10/28 Ming AMPS 457 or 25.4 / PMPS = 24.1 or 434

Previous: http://www.felinediabetes.com/FDMB/...14-7-ps-dosed-6-units-pmps-28-4-511-s.205492/

He’s loooowwweer!!!!! And he was being a nut half hour before breakfast. Playing with a paper ball I rolled up yesterday for him and bothering me for breakfast.

He’s back to sleeping now. At least he wasn’t looking eyes half closed and feeling horrible like he was last night before dinner.

I gave him 6 units.

And thanks @Sandy and Black Kitty and everyone else for the encouragement and reassurance. I’ve been crazy and freaking out all over this forum. Thank you for putting up with me and providing both advice and much needed hand holding!!!

 

You held the dose - well done!

Float on down today Ming...nice and easy...

 

Hang in there!

 

*cue dancing* YA YA YA

22.9 or 412 at +2

Slowly but surely

 

That's the way to do it! Keep it going Ming!

 

WOO HOO!! Sure makes us feel good when our kitties are feeling good, doesn't it?

Glad you went ahead and held the dose....let's see what it'll do!! We can always go up if we need to, but first we need to start from a stable depot

 

Yaaaa. Exactly. Increase after we figure out exactly what’s wrong. Less variables. Less headaches.

He’s feeling a little better and I’m feeling better too.

No change since +2. He’s still at 412 or 22.9 at +4.

 

Neggie in the k-tone area

 

The boy is staring daggers at me. I think he wants TREATS. He's walking around and oh, he just jumped on my desk lol. I'm testing in 15 minutes but this is a good sign.

"bhbg" - a message from Ming. I think he means thank you

 

DRUMRRRRRROLL PLEASE!

17 or 306 at +6!!!!!!!

It's working. It's working! *cries*

 

How wonderfull.

For most kitties this (+6 or about) is the nadir. So now they will start rising to next shot. This is normal. This is what is suppose to happen. So don't panic, don't get upset. Over time (different for everyone) all the numbers start getting lower.

Should vet ask, just say Ming is getting use to the lantus and your seeing results and leave it at that. Should they ask more then tell them, and say you researched use of lantus in cats and the doses need to be consistent to work properly. Again leave it at that.

If you look at other ss you will see the same thing. They start high, slide down, start back up. Like a roller coaster or the curve of a smile.

 

Got it! Yes I’m used to actually seeing him jump up with PZI after +6. I do wonder if he has a later nadir since last night he seemed to be lower near the end of his cycle but that’s probably just him absorbing the insulin maybe??

I think I can sleep well tonight

As for the vets, I told one of them already through text. No reply. I hope they don’t reply lol. The data speaks for itself

 

Could possibly have a later nadir. Getting tests later in cycle will tell you. But even that can change at anytime.

 

Yaaa it does seem like he’s a late nadir kitty. I saw that SOMETIMES during PZI so that’s why I wondered.

He’s at 15.9 or 286

 

Ahhh...floating on down...and yellow!
Beautiful!

Volumes.....

 

I was going through some threads in the main forum and I know someone asked if I have tried ondansetron before. I also went to my local raw food pet store and saw that they had CBD oil (Noah's Ark) but I know many have mentioned they use Charlotte's Web.

I'm just thinking.. there are all these options to help with nausea and pain... Should I jump on and use any of them? I probably won't use them until we get Ming's insulin resembling some form of regulation. Right now, he's getting cerenia everyday for 7 days and then one 16mg tab every other day.

Also, anyone particularly living on the West coast of Canada that uses these products?

 

I'm doubting myself again that I shot into the skin. Goooossh! He did "yelp" in protest. I have relion syringes that are very short. Good for the cat, but makes me doubt myself in times like these. I think I'll go see if Walmart or wherever has longer needles.

 

I also know some of you asked to test for Acro/IAA. Which I have not ask about with my vets. Kind of scared to. I need to do more reading up on it. All I know is they need higher doses?

I looked at a few member’s SS. Most seem to just use 1-3 units. Is there anyone that isn’t Acro that uses as high as a dose as Ming?

 

Not at the moment anyway......but as long as I've been here, when a cat has gone above 6U or so (and has been increased slowly) and been tested, they've always come up positive for one, the other or both.

 

There's more to know than just that the cat needs more insulin than most. If they're positive for acromegaly, there's lots of other health problems you need to be aware of and keep an eye on.

IAA tends to be self-limiting....usually if the dose is increased sanely, it reaches a point where it "breaks through" the resistance and they start coming down in dose. This usually is around a year.

They don't....they used to have 8mm needles, but the trend in insulin syringes is shorter and shorter needles so they only have the 6mm.....the "pen needles" that humans use with the pens are only 4mm!

Are you "tenting"?

 

*deep sigh* I'm just thinking could it be from infection that Ming's insulin needs to be higher. He was doing well with 4 units of PZI and I guess that's high?

Now we have the added thing with the steroids and two weeks of being high and unregulated.

I read that one symptom is increased proteins in the urine. I know he was borderline proteinuria in his last urine test last week.

