NEW! 9/7 - Revson - AMPS 341

Status
Not open for further replies.
A

Amy & Revson

Member Since 2011
Good Morning. Revson and I are new to FD. When diagnosed on 8/29 he already had DKA. He was at the vet's office from 8/29 until 9/2, then he went home with my ex-husband. He had a UTI and a secondary infection (white blood cell count 32,000). He's been on Lantus since 8/31 and has been on 2 antibiotics as well. He has a follow-up appointment later today.

I have been travelling, but will take him home with me next week. So, we have some numbers but not a complete profile and I have not filled out any spreadsheets.

His BG seems very high, but he has no ketones in his urine (using a test strip).
He is getting 1ml(?) of Lantus, at 10a/10p.
We have not been able to poke his ear, but have gotten a blood sample from picking a little scab.
He is eating mostly wet food from the Binky list, but the vet sent home Purina D/M dry that he is eating too.
Revson will be 12 years old this year.

9/3 AMPS 495 (8am), 202 (4p)
9/4 No BG numbers
9/5 392 but no time noted
9/6 AMPS 463, 335 (7p)
9/7 AMPS 341

I will have better records when he is in my care, but for now it's the best I can do.

What questions should I be asking at the follow-up visit today?
What is a good technique for poking? I watched a you-tube video but still had no luck.

I have yet ordered the newbie kit, but should be able to do that today.

Whew. Sorry for the long post, but trying to give as much info as possible.
Thanks in advance for any help you can provide.
Amy
 
Re: 9/7 - Revson - AMPS 341

Welcome! So sorry you are going through this but you have found a great place. Some of the more experienced members will be here soon to help and will ask a lot of questions so they know where you are at exactly and how to help you.

First, I would edit your original title to say NEW so that it will flag them to stop by.

Second, it is important that you get your ss set up. However right now you are not testing yet, so just go ahead and reply to your post as needed.

Third, start reading the stickies at the top of this forum. They are all very important and may not make a lot of sense right now, but you will begin to understand them. There is a lot of information to take in and it seems very overwhelming.

Welcome again and good luck!!
 
* I changed the heading to say New, thanks for the suggestion.
* I started reading the stickies before I posted today.

*Revson is eating canned 9-Lives from the Binky list (very low carb, less than 8). He also has Purina D/M dry that the vet sent home, he is eating that too.
*I think he is eating about a full can of food each day. And getting lots of fresh water.

*He has lost significant weight over the last 4-6 months.
*The original thought was his bad! teeth were causing him no to eat, now we know it was probably the FD.

Amy
 
Something to keep in mind is that Revson's BGs may be higher because he is at the vet. It will be much more accurate once you get him home and start testing there. My kitty had BGs about 100 - 150 higher when he is at the vet because of the stress.

You definitely want to switch to canned as soon as possible. Vets like to try and get you to go with the dry "D/M". Also, when you do switch to canned, there is a food list ( http://binkyspage.tripod.com/canfood.html ) that you will want to reference. The lower the carbs the better for diabetic kitties. You will just have to find one that Revson likes. However, the vet "d" foods are not carb or diabetic friendly so don't let them tell you otherwise. A lot of us use Fancy Feast classic from Walmart and it is actually better for them than the prescription foods.

Poking may take you awhile to get, but you will figure out what works best for you. In the beginning, I straddled my kitty to test in the bathroom with the door shut. This was the only way I could keep him contained. Now, I put my kitty on the couch wedged between me and the couch arm and test from the ear. He is black so I test from the inside of the ear. A lot of people test from the outside if their kitties are lighter color.
 
hi amy!

you've found the right site to help revson get back to himself again. when you get home i'm going to encourage you to master the hometesting. it is intimidating because we're not used to poking our kitties, but that's the ticket to getting his BG regulated and getting him well again. you can do it! we'll give you the little tricks - everyone's got their favorites that worked best on our own kitties. once you've done it a couple of times you'll know you can master it. picking at his scab has got to be worse than poking him.

along with your other testing supplies (a meter, strips, lancet device & vaseline), get some neosporin with pain relief. i like the ointment cuz it seems to me the greasiness helps the blood bead up, some people like the cream. it takes away the pokey pain and you won't feel as badly for poking him.

glad you're here!

julie
 
Hi guys, and welcome to lantus land from us!

