Pls take a look at Mookie's new bg numbers -- feedback?

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Randa & Mookie

Randa & Mookie

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Hi, everyone,
Mookie went to the vet yesterday morning for a recheck. She took his first bg reading since he started 1.5U Lantas (2x/day) on 11/25. I did a home test in the afternoon.

AMPS = 239; PMPS = 345 Each test was done 12 hours after the previous shot, on an empty tummy.

Assuming the first number reflects a stress spike from being at the vet's office, how low do you think it had actually dipped?

I asked about the abnormal lab results, and she was pretty vague. She thinks he probably has pancreatitis; his liver is probably involved; and I shouldn't worry about trace ketones in his urine. I requested some buprenorphine (corrected) for pain management and decided to pick up some ketone testing strips this weekend. I'll post numbers throughout today on his spreadsheet. I'm worried but hanging in there!
 
It would be good to get some numbers at home today, Zoe. That will give you a much better picture of how the insulin is working. Especially try to a mid cycle number around +5-6 and then some other numbers during the day.

I would not dismiss any trace ketone readings, if I were you. I think you are wise to test.

Hang in there. Data is a very powerful tool and you will be collecting some today.
 
Zoe & Mookie said:
Hi, everyone,
Mookie went to the vet yesterday morning for a recheck. She took his first bg reading since he started 1.5U Lantas (2x/day) on 11/25. I did a home test in the afternoon.

AMPS = 239; PMPS = 345 Each test was done 12 hours after the previous shot, on an empty tummy.

Assuming the first number reflects a stress spike from being at the vet's office, how low do you think it had actually dipped?

I asked about the abnormal lab results, and she was pretty vague. She thinks he probably has pancreatitis; his liver is probably involved; and I shouldn't worry about trace ketones in his urine. I requested some buproprion for pain management and decided to pick up some ketone testing strips this weekend. I'll post numbers throughout today on his spreadsheet. I'm worried but hanging in there!
Click to expand...

What part of the lab results were abnormal? Pancreatitis is very painful; the the vet give you any pain meds? You also need to give fluids for the pancreatitis, and give 1/4 tab of Pepcid AC regular strength 10mg BID.
I am not clear why the vet would think pancreatitis but not give you what is needed to treat it.
Is Mookie eating ok? When you go to pick up the bupe for the pain, get a fluids kit from the vet as well.
 
Hi Zoe and welcome to FDMB.

Sue asked that I stop by since I spend much of my time on the Lantus board. I echo Sue's suggestion to take a look at the starred, sticky notes on the Lantus board. There's a wealth of information there. Here are the links and an overview of what they contain:

  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in Germany and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
  • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot/shed: This is an important concept for understanding how Lantus works.
  • Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as information if you have a low pre-shot number or a drop into low numbers during the cycle.

Lantus dosing is based on the mid-cycle (i.e., nadir) numbers. It's important to get pre-shot tests every time you plan on giving a shot in order to make sure that it's safe to give an injection. In order to evaluate the effectiveness of your dose, you'll also need to start getting some spot checks during both the AM and PM cycles. We encourage people to get at least one test per cycly -- many of us test more than that.

Pancreatitis is tested for with a spec fPLI. It is the most reliable test out there. I think you mean buprenorphine/buprenex for pain -- buproprion is a totally different drug (it's a psychiatric med and not used for pain). Not to disagree with your vet, but I would be very worried about trace ketones. Please get some Ketostix and test for urinary ketones at home. Ketones can go from trace to a life threatening level in a matter of hours. It is a costly hospitalization and one that should be avoided by preventative testing and adding water to a cat's canned food diet.

Please let us know how we can help.
 
Sue, I'll try to get a reading every 2 hours, but it's not what I'd call a pleasant way to spend the day for him or me. I've had to poke his ear 2-3 times for each reading. :(

Sienne (and Sue), thank you for the links to the Lantas board. I'll start reading the board today between ear pokes. And yes, I meant buprenorphine!

Gayle, Mookie's lab test results are posted in http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=57552. I have some buprenorphine from the vet -- she didn't offer it; I asked for it. We were giving him an antacid a month ago when his appetite started to decline; I'll start giving it to him again. His appetite is much better, although he only eats small amounts at a time (e.g. 1/4 of a 3oz can Wellness).
 
I don't think you need a number every 2 hours - especially if it is hard. Just a couple numbers during the cycle.

Is he not bleeding easily? Tell us what the problem is and maybe we can offer some more suggestions.
 
Sue, Mookie thanks you for telling me I don't need to get a reading every 2 hours. He does bleed; I'm just tentative with the jab out of fear of hurting him. I'm not using the lancet device -- would it be easier if I did?
 
I liked the lancet device (with the clear top on if you have one) but lots of people like to free poke. I could never do that - it felt too much like stabbing. But I am a real wimp. It doesn't matter. Whatever works for you and Mookie.

If you give him lo carb treats every time you poke, he will soon forget any discomfort. And remember, every poke keeps him safe.

Probably the most important test today is around +5 or +6 to see when he might be lowest or headed back up.
 
Whenever you get a test that doesn't make sense, Zoe, test again.

If he still tests about there, start a new topic with your number and the time and ask for Lantus advice.

(I don't use Lantus so can't advise on what to do)
 
Zoe,
PLEASE don't take this wrong but the only way you're going to know how to take care of Mookie is to test. Lantus is dosed by the lowest number in each cycle (nadir) rather than the number you get 12 hours after his shot.

Sue, I'll try to get a reading every 2 hours, but it's not what I'd call a pleasant way to spend the day for him or me.
Click to expand...

It's not something any of us want to do but it's what's needed to keep our cats safe. The more information you have to understand what Mookie does with his dose makes it easier to see when HOPEFULLY his pancreas DOES kick in and start putting out it's own insulin. I test a lot more often than some people but KT was probably diabetic for quite some time before he was actually diagnosed and insulin started...he's not really regulated yet. His numbers will go along high, high, medium, high, medium, jump off the cliff LOW, high, medium, etc.....those 'jump off the cliff LOWs' are what needs to be watched.

KT's spreadsheet is in my signature - no, you don't need THAT many tests...and btw, he reminds ME if I forget to test for several hours.

I hope that made sense and didn't offend you...I couldn't think of any other way to put it...

Big hugs!!!
 
Zoe,

Your spreadsheet isn't in your signature anymore (except on the initial post this am). You probably need to copy it into your signature again.

Check the first post on the thread. Zoe got 3 mid cycle tests today.
 
Sue and Oliver (GA) said:
Zoe,

Your spreadsheet isn't in your signature anymore (except on the initial post this am). You probably need to copy it into your signature again.

Check the first post on the thread. Zoe got 3 mid cycle tests today.
Click to expand...

Ah THERE it is, thank you Sue! I read the thread and couldn't find any numbers - those numbers are looking really good but it makes me second my posting above. This early after diagnosis and beginning insulin, you may be one of our next 'Dancin' with Sugar Cats' contestants!

Hugs,
 
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