6/25 Eddie AMPS 243, +6.5/169, PMPS 419, +4/300

[Jen&Eddie]

Hugs to you Elise ~ here is Eddie's condo. :smile:

6/23 Condo

YESTERDAY: AMPS/245, +2.5/282, +6/257, +11/262, PMPS/316, +2/309, +4/309, +5/285, +6/275, +8/266
TODAY: AMPS/243, +2.5/216, +6.5/169, +7.5/204, +8/202, +10.5/297, PMPS/419 :cry:, +2/360, +4/300

Hi LL. Something is going wrong here and I'm hopeful someone has some suggestions as to what to do. This pattern is not typical for Eddie at all so I have no idea how to interpret it.

Despite walking up the dose, Eddie's numbers are barely budging for the last 5 days. :cry: He last had green nadirs (propped up steering with food) on the PM cycle of 6/20. He's hit blue twice since then. Other than that, it's been yellow (mostly around or above renal threshold) or pink, and then this horrible red tonight for PMPS.

I'm beating my head on a wall here, and hope someone can help maybe rule in/out some of these things?

Bouncing - still?? 9 cycles of bouncing would be way longer than normal for Eddie. I suppose it's possible that he dropped between AM +2.5 and AM +6.5 today, but Eddie's not usually a huge diver, so I really doubt that he nadired super low, super early today. Bouncing off mid-blues at nadir today? Maybe - but bouncing into the 400's is really pretty unusual for Eddie.

NDW? AM's cycle was the 4th cycle at 1.75, so I'd be very surprised if it were still NDW. He usually seems to see some movement within the first two or three cycles after an increase - particularly when he's had good nadirs on the last dose.

Needs more juice? I can live with that. Glucose toxicity getting ahead of us? Probably need to increase after 6 cycles if this keeps up?

Insulin is toast? We have a vial from 4/4, so it's getting close to 3 months old. It looks fine. We try to be very gentle with it. Not in the fridge door, kept refrigerated, etc. I have busted DH sometimes see-sawing the dose. The vial did travel with us, but I think we kept it pretty stable. Vet was initially reluctant to prescribe pens when we first switched to Lantus, simply because she had never heard of anyone using pens for a cat, so I didn't force the issue. Now, I am going to press the issue with pens. If it is in fact the vial, and I have to get another vial - that's an extra $200 for a new vial to test whether or not the current one is shot. :YMSIGH:

Infection? Eddie doesn't have any symptoms of a URI or UTI or dental infection. I know they checked out his teeth when he was first diagnosed, and there was nothing obvious. I can't see anything obvious. He's not pawing at his mouth, and his appetite is totally normal. We did have one inappropriate pee incident a few weeks ago when I caught Eddie peeing on a towel. Since then, I don't think he's had any other inappropriate pees. He's not straining or avoiding the litter box. In fact, I put him in his box tonight to see if he'd pee so I could get a ketone test, and my ever-cooperative boy did pee. I saw no evidence of discomfort or straining. No snuffles or sneezing or goopy eyes. All P's are normal, except he does seem a little less energetic.

I called the vet tonight and have Eddie scheduled to go in on Friday afternoon. I'm not sure which vet we're even meeting with since I'm scheduling on short notice. Our regular vet is great and our regular tech is an angel, but some of the other staff have not historically been as good about working "with" us on Eddie's FD. Either way...I've requested B/W and a urinalysis? Anything else I should request?

Am I missing something? Panicking for no reason when I need to just pull up the patience pants?

 

[tiffmaxee]

Re: 6/25 Eddie AMPS 243, +6.5/169, PMPS 419

I wish I knew. Sending along request for vines. Maybe that 419 is the high before the storm ends. I sure hope so. My lantus lasted for almost 5 months when I started asking if it lost it potency. :YMHUG: :YMHUG:

 

[carfurby (GA)]

Re: 6/25 Eddie AMPS 243, +6.5/169, PMPS 419

I don't have any advice on Eddie's numbers. It can be frustrating when they have high numbers and we can't figure out why. I hope the vetty visit can help you rule things out. When I was using the vials, I used one vial for almost a year and didn't have any problems. :YMHUG: :YMHUG:

 

[julie & punkin (ga)]

Re: 6/25 Eddie AMPS 243, +6.5/169, PMPS 419

gosh i'm glad i just happened to open your condo today. make sure you use the ? post icon when you have concerns, or put them in the subject line, so you don't get missed. this sounds pretty important.

He is bouncing. i can see a bounce from the greens on the night of 6/20 that resolved in the late night cycle of 6/22.
on the morning of 6/23 he's blue and he's already beginning a new bounce and i think he's only just resolved that bounce in the day cycle today.

It does look like something's going on, though. could be the insulin, although most of the time after a trial with new insulin, it turns out that the old insulin was ok. since DH has see-sawed the dose, it's possible the insulin isn't as effective as it was. Still, I would increase the dose tomorrow night by 0.25u (so you will have had 6 shots at this dose) but when you increase the dose tomorrow night, that means that he has doubled the dose since 6/14 - less than 2 weeks. i'd be concerned too. All the things you mentioned could cause higher BGs. Since you have a vet appt already, i'd ask for bloodwork and a urinalysis, but in the meantime i'd increase tomorrow night.

 

[Jen&Eddie]

Elise and Carla - thank you! I'd be bummed if Eddie's insulin is toast after less than three months, but if that's the problem, so be it.

Julie - thank you!! I always forget to put the question mark on Eddie's condos when I have a question. Thankfully, Eddie's coming down out off the red floor, but this upward trend makes me think something has to be going on. Whether it be insulin that's lost its oomph or maybe he's got an infection brewing. He seems to feel OK, and he was negative for ketones (and no history of DKA or ketones thank goodness). We've lucked out and never had a UTI to deal with before with Eddie or with any of the others. Am I right in thinking an infection can be brewing with no obvious symptoms? Unless something crazy happens tonight or tomorrow, I'll take him up to 2u tomorrow evening. Thank you again. In a weird way, I feel a little relieved ("relieved" may or may not be the right word) that I'm not panicking over nothing.

 

[Wendy&Neko]

Yikes Eddie - what were ya doing up there? Good to see you left in a hurry, but take your time, no rush.

After we had our radiation therapy session for Neko, the internal medicine vetty I talked to recommended getting b/w and full urinalysis done every 6 months. Her comment was that kitties are very hard to read and can easily have something brewing that's not obvious to us. Diabetic cats are prone to more UTI's that other kitties and often the only symptoms are higher numbers. Good plan on getting him checked out with the vet. That'll be one variable that hopefully you can eliminate, or if not, then treat to get him back on track.