Pm dose???
- Thread starter MFairy
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Katherine&Ruby
Member Since 2020
Hi Mary,
Here is your thread from the Main forum: https://www.felinediabetes.com/FDMB/threads/new-mary-and-taco.251714/#post-2840854
Since you're new, you can give a full dose for any number above 200. Do you have extra test strips and high carb food or honey/Karo syrup on hand?
Katherine
Here is your thread from the Main forum: https://www.felinediabetes.com/FDMB/threads/new-mary-and-taco.251714/#post-2840854
Since you're new, you can give a full dose for any number above 200. Do you have extra test strips and high carb food or honey/Karo syrup on hand?
Katherine
MFairy
Member Since 2021
I have test strips and Karo. I only gave .5 though I was too scared.
Bandit's Mom
Member Since 2019
It's good you dropped to 0.5U. You may want to keep her at 0.5U for a few cycles and see how she does on it.
Were you able to get any tests tonight after the shot?
Bandit's Mom
Member Since 2019
Do you think you can get one now?
Bandit's Mom
Member Since 2019
Ok. Then wait till the AMPS to test.
It's good to feed small meals through the day and night rather than just 2 big meals with the shots. Most of us feed every 2-3 hours. But no food 2 hours before the shot.
MFairy
Member Since 2021
Good to know! He likes snacks better anyway
Bandit's Mom
Member Since 2019
It will get better.
MFairy
Member Since 2021
This morning reads 163 so I will hold. I don’t really understand why it’s so low?
Bandit's Mom
Member Since 2019
Hi Mary, how is Taco this morning?
He is responding well to insulin.
163 is a good number, but considering you can't test him very much and don't have enough data on Lantus, I'm not sure if you want to shoot.
(Btw, the normal range of blood sugar for a cat on a human meter is 50 - 100 mg/dl)
Let me see if @Bron and Sheba (GA) or @Sienne and Gabby (GA) are around to advise about dosing.
Bandit's Mom
Member Since 2019
Have you fed him his breakfast? If you give him insulin, will you be able to test him during the day?
Bron and Sheba (GA)
Member Since 2015
Can you get some tests in during the PM cycles at all? At the moment we don’t know what is happening at all at night.
If the BG is dropping you can also give a snack to stop it dropping too far.
Are you going to be home this morning to test the BG if you shoot?
Yes,you should give snacks during both the cycles. main meal before the shot and then a couple of snacks during the first half of the cycles say at +2 and +5.
If the BG is dropping you can also give a snack to stop it dropping too far.
Are you going to be home this morning to test the BG if you shoot?
Pattylynne and Tigger
Member Since 2021
Mary, the cats seem to bounce around lots when you first start, it will drive you crazy, at least it did with Tigger, they do seem to smooth out some as you go on. With Lantus they build up a reserve or depot of insulin which is what helps long acting insulins give on going coverage, so the insulin you inject today not only effects the next 12 hours but can influence what happens over the next several days. This is one of the reasons it is important to try to get on a consistent schedule and dose, it's a juggling act and can be maddening especially at first. Your comfort with when to shoot and when to hold or cut a dose will develop as you go. There are many here to help. With the little data you have and me being new get dosing advise from more experienced. When you have some time and a spare brain cell not worrying about Taco's immediate needs you should read this sticky note: https://felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/
Also do his asmatha meds have any steroid in them? They will make things a bit harder. It will come, just remember to breathe yourself.
Also do his asmatha meds have any steroid in them? They will make things a bit harder. It will come, just remember to breathe yourself.
MFairy
Member Since 2021
I decided not to shoot mainly because we have this hurricane coming and I’m being overly cautious about hypoglycemia given that I might not be able to get him to an ER.
MFairy
Member Since 2021
Yes he is still on steroids every other day. Do you know how that impacts the BG?
