Argyle 10/13 - scary meter story

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jackie

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Hi -
Argyle is doing so-so today, but this morning convinced me that I have to get a different meter.

PMPS 286, shot 0.2U
+5 529 (ugh)
+13.5 123 (yea)

That was the lowest BG she's had in months, so I was really,really psyched, but for some reason (maybe being kind of a pessimist), I thought to myself 'I should really double-check that' - and got a second reading two minutes later of 551 !!! I checked her again at +14 and it was "HI", which is >600 on the TrueResult. Yikes! I gave her 0.2U this morning when I got the "HI" reading. She was 448 at +12.5 tonight (didn't get any daytime numbers), so I gave her another 0.2U.

Jackie
 
I am completely confused by the numbers. Normally it would definitely call for dose increase. But we had been thinking trying no insulin at all.

How old is your PZI? Is it clear or cloudy? I'm wondering if it is sure good.

I guess I would suggest you give the new meter another day. Have you sure used the control solution (if required). Did you try it on yourself to make sure it is accurate?

I am also concerned about her other issues. When was the last time she had a check up?

I feel like I am grasping at straws, Jackie, but nothing fits here....
 
Hi Sue -

I agree - it's been a really confusing day. I just checked the meter on myself and it was normal. I don't know what was up with the 123 reading.

I am really worried about the weakness. I took Argyle to the vet on September 8th, just to see if they could find anything. They did the normal blood work (chemistry, blood counts), a thyroid test, and urinalysis. She does have some chronic kidney disease and anemia, which she has had for the last couple of years, and her potassium was a little low but the vet said she didn't want to give her a supplement. The vet also said that some liver numbers were elevated but that she didn't think it had anything to do with the weakness. I wonder if that could have anything to do with all the the liver panic or rebounding Argyle's been doing. The vet said that the next step would be x-rays and ultrasound. Argyle had those in March when she was in the hospital with DKA and they were normal then, and unfortunately I can't really afford to repeat them at the moment.

Jackie
 
Jackie
Bob has had potassium troubles, so I am familiar with them. Low potassium causes muscle weakness. See if you can ask the vet what the number they got was when she was tested. I would definitely try another meter too. You can ask Lori to send you one from the newbie kit supply maybe.
Carl
 
Hi -

Sue - I realized I'd forgotten to answer your question about the insulin. The bottle I'm using is from March, so it's a little old. It has always been 'cloudy' - I thought that the ProZinc was a suspension so that it was supposed to be that way. I rock and roll the vial gently to mix it before drawing up her shots. It seems like it is still working. Well, not working exactly, but still doing something to Argyle anyway.

Carl - Her potassium was low at 3.6 (normal 3.9-5.3) and her chloride was also low at 109 (normal 111-125). They didn't measure her magnesium. What was your experience with Bob? How do you treat this and did it make a big difference?

Jackie
 
As long as there are no "floaties" we assume it is okay, but some people get new when things start to go South. 8 months is pretty long. Hate to see you buy some more if she is taking tiny amounts.

What numbers today?
 
Hi

Argyle's having another off day. She woke me up early and she was really weak. I gave her ~75 mL of fluids after breakfast (about five hours before AMPS).

AMPS 460, shot 0.1U (14.75 hours since last shot)
+2.5 417
+4.75 320

I noticed a faint odor of ketones on her breath at around +4, so I gave her ~25 mL more fluids. She was really bumming, but perked right up when I brought her some cooked chicken.

Do you think would it be ok to give her another 0.1U?

Jackie
 
Can you test for ketones? Are you only at +5? I don't like the possibility of ketones, bit it is dangerous to give any more unless you are sure she is headed up.

Get a ketone test ASAP.
 
I just happened to catch this post....I might be behind on this, so please forgive me..

Do you test for ketones...urine strips or blood ketone meter? It is my impression that if you can "smell" ketones they must be at a reasonably moderate level.

I am not sure of your experience with ketones, but my Kitty went into DKA. Ketones make me very nervous and can progress very quickly. The fluids will help, but you really need to know the levels of the ketones to determine the treatment needed.

Sorry to be asking so many questions....but, ketones are very serious.
 
Okay, I went back and read the whole thread.......she has been DKA before, that is concerning...because once a kitty has thrown off ketones, the possibility is always there for a repeat.

I am sure you know this....but, the keys to helping with ketones is sub q fluids, eating, and adequate insulin supply.

I am sorry I was a little to early to respond initially. So, have you checked the level of the ketones?
 
jackie said:
Hi -

Carl - Her potassium was low at 3.6 (normal 3.9-5.3) and her chloride was also low at 109 (normal 111-125). They didn't measure her magnesium. What was your experience with Bob? How do you treat this and did it make a big difference?

