Journey continues for Ottie - CKD and Diabetes
- Thread starter Kili
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Here's the link for the calliper method, although it's mainly used with U100s, because we don't have the option to use a different syringe. Like we stated before, U40 insulins can be easily (easier to be) fine dosed with U100 syringes. U100 insulins, however, absolutely cannot be used in U40 syringes, hence why this method was developed.
But I'll drop you a message, give me a minute.
Edit: sorry, forgot to say that -evidently- the method and the principle is the same when using the callipers with U40s as using them with U100s.
But I'll drop you a message, give me a minute.
Edit: sorry, forgot to say that -evidently- the method and the principle is the same when using the callipers with U40s as using them with U100s.
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Suzanne & Darcy
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Kili
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I reduced back down the dosage for Ottie... BUT my concern is that his BG nadir won't drop below 8.
I have tried to do a dosage that is inbetween 0.1U and 0.25U, by using a transparent ruler... but at such small amounts, the only certainty I have is that the dosage I'm giving is less than 0.25U.
Using U40 syringe... it's actually quite hard to microdose. Microdosing happens within the area less than 0.5mm
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Suzanne & Darcy
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Yep. It’s virtually impossible to make those tiny adjustments in dose (with any certainty) when just eyeballing it with a U-40.
Elizabeth and Bertie
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What sort of vomit exactly?
A couple of mine are throwing up fur at the moment (a seasonal thing, albeit late in season...)
Another throws up clear liquid if she doesn't eat often enough (poss due to CKD, but also could just be due to too much stomach acid).
Or is Ottie regurgitating food?
...Any constipation..?
Kili
Member
Before... it was vomit that had hair... so I presumed that it's down to the season like you say. I have started recording it on the spreadsheet below the comment column.
Ottie seems to vomit just once a day. Typically early in the morning. In the recent 2 days, he has had a bit of constipation but still managing to produce poo. Prior to that, he has been regular.
But recently, he just seem to vomit every other day. I have attached a picture for reference. Luckily, today... no vomit.
Ottie seems to vomit just once a day. Typically early in the morning. In the recent 2 days, he has had a bit of constipation but still managing to produce poo. Prior to that, he has been regular.
But recently, he just seem to vomit every other day. I have attached a picture for reference. Luckily, today... no vomit.
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Kili
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Could you comment on how much you give? From the guideline below... it seems like for a cat that weighs 5.6kg, the dosage should be 168mg.
http://felinecrf.org/phosphorus_binders.htm#dosage
Are you using the same phosphorous binder?
https://hyperdrug.co.uk/aluminium-hydroxide-powder-30g/#feefo-product-review-widgetId
Elizabeth and Bertie
Very Active Member
Yes. I was previously using Alu-Caps, but those were discontinued so I use the one in this link.
I give a very slightly rounded scoop per day. ...I actually can't remember what dose that equates to now....
I put the day's amount into a little glass salt cellar. And I get that onto as much food as possible over the course of 24 hours.
My cat eats numerous mini meals. She likes to eat 'something' every few hours around the clock, day and night, even if it's just a few little bites... This has been challenging when it comes to getting phos binder into her food. And it is certainly easier if a cat eats a fixed number of meals (easier to get right amount of phos binder in each of the meals).
Eliz
Suzanne & Darcy
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The comment above about one scoop per 10 lbs of body weight per day, twice a day, was in reply to your question about how much of the Epakitin to give. On a different topic, I do have a dosing chart for the aluminum hydroxide powder, if you are going to switch to that kind?
Suzanne & Darcy
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With regard to the vomiting, I'm sure that Ottie could benefit from a daily dose of Cerenia, but as I said before, I'm not sure they allow this in your country.
Kili
Member
I am thinking of switching to aluminium hydoxide... since most CKD people recommend it over calcium based ones. However, my confusion is on how much to give.
Tanya's website recommends
That would mean that Ottie being a 5.6Kg cat would take a dosage of 168mg (based on 30mg per kg)? But according to the hyperdrug website, their scoop measures at 240mg.
OR... is it enough to just give one scoop per day.
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Kili
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BACK TO DIABETES QUESTION...