MFairy
Member Since 2021
Also his asthma was bad last night so I gave him rescue inhaler and tried not to disturb him. I am not good at testing yet so I’ve scared him and want to undo that if he’s going to need testing for his whole life.
Bron and Sheba (GA)
Member Since 2015
It’s important to always try and get at least one test in overnight each night. A before bed test is a good habit to get into. If that test is below the preshot BG I would set the alarm and get up and test again to see a taco is safe.
Katherine&Ruby
Member Since 2020
Yes, steroids can impact glucose levels. My kitty has been knocked out of quasi remission because she needs to take prednisolone for her small cell lymphoma. When I did once a day dosing of the steroids, her BGs would climb up and then dip down again after the steroid wore off. You might want to mark on your spreadsheet when you administer the inhaler to Taco so perhaps you can see a pattern of increases.
And yes, definitely test at least once at night. A test at +2 is helpful because that is when Lantus starts to take effect and then you will know if Taco is going to be heading higher or lower the rest of the cycle. If the +2 number is the same or lower than the preshot numbers, he might be heading lower the rest of the night.
The testing routine takes some time for both of you to get used to, so try not to feel badly about it. It took me six weeks after discovering the FDMB to get it right with Ruby after a lot of crying and
. I usually feed her a small meal after every test so that she associates it with something positive and will be willing to sit through the poke. Lots of people use low carb treats like chicken from Pure Bites after tests to motivate the kitties.
Pattylynne and Tigger
Member Since 2021
MFairy, post: 2841150, member: 33932"]Yes he is still on steroids every other day. Do you know how that impacts the BG?
In humans certainly effects, also in cats. Steroids general cause Blood sugars to rise, its use can cause the onset of diabetes. Lots of people here with steroid kitties, they will chime in. You can always post in feline health asking for help with a new FD that takes steroids. Good luck with the hurricane and good thoughts for Taco. We have all been overwhelmed and unsure especially in the beginning
In humans certainly effects, also in cats. Steroids general cause Blood sugars to rise, its use can cause the onset of diabetes. Lots of people here with steroid kitties, they will chime in. You can always post in feline health asking for help with a new FD that takes steroids. Good luck with the hurricane and good thoughts for Taco. We have all been overwhelmed and unsure especially in the beginning
Margaret and Pearl (GA)
Member Since 2020
Hi, Mary! My cat Pearl has asthma and I"ve been through a lot with her. Can you explain more about Taco's asthma to me? What I have read is that he got pulled off Flovent a couple weeks ago due to scabs etc on his nose area? In general, aside from the scabs, how was the Flovent working and were you giving it every 12 hours every day? And what dose? I do not know Cushings disease well. Is there any possibility the nose scabs are a reaction to the rubber on the inhaler, and if you wipe him off afterwards, they will not develop? I have seen pics of other fur babies who react to the rubber facepiece.
What is the current treatment regimen? I read above you administered Albuterol today. What else is Taco on for treatment?
I will that you that in my experience inhaled steroids do NOT affect BG, at least for Pearl. They are the safest steroids to give as for not affecting BG. I can show you about how you can test them on Taco if/when you're ready, so that you know whether it is likely his BG and the inhaled steroids have any correlation (Flovent and Albuterol in this category).
When there is an asthma attack or series of attacks, expect the BG to go up. The stress and anxiety of the trouble breathing is enough to shoot that BG up a good amount, and it will stay elevated while that extra stress in the lungs is present. For Pearl, this means when she gets an attack, her BG will show it (for a single coughing fit) for about 5 hours. I'm glad you administer Albuterol in those attacks too. But since there is an attack going on and we know that attacks raise BG, you can't tell in those moments if the Albuterol raises the BG too (it likely does NOT in my experience). I can show you too how to test that in non-attack moments.
I hope if Taco isn't on an inhaler (or nebulizer) that he is getting Pred. Pred will raise BG in a diabetic cat, but as someone told me when I was nervous about administering it to Pearl..."kitty gotta breathe", and yes we can always adjust the insulin dose. So the breathing comes first.
