6/14 Ernest AMPS 335 +1 322 +3 335 +5 279

[LJ and Ernest]

We are doing a BG curve today. The vet recommended it yesterday, so we can determine how low he actually goes and see if we need to increase from 2u Lantus twice daily to 3u Lantus.

He is doing really well right now and eating and all the normal stuff (after a horrible weekend a few weeks ago and ketoacidosis over memorial day), but his numbers are generally in the 300s for AMPS and PMPS.

He has gained back his weight and is in the normal range and eating Wellness Turkey and Salmon canned. The question now is, will more insulin help or is he ok where he is?

 

[MJ and Gobnait]

Oh Ernest! I'm new to the kittybetes so will be of little help except to say your cat is adorable and good luck!

Now I have to go look up ketoacidosis so I can worry about that too....

 

[LJ and Ernest]

Hi MJ,

Ketoacidosis isn't something to worry about, exactly. It's pretty dramatic and awful and you only really need to worry about it if Gobnait gets really sick and you aren't sure why. But when people tell you to check for ketones, they are recommending you look for that which causes ketoacidosis or is a sympton of it.

But Ernest lived through it thanks to ICU team at our local animal hospital.

Also, "kittybetes," I'm totally going to use that phrase now.

 

[Sienne and Gabby (GA)]

I would really encourage you to review the Tight Regulation Protocol sticky at the top of the board. I'm suggesting this for a couple of reasons. The protocol we use has been published in a leading veterinary journal by a top feline diabetes clinical researcher. Based on that protocol, with Lantus, dose increases are typically made in the amount of 0.25u unless the NADIR (lowest numbers in the cycle) is over 300. You should not be increasing Ernest's dose by 1.0u. Further, you are not routinely testing during either the AM or PM cycle. You must, must, must get at minimum one test during both cycles in addition to your pre-shot tests. Lantus dosing is based on the nadir, not on the pre-shot values. You could easily have a cat whose numbers are dangerously low at the middle of the cycle and not know it. Please start to get more spot checks during the day and the evening.

Having had a cat that went through DKA, the signs can be very subtle. A normally active cat that is lethargic will always cause me to ask about whether someone is testing for ketones regularly. Most of us will test with some degree of frequency since it is a definite ounce of prevention. The cost of a cat sick with DKA can be prohibitive financially as well as emotionally. Many cats do not survive DKA. Spending $15 on a box of test strips is well worth the investment.