2/22 Sabrina AMPS 367, +2.5 329, +3.75 348 ????

Discussion in 'Lantus / Levemir / Biosimilars' started by milfordcollector, Feb 22, 2015.

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  1. milfordcollector

    milfordcollector Member

    Joined:
    Nov 15, 2012
    Sabrina's 2/21 Condo
    Good Afternoon LL I am kind of at a loss as to why Sabrina is staying high with a pretty much flat curve. I increased her dose to 1U to try to break this cycle. Is there some data that I might be overlooking?????? Opinions, thoughts appreciated....... Cindy & Sabrina:cat:

    2/22 Recap:
    AMPS 367 1U - ketones 1.6
    +2.5 329
    +3.75 348 :confused:
    +5.25 350 - Sub Q fluids 100ml (squirming, will give add'l 50 ml later)
    +8.25 225 - Additional fluids given
    +9.75 162
    +11.5 155 - Ketones .3 :woot: keep them going down!!!!!!
    PMPS 159 1U
     
    Last edited: Feb 22, 2015
    Reason for edit: update data
  2. lovey11

    lovey11 Well-Known Member

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    Aug 6, 2013
    How is she feeling? Is she eating OK?

    I know wen they are high for awhile even a few weeks. It sometimes take awhile for them to get back to better numbers. It is good you increased. I pray for a breakthrough for Sabrina.

    I am not too familiar with ketone levels. What is 1.6 signify? light
     
  3. milfordcollector

    milfordcollector Member

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    Nov 15, 2012
    Hi! She's eating ok & just gave her sub q fluids a little while ago. Yes the ketones are light, more than a trace but can climb quickly with elavated bg's . This is the second time in 6 months she went into dka & I don't think she's bouncing back as quickly as the first time......maybe I'm worrying too much & have to put on my patience pants, which is extremely hard to do right now......:confused:
     
  4. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    I think going up was the right decision too

    Especially when dealing with DKA, we want to be sure not to hang onto a dose too long that's not getting Sabrina where she needs to be
     
  5. Vyktors Mum

    Vyktors Mum Well-Known Member

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    Nov 15, 2011
    Work that extra juice Sabrina. Sending special ketone strangling vines your way.
     
  6. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    With ketones in the picture, you want to get the maximum amount of insulin in, even if you have to give high carb in order to do so. it was good you increased the dose. I'd just give it 6 cycles total (4 more after the 2 you've already given) and re-evaluate to see if you need to increase again. I wouldn't rest on any dose longer than that, at this point. Remember green is the goal - there's none on her ss in 2015. Normal numbers (50-120) don't prevent ketones, but part of the ketone equation includes "not enough insulin" and higher blood sugar is one indicator of that.
    • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
      • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
      • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
     
  7. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    Oh, I meant to address the first part of your question - why is she remaining high? She very likely has Glucose toxicity, where her body has become accustomed to high blood sugar and is now accepting it as the norm. Once a cat's body has done that, you have to give even more insulin to bring it down. You just have to be dogged and persistent in your dosing to overcome it.
     
  8. milfordcollector

    milfordcollector Member

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    Nov 15, 2012
    Thank you all......Vyktors Mum.......those ketone strangling vines are working their magic.....this is the 2nd time in 6 months Sabrina was thrown into DKA & I hope & pray I can keep her safe & not have it happen again!!!! Any suggestions...food, fluids, etc would be greatly appreciated!!! Cindy & Sabrina:cat:
     
  9. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    The best suggestion to prevent this getting worse that i can think of is to be aggressive on the dosing and just give high carbs to keep her safe.
     
  10. milfordcollector

    milfordcollector Member

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    Nov 15, 2012
    Thank you Julie!!! I mentioned the glucose toxicity to the vet & she looked at me like I had 3 eyes & didn't understand my question. Also I told her I have the Nova Max blood ketone meter & she couldn't decipher the data:banghead: 3rd she said my relion confirm meter wasn't accurate & I should get an animal specific meter....maybe I should print out & give to her the conversion info re the human vs pet specific.....:rolleyes: Cindy & Sabrina:cat:
     
  11. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    That's gotta be frustrating for you! There isn't an exact conversion between the human and pet meters. The info is conflicting - in some places you'll see that they are very close in the lowest range of numbers, but higher in the high range, even as much as 40%. I don't even try to convert - we just encourage people to use human glucometers because the strips are cheaper and the bottom line is that what you care about is getting a cat into normal numbers and keeping them from a hypo. The human glucometers will do that just fine. It's most difficult when people try to use both meters and compare the BG tests.
     
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