Re: 4/6 Morlei AMPS 286
julie & punkin said:
nice to see a Morlei condo, becky! i was wondering how you guys were doing!
if Morlei continues with the 200's for the nadir after you've seen at least 4 cycles on the 5.0 units, you have the option of increasing at that point or waiting 2 more cycles, and you also have the option of increasing by .5u instead of .25u. it would just be good to get ahead of these constant highs.
from the Rand/Roomp TR protocol:
If nadir blood glucose concentration 200-300mg/dL (11-17 mmol/L) Increase every 3 days by 0.25-0.5 IU depending on if cat on low or high dose of insulin
from the Tilly Protocol:
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.
from FDMB General Guidelines:
Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
All of these come from the yellow starred sticky on the Tight Regulation Protocol. Do you have any thoughts about what you would like to do? questions?
After I re-read the TR protocol I increased .5 from 4.25 to 4.75 but then decided to just go up .25 last night to get it to a nice even number so we continue increasing at easier-to-measure .5 intervals.
I didn't know that I could increase after 4 cycles, I thought I had to wait 6 cycles, so we'll definitely be increasing at the 4 cycle mark then this weekend.
I'm getting frustrated that we aren't seeing any results. There has to be some other underlying problem that is affecting the diabetes. I remember she had a few high-ish numbers on her blood test when she was first diagnosed but no one at the clinic even said anything about them...they may have just been concerned with the diabetes though. I went back to my first condo (wow so weird to read that, I sound so scared!) and here are the results that were considered abnormal:
Albumin: 4.3 HIGH (reference 2.5-3.9 g/dL)
Glucose: 414 HIGH (reference 64-170 mg/dL)
Na/K ratio: 28 LOW (reference 32-41)
Cholesterol: 228 HIGH (reference 75-220 mg/dL)
Amylase: 1302 HIGH (reference 100-1200 IU/L)
IN URINE:
Protein: 3+ HIGH
Glucose Strip: 3+ HIGH
Occult Blood: Trace HIGH
Microalbuminuria: >30 HIGH (reference <2.5 mg/dL)
I had her thyroid checked before we started the Lantus, came back fine.
The whole dental thing is weighing heavily on my mind...I can't get the horror stories out of my head...the other day I read about a kitty on here that had their windpipe punctured during the procedure and they didn't know until it had to be rushed back to the vet. I will never forgive myself if something happens to Morlei during an "elective" procedure. However I do want to take her back in for an exam and blood test, I'll have the vet do a dental exam and see what she thinks. I bought a kitty toothbrush and some gauze and I was going to start cleaning their teeth that way for now...can I use the same toothbrush for all 4 cats?
Food is all under 5% carbs, freeze dried chicken bites is the only treats she gets, boys are fed their portion of dry in a separate room on plates that are picked up and kept in a high cupboard along with the bag of dry (I cannot get them off the dry to save my life!). She eats about 8.5 oz a day. Her fur is soft, she doesn't look thin, eyes are bright and beautiful, she's a lazy cat and doesn't play much but is walking fine, runs up the stairs whenever it's food time! Looks like a mountain goat when she does that haha.
I feel like I've covered all the bases with what I can do myself at home. Do you have any other suggestions?
I do have one question about shot location. I read that continuously giving the shot in the scruff can cause scar tissue so we started moving the shots to either side of the scruff and a little further down, left in the morning, right at night. Where do you usually give Punkin's shots?
I need to post more, I really do, but when she's getting the same numbers every day I feel like I would bore everyone to tears looking at my condos haha.
