5/19 Kasha AMPS 513 PMPS 474, 134@ +4, 90@+5

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kryskat

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Think I'm going to take Libby's advice and dosecrease tonight (1.25 u) so I can monitor her instead of waiting till tomorrow morning.

She ate most of breakfast with encouragement this morning. No ketones.

The other thing that is concerning me is about when she goes to pee - the last day or so, either nothing comes out at first and it takes a few seconds or it starts right away but instead of peeing in a torrent from all the water she's drinking, it's coming out it kind of gushes. I could be wrong - it could be that she was peeing in a weird place and since she was peeing 1/2 on the litter box and 1/2 in the litter, maybe it just sounded funny because it didn't sound like she was peeing very much but when I went to scoop it was a full sized scoop, so I don't know. She is not straining or seeming in any way uncomfortable, so I'm keeping an eye on this. Might call the vet - I just don't know if the ABs are doing their job...

Yesterday
 
Re: 5/19 Kasha AMPS 513

Well, I made a vet appointment this afternoon. I just can't take the chance that there's something going on - have to at least see if the vet can find something or suggest a course of action.
 
Re: 5/19 Kasha AMPS 513

(((((Krys)))) I know you have been battling this UTI with Kasha for weeks now. One of my kitties when he pee's it sounds funny because he pushes and then stops so it sounds like a gusher that stops and goes. :roll: As long as she is able to pass with no blood we can only hope these antibiotics will help soon.

Forgive me because I have been away---when did you start the meds and how often does she get them? Thank goodness the ketones are negative.

Is she feeling ok otherwise?
 
Re: 5/19 Kasha AMPS 513

I took her to get tested for a UTI last Wednesday because her numbers got all wonky (like they did the time before when she had a UTI) and she was meowing at me. The time before, I waited till she was meowing at me really insistently and then it turned out she had a UTI. Which also happened before that, when she was initially diagnosed. So, I don't like to wait when she's meowing at me like that, cuz she's trying to tell me something. Unfortunately, it's really hard to tell the difference between the "I don't feel good" meow and the "I want a bowl of chicken" meow. So, I gave her chicken and some more canned food today and she was like "Oh, thanks" and ate for a bit then turned back to me and meowed like "Oh, yeah, back to what I was trying to tell you..."

Anyway - she had a c & s done to determine it's an e. coli infection and they put her on Baytril starting last Friday, one a day (PM). She just had her 5th tablet last night (out of 14). I was really thinking I'd notice an improvement by about now.

Yeah - the way you described your kitty peeing is what it sounds like. She's also shaking her tail a little, like they do when they spray (but she's not spraying). Before the last day or so, I don't recall her doing either of those things. I wouldn't think they were necessarily bad signs, but the meowing at me part combined with that concerns me.

Other than that, she's basically acting ok - she trotted after me when I had some chicken for her, which is good (she doesn't usually move all that fast). She is lying around the house in places that she doesn't normally lie though - like in the middle of the floor, but they do change things up when the seasons change, I've noticed, and maybe these are going to be her summer hangouts. I just don't know.
 
Re: 5/19 Kasha AMPS 513

I agree with Sienne, and I would have hoped as well that by day 5 you would see some difference. Wishing you well at the vet.

And I would most certainly take the dosecrease tonight. I don't like those BG's.
 
Re: 5/19 Kasha AMPS 513

So, you all think a .25 unit increase (to 1.25 units) is what I should do? Is there ever a time you increase more than .25 units?
 
Re: 5/19 Kasha AMPS 513 Dose question

Yes, there is a time. If you take a look at either the full Tilly Protocol or our modified version:

LL modified protocol said:
Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.

--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

The recommendation was for a 0.25u increase because you saw some nadirs of <300 and because we were thinking to be a bit more aggressive given how high Kasha's numbers have been coupled with an infection. The Tilly Protocol allows for an increase in 2 days with high numbers. Right now, you'd be increasing after completing cycle 6 (2.5 days).
 
Re: 5/19 Kasha AMPS 513 Dose question Vet updt

Ok - back from the vet. No ketones and less blood in the urine than last time, which indicates that the AB is actually working, but the vet thinks the diabetes, especially with Kasha's high numbers, is causing the infection to hang on longer than it might otherwise. We looked at Kasha's teeth and they need work, but vet is concerned both about her kidneys (due to her urine concentration - or lack of concentration) and the possibility of some underlying cause that might be making Kasha not respond consistently to the insulin. She is referring me to an Internal Medicine specialist to check in particular for endocrine/adrenal issues that might be making regulating Kasha more difficult. I made an appointment for next Tuesday morning.