I have just got a 7.8 reading for PMPS... Does that mean it's a no shot situation?
UPDATE
As per the guideline, I have decided on a NO SHOT.
Ottie's BG has remained flat since his +6 reading... all the way to preshot, despite the fact that he has eaten right up to -2hrs PMPS.
I should have just waited another 30mins without feeding to do another test... but I messed that up, and fed Ottie... so too late. I will do a +4 reading tonight... despite having given NO SHOT.... to monitor his BG. Hopefully, no spike...
I have just got a 7.8 reading for PMPS... Does that mean it's a no shot situation?
UPDATE
As per the guideline, I have decided on a NO SHOT.
Ottie's BG has remained flat since his +6 reading... all the way to preshot, despite the fact that he has eaten right up to -2hrs PMPS.
I should have just waited another 30mins without feeding to do another test... but I messed that up, and fed Ottie... so too late. I will do a +4 reading tonight... despite having given NO SHOT.... to monitor his BG. Hopefully, no spike...
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Suzanne & Darcy
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Elizabeth and Bertie
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Yes, we can get Cerenia in UK, Suzanne. And some vets (like mine) let us have a supply to use at home on an as-needed basis... ....I really don't know what I'd do without Cerenia...
Kili
Member
I had a catchup with my vet today... Mainly to discuss ongoing bloodworks to monitor CKD.
The topic started with Ottie's diabetes. Some of the things my vet said raised by eyebrows, and quite surprising.
My vet has access to the spreadsheet that you all have access to. First thing my vet said is that I am testing Ottie way too frequently, and commented that Ottie's ears would be completely mangled because of my incessant testing. She kind of told me off for testing Ottie too much.
I then asked her how often should one test... and I was surprised to hear from my vet that testing is only required when you are performing a BG curve after one week on the same dose of insulin. I asked my vet whether one should test preshot, and then once post shot to check whether the kitty is ok. She's indicated that that's overkill... and as long as they look happy and normal, there is no need to test. I proceeded to ask her how one can shoot without doing a preshot reading. My vet indicated it's not necessary... and as long as the kitty looks normal and is eating, there's no need to test. She also indicated that I'm the only one in her patient care that tests this much. The only thought I had at the time was WTF?? Can you guys confirm your thoughts on this?
My vet then insisted that I need to shoot at 0.25U... and I asked her whether I should drop the dosage if I see hypo numbers... and she proceeded to say that there is no need to drop the dosage, and should maintain course with the dosage. My vet thinks that a one off hypo number doesn't mean anything, and because Ottie got out of it unscathed, it's nothing of concern, and I should maintain dosage.
I then asked her if I get a preshot reading of less than 8, should I miss a shot? My vet said no. I should only consider it if my preshot number is below 5.
My vet insisted that because Ottie's nadir is not in the region of 3.8-5, that I need to increase my dosage to bring the numbers down. What do you guys think?
I then even asked her about what she thinks of Aluminium hydroxide as a phosphorous binder. Whether it's better than the Ipakitine that I'm using. To my surprise... my vet has never heard of it. She even questioned whether aluminum hydroxide is an alternative, and I pointed her to Tanya's website.
All in all, my vet just confused me even more.
The topic started with Ottie's diabetes. Some of the things my vet said raised by eyebrows, and quite surprising.
My vet has access to the spreadsheet that you all have access to. First thing my vet said is that I am testing Ottie way too frequently, and commented that Ottie's ears would be completely mangled because of my incessant testing. She kind of told me off for testing Ottie too much.
I then asked her how often should one test... and I was surprised to hear from my vet that testing is only required when you are performing a BG curve after one week on the same dose of insulin. I asked my vet whether one should test preshot, and then once post shot to check whether the kitty is ok. She's indicated that that's overkill... and as long as they look happy and normal, there is no need to test. I proceeded to ask her how one can shoot without doing a preshot reading. My vet indicated it's not necessary... and as long as the kitty looks normal and is eating, there's no need to test. She also indicated that I'm the only one in her patient care that tests this much. The only thought I had at the time was WTF?? Can you guys confirm your thoughts on this?
