Advice? PM +2 424. New Solostar cartridge.

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SHK

SHK

Member Since 2012
I can't follow tight regulation due to my work schedule, but I hope you'll forgive that and still give me any advice you can. :oops:

EQ has not been doing well lately - please a look at his spreadsheet? I was concerned and due to some responses on another thread, I recently reduced his dose from 6u to 5u. That ultimately did not work and his numbers started going higher than they had been previously. I have been on vacation this week, so I've been able to get more numbers than usual. Hopefully this will give more information to Tight Regulation folks who needed more numbers in order to help advise me.

We just had a vet appt with bloodwork & urine culture a couple days ago. I brought my laptop to show them the spreadsheet (I don't have a printer). It was kind of cool since there are two vets at the practice with diabetes experience and they both talked to me about EQ. Good news? No thyroid issues, kidneys look fine, no ketones (which I test for regularly). Bad news? Slight heart murmur, possible dental infection - lots of tartar despite a deep cleaning and extraction eight months ago (but no visible abscesses), and possible urinary infection (waiting on culture results). By the way, his urine output is still very high - hasn't decreased one tiny bit since before the dx. We began Baytril for seven days, for possible infection. I'm adding sugar-free acidophilus to the food to prevent diarrhea and tummy issues; so far, so good. The plan was to finish antibiotics, get a new source of Lantus, keep the dose at 6u until all of this is over, and keep monitoring BG levels. Then if no results, we'll start eliminating other issues (IAA, Acromegaly) and/or switch insulin.

I had been using a 10ml bottle of Baytril since the DX. Despite my precautions, I am unsure if it is going bad or not. Got a SoloStar pen today and began using at the PM dose. However, his PMPS +2 hours level is 37 points higher than it was pre-shot. Is this normal? I know about the shed/depot, but do you know how long it might take for the new Lantus to start working, if the possible problem was the old bottle? Would it be immediate? These numbers in the 400s are really freaking me out.

Thank you in advance!
 
There are a couple of issues. Any infection or inflammation, dental, UTI, etc. will raise BG numbers. The Baytril may help but if there's gingivitis, it's not going to solve the problem. In addition, unless the vet got a sterile urine sample via needle (cystocentesis) and is running a culture and sensitivity, you don't know if Baytril will target the source of a UTI. If there are dental issues, I'd give serious consideration to having another dental.

If your Lantus was old or bad or whatever, it means that the insulin depot may not be filled with the good "stuff." It will take several days for the new Lantus to replenish the depot. You'll need to be patient.

The difference between your pre-shot and +2 is trivial -- it's within the 20% that is attributable to meter variance. In essence, they're the same number.

If you are convinced that EQ needs this much insulin, you may want to consider having him tested for high dose conditions. Acromegaly and/or insulin resistance (insulin autoantibodies) are far more common than most vets think. It was thought that these conditions were rare. More recent studies suggest that 25 - 33% of diabetic cats may have acromegaly. This is a link to information on high dose conditions. There's information in this post about getting your cat tested. The blood work is done only at Michigan State University vet labs. The cost for the two tests is very reasonable and it will answer whether there is a medical explanation for EQ's dose. We begin to think about the possibility of a high dose condition when a cat needs 6.0u. You may want to wait until the dental issues are dealt with and your vet sorts out if there's any other infection present.
 
Sienne posted just as I was about to with basically the same info so I won't reiterate. But I do want to tell you that seven days is not enough on the baytril IF there is a UTI and they did need to do a cystocentesis for a culture and sensitivity. The normal dosing time...minimum for a bona fide UTI is ten days.
 
Thanks, I do have 10 days worth of Baytril and plan on using it.

I did mention in my post that the next step will be to test for IAA and Acromegaly, but that will be after the course of antibiotics and when the urine culture results come back (it was a sterile procedure with a needle in the vet office).

I agree he needs another dental cleaning. His last one was before the diagnosis. Is there a specific risk of putting diabetic cats under for a dental procedure? I know it gets riskier as a pet ages, and I don't know his exact age - I'm guessing 10-12.
 
Thank you for that link! Will do. :smile:

P.S. Is there anyone you know of on Tight Regulation with a dose as high as 5 or 6u that might offer advice to us too? I know all cats are different, and I might just have myself a high dose cat, but it seems most of the cats in this forum all have much smaller doses.
 
The spreadsheet I often refer people to is Randi/Max's. Max was up to about 6.0u before he decided he was tired of being on insulin and went OTJ. I'm not recalling anyone off the top of my head who's cat is up to 6.0u but I know there are a couple of people who may be close. Tip's currently at 4.0u.
 
Sienne and Gabby said:
The spreadsheet I often refer people to is Randi/Max's. Max was up to about 6.0u before he decided he was tired of being on insulin and went OTJ. I'm not recalling anyone off the top of my head who's cat is up to 6.0u but I know there are a couple of people who may be close. Tip's currently at 4.0u.
Click to expand...

Thank you so much. I feel less alone now after looking at both of those sheets.
 
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