? Dose advise AMPS 428 +2-290 +2.5-221 +4-184 +5-79 even after vet stress

[Tuxedo Mom]

Last night's conversation:
http://www.felinediabetes.com/FDMB/...9-5-121-time-for-hc-food.135641/#post-1398448


I am using the AT2 pet monitor so my readings will be higher than a human meter. His +5 reading was 79 with the AT2 pet meter and 54 with the FSLite human meter, so this is an example of the variance between pet and human readings.



Tuxie is on day two of his dose increase .25units. He hung in the blue for a while in the evening. This morning he was higher but dropped rapidly.

I also noticed him having trouble with pooping/peeing first thing this morning. He managed to get a decent poop but was constantly going to the LB trying to pee. I took him to the vet and they did a urinalysis and bacteria count. He also had an x-ray done to make sure there was no major amount of poop stuck in his intestines. His intestines are not bunged up at all but there was blood and bacteria in the urine (from a sample I was able to get at home). So he will be on zenequin 12.5mg for 10 days.

However my concern is how much he dropped in such a short time, especially considering he was at the vet between +4 and +5 hours. He is very stress prone and this would normally put his levels up, plus combining that with a UTI...his numbers should be much higher????

Any suggestions on where I should go with the dosing right now. I have given him friskies with gravy at +2.5, +3 and +5. I also gave him syrup at +5. I am inclined to reduce his dose based on his rapid fall and lower numbers.

 

[Tuxedo Mom]

+6 is now at 160 after syrup and HC food...

 

[Sienne and Gabby (GA)]

You might want to add Tuxie's name to your subject line! He deserves credit for the good numbers!

Not all cats' numbers go up with stress. Some kittie's numbers actually drop. It's also possible that even with the stress and the UTI, Tuxie really likes this dose.

I would encourage you to keep an eye on his numbers. You're right in that the UTI would cause his numbers to go up. However, when the antibiotic (AB) kicks in, it will drop numbers. Until we know more about how he's responding to this dose and especially if his numbers stick around the blues and greens, they could drop as the AB starts working. Conversely, dropping from 428 to 79 is likely going to trigger a bounce.

I'm not really sure why you ran to the HC. In the future, you might consider feeding some LC to slow a drop and see if that will encourage some surfing.

Even with the AT meter, the 79 doesn't indicate that you need to reduce the dose. Generally, with an AT meter, the dose can be reduced when numbers are in the low 60s. I'd stick with your current dose unless there's some dramatic change by PMPS.

 

[manxcat419]

I don't have any dose advice - sorry. His numbers are looking really good since the last increase though. I did think of something I've heard previously when I looked at Tuxie's ss though - I know we talk a lot her about BG being raised by vet stress, and most of our cats do seem to bear that out but I have read that mental stress can also cause BG to drop in some people and I wonder if the same might be true for some cats. I'm not sure if there's any way to tell other than seeing what his trend is over several vet visits. I haven't looked into it fully as Rosa's numbers very obviously elevate at the vet and for several hours afterwards, but it might be worth a look around for information to see if cats can get that effect too.

 

[manxcat419]

Sienne - looks like you type faster than me! Your information must have showed up while I was still typing my message.

 

[Tuxedo Mom]

You might want to add Tuxie's name to your subject line! He deserves credit for the good numbers!

Not all cats' numbers go up with stress. Some kittie's numbers actually drop. It's also possible that even with the stress and the UTI, Tuxie really likes this dose.

I would encourage you to keep an eye on his numbers. You're right in that the UTI would cause his numbers to go up. However, when the antibiotic (AB) kicks in, it will drop numbers. Until we know more about how he's responding to this dose and especially if his numbers stick around the blues and greens, they could drop as the AB starts working. Conversely, dropping from 428 to 79 is likely going to trigger a bounce.

I'm not really sure why you ran to the HC. In the future, you might consider feeding some LC to slow a drop and see if that will encourage some surfing.

Even with the AT meter, the 79 doesn't indicate that you need to reduce the dose. Generally, with an AT meter, the dose can be reduced when numbers are in the low 60s. I'd stick with your current dose unless there's some dramatic change by PMPS.

Thank you for helping me calm down..lol

I probably panicked a bit since Tuxie didn't eat all his food after his AM test which for him is VERY unusual. Then he was running to the LB a dozen plus times and only getting a few drops of urines out. He usually pees 3-4 ounces at a time. Then he was meowing and stressing and running from room to room. So as his stress levels went up so did mine. THEN I start seeing his numbers falling like a rock!!! EEEEK!!! So while making the vet appointment, testing him, giving him HC food and still seeing the numbers dropping I hit panic mode!!

Tuxie is very prone to stress. The first vet I had (before I knew better) did a glucose curve and his numbers were WAY higher than at home. So it is very strange that with the stress of the UTI and the visit to the vet (he is basically a stone statue when at the vet) the x-rays and all I expected his numbers to be up when I got home but instead they had dropped more. So I gave him some syrup and HC food with his zenequin.

