Charlie AMPS 320, +2 292, +4 253, +6 296, +10 321, PMPS 297

Sarah & Charlie-cat

Member Since 2022
https://felinediabetes.com/FDMB/thr...treating-ketones-at-home.279839/#post-3090807
https://felinediabetes.com/FDMB/threads/charlie-ketones-2-1-at-2-pm.279838/#post-3090367
Most recent posts ^^^

Curve suggests we should increase his dose. I wasn't thinking and gave him 4 u this evening. Hopefully will remember to give 4.5 in the morning before we go to Iowa State. I feel so lost and helpless with all of this. Any advice is appreciated on how you get the vet to listen to you and not completely disregard your data or observations.

I am still hoping we can get some answers about why he tries to die every three months... first he stops eating, then he throws up, then he develops ketones and then we're in the ER vet. I am really at the last of my ability to pay 2000 to keep him going every 3 months.

I do feel like I have some better tools in my tool kit now. I have gabapentin and buprenorphine. I also know I can increase his Zofran and Cerenia. And I can give him more fluids. But I still worry that won't be enough to get him through the next bout.

What we know/suspect:
Pancreatitis: chronic, which appears to intermittently become acute from blood work and ultrasound
IBD: suspected via ultrasound only, no biopsy

Sketchier: Bloodwork suggested large cell lymphoma in May but the oncologist saw no mass, although our vet felt and saw one a few weeks earlier via ultrasound.

The ER vet insisted I reduce his insulin dose a few weeks ago, which I'm not sure was the right thing so was at 3.5 and then up to 4. He did have a funny 84 PMPS after a day at his regular vet to double check for ketones (because I refused to let them keep him 3 days at the tune of 6k) that I didn't end up stalling because he hadn't eaten all day and was starving. I fed him, waited 2 hours and he was back up. I know that wasn't the best plan. Ug. Anyway. I hadn't quite decided to go back to SLGS at that point, otherwise, that would have been a reduction. But shortly after that I decided I couldn't do it anymore, I cannot test often enough, especially at night. I just cannot. Even if I leave the testing stuff out so I see it when I feed him, I'm not awake enough. So now I just feel like I've massively screwed up in every way.

He did have some blue numbers about a month ago on 5.5 and 6.5 U.

Other than his mostly high (250s-330s) numbers he's been doing well. He's been eating really well, his weight has been stable and his ketones have been 0.6 and below every time I've tested.
 
The ER vet doesn't hold the syringe, you do. The ER vet was wrong to have you decrease the dose. Next time you hear a vet tell you to reduce, ask what dosing method they are following. His numbers could have been lower due him not eating enough. None of the rest of his numbers that you do have show him even under 200, much less under 100. I stopped asking my vet for dosing advice - I gave her copies of the dosing method I was following and the spreadsheet.

On one of your previous threads, I talked about the importance of getting at least one test in the PM after the PMPS test. That's the only way we can safely increase him as quickly as possible to a better dose. How late can you test at night? Can you even do a +2? Can you move shot times so that is possible?

I'm glad to hear he's eating well and ketones have been OK. Good for you for testing those regularly.
 
Yes, you are totally right. I feel like I've lost my nerve entirely and let myself get bullied by them. He did have one number under 100 on a lower dose, which made me wonder but haven't seen anything else since then approaching 100.

This particular vet practice doesn't even believe that the goal should be under 200 at all. And said he would never get regulated if I fed him when he was hungry (ie more than twice a day). Why we aren't going back!

I can try to get a +2 more consistently. I did one recently and noticed he dropped about 100 over two hours but didn't manage to get another test but I really don't think I'm seeing bounces. I've also been giving fluids at +2 so it feels like a lot of needles but maybe he'll tolerate it.

After we get back, I'm going to try 7 or 7:30 see if that helps my poor brain. 6 am and 6pm are better in the evening but a terror in the morning.
 
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