Diabetes Diagnosis

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elizabeth and gus

elizabeth and gus

Member Since 2015
Hi

I am new member of this board. The challenges of management diabetes for my feline family member are very overwhelming. Today I am going to the vet. to talk about TR protocol and insulin choices (Lantus or PZI compounded or?). I would appreciate any comments. Below is my story.

Thank you

Elizabeth


Gus is a 16-year-old neutered male indoor only cat. He had eaten grain-free dry food since he was a kitten. Occasionally he would get some canned food but it wasn’t his favorite so we stopped offering it to Gus. He had been healthy for 16 years but was overweight at ~18 pounds. We noticed that he seemed to be losing weight despite eating very well. Gus was drinking a lot of water and urinating a lot. We took Gus to his vet. A blood test showed that his blood sugar level was 545 mg/dl thus he was diagnosed with diabetes. He was prescribed insulin Novolin N at 2 units ones per day. We started injections following morning after Gus had his food. We noticed that he was bit less thirsty and he was fine. We replaced his dry food with low carb wet food. Next morning Gus eat his food and shortly after we injected 2 units U100 insulin. About hour and half later Gus was looking very confused at first and urinated on the kitchen floor (this happen for the first time in his life). We started to watch him closely. Gus had problem standing and in sitting/standing position was wobbly and it persisted for a while. I give him sugar solution. By the time we were in the car driving to emergency veterinary hospital Gus was back to normal. At the clinic his BG level was 148 mg/dl.

On the vet’s recommendation we stopped insulin for couple of days and continue feeding low carb wet food only. We started to measure his glucose.

23 Feb 41/2 hours after eating – 388 mg/dl

24 Feb fasting - 443 mg/dl

25 Feb fasting – 500 mg/dl
 
Welcome. It is good that you are home testing now. Also, good with the lo-carb caned food.
When you start on an insulin better than N I would start at 1/2 unit based on your experience with N.
 
Hello Elizabeth and extra-sweet Gus,
Welcome to FDMB :bighug:

A diagnosis of feline diabetes certainly can be overwhelming at first. We've all been there, and we understand how you feel.
But fortunately diabetes is very treatable, and with good care, a diabetic cat can live as long and as healthily as a non-diabetic cat. And some cats can go into remission from the diabetes and become diet-controlled diabetics.

It does sound, from the symptoms you describe, as though Gus had a hypoglycemic episode; in which case the insulin dose was clearly too high for him. (Well done for thinking to administer sugar, BTW!)
Switching from dry food to wet low carb food can also reduce the blood glucose quite a lot in some cats, and a dose that may be OK on a higher carb diet can need lowering if the cat is switched to lower carb.

A cat's blood glucose can often swing up high after a hypo, and the body can release counter-regulatory hormones, the purpose of which is to keep the blood glucose high for a time. This can sometimes take up to a few days to clear the system, so the numbers you're seeing now might not give a true picture.
Well done for starting to hometest! That is excellent!

I've not used Novalin but understand that it can drop the blood glucose fast and usually has quite a short duration in the system.
The recommended insulins here are PZI/Prozinc, Lantus and Levemir as they tend to be 'gentler' and have longer duration.
There's some info about Novalin in the following link that may be useful:
Humulin N Primer

Can you tell us what you're feeding Gus at the moment?
Has he tested positive for ketones? (If the vet didn't check then you can test his pee yourself using Ketodiastix strips available from pharmacies).
Which glucose meter are you using?

Eliz
 
Thank you so much for taking your time to reply.

I have experimented with different wet food with ~ 5% carbs or less. Gus didn't like EVO or Wellness. So far his favorite is Merrick Perfect Bistro Cowboy Cookout 1 and 1/3 ( 5.5oz) can per day.
We didn't test him for ketones so I am going to get the strips.
I am using Relion glucometer.

I just come back from vet. BG on her veterinary type meter was HI and my measurement was 470.
My vet is convinced that the injection went into a vein or muscle thus rapid glucose drop. So this is her recommendation:

inject 1U (100u/ml) Novalin N once per day - monitor BG and diabetes symptoms. Once we see that it is well tolerated dose will be adjusted and injected twice daily.

She didn't think that at this time there is a reason to change insulin because they all have pros and cons and each cat react differently.

Please comment I have lot to learn.