I should have waited in hindsight but I will just keep monitoring and see how it goes.

 

[manxcat419]

Oh I panic all the time too - I had a total meltdown last night when Rosa was sick and wouldn't eat. Of course she's fine this morning, but this is the one place where everyone understands how much we worry as soon as the slightest thing seems out of place or unusual with our extra-sweet kitties.

You could very well be right that Tuxie might be heading for a reduction - if he is then no doubt he'll get himself there over the next couple of cycles. It does sound as though he was pretty stressed but maybe with the infection as well it's just possible he had an unusual response to the stress this time around. It sounds to me as though you handled it just fine - I think I'd have gone with the HC a little above the usual 68 on Alphatrak too that close after a vet visit - additional stress from a low number really isn't needed at that point for either you or Tuxie!!

 

[Tuxedo Mom]

Oh I panic all the time too - I had a total meltdown last night when Rosa was sick and wouldn't eat. Of course she's fine this morning, but this is the one place where everyone understands how much we worry as soon as the slightest thing seems out of place or unusual with our extra-sweet kitties.

You could very well be right that Tuxie might be heading for a reduction - if he is then no doubt he'll get himself there over the next couple of cycles. It does sound as though he was pretty stressed but maybe with the infection as well it's just possible he had an unusual response to the stress this time around. It sounds to me as though you handled it just fine - I think I'd have gone with the HC a little above the usual 68 on Alphatrak too that close after a vet visit - additional stress from a low number really isn't needed at that point for either you or Tuxie!!

For someone who was usually pretty laid back I have developed into a hyper "cat Mom"...it doesn't take much to get me in high worry mode...any change and I am on instant alert. And since I am so tuned in to Tuxie's norms any change gets my "spidey sense" going. For 2 hours this morning I foloowed Tuxie down to the LB every time he went down and sat and watched...I kept rooting..first for a good poop which he did, then for a good pee..which he didn't do. The worst part was having to wait 2 hours until the vet's office opened then coercing them into getting me first thing..even ahead of a scheduled appointment. I think they are scared of the "crazy cat-lady_..LOL

I will just keep testing and see where the numbers go. It is just weird since this is only the 3rd shot in his new dose increase and he got so active last night and this morning. Thank goodness Tuxie is such a sweetie about having his ears poked so much

 

[manxcat419]

For someone who was usually pretty laid back I have developed into a hyper "cat Mom"...it doesn't take much to get me in high worry mode

You and me both! After years and years of 'oh she's fine...just being a cat...she has a hairball' etc, I'm now into instant panic mode the second something seems a little off. Only with Rosa though - the others still get the 'you're fine really' treatment unless there's something very obviously badly wrong! I surprise myself by the amount I worry some days - it's really not like me at all (not that most people here would believe that after the meltdowns I've had on this site).

I do think you might have got to 'that dose' this time around - the one that'll start bringing him back down the scale (anti-jinx). It just looks to me like that's where his numbers might be heading. It's great that he'll let you test a lot - that way you'll know as soon as he does earn a reduction. Rosa had a lot of extra active cycles when she started earning reductions too - worrying and exciting at the same time!

Oh and because stressful mornings and vet visits need them...

 

[Tuxedo Mom]

You and me both! After years and years of 'oh she's fine...just being a cat...she has a hairball' etc, I'm now into instant panic mode the second something seems a little off. Only with Rosa though - the others still get the 'you're fine really' treatment unless there's something very obviously badly wrong! I surprise myself by the amount I worry some days - it's really not like me at all (not that most people here would believe that after the meltdowns I've had on this site).

I do think you might have got to 'that dose' this time around - the one that'll start bringing him back down the scale (anti-jinx). It just looks to me like that's where his numbers might be heading. It's great that he'll let you test a lot - that way you'll know as soon as he does earn a reduction. Rosa had a lot of extra active cycles when she started earning reductions too - worrying and exciting at the same time!

Oh and because stressful mornings and vet visits need them...

Thanks so much for the calming words and hugs. It is very comforting to see that I am not the only "crazy cat lady" out there. Fingers crossed that this dose and maybe even the stress today will be the start of better numbers.

 

[julie & punkin (ga)]

It's good you say loud and proud that you're using an AT - most of us have experience with human meters & with our docs all in human meter #s; it's a constant effort to get it right with ATs. I appreciate having it in the title of the spreadsheet, especially. Can't miss it there. Thank you!

I agree with Sienne. I don't really think he's dropping like a rock - the higher they start the farther they fall. That's one reason why being able to shoot a lower number is so successful - there just isn't as far to fall. Low carb is often enough to get a cat surfing along and staying in good numbers. I'd just hang onto this dose and hope for a chance to shoot low and prevent those high starts to the cycle. The drop this morning was likely enough to trigger another bounce, and that combined with the extra carbs is likely to send him high before long. Let's see where he goes after the 79. You don't need to give him carbs til he's under 68, though.