I hope this helps and I am happy to give more information on asthma that I have found in my journey. Pearl is on Pred now every 4th day (she gets inhaled steroids every 12 hours and an antihistamine for allergies that help expand her airways, and Azithromycin pulsed every 3rd day to keep upper respiratory infections away which affect her asthma and development of chronic pneumonia), but her asthma is tightly controlled. If Taco is on Pred now every other day (I think I read something in your condo about every-other-day steroid), how much? And in my opinion, if the attacks are not well controlled and he can't go back on Flovent, you might need more frequent Pred. One other option I have never tried but people have a lot of success with is a nebulizer box! Have you ever considered that as a way to administer inhaler steroids?
I hope this helps and so glad you found us here!!
What is the current treatment regimen? I read above you administered Albuterol today. What else is Taco on for treatment?
I will that you that in my experience inhaled steroids do NOT affect BG, at least for Pearl. They are the safest steroids to give as for not affecting BG. I can show you about how you can test them on Taco if/when you're ready, so that you know whether it is likely his BG and the inhaled steroids have any correlation (Flovent and Albuterol in this category).
When there is an asthma attack or series of attacks, expect the BG to go up. The stress and anxiety of the trouble breathing is enough to shoot that BG up a good amount, and it will stay elevated while that extra stress in the lungs is present. For Pearl, this means when she gets an attack, her BG will show it (for a single coughing fit) for about 5 hours. I'm glad you administer Albuterol in those attacks too. But since there is an attack going on and we know that attacks raise BG, you can't tell in those moments if the Albuterol raises the BG too (it likely does NOT in my experience). I can show you too how to test that in non-attack moments.
I hope if Taco isn't on an inhaler (or nebulizer) that he is getting Pred. Pred will raise BG in a diabetic cat, but as someone told me when I was nervous about administering it to Pearl..."kitty gotta breathe", and yes we can always adjust the insulin dose. So the breathing comes first.
I hope this helps and I am happy to give more information on asthma that I have found in my journey. Pearl is on Pred now every 4th day (she gets inhaled steroids every 12 hours and an antihistamine for allergies that help expand her airways, and Azithromycin pulsed every 3rd day to keep upper respiratory infections away which affect her asthma and development of chronic pneumonia), but her asthma is tightly controlled. If Taco is on Pred now every other day (I think I read something in your condo about every-other-day steroid), how much? And in my opinion, if the attacks are not well controlled and he can't go back on Flovent, you might need more frequent Pred. One other option I have never tried but people have a lot of success with is a nebulizer box! Have you ever considered that as a way to administer inhaler steroids?
I hope this helps and so glad you found us here!!
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MFairy
Member Since 2021
Wow!! That’s a lot of helpful info about the asthma. Taco has struggled with asthma for years. He is a flat faced cat so it’s been recommended that he have surgery to make his nostrils bigger etc but he’s never made it past the carrier drop off without going to the ER for a bad attack. He took 1ml Prednisolone daily for almost one year and had been doing much worse so the vet increased to 1ml twice daily then 1.5 ml twice daily. That’s when he had so many side effects we started weaning down but by then he had diabetes and all his blood work numbers were terribly off and he became jaundiced too.
Never tried the nebulizer I don’t know how that works with cats I will have to explore that. As for the inhaler I would wash his face and the plastic and he would bleed out of his nostrils so I think it’s the actual medicine. What is the antihistamine? Hmmm a lot to consider because I know if he was breathing better he would be less stressed overall. He also takes Turbutaline orally .5ml twice daily as a bronchodilator. And he just had a Convenia shot of antibiotics after the vet tried a bunch of other antibiotics to no effect. I never heard of pulsing the antibiotics? Can you tell me more?
MFairy
Member Since 2021
Oh and yes he was also on Flovent 2 puffs twice a day for almost one year. Sorry if I’m not being clear, we increased the oral steroid to compensate for taking off the inhalers
Margaret and Pearl (GA)
Member Since 2020
Hi Mary!
