9/30 Oberon +10 310, AMPS 348/5.3, +3 381, +6 393/4.8, +9 341, PMPS 357/5.0, +3 362, +5 339/4.4

Lisa & Oberon

Lisa & Oberon

Member Since 2020
yesterday (with dexa results): https://www.felinediabetes.com/FDMB...8-6-0-3-360-6-8-5-25-326-dexa-results.236090/

Still mid 300s; ketones are down from last night (6.8 at +3!) but still high (5.3 at AMPS). His appetite is fine and behavior is normal. Definitely going to talk to the vet about adding on Humulin R today. Hoping to get most of the rest of the test results back today (waiting for senior panel +T4, B12, IGP, and IAA). For now I'm hoping to go back to bed for a bit.
 
Hope you got a little more rest, Lisa :bighug: Hope Oberon's numbers come down - glad to hear he is eating :cat:
 
So good to hear he has normal behaviour and appetite! Paws crossed that test results come back good for your boy.
You must be exhausted. Rest up and take good care of yourself as well.
 
IGF-1 and IAA would be Friday at the earliest, possibly the weekend. The IGF-1 results are only run once a week, I think it's started Wednesday and run for a day. Since you live in the east, hopefully the blood got to MSU in time. Mine didn't, had to wait an extra week. :nailbiting:

Thank goodness the ketones are going downward!
 
Got back to bed for a bit (complicated by Ariel the scaredy cat deciding she needed to wash my face and eat my hair), but still dragging. Luckily I don't have much going on today. My regular vet called and they're getting together the saline and stuff, and said I can get a pill gun from them, so hopefully I'll finally be able to get some Baytril into him. I've decided to test the ketones less often (maybe just AMPS and PMPS); the high numbers just freak me out, and he's acting fine. Purring a lot this morning, which he didn't do yesterday. Right now he's banging on the recycling bin to tell me he's out of food. (He has food; it's just a little dry. I'll wet it down again for him. Prima donna...)

Paula mentioned yesterday that the IGF and IAA tests could take a while. I'm actually more interested in the senior panel right now so we can get a feel for renal function and stuff in case there's something that needs more urgent attention. Then later I can integrate the IGG, IAA, and dexa results to sort out whether there's something chronic underlying his high BG.
 
Vet is supposed to call this evening with results, so I can discuss the Humulin R then, and ask how long to keep going with the fluids. Meanwhile, because I'm a geek, I made another graph. Check out the ketones vs. date tab on Oberon's SS. The first small increase is the one that brought us to the ER on Thursday. The second big increase started right after the dexa test. At the moment it looks like it's trending downwards; I'm hoping that continues. I'll check at PMPS.
 
Hope you get that phone call with the vet soon. I saw in yesterday's post they were talking another form of Humulin. If it's N, try to hold out for R.
 
Wendy&Neko said:
Hope you get that phone call with the vet soon. I saw in yesterday's post they were talking another form of Humulin. If it's N, try to hold out for R.
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No call yet; I know the hospital itself is 24/7 but I assume at this point (9:30 pm) I won't hear from the vet until tomorrow. Pretty sure what she mentioned was Humulin 70/30 or 80/20, which is apparently a mix of 70 or 80% N and 30 or 20% R. I'll push for just R.
 
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Wendy&Neko said:
It would be better to have someone help who has experience with the insulin - not sure who here has used the mix.
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Is there a specific protocol or anything that you could direct me to? I'm thinking it might help to show the vet that we have a plan in mind.
 
Ketones appear to be slowly coming down. BG is bopping around in the 300s, as usual. Last cycle at the current dose starts tomorrow morning, and then he'll get an increase to 5 U in the evening. (Or maybe 5.25 U?)
 
Christie & Maverick said:
Happy to see lower ketones, yay! I'd bump up the dose tomorrow evening by 0.5u, nadirs have been over 300.
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Yep, that's my thought. He had one very very brief dip into the 200s at this dose, but pink is still very clearly his favorite color.

Something I've been wondering... does anyone ever measure circulating insulin levels? Seems like that would be a good way to help tell normal diabetes (insufficient insulin production) from insulin resistance (normal or maybe even elevated insulin production early on, but cells don't respond properly). I guess you'd have to do it before starting insulin treatment, though, unless the test could distinguish endogenous feline insulin from the synthetic stuff.

And with that, I'm off to bed to ponder the unknowable...
 
Lisa & Oberon said:
Is there a specific protocol or anything that you could direct me to? I'm thinking it might help to show the vet that we have a plan in mind.
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No, and that's because we don't want lurkers to just try it on their own. There have been some scary situations of people who have done that. Basically we start low, with an experienced person online with you, probably at 0.25 units, test every hour to see if we can figure out the R action. Do that a couple times to gather data. And depending on what the results show we might increase the R dose. Note that the amount of R needed per cat wildly varies. Neko never got above 0.5 units, even at 7 units of Levemir. I've seen cats on much higher doses of R, but also a 30 unit Levemir cat who didn't need more than 0.5 units.
 
Makes sense. I'll let you know once I (hopefully) get the R. I'm also bumping up his dose tonight. I assume we wouldn't want to do this when he's heading into one of his dips, but I'm not sure how easy it is to see them coming.
 
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