9/29 Sootie update: PMPS at +11.5 = 134; tonight's Lantus shoot window 8-9pm (et)

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HWright

HWright

Member Since 2016
http://www.felinediabetes.com/FDMB/...166-possible-uti-dose-pm.165784/#post-1789563

Sootie starting orbax antibiotic today for UTI with vet ok to continue with uromaxx if I think it helps. No glucose spill.

So.... bearing in mind UTI now in equation and that she has had am dose of 0.1u Lantus this morning and past few days but no pm doses past few nights during this phase of microdosing (SS notes reasons):

1. Effect of UTI and antibiotics on pancreatic function and exogenous insulin?

2. Do I maintain same dose even if bg higher than cycle norm or adjust accordingly? If adjust, by which increments up or down? And conversely if bg lower, noting if in green at pmps or amps, to hold food, ask for dosing advice before feeding and dosing.

3. Suggestion on earlier thread to offer mini-mid-meals makes sense. And I do think it helps her pancreatic function, with or without micro dosing. So i add this to her food offerings more consistently, whether her freeze dried treats or her wet food, mid-day to mid afternoon and again two or three hours after supper ( the pm I'll most often rely on dh to help with). Make sense?

4. Other?

Sootie's pm shoot window tonight is between 8-9pm (eastern Time).

Thanks
Sina

@Marje and Gracie, @Gussie's mom, @carfurby
 
If Sootie were my cat, I would hold this dose for a minimum of six consecutive cycles and see what she is doing. You are not going to be able to see the effects of this dose for her if you aren't shooting twice a day. I understand about the oil spill issue but I would have shot other than that. The more shots you skip, the longer you will need to hold the dose because we look at consecutive cycles.

To answer your questions:
1. Did your vet do a cystocentesis and culture and sensitivity? If she prescribed orbax just based on symptoms, it's possible Sootie just has sterile cystitis brought on by stress from the recent events. The best diagnostic would have been the cysto and c&s. Once you start a/bs, those tests won't reflect if she did have a UTI. Usually, but not always, with a UTI, we see higher numbers than what they've had. Every cat is different, but often, the BG trends way up into yellow at least. I don't necessarily think a UTI would affect exogenous insulin production but I am also not convinced that she's really producing much, if any, exogenous insulin.

2. I would hold the dose six consecutive cycles. IF she goes way up into yellow or higher, we should reassess dose. If she has an infection and numbers go up, we don't want to risk DKA. If she has a green PS, yes, hold food and pls post for help.

3. Typically it is best to feed all mini meals before nadir so as not to affect the duration of the insulin. Feeding after nadir can act like slamming on the brakes of a car. If she's starving afte nadir, a few LC freeze dried treats are fine.

I am, unfortunately,moving to be out to dinner at your shot time. But, unless she is really high or in green, I would shoot the 0.1u. If she is really high or green, pls post for help.

Have a great day!
 
Hi
To Marje's #1 asking about testing:

Yes, as you suggest, could well be ideopathic cystitis that didn't get clarified from my original query about UTI. No, vet did not do cystocentisis. Today's Rx based on history, recent symptoms, bg trends, my observations (and home test for glucose in urine). She had cystitis when very young, and a UTI/bladder infection some years ago. A couple months ago, she had similar symptoms as the recent ones but without visible blood in urine. Lab work then was normal, ua normal, no blood in urine, no infection, no glucose spill. I return with Sootie on Monday (they were just barely squeaking me in amidst emergencies and surgeries). So could very well be that he rx'd the antibiotic in hopes to alleviate discomfort on Sootie's part and 'just in case,' even tho I tend to be averse to antibiotics unless absolutely necessary and germane to the infection. I certainly can hold off on the antibiotic for now and continue with the uromaxx herbal alternative for a few days anyway.

Re Marje's #2 and #3: understand. Ok. Thank you.

re tiffmaxee suggestion to post tonight's pm bg: will do.

And, Gussies mom: hi and thanks for thread nuance tutoring.

Til in a bit,
 
Sootie's +11.5 (at 7:27pm) was 134. Picked at supper when offered. Now going to try to see if fd salmon topper will whet interest. Shoot window tonight is 8-9pm, provided eats a bit more.
 
Thanks, thinking same, and as per Marje. After first food offer, Sootie went to bathtub wanting to drink from faucet. After doing that I brought her to supper dish, added crumbled freeze dried salmon and turkey. Ate a couple tbs worth. Ya think that's enough? I'm thinking not quite enough, but is something. Will encourage her to resume eating. Is now drinking at water fountain.
 
Thanks Chris. Yes, understand about that. Yet, with appetite being off recently.... When appetite good, I know she's eaten enough and will finish meal or at least most of it even if I shoot during meal. She's eaten a bit more just now, enough for me to feel it's ok. So will do the 0.1u by 8:30.
 
Good job shooting.

One note: I am it suggesting you take her off the antibiotic if the vet has prescribed it. I'm not a vet so you should go with your vet's instructions. I was just making a general observation that it's hard to distinguish between UTI and sterile cystitis without a cysto and c&s.
 
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