked into the house I noticed that our piano is gone...
He must be setting it up for her. Good thing its on wheels. :lol: :lol:
 
Re: 4/16 Lattte AMPS-246, +10.5-371 (DOSE HELP, pleeeeaaase!)

There really isn't a "rule" for dosing when steroids are part of the mix. It truly is an ECID situation given how some cats number are influenced and others are not by a steroid. Bottom like is that the insulin dose can be tinkered with to compensate for the steroid. IMHO, I would rather see you work up to a dose vs. have to come down from a dose. You can always increase every 4 cycles if you need to aggressively increase. You are very in tune with Latte's needs and you will test to insure her safety. You are not new at this so I think it's fine to be aggressive if you need to increase the dose.

I hope that makes sense.
 
Re: 4/16 Lattte AMPS-246, +10.5-371 (DOSE HELP, pleeeeaaase!)

Ah...Sienne to the rescue....you are SO good Sienne! :mrgreen:
Hope you guys have a good evening...ya for Friday!!!
 
Re: 4/16 Lattte AMPS-246, +10.5-371 (DOSE HELP, pleeeeaaase!)

I wish Cheryl and Winnie were here, she's the best under these circumstances. I think if Latte was mine, I would give the s2u -2u tonight and then wait for Cheryl and Winnie. To me it makes more sense that numbers are going up from the increased pred. rather than from a bounce.
 
Re: 4/16 Lattte AMPS-246, +10.5-371 (DOSE HELP, pleeeeaaase!)

I haven't looked at your SS yet in order to be more specific, but no, I wouldn't let my cat sit in the 300-400 range for that long. I would increase when needed, and then be prepared to run down the dosing scale when that is called for. We do the same thing with cats who are sick or having extended CP flares, etc. I'll look at the spreadsheet now and see if I still agree with myself. ;-)
 
Re: 4/16 Lattte AMPS-246, +10.5-371 (DOSE HELP, pleeeeaaase!)

I have to apologize for anyone who tried to look at my ss and it was not updated. I went right over there after posting, but then got a phone call. LOL, was hard talking and plugging in numbers. I think they should all be right now.

The difference between her 1.75 and 2 is literally 2 drops. Im thinking, since I will not be home much next week to encourage eating wet. *if* she is eating it will most certainly be kibble. Thats only going to make her BG's worse.

Im leaning toward increasing to the 2u and backing down if need be. I CANNOT be home to monitor increases until we start reducing the pred again. I will be home all weekend, however.

Im having a hard time getting out of my head what one drop can do for her. My gut feeling is this is different and the one drop isnt going to do a thing when I look at the entire picture.
 
Re: 4/16 Lattte AMPS-246, +10.5-371 (DOSE HELP, pleeeeaaase!)

looked at ss. This *could* be a bounce from the low blue a couple of days ago, but Latte has also been eating a lot better, and there's the extra pred too. I would go ahead and increase, knowing that you'll probably have to come back down again. If you're home this weekend, I see no harm in going to 2.0, but that decision is up to you.
 
Re: 4/16 Lattte AMPS-246, +10.5-371 (DOSE HELP, pleeeeaaase!)

carolynandlatte said:
Im having a hard time getting out of my head what one drop can do for her. My gut feeling is this is different and the one drop isnt going to do a thing when I look at the entire picture.
Click to expand...
go with your gut, carolyn. you'll be home this weekend. if the dose needs tweaking, you'll be there to see it...
 
Thanks so much! I didnt expect any last minute help (that was my fault...trying to get my ducks in a row/errands run so I could relax this weekend before next week).

I shot 2u and Im comfortable with it. We have a whole new ball game here. All the data I have collected in the last 6 months is almost worthless for this next week or so. right now, she is just a cat sitting in horrendously high numbers. She has had 2u before and made it for short spurts before needing to be lowered. And that was with only half the pred on board. The only problem I forsee (but will be here to monitor), is this weekend I am giving the pred 2 hrs AFTER her shots, to give her time to go down a little before it kicks in. Not sure if this theory is even valid when getting the steroid twice/day. Im also not doing handstands to presuade her to eat after her shot, as long as she has food 'on board' during the last cycle. If her numbers chill out, it could cause her to go lower than desired (highly doubt it though). Next week she will mainly be getting the evening pred hours before her shot.

thanks again. :mrgreen:

ANSWERS/RESPONSE to Cheryl (of course everyone can read it, if you dare! ;-) )

Pancreatitis - I think if I was highly suspect it was the main issue, I would have pushed it more. he is a good vet, but sometimes comes up with reasons why something is not the case that are just down right silly (or from a text book).