Siiiigh siiigh siiigh. I'll definitely be asking the vet tomorrow about that. Actually, I'll probably email the IM specialist now and also "confess" to not following her dosage plan rofl. All in one go.

 

Infection and steroids can cause the BG to be higher....and it can take quite awhile to get steroids out of the system.

Just tell the IM that you just weren't comfortable giving that much insulin. You realize the risks and choose to do it this way.

If they don't like it, well....there's always that place where the sun don't shine

 

LOL!!!!!!!!

I'd like to keep good relations and I know myself: I hate lying. So "confessing" will make me feel better. I'm in the process of drafting the email and telling her what FDMB believes. I do hope I don't sound like I'm talking down to her or questioning her abilities (I mean I am but.. yknow). So I'm doing a lot of apologizing and being very ... submissive? LOL That's not the right word. I'm saying things like "I understand it must be frustrating and disappointing to hear that I did not listen to you recommendations" etc.

And then I'm going to suggest possibly doing a test for Acro/IAA. God. I hope it's just because he's so messed up with everything and his pancreas is just shot.

He did do an ultrasound but can they see things that point to acro in ultrasounds?

 

BK was the first FDMB kitty to test for IAA (insulin auto-antibodies) an idiopathic condition where the body views exogenous insulin as the enemy, then produces and dispatches antibodies which bind to the insulin making it unavailable to convert food into usable energy that under normal circumstances would be delivered to the cells. He tested positive - he had extreme insulin resistance.

Mings ss does not, to my eye, look like IAA. If you look at BKs ss, you will see it was 6 months before he saw green. His dose at that point was 9u Lantus and on that particular morning a 3u bolus of R. The green lasted about 3 hours and it was another 6 weeks, at which point he was at 12.5u Lantus along with 3-5u R, before he saw green again. He was mostly swimming in a relentless sea of pinks.

I would put testing for high dose conditions on the back burner for now. Once the dust settles, and you and Ming are in the groove with consistent dosing, then you will be better able to evaluate and decide if testing is needed.

 

Oh that makes me feel so much better, Sandy.

 

Cycle 3 of 6u

When a +2 is the same or lower than the PS, it could mean the cycle will be an active one so it's best to continue to monitor.

eta-I'm stalking your ss

 

Okay! I had planned to continue my monitoring of every 2 hours. But how do most people monitor? I just get really antsy and want to KNOW so that's why I was testing every hour haha!

 

West coast Canadian here, didn’t have CBD oils around at the time my kitty was here and not sure I would want to used them. There has been no research done on their use in cats and Colorado State University is the first to be researching their use in dogs. What type of pain are you trying to treat? I found acupuncture good for my girl’s arthritis pain, plus buprenorphine.

I notice you said he yelped at the shot. Keep an eye on that, might be a reaction to Lantus sting if you see it again.

As for testing, I determined when to test based on how high she was and how far in the cycle. He is dropping but not plummeting and still pink. You could probably wait three hours to the next test.

Neko was IAA and acromegaly. She saw green at a little over three units, and kept seeing it, then losing it. Never got up to nine units. ECID each cat is different. There have been acros on as low a dose as one unit, but the only cats I have seen over six units have either a high dose condition, or have not been tested for high dose conditions but with some symptoms, or been tested too soon after starting insulin and still have symptoms. There can be false negatives if tested within the first couple months of starting insulin. You don’t need to test right away for high dose conditions, let’s wait to see what happens to his dose now that things are more steady.

As for the vet, just say you want to follow a published dosing protocol followed by many others, including some on higher doses.

 

How folks monitor varies...work, commutes, family obligations, family participation....it's different for each of us.

I'm glad your work schedule afforded you the opportunity to closely monitor Mings transition to Lantus; the data you are collecting will be very valuable.
Of course none of this would have happened had you not followed your instincts to seek out something better for Ming.
And that one last requirement - taking the leap of faith that we know about FD and are not a bunch of crazy people

 

What???? We aren't?? I'm a proud crazy cat person!!

Sometimes you have to smile....this is a serious disease we're all fighting, but if all you do is worry, you'll drive yourself crazier than you already are.

 

Oh hi Wendy! I see you live in the North. I live where everyone has a rep for being bad drivers. Haha!!!!

I was just told by a few people back in PZI and also from NN about exploring CBD for his pancreatitis. I thought I'd ask about it. I'm a little hesitant too just because I'm a chicken. And it's expensive.

I also thought about acupuncture since one of the vets at work do it as well. But was told it's not usually used for pancreatitis.

It was when I stuck the needle in when he yelped. NN told me to poke him lower on the back to the side rather than the neck/scruff. She said it absorbs better but is more painful to poke. But yes, I will watch out to make sure it's not because it stings.

I wrote a long long email. I quoted some things from the forum from the stickies but didn't want to link her to here just because I'd like this to be a safe space. Although, I'm sure it would be very easy for her to find us. But I bet she's too busy anyway to take the time to do that.

