Pmps 105?

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Priss

Priss

Member Since 2012
Hello,

I was wondering if someone could help and take a look at our sheet for the last few days. Priss has had preshot numbers from 280 to the lowest today at +10 110 and preshot 105. I skipped her shot a couple of times but am concerned she'll end up with ketones again. She had DKA this December and the vet said to raise her to the 1.5. This weekend when I'm off work I'll be able to do more blood tests during the day. Do you think she is ready to go from 1.5 to 1 unit again?

Thank you,

Elizabeth
 
Priss said:
Hello,

I was wondering if someone could help and take a look at our sheet for the last few days. Priss has had preshot numbers from 280 to the lowest today at +10 110 and preshot 105. I skipped her shot a couple of times but am concerned she'll end up with ketones again. She had DKA this December and the vet said to raise her to the 1.5. This weekend when I'm off work I'll be able to do more blood tests during the day. Do you think she is ready to go from 1.5 to 1 unit again?

Thank you,

Elizabeth
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Good morning Elizabeth - some more experienced folks should be by in a bit to help you with this because I'm not a dosing expert. I took a look at the spreadsheet and will make two comments. Whether you are using the tight regulation or the relaxed protocol, because of the way Lantus works in the body, its the nadir (lowest part of the cycle) numbers that determine dosage adjustements - not the preshot numbers. So it will be a lot easier to judge when you are able to get the midcycles.

The other thing is that Lantus builds on itself, so it works better if you give a consistent dose and hold it for a while while the "shed" fills - I see that you've been changing the dose around based on the preshot numbers. You might not have to do that so much if you go down in dose.

Every cat is different but I wouldn't worry about ketones with the the numbers you've been getting. The frutosamine test back then was over 500 and your cats been running a much, much lower average BG currently.
 
Just a suggestion: why don't you post in the Tight Regulation user group something about help with dosing? Maybe a subject line, like "need help with Lantus dosing" and use the "?" icon....I am sure there are/will be experienced advisors online today who can help you.
 
It is really hard to tell what is going on without a lot of midcycle tests, but since you are having to skip shots because of low preshots then my best guess is that she is going lower yet in the middle somewhere.

With no more nadir checks that are on your spreadsheet and the fact that she has already had DKA I'm not terribly comfortable suggesting that you reduce down to 1u, I think I would probably if she was mine reduce to 1.25u and see if that gives you two shootable numbers at both am and pm shot times.

Mel, Maxwell, Autumn & The Fur Gang
 
Hi Mel,

The vet asked I check her over today also, I updated my spreadsheet. She didn't eat after the morning. I noticed with my cat she seems to keep going down sometimes, not a curve going down then back up. Today she started at 277, then 280, then at 6 hours 109, now at preshot 106. Back in January the same thing happened but it was about 230-93 over 12 hours. Are some cats just this way or do you think its due to too high a dose?

Thank you,

Elizabeth
 
Actually it could be a couple of things...either she just has a very late nadir, or the dose is too high. But since you are having to skip shots because of those lower than normal preshots I would back her off to 1.25u and see if that gives you two shootable numbers both am & pm

Mel, Maxwell, Autumn & The Fur Gang
 
Hi Mel,

We're going to go ahead and try that I guess you eyeball between 1 and 1.5 markings? She's been drinking a lot of water lately and I'm concerned its because of having to skip shots. Plus she's been picky about her food so I had to change to a different variety. We checked for ketones Saturday and clear there, but will try again today. She had DKA twice before and I won't be able to afford the vet bills again so get a little scared about reducing the dose. She ate more today so I'm hoping that's it.

Thanks,

Elizabeth
 
Unfortunately I checked her urine and she has ketones again. Hopefully the vet will let us give fluids at home since we can't afford another vet visit.
 
So sorry to hear she isn't doing well. :YMHUG:

Mel can give you some advice if you can get your vet to teach you how to give fluids at home, as Mel has done this before too. That will save you a ton of $$ if you can do it yourself, just like running your own curves, vets charge a fortune.

Best of luck and many prayers for you and your Sugarcat.
 
Thank you Debbie. I just spoke to one of the vets from the hospital and they will give me the fluids to do at home tonight. We did it before when she had DKA so luckily have some experience on it and at least caught it early this time.
 
Priss said:
Thank you Debbie. I just spoke to one of the vets from the hospital and they will give me the fluids to do at home tonight. We did it before when she had DKA so luckily have some experience on it and at least caught it early this time.
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I'm glad they are willing to work with you...I understand totally about the cost thing......and I have no doubt your experience and willingness to do what's necessary at home will be every bit as useful as putting her through the stress of the vets.
 
If you need any extra needles for giving sub-q fluids I have about a dozen here left from my girl I lost to DKA. How high was the ketone test?

Mel, Maxwell, Autumn & The Fur Gang
 
Thank you Mel the vet gave us 10 needles and a bag of fluids. When I tried giving her the fluids she threw up a hairball and some food from this morning. We're giving her 100cc a day. Hopefully she pulls through OK. We have the CVS generic strips and according to that its moderate or 40, I don't think its exact because its a shade of purple. After this I think I'm getting the blood monitor and might try giving her some higher carb food during the day when I can't monitor between shots since I heard from someone that could be a good idea with how ketone prone she is.
 
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