Weight - she had not LOST weight. She has GAINED :shock: She is bigger than ever! He even said she should not gain any more, especially with the arthritis. She has a funny looking body now...round in the middle and atrophy in the back. She always used to be a long, lean cat. In the past few years a little bony. She does not need to be eating twice her calories. She just needs to eat enough to maintain weight (and preferably around shot times!). I did put less in her bowl last night and this a.m.....just in case. She also has been eating some wet food, probably because I am home to open a fresh can every hour. :roll:

Output- :lol: Youre too funny. Its actually been very dry for the last month. and not going every day. She had a beauty this a.m. Still a little dry, but much better. I think she had not had a good poop in a few days. Im usually diligent with checking it, but its been a little crazy here.

Calcitrol/Azodyll- I could never get the A in her. I struggle to get any pills in her. Thats one thing thats making the pred so hard right now. She has a history of high calcium, so I always assumed calcitrol was not a wise choice. What really needs to be addressed is the M.A. That Im certain is speeding up the renal failure. As is the pred, Im sure. Her numbers were stable until she started taking it. Ever since it has been a slow, but steady increase of her creatinine. I cant get the potassium citrate in her w/o potentially triggering pukus.

Hope that answers all. Glad you stopped by this a.m. Thank you!!!!
 
Carolyn - regarding your ? on adequan. We did the shot at home, did it sub q in scruff of neck. Didn't seem to bother
her at all. I'm supposed to give her .1 every 5 days for 4 doses then back it down (? every 10 days or so). I'll let you know if it starts making a difference
 
I shot 2u and Im comfortable with it.

sounds like you did good !

, is this weekend I am giving the pred 2 hrs AFTER her shots, to give her time to go down a little before it kicks in. Not sure if this theory is even valid when getting the steroid twice/day.

The only way to find out is to try it ! You want to get the peak action of the roid to hit the same time as the peak action of lantus.

Pancreatitis - I think if I was highly suspect it was the main issue, I would have pushed it more.


you know latte best ;-)


Weight - She has a funny looking body now...round in the middle and atrophy in the back.

that type of *figure* can often come w/ long term roid use. She has lost some muscle mass -- you said she was more boney -- but gained fat :o that will come with malabsorption ( IBD, CP) and yes roid too. and... I hate this answer, but does seem to come w/ sr. cats. )

She just needs to eat enough to maintain weight (and preferably around shot times!).

Have you ever calculated out what calories she needs for her size and ideal weight?

She also has been eating some wet food, probably because I am home to open a fresh can every hou Ir. :roll:

hey-- she likes what she likes and she has someone to cater to her needs :-D

Output- Its actually been very dry for the last month. and not going every day. I think she had not had a good poop in a few days.

that can make her uncomfortable and one more thing to effect that fragile appy of hers.
have you ever given her anything to help smooth her export through the customs process?

[b]Calcitrol/Azodyll[/b]- I could never get the A in her. I struggle to get any pills in her. Thats one thing thats making the pred so hard right now.

Winnie and Wolfie ( as well as other civie oscar(ga) ) all easy to pill..... so it kinda makes it hard for me to relate. I've been soooooo lucky .
Is it a matter of getting pill in mouth or getting Latte to hold still to let you do the job?

She has a history of high calcium, so I always assumed calcitrol was not a wise choice.

If you really wanted to pursue you could see if her ionized calcium was ok. WCF could really help you out with that. she monitors Meowzi quite diligently and is very knowledgeable about its use.

What really needs to be addressed is the M.A. That Im certain is speeding up the renal failure. As is the pred, Im sure. Her numbers were stable until she started taking it. Ever since it has been a slow, but steady increase of her creatinine. I cant get the potassium citrate in her w/o potentially triggering pukus.


I have only a little knowledge and know that giving ringers helps as the lactate converts to bicarb in the liver. I know you said her bicarb is low....... random thought-- her liver values all good? are you giving any liver support-- denasyl.... wonder if that might help??? is a powerful antiox and good for cp too.
of course the flip side is that if cat has high CA then usu ringers is not recommended --normasol is.
Have you posted on health about MA to see if you find someone w/ info that might help? worth a post?

Wolfie has had CRI for 6/7 years... he has been on pred for at least 1 1/2 years... maybe longer.
Winnie had CRI, but not so much as wolf -- her values were very much effected by her cp.
haven't seen any increase in renal values due to roids for either.
I know there is possibility -- but it also could be from other causes. just don't want you to scare off b/c of that. you are juggling. but please don't forget that you have to prioritize illnesses..... and treatment based on QOL issues. If the roids keep her eating and feeling better then better to give that then worry about long term renal values don't you think? ( ok you will worry anyways. I would ;-) but you kwim ? )

as far are the potass citrate -- pukus from size of pill or from med ? have you tried liquid form?

hope her numbers are nicer today. and that dosecrease kicks in soon!
 
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