? To shoot or not to shoot? + infection affecting BG?

[Nat & Fluffy]

!!! Oh my goodness, so my mom forgot to tell me that my cat Fluffy was given antibiotics for a possible suspected infection?

I have to papers here too from the blood test and it says: "PLT Aggregates Detected" "Band neutrophils suspected" "nRBCs suspected". His PLT readings were a little bit low, but otherwise than that, and the high BG, there is nothing else wrong. She said the vet wanted to make sure this possible infection was gone so he gave Fluffy antibiotics at the same time he took the blood test on Oct 5th, yesterday, when he was also diagnosed again with diabetes, which broke my heart to hear him go through this again

??? I know that infection can actually cause BG to rise? Or the BG rising caused him to be more susceptible to infections? And his kidneys may be starting to get a little weak because he's had diabetes before and he is 16 nearing 17 in March who knows... is it too soon to tell?

Anyways for the backstory, my cat has been in remission for quite a long time if you see his spreadsheet, almost a year, and then somehow he got diabetes recently, took him to the Vet, and my mom and I have been coordinating watching him since I'm going to college as well. My mom gave him his shot around 8:30 today of <0.5 U, but she says she might have missed it because she is very new to putting the shot in and taking care of a sugar kitty (I was the one who did everything when he had diabetes way long ago because I was home and not at college at the time). Seeing his numbers, I gave him 0.5 U at +6 day and I will be schedule to give him his once-every-8hr-dose in about an hour.

What do you think? I'm going to test him in an hour when his shot is schedule but I just wanna be sure what dose and everything. I'm thinking I might have to keep it at a little less than <0.5 U if it's climbing back to like 160 or 170 or something, but I fear that's too much... maybe like 0.25...

Maybe I should call my vet to go over with me about this possible infection tomorrow. I feel like his diagnosis may have been a result of his infection. But what do you think?

 

[Callie & Patches]

An infection can have a big difference in their BG. The sugar in their urine can increase the chances of getting a UTI. Calling your vet is always a good idea.

 

[Critter Mom]

With antibiotic treatment in progress you need to be extra-vigilant with BG testing, Natalie. As the infection resolves BG can start going back down to better levels without any warning.


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[Nat & Fluffy]

@donnalea and @Critter Mom thank you so much! Yesterday when I got home I did testing every two hours. His levels were doing fine until I checked this morning twice at 5 am; around 222 and 247 I don't know if it's a rebound because when I gave him 0.25 U of Novolin last night at 10 pm, his levels were 157. I kinda wonder if I should have refrained from giving him any of his dose last night. I would've given him his dose of 0.25 at 6 am, but I had to leave at 5:15 am, and my mom didn't get up to give his shot until 8 am... ugh... I figured better safe to wait so he doesn't go hypo.

My mom still hasn't gotten the hang of testing when I'm at school in the morning and early afternoon :/ But she's gonna try. I'll be at home this evening with Fluffy and staying until Monday night/Tuesday morning, so I'll be watching him very carefully.

I'm telling her just to keep an eye out if he starts acting very shaky and to give me texts throughout the day, as well as trying to see if she can attempt at BG testing every few hours (my poor mom says she got so nauseous poking his little ear!). We have dry food, treats, and syrup in case he goes hypo.

Today I'm going to call my Vet and see if he can talk to me about the antibiotics and his infection. I'm also ordering Lantus today from Canada. I've been running for the past few days on 3-5 hrs of sleep D:

 

[Critter Mom]

I've not used Novolin N so can't share any experience with you on that side of things but I do know that especially with an infection it is important for a diabetic kitty to get some insulin. I suggest ringing your vet to discuss what would be a suitable token dose for periods when Fluffy may not be as closely monitored.

Are you testing daily for ketones? If not, then I recommend that you do so (e.g. with Keto-diastix). Because of the infection and perhaps needing to token dose at times it's even more important to check that Fluffy is ketone-free.

Good news about the Lantus. When that arrives you'll be able to get much more help with dosing, etc; the L&L support group is very active and there are a number of very experienced members in it.

My mom still hasn't gotten the hang of testing when I'm at school in the morning and early afternoon :/ But she's gonna try.

Sending a big to your mom, and a for you, too.


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[Nat & Fluffy]

I've not used Novolin N so can't share any experience with you on that side of things but I do know that especially with an infection it is important for a diabetic kitty to get some insulin. I suggest ringing your vet to discuss what would be a suitable token dose for periods when Fluffy may not be as closely monitored.

Are you testing daily for ketones? If not, then I recommend that you do so (e.g. with Keto-diastix). Because of the infection and perhaps needing to token dose at times it's even more important to check that Fluffy is ketone-free.

Good news about the Lantus. When that arrives you'll be able to get much more help with dosing, etc; the L&L support group is very active and there are a number of very experienced members in it.


Sending a big to your mom, and a for you, too.


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Ugh my mom isn't able to watch him because she has to take my brother to the doctor for a fever!!!

I have no idea when she'll return home but I'm guessing before his potential scheduled shot at 4 pm today because that's when she has to pick up my other brother from school around 3:30. I'm hoping the morning 0.25 will not make him dip far, it hasn't seemed to do that ever in his entire history of diabetes. Fluffy has only went in hypo levels in the past when I didn't know squat about diabetes and vet said to give him 2 Units to start out with Dx

The hospital said Fluffy's vet will call back today and go over the lab results in detail with me since I was not present there when he is finished with his appointments. Whew!

Thank you for the support!! <3 Fluffy and I need it so much!

