Help!! AMPS 492

Gingembre1

Gingembre1

Member Since 2018
Hi all,

Posted here a couple days ago with my first BG curve, increased Ballsnacks’ dose to 2 units 2x/day, but his readings were all really high, and then this morning he shot up to 492, his highest yet. I’ll be around today, so went ahead and bumped him up to 2.5, but freaking out about his readings. He’s clearly not feeling good, I’m afraid he’s in keroacidosis.

What should I be doing?
 
I don't see any mention of ketone readings on his SS. Do you have strips or a keto meter?
Can you go out and get some ketone strips? It could be a challenge to get urine midstream, but it's doable.

I don't know anything about ketoacidosis so I hope one of the experts chimes in soon.
Sending healing vines :bighug::bighug::bighug::bighug::bighug:
 
If you think he might be headed toward DKA, you REALLY need to get a ketone test today. Get ketone urine test strips at about any pharmacy that sells diabetic supplies. If you can't go in when he pees, crinkle some clear plastic wrap (Saran wrap type) in the litter box where he'll pee. Some fresh pee will collect in the folds - you just need enough to wet the little pad on the end of the strip. Count to 15 seconds and compare against color on bottle. It's only accurate at 15 seconds so ignore if it turns darker after that.

If you do see ketones, it's time NOW to get him to vet...
 
First off, take a deep breath and relax. You need to have patience. Lantus does not do a good job at shooting down high numbers, but is a more gentle longer lasting insulin because of the depot. You have to go SLOW and give the depot time to build. Someone here likened Lantus like turning a large freighter instead of a speed boat. You make small changes then wait for the changes to happen.

We determine how to change the dose based primarily on how low the dose takes the cat, not the high numbers. There is also a phenomenon called New Dose Wonkiness where the numbers can temporarily go higher after an increase as the depot stabilizes. It can take six cycles after an increase before you see what the dose can really do.

You have said you want to follow SLGS. It requires holding a dose a week and making changes by 0.25 units at once. Those guidelines are there for safety.

Summary, you cannot jump up the dose that fast. You need to give each new dose more time to settle in the depot before increasing. Quick changes combined with no testing during the night time cycle means you can easily go past a good dose and be overdosing him. That high this morning could be because he's bouncing from however low he went last night. Which we don't know because there were no tests last night.

The link to your previous post here for continuity: http://www.felinediabetes.com/FDMB/...359-6-431-8-464-10-459-pmps-444-2-472.207651/ Please make sure the spreadsheet is up to date with the data, if there was no shot last night, that's another reason he could have been high this morning.
 
Wendy&Neko said:
First off, take a deep breath and relax. You need to have patience. Lantus does not do a good job at shooting down high numbers, but is a more gentle longer lasting insulin because of the depot. You have to go SLOW and give the depot time to build. Someone here likened Lantus like turning a large freighter instead of a speed boat. You make small changes then wait for the changes to happen.

We determine how to change the dose based primarily on how low the dose takes the cat, not the high numbers. There is also a phenomenon called New Dose Wonkiness where the numbers can temporarily go higher after an increase as the depot stabilizes. It can take six cycles after an increase before you see what the dose can really do.

You have said you want to follow SLGS. It requires holding a dose a week and making changes by 0.25 units at once. Those guidelines are there for safety.

Summary, you cannot jump up the dose that fast. You need to give each new dose more time to settle in the depot before increasing. Quick changes combined with no testing during the night time cycle means you can easily go past a good dose and be overdosing him. That high this morning could be because he's bouncing from however low he went last night. Which we don't know because there were no tests last night.

The link to your previous post here for continuity: http://www.felinediabetes.com/FDMB/...359-6-431-8-464-10-459-pmps-444-2-472.207651/ Please make sure the spreadsheet is up to date with the data, if there was no shot last night, that's another reason he could have been high this morning.
Click to expand...

Thank you! I needed this reminder, and grounding in how Lantus works and how to work with it. This really helped.

I did dose him last night, and have updated with his readings.

I also tested his urine for ketones, and according to the strip, he doesn’t have any ketones in his urine. I’ve been making sure he’s drinking as much water as possible (adding water to his food, keeping his water supply as fresh as possible, etc).

Should I decrease his dose to just 1.75 and hold for the next 5 cycles? Or stay with the 2? I freaked out this morning and went to 2.5. ☹️
 
I would go back to 2.0 units for now. Can you get any tests in today to see how he's reacting to the 2.5 units?

How is Ballsnacks doing? It's important to know how kitty is feeling/doing as they are more than just their numbers. We have a measurement we call the 5 P's (peeing, pooing, purring, playing, preening).
 
Wendy&Neko said:
I would go back to 2.0 units for now. Can you get any tests in today to see how he's reacting to the 2.5 units?

How is Ballsnacks doing? It's important to know how kitty is feeling/doing as they are more than just their numbers. We have a measurement we call the 5 P's (peeing, pooing, purring, playing, preening).
Click to expand...

He’s been acting like his ears are really sore, so I’ve been trying to give his ears a little break. But I’ll try to grab a test or two this afternoon.

Update: Tried to test, but he’s acting like his ears are really sore

He was definitely acting like he wasn’t feeling good earlier, a little bit off his food, which is super unusual for him, even pre-diabetes. But he’s pooping and peeing fine. He’s never been playful, my marker for him is how affectionate he is. He has always been the most affectionate cat, loves to be held and snuggled like a teddy bear, could spend all day in your lap. He definitely hasn’t wanted as much affection since the diabetes developed, but I can tell when he’s feeling better because he’ll ask for head rubs, curl up next to me. So earlier today, he definitely didn’t want to be touched. But right now he’s laying near me, and has been giving me some head butts now and then for rubs. He was also happy being carried earlier. He has a very light purr happening. He’s also doing some very minor grooming.
 
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Do you have some Neosporin with pain relief? A little of that on the ears might help heal and take away the sting.
 
Gingembre1 said:
He’s been acting like his ears are really sore, so I’ve been trying to give his ears a little break. But I’ll try to grab a test or two this afternoon.

Update: Tried to test, but he’s acting like his ears are really sore

He was definitely acting like he wasn’t feeling good earlier, a little bit off his food, which is super unusual for him, even pre-diabetes. But he’s pooping and peeing fine. He’s never been playful, my marker for him is how affectionate he is. He has always been the most affectionate cat, loves to be held and snuggled like a teddy bear, could spend all day in your lap. He definitely hasn’t wanted as much affection since the diabetes developed, but I can tell when he’s feeling better because he’ll ask for head rubs, curl up next to me. So earlier today, he definitely didn’t want to be touched. But right now he’s laying near me, and has been giving me some head butts now and then for rubs. He was also happy being carried earlier. He has a very light purr happening. He’s also doing some very minor grooming.
Click to expand...
When you poke his ears, are you avoiding the vein? Make sure not to poke the vein as it hurts more and can cause the ear to bruise
 
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