What is the Convenia for? In general, there are much better meds for upper respiratory or lower respiratory (or liver if it was given b/c of the jaundice). For URI, the drug of choice is Azithromycin. For lower respiratory (lung infections pneumonia and bronchitis), Veraflox class of drugs is excellent. The Convenia is nice b/c you don't have to try to give oral meds, but it may not help with the above areas.
Jaundice is liver. What did your vet say about liver values and how is Taco being treated? Do you know what Taco's values are by chance (ALT, ALP etc)? A low-hanging fruit hypothesis for liver is to treat an infection, and for that Veraflox or Baytril is an excellent choice. It may turn out to be something else with liver, but this is literally the most basic level hypothesis you can start with (and for all of my cats with liver, it actually has worked). What else is wonky on the bloodwork? Pancreas values ok? Does Taco have IBD by chance? I am asking to try to determine whether you might have some primary liver disease potential or maybe some kind of Triaditis going on (that is where organs in the same general area all get inflamed together).
When you say Taco (btw LOVE the name!!) gets 1.5ml Pred twice daily - can you write what the bottle says, how many mgs/ml? That is how we can determine what actual dose he is getting. He might not be getting that much Pred, it all depends on the mgs/ml.
I am pretty sure Pearl also got FD due to prolonged oral steroid use - she has had asthma for about 4 years now, and chronic pneumonia. It has been an awful journey, but in the past year we've had a lot of improvements. A couple new things we added in that have made ALL the difference - the Cyphroheptadine and the Azithromycin. Cyphroheptadine is the antihistamine (it's actually used by vets as an appetite stimulant, lol! The appetite stimulant is a side effect, but the drug is actually for allergies, and is particularly effective with asthmatics).
For the Azithromycin, Taco might really benefit from something like this as a flat-faced kitty. This is how we got on it: so, Pearl had pneumonia from Dec 2019 literally until August 2020. With hardly any break. We were on the Veraflox almost year-round. She would just get the "all clear" with x rays showing the infection was gone, and then it would recur. And I HATE keeping my cat on Veraflox in general (although it or Baytril are really very very effective - they are "big guns"). Finally, I noticed that she was having some small breathing issues before the full-blown pneumonia would happen. These were hardly noticeable issues and I never took her to the vet for them. But once she got on the Cyphroheptadine (it was obvious she needed that, her entire face was puffy, nose and eyes runny without it), she still had the small raspy or breathing noises. So, my vet suggested we do the Azithromycin for a course to see if there is a bacterial URI. She improved on it. Then my vet told me the beauty of Azithromycin is that it is actually one antibiotic you can stay on long-term pulsed and it helps. So, then we went to every 3rd day, and TO THIS DAY - my Pearl has not had a single pneumonia and only a handful of asthma attacks. Huge difference with the Cyphroheptadine and Azithromycin on board!
What is the Convenia for? In general, there are much better meds for upper respiratory or lower respiratory (or liver if it was given b/c of the jaundice). For URI, the drug of choice is Azithromycin. For lower respiratory (lung infections pneumonia and bronchitis), Veraflox class of drugs is excellent. The Convenia is nice b/c you don't have to try to give oral meds, but it may not help with the above areas.
Jaundice is liver. What did your vet say about liver values and how is Taco being treated? Do you know what Taco's values are by chance (ALT, ALP etc)? A low-hanging fruit hypothesis for liver is to treat an infection, and for that Veraflox or Baytril is an excellent choice. It may turn out to be something else with liver, but this is literally the most basic level hypothesis you can start with (and for all of my cats with liver, it actually has worked). What else is wonky on the bloodwork? Pancreas values ok? Does Taco have IBD by chance? I am asking to try to determine whether you might have some primary liver disease potential or maybe some kind of Triaditis going on (that is where organs in the same general area all get inflamed together).