We did actually talk about TR during our consult. It's why I felt SO good after talking to her. And then so incredibly SHOCKED at what in tarnation was going on with Ming in hospital. I know they felt it was necessary since his numbers were SOOO high during the AM but you'd think they'd look at the PM numbers and wonder why the heck was he dropping 200 points in 3 hours?! I told them two times what I was noticing! Gargh! Okay, I won't dwell on that anymore. It's over now. I have complete control over Ming's doses now and I'm happy. NN is super happy too. Did I mention enough that I love NN? LOL She's the voice I don't dare to admit I have.

We're not crazy but also we ARE crazy because you gotta be crazy dedicated and patient and knowledgable to be able to regulate these kitties. I find that for everything, the crazies are the people doing the thing best. I also have multiple fish tanks and LET ME TELL YOU: People come over or hear about what I do for my fish and think I'm insane. But everyone who is really serious about fishkeeping think its 1000000% necessary to do what we're doing. I'm talking about doing water changes every 5-7 days, putting a single goldfish in a 30 gallon tank, and having 2-3 filters running at the same time. (I have 6 goldfish in a 100 gallon tank that has 3 filters running. I change 90% of the water every 5 days. I also used to have 3 other tanks with a single betta/fighting fish in them with plants that needed CO2 systems. Needless to say, I became very poor, VERY FAST lol. Also my mom hated me because there were just tanks all over the house. But I know she secretly enjoyed them.).

Haha! No truer words written

 

Ming's mostly been sleeping all day. He had a couple of hours where he tentatively was walking about. But even now, just sleeping, sleeping, sleeping. I know cats sleep for 16 hours a day but usually he's following me around. In the first year I got him, he would follow me to the washroom down the stairs and then back up to my room. It was very annoying and I felt bad he had to walk down so many steps just to watch me pee for 2 minutes LOL!

Maybe he's just catching up on 2 weeks of little to no sleep and all the ups and downs of his BGs. I'm just so overly sensitive to everything he does these days. Ugh.

 

I shot Neko for five years around the shoulders/scruff area. I tried elsewhere, she told me to go back to the shoulders.

Lantus isn’t good for yanking down high numbers. It excels with relatively flat cycles when shooting lower numbers. With high dose cats we will sometimes use a bolus insulin, such as Humulin R, to bring the higher numbers down to a point where Lantus works better. Anyway, just tuck that thought away, not something for the short term for you, unless ketones show up again.

I read one of your earlier threads where you talked about where to buy insulin. Strangely enough, I found Safeway Pharmacy to be the cheapest in diabetic supplies. Though sounds like you are cross border shopping for syringes. I did that for test strips.

Neko had proteinuria. Have you had a urine protein creatinine ratio test done yet?

I did like using ondansetron. It and Cerenia target different nausea receptors. Sometime one or the other work better. Some cats need both.

 

But the numbers will lower over time right? The use of humulin is to jump start the process? I know you told me to tuck this thought away but lol! Now you got me curious!

Edit: I just re read your post for the third time and yes, I think you already answered my questions lol! My reading comprehension is out the window sometimes.

 

The IM specialist summarized things in her report. The culture came back negative. But here's her full report:

1. CBC and chemistry panel October 13, 2018: There was a neutropenia with a significant basophilia noted (I can’t tell if this was run through Idexx or an in-house lab machine) and there is no path review available associated with this lab work provided in the medical record. The chemistry panel demonstrated a hyperglycemia as expected a low serum albumin but a high globulin (albumin = 19 G/L, globulin = 50 8G/L). Albumin can be low as it could be acting as a negative acute phase protein in the face of pancreatitis. Globulins could be elevated secondary to systemic inflammation related to pancreatitis, occult infectious disease or occult neoplasia. Total bilirubin was borderline elevated. Serum lipase was elevated marginally most likely secondary to pancreatitis although amylase and lipase are not reliable indicators of pancreatic inflammation in cats. Liver enzymes were normal. Electrolytes were normal. On associated urinalysis glucosuria was present as was protein. USG was well concentrated at >1.050. Urine sediment was clean with no evidence of infection.
   
   
2. Repeat CBC with differential Idexx lab October 14, 2018: Total white count was normal. Total neutrophil and basophil counts were normal. Mild toxic change reported, platelets were normal.
   
   
3. Spec FPL–feline = 34 ug/L (normal reference range 0.0–3.5). This elevated spec FPL was consistent with pancreatic inflammation.
   
   
4. Urine culture and sensitivity true North lab–has returned negative
   
   
5. Repeat mini chemistry panel 10.16.18 normal creatinine, albumin, globulin, liver enzymes,
   
   electrolytes.
   

I probably understand like 10% of all of that.

 

Oh my god, again! Reading comprehension. I have no idea why I thought you asked if he had a urine culture.

 

@Wendy&Neko do you get onstdanstron from the vet or pharmacy? Do u need a prescription first?

 

It's a human drug...used for chemo patients that have trouble with nausea. It requires a script and can be bought at any human pharmacy

 

I wear my crazy cat lady hat proudly