Sounds like you are getting lots of good advice from everyone here ... We used to rub the outer edges of mochas ears to get the blood flowing when it was time to poke her .. when that didn't work, we heated up a small rice bag to warm up her ears .. eventually they bled easier .. I do know some people on here have better luck with paw testing though ..

You guys will do great!
 
Hi Revson! Welcome to Lantus Land :-D . I'm pretty new here as well- Smokey was diagnosed on 8/3/11. I just wanted to send encouragement- hometesting was hard for me and Smokey to get the hang of but we're pretty decent at it now (about 2 weeks into to testing pretty frequently). Plus- Smokey likes it because he gets a freeze-dried shrimp treat after :-D . You'll get the hang of it- the stickies are very helpful and the people here are great! Hang in there!
 
Welcome to FDMB and LL! :-D It sounds like Revson has a lot going on. Getting him home and starting to test is important. Also ditch the dry food. Dry is bad for cats for numerous reasons. Cats taken off dry food often see up to a 100 point drop in BG, so watch carefully as you withdraw it. Fortunately it sounds like he willingly eats canned and isn't getting that much dry.

The meds Revson is getting, any infections, being at the vet and the bad teeth can all raise BGs. Once all the other stresses are dealt with I hope you will see a marked improvement in his numbers. You didn't mention if the teeth have been taken care of. I realized that w/ the DKA it would have been put on the back burner, but many cat show great improvement after a dental.

it sounds like you are off the a great start in managing Revson's sugar dance. Just remember, he leads! :lol:
 
Hello and Welcome!

You've come to the right place. Along with the great advice you've already recieved regarding dumping the dry food, please make sure Revson is eating well. A kitty recovering from DKA needs 1.5x the normal amount of calories required for ideal weight. What is his ideal weight and how much does he weigh now? It's also a good idea to mix some water into his food to make sure he stays well hydrated. Test for ketones frequently, you want to be on guard for them.

Testing is important, in time you'll be a pro. The data you collect with testing will guide you in proper dosing. Getting enough insulin is another important factor in fighting DKA relapse.

Bad teeth and gums were my kittys achilles heel, however we had to address DKA x2 first.
 
Welcome, Amy and Revson,
We are glad you found FDMB. There is so much to learn at first and it may seem overwhelming, but keep at it and ask as many questions as you need.
You will get much better at testing Revson's blood. It really helps to warm up the ear with a baby sock that has been filled with raw rice and microwaved for about 15-20 seconds, or a warm washcloth put into a plastic baggie (test the degree of heat on your own ear first!). A little vaseline put around the edge of the ear will help the blood to bead up and make it easier to get on the test strip. I hold a small gauze pad under the spot I am poking, use a lancet device and do the poke against my finger, and after touching the test strip to the blood drop, I fold the gauze pad around the ear to staunch any extra blood. It usually takes a few weeks to "train" the ears to bleed (they develop more capillaries), and usually one ear bleeds better than the other. It is very important to give a treat after every ear poke! (Most of us use the freeze-dried 100% chicken bits: get the large bag in the dog aisle in PetSmart or another pet-food store and break the bits into cat-size pieces; the tiny bags made for cats are much more expensive.) At night, after the last test of the day, I always put a little Neosporin Creme with pain relief on Rusty's ear. This helps it to heal overnight and is not greasy; it absorbs very quickly.

End of blood-testing "lesson". Revson has a lot going on, but with the help of some of the very knowledgeable people here, you will do fine.

Again, welcome,

Ella & Rusty
 
Welcome Amy & Revson. :-D :-D You are in the right place and already getting great advice! I'm pretty new here...wish I had started earlier after dx....but I'm here now. Very glad you are starting off right.

Hometesting is your key to control. At first I had a tough time, cried and thought I was hurting him, couldn't get blood...ready to give up. nailbite_smile But I wanted Ollie back to good health and trudged on. Then (really not too long into it) it clicked. Now Ollie actually purrs when I test. He comes to find me at preshot time. I would never have believed it during those dark days.