When you say Taco (btw LOVE the name!!) gets 1.5ml Pred twice daily - can you write what the bottle says, how many mgs/ml? That is how we can determine what actual dose he is getting. He might not be getting that much Pred, it all depends on the mgs/ml.
I am pretty sure Pearl also got FD due to prolonged oral steroid use - she has had asthma for about 4 years now, and chronic pneumonia. It has been an awful journey, but in the past year we've had a lot of improvements. A couple new things we added in that have made ALL the difference - the Cyphroheptadine and the Azithromycin. Cyphroheptadine is the antihistamine (it's actually used by vets as an appetite stimulant, lol! The appetite stimulant is a side effect, but the drug is actually for allergies, and is particularly effective with asthmatics).
For the Azithromycin, Taco might really benefit from something like this as a flat-faced kitty. This is how we got on it: so, Pearl had pneumonia from Dec 2019 literally until August 2020. With hardly any break. We were on the Veraflox almost year-round. She would just get the "all clear" with x rays showing the infection was gone, and then it would recur. And I HATE keeping my cat on Veraflox in general (although it or Baytril are really very very effective - they are "big guns"). Finally, I noticed that she was having some small breathing issues before the full-blown pneumonia would happen. These were hardly noticeable issues and I never took her to the vet for them. But once she got on the Cyphroheptadine (it was obvious she needed that, her entire face was puffy, nose and eyes runny without it), she still had the small raspy or breathing noises. So, my vet suggested we do the Azithromycin for a course to see if there is a bacterial URI. She improved on it. Then my vet told me the beauty of Azithromycin is that it is actually one antibiotic you can stay on long-term pulsed and it helps. So, then we went to every 3rd day, and TO THIS DAY - my Pearl has not had a single pneumonia and only a handful of asthma attacks. Huge difference with the Cyphroheptadine and Azithromycin on board!
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MFairy
Member Since 2021
Ok so let me try to run through all this. Taco’s liver numbers were horrible, maybe I can post his lab work is there a way to attach something? He’s also slightly anemic but really has a lot going on so I’m waiting on a portable ultrasound appointment. Taco literally can’t go to the vet anymore. The last time the vet actually brought him back out to my car and to give him his rescue inhaler and only did quick labs. Taco tried Veraflox and azythromicin twice each and Clavamox too I think for maybe a whole month some time back but he continues to get respiratory infections. He takes Flagyl for diarrhea currently also.
Current Prednisolone dose is 1ml every other day 5mg/ml which we decreased due to the suspicion of Cushings disease the vet wants to get him off or lower as fast as possible.
Current Prednisolone dose is 1ml every other day 5mg/ml which we decreased due to the suspicion of Cushings disease the vet wants to get him off or lower as fast as possible.
Margaret and Pearl (GA)
Member Since 2020
When you say Taco tried Veraflox and Azithro "twice each" - what does that mean? How many doses/days did he try these things? Did he try each of those drugs for a month, or did you flip around from med to med (if so that could be the problem)? If he is getting continual resp infections, something isn't right. Not long enough on the medication, and/or needs long term. Azithromycin best for UPPER respiratory. Veraflox best for LOWER respiratory. Clavamox not really best for either. And is it upper or lower lung infection he is getting?
I see the horrible liver numbers - what is the medicine/support is he is on for it now? He needs stronger than Convenia. I vote for Baytril or Veraflox - can you tell me if you have tried these before for liver? They should work if any med is going to work for liver. Need to get on for multiple weeks, see if any difference is made. Did your vet diagnose anything officially with the liver?
If you go on your spreadsheet, there is a tab that says "labs". You can enter the numbers there, it would be great to see what is going on with our friend Taco!!
