9/14 Yosh amps 506 +5 457 +8 554 pmps 475 +2 425

Sleeping now. Ate small snack at and 3a and 5a and after am shot. Hungry, but he always is even when in remission

I think he’s constipated. Been giving him miralax
 
I need to pick up some miralax, just to have. Yoshi really is beautiful and I believe he will get better pretty soon. It's so hard when you don't see improvement quickly. If his lowest point doesn't go below 300, you could increase to 2 units in the morning, or to 1.75 if he goes below 300 (but above 200). That would be using TR, if you don't want to wait longer. As odd as it sounds, some cats (I've read and seen) wait until the 6th cycle to show much change. Right at the dosecrease threat time.
I hope you have a great day:)
 
Tina Marie and Jan said:
I need to pick up some miralax, just to have. Yoshi really is beautiful and I believe he will get better pretty soon. It's so hard when you don't see improvement quickly. If his lowest point doesn't go below 300, you could increase to 2 units in the morning, or to 1.75 if he goes below 300 (but above 200). That would be using TR, if you don't want to wait longer. As odd as it sounds, some cats (I've read and seen) wait until the 6th cycle to show much change. Right at the dosecrease threat time.
I hope you have a great day:)
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Thank you so much for your advice. Your cat looks so sweeeeettttttt! I will try to have a better day! You have a good one as well
 
Sue and Luci said:
I agree...time to start the 'dose increase threat' - since tonight is the 6th cycle - maybe if he hears you say it out loud, he'll find his way down to some better numbers...it often happens that way...it's really stunning - I do think they hear us :)
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I’m going to have a talk with him at pmps. Syringe in hand.

He may not go down tonight because he has the dreaded vet at 2pm today. I’m sure his numbers will be in the trillions when we get back
 
I've only been here 18 months so I do not give dose advice (not enough experience) BUT it sure looks to me like Yoshi needs more insulin. (how old is Yoshi?)

Maybe @Sienne and Gabby (GA) is available to advise you?

images
 
For SLGS you should hold the dose for a week, do a curve at the end of the week, and change dose based on the nadir. According to SLGS Yoshi isn’t due for an increase quite yet.

I know members have mentioned before that you test enough for TR and I think they’re right. Do you think you would consider trying it? No pressure, but The reason I ask is because I, like you have more of a TR dose change mentality, but you really can’t mix both methods, especially if you’re still getting used to how Yoshi reacts to Lantus.

If I could follow TR I would but my work schedule makes it impossible. If you can test during the day I think it actually might suit your dosing mentality better.

Of course, do what’s best for you and Yoshi... just my two cents
 
L
AmandaE said:
For SLGS you should hold the dose for a week, do a curve at the end of the week, and change dose based on the nadir. According to SLGS Yoshi isn’t due for an increase quite yet.

I know members have mentioned before that you test enough for TR and I think they’re right. Do you think you would consider trying it? No pressure, but The reason I ask is because I, like you have more of a TR dose change mentality, but you really can’t mix both methods, especially if you’re still getting used to how Yoshi reacts to Lantus.

If I could follow TR I would but my work schedule makes it impossible. If you can test during the day I think it actually might suit your dosing mentality better.

Of course, do what’s best for you and Yoshi... just my two cents
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I am off Fri-Sunday and m/w I can get home to do a + 8 or 9. T/th I get home just in time for pmps.

I’m at the vet now and ready to hear her wrath on why he is not at 2u yet. I plan on increasing tomorrow morning. I don’t know if I will do 1.75 or 2.

He’s getting urinalysis now to see if bacteria is cleared.
 
It's highly likely that the high BGs you are currently seeing are from the infection. Orbax is a much better choice of antibiotic than the Convenia. Hopefully Yoshi will be feeling better very soon and start seeing some better numbers.

In the meantime, I would hold the 1.5u dose. BG may start dropping fairly soon after the antibiotic is started and you really need to give that dose a chance. It's also possible the dose may need to be reduced once the infection is dealt with.
 
I was just about to make the same point as Linda about the high BGs due to infection, and about being very vigilant now that a (hopefully) more effective AB has been prescribed. When that infection clears, his BG could drop a lot!

Hope Yoshi is feeling better very soon!
 
MrWorfMen's Mom said:
It's highly likely that the high BGs you are currently seeing are from the infection. Orbax is a much better choice of antibiotic than the Convenia. Hopefully Yoshi will be feeling better very soon and start seeing some better numbers.

In the meantime, I would hold the 1.5u dose. BG may start dropping fairly soon after the antibiotic is started and you really need to give that dose a chance. It's also possible the dose may need to be reduced once the infection is dealt with.
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You read my mind. My next question was going to be if I should still increase tomo. I will hold. He just tested at 554 + 8. But it was shorty after we got home from the vet and he was panting in the car.

