charly starts antibiotics

Oh, and obviously we will not be increasing the dose while she’s on the antibiotics. I still find that to be a very short course of antibiotics for her. My cats are usually put on ten days of Clavamox (same drug different name). I think she’s taken Synolux before though and she was able to tolerate it. I can’t remember if she lost some appetite, but that’s a possibility.
 
I don't know what happened this afternoon. She seemed stable on yellow when I went out And black when I got back.

Not sure if she drifted up or went to down and then bounced up.

It's not what I was expecting
 
Suzanne & Darcy said:
Oh, and obviously we will not be increasing the dose while she’s on the antibiotics. I still find that to be a very short course of antibiotics for her. My cats are usually put on ten days of Clavamox (same drug different name). I think she’s taken Synolux before though and she was able to tolerate it. I can’t remember if she lost some appetite, but that’s a possibility.
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I don't know. He leaflet in the box says "most routine cases respond to between 5 and 7 days of therapy" so it sounds like it might be fairy standard?
 
ketones at 1.2 this morning. which had me worried. but LO by +3. i'm choosing to be happy about how quicly they went away rather than stressed about how quickly they appeared.
 
That’s the thing about ketones… they fluctuate a good bit. As long as they don’t stay high, I feel like she’s okay. I am not happy with the high numbers though. Hopefully the antibiotics will help soon.
 
Hmm. Not much sign of improvement yet that I can see in her numbers. Really disappointing.

On the other hand she is looking very happy today. And skipping around the with the most bounce I have seen in a long time.

Im a bit confused
 
Well at least she seems to be feeling well today. That’s very important. She just started the antibiotics yesterday, right? So I guess we need to be patient.

edit: She started the antibiotics a couple days ago then? How much longer until she’s finished?
 
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Normally, looking at those numbers, I would say that she just needs an increase in insulin, but I still feel like we need to wait a little longer due to the uncertainty of the antibiotics. I’m sure you would agree.

I have seen cases before where a cat was getting good numbers at a certain dose and then starts earning some reductions and then the reductions just fail and the cat’s dose needs to be increased again. It’s what we call “back to back reductions” and they sometimes fail. In Charly’s case, I still would only recommend following MPM protocol to raise the dose and not go right back up to the “last good dose” because it’s actually not apparent what the last good dose was. Also, we have the UTI/antibiotics and we really have no idea of the extent of the impact of these on her numbers. It’s really frustrating. Soon, we should have an idea about whether she needs an increase. I’m really sorry this is happening because she had been doing so well and something derailed that.
 
Suzanne & Darcy said:
Well at least she seems to be feeling well today. That’s very important. She just started the antibiotics yesterday, right? So I guess we need to be patient.

edit: She started the antibiotics a couple days ago then? How much longer until she’s finished?
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due to finish wednesday
and yes she doing well today. i'm slightly encouraged by a strange drop from black to pink at end of todays am cycle. I don't think we've seen anything like that before
 
Suzanne & Darcy said:
Normally, looking at those numbers, I would say that she just needs an increase in insulin, but I still feel like we need to wait a little longer due to the uncertainty of the antibiotics. I’m sure you would agree.

I have seen cases before where a cat was getting good numbers at a certain dose and then starts earning some reductions and then the reductions just fail and the cat’s dose needs to be increased again. It’s what we call “back to back reductions” and they sometimes fail. In Charly’s case, I still would only recommend following MPM protocol to raise the dose and not go right back up to the “last good dose” because it’s actually not apparent what the last good dose was. Also, we have the UTI/antibiotics and we really have no idea of the extent of the impact of these on her numbers. It’s really frustrating. Soon, we should have an idea about whether she needs an increase. I’m really sorry this is happening because she had been doing so well and something derailed that.
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yes i was thinking not to do anything until shes finished the antibiotics. i'm just a little concerned as to why she is so often so high now. she seems more often in black now than when we started out
 
Suzanne & Darcy said:
I find that very strange. I question the 518 to 380. The 518 seems off.
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could be rogue reading i suppose. just double checked the meter record to make sure I haven't made a mistake, but no, those are deffo the readings we got. the 518 didn't seem unexpected tbh. it was the 380 that surprised me!
 
