PMPS 70, retest 74

Discussion in 'Lantus / Levemir / Biosimilars' started by Butterscotch's Pawrents, Oct 5, 2019.

  1. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    Aug 22, 2019
    Butterscotch is throwing us a curve ball again. We've been shooting the full dose in the low 100s lately and one at 95 a few days ago. This PMPS of 70 is throwing us off. So, for now we're going to stall and re-test in 30 minutes. Any advice appreciated.
    We haven't been doing as much testing as we would like because we've had a really difficult time getting Butterscotch to bleed for the past week or so. It's now taking us 2 to 3 pokes to get a drop, and she's been very irritable about the testing as well. As a result, we have not been making dose adjustments.
     
  2. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    Aug 22, 2019
    We have plenty of supplies and can stay up to test.
     
  3. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Let's see what's going on at PMPS!

    But usually, if you're able to test and have plenty of supplies, shooting those low numbers is a gift you should take advantage of!
     
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  4. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    Aug 22, 2019
    PMPS was 70. This is 25 pts lower than the lowest pre-shot she's ever had. Yes, we'll see what the re-test looks like. :)
    Are you saying it is okay to shoot that low of a number?
     
  5. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    On TR, we gradually shoot lower and lower numbers......I'd shoot China if she was 50 or higher.

    If you're not ready for that yet, you can skip tonight, but I hate for you to lose the momentum you've got going.

    Even if you were to shoot a lower dose tonight wouldn't guarantee she wouldn't drop too low if she's going to because the depot is still going to be influencing tonight's cycle.

    As long as you have plenty of supplies and can test as long as necessary tonight, shooting the scheduled dose is usually the best choice but you'll want to get a +1 and +2 so if you need to intervene, you can do it early
     
  6. Penelope and Mačka

    Penelope and Mačka Well-Known Member

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    Good luck tonight with the shooting and the testing too!
     
  7. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    Aug 22, 2019
    Re-tested at 74, 30 min later.
     
  8. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    So what are your feelings? You could stall another 30 minutes but that means adjusting your shot times over the next few cycles
     
  9. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    Aug 22, 2019
    Our main concern is that the change in the preshot is so sudden. Because of work schedules, we need to stay somewhat on schedule. Since we can monitor and feed overnight, do you think that shooting .25 less might be advisable?
     
  10. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Shooting less isn't going to guarantee she won't drop low tonight....the depot is still in play.
     
  11. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    Aug 22, 2019
    I know it prob won't help much but we cut dose by 1/4 and shot 2.5u
    Hopefully this goes well and then we won't be so nervous shooting the low numbers next time. Have to build up our bravery lol
     
  12. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Still get a +1 and +2 and I'll try to keep my eyes on you!!
     
  13. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    For sure! Thank you for helping this to not feel so scary.
     
  14. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    You bet!! We have a tradition here...the first few times someone shoots a lower number, if we encourage them to go ahead and shoot, we agree to be able to stay on and keep an eye on them (or find someone with experience who can)...if we can't, we'll tell you up front so you know you're on your own.
     
  15. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    Looking in too, we are in the same time zone, same state. I will keep watch.
     
  16. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    Aug 22, 2019
    +1 100
    We had to poke her 3 times to get a reading, and she was not happy about that!
    Given that it is so challenging to poke her right now, and that she came up a bunch, do you think that it would be reasonable to skip +2 and do a reading at bedtime... about 3 hours from now? We would also feed her after that test.
    Thanks! :)
     
  17. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    Poor Butterscotch! Are you comfortable with that? I will not be up in another 3 hours, and it seems like she is not dropping lower. You have the supplies to intervene if necessary.
     
    Dandelion likes this.
  18. Idjit's mom

    Idjit's mom Well-Known Member

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    Hello? Is that what you are going to do?
     
  19. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    Aug 22, 2019
    Yes, we appreciate your willingness to stay up with us. We'll do the +4 at bed. I think that we will be okay. :)
     
  20. Idjit's mom

    Idjit's mom Well-Known Member

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    Apr 3, 2018
    Ok, I hope you have an uneventful restful night, and Butterscotch doesn't get too cranky with you.
    Be sure to keep the ss updated in case things turn around later. Bron and Sheba in Australia usually checks in. Very experienced, knowledgeable and helpful.
     
    Chris & China (GA) likes this.
  21. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    I would really like to see another test no later than +3....the shot you gave hasn't even started to kick in yet.....Lantus doesn't usually start to kick in for 2-3 hours after it's given
     
  22. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    I hope you manage to get the +4. Or if you wake up during the night for other reasons, poke Butterscotch.
     