The good news is is that I mixed the new antibiotic in his food and he ate it all. I can’t thank you guys enough. WE can’t that you enough
 
Nan & Amber said:
I was just about to make the same point as Linda about the high BGs due to infection, and about being very vigilant now that a (hopefully) more effective AB has been prescribed. When that infection clears, his BG could drop a lot!

Hope Yoshi is feeling better very soon!
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THANK YOU :bighug:
 
Here is the link to your previous post, included for continuity http://www.felinediabetes.com/FDMB/...37-3-377-7-454-9-5-456-pmps-468-4-394.219290/

I am going to comment a few things said here, that’s the joy of a peer reviewed board. ;) First, kitties coming back from remission can be harder to regulate. If you can, it’s good to be more aggressive in the beginning to get him back into good numbers sooner. Otherwise the chance of a second remission may be lower. However, it is still possible. Second, lingering in high numbers is likely leading to glucose toxicity, and frankly, Yoshi’s numbers are ugly. Note, so were Neko’s at first. The longer you wait to increase, the harder it will be to overcome glucose toxicity. Next, when kitties come back from remission, they often have to go back to their old highest dose, or even higher. Yoshi was on 2 units of Prozinc.

Antibiotics take a couple cycles to take effect. But we still don’t know it’s the right antibiotic to treat the possible infection. It’s the weekend when more monitoring can be done. If you were following TR, I would recommend an increase and frankly, you could even do it tonight. You could increase to help battle the high numbers of an infection, and let the numbers tell you if the antibiotic is working and the dose should be reduced.

Finally, some cats go lower at the vets, mine did.

It’s your decision which approach you want to do. I just wanted to balance the discussion with the safe but aggressive points.

How is the daily ketone testing going? Infection/inflammation plus insufficient insulin are not a good combo. How is his appetite?
 
Wendy&Neko said:
Here is the link to your previous post, included for continuity http://www.felinediabetes.com/FDMB/...37-3-377-7-454-9-5-456-pmps-468-4-394.219290/

I am going to comment a few things said here, that’s the joy of a peer reviewed board. ;) First, kitties coming back from remission can be harder to regulate. If you can, it’s good to be more aggressive in the beginning to get him back into good numbers sooner. Otherwise the chance of a second remission may be lower. However, it is still possible. Second, lingering in high numbers is likely leading to glucose toxicity, and frankly, Yoshi’s numbers are ugly. Note, so were Neko’s at first. The longer you wait to increase, the harder it will be to overcome glucose toxicity. Next, when kitties come back from remission, they often have to go back to their old highest dose, or even higher. Yoshi was on 2 units of Prozinc.

Antibiotics take a couple cycles to take effect. But we still don’t know it’s the right antibiotic to treat the possible infection. It’s the weekend when more monitoring can be done. If you were following TR, I would recommend an increase and frankly, you could even do it tonight. You could increase to help battle the high numbers of an infection, and let the numbers tell you if the antibiotic is working and the dose should be reduced.

Finally, some cats go lower at the vets, mine did.

It’s your decision which approach you want to do. I just wanted to balance the discussion with the safe but aggressive points.

How is the daily ketone testing going? Infection/inflammation plus insufficient insulin are not a good combo. How is his appetite?
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Oh man. Thank you for this. I have some decisions to make in a couple hours. I will see what his pmps looks like and go with my gut.

I just tested for keytones, negative. His appetite is very good. He’s pretty constipated. Hasn’t gone today and a few hard poos yesterday. Giving him miralax but when I pick him up I can feel he’s full of poo.

We are a hot mess. I am completely exhausted
 
Great on negative ketones! Could you note that in the Remarks on the spreadsheet, or I and others will keep asking. ;)

Constipation can also bump up the numbers a little. With those high numbers he is probably a bit dehydrated. Maybe some plain meat broth (no salt or onions) or tuna water might help him drink a bit more? I presume you are watering down his food.
Stressedcatmom said:
I am completely exhausted
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That is totally a factor in what you do tonight. If you can’t monitor well, keep it status quo.
 
Wendy&Neko said:
Great on negative ketones! Could you note that in the Remarks on the spreadsheet, or I and others will keep asking. ;)

Constipation can also bump up the numbers a little. With those high numbers he is probably a bit dehydrated. Maybe some plain meat broth (no salt or onions) or tuna water might help him drink a bit more? I presume you are watering down his food.

That is totally a factor in what you do tonight. If you can’t monitor well, keep it status quo.
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Thank you. Part of our conversation is, “no keytones, Yoshi. No mf keytones my love...”

I have unsalted chicken broth. 1g carb per cup and 40mg of sodium. Although he did drink a lot today and I am watering his food w the miralax.
 
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