9/2 Smudge AMPS 249, +3 130, +4.25 125, +5.75 130, PMPS 224, +2 230

Good morning Alli and Smudge! Good to see you over here at the LLB.

There's still not a ton of data but I feel like 2U is settling in at least. You certainly do enough BG testing for TR! I am interested to see what 2U brings today, if he has cleared what appeared to be a bounce. :bighug:
 
Hendrick Cuddleclaw said:
Good morning Alli and Smudge! Good to see you over here at the LLB.

There's still not a ton of data but I feel like 2U is settling in at least. You certainly do enough BG testing for TR! I am interested to see what 2U brings today, if he has cleared what appeared to be a bounce. :bighug:
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Thank you Kyle! Glad to finally feel comfortable enough to be over here.

I am happy to see consistent PS numbers in the mid to high 200s for 3 days - feels like progress is being made in baby steps. I will probably test at +3 & +6 again today. He tolerates those times best.
 
all your work with Smudge has reminded me that I'm supposed to do spot check BG test on Hen once a month. Well, just checked his SS and last one was 5/17. Whoops!

I was very worried that we both would be terrible at it now but I just gave it a go just now and got a test on my first attempt woohoo! He purred and purred, lol. Always makes me feel a little guilty when he purrs as I am stabbing his little ear!

He rang in with a healthy looking 77 at what would be +2 if we were still shooting insulin. :D:D:D
 
I’ll be interested to see how today plays out.
You’re getting some good data. :)

Encourage fluids and please keep testing for ketones daily..
 
Hendrick Cuddleclaw said:
all your work with Smudge has reminded me that I'm supposed to do spot check BG test on Hen once a month. Well, just checked his SS and last one was 5/17. Whoops!

I was very worried that we both would be terrible at it now but I just gave it a go just now and got a test on my first attempt woohoo! He purred and purred, lol. Always makes me feel a little guilty when he purrs as I am stabbing his little ear!

He rang in with a healthy looking 77 at what would be +2 if we were still shooting insulin. :D:D:D
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77 is amazing after your 3 month oops! Great job, Hen!! And you for the first try poke. :)

JL and Chip said:
I’ll be interested to see how today plays out.
You’re getting some good data. :)

Encourage fluids and please keep testing for ketones daily..
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Glad you think the data is good too! He drinks water well and I always add more to his wet food. He has a bowl of clean water and a water fountain to choose from. He's eating an entire can of DM every 12 hours, so 2 full cans a day (I can see my bank account draining...hopefully getting him on FF classic pate when he stabilizes).
 
allicatmeow said:
+3 @ 130
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when you see that much of a drop from the Pre-shot, you might want to get another test in an hour just to make sure he's not still dropping

I suspect he may either flatten out or be on the rise, but who knows especially given how the 4U just kept on acting the other day up to like +7

he sure cleared that bounce though!
 
Hendrick Cuddleclaw said:
when you see that much of a drop from the Pre-shot, you might want to get another test in an hour just to make sure he's not still dropping

I suspect he may either flatten out or be on the rise, but who knows especially given how the 4U just kept on acting the other day up to like +7

he sure cleared that bounce though!
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Thank you. 125 @ 4.25
 
you can put 125@4.25 in the +4 or the +5 cell and then manually color code it btw, that's what people usually do

like this, in case my explanation is poor. Also I found it super-helpful to add a time row above the date.

upload_2023-9-2_12-11-17.png



edit....nm you already did that before. Ignore me! haha

but the time row is a good suggestion anyway....lol

:banghead: o_O :oops:
 

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Hendrick Cuddleclaw said:
you can put 125@4.25 in the +4 or the +5 cell and then manually color code it btw, that's what people usually do

like this, in case my explanation is poor. Also I found it super-helpful to add a time row above the date.

View attachment 67557


edit....nm you already did that before. Ignore me! haha

but the time row is a good suggestion anyway....lol

:banghead: o_O :oops:
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Sorry for the delay! I have to do it on my computer because Sheets is still doing the View Only error. I'm going to add the time row, good idea!

So the flat number seems good? I'd like to leave him alone til about 5.75/6, but then I have to head out til PMPS.
 
wow what a great cycle

I guess this means hold that 2U at least a few days and see what develops? We'll see what the experts say. I do not give dosing guidance, wayyyyyy too new at this.

Great numbers though, actually around the upper range of a normal non-diabetic feline! And the more time in each cycle spent in the normal range, or at least close-to-normal, the better it is for him.
 
Excellent numbers, especially on an AT.
This is only day 2 on this dose so I’d sit tight and keep collecting data.

Some cats drop lower at night, so at some point, you might want to grab a mid-cycle test during the PM cycle. Not necessarily now (unless he’s giving you strong signs of an active PM cycle that needs to be monitored more closely), but worth keeping in mind as you move forward.

And of course, keep testing ketones daily. :)
 
I don’t have time to go back and read to find out why yiu went from 4 units to 2. Would you mind explaining? With TR. A dose is held for 6 cycles minimum usually. If just based upon your vet’s recommendation no need to explain but that’s a huge drop.
 
tiffmaxee said:
I don’t have time to go back and read to find out why yiu went from 4 units to 2. Would you mind explaining? With TR. A dose is held for 6 cycles minimum usually. If just based upon your vet’s recommendation no need to explain but that’s a huge drop.
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He had a crash 2 days ago and the vet approved me lowering to either 3U or 2U, based on his numbers and my gut (I have a very long standing relationship with them). I chose 2U. He had only been on 4U for a week and it was his hospital dose. I felt it was far too high for being out of hospital and settled. I was forced to do SLGS but default and adjustment out of hospital/DKA, but would like to move to TR.
 