  23. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    Aug 22, 2019
    Thanks so much for checking in! Just got a +5, 87. Butterscotch is eating her midnight snack, now.
     
  24. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I’m around if you need any help later when the others head off to bed.
     
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  25. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    Aug 22, 2019
    Uneventful night, and AMPS 107.
    Unrelated to the low PS last night, she's been making us both sad lately. We know she's got something undiagnosed going on, as she's drinking around 300 mL per day, which has not resolved despite the lower BG for a few weeks. She's been especially grumpy, with lots of growling, and had little interest in going outside the past several days. Vets all just want to "wait and see." Super frustrating.
     
  26. Penelope and Mačka

    Penelope and Mačka Well-Known Member

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    Has she been checked for Kidney disease? (sorry if it was already asked before)
     
  27. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    Aug 22, 2019
    She's had full labs in March (no diabetes), August (diabetes Dx), and waiting on labs from Thursday (diabetes regulated) to come back. In March, vet said labs looked mostly unremarkable, but early kidney disease. We've had 3 other vets (2 at visits, plus a friend) say that her lab values are not indicative of kidney disease advanced enough to cause her symptoms, and that diabetes was not evident in March labs. We'll see what the new labs tell us. I am hoping for some sort of answer, but have little faith in the vets we've seen so far. The lethargy and water have gotten especially bad in the past week.
     
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  28. Penelope and Mačka

    Penelope and Mačka Well-Known Member

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    I hope you find an answer very soon, and that it’s not too serious :bighug:
     
  29. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    Aug 22, 2019
    Per her labs on Thur she has Stage 3 CKD and she isn't doing well at all. We are having an unbelievably awful time with every vet we've seen. In general they haven't been taking our concerns seriously and here we are now being advised to euthanize her. Our hearts are breaking and we are so angry that we could have been making an effort to slow her CKD since March at our first vet visit but were given poor information and false advice. We've started her on some subQ fluids for her comfort while we try to figure out where to go from here.
     
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  30. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Can you post the lab reports and @Marje and Gracie may be able to help you with ideas on how to help Buterscotch.
    If she is dehydrated the lab reports may improve who hydration.
    Stage 3 is very treatable.
    Some vets make me very angry. Is there another vet you can see.
    There is also a very good crf site with very helpful advice and support. I can't remember the full name of it but I'll text someone who might know @tiffmaxee
     
    Last edited: Oct 9, 2019
  31. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    Aug 22, 2019
    Her lab results are in our SS link and I just posted a brief synopsis on the main health forum.
    We have gone to several sites and are on data overload. I guess I don't know where to start or if anything I do will even help her.
    At this point we have seen 3 different vets in person and a 4th has done consults with us via email. We are feeling the financial burden at this point and have a loss of faith that any good vets are available to us.
    We would be grateful for any advice.
    So sorry if my responses are short. I am terribly exhausted and full of grief and anger. Our lives have revolved entirely around research and care for our furbaby over the last several months.
     
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  32. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I completely understand the exhaustion and grief.
    @Marje and Gracie know a lot about the lab results and will be able to give you some direction I am sure. Thanks for posting them in the SS
    Hang in there :bighug::bighug::bighug:
     
  33. tiffmaxee

    tiffmaxee Well-Known Member

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    The CRF site is http://www.felinecrf.org/

    I’ll take a look at the labs.

    Her phosphorus is high which will make her feel sick and have a picky appetite. You should try and find a lower phosphorus food she will eat or add a phosphorus binder. You can read about this on Tanya's site.

    One of my three year olds has EGC too. How are you treating it? My Mocha was switched to a different protein and has been good for over 11/2 years but now might be relapsing.
     
    Last edited: Oct 9, 2019
  34. Penelope and Mačka

    Penelope and Mačka Well-Known Member

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    I confirm it is treatable. Of course many vets will tell you to euthanize her, that's what they always say.
    Please don't be discouraged yet. It's really tough when you have a sick cat at home, and it lasts for months, and all your life revolves around them and the disease :( we all are in the same boat and it's consuming/depressing. You spend your life worrying. I'm so sorry.
    Some people more experienced with kidney disease will jump in and help you :bighug::bighug::bighug:
     
  35. Sonia & Leo

    Sonia & Leo Well-Known Member

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  36. Tina Marie (GA) and Jan

    Tina Marie (GA) and Jan Well-Known Member

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    I feel your pain. Tina and I are in a very similar situation, and have had very poor vet experiences (including the vet telling us her blood work was fine in February; he later said he thought the 500+ BG was stress; I was a fool to have trusted, I will now always request the bloodwork I paid for).
    Just today, I was shown how to give subcutaneous fluids, and am instructed to do so every other day (100ml). You can look at her labs I also posted today.
    You are at the best possible place - full of people who love cats, have a lot of experience and knowledge, and have also had their hearts broken. There IS hope though. That's what I believe. Love your cat now, and don't focus too much on those numbers. Something I noticed after Tina got the fluids, is that she literally ate with gusto, like I haven't seen in a while.
    I love research. However, I'm also exhausted and so tired of conflicting information (from vets too) when it comes to our cat's healthcare. I almost feel dumber instead of smarter at this point.
     