Elizabeth
 
The problem with only giving 1 shot a day (especially of N) is that it is a very fast acting and short duration insulin. Meaning it may last up to 5/6 hours in the body. As there are 24 hours in a day, that means he is spending most of the time without insulin and high BG's. It also means that you are on a yoyo cycle of giving him insulin, bg dropping for a time then skyrocketing again.

there are people who use N successfully that can offer more guidance if you continue with that insulin. Kimber is one of those people (not sure her official board name), but she's on FB as Kimber Bush.

Anyway, if you opt for a different insulin-

Prozinc is a good choice, as it's similar to N in the fact that there is no depot or overlap of insulin in the body. Once it's used up, it's done.

If you opt for Lantus or Levimer - I suggest getting Levimer. While these two insulins work in a very similar fashion and I used Lantus too, I've been reading on here and there is a piece in Think Tank that talks about how the ingredients in Levimer seem to have better result for many cats. Cats that were hard to regulate on Lantus, were better regulated using Levimer.

Again, use this site and read for yourself. But that's my 2 cents on the subject. And I'll alert Kimber to pop over here to better advise you on using N, especially if you continue with that.
 
Thank you all for the information. I am getting it but my vet is not willing to prescribe different insulin. She insists that we inject 1U Novolin N once per day for next 2 weeks.

Gus received 1U Novolin at 5:00 am today.
8:00 BG 127
11:00 BG 225
3:30 BG 412

We just started hometesting and I was going to do curve (+2, +3, +4 etc) but is it even worth it? Is it time to look for another vet.

elizabeth
 
Yes, I would definitely recommend finding another vet. This one is not at all open to the facts and is not even using a not great insulin choice in the best way possible. Only shooting once a day, especially with N is going to keep your cat in high numbers too much of the day. If you are going to use N (at least for now) you need to at a minimum shoot twice a day.

All insulins require twice a day (BID) shooting.

Gus received 1U Novolin at 5:00 am today.
8:00 BG 127
11:00 BG 225
3:30 BG 412

Just look at these numbers and you can see just how quickly it worked (by the way did you test BEFORE giving the shot? As that will tell you just how quickly he dropped 3 hours after the shot and then by hour 6 (11:00), you can see how the insulin started wearing off and by hour 10 (3:30) it totally wore off.

 
Hillary & Maui (GA) said:
Yes, I would definitely recommend finding another vet. This one is not at all open to the facts and is not even using a not great insulin choice in the best way possible. Only shooting once a day, especially with N is going to keep your cat in high numbers too much of the day. If you are going to use N (at least for now) you need to at a minimum shoot twice a day.

All insulins require twice a day (BID) shooting.

Gus received 1U Novolin at 5:00 am today.
8:00 BG 127
11:00 BG 225
3:30 BG 412

Just look at these numbers and you can see just how quickly it worked (by the way did you test BEFORE giving the shot? As that will tell you just how quickly he dropped 3 hours after the shot and then by hour 6 (11:00), you can see how the insulin started wearing off and by hour 10 (3:30) it totally wore off.
Click to expand...
I totally agree. I just talked with another vet that previously helped me with with my chicken. She currently cares for diabetic cats using PROZINC but is open to other options. Unlike the current vet she was interested in looking at my home testing numbers as well address proper diet.

Gus tested in 470 to over 500 mg/dl befor insulin.

Thank you for your input
Elizabeth
 
OK - so his numbers looked like this today:

AM Pre- shot 500 1U Novolin
+ 3 127
+6 225
+10 412

See how he started high, dropped low very quickly, then started rising again...

PS - I wrote it in this manner, because when you start your spreadsheet, this is how you would write it. As we are all in different time zones, it's the easiest way we can communicate and talk the same time language.

Now if you tested him at say +8 and gave him another shot then, he would have dropped down again and not crept up as high. This is why N is a more difficult insulin to use. Cause you could end up having to dose three times (TID) a day in order to cover the 24 hour period.

You also don't want him yoyoing like this as it's going to make him feel horrible and it really does a number on the body.

Look at other people's spreadsheets and see how smoother their BG's are without these wide swings in numbers. You want the BG's under the renal threshold and with a smoother range so he isn't yoyoing like he is now.