Punkin had low numbers one time while we were headed to the vet's, so I took along the gravy and the meter and was testing him in the waiting room. There was a loud slobbery barking bull dog being weighed about 6 feet away from us and his blood sugar never rose. It was really interesting because i'd heard lots of people mention vet stress reflected in BGs, but we had nothing. This is a very individual thing whether or not a cat has increased BGs in response to stress.

 

[Tuxedo Mom]

It's good you say loud and proud that you're using an AT - most of us have experience with human meters & with our docs all in human meter #s; it's a constant effort to get it right with ATs. I appreciate having it in the title of the spreadsheet, especially. Can't miss it there. Thank you!

I agree with Sienne. I don't really think he's dropping like a rock - the higher they start the farther they fall. That's one reason why being able to shoot a lower number is so successful - there just isn't as far to fall. Low carb is often enough to get a cat surfing along and staying in good numbers. I'd just hang onto this dose and hope for a chance to shoot low and prevent those high starts to the cycle. The drop this morning was likely enough to trigger another bounce, and that combined with the extra carbs is likely to send him high before long. Let's see where he goes after the 79. You don't need to give him carbs til he's under 68, though.

Punkin had low numbers one time while we were headed to the vet's, so I took along the gravy and the meter and was testing him in the waiting room. There was a loud slobbery barking bull dog being weighed about 6 feet away from us and his blood sugar never rose. It was really interesting because i'd heard lots of people mention vet stress reflected in BGs, but we had nothing. This is a very individual thing whether or not a cat has increased BGs in response to stress.

Thanks for your input. To me Tuxie was dropping like a rock when he had the UTI issue and I had the vet visit to go to. The vet's office said that since I wasn't an appointment I might have to wait an hour or so to be fit in between patients, so I was freaked out what might happen when I was at the vets. Tuxie turns into a stone cat once he is away from the house and won't eat or drink or pee or poo. When I had him at the first vet for a BG curve for 8 hours he just lay in the litter box and did not eat or drink. Once he was home he went nuts eating and drinking and peeing and everything This is why I say he is a high stress cat. My vet's technicians love him since he never moves even when they are putting an IV in...but that is because he is in a catatonic state away from home.

I really did panic too much today but it because of everything happening at the same time. If I had been at home with no UTI problems I might have tried to ride it out. Oh well...I goofed up!! Especially since his PMPS was through the roof again. I will let it ride and just keep monitoring and see what the next day or two brings.

 

[julie & punkin (ga)]

You know, I don't think you goofed. You have to trust your instincts, and it's ALWAYS better to err on the side of being too cautious than it is to be too casual about things. Insulin is a powerful hormone and it needs to be respected. Just take it all as a learning experience and for the next time, see what happens when you use low carb. Good notes on his ss will help you try a different thing next time - and there will no doubt be a next time.

That's a mighty powerful reaction to going to the vet! I would assume it would increase his blood sugar too! That's gotta be a little unnerving to have him turn into a stone when he goes to the vet. Punkin always just wanted to climb back up onto my shoulder - he'd be facing me and then his paws would go up on my shoulder and his back feet would get into the act. It was always very sweet.

 

[Tuxedo Mom]

You know, I don't think you goofed. You have to trust your instincts, and it's ALWAYS better to err on the side of being too cautious than it is to be too casual about things. Insulin is a powerful hormone and it needs to be respected. Just take it all as a learning experience and for the next time, see what happens when you use low carb. Good notes on his ss will help you try a different thing next time - and there will no doubt be a next time.

That's a mighty powerful reaction to going to the vet! I would assume it would increase his blood sugar too! That's gotta be a little unnerving to have him turn into a stone when he goes to the vet. Punkin always just wanted to climb back up onto my shoulder - he'd be facing me and then his paws would go up on my shoulder and his back feet would get into the act. It was always very sweet.

Today was such a whirlwind with too many things happening all at the same time. If it had just been a normal at home day I would have treated the drop differently, but as you said it is better to be too cautious than too casual. At the vets if I put him on the floor he basically will do a belly crawl to try to get under something..on the table he is just a lump of stone. The vet even said she has trouble palpitating his belly since he gets so tense. At home with just me he is laid back and lovey...but if other people come in the house he is more than likely heading up the stairs to hide under my bed....a total skitty kitty. Knock on wood..I can't afford to be sick or injured because I don't think I could find anyone to test and shoot him. I was talking to my son tonite and telling him about my morning. I said "I REALLY need a holiday" and he said well just take one. YEAH RIGHT!! Even if I had extra cash (which has all been spent on Tuxie) I couldn't go away and leave him.

Well at least his numbers tonite are not too bad. Not as low as I would like but at least they are coming down and there are no big swings. Of course tomorrow could be a whole new story!!