I think the antibiotics have been given a fair chance to work by now. I would increase her dose by .25 units. How many days total on the antibiotics has she had now?
 
I see she gave you a 97 tonight. Unless she goes lower than that, or throws you an unusually low preshot tomorrow morning, I would still go ahead with the increase.
 
she seems to be going down slowly all day today.

today looks a lot like 15 March so far. she was on the same dose then and still going down slowly at pmps. we gave her 1 unit for pm cycle and she went lime green at +4 black by next morning.
 
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This long string of blue is nice to see on her spreadsheet! It’s been a while since we’ve seen something like that. I am glad you gave the 1.5 dose.
 
Yes. Lovely cycle today. :D Do you put any flea/tick preventatives on her? I’m glad it wasn’t on there very long. It was just in her fur but not burrowed under her skin?
 
Suzanne & Darcy said:
Yes. Lovely cycle today. :D Do you put any flea/tick preventatives on her? I’m glad it wasn’t on there very long. It was just in her fur but not burrowed under her skin?
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Yes usually I do it seasonally. I like to give her a break from the chemicals in the winter months when she doesn't get out much. With all her other health concerns I've completely forgotten to start again this spring.

Tick was in the fur not under the skin but it had attached itself
 
how do reductions work the mpzm? is it only on lime greens? that seems quite a stressful method. lots of late nights and lots of testing waiting for a hypo event?

i'm just wondering because her nadirs seems to be edging very slowly lower and she is getting grumpy again with all the testing
 
She hasn’t had any 50s yet and only one evening number in the higher 60s (67). It can definitely be a lot of work monitoring when they’re in the greens at least until you are confident of patterns (like how your cat is able to surf in green with just an LC snack or two.) Yes, the protocol for modified ProZinc method is that,
  • If your cat is in the first 3-6 months of diagnosis (which Charly is) reduce the dose by 0.25u anytime you see a BG below 50 on a human meter or 68 on a pet meter.
Are you looking to keep her in numbers where you will not feel the need to test very much (because she is getting testy about it?) I feel really good about her numbers where they are right now, but I am not the one doing the testing.
 
No I think we can cope if that's how it works. Learning to surf greens is fine It's the <50 moments that are hairy and there seems no way a recovering cat can avoid them on mpzm.

Slgs reduces at 90. I guess I'm just wondering why mpzm require the cat to go lime green and floppy to earn a reduction! I would be tempted to reduce in low 50s perhaps to avoid this.
 
A cat who is in the 40s should not be floppy. Many non diabetic cats have numbers in the 40s. Of course, they aren’t on insulin and don’t have the potential to drop really low into 30s because a cat not on insulin cannot hypo. The 50 threshold is there for safety because of the insulin. Did Charly have a time when she was actually floppy or have other symptoms. Most people here (ProZinc forum) who have had cats go into the 40s report that their cat is walking around acting normally (and they’re surprised). It’s the poor caregiver who is freaking out (and definitely should be taking action, of course.) I am not minimizing the situation either. It can require intense management in some cases as I believe you already have experienced. Sometimes a cat will come up after just a little HC food … and stay up…. But sometimes it requires a lot more work as you know. It just concerned me when you said floppy so I wanted to know a little bit more about what you meant. We have to make a reduction point somewhere. With SLGS it’s 90. That is designed for newcomers and people who are not able to keep their cats in the normal range of cat BG for varying reasons (testing, physical limitations, schedule limitations, the cat, etc.) MPM is more for people who really want their cat to spend most of its time in the normal BG numbers. Many caregivers following MPM are pursuing remission. Having said all that, if you don’t want her dropping below say 60, you can set a custom reduction point for Charly. You’re the boss here, David.
 
Yes she's definitely been floppy. She gets intensely relaxed / very sleepy as she gets into the low green numbers. It's not happened in these last few days but when she was going through that series of reductions a few weeks back it was happening then - that's why I was wondering if she had to do this again to earn another reduction on mpzm.
 
