Quick Gem update

Status
Not open for further replies.

jkbank

Active Member
Hi all
So I spoke to the vet very quickly, and he is not the one generally treating Gem so he's only sort of familiar with her case. Anyway, here's what he had to say:

*fructosamine was low 300's - he said that means that even though it's a bit high, she's fairly well regulated - I don't know what he means by that

*he wants to run a urine culture because whatever test they already did on her urine showed some bacteria. She's already had an antibiotic shot and is taking oral antibiotics (they really want to make sure she doesn't get an infection from the open wounds) so I don't know what else would be done if she does test positive for a UTI, but we'll see

*her cortisol level is still high, ideally we'd like to see that coming down, but it's only been 2 weeks on the trilostane. He is sending the results to Dr Peterson to look at, I assume he will have more insight into the numbers as far as that's concerned

*I asked whether he felt that the Cushing's and/or Trilostane would affect how her body handles insulin. He said no, other than that if the cortisol levels were more regulated, it would help the BG levels. I will follow up with Dr P on this as well

I still don't know what to make of Gem's SS numbers. Today's was really unexpected. This is hard, guys!!
 
One other question - will any food cause the BG to rise? I am giving her her PM medications at +11 because she is crying to eat but it's not time, and this holds her off for a bit. If I give her the meds with some lo-carb food (i.e. plain chicken) instead of pill pockets, will that cause her BG to go up, same as if I gave her dinner at that point? I'm trying to hold off on dinner til closer to shot time so I can test, feed and shoot, but I don't know if I would be throwing the test numbers off with a little bit of chicken.
 
Hi Karen

I am not terribly sure about the Fructosamine interpretation. I believe that the lab sends back a series of ranges for interpreting the results. A certain range of numbers will indicate good regulation or fair regulation or poor regulation. The tests gives an indication of average BG's over a period of time. It might give an indication if BG was high, but it won't tell you why it was high (dose too high or dose too low). I don't think it is necessarily a good tool for adjusting insulin dose, but vets love to do this test. It does give you (and the vet) some information. I think it is good that is was a pretty good result (according to your vet), rather than a worse one.

The urine culture is a good idea if her urine has already been suspicious for bacteria. The urine should be collected via cystocentesis (a needle through the abdomen and into the bladder) in order to get a sterile sample. I don't know if this will be possible for Gem? It may not be fruitful to do a C & S (culture and sensitivity) on a free catch sample, as there is a good chance that the sample will be contaminated. The test tells you not only if bacteria are present, but also the type of antibiotic that would be effective in treating the infection. It's possible that the antibiotics she has had are not targeting the bacteria in her urinary tract (if any).

I see on your SS that you mention laxatone. That may contain glucose, and may affect BG.

I think that any food may affect BG, but that a small amount of protein is going to have less effect than a big meal containing more carbs. You could open a thread in the Lantus Tight Regulation forum if you like. There are people there who use food in a very regulated way, in conjunction with insulin dosing, to maintain control over their cats' BG levels. You may get some info there about the effect of food on BG levels.

You are asking a lot of very good questions. I wish I had more to offer in the way of good answers, but getting more eyes on your thread might help.
 
I think you should pat yourself on the back for doing such a good job, Karen.

If her average BGs are around 150, then that's good.

Keep posting and we'll keep supporting. See ya over in the Lantus forum?
 
Cindy + Mousie said:
i'm not of much help as far as Gem's overall case but i can help with what the fructosamine number means. there is a conversion chart for fructosamine. so your 300 actually translates into an average bg level of 150 which is really pretty good all things considered. here's the chart i'm talking about
http://www.sugarcats.com/articles/Fruct ... on-charts/

Thank you, this is very helpful! Since I was standing on line at the bank while talking to the vet, I don't remember the exact number he said, but it definitely started with a 3! So based on those charts, she is anywhere from 150 - 210….that's pretty positive! Makes me rethink the dose lowering, but I know the fructosamine is not really that helpful in dose adjustments.
 
Linda and Bear Man said:
Hi Karen

I am not terribly sure about the Fructosamine interpretation. I believe that the lab sends back a series of ranges for interpreting the results. A certain range of numbers will indicate good regulation or fair regulation or poor regulation. The tests gives an indication of average BG's over a period of time. It might give an indication if BG was high, but it won't tell you why it was high (dose too high or dose too low). I don't think it is necessarily a good tool for adjusting insulin dose, but vets love to do this test. It does give you (and the vet) some information. I think it is good that is was a pretty good result (according to your vet), rather than a worse one.