Ok, so 1ml of 5mg/ml every other day of Pred is only 5mgs every other day. That is a moderate dose of Pred if given daily. If this is the only med he is on to control his asthma, and it's not working, then something has to change. (For comparison, Pearl gets 2.5mgs every 4th day - but you've read the huge list of all the other stuff she takes daily). So, Taco really is not getting very much support for his asthma at this point. (Terbutaline works for some cats and for others does not work at all, so if you don't notice any differences on/off it, it may not be helping. ALSO Taco cannot be on Terbutaline and Veraflox at the same time they are contra-indicated). I would be inclined personally to do the 1ml daily of Pred daily. And then to see if the asthma is more controlled at that rate, and then to come down slowly with the daily Pred till you're at a smaller dose before you go to every other day.
What does your vet think is going on with Taco's liver? You mentioned portable ultrasound - do you know when they will be coming for that? The diarrhea could be IBD. And with FD you've got a compromised Pancreas. I would not be surprised if some kind of Triaditis is at play.I don't know a lot about primary liver disease, just about when liver disease is paired with pancreas and IBD. The ultrasound will really help.
Also, one more - sorry this is so info-packed. Is Taco on any pain meds? I think liver issues can be painful if I am remembering rightly.
This is a lot of info. Does this help at all?
I see the horrible liver numbers - what is the medicine/support is he is on for it now? He needs stronger than Convenia. I vote for Baytril or Veraflox - can you tell me if you have tried these before for liver? They should work if any med is going to work for liver. Need to get on for multiple weeks, see if any difference is made. Did your vet diagnose anything officially with the liver?
If you go on your spreadsheet, there is a tab that says "labs". You can enter the numbers there, it would be great to see what is going on with our friend Taco!!
Ok, so 1ml of 5mg/ml every other day of Pred is only 5mgs every other day. That is a moderate dose of Pred if given daily. If this is the only med he is on to control his asthma, and it's not working, then something has to change. (For comparison, Pearl gets 2.5mgs every 4th day - but you've read the huge list of all the other stuff she takes daily). So, Taco really is not getting very much support for his asthma at this point. (Terbutaline works for some cats and for others does not work at all, so if you don't notice any differences on/off it, it may not be helping. ALSO Taco cannot be on Terbutaline and Veraflox at the same time they are contra-indicated). I would be inclined personally to do the 1ml daily of Pred daily. And then to see if the asthma is more controlled at that rate, and then to come down slowly with the daily Pred till you're at a smaller dose before you go to every other day.
What does your vet think is going on with Taco's liver? You mentioned portable ultrasound - do you know when they will be coming for that? The diarrhea could be IBD. And with FD you've got a compromised Pancreas. I would not be surprised if some kind of Triaditis is at play.I don't know a lot about primary liver disease, just about when liver disease is paired with pancreas and IBD. The ultrasound will really help.
Also, one more - sorry this is so info-packed. Is Taco on any pain meds? I think liver issues can be painful if I am remembering rightly.
This is a lot of info. Does this help at all?
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I moved this post to Main Health as new members should not rush to the insulin support group. They need a little more time with the basics before they start posting in a more advanced setting found in the ISGs.
Mary, when you’ve got another week or so under your belt and are comfortable with testing and feeding, please join us in the LBL forum. We have specific Posting Guidelines there and you can take the next week to familiarize yourself with them. Keep in mind that your subject line, no matter where you are posting, should reference your kitty’s name so it makes it easier for those who have been helping to find you all. Thank you and welcome!
Mary, when you’ve got another week or so under your belt and are comfortable with testing and feeding, please join us in the LBL forum. We have specific Posting Guidelines there and you can take the next week to familiarize yourself with them. Keep in mind that your subject line, no matter where you are posting, should reference your kitty’s name so it makes it easier for those who have been helping to find you all. Thank you and welcome!
MFairy
Member Since 2021
Ok sure I am very computer illiterate so I am probably messing all this up. I will see if I can find the main health
You are on it. That’s where I moved this post.
MFairy
Member Since 2021
And he was definitely on both Turbutaline and Veraflox at the same time, so that’s concerning
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