Update is reallllllly long but it was interesting to say the least...
We saw the vet. :? I went in prepared with her spreadsheet to show them how she was doing (which was good, I thought) and it didn't quite go as expected. I'll start off by saying it's a large vet practice with over 10 doctors so depending on the need and urgency you don't always see the same doctor but rather who is there at the time. Regardless, I still like the practice, it's 10 minutes away and has a 24-hr ER and hospital that always has a vet there which is great. It's not always an ER, just a huge, busy, regular practice that has that as an added feature so they're never closed.
The car ride there consisted of projectile vomiting and peeing in the carrier. However, we and the car were prepared. I lined the backseat with garbage bags so the mess was easy to clean up. However, because she was so filthy from her mess they took the her still in the carrier to the back for a bath. This happens every time we go. Except the tech brought her back and said the doctor examined her back there and was looking at the urine sample now (found out it was urinalysis only). Huh? The vet came in and let us know she does have a lot of blood and sugar in her urine and she was going to get her on an antibiotic. I asked about sterile sample, culture and sensitivity and she said because of the amount of blood and sugar she saw and that being a bad combination because diabetics have trouble fighting infections she was automatically going on an antibiotic. She wanted to give her that shot that lasts two weeks but I know better so I at least got her to give her pills (Julia will eat them with pill pockets as she's done before) and so, she's on Clavamox for 2 weeks. She already had her first dose while refilling her belly after the vet. She was starving which I was happy to see. And ketones were negative yesterday for me and today for the vet.
Interestingly enough, after her bath Julia was brought back in the room in her carrier meowing like she was being skinned alive. As soon as Mom opened that door on the carrier and started petting her she quieted down. Then she came out and laid on the table looking around and quite calm.
Could Mom's calming her have anything to do with the difference in the BG I talk about in the next paragraph?
As for her BG...when the vet tested her she was well over 400 (during her exam in the back away from us)! I forgot the exact number but I can get it if I have to. Huh? I know about vet stress so that can account for some of it of course. She probably tested her right after her car ride, puking, bath, and exam which is stressful. However, we then tested her right in the room in Mom's arms and she was 257 which is close to a 200 point difference. The vet said based on the number she had and the amount of sugar in her urine, she thinks our meter is reporting lower than what she actually is and she's not as controlled as we think she is. Also, I don't think she's controlled yet (those were the vet's words). I think we're simply a work-in-progress hopefully doing things early and aggressively enough that we have a chance at going OTJ. For the record, the vet said they use a human meter with animal test strips calibrated to 700 for cats that will work on that meter. What the heck? I have never heard of such a thing.The vet proceeded to tell me what a Lantus curve should look like and because Julia bounces I know her 12 hour cycles don't quite follow the norm as she seems to clear a bounce every night/morning. I told her about Julia's lower #'s on 1.25 and 1.00 units and she asked about symptoms when she was that low. For the 38 I could feel her shaking a bit (not a seizure or anything) which seemed to puzzle her because that would mean she really was as low as I said she was.
I decided to go back up to 1.00 unit tonight (from 0.75) because of the infection. Also, I think her depot was a bit emptier from the 1.25 dose being gone in that she never hit green today when she's more recently been a frequent visitor in the morning cycle. I am home all weekend and would rather try to keep her on the lower side until this infection clears (and all of the time of course) - proactive rather than reactive. Of course we'll adjust as need be.
Does this sound like a bad idea to anyone?
The vet's plan is for me to shoot 1 unit twice daily for the next 4-6 weeks and then we'll do a fructosamine (sp?) to see where things stand. As far as the fructosamine, this sounds reasonable to me in that it will give an overall view and not just the spot checks. However, in my head I know that steady and holding at 1 unit is
not how Lantus works best (from what my newbie brain knows). It's amazing that as much as I know from this site and people here, the darn vet can put so much
doubt in my head as to what I'm doing for my cat. She talked about us micromanaging her like a human would do for themselves but cat's are different. Duh! I do think we micromanage our cats as we adjust dose, feed certain kinds of food at certain times, and test. But somehow the vet made me feel like it's a bad or negative thing. I would like to think I'm doing the best I can for Julia. I try to shoot as low as possible even when she's dropping and then controlling with food because I know the consistent 12 hours is best and she's always dropping before her morning dose. Stalling would just make life more chaotic and unpredictable as we're dropping more times than not in the morning. Keeping those numbers low is better for her. I do wonder if she was "somewhat" (term loosely used of course) controlled how much sugar shows in the urine? She said there was a lot which is part of why I doubted if she was as really low as I think.
Or could that much sugar show up because she still goes into the 300's even with the bounce, which, just happened to be happening at the time of the vet visit (an hour before normal shot time)?
I don't know what to do about the C & S (that we didn't get but not for lack of trying) now that we've seen the vet.
Should we give the meds a chance to work and watch her? She peed with blood in at least 4 places we could see today (shower, 2 different bathtubs, and on a plastic bag) so should we just keep our eyes open? Her behavior otherwise is perfectly fine, appetite was great today.
We're still sticking with our Relion Micro and dosing on here but boy-oh-boy did she mess with my head today. I am going to get a new Micro tomorrow just for peace-of-mind since it's so cheap to see if she tests any differently on a 4-yr old meter vs new.
Should I be using the control solution every time I get new strips? If so, I need new control solution. Even Dad suggested since they're so cheap, go ahead and get a new one. We do have a Confirm as a backup. And I got some needless syringes (for hypo kit) from the vet so that was a win. *Winning!* :lol:
Last question...When on antibiotics last year Julia had plain yogurt to help with the upset belly and runny poops. Is that okay to use with the diabetes (she loved it) or is there something better we should be doing?
If you made it this far I thank you very much for reading and any advice and kind words shared. I know I don't get to as many condos as I would like (where does time go?) but I still receive support and advice and for that I am grateful. As a reward, these videos on YouTube is hilarious and a must-see for anyone, especially animal lovers.
Disco the Parakeet and
Disco talks to Daddy