 

[Critter Mom]

(((Nat & Fluffy)))

Hope your brother feels better very soon.


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[Callie & Patches]

I wouldn't worry so much. I usually don't test so often unless I'm doing a curve or watching because low numbers. The numbers look ok. Just give the smaller doses until you hear from the vet. Try to get some sleep. You won't be any good for Fluffy if you're exhausted.
Take it easy on your mom. She doesn't need to be testing all the time. The test before eating and the shot is the most important. A late shot is ok. You can only do what you can.

 

[Nat & Fluffy]

I wouldn't worry so much. I usually don't test so often unless I'm doing a curve or watching because low numbers. The numbers look ok. Just give the smaller doses until you hear from the vet. Try to get some sleep. You won't be any good for Fluffy if you're exhausted.
Take it easy on your mom. She doesn't need to be testing all the time. The test before eating and the shot is the most important. A late shot is ok. You can only do what you can.

@donnalea thank you so much for the support I need someone to tell me that! I am so grateful beyond everything for my mom's help. She really is trying hard. I can't imagine. She has my two other brothers to take care of and I understand they're first priority.

 

[Critter Mom]

Not to put a downer on things but for Novolin the mid-cycle tests are important too, Nat - especially with antibiotic treatment on the go at the moment. Try to get them in as best you can (and yours is a good best!).




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[Nat & Fluffy]

@Critter Mom you can count on me!! My vet called me back and we talked for about 20 minutes. He says that when I get Lantus, he recommends starting on 2 U once every 24 hours o.o From all the readings I've done, that doesn't sound right o___o I thought starting off with a small dose and once every 12 hours is what is supposed to be done.

I've ordered the Lantus, fingers crossed that it arrives soon.

 

[Critter Mom]

He says that when I get Lantus, he recommends starting on 2 U once every 24 hours o.o From all the readings I've done, that doesn't sound right o___o I thought starting off with a small dose and once every 12 hours is what is supposed to be done.

Correct. Lantus is best started on a low dose (based on weight of the cat) and should be dosed every 12 hours. Dose adjustments are done in small increments (typically 0.25IU).

I've attached a copy of the published Roomp-Rand tight regulation study below. I assume you're already working your way through the stickies at the top of the Lantus & Lev board. You'll see info on the Tight Regulation Protocol and also the Start Low, Go Slow treatment method developed at FDMB. Whichever treatment route you decide to go with for Fluffy, it might be worth using the Roomp-Rand document as a basis for discussion with your vet about your concerns over starting dose and dose frequency before you actually start giving Fluffy the Lantus. Rand is a veterinary professional and a world authority on feline diabetes so the study should carry the necessary weight with your vet in terms of the legitimacy of its dosing recommendations.


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[Nat & Fluffy]

@Critter Mom WOW! This pdf is GREAT. I'm going to share it with my Vet and discuss with him this plan when Lantus arrives. Hopefully he doesn't think I'm trying to undermine him, he's been incredibly helpful and so detailed in answering my questions, but this should be effective.

I'm having a lot of trouble keeping on a regular schedule with Novolin because of outside issues (If only the Lantus could arrive quickly!!!) My chart looks all messy and his numbers don't look so good but I guess I have to be patient... Poor Fluffs. I'm going to try to get some ketone testing kits tomorrow.

The next four days I'm here, the doses will be at 11 pm, 7 am, and 3 pm. I'll make every effort to come home during Tuesdays thru Thurs, but Wednesdays I definitely can't, and so mom will have to dose him at 10 pm instead of 11 pm, and might have to dose him also between 7-8 am because of her schedule. It's the best we can do.

 

[Nat & Fluffy]

!!!!!! Fluffy was at 400 this morning! So I gave him 0.75 U...

I'm wondering if he keeps rebounding during the night because I'm not there to watch him Is this insulin doing any good??? I think his numbers drop way too fast on this stupid thing and causes his numbers to quickly spike up. I don't know. Last night at 10:30 I gave him <0.25 because he was at 152... Maybe I should have refrained from shooting him then...

If the numbers are dropping to 150 during the time of his next dose, should I not give him any insulin? Just to see what happens? I'll be testing excessively today! Poor Fluffy's ears, I don't even have to warm them up because they bleed so well now!

 

[Dyana]

I agree with the testing at mid-cycle. He probably went lower or lower too fast last night and bounced this morning.
I am not experienced with using N, but when you start Lantus, you want to keep the dose consistent every 12 hours and depending on the method or protocol you choose to follow, you would keep the same dose for a certain amount of days. With Lantus, it is not the pre-shot tests that determines the dose, but the mid-cycle tests. The dose adjustments with Lantus are based on how low the insulin takes the cat during the cycle.

 

[Nat & Fluffy]

I agree with the testing at mid-cycle. He probably went lower or lower too fast last night and bounced this morning.
I am not experienced with using N, but when you start Lantus, you want to keep the dose consistent every 12 hours and depending on the method or protocol you choose to follow, you would keep the same dose for a certain amount of days. With Lantus, it is not the pre-shot tests that determines the dose, but the mid-cycle tests. The dose adjustments with Lantus are based on how low the insulin takes the cat during the cycle.

Thank you @Dyana . I've been hearing so much wonders from Lantus. If it could ship faster that would be great I can't stand watching my cat stay in high numbers and dip down low so fast. I'm trying to get lowers doses, and to feed him lots before he dips too steep, and he seems to be doing okay so far besides occasionally seeming uncomfortable in high numbers. I might just skip dosing all together if his numbers are around 150 at 3 pm today.