Jackie

Jackie,
Bob's potassium was perfectly normal when he was diagnosed with diabetes. A few days later, he threw lots of ketones, and ended up staying at the vet for 3 days, diagnosed DKA. Blood work after that showed that his potassium was lower. It was 2.6 or 2.8, and when they sent him home, they also sent a bag of lactated ringers with potassium added to it, and I had to start giving him sub-q fluids every day. At first, it was 200ml a day. Then 100 every day, then every other day, then twice a week. In all, he got almost 40 treatments (4 bags, 1000ml per bag). After the 3rd bag, they checked his potassium and it was just above the low end of "normal", so they made me continue with one more bag. Unfortunately, the last time he got checked a month or so ago, it had dropped a little. My vet told me that "normal range" was from 3.6 to 5.something, and he was at 3.5.
I told my vet that I didn't want to give him sub-q fluids anymore, and would rather get a potassium supplement to administer.
The sub-q with added potassium did work, but I didn't see the point in continually pumping fluids into Bob when he wasn't in need of hydration, just to get some potassium into his system. He (and I) didn't enjoy the sub-q procedure. If I had to do it again, I would definitely get the smaller needles (22 g instead of 18g). The 18g are referred to here as "harpoons", and for good reason. They're huge! And it made me quesy, and made him squirm, when I had to poke them into his skin.

My vet told me I could go online and buy a potassium supplement without a prescription. I tried, and I can't. So I have to get a 'scrip, and haven't done so yet. There's something called "Tumil-K" and it comes as a paste or a pill. I am going to get the pill form, since the paste contains "sugar", I guess so kitties will actually eat it because potassium apparently tastes like ick.

All that said, if Argyle's Potassium is at 3.6 (and your vet says 3.8 is within the normal range, then it probably isn't low potassium that is causing problems. But it could be a result caused by some other condition going on.

Bob isn't really having any problems, but my vet is concerned that the low levels are being caused by "something", and if not treated, will get worse. When Bob was really low, the evidence was muscle weakness. Weak enough so it was noticeable. A lot like neuropathy symptoms, but not as severe. Back leg weakness, but not walking "funny". He just wouldn't climb and jump like he used to, and wasn't very active/playful. That is better now than it was then. He's jumping up on the furniture and playing more.

Low potassium can cause muscle and heart problems. Oddly enough, so can high potassium. The heart is a muscle. One way (low) it has to work too hard, the other way (high)it can cause damage to the muscle. (That's what I was told by my vet)

Is Argyle lethargic, or not as mobile as she used to be? The only thing you've posted that causes concern was what you said in your other thread about her "hanging her head when she feels lousy". That is one of the symptoms of neuropathy, I think, but if you haven't seen other mobility problems, then it might be a symptom of something else, or just the way she lets you know that she feels bad.
Carl
 
If you aren't averse to cutting up a tablet, you could ask the vet what the dose would be and purchase a low dose human supplement, cut it into the right sized dose, or even powder it, and then roll it up with a bit of a pill pocket for administration..
 
Hi -

Argyle has had some neuropathy in her hind legs for a couple of years, but her mobility has been decreasing since sometime over the summer. I think it's a symptom of weakness in general. She started sitting lower on her hind legs, sometimes she stumbles over her feet because she doesn't pick them up, she sometimes doesn't squat down so she pees over the edge of the litter box. (Not a litter box issue - she doesn't do it all the time, just times when she seems weaker). She can't really jump up and down too much anymore. Sometimes when she shakes her head, like after I measure her BG, she knocks herself over. When we go outside, she doesn't walk around a much as she used to.

She doesn't seem to be apathetic - she's generally alert and interested. The head hanging was much more noticeable back in March/April when she was having more trouble with ketones - her eyes would narrow and she just looked really sick and miserable. She doesn't look like that now - just doesn't seem to have any strength or energy.

Her mobility has worsened pretty dramatically over the last month. The vet didn't find anything that she thought could account for it on her September 8th visit.
 
Hi,
Henry started showing what I thought were signs of neuropathy back in April? I think.
He hunkered down on both front and back legs and walked low to the ground and also quit jumping onto the chairs at the table, on the table and beds. He had difficulty jumping on to couch. He also walked kind of "wobbly" crossing his front legs in front of each other.
When I took him into the vet for this and she observed his gait and poked his feet there was big response so she said it wasn't neuropathy.
She asked if he could have fallen and injured himself but I am sure not. She did xrays and he has degenetrive disc disease in his mid/upper verterbrate that are irritating a nerve root and arthritis. Because of his diabetes, he can't have prednisone so he gets 1/2 a baby aspirin every 3 days for inflammation. He also kind of hung his head like it was hard to hold up.
Hes much better now, up on his toes more instead of his hocks, moving around faster and he jumps onto couch and ottomans. Just in the past few weeks, he has been running and trying to chase my other cats like he used to.
Just thinking it could be a number of things causing the weakness and difficulty walking for Arygle.
 
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