Shaikha 5/3 AM & PM PS + HIGH AGAIN - help!

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wombat88

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I gave her shot an hour early yesterday, but PMPS was still higher than I'd like to see despite the higher dose. No interim readings taken. Though she's come down a little from the blacks she was getting, she's still in the 400s the past few days AM & PM PS (was >600 on Sunday). We increased her dose Sunday PM from 1.5 to 1.8. Am suspecting we'll eventually need to bump her back up to the 2 units I'd been giving previously. My friend came over last night and got trained on how to do blood tests on cat ears. Her father is diabetic, so she's familiar with the condition at least. She's going to email me daily with readings and I'll also give her the web address here so she can post if she gets stuck, and of course she's also got my vet to consult with. Am guessing she'll need to bump up the dose though after I leave since it has only been a few days on the higher dose. I leave Thursday, so Wednesday will be my last chance to do any type of mid-day tests.

She seems to be feeling much improved. I'm still giving fluids, but have been able to back off the buprenex. I think the antibiotics have also done the trick. Her stools are still less firm than they should be and one looked suspicious to me this AM. Will take her to the vet one more time for more blood tests tomorrow. He said he'd like to do more tests if she's still not 100% or if her anemia is not better, and I think that's a good idea. That's one of my biggest concerns right now, actually. I'd like to see her PCV (red cell count) get a healthy way above 20%.

+11 = 343
AMPS = 417, gave 1.8U
+3 = 210
+6 = 345 (well UGH! That's not good. This is several days in a row she isn't budging much from higher numbers)
+9.75 = 523 (double UGH -- back to blacks!)
PMPS = 562
 
Re: Shaikha 5/3 AM & PM PS + others

Rob & Harley said:
It sounds like you have a great plan in place. How long will you be gone?

Nineteen days, so it is a lot of time but it is for work and I have to go. I'm just hoping she stays relatively well while we are gone. Am hoping for a better set of numbers today because that may mean her pancreatitis is calming down some.

Wendy
 
Re: Shaikha 5/3 AM & PM PS + others

It's hard to leave when our kitties are not well, but you are certainly doing a good job of making sure she will be well taken care of.hope the trip goes well.
 
Ugh, well I just lost the post I'd typed up. Notice her pattern for today. She may have gone lower than 210 (at +3 today) but by +6 she was already above 300 and she is still climbing. With her in the blacks already, if I wait until +12 to shoot she'll be well over 600 again. Any ideas??? Is her dose still too low? Should I shoot a little early to avoid her from being really high for long? Ugh. I know her pancreatitis is complicating matters, but it just seems like we are not getting great control with this insulin and I'm not sure how to change that. She did seem to get better numbers with a higher dose though but don't want to change things too quickly.

She does see the vet tomorrow for more tests and of course I'll bring the spreadsheet. I do think she is feeling better, so am not sure if this is just an artifact of an unhappy inflamed pancreas or the dosing. Ideas???
 
You could go up to 2 units but that might give her a steeper drop. That +3 210 usually would suggest to me that the dose is a little high but you've been at this dose for 4 cycles now with no real changes.

I don't have any experience with TID. I hope Joanna comes by tonight, she can give you more info on that.

Have you started reading up on the L's?
 
Uh oh, I just scrolled w/o reading and then saw my name. :oops: Sorry I haven't been keeping up lately, and I'm not sure I can get my mind around the data. You got a 50% drop by +3, which is really quite a bit, but then higher #s after that. In a different cat, or with lower #s, I might think the dose is too high, but 1.5 looked too low, and the #s are just so high I'm not seeing where 1.8 is too big a jump, I really can't imagine you would see perfect #s on 1.7 or something.

She is really a mega-zoomer. Do you think that is coinciding with the pancreatitis? Could be from the Pred too I guess.

If it were me I would probably try a different insulin. If you have factors like steroids and pancreatitis flare-ups that may always lead to high #s when the insulin wears off, PZI may not be the insulin for her. I'm not saying it can't be done, but it may be a perpetual struggle. I love PZI, and I also think there are certain scenarios where it's not the best choice. I can't say conclusively that's the case here, just that if I had a kitty on steroids throwing whopper-high PSs regularly, I'd probably want to be on Lev.

Sorry not to be more encouraging, it's been a long day. Maybe on another day I'd have some better ideas for you for making PZI work for you.
 
Sorry to be responding so after the fact. Seems to me that it is OK to shoot an hour or so early under these conditions. That is not really TID dosing. More like what Angela and Henry were doing in playing with changing the hours of the 12 hour cycle a little.
 
Ugh, just lost another post. I can't figure out why it is doing that. I look like I'm logged in, but when I try to submit the post, it asks me to log in again and then I lose everything I wrote.

I think her pancreatitis is acting up a little. She started acting skittish again around dinner so I gave her buprenorphine and she is acting much calmer now, so I think she was in pain. She is eating okay, which is good. I started reading up about acute pancreatitis in humans and the symptoms really match hers. One thing that caught my eye was that in addition to fever and pain, and sometimes anemia, they also mentioned that you can get pale, oily-looking, foul-smelling stools if the pancreas isn't producing sufficient enzymes. The problem is that exocrine pancreatic insufficiency has similar symptoms to IBD, which she also has. Still, it might be worth checking for EPI just in case. Naturally all of this happens a few days before I leave the country. I'm not happy with her gum color, so I'm hoping her anemia is not worse. Trying to manage that from halfway around the world would not be a good thing, so I'm hoping I'm wrong.

I'm glad you chimed in Joanna. What we may need to do since I'll be gone is to just manage the diabetes the best we can, even if she isn't staying as controlled as I'd like her to be. Changing insulin types while I'm gone just can't happen, nor can shooting three times per day. Hopefully we can just keep her stable until I can get back here and try to figure out what to do.

Will let you all know what the vet finds tomorrow. I did shoot an hour early, by the way. She was still zooming up so I figured that wouldn't hurt. Will update her PMPS now and will try to retest her before bed to see if she dropped a ton or not like she did earlier. My guess is not. I think the problem we saw today is her pancreas going wild again.
 
Oh yeah, hour early is usually no big deal. If you get more than 2hrs early you should reduce dose (in general terms, not necessarily if you know your dose is too low). You always want a rising # when shooting early - if they are starting to zoom already then there you go.

Yay Bupe! Hope she stays feeling better, it sounds like you guys really have your hands full.
 
p.s. I learned a while back to highlight & ctrl-c copy everything before clicking on Submit. I haven't really had problems in months, but once I had some problems and got in the habit I have stuck with it.
 
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