9/25 Angie - back onTJ - pmps=297 +2=288 +5=fail

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GraceAndAngie

Member Since 2013
Hi dear Lantus land,

Angie missed you it seems - I wish she had asked me to come and visit rather than giving me a blood sugar reading like this to bring us back here!

Our vets are very supportive of our home testing and are familiar with the Queensland University protocol. Our vet said we could start her out on 0.5 units. Does that sound right to you? Last time she came back out of remission her blood sugar wasn't as high and we started her back on 0.25 units. I gave her a little bit of food when we came home from the vet -- maybe half a meal size. I probably shouldn't have done that till I checked in. Will I still be able to give her insulin tonight? I feel new again.

I was thinking of giving her shots at 6 am/pm to make monitoring in the evenings easier. It's 6 pm now, so I can shoot late tonight and move her shots forward 15 minutes at a time.

Angie has had a lot of health troubles since we were hear last and my civvie, Jetzin, fell sick and passed away from Feline Infectious Peritonitis. I've been doing a lot of cat nursing, as well as still being sick myself, and have thought of you all but haven't had much spare to come and visit. The vet thinks that her return from remission was brought on by Momentamax (mometasone furoate monohydrate, clotrimazole and gentamicin sulfate) drops in her ears, which we discontinued today, because her infection is better. Our vet hopes that she'll go back into remission again as we've stopped those drops.

I haven't yet caught up on condos -- just wanted to get this up for advice first. I hope all of you (cats and people) are well and happy. I'll visit you shortly.

Our last condo was here, on the 7th of January.

Thanks in advance,
Grace



ANGIE'S HEALTH HISTORY (a bit long, sorry):
Last time we were here Angie had just been diagnosed with early CKD. We've had appointments with Dr Lisa Pierson, who developed a diet for Angie. Her CKD has barely progressed since then. (Thanks very much, Dr Pierson!!!)

Angie has had multiple allergy symptoms, which we have more under control, having isolated chicken and dairy products as allergens - Dr Pierson gave me diet options to test and eliminate allergens. She's had impacted anal glands, with thick waxy black stuff in there. Unfortunately, took her to 5 different vets thinking she was constipated and the first 4 sent us home saying she was fine. The 5th (our current beloved vets) discovered her impacted glands, but not before one had popped inside her. :( Poor old girl. A consulting surgeon thought that we would be better off not operating to remove her gland as she is old and didn't recover well from her last general. She's also had asthma, skin flaking and excess wax in her ears - all allergy symptoms. She's had three rounds of ear infections from the excess wax and has been treated with "Apex PMP" (miconazole nitrate, polmyxin b sulfate, prednisolone acetate) drops in her ears for the first two fungal infections and a bacterial infection. The bacterial infection was resistant and so it has also been treated with "Momentamax" (mometasone furoate monohydrate, clotrimazole and gentamicin sulfate) drops.

Angie had her teeth cleaned under a general anaesthetic, while they checked out her anal glands, cleaned them and put in some antibiotics. She was very stressed during her recovery and may have injured herself while we were driving home. Since then she has a twitch where she jerks her head every now and then.

She was extremely anxious when Jetzin passed away - howling if she was left alone and wanting to be on my lap at all times. She slept on my chest at night and woke me up by patting my face frequently. We ended up putting her on some anti-anxiety medication (I can't remember which though) because I couldn't sleep and she was so distressed. She still won't go outside without one of us (Jetzin used to be a protector) and she sleeps next to my pillow. She's lucky I'm single!

After her first ear infection cleared up she must have been feeling a whole lot better because she started climbing up on furniture, running and jumping again. It was lovely to see but she's also old and not as fit as she used to be. She had a few falls and in May this year fell from the television onto the corner of the coffee table before landing on the floor. She broke her sternum and put her back out of place. Her X-rays show that her sternum is pushed in and pushes on her lungs. The vets didn't feel that it could be put back in place. She was treated with a topical anti-inflammatory to help reduce the pain of these injuries and was also treated with acupuncture (our vets are multi-talented). A topical anti-inflammatory, tramadol trans-dermal) was chosen to avoid impacting her diabetes and CKD. I rubbed it into the inside of her ears. Unfortunately she had a skin reaction to it so it had to be discontinued. We just treated with acupuncture after that.