Here is the link on how to create your own spreadsheet - http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/
 
Good morning
We went to new vet. Got Lantus 1U twice daily.
This morning we started injection and curve.
AM pre-shot 366 1U lantus
+2 155
+ 4 55 repeat 67

I am very concerned that it is getting to low. He eats well and after +4 test he got a bit of dry food. We will continue testing but I am thinking that we should decrease to 0.5U his PM dose.
Please comment
Elizabeth
 
Hi Elizabeth. I am new to this stuff too. Sorry, I don't know much about this stuff, but want to share this with you. We started insulin this week at 1 unit and went up to 2 u last night. Got a value of 58 after morning dose today. We already had an appointment booked with the vet for early afternoon. He was not concerned with that number (although I was, not having any other numbers to work from and seeing a change in Sasha) and he said that Lantus keeps levels more stable that some other treatments. He recommended that I hometest pre-shot and keep at 2 u if BGL is >270. If less than that, I can reduce the dose. I don't know what others here have to say about that.
 
OK that is a steep drop and what you want to do now is:

1) take 1 tsp of gravy from the high carb food and just feed that alone
2) wait 15-30 minutes and test

if the BG's continue to drop, then repeat steps 1 and 2

you want to get three consistently rising bg's. While you are not in trouble, you are nearing possible hypo and you want to stave this off -

read this about hypos:

http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

http://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/


feeding dry food while it will raise the bg - it will also stay in the system for a couple days and can cause wonky BG's later on...you also don't want the cat to fill up on food and not want to eat as you may need to repeat steps 1 and 2 for several hours.

If necessary you can give some karo, sugar, syrup, etc - 1 tsp at a time if you don't have gravy - what to do is take 1 tsp of sugar and mix it into 1 tsp of low carb canned food.

again you want to keep the food at a minimum so the cat doesn't get full or vomit from too much food.
 
I would suggest that 1 unit is too much and to start over next shot at 1/2 unit. If the bg pre-shot is under 200 - you may even want to consider skipping the shot just as a precautionary measure.

when starting out, some people have a shoot/no shoot number they go by - starting at 200, then over time dropping that down. Once you have more testing and understand just how the insulin is working you can remove the shoot/no shoot number.
 
Thank you so much

We tested Gus at +6 and BG 135 so looks like he peaked at + 4 we will continue testing. It looks like PM injection needs to be decreased to 0.5U. So we will see what PM pre-shot will look like.

Thank you
Elizabeth
 
elizabeth sierant said:
We tested Gus at +6 and BG 135 so looks like he peaked at + 4 we will continue testing.
Click to expand...
Glad to hear you're OK, Elizabeth.

It may not be that Gus 'peaked' at + 4. It may just be that his blood glucose rose because of the dry food. And/or it may even be that the low numbers he experienced triggered his blood glucose to 'bounce'.
(When the blood glucose drops lower than the kitty is comfortable with his body may release stored glucose into the system to raise the level.)

Sometimes Lantus kitties can drop quite late on into the cycle, so it would be prudent to get another test or two just to make sure that the blood glucose doesn't start to drop again over the next few hours.

Congrats on the hometesting, BTW!
Edited to ask: Are you using Alphatrak or a human meter, Elizabeth?

Eliz
 
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Fiona and Sasha said:
Got a value of 58 after morning dose today. We already had an appointment booked with the vet for early afternoon. He was not concerned with that number (although I was, not having any other numbers to work from and seeing a change in Sasha) and he said that Lantus keeps levels more stable that some other treatments.
He recommended that I hometest pre-shot and keep at 2 u if BGL is >270. If less than that, I can reduce the dose. I don't know what others here have to say about that.
Click to expand...
Hi Fiona,
How long after the shot did you get that 58? That would be a very low number to see early on in the cycle, and could indicate that a dose reduction is needed.
At the peak of the cycle that 58 would be a very nice number to see (though would be too low for some folks to aim for, especially initially).

Lantus dosing is adjusted according the lowest number of the cycle, not the preshot number.
Most Lantus folks here recommend that the same dose is given for a period of time. That's because of the way Lantus works; it's a 'depot' insulin that builds up a store in the body and is used over time. Changing the dose can reduce/increase the depot, which affects not only that current cycle, but also the next few cycles down the line.

Are you using Alphatrak or a human meter?

Eliz
 
Elizabeth and Bertie thank you for the explanation I am bit lost. So I am going to test at +8 , +10 and +12 and base on that will see if 0.5 U injection is appropriate.

Elizabeth
 
I think you've gotten some good advice. I agree with Hillary's suggestion to decrease the dose to 0.5u and hold it there for a few days unless you see a number under 50.

