Bubba's vet visit today 12/23/12

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chubbabubba

Member Since 2012
Hi everyone,

Well, last night was Bubbas first full day on Humilin. It was a rough night. Thanks to all of you
it made it much easier. Last night was especially rough due to the lack of night time home testing as my Alpha Trak strips never arrived.
I did buy a meter, but as posted it freaked Bubba out and thats the last thing I want to do. So I stayed up and watched him all night.

Ok, at the vet at 9am. No temp, tested ketones at home. Slight trace yet a lot lighter then the previous day.
Drinking ok, ate 1 can of ff so far today and nibbles here and there. He normally eats about a can before I go to work and I leave him out another half when I leave to nibble one during the day. I cant say he is normal in the eating as he's not its work. Spoon feeding, etc.
Oh but bring out the Halo treats and ge will eat them all! :shock:

His morning number before food at 223, with the original Alpha Trak, new Alpha Trak 2 strips.
Ok, so I was excited that he was below 300 this morning but it may have been short lived.
From what I read, when using old meter and new strips ( alpha) the code needs to be 7 no matter what.
Please correct me if I am wrong?
It didnt hit me until I did his 1130 reading and he was at 303. Alpha 2, Alpha 2 strips ( they gave me some and I saw the container- Alpha 2) So I took the code and performed home. I think the morning reading was off. I dont know if all the meters in the office are like this,
But I am alerting my vet in the early am.

Afteroon reading dropped,I have to keep in mind that he must graze during the day so I left some food out but not like yesterday so I can get food into him at shot time. Didnt sleep last night, without being able to test I was a wreck.
The Dr feels he really needs a cleaning, this was noted on his chart as a future suggestion from the Philadelphia animal hospital
yet not urgent they said. I do feel its getting in the way of his eating, he makes this strange motion with his tongue ( like side to side and he cant chew right) So yes I am afraid and hope his numbers come down before it. But it will be a priority.

He is still on Humilin and until the ketones are gone ( he said a few more days) we will then go to Lantus.
as mentioned he was on H, yrs ago but after reading this board an know how it works, its clear. It hits hard, and drops fast.
I can notice it by the way he acts. I am so afraid to leave him home tomorrow alone. mm in a panic.
 
We refer to Humulin N as "N". (There's also Humulin R which is even faster acting and that's referred to as "R".) The advantage of N is that it will bring numbers down quicker than Lantus. The trade off is that it does not have Lantus' duration. With N, you probably don't have any insulin in Bubba's system for at least the last 4 hours of the cycle. Lantus has a much longer duration and you get overlap between the doses. If it were me, I'd be asking the vet about starting Lantus tomorrow. I'd also ask about using Humulin R in addition to the Lantus. This is referred to as basal (Lantus) and bolus (R) dosing. You can use the R to bring the numbers down during the cycle. Libby and Dyana both have used R and can help you with it's use if you're interested.
 
Thank you, I will ask him . I have a question.
Bubba received his morning shot at 9 am today.
That would leave him to have his night shot at 9pm
I am now worried as I walk out my door at 8 am
For work tomorrow. I don't want to hurt him and shoot to early.
I think I remember the emergency drs saying increments
Of half hrs was ok. Dr said an hr or two was ok.????
I just don't want to be up all night worried.
I really don't know what to do. I could shoot tonight at 830 and tomorrow like 745am
I just wanted some additional thoughts .,
With N is. That like a dose increase? Giving early?
 
Normal duration with N is less than twelve hours. I think it's more along the lines of 8 hours. So you should be okay if you give the shot early in the morning. Or you could do what you said, shoot at 8:30 tonight, and then at 7:45 in the morning.

See what his number looks like tonight at 8 PM. If this morning's dose has worn off by then, you could shoot at 8 tonight. Then you could give the shot tomorrow morning at 7 if that works better with your schedule.

What dose are you shooting?

Carl
 
Thanks Carl. He is getting 2 units. How much food should he be getting
Before? He is not eating like he was a few days ago. Wasn't great but way better then now.
So I have to start early with small amounts and have the food in his tummy by 730 ish.
I'm going to give shot at. 815 pm and test at like 730 pm tonight?
Give food and test. Oh this not eating is driving me crazy.

We got blood last week, perhaps I should run again to see liver, potassium
Ketones, etc. Since he's struggling eating
Even more so since starting insulin.
 
If N is like R, then it's in and out of the system, so there's no depot leftover like there is with Lantus.
If the duration of N is about 8 hours, and you are comfortable shooting at 7:00pm (your +11?) tonight, that should be fine, as the N will have run it's course by around +8, and be out of his system already.

The last test I see on his spreadsheet is a +4. If you have more tests, can you update his spreadsheet, please, so we can help you?
 
Diana,
Until tomorrow after work I have four test strips left
One for tonightd pm pre shot., another into tonights cycle and one for am pre shot and another before I leave for work.
When I arrive home, test strips will be here.
I'm unhappy about this but i have no choice .
Is testing now to early , I'm afraid I won't get the required food into him by 815.
 
Just tested now was at 273 no real food.
I'm starting to try and feed him for tonights shot.
He didn't even come when I opened can.
 
Jackie:

With N, you want to test, then feed then shoot. You want to have more food on board than what you would need with Lantus. With N, the onset of insulin action is very early -- 1 hour (although this can vary with each cat). With Lantus, onset is usually in 2 hours. Because it takes longer for Lantus action to start, it's more forgiving with respect to feeding.

Like others have said, the duration of N is approx. 8 hours. Since there's no insulin depot with N, it's probably OK to shoot early. I like Carl's suggestion of shooting 30 min. early tonight and 15 min. early tomorrow if that will work.
 
Thank you. I am going to test again by 10. He ate about a can of FF, bits of boiled chicken .
I weighed him tonight and he didnt drop any weight, He needs to loose it but not this way.
Once things are under control number wise we will revisit a slow diet.

I also tested him this morning and tonight. Ketones still the same. Trace
We had blood work last week and I am wondering if I should re-run to take another look at liver and potassium levels
Is that overkill or would you guys wait?
Is Ketones ( blood) a separate test or does it show in your normal panel?
I dont have tons of money right this second, ( or any lol) but want to get the best work up I could.
 
Ketones are not a part of a usual blood panel.

Did your vet suggest getting liver values and potassium re-checked? If these values were normal last week, I'm not sure whether you'd see much change in liver values. Potassium, however, could change. Are you seeing symptoms that you'd associate with changes in these values?
 
I believe ketones are a separate test because I've never seen them on Gracies SuperChem. If you get a blood ketone meter, you can check at home alot cheaper than at the vet.

Here's some info on how to get a free blood ketone meter:
Nova Max Plus has a free blood/ketone meter offer here: http://www.novacares.com/cwd.php. i answered the questions as follows: parent of a child with diabetes, 18+, take insulin via injection, 14 (i think), and no coverage. using a blood/ketone meter is often the ticket when a caregiver has a hard time collecting urine.

And as Ann said, you can get the strips through American Diabetes Wholesale. Are you giving fluids?
 
OK, the SS says he was at 273, you shot 2u, and at +2 he was at 267? That looks okay. Are you going to up for a bit?

Carl
 
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