Akila's progress and next steps

[penni]

It's about our one week anniversary here at FDMB and without declaring victory, I feel like there is some reason for optimism. Her BG values have been fairly consistent pre-shot and I hope to do a curve in a few days to a week. The reason I am waiting is, she's about to drop down to a lower dose of medrol, a steroid to control an autoimmune disease she has. The high dose she is on right now can't be more than temporary so I think doing a curve right now could possibly gather a lot of data that isn't predictive for the future. However, the next (and perhaps permanent) step is to do an every other day dose of the steroid. Does anyone else have every other day dosing of steroids and if so, do you find that BG is higher on steroid days than non? I'm not sure whether to do her curve on a steroid day or non-steroid day, or try to do two curves in a row.

Her BG hasn't been out of the low 200s much in my recent testing, and in anticipation of it possibly going lower with a reduced steroid dose, I have no plans to up the insulin dose for now. However, she is still having some instances of not making it to the litterbox to pee, or not getting far enough in to keep the urine in the box! I know I'm lucky she consistently is obviously trying to be in the box, so I have high hopes for more litterbox success when her diabetes is more well-regulated....but are my hopes too high? With pre-shot BG numbers in the low to mid 200s, shouldn't she be drinking less and having less bladder urgency? I'm just supposed to be more patient right?

I guess I'm trying to be optimistic because, while part of me realizes I have it pretty good with her diabetes, it's tough to keep my chin up at times. I'm giving her up to 16 separate administrations of medication per day and it's just psychologically and financially stressful! The newest one is a chemotherapy drug with all kinds of scary radioactive warnings. She's such an angel for how willingly, even enthusiastically, she takes most of those medications, and I am grateful. But you know, it is *tough*!

 

[Chris & China (GA)]

Steroids or no, I think you should really be going ahead and getting more tests in if you can. The pre-shot tests only tell us if she's high enough for insulin at all.....they don't tell us how low the dose is taking her, and that's how Lantus is dosed.

I see that you reduced to .75 last night (I'm guessing because of the lower Pre-shot)....Lantus works best when given at a consistent dose, so it would have been better to stick with the 1U dose.

If at all possible, I'd try to be getting at least 1 mid-cycle test on the AM cycle (between 5-7 hours after the shot) and a "before bed" test on the PM cycle. Most cats go lower at night, so it's really important for her safety to get that test on the PM cycle.

Doing "curves" is fine, but what works best is to get tests at different times on both cycles. Think of your spreadsheet like it's a puzzle.....if the only pieces you have are the edges, it's impossible to know what the picture is, but if you have pieces sprinkled throughout, the picture becomes clearer!

We've had lots of cats on steroids here...usually, as they attempt to taper off, they do tend to run higher on steroid days than non-steroid days, but ECID (Every Cat is Different). By getting more tests on Akila, you'll learn more about how she's responding.

The good news is that for a cat on steroids, her numbers really aren't too bad! Hopefully she will respond well to the Lantus and continue to improve!!