My only other suggestion is dump the dry food. Knowing what I know now I would never feed another cat kibble ever again. Once you see the food charts you will most likely agree. Trust us when we say losing the dry food will make a difference in Revson's numbers.

Ask questions and post. Revson will be his old self soon!
 
Hi Amy!! Welcome!! FD seems so overwhelming at the beginning and it has to be doubly hard for you since you're not able to be home with your baby when he's sick. You've already received excellent pointers on doing the BG testing. I was lucky in that Champ never had a problem with me sticking his ear. Ella is right in that it may take a little bit for his ear to "learn" to bleed. I find that using a lancing device (usually comes with the meter) is much easier. The depth you set the needlestick of the lancet will have to be deeper than you would use for a human. For some reason, even though a kitty's ear seems thin, they don't like to bleed very well unless you get a nice deep stick. I've gone all the way through the ear a lot (which is why you hold a cotton ball, etc.) behind their ear when you do the stick. Not fun to stick your own finger!! Don't worry...it doesn't hurt kitty when this happens. Also, I know with Champ that it's easier on him for me to stick him twice in order to get a decent blood drop size than it is to squeeze and squeeze trying to get the blood from a stick that wasn't adequate, Your cat will definitely let you know what he prefers. :lol:

I'll echo others and say you really need to get Revson off the dry food. It really is terrible for him. But, that being said, you will need to make sure he is eating plenty of the wet in its place so he keeps his calories up and you will need to be hometesting at the time you make the switch because his numbers can come down quite a bit with the change. It might not be as much as anticipated, though, since he's already eating canned food. Good job on finding Janet & Binky's food list already!! Most of us try to keep the carb count even lower, between 4-5%, though sometimes that can be hard unless its a seafood flavor which should be limited to one or two times a week (can causes urinary problems or something related).

A spreadsheet is essential, not only for those who want to help guide you, but it will help keep you on track as to when to increase/decrease Revson's dose and it gives you a good visual as to how he's doing.

This is all going to remain a bit overwhelming for a bit, but it does get easier and all of us here have been in your shoes so we're here for you. Keep your chin up...everything is going to be just fine!!!
 
Hi Amy and Revson! You've already gotten hit with a lot of info today, so I'm just stopping by to say "Welcome"! LantusLand is a very special place, and you will find nothing but support and knowledge here. Keep asking questions...before you know it, you'll be an expert at poking and Revson will be back to his old self!

Amy
 
Welcome Amy! If you have to be here, this is a great place for learning how to manage Revson's diabetes.

The others who have posted have covered a great deal of ground. There's an overwhelming amount of information for you to absorb. Please let us know how we can help. The people here are very generous with their time and their knowledge.

I do have a couple of questions. Has Revson been back to the vet to determine whether the UTI has cleared? If so, did the vet get a sterile urine sample (i.e., cytocentesis) and run a culture and sensitivity to determine which antibiotic to use and if the AB did the job? I'm concerned because infection + not enough insulin + not eating is the basic recipe for ketones. If the infection is cleared that is a huge plus.

At this point, it would be helpful to have more test data. If I understood your post correctly, your ex was taking care of Revson and not testing all that regularly. It's important to get pre-shot tests and at least one spot check during both the AM and PM cycles. That will allow you to see where Revson's numbers are. Lantus dosing is based on the nadir (lowest number in the cycle), not on the pre-shot value. Thus, we really need more information in order to help you with dosing.
 
Thank you a million times for your help!

The vet visit today was low-key.
Temp (100.5) and BG (320s). Visual check, but nothing more.
Increasing insulin - 2 units AM, 1 unit PM - starting tomorrow.

I have asked John to add water to his wet food starting tomorrow too.
I will reduce the dry food (and increase the wet food) next week when I take him.
And I can start charting better then too.
He's getting good exercise up and down the stairs several times a day at the house.
Right now he lives with another cat and 2 labs.
*Added stress will be moving to a new place - for both of us!

Someone asked about additional testing for the UTI.
Unless it was done before he left the clinic last Friday (when he came home), no additional testing was done today.
Blood test next week (fP-something).

Amy
 
Looks like you've gotten a great deal of good information already. Sienne is right... this is the most amazing place you hope you never have to be at! Just want to throw another welcome and hello into the ring! I look forward to learning more about you and Revson both!
 
