Grayson 6/10

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Grayson & Lu

Grayson & Lu

Member Since 2012
Sorry I've been so scarce again. Laptop is down again, had to come into the office to get online...

Grayson continues to be in the reds for most preshots. I'm wondering if, as I read on someone elses thread a few days ago, if that's an indicator of too high of a dose?

If so, what is the procedure to reduce? Does that vary w/ Acro cats as does increases? (6 cycles then increase).

Updating SS in just a few. I would appreciate some eyes on it if anyone is available.

Thanks,
Lu-Ann
 
I posted an answer to your question in Thumper's thread, but forgot that Grayson is an acro/IAA kitty. I would defer to an acro parent on this because there are different reason for raising and lowering with an acro.

I don't think Grayson is getting too much insulin. You are still at only a third of his total daily insulin that he got on tid dosing with ProZinc. You probably just need to continue stepping up every 3-5 days - and .5u amounts are OK since he is at 4u already.
 
Grayson 6/10 --- for those who have used both L's

Dr. Timian at CSU has indicated a need to continue increasing his dose. That's the direction I was headed, then read the following and thought maybe it was too high of a start.


Sheila & Beau & Jeddie said:
I agree that raising the dose was probably not the best thing to do. But I also see a pattern that suggests Chip was started at too high a dose on lantus. Why do I think this? Because, the 1.5u dose on H was too high (causing 500s) and the starting lantus dose was based on that amount. Just a comment on the curve on H: when you see numbers above about 350 in a cat eating a low carb wet diet, they are almost always caused by too much insulin. That is my experience, at any rate, and something we generally believe in the lev ISG. Next, Chip got to low-ish numbers off a few days on 1u (on the 26th) and when you stayed at .75u the numbers were flat. Then you went back to 1u and suddenly had the lowest PS yet followed by flat 400s.

Does Chip have any history of ketones? If not, and you can easily test daily for them, I think you would learn a lot from dropping him to .5u and let that settle. If he is getting too much now, that will probably show it with improved numbers. And then decisions can be made on what to do next. Essentially, I am saying start over at .5u. If he needs the dose raised, it would be in percentages not to exceed 20% - so next would be .6u, then .7u, then .8u and then .9u. Those .1u changes actually make a significant difference when the dose is below about 1.5u.

That would be trying to come in at or below best dose so you can slowly raise the dose in increments and numbers will make better sense in relationship to the dose. It's easier to do that then to get the "swings" started by too high a dose and try and figure out what it going on.
Click to expand...

Thanks for your insight. Limited computer time right now... haven't been on FB to catch up w/ the Acro group in a while. Also on my TO DO list.

Thanks!!!

Lu-Ann
 
Re: Grayson 6/10 --- for those who have used both L's

Grayson & Lu said:
Dr. Timian at CSU has indicated a need to continue increasing his dose. That's the direction I was headed, then read the following...
Lu-Ann
Click to expand...

That would be Chip and Sheila was correct about the 0.5U for Chip. Hopefully he isn't Acro. Chip's never needed high doses thus far. But we still have a ways to go.

Lu Ann what was Grayson's weight doing before you saw those ketones? Was that your first test? It almost looks like his glucose was looking better back in those days than since. Looks like some blues (and even greens) then if I'm seeing that right. Before you dropped below 0.75U and before he got into dry food in February.

What was the old glucose meter?
 
Re: Grayson 6/10 --- for those who have used both L's

[quote="Dale 'n' ChipLu Ann what was Grayson's weight doing before you saw those ketones? Was that your first test? It almost looks like his glucose was looking better back in those days than since. Looks like some blues (and even greens) then if I'm seeing that right. Before you dropped below 0.75U and before he got into dry food in February. What was the old glucose meter?[/quote]

Last June Grayson was 21.6#. I was trying to cut him back to lose some weight, but not so successfully. Started w/ symptoms in Nov/Dec. Came back after Christmas at my mom's and he looked TERRIBLE! Jan 3rd (first time vet was open), he was 18 pounds & change. By the time we did the food change, (which he was extremely reluctant about) and started insulin (Jan 13th), he had dropped somewhere near 13. He dropped a little more, and despite a ravenous appetite and LOTS of FF, he's holding now around 13. He's still REALLY REALLY skinny at his waist. Otherwise looks good.