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  37. tiffmaxee

    tiffmaxee Well-Known Member

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    OMG, stage 3 CKD is very treatable. It’s overwhelming to have to deal with so many different illnesses but doable. I suggest you read on Tanyas a little at a time. Start with how to lower the phosphorus. I also suggest that you join the yahoo CRF group. You will need a yahoo account if you do not already have one. I just mine just for cat issues. Erika and Maureen are really knowledgeable about cat diseases and supplements needed to make Butterscotch feel better and live with kidney disease. :bighug:
     
    Last edited: Oct 9, 2019
  38. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    Aug 22, 2019
    We are very familiar with Tanya's site, it is a fantastic resource that we've been using since her first vet visit in March. Due to her pickiness at this point we have to just feed her whatever she will accept but we are ordering a phosphorus binder.

    Butterscotch got EGC lesions on her legs a lot initially that would mostly resolve on their own and then when she would occasionally get them on her lips or eye lid we had to give her steroid injections. She probably receive a total of 3-4 steroid shots in her life. Knowing that these might cause her to be diabetic (which they likely did), we went with dietary changes. We did a quality single protein source and grain free diet until her recent health issues and that diet seems to significantly reduce the number of lesions. We reserved the steroid shots for the ones on her lips/eye lids because once she got them there, they would never go away and would only continue to get worse.
     
  39. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    Aug 22, 2019
    We've been on Tanya's site and are trying to absorb all of the information :confused: Definitely working on choosing a phosphorus binder now. Thank you for the CRF group recommendation, we'll sign up there now.
     
  40. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    Aug 22, 2019
    We've had two vets actually try to tell us she didn't have CKD but just "normal older cat kidneys" and said they wanted to focus on treating her diabetes only. With the most recent labs, her new vet said her kidneys were fine, until we called back and said she was IRIS stage 3 and then he suddenly said her reviewed the labs again and that "her kidney's are really bad, she is close to needing dialysis, and that we should consider euthanizing her soon."
    Currently I am not terribly interested in her lab numbers themselves but I am heartbroken to see her looking and acting so ill. Like I just feel like at any moment all find her in a corner not breathing. She's been like this for months and steadily declining but none of the vets seem to recognize how awful her symptoms are and have been even when her labs weren't that bad. I just feel like none of them are actually hearing our concerns. And the last vet told us in the office she had quality of life and then 3 days later is telling us to euthanize. We are grateful to our fellow cat parents on here because otherwise we are feeling terribly alone and like we are trying to figure out her treatment entirely on our own. Doing all of the research and finding so many potential conditions is making my head spin.
     
  41. Butterscotch's Pawrents

    Butterscotch's Pawrents Member

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    Aug 22, 2019
    Having trouble finding the yahoo CRF group, do you have a link?
     
  42. carfurby (GA)

    carfurby (GA) Well-Known Member

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  43. Dandelion

    Dandelion Member

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    I haven’t visited these sites but found them while looking up CKD info after reading about your cat. Maybe they are the ones you are seeking.

    http://pets.groups.yahoo.com/group/tanyas-crf-support/ (This is connected to the .org site. )
    http://pets.groups.yahoo.com/group/Feline-CRF-Support/


    My kitty is diabetic and CKD also. Started phos-bind a while back and will get some labs soon. Hoping it’ll bring his phos number down and help him feel his best. Overall since achieving better regulation he’s physically much much better. Still working at it - only been 3 months - but so far it’s worth every single night of disturbed sleep.

    I have read some horrific stories about people’s experiences with their veterinarians and today I am feeling a gush of gratitude for mine.
     
  44. Sonia & Leo

    Sonia & Leo Well-Known Member

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    That was beautifully said Jan. xo
     
  45. tiffmaxee

    tiffmaxee Well-Known Member

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    Sonia & Leo likes this.
  46. tiffmaxee

    tiffmaxee Well-Known Member

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    See above.
     

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