DavidJ said:
Yes she's definitely been floppy. She gets intensely relaxed / very sleepy as she gets into the low green numbers. It's not happened in these last few days but when she was going through that series of reductions a few weeks back it was happening then - that's why I was wondering if she had to do this again to earn another reduction on mpzm.
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Not necessarily. I think we can set a custom reduction point for Charly. She may just need more time to get used to the lower numbers. It’s not uncommon for cats who are not used to lower (but normal) numbers to feel strange and they react in different ways. Some cats will even hide under beds.
 
Even the ProZinc sticky mote about dosing mentions this:

“if your cat is new to nadirs under 200, you may notice that she/he feels a little sluggish and sleepy when first getting into healthier numbers. This is normal and will get better in time.”

I find this to be true in a lot of cats. People describe it as their cats being lethargic. I have heard some of our moderators describe this as being like those of us who are accustomed to having our caffeine every day … and then we are cut off. Our cats are used to having a constant sugar rush.
 
She really had quite a drop tonight — going from yellow to green in only 4 hours. I am not saying this is bad necessarily. She does frequently have similar drops. I am just wondering if she’s been eating her snack around +2 or after that?
 
Suzanne & Darcy said:
She really had quite a drop tonight — going from yellow to green in only 4 hours. I am not saying this is bad necessarily. She does frequently have similar drops. I am just wondering if she’s been eating her snack around +2 or after that?
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Yes usual food at usual intervals.
 
Suzanne & Darcy said:
Even the ProZinc sticky mote about dosing mentions this:

“if your cat is new to nadirs under 200, you may notice that she/he feels a little sluggish and sleepy when first getting into healthier numbers. This is normal and will get better in time.”

I find this to be true in a lot of cats. People describe it as their cats being lethargic. I have heard some of our moderators describe this as being like those of us who are accustomed to having our caffeine every day … and then we are cut off. Our cats are used to having a constant sugar rush.
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Yes I had spotted this. It just felt a bit more than a little sluggish in charlys case. And alternating with vomiting as it was on one occasion all seemed a bit extreme . But yes if that's a slightly unusual reaction and we can set a custom reduction point then it all makes more sense. I was confused thst it seemed to be what the protocol required to earn a reduction.
 
Ih that is wonderful about her not being floppy! I feel much better about that. What was the percentage of carbs you gave her last night? It says medium carb.
 
she had usual lc meal with the shot. then when she was green at +2 i gave her half her usual food amount but mc instead of low carb. and the other half an hour later mc again. the same at +4 and +5. and a spoon of lc at + 6 the mc was about 14 %
 
Good. I think you managed it well. So the question is, do you want to hold the dose or do a reduction? Since you gave her the MC, it’s possible that she may have dipped below 50 last night. I would say our options are to (1) go ahead and give the reduction and see how it goes for a few days, or (2) continue to hold this dose to see if a similar scenario happens again — and then do the reduction. She will probably be high for a cycle or two from that long run in green last night.
 
So tell me… how was Charly last night during all this time in green? Was she eating up all the snacks eagerly? Was she getting irritated with the testing? Was she happy and alert (while you were staying up too late :confused: )
 
from around +2 to + 5 she was a little slow and had a slow sleepy look in her eyes but she was up and about and mostly food focussed. she wasn't flat out and floppy as she has been previously in these numbers. Happily walking to our testing zone and offering only a token lifted paw in way of resistance to testing. Happy to put up with it because she was hungry and she knows it results in food. And eating enthusiaastically. After +5 she stopped staring at her bowl jumped up on the bed and went to sleep. which is what she usually would be doing at that time of night.
 
Suzanne & Darcy said:
Good. I think you managed it well. So the question is, do you want to hold the dose or do a reduction? Since you gave her the MC, it’s possible that she may have dipped below 50 last night. I would say our options are to (1) go ahead and give the reduction and see how it goes for a few days, or (2) continue to hold this dose to see if a similar scenario happens again — and then do the reduction. She will probably be high for a cycle or two from that long run in green last night.
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its much less stressful when she is a bit more lively in the low greens so I'm fairly relaxed about holding the dose for now. but i was thinking perhaps to shoot a bit lower next time she is in blue at preshot?
 
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