Eukanubo is back with a relapse

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hbs60

hbs60

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Good evening,
I haven't posted here in maybe 2 years, for good and bad reasons. The good reason is that my 16 y/o cat Eukanubo has been in remission from his diabetes, he's had two bouts that required insulin for several months and has gone into remission, doing well for the most part other than kidney issues, he's probably got early renal failure. The bad reasons for not posting is that I have been taking care of my elderly parents, my father is struggling with prostate cancer and not doing well, and last year my significant other got diagnosed with lung cancer and died just over a month ago. So, the cats have been low priority, but I'm grateful that he hasn't needed insulin until now. When my SO died, I had to board both my cats for two weeks, so I presume that the stress is probably triggering the relapse. He's been running sugars in his 500s, so today I got a new PZI vial and shot my first unit. While I'm comfortable with the mechanics of it, I'm worried about dosing, because of his kidney insufficiency. His PMPS reading today was 433, +2 reading was 345, the +4 reading is 193. Normally I would be pleased with such a good response but I'm worried it might be a tad too fast and I don't know if the insulin effect will last longer than normal. He is looking fine, sleeping as he always does but easily arousable, but I'm not sure at what point I should start getting nervous. Maybe I should have started with 1/2 unit?

Thanks!
 
Welcome back, but sorry you have to be here. Maybe give him some food and see if he flattens out a little. As long as he is higher than 50 by nadir, you should be fine. If not, do you remember the routine? A little gravy off higher carb food and check again in 20/30 minutes. If he drops to 40, honey and retest. If still dropping, the vet.

Depending on how this cycle goes, you might reduce to .5. Always easier to raise the dose than have it too high.
 
Thanks,
I just checked his +6 reading and it down to 80, but he looks very good, and just ate, even stole some dry food from the other cat. The meter also under-reads by 50 points, so I think he'll be OK on those fronts, the one variable I don't know if whether the poor kidney function would make the insulin effect last longer, so instead of hitting his nadir around now, would he hit it say, 8-9 hours later?
 
Have you joined the crf yahoo group? You may find some more answers pertaining to the kidneys and how the insulin may effect it differently. Its hard trying to manage different health issues all at the same time. I joined that group because according to my vet Hidey is showing signs of beginning kidney disease so I was searching for a little bit of info on how to manage both.
 
I wasn't aware of the CRF group, will be checking it out.
Today it's been his first complete day on insulin, I scaled down the dose to 1/2 a unit and he seems to be getting decent numbers, considering that it's only been one day, he's no longer doing 400s or 500s and today he had a nadir of 204 (+6 ), right now I just checked a +4 and it's 199, so I don't expect a huge further drop tonight, especially since he's been eating. He also looks a lot perkier which makes me happy. I think he just needs some insulin for pancreas support but don't need big insulin doses, then again, it's been only one day, too early to tell, but so far, so good.
 
Euk! Hey Buddy! You doin' the sugar dance again? Good thing PapaBear already knows the steps! Together you danced right off dat juice last time, hopefully this time will be as quickly too!

HUGS PapaBear!
 
Thanks for the welcoming responses, it's good to have all this support.
Euk is doing fine, he looks better since starting the insulin. I'm being stingy with his dose as I fear hypo, and so far his glucose readings have been fairly decent, he does spike into the 400s but during daytime they get much better. I'm eyeballing a dose of 0.5 unit, feel hesitant to give him a full unit, I may consider switching to the U100 needles and giving him either .6 or .8 units, for the time being I want to see how he does over the next few days.
 
I think you're wise to give it a couple cycles. Yesterday, that was a big drop for the nadir, from 419 to 154 but it didn't look like much a bounce after that, unless it was just the next flatter cycle after. The U100 needles will make dosing a lot more precise.
 
Hi HB & Euk!

So sorry to hear all that has been going on, and especially about your loss. As we've discussed previously, elderly parents can be a full-time job. Thinking of you.

SOOOOO thrilled to see Eukanubo is still with you! Seems like just 2 years ago he had an appointment at the bridge. He has truly blessed you with the gift of time.

Back when G and I were here regularly, we barely saw movement from 375 to 350, so I didn't have much experience w/ low numbers. Once we broke through his resistance, I got more comfortable shooting low numbers. The numbers he gave you are great - he probably just needs to get his sea-legs back after that time at the vet. Sometimes going is enough trauma to make them go into a tailspin. I would encourage you to continue to shoot when your preshot is high, and to adjust downward when it drops. I get my U-100s at Walmart - 100 syringes for $12.80. The conversion chart made it really easy to use them. One thing I do now, now that G is at 1/2 to 1u, is to draw up the insulin, then pull it down some to confirm the accuracy of it - as sometimes the top line is not really at "0". Last week G was at NC State and they provided insulin for him - supposed to be 1/2u... but when I pulled it down, it was closer to 1u. I thing that's how it's so easy for kitties to get too much insulin. Anyways, a good problem to have after crazy-high doses!

Wishing you & Euk continued good days ahead.

Hugs to you,
Lu-Ann
 
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