I would do this regardless of whether or not you see high numbers at preshot tonight. When a cat either drops too fast (say over about 50 points per hour) or if a cat gets into a range lower than they are used to (the 50's you got today) that can trigger a bounce. Here is a description of a bounce:

BOUNCING

Here is an example of a bounce from someone's recent condo:

you can spot a bounce this way (this only took me 6 months to learn and a bunch of people explaining it! i'm a slow learner!)

yesterday morning you had a 215 - then it went 235, 271, 270, and then 308 this morning - basically straight up. no curve. and then look backwards in the ss and the night before was that sweet little 148 12 hours earlier.

if you imagine that night-time cycle, starting at 148, kitty probably went down in a nice little curve, hitting something under 100 mid-cycle. that lower-than-usual number would've shocked her body. they get accustomed to whatever range they're in, and any sudden dip lower can set this off.

"HELLO WE"VE GOT A 911 HERE- KITTY'S GOING DOWN!" yells Mr. Liver. Fortunately, mr liver has a storehouse of counter-regulatory hormones and stored sugar (in case kitty needs a little nommy sweets in the middle of the night) and when Kitty gets into a range of numbers lower than usual, Mr. Liver lets loose with the sugar and the hormones and sends Kitty on a rocket to the moon. this is the cat's body's protective mechanism to keep the cat from becoming hypoglycemic. unfortunately, mr liver doesn't seem to know that anything above 40ish isn't a crisis and it will do this regardless of the range of numbers, even at 200 if the cat has become accustomed to 400.

A second cause of a bounce is if a cat drops very quickly. 100 points in an hour, for example, regardless of the range the BG number is in, can cause a bounce as well.

So, what to do now? don't increase the dose because of these higher numbers. once this bounce clears, which can take up to 3 days of high numbers if mr liver is super-active, then if you had increased the dose, it would be too high. you are entering the phase of treatment that we say requires "Patience Pants." when you think you're seeing a bounce, you have to wait it out, then you can see what the dose really does. You will know the bounce has cleared when you start seeing numbers you were seeing before - like that 148 again.

edited for clarity.

Punkin's SS
Punkin's Profile & pictures
Punkin & Anya video, Punkin Acupuncture
DX 12/4/10 Lantus, 1/2012 R, 14 lbs, 12.5 yrs old DLH orange male, ACROMEGALY dx 6/2/11
Punkin's SRT Treatment Sept 2011 GA may 20, 2013 age 15

​
That's why i'm suggesting you reduce the dose tonight. You might see a bounce - but Lantus dosing is based upon how LOW a dose can take a cat. The high numbers are less important than the low numbers. The way Lantus works is that when you inject it, some of it builds up in the body and sort of slow-releases. So it can take a few days to see what a dose really does - it has to have time to build up. The reason folks are suggesting you immediately drop the dose tonight is because you saw 50's on the first shot. That suggests that as you continue giving 1.0u, it would become too much when the depot builds up and begins slow-releasing.
 
It is a great number - actually, for a cat on insulin, the 50-120 range on a human glucometer is considered "normal." When a newly diagnosed cat spends time in that range, that is an opportunity for the pancreas to heal. Unlike people and dogs, cats can become diet-controlled if their pancreas heals and some can go off of insulin. Pretty cool.

So yes, it's great to have cats spend time between 50-120.
 
Elizabeth and Bertie said:
Glad to hear you're OK, Elizabeth.

It may not be that Gus 'peaked' at + 4. It may just be that his blood glucose rose because of the dry food. And/or it may even be that the low numbers he experienced triggered his blood glucose to 'bounce'.
(When the blood glucose drops lower than the kitty is comfortable with his body may release stored glucose into the system to raise the level.)

Sometimes Lantus kitties can drop quite late on into the cycle, so it would be prudent to get another test or two just to make sure that the blood glucose doesn't start to drop again over the next few hours.

Congrats on the hometesting, BTW!
Edited to ask: Are you using Alphatrak or a human meter, Elizabeth?

Eliz
Click to expand...

I am using human meter.
Thank you for holding my hand in this difficult journey.

Elizabeth and Gus.
 
Good morning

Gus did OK yesterday and this morning. His highest BG stayed at ~400 unlike before 500 and more. We planning to stay with 0.5U Lantus and continue monitor BG.

Today I am reviewing his diet and based on "CAT FOOD _ NUTRITIONAL COMPOSITION" by Lisa Pierson updated 5/31/14 Merrick Cowboy Cookout wet food has 18% carbs. A few days ago I called Merrieck company and was informed that this food is 4.5% carbs and they send me email with carb content for all their wet cat food. I am totally confused.