She also mentioned the phrase "fragile diabetic" in reference to a cat who can be doing fine one minute and then their numbers go all wonky when the wind blows funny. Anyone here familiar with that phrase or have any comments?

I'm also going to be giving Kasha SQ fluids every day or every other day for the foreseeable future - it makes her feel more comfortable and since her kidney numbers have been borderline for some time, it seems like a good thing to do. So, I just finished giving her 150 ml SQ fluids, easy-peasy. Although she did spring a little leak... Just some damp fur.

Going to give her the dosecrease tonight and see how it goes. Maybe it's a good night to pick up a pizza for me while I'm watching her.
 
Re: 5/19 Kasha AMPS 513 PMPS 474 Dosecrease Vet updt

Had to feed early tonight. Because Kasha was so insistent that she HAD to eat, I didn't want to test her. Her appetite is so iffy lately, I'm not going to argue with her. I used to feed 1 hour before shooting, so that's what I did today. She ate like a champ - apparently her harrowing vet appt and the SQ fluids made her hungry - she ate a little more than her average meal, but just ate it up in pretty much one sitting (ok - I moved the bowl to follow her, but she'd already eaten most of it) which is not exactly the norm for her.

I'm going out for a walk, so I'll offer her a snack when I get back.

She also took her 6th Baytril like a champ - I gave her a Feline greenie, then I gave her the pill - just like a treat. She said "Oh, you must be mistaken" and spit it out. I offered her another greenie and slipped her the Baytril instead. Spit it out. I offered the greenie again and this time she was like "Ok, I'll just eat it and be done with it if it will get me another greenie". And that's what she did. She just ate it, swallowed it down and asked for the greenie. Which she got. I highly doubt that sequence of events will ever be repeated, but I appreciated it this time.

Oh - when I tried to measure her insulin tonight, I forgot I had to measure 1.25 when I was squirting out the excess. I thought, oh great - I'm going to have to draw more insulin and remeasure. But when I looked at the syringe, it seemed to be exactly 1.25 units. What are the odds. I'll probably never be able to measure it that perfectly again!
 
Re: 5/19 Kasha AMPS 513 PMPS 474 Dosecrease Vet updt

Good luck with the dosecrease. I hope that nothing comes out of the IM visit. I hope it is just her high BG's that are making it hard to rid the UTI.
 
Re: 5/19 Kasha AMPS 513 PMPS 474 Dosecrease Vet updt

Good luck with the dose crease; sometimes it takes just a wee bit more to hit the perfect dose.

I wanted to ask what litter you are using. I always use clumping litter because I can better gauge how much urine is being deposited by each of my cats. It's the only way i can know when there is less urine.
 
Re: 5/19 Kasha AMPS 513 PMPS 474 Dosecrease Vet updt

kryskat said:
She also mentioned the phrase "fragile diabetic" in reference to a cat who can be doing fine one minute and then their numbers go all wonky when the wind blows funny. Anyone here familiar with that phrase or have any comments?
I've heard the term "brittle diabetic" used in the way you described above. I've only heard it used with humans, but I guess kitties could be brittle diabetics too, just like people.
 
Re: 5/19 Kasha AMPS 513 PMPS 474 273 @ +2!

It's going to be a fun night, I can tell. She's dropped to 273 at +2. +2! What the...

Well, at least something is working. I want her to have a snack but she only wants my pizza, so that's not working out so well.
 
Re: 5/19 Kasha AMPS 513 PMPS 474, 273 @ +2!

Hi Krys and Kasha! Dropping in to see how things are going with Kasha today, and Krys, I have to say that you are sounding much better, even through Kasha's UTI.

I hope that the dose crease helps with Kasha's numbers...It's nice to see numbers in the 200 range :smile:

Hope the ab's work their magic and that Kasha begins to feel better.
 
Re: 5/19 Kasha AMPS 513 PMPS 474 Dosecrease Vet updt

Gayle and Shadoe said:
I wanted to ask what litter you are using. I always use clumping litter because I can better gauge how much urine is being deposited by each of my cats. It's the only way i can know when there is less urine.

