4/17 Ruarach AMPS 261; +1 306; +3 226

L

LauraZZ

Member Since 2023
4/17. Ruarach's AMPS is 261. Gave 1.25U at 820 am. Am doing a glucose curve today (BG every 2 hours until +1, +3, +5, then hourly until about +9).

During 4.16 glucose curve (every half hour rdg), had not given liquid meds (ondansetron, lactulose, elura) before PM insulin. Have resumed 'normal' ondansetron and lactulose today. Elura is on an as-needed basis and he hasn't seemed to need it the last few days.

Dropped to 1.25U in evening 4.16 for reasons listed in 4.16 thread. This probably was too large of a drop, but I wanted to be safe. Will give 1.25 U for several days, then bump up to 1.5 U if glucose readings allow.

4/16 thread here: https://www.felinediabetes.com/FDMB...9-unsure-re-insulin-in-pm-gave-1-25-u.276517/
 
Your are very thorough and seem to being managing everything well. There’s a lot to read so I just glanced. I think you are on track to finding a dose you can stick to every hours. Are you going to use 90 as a reduction point? If not it would be good to put in your signature what your vet has chosen.

I can see you will be a testaholic like I was. For curves it’s not necessary to test every half hour. Our method suggests every 3 hours but until you get a sense for this every hour might not be a bad idea. Once up and not dropping hourly would nit be needed but I’ll never say no to gathering data.

Is ondansetron for nausea from ckd or something else? My Max had chronic pancreatitis which is very common with fd and might have led to Max becoming diabetic. It worked well. I found I’d give it until he was eating normally and then gradually decrease the amount and watch to see how he did.
 
Hi Max, thanks for the reply.
Ondansetron is for nausea. Started with his mid-March severe constipation. I'm giving as necessary - more like once every 18-24 hours. It seems to help him eat more. With kidney disease, nausea can become an issue as it progresses.

Ruarach has had kidney disease dx for about 15 months; diabetes dx since mid-March. He's about mid stage 3 kidney disease (more towards the top end of 'mid').

I did the intensive glucose curve 4.16.2023 so I could have a detailed picture of how his body responds to the insulin.
Today, I'm doing BG rdgs less frequently - but will increase frequency from +5 to about +9 so I can see more detail around the nadir.

The sudden drop in BG Saturday evening before the PM insulin dose made me very nervous - I think that occurred because I've gotten him on a lower carb mix of foods. So a few days of glucose curves will give me useful data going forward to guide insulin adjustments.

I think for now I'll use 90 as reduction point. I'm still learning and getting comfortable with these lower numbers - want to avoid hypoglycemia at all costs (but have my hypo supplies ready if needed).
 
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Max was my sugar baby. You do know that ondansetron works for 8-12 hours for cats and possibly has shorter duration? How much do you give him? If you want consistent eating I’d try it at least once or even twice a day. It will help stabilize the insulin. Just a thought to consider as you gather data. You know your cat well.

I’m familiar with ckd unfortunately. All my cats have had it. I was just wondering if there were any other medical issues.
 
Hi Max,
I didn't realize ondansetron affects blood glucose - does it tend to increase BG then? Or what do you mean by stabilizing the insulin?

Vet had originally prescribed 1 4-mg tablet once every 12 hours in mid-March due to the constipation crisis, but when I saw her last week, she said less frequently is fine. I had been thinking maybe he could go off it over time; that's why I've been making it less frequent and observing how that affects him.

Right now, he's eating fairly well; I've only just started reducing the ondansetron - and cut out the Elura 3 days ago. He dropped 8-10 oz mid-March but has gained all that back and is slightly over 10 pounds; could gain a few more ounces so he has a cushion for the next crisis. I weigh him every few days (using a postage scale) just before I give him fluids.

Would be really happy if I could get his diabetes into remission. Kidney disease alone was enough. Vet is more concerned with maintaining the diet for kidney disease (and thinks more protein is not good) than lowering carbs, but I know high BG is really bad for the body in general. So I'm striving to find some balance between the two - decreasing carbs somewhat (but not super-low) had more of a quick effect on BG than I really expected..

For kidney disease, there's no really definitive high quality research on protein, but I'm inclined to believe high quality animal protein (but not too much tuna) is more acceptable than any non-animal protein source. What do you think? A friend who had a kidney cat that lived to 21 (with 6-7 yrs of kidney disease) had come to the same conclusion based on his reading of the research and vet opinions & guidelines.
 
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