Another thing that I am trying to understand is storage conditions for Lantus pen after is punctured (in-use). Package insert reads "SoloStar should NOT be refrigerated" but lot of people refrigerate pens to extend its life.

Please comment

Elizabeth
 
The manufacturer sent you the guaranteed analysis. The same information on the label. This information is useless. What you need to ask for is the "as fed values". This is what Dr. Lisa used to calculate the components (including carbs).

Storage of Lantus -- Remember that lantus is designed for human use. Most humans when using the pens do so because of the convenience of carrying it around. Humans always typically use higher doses than what we give to our cats. Meaning they will use up a pen within a month. While a pen can last us 3-4 months or longer.

While it does not require refrigeration, we HIGHLY recommend it - to increase the shelf life of the insulin.

HAve you visited the Lantus forum yet? It has tons of information on there about using, storing Lantus, etc. I suggest you visit the forum and look at the sticky posts at the top of that forum. http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/
 
Just to reassure you about the Lantus storage, my vet also recommended refrigerating Lantus to extend its longevity. Make sure to store it in the body of the fridge, not the door. :)
 
Almost there on the spreadsheet.
You need to File, Publish it to the web, and select anyone with the link may view.
You may also need to click the Share icon in the upper right corner; I find that it helps me see it on my Android phone when someone has done that, too.
 
This morning Gus throw-up and started walk around the house and pee very small amounts. He eat a bit. His BG at +3.5 was 207. He continued to pee in places BG at +4.5 was 128 (Ketons - neg). We took him to the vet. It was new vet because his vet was not available. We decided to move to the larger practice that is open seven days per week.
We opted for Senior cat package that included blood work, urine analysis and ex-rays. Lab work expected in two days. X-rays (radiologist will review) nothing really looked abnormal.
Urine was send for culture - results expected in five days.
Gus was prescribed antibiotic Orbax just in case it is UTI or other bacterial infection.

Recent history:
On 2/27/2015 Gus received Convenja injection because previous lab results from 2/26/2015 shoved elevated BUN=49 (normal range 14-36). All lab results are attached in his ss.

Please review and comment.

Elizabeth
 
BJM said:
Almost there on the spreadsheet.
You need to File, Publish it to the web, and select anyone with the link may view.
You may also need to click the Share icon in the upper right corner; I find that it helps me see it on my Android phone when someone has done that, too.
Click to expand...
Thank you. Done. Please let me know if it works now.

Elizabeth
 
Well, my phone is balking, so I'll have to check when I get home to my computer.
When you have a chance, put a few notes in your signature, such your cat's name, insulin, date of diagnosis, and any special details, such as renal disease, hyperthyroidism, previous diabetic ketoacidosis, and so on. This may help us give your better feedback.
 
Low AMPS 220 Gus is not eating much. Should we decrease insulin or skip?? I am going to wait 15 minutes and retest.

Please comment
Elizabeth
 
Larry thank you for the replay.

Gus eat little bit and after 30 minutes we retested BG 299. We injected 1U and will monitor him very closely. Aside blood sugar control I am very concerned with his decreasing appetite. Tomorrow we should have Lab results and better understanding what is going on. He is on antibiotic for possible UTI.
I am monitoring his food intake and considering offering little bit of his dry food to see if he would eat it better.
Elizabeth
 
My PC sees the spreadsheet fine. (!@## phone!)

Something you may say is bouncing. This is when the glucose drops rapidly and/or drops to an unfamiliar level. The body responds with hormones which release stored glucose (glycogen). This raises the glucose back up and then some, for up to 3 days.

ps - would you put the insulin name in your signature, plus date of diagnosis? This will help others give you feedback, as duration of diabetes and insulin type may affect dosing suggestions.
 
Couple of things - just to reiterate that Lantus dosing is based upon how LOW a cat gets on a dose. You don't want to see a high number and increase the Lantus because of it. High numbers can be caused by bouncing or even a dose increase. Please read this link to understand more about Bouncing & New Dose Wonkiness. They are really important to understand. High numbers caused by a dose increase might last a day or two. High numbers caused by bouncing might last as long as 3 days. Not all high numbers mean you need more insulin. This is a really important thing to grasp about Lantus because the older insulins (N and even Prozinc, although it's not old) were dosed on a sliding scale based upon how high the cat was at preshot.