She had a full blood screen in June - I can't find the results at the moment - but I'll find them and add them to her chart.
 
Re: 9/25 Angie - back again - bg=342 :( what dose to start o

I just thought I should add, Angie weighs 3.1 kg and is a little under weight. Ideal weight would be about 3.2 to 3.3 kg. That would make her starting dose (based on the modified protocol) 0.75 units. The vet initially suggested 1 unit to start with but reduced that to 0.5 units because I was worried about giving her a whole unit -- she's been quite responsive to insulin in the past.

Does 0.5 sound good or should I go with the modified protocol of 0.75?
 
Re: 9/25 Angie - back again - bg=342 :( what dose to start o

I've just been doing some refresher reading of the protocol and also of treating hypos.
I've got lots of all the supplies needed and a brand new bottle of lantus. I don't have high carb cat food though. I'll make a gravy from lamb and flour and mix that in with some of her low carb cat food.
 
Re: 9/25 Angie - back onTJ - earlier bg=342, pmps=297 - am d

I felt like I should give her some insulin and it was getting a bit late. I gave her 0.25 units to be on the safe side. I'll test at +2.
 
Re: 9/25 Angie - back onTJ - earlier bg=342, pmps=297 - am d

Hi, Grace. Sorry that Angie wanted to come for a visit. Let's hope it's a very short stay and she'll get back on course quickly. Likewise, sorry no one saw your post. That 'half way around the world' thing means you were posting initially at 4:00 AM on the east coast of the US and a lot earlier for the west coast folks.

I'm going to assume you've had her in to see your vet to make sure there's nothing medical going on (e.g., an infection brewing) and her allergies aren't flaring. Allergy is an inflammatory process and it could impact BG numbers.

Starting at 0.25u is fine. Angie was never on a large dose of insulin so this is a conservative way to start out again. Don't be surprised if Angie needs more insulin than during the last bout of FD. I hope Angie has settle down some after your losing Jetzin.
 
Re: 9/25 Angie - back onTJ - earlier bg=342, pmps=297 - am d

Hi Sienne,

Thanks so much for your reply. I remember having trouble with pmps advice in the past for that reason. I could move her shot to 9 am/pm but that means very late nights. I'll think about it, if becomes an issue.

We saw the vet today. I was worried about her ear infection because she seemed suddenly worse over the last few days. I didn't even think about diabetes. ohmygod_smile She started the new meds for the ear infection last week. The vet suspected diabetes and tested her. Her ears have cleared up and there's no sign of any other infection. Her allergies had flared up a little while ago when we tested her on dairy products but have slowly been getting better since removing them again. The vet thinks that this new med for her ear caused the BG spike - it's anti-inflammatory as well as antibacterial. It was supposed to be lower risk because it goes in her ears rather than in her mouth, but of course cats ingest a bit of anything that gets on their fur.

Angie has been off her anti-anxiety meds for two months now and is doing well. She just spends a lot more time with me now, which is fine by me! She won't go outside without one of us but other than that she doesn't seem to be anxious any more.

Off to test the kitty...
 
Re: 9/25 Angie - back onTJ - earlier bg=342, pmps=297, +2=28

Morning Grace ~O) ~O) ~O)

I am sorry Angie felt the need to revisit us here in LL! I hope too that soon she will be in remission again. Could be!

I am sorry about Jetzin. it is good though to read that Angie's anxiety over it has subsided. it's always hard when our furkids need to leave us.

Take care! it was nice to hear from you.
 
Re: 9/25 Angie - back onTJ - earlier bg=342, pmps=297, +2=28

Good morning Michelle (it's almost 2 am so that counts!). Lovely to hear from you but I'm too tired to reply tonight.

I failed on Angie's +5. I really wanted to get that reading to give us a picture for tomorrow. I tried 4 times and she managed to flick away the blood or I didn't get enough. She was upset by the end and so I thought that as her numbers were so high, it would be better not to upset her further at this early stage in the game.

See you all in 6 hours, back in the land of not quite enough sleep.

Good night all (have a nice day!) :-D
 
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