Nervous about Shanti

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Shantismom

Member Since 2014
Shanti ate about half his food this morning, received his 3 units of insulin. His morning number was 319. He did eat some food during the night and had a small bit about 2 hours before morning meal, he can spit up if his stomach is empty for too long, for some reason our other cat does the same thing. He is laying down which really is typical for him after eating in the morning, but something about him seems a little down. Maybe I am just watching more and he usually acts like this but I don't pay attention. He had his shot about an hour and 20 minutes ago. Thought I would check his BG at +3. I am really a nervous wreck lately with him, after taking care of him for 7 months with this and 12 years with various other things I don't know why I feel so nervous. Just wanted to share in case there is something else I should do.
 
We all know how you feel...all of a sudden we become super-duper hypersensitive about every little nuance!

You could check Shanti's BG right now...that will give you peace of mind, and it's never a bad thing to have extra data!

Does Shanti (or you other kitties) take Pepcid for the empty stomach spit up issue? Trix takes pepcid twice a day because she has the same problem; others here use Slippery Elm Bark. It's not all that uncommon for an empty stomach/stomach acid issue to cause spit up with diabetics or kidney disease cats.
 
Just keep doing what you are doing, this whole sugar dance can be very nerve wrecking, I was the same way, causing me to become unfocused at work not knowing how he was doing and still do sometimes.
 
Morning!

I agree with the others. I too was a nervous wreck at first, After a while you get used to it, though there were alwyas those days.... As Amy said, you could test now, give yourself that peace of mind, build some data history too. Good luck today. I think you are doing just fine, the nervous mama is all part of the dance.
 
Just tested, about + 1hour 50 minutes 327, BG went up. Don't know what that means but at least I know it's not hypo.
 
I was just looking at Shanti's SS and see that he is on baytril. Does he have an infection of some sort? Either an infection or the baytril can definitely have an affect on the appy and how they feel in general. What appetite stimulant did the vet give you? This is all information that will help others guide you with Shanti.
 
Shantismom said:
Just tested, about + 1hour 50 minutes 327, BG went up. Don't know what that means but at least I know it's not hypo.
Click to expand...

When the meter variance into account, this is almost the same number as Shanti's AMPS. This is a good thing! It will be interesting to see what Shanti's next test shows.
 
Appetite stimulant is Mirtazapine, just a tiny amount, 1/8 of a 15 mg tablet ( they cut them for me) and every other day. He can have it today around noon, the vet said 48 hours between.

I asked the vet about the baytril and she said because his teeth are getting bad. I may not have posted that here but she is hesitant to do a dental because he has athma and has developed a heart murmur. The new pet insurance coverage comes out in 3 weeks and will cover the blood panel and heart blood test, she would like to wait until then for these tests if Shanti does all right. After the test if need be, he will have an ultrasound and echocardiogram to see what is going on with his heart. Even years ago they were always cautious when they did a dental because of his athma and of course he has some new issues now.
 
Thanks for sharing that info, Marlene. It's also a good idea to make those kinds of detailed notes in your spreadsheet, too, since that is the "go to" document for folks here when they are trying to figure a kitty out....that way ALL pertinent info will be in one location.

The other thing that helps us is how you format your subject line. You'll notice that we all start with the date, our kitty's name, AMPS or PMPS, and the follow-up tests. This lets us see at a glance how things are shaping up. If you have a specific question or comment, you can take it on at the end of the test data in your subject like to draw attention to it.

You're doing great....keep posting, we're here to help and lend support!
 
hi marlene!

Bad teeth can make it difficult to get a cat regulated. We've seen some amazing results to getting teeth cleaned and all the dental issues resolved. Even to the point of going OTJ. I think Sandy has posted to you before - BK went off of insulin when his teeth got done. The stars have to all align, it's not just that, but dental issues can prevent regulation.

Leaving food out is a great plan! that way you know there is something available. i think you get more nervous as you learn more and realize the possibilities, but you're doing everything right. Learning how he and his insulin work together is the way to go.