Lantus is different - the focus is primarily on the low numbers.

Bladder infections are common in diabetic cat. Sugar is floating about in their body (high blood glucose = glucose in the blood) and it can create a climate for bacteria to grow in the urine. I'm glad they are culturing the urine to see if that's what he's got going on.

Infections can increase blood sugar. As the infection resolves, blood sugar will likely also come down.

High blood sugar means that the glucose isn't getting into his cells to nourish him - that is why a cat in high numbers is starving. As Gus' blood sugar comes down and he gets better under control, his appetite will also return to a more normal level. I'm not sure if that's why you're seeing his appetite decreasing, but wanted to mention it.

We use 2 dosing guidelines for Lantus on FDMB. You might want to take a look at both and see what's going to work for you and Gus.

Start Low Go Slow
Tight Regulation Protocol
 
Julie thank you this is a great info. I was just concerned with AMPS 220 and with Gus not eating much. We waited ~45 minutes and retested BG 299 and injected 1U. At +3.75 hour BG 348. We will continue testing and try to hold the insulin dose according to SLGS. Hopefully when his bladder infection issues is resolved we will see better sugar regulation.

Elizabeth
 
If you've decided on SLGS, it would be helpful if you edit your signature line and put it in there. That way people will know how you want to be helped.

I hope Gus is feeling better soon.
 
Update on Gus

Gus is not eating much lately but still drinking lot of water. Tried different can foods with FortiFlora. Sunday 3/15 he eat very little mostly licked liquid. This morning food that we left for him overnight was unattached. Fresh 3oz can of FF with water and FortiFlora he eat maybe 1.3 of it.
AMPS BG 210 - decreased Lantus to 0.5U
+4 BG175
Offered little of his dry food that he liked and he just had few pieces. Other than lack of appetite he behaves normal.

History
2/19/2015
Initial diabetis diagnosis (started on Novolin N 2U once daily) second day hypo episode - ER
Lab results BUN 49 all other results within normal ranges.
2/27/2015
New vet started on Lantus initially on 0.5U increased to 1.0U Due elevated BUN convenja injection
3/14/2015
This morning Gus throw-up and started walk around the house and pee very small amounts. He eat a bit. His BG at +3.5 was 207. He continued to pee in places BG at +4.5 was 128 (Ketons - neg). We took him to the vet. It was new vet because his vet was not available. We decided to move to the larger practice that is open seven days per week.
We opted for Senior cat package that included blood work, urine analysis and ex-rays. Lab work expected in two days. X-rays (radiologist will review) nothing really looked abnormal.
Urine was send for culture - results expected in five days.
Gus was prescribed antibiotic Orbax just in case it is UTI or other bacterial infection. Later that day Gus urinated in his LB and had no more pee outside LB.
3/16/2015
Received call from vet: BUN 57, CREA elevated, GLUC 157. Still waiting for urine culture results x-rays didn't show anything abnormal for his age (16 years old)
Vet recommended that we stop antibiotic because it could be the causes lack of appetite. He thinks that it is kidney failure. He also recommended to stop insulin since Gus is not eating and comeback for fluids to flush his kidney.

Please post your opinion.

Elizabeth
 
Fluids to hydrate and help the kidneys work are a good idea.
Pop over to Feline CRF for tons of info on renal disease in cats.
 
BJM thank you so much for the link. This is great information.

On a positive note Gus started to eat little bit this afternoon. I am not sure if it had anything to do with stopping antibiotic.

Tomorrow back to the vet for fluids.

Elizabeth
 
Hi Elizabeth,

I'm glad that BJ gave you the link to Tanya's site. There's a mine of information there about nausea, inappetence and treatments that can help.
 
I am so confused please help. Vet called urine culture is negative. He recommended that we first control glucose levels and retest him for kidney function markers. Vet thinks CKD? but it could be uncontrolled diabetes.
Gus's BG is allover the place and now his numbers are higher than he had before starting insulin. Is it possible that two doses of Orbax cause this. As far as eating soon after we stopped Orbax he started eating again.

3/17
AMPS 493 1U Lantus
+6 412
PMPS 385 1U Lantus
+4 515

3/18
AMPS 574 1U Lantus
+3 331
+6 316
PMPS 591 1U Lantus

Please look at his numbers. Is it time to switch insulin?

Elizabeth
@julie & punkin (ga)
@Suzanne & Cobb(GA)
@Chris & China
 
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