My vet then insisted that I need to shoot at 0.25U... and I asked her whether I should drop the dosage if I see hypo numbers... and she proceeded to say that there is no need to drop the dosage, and should maintain course with the dosage. My vet thinks that a one off hypo number doesn't mean anything, and because Ottie got out of it unscathed, it's nothing of concern, and I should maintain dosage.
I then asked her if I get a preshot reading of less than 8, should I miss a shot? My vet said no. I should only consider it if my preshot number is below 5.
My vet insisted that because Ottie's nadir is not in the region of 3.8-5, that I need to increase my dosage to bring the numbers down. What do you guys think?
I then even asked her about what she thinks of Aluminium hydroxide as a phosphorous binder. Whether it's better than the Ipakitine that I'm using. To my surprise... my vet has never heard of it. She even questioned whether aluminum hydroxide is an alternative, and I pointed her to Tanya's website.
All in all, my vet just confused me even more.
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I had the exact same conversation yesterday after I brought my cat in for a post-op check up. The vet nurse told me I should only test ONCE A WEEK at around +6 to determine whether an increase was needed.
Asked me how many times I test a day, I told her at least 4 times. She was shocked.
I have already taken my cat to a specialist for his diabetes, so I took absolutely no notice of her comments on this matter.
I made sure she took care of his sutures and went over the post-op check up protocol and left.
With that said though, I was indeed told by the specialist to try and stress less over the numbers and observe his pathological signs more. Her words were "the numbers are important, but are not everything". I get it, absolutely, but when you microdose and your goal is remission, you do need to focus on the numbers in my opinion.
Kili
Member
I'm not sure whether I got the measurement right... but it seems like small amount of powder is given per day?
When I ordered aluminimum hydroxide from hyperdrug... it comes with a plastic scoop that they reckon is 240mg. Is this right?
On the picture you wrote that 1/2 a tea spoon is 600mg... Is that what you give your cat? I presume you give him a rounded scoop like you suggested... so probably around 300mg instead.
I'm not sure whether you have experience with Ipakitine... but in comparison, it appears that you give much less aluminum hydroxide than Ipakitine. Is this the case? Ipakitine I give 2 scoops daily. The scoop inside Ipakitine is also larger (it measures 1g per scoop).
Finally...
Does anyone know why aluminium hydroxide is more effective than calcium based? I cannot seem to find an answer anywhere.
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Kili
Member
Eliz,
I have recently ordered aluminium hydroxide from hyperdrug.
What I don't understand is that when I ordered last time, the powder looks different to the current. The old powder was more coarse and dense, whilst the new one looks more like talcum powder.
What is also different is that although the scoop they give is exactly the same (0.5ml), it says now that one scoop is approx 634mg instead of 240mg last time.
Has hyperdrug changed the product and made it more concentrated?
I gave Ottie 1 scoop before, but it seems like I should give half a scoop?
I'm really confused on the dosage now. Can you please help?
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Elizabeth and Bertie
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Hi Kili,
Hmmm.... The tub I have is 240mg. This is the first tub I've bought. (Prior to this I was using a different form of alu hydroxide).
That is a huge difference - 240mg to 634mg. Maybe best to message Hyperdrug and ask them directly about this...?
Eliz
Kili
Member
I'm finding out that hyperdrug as a company are absolutely irresponsible.
So far, their own labelling seems to be false. But these are some guidelines.
If you ordered aluminium hydroxide from hyperdrug... and the tub is almost full, and the powder is fluffy... this version is the weaker version and likely that each scoop is equivalent of 240mg.
However, when you ordered your 30g tub, and it arrived half empty, and the powder looks more dense (opposite of fluffy)... then you have the more concentrated version and each scoop is 634mg.
In my case, the fluffy one was labelled with 634mg whilst the half empty, dense powder version was labelled with 240mg per scoop. In another words, I may have accidentally overdosed my cat with 634mg.
I never knew that there was 2 versions since there is no mention of that in their website. I am very worried that their labelling may have lead me to overdose my cat.
At this point, can we even trust what each scoop is equating to?
I have attached pictures below. The first is the fluffy one... and you can see the tub comes almost full. The second one is the more concentrated one, and although you can just about make out the powder looking dense, the tub arrived half full.
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