:YMHUG:
 
I know teeth issues create problems but really my vet hesitates because she has concerns about his going under anesthesia, he may not survive the procedure. She said if he gets to where they have to be done, we will do them. Kind of like if you don't do them he will deteriorate to the point of death then we will risk it. I think after the heart results are determined she will know better if his chances are better. He is 14 years old and has had many years of athma, and maybe 8 years with IBD. He has been doing well with few signs of athma, probably because of the pred, also his IBD has been better after 3 years of struggles. One of the things that makes me nervous is that if he has many hypo problems and is always getting the "other" food he will start with his bowel problems again. Please don't misunderstand me, I would not risk his life by withholding this food but I am hoping these episodes will be few and far between. I think that has made me almost accept higher numbers, knowing that at least it's not a hypo. But recently I started worrying about the long term results of higher numbers, everything just makes me worry.
 
I think you will feel a lot better after you get the results of the echo. My Minka is 15, and although she does not have FD she is hyperthyroid, has COPD and asthma and has a heart murmur. She had a dental cleaning last year and came through like a champ. As long as the murmur is idiopathic, which lots of them are, it shouldn't affect Shanti's ability to have the dental work done. It's great that your vet is taking every precaution.

Worrying obsessively is all part of being the mamabean to an FD kitty. You are in very good company here.

BTW: I notice you started a new condo with the perfect subject line info. We prefer that you only do one condo a day, to avoid confusion. What you can do is go up to your first post on this condo and click on the "edit" button in the upper right corner. Then you can change your original subject line to reflect Shanti's info. Click submit and it's all set. You might want to go ahead and delete the other condo before people start posting to it. Don't worry - we all took a while to get the hang of the posting guidelines! :razz:
 
Hi Marlene - I see you started a second topic here. Due to the number of kitties on this forum, we ask that you start just one post a day. If you have new questions or updates, just go to the first post you started that day and click the edit button to edit the subject line, then do a Post Reply to add a new question on the end and bump it up.

To answer your question from the other post:

Yes, Shanti is bouncing. Whenever you see a cycle where the +2 test is significantly lower than the preshot - like last night - I would have at least gotten a +4 test. Cat's can bounce because of fast drops or because they get to numbers lower than they are used to. Shanti did both last night. From preshot to +2 he was dropping 50 or so points an hour which is considered a fast drop.

The +2 test is a good indicator on Lantus on how the cycle will go. If it's significantly lower than the preshot, then you are going to have an active cycle and more testing is needed. If it's about the same, then you'll likely have a normal Lantus cycle and may need more testing, depending on how low the numbers are. If the +2 is higher, you can put aside your test kit and go do something for yourself.

It's really easy to get obsessed with feline diabetes. I'm sure most of us have at one point or another, especially at the beginning. You do have to learn to take care of yourself and do stuff for you too. :YMHUG: Bounces are an opportunity to do that, as much as we hate them.

And here is your post from yesterday: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=125414

My Neko also has a heart murmur and the echocardiogram did a lot to easy my worries. She has since had a dental, though we went to a dental specialist because they have digital X-rays and are more used to dealing with older/trickier patients.
 
I think the caution on the part of your vet is wise. A couple of thoughts...

Once you have the results of the echo, you might want to consider a consultation with a veterinary cardiologist if there's cause for concern. Likewise, if the dental is needed, a consultation with a veterinary dentist may not be a bad idea given the medical conditions that Shanti is dealing with. If you want links to how to find providers, let us know. Each of these specialties has professional organizations where there are links to board certified veterinary specialists. We also have a post with lots of info on dental procedures if you are interested in being inundated with even more info.

I agree with Wendy -- it looks like a bounce to me, as well. Shanti dropped 100 points in two hours and probably his numbers were lower at nadir.
 
punkin also had some heart concerns, so the caution makes sense to me as well. He had an echo done to check on his heart, and it wasn't too bad. When i had his least dental done, i opted for a veterinary dentist instead of just the vet. I intended to have a separate doctor there for the anesthesiology, but it would've added almost $1,000 to the bill. My sweet punkin was made of gold! ;-)

In any case, after chatting with the veterinary dentist, we opted to have a tech there just to monitor his anesthesia.

I don't think you necessarily have to have it done. You've got valid concerns. I'm just saying that it can be a cause of high and wonky numbers.

It looks like he was clearing a bounce last night (see how his BGs went down all day), and then he took off again on a new bounce. We'll help you get him to a better dose - it just takes being methodical about it. The good news is that it looks like he got into some better numbers last night. The protocol suggests:

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...

After staying with the 3.0u, let's just stay there and let him settle down and see what that dose can do.
 
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