? Theodore -11/20 PMS 407 +1 272

[NadineTheodore]

Hello,

I have an appointment with internal medicine Wednesday. For the first time I am actually seeing movement in a positive direction for Theodore so I am thinking of canceling it as I don't want to stress him out while we have a good thing going. My vet just wanted another ultrasound as she thinks he will have cancer since it's common with FIV+ cats. However it's very expensive seeing the specialist with ultrasound and stressful plus the Canadian winter has officially started so I rather not stress him out if I do not have to Just wanted some feedback from everyone here if they think it's worth keeping his appointment. For the acro test, I can simply do it at my local vet 5 mins away since it's simple blood work but I am not sure I even need to give his results are looking better?

Please advise. Also should I be reducing .25 giving nadirs are low?

Just to be clear, no real reason to suspect cancer other than FIV, only things odd on his ultrasound last time was slightly larger organs i.e. spleen, liver, and one kidney...but he's a larger cat too and those organs were mostly larger when we compared to an old X-ray from 2019 the vet had on file

 

[tiffmaxee]

First, with SLGS you reduce at the next cycle if ever the BG drops under 90. With TR when using a pet meter reduce if under 68 so please reduce to 5.0. I would gave retested they +2 this morning as they as is a huge drop and might have been a bad strip.
If he is acting well I would not stress him with a vet visit.

 

[Wendy&Neko]

I agree with Elise. I would have retested that +2 this AM. Especially since Levemir onsets well after +2. It's hard to tell from the spreadsheet, but it looks more like the Lev onset is at least +3 for Theodore. Have you ever thought of using a Freestyle meter with the FS strips. Some of the numbers you've been getting do look wonky. Plus the AT2 is no longer supported.

When doses are over 5 units, we usually suggest changes by 0.5 units, so that means going down to 5.0 units, then if he earns another reduction it would be a 0.25 unit change.

Out of curiosity, have you tested his ketones lately?

There is some reason Theodore's dose got up to 6 units. Would be good to know why, and if there is treatment for whatever it is. My vet has a travelling ultrasound vet who comes to her office. Would be much easier (and cheaper) if your vet had the same. I wouldn't do an ultrasound just on the possibility he might have cancer, unless there were other signs it's a possibility. Has he had blood work lately? Is he eating fine?

 

[NadineTheodore]

First, with SLGS you reduce at the next cycle if ever the BG drops under 90. With TR when using a pet meter reduce if under 68 so please reduce to 5.0. I would gave retested they +2 this morning as they as is a huge drop and might have been a bad strip.
If he is acting well I would not stress him with a vet visit.

Thank you I was thinking of cancelling as well but I feel guilty as a bad parent as there's always the what if...truthfully I think the vet just wanted to be extra cautious but it seems he's doing good. Theodore behaviour wise has been so well and to take him to the internal specialist will be a long 45mins -1 hour each way that's why I was really dreading the stress for him

 

[NadineTheodore]

I agree with Elise. I would have retested that +2 this AM. Especially since Levemir onsets well after +2. It's hard to tell from the spreadsheet, but it looks more like the Lev onset is at least +3 for Theodore. Have you ever thought of using a Freestyle meter with the FS strips. Some of the numbers you've been getting do look wonky. Plus the AT2 is no longer supported.

When doses are over 5 units, we usually suggest changes by 0.5 units, so that means going down to 5.0 units, then if he earns another reduction it would be a 0.25 unit change.

Out of curiosity, have you tested his ketones lately?

There is some reason Theodore's dose got up to 6 units. Would be good to know why, and if there is treatment for whatever it is. My vet has a travelling ultrasound vet who comes to her office. Would be much easier (and cheaper) if your vet had the same. I wouldn't do an ultrasound just on the possibility he might have cancer, unless there were other signs it's a possibility. Has he had blood work lately? Is he eating fine?

I will likely switch to using the FS lite just worries me as the numbers are typically lower and I get worried.

Theodore has no ketones and eats well but not as much as he used to (I think this is positive because you would think I was starving him before). I increased him to 6 units after his Lantus stunt because it seemed he was not responding to 5.5 units although I am thinking this was just a bouncing effect looking back?

No suspicions on cancer just the likelihood that FIV+ cats are greater risk plus some organs larger than normal. That said he is a LARGE cat. His numbers more less okay on blood work. Last test was September 2023. ALP was slightly elevated at 90, UREA was 14.9 but she thought that was dehydration due to diabetes as IDEX and creatinine were normal. The vet said she wasn't really loving their mobile ultrasound tech as well that's why she wanted me to see the internal specialist but just not sure it's worth the stress for him. I don't want to send him wonky again.

 

[NadineTheodore]

First, with SLGS you reduce at the next cycle if ever the BG drops under 90. With TR when using a pet meter reduce if under 68 so please reduce to 5.0. I would gave retested they +2 this morning as they as is a huge drop and might have been a bad strip.
If he is acting well I would not stress him with a vet visit.

I retested just now, alpha track read 8.7 and Freestyle Lite was 12.3. It's a little odd as freestyle usually is a little lower..

I should add that I poked twice so not necessarily the "same sample" but taken 30 seconds apart

 

[tiffmaxee]

You don’t need to test twice unless like this morning when the reading dropped so dramatically from 338 to 83 at +2. That’s not a normal drop especially with lev which doesn’t normally onset at +2.