I use clumping litter - usually World's Best Litter (corn) mixed with a little of that Dr. Elsey's Precious Cat or Cat Attract litter (I don't know why, but she prefers the more expensive litters. Maybe less perfumey or something but they do NOT like when I switch litters). Right now I have 3 sick cats and no one is definitely keeping to a routine so I don't know who is doing what where in their 4 litter boxes. I have to catch Kasha to be sure of what she is doing (I can guess, but it's not for sure unless I'm a witness).

Got her to eat a snack just now - a spoonful or 2 of FF. And some pepperoni grease from my fingers (oh, don't think I've eaten - I just touched the pizza and then she begged and begged for a tiny piece of pepperoni and then I fed her and now that my pizza is good and cold, I'm going to eat some of it!)
 
Re: 5/19 Kasha AMPS 513 PMPS 474, 273 @ +2!

Deb & Spot said:
Hi Krys and Kasha! Dropping in to see how things are going with Kasha today, and Krys, I have to say that you are sounding much better, even through Kasha's UTI.

That's because I've lost my mind, Deb. I'm still having a really hard time, but trying to joke about it more.

Just realized you're only a couple of hours from me. Maybe you can come visit me when they lock me up in that padded room...
 
Re: 5/19 Kasha AMPS 513 PMPS 474, 273 @ +2!

One thing to keep in mind is that squids (sub-q fluids) can cause a drop in BG numbers. Remember, you're adding volume to the blood so the glucose that's there becomes diluted. As Kasha's numbers come down, you will want to think about when you give fluids so it doesn't bottom out her numbers.
 
Re: 5/19 Kasha AMPS 513 PMPS 474, 273 @ +2!

I've heard that before, but it didn't seem to affect her the other couple of times she got fluids (at least once it was late afternoon around the same time I gave them today). I'm not sure when I'll be able to give them - what's better? Before I shoot, after or midway between shots? I was thinking of shooting near the nadir, but if she's low, that's not going to work.
 
Re: 5/19 Kasha AMPS 513 PMPS 474, 273 @ +2!

Drop Carolyn/Latte a note. I'm pretty sure she gives squids around meal time. However, I would suggest getting a curve. If Lantus onset is early and Kasha doesn't have a food spike, that may not work. An hour or two before PS, it that works for your schedule may be feasible. I don't have experience with fluids so check in with someone who does.

Also, you may want to see if Kasha will nibble on some LC to slow that drop.
 
Re: 5/19 Kasha AMPS 513 PMPS 474, 273 @ +2!

it's good to see yellow! Sienne is right, a couple of bites of food might help (unless she is too full from pepperoni juice). :smile:
 
Re: 5/19 Kasha AMPS 513 PMPS 474, 273 @ +2!

I gave her a snack (couple tsp FF) around + 2.5. She's dozing off now.
 
Re: 5/19 Kasha AMPS 513 PMPS 474, 273 @ +2!

Sienne and Gabby said:
Drop Carolyn/Latte a note. I'm pretty sure she gives squids around meal time. However, I would suggest getting a curve. If Lantus onset is early and Kasha doesn't have a food spike, that may not work. An hour or two before PS, it that works for your schedule may be feasible. I don't have experience with fluids so check in with someone who does.

The only time I'm ever available 2 hours before PS is on the weekends (or days off). I thought her onset was usually around 2 hours or maybe a little before but all bets are off right now. And Kasha rarely eats much all at once, so I'm not sure how much she spikes. I'll see what Carolyn recommends. It would be awesome if I could give the squids before she eats because it seems to boost her appetite.
 
Re: 5/19 Kasha AMPS 513 PMPS 474, 134@ +4!

134. ONE THIRTY FOUR.

Wow.

She's still dozing -not interested in snacks. I wonder what's going to happen now. Big bounce?

At least the insulin is finally doing something.
 
Ok - between the effortless pill-taking, the appetite for dinner and now blues and greens - I feel as though I must be dreaming. Am I awake?

Wondering if today is just another aberration. We've had too many ups and downs lately.
 
Love the effortless pill-taking, I don't think I'd have any fingers left if I tried to pill my kitty very often.

This is quite a drop tonight so Kasha probably will bounce tomorrow, so don't panic. Obviously the insulin is working! That's a good thing to know. And yeah, for the appetite for dinner, that's great!
 
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