Used Prozinc until May 31. Initially he did okay on it. Started some marathon dances, which led to dose reductions. Went from 1u down to .2u. He did best at .2u .4u, and .75u, before the first ketone scare Feb 23rd (been testing for ketones regularly since day 1). Raced up the charts w/ insulin, was giving fluids and he continued to eat (thankfully!), so never went DKA. No sign of infection, although we did an AB for a few days at my insistence.

Mostly have used Relion Ultima meter. Had some really goofy readings, which led me to try others. I have a Relion Confirm, the Nova Max (which also tests for ketones, and eventually the Accu Chek Aviva - currently my primary meter. I ran simultaneous checks for a long while, and am still doing duel w/ the Relion Ultima. Accu check is sometimes more - particulary at preshots, and sometimes w/in a point or two. Every once in a while I'll get some totally wonky number w/ the RU.

So, initially, I've been seeing better range w/ the Lev, although I expect it will level out. The Insulin REsistance [IAA=50] was clearly a factor w/ the ProZinc. I was hoping it would take a little while for it to acclimate to the Lev. So far, so good.

So.. that's how we got to where we are.... welcoming any insight you may have to share.

Lu-Ann
 
Re: Grayson 6/10 --- for those who have used both L's

Grayson & Lu said:
...By the time we did the food change, (which he was extremely reluctant about) and started insulin (Jan 13th), he had dropped somewhere near 13. He dropped a little more, and despite a ravenous appetite and LOTS of FF, he's holding now around 13. He's still REALLY REALLY skinny at his waist. Otherwise looks good.

Used Prozinc until May 31. Initially he did okay on it. Started some marathon dances, which led to dose reductions. Went from 1u down to .2u. He did best at .2u .4u, and .75u, before the first ketone scare Feb 23rd (been testing for ketones regularly since day 1). Raced up the charts w/ insulin, was giving fluids and he continued to eat (thankfully!), so never went DKA. No sign of infection, although we did an AB for a few days at my insistence...

Lu-Ann
Click to expand...
So if Grayson was eating that much and his weight was still way down and not recovering, then no matter what the glucose levels were showing, he wasn't getting enough insulin. Sounds like the meters are good those numbers were likely correct. Chip was a little underweight on 1.5 U NPH tid and now seems to be gaining (fast) on 1.0 -0.5U Lantus bid after only 2 weeks. So I have to assume Chip is getting enough now. But only time will tell.

Great job keeping Grayson out of DKA. Hopefully he likes Levemir. I have a feeling if Chip gets ketones I will be running to Wal Mart for some R and doing it myself since we can't afford to repeat the intensive care again.
 
Lu-Ann, I think with an acro kitty, especially a fairly newly diagnosed one, you have to look at what his insulin needs are NOW, not several months ago. I am guessing the "diabetes" diagnosis was an early catch of the acro developing, and, as the pituitary tumor grows it puts out more IGF-1 and blocks more of his own insulin and his dose goes up.
 
Hi Luann
Just checking in on the 2 of you to see how Grayson is doing!
Hang in there...I pray it will get easier for you both!
 
Re: Grayson 6/10 --- for those who have used both L's

Dale 'n' Chip said:
Great job keeping Grayson out of DKA. Hopefully he likes Levemir. I have a feeling if Chip gets ketones I will be running to Wal Mart for some R and doing it myself since we can't afford to repeat the intensive care again.
Click to expand...

Thanks! He's hit MODERATE three times. The first was scary... the others, not nearly as bad. Knowing what to do, and having the benefit of him continuing to eat, made all the difference - as does the bag of fluids hanging from my overmantel! I rolled the dice the first time, and took him to the regular vet first thing in the morning. Had he not been eating, we'd have been at the vet school! But when I talked to them, they told me that usually by the time people bring them in to see them, they haven't eaten for 3-4 days. That would NEVER happen with Grayson - there's a reason he was 21.6#... the boy LOVES to eat! Thank goodness that hasn't changed!!!

His skinny little waist is the one thing that makes all the vets scratch their head about being Acro. Seems everyone is large - except him! Course, if he's like his mommy, it will all catch up with him soon! :lol:

As many people as I've encouraged to test for ketones - it sure saved Grayson and my wallet! Best little insurance policy in a $6 bottle!!!
 
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