7/19 Can you guys look at Sammy's Spreadsheet

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Yes, he's still on Cisapride but it's no longer that cherry goop. Now it's a tuna flavor. I haven't been checking for ketones. I gave my stripes to somebody whose dog just came down with diabetes. I went and got new insulin on 7/11 thinking that maybe the first bottle was no longer effective.
 
ok, thanks,,,
if u can check back thru the day - let's see what others can suggest about the numbers ok?

anything else going on? eating ok? (what does Sammy eat again?)
 
OK, I just called the lab that makes the Cisapride and asked them if it has sugar in it and they said yes and then I asked them if they can make it without the sugar and they said yes. A bottle is now on it's way here. And I am going to go talk to the doctor.
 
ok, I looked at the ss and I'm going to venture to say that the cisapride may be the culprite. When Spot had his dental, they gave him some pain meds flavored with.....cherry syrup. I asked the vet about that and she said as long as he was getting insulin he should be ok because there was a very small amount of syrup in it....wellllll....not true. His numbers went up up up and I decided to stop the meds and numbers started to come down.
 
Hi Maureen.

I don't think the results are abnormal. I just think Sammy needs a dose increase. I think you've been holding Sammy's dose for too long. Just as a reminder, from the Tight Regulation sticky:

"General" Guidelines:

--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).

--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).

--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.


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
Click to expand...

I'd have increased Sammy's dose to 2.25u rather than fattening dose. You should probably hold the fat 2.0 for another 2 days (4 cycles) and then increase to a fat 2.25u if the nadirs are still in the yellows or higher.

Good catch regarding the sugar in the Cisapride. It's amazing that a compounding pharmacy doesn't ask if there are any other health issues they need to know about! I don't think the numbers are solely a result of the Cisapride, though. The sugar may bump numbers up but I doubt they'd stay up the entire day.

Also, 3 mos. is a considerable period for Lantus to be viable. On the other hand, there wasn't much of a change with Sammy's numbers so it's hard to know if your bottle was OK or not.
 
OK, on the theory that the difference between a 2U and f2U with the inexact syringes we use isn't worth debating I jumped from 2U to 2.5U b/c it says in the stinky that "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." He's approaching his third 2.5 cycle and the numbers are not improved. In rereading the stinky I was reminded that a late does = an decreased dose and an early dose = an increased dose so maybe some of Sammy's problem (and he's been acting really low today like he's not feeling well) is my fault for moving the times around enough to have screwed up the ss somehow so the dates aren't right. All the numbers are there they're just not in the right places - it's like a checkbook that won't balance. One of these days when there's not a line of people stretching around the block asking me to do things I'm going to figure out where the heck I went wrong. With two absolutely confirmed poops yesterday and today I didn't give him the sweet Cisapride today waiting for the new batch and hoping for he'll go on his own. I ran out and bought somenew Keto-Diastix and he's got no ketones but he's peeing glucose like crazy.
 
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