The urine culture is a good idea if her urine has already been suspicious for bacteria. The urine should be collected via cystocentesis (a needle through the abdomen and into the bladder) in order to get a sterile sample. I don't know if this will be possible for Gem? It may not be fruitful to do a C & S (culture and sensitivity) on a free catch sample, as there is a good chance that the sample will be contaminated. The test tells you not only if bacteria are present, but also the type of antibiotic that would be effective in treating the infection. It's possible that the antibiotics she has had are not targeting the bacteria in her urinary tract (if any).

I see on your SS that you mention laxatone. That may contain glucose, and may affect BG.

I think that any food may affect BG, but that a small amount of protein is going to have less effect than a big meal containing more carbs. You could open a thread in the Lantus Tight Regulation forum if you like. There are people there who use food in a very regulated way, in conjunction with insulin dosing, to maintain control over their cats' BG levels. You may get some info there about the effect of food on BG levels.

You are asking a lot of very good questions. I wish I had more to offer in the way of good answers, but getting more eyes on your thread might help.

Thanks Linda

I am pretty sure they got her urine via cysto…I didn't bring the sample in, so unless they got very lucky and got a free catch while she was there, I'm assuming they went in and got it. Yes, I think that's what the vet was getting at - making sure they're using the right abx.

I do know about the laxatone, and had pretty much stopped using it, but I noticed that she hasn't had a BM in a while so I wanted to get things moving. I know miralax is the preferred choice here, but I had to go with what I had! I put a very small amount in her food this morning, so I thought that might account for that higher number. But the whole rest of her day has been a bit whacky so who knows!

I'm happy to post in other places but I didn't know whether those lantus forums were appropriate for me, given my testing limitations (though I've gotten a decent amount the past few days!). I certainly don't think Gem is a candidate for TR with everything going on, but if you think they wouldn't mind my posting there just for people to have a look at her SS, sure, I can do that.

Thanks so much, you are always so helpful, I really appreciate it!
 
Dyana said:
I think you should pat yourself on the back for doing such a good job, Karen.

If her average BGs are around 150, then that's good.

Keep posting and we'll keep supporting. See ya over in the Lantus forum?

Thanks as always for the support! Sometimes I feel so frustrated and confused that I am ready to throw in the towel, but I know Gem needs me (even though she runs from me now :(

See my post above re posting in a lantus forum…I don't know if that's the right place for me, I can't stick to the protocol to that degree.
 
Besides Miralax, I've heard you can also use a little vaseline, or a little butter.

I know, you may not get much dose advise because of the limited testing, but you can get some more eyes on a question, sometimes, in a busier forum. And if you need an answer quick, there's usually someone logged on and willing to help most hours of the day and night. The Main Health Forum is fine to use, too. :-D
 
jkbank said:
And what the heck is with a PMPS of 496???
Test error? Bounce? Mistake in lowering the dose??
Up 150 points in an hour. I'd say that is a bounce, or she got into something she shouldn't have. Kid's crackers?
 
jkbank said:
I'm happy to post in other places but I didn't know whether those lantus forums were appropriate for me, given my testing limitations (though I've gotten a decent amount the past few days!). I certainly don't think Gem is a candidate for TR with everything going on, but if you think they wouldn't mind my posting there just for people to have a look at her SS, sure, I can do that.

I don't think that they would mind at all! You don't have to be doing TR to post there. You can give a summary of your situation and your limitations, ask for input on your SS and dose, and ask your other questions. People will help as much as they can.
 
Dyana said:
jkbank said:
And what the heck is with a PMPS of 496???
Test error? Bounce? Mistake in lowering the dose??
Up 150 points in an hour. I'd say that is a bounce, or she got into something she shouldn't have. Kid's crackers?

I don't think so, she was never one for people food. She did have her meds in there, so 4 chicken flavor pill pockets, and I tossed her a few teeny pieces of plain white mean chicken. The pill pockets are a constant before the PMPS so that shouldn't cause such a larger fluctuation than any other day, I would think?!
 
Linda and Bear Man said:
jkbank said:
I'm happy to post in other places but I didn't know whether those lantus forums were appropriate for me, given my testing limitations (though I've gotten a decent amount the past few days!). I certainly don't think Gem is a candidate for TR with everything going on, but if you think they wouldn't mind my posting there just for people to have a look at her SS, sure, I can do that.

I don't think that they would mind at all! You don't have to be doing TR to post there. You can give a summary of your situation and your limitations, ask for input on your SS and dose, and ask your other questions. People will help as much as they can.

Thanks, I know everyone here has been so helpful! I posted in the loose lantus forum to start, we'll see what they have to say!
 
Status
Not open for further replies.
Back
Top