Hi Amy and Revson!

I'm new here, too. Lots of great people here!
Just wanted to say hi and welcome :smile:

Michelle, Jetson and the girls
 
Ummmm......

Not to contradict your vet but, Lantus works best if you shoot the same dose at AM and PM. Lantus is a depot-type medication. There is a reservoir of insulin that builds up and it is responsible for Lantus being a gentle insulin that has long duration and overlap between doses. If you dose differently at AM and PM, you keep altering the amount in the depot (we call it a "shed") and the net result is wonky numbers.

If you take a look at the sticky on the Tight Regulation Protocol, you'll also note that doses are typically increased by 0.25u. If you had spot checks, it might be possible to increase the dose by 0.5u at each shot but without any idea about where the lowest number in the cycle is, it's best to be conservative -- providing you're getting negative ketone tests. Frankly, I'm concerned about doubling the AM dose. It doesn't look like your ex is around to test all that much and increasing the dose by that amount could be dangerous.

Did the vet get a ketone test today and is your ex testing for ketones? To test at home, you need Ketostix and you dip the stick in the cat's urine stream and then follow the directions on the container.
 
hi amy!

i'm going to encourage you to read a little bit about the protocol that we follow here. Lantus & Levemir: Tight Regulation Protocol it's a proven method. One of the good things about this site is that the people here all have diabetic cats, some of them have been doing this for years and years 24/7. you have just tapped into a vast resource of experience on feline diabetes.

i know my own vet, who i adore, simply doesn't have a lot of experience with feline diabetes. fortunately, he's been willing to learn from me, as i have learned from the people here. vets have to treat many animals and many conditions and aren't specialists in feline diabetes. unfortunately, you're experiencing right now what pretty much all of us have experienced - a conflict between the vet's directions and what you're hearing here.

it's a tough spot to be in. i like my vet. and hello, this is The Internet. ;-) i read and asked my vet questions, and ultimately decided to continue my cat's health care there but the dosing advice i get from here. then i tell him what punkin needs. :lol:

you'll figure out how to handle it for yourself. do lots of reading and ask lots of questions everywhere.
 
Hi Amy and Revson: Welcome to lantus land!! You've gotten lots of good info today and I hope it will help you.

I have to totally agree with Sienne and Julie. First, lantus works best with consistency so the same dose AM/PM will help. Also, by increasing the dose that much, you could totally be missing his "fitting dose" and getting into an overdose situation. The problem with that is that sometimes overdose looks like too little insulin and the tendency is to up the dose more. We've had many folks join us that this has happened to based on instructions from their vets. Keep in mind that we live and breathe this 24/7; most vets do not and they also are not familiar with what a cat does on lantus. My vet is awesome but she was blown away by the SSs I showed her.

Most of us manage FD with the help of this group as the knowledge is here, the experience is here, and there is almost always someone around to help you out.

Please ask questions. We're here to help Revson get better.
 
I've been reading enough here to see that vets are not very familiar with FD and that most members have better experience.
My biggest problem is not being around until next week.
My ex will test for BG, we just are not doing well finding a spot to use.
My vet does not have anyone that home tests, so she is not able to help with techniques

So, what would you think about a "fat" dose each time instead of the 2 AM and 1 PM?
The syringes we have are not marked besides the full unit.
We dose at 10/10 and it's 7:15 here.

Amy
 
If you are having trouble testing along the rim of the ear, some people will test on paw pads. It does take a while to get the ear poke technique down. If you post on Health, the folks there are pros at helping with testing.

There's a dilemma here. It's very hard to make a recommendation because Revson isn't in your care and it doesn't look like your ex is testing enough to have a handle on what's going on. Would he be willing to increase the testing, especially if you're going to increase the dose? Having a cat with a history of DKA is also a huge factor. Ordinarily, we're pretty aggressive about dose in a cat who's had ketones. Your ex also needs to get Ketostix and test for ketones. Otherwise, you could be looking at another big vet bill.

You can approximate the dose by how you place the top of the plunger in relation to the lines on the syringe. There are photos in the New to the Group sticky note. I'd also recommend that you get syringes that are marked in half unit increments.
 
Status
Not open for further replies.
Back
Top