With DKA TR is a better method. We usually reduce no more than .50 and usually .25, especially with DKA in the picture. What dose were you giving before 4.0? The larger depot will affect about 4 cycles. That’s what is keeping the bg in the 100’s.
 
tiffmaxee said:
With DKA TR is a better method. We usually reduce no more than .50 and usually .25, especially with DKA in the picture. What dose were you giving before 4.0? The larger depot will affect about 4 cycles. That’s what is keeping the bg in the 100’s.
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He was only diagnosed on 8/25 with diabetes and immediately went into the hospital same day with DKA. He has only been on 4U and now 2U (see spreadsheet for dosing, I don't have full hospital notes/BGs yet). This morning was his 4th cycle on 2U.
 
well like Elise said, it is likely the 4U depot still at work today but even still...nice cycle! The next couple cycles on 2U should be clear of the 4U depot so we'll see what happens.

@tiffmaxee the other reason for the big reduction from 4U to 2U right off the bat was advice from multiple senior members here, (over in the welcome forum) who were concerned 4U was way too high of a starting dose even with DKA in the mix



I like graphs. Smudge surfed this wave today :D
upload_2023-9-2_19-28-50.png
 

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Alli, not to muddy the waters, but it would be great once you get the hospital notes to confirm that it was truly diabetic ketoacidosis (DKA) and not just ketones or ketosis. DKA is associated with metabolic and electrolyte changes. I’m still pondering that they treated DKA primarily with Lantus (with only two doses of fast acting insulin), if that’s truly the case.

In any event, you’re doing great for being so newly diagnosed. And (being a broken record again), remember to get ketone tests daily. Even if Smudge only had ketones and not DKA, ketones can advance quickly into DKA and a life threatening situation. That’s why we harp on the ketone tests (and the ketone meter should give you faster notice than a urine dipstick). :)
 
Hendrick Cuddleclaw said:
I like graphs. Smudge surfed this wave today :D
View attachment 67560
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That's a beautiful graph!!! What a wave!!

JL and Chip said:
Alli, not to muddy the waters, but it would be great once you get the hospital notes to confirm that it was truly diabetic ketoacidosis (DKA) and not just ketones or ketosis. DKA is associated with metabolic and electrolyte changes. I’m still pondering that they treated DKA primarily with Lantus (with only two doses of fast acting insulin), if that’s truly the case.

In any event, you’re doing great for being so newly diagnosed. And (being a broken record again), remember to get ketone tests daily. Even if Smudge only had ketones and not DKA, ketones can advance quickly into DKA and a life threatening situation. That’s why we harp on the ketone tests (and the ketone meter should give you faster notice than a urine dipstick). :)
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To be honest, I'm unsure I will be able to determine that from their notes. The only bloodwork done is what you see in my spreadsheet. He had most of the physical symptoms of DKA, along with the recorded high BG and ketones.
 
allicatmeow said:
To be honest, I'm unsure I will be able to determine that from their notes. The only bloodwork done is what you see in my spreadsheet. He had most of the physical symptoms of DKA, along with the recorded high BG and ketones.
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That’s fine. It doesn’t hurt to assume DKA; both play into the decisions, so was just curious. Hopefully whatever it was is a one-off and he’ll never experience it again.

Please remind me … is he on antibiotics for the wound that wouldn’t heal? Infection plays a role in DKA as well.

Glad he’s eating and acting well. That’s a big positive.
 
JL and Chip said:
That’s fine. It doesn’t hurt to assume DKA; both play into the decisions, so was just curious. Hopefully whatever it was is a one-off and he’ll never experience it again.

Please remind me … is he on antibiotics for the wound that wouldn’t heal? Infection plays a role in DKA as well.

Glad he’s eating and acting well. That’s a big positive.
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Yes, he was given Convenia at the start of the abscess on 7/8 (it had burst and needed to be flushed, my mom was also unsure she'd be able to pill him) as well as Animax for topical. He was given Convenia again on 8/24.
 
Now that I know he was recently diagnosed I agree 4 units was way too high a starting dose. As I said I was not able to go back and read as I have a lot going on here. @Hendrick Cuddleclaw and @JL and Chip Chip. Thanks.

Did the vet run a culture to see what might be a good antibiotic. Can you pull him?
 
+2 @ 230

tiffmaxee said:
Did the vet run a culture to see what might be a good antibiotic. Can you pull him?
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He has a follow-up appointment this coming Friday and based on what they think of the wound, I may ask for a culture because I am certain I can pill him now that I have him and see what a good boy he is for all his pokes. (To give you the short version of his background, he was a neighborhood stray that my mom took in, he had a fight with another neighborhood cat which caused the abscess, and 6ish weeks after the abscess wasn't healing properly he was diagnosed with diabetes.)

Diane Tyler's Mom said:
Glad to zee you over to the Lantus forum, you're doing a great job :cat:
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Thank you! Glad to see you here. :bighug:
 
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