5/17 Sebastian AMPS 271 +3 281 +6 261 +9 258 PMPS 292 +2 340 +11 266

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Justin & Sebastian, May 17, 2019.

  1. Justin & Sebastian

    Justin & Sebastian Well-Known Member

    Joined:
    Feb 1, 2019
    Yesterday

    AMPS 271. Still waiting for BG to come down. Blood ketones: 0.6. Still waiting for this to stabilize and go away. Still getting some soft BMs so also still waiting on that to get back to normal. Appetite is good at least.
     
    Last edited: May 17, 2019
  2. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    It's a lot of waiting. Hope it isn't to much longer.
     
  3. Sonia & Leo

    Sonia & Leo Well-Known Member

    Joined:
    May 24, 2018
  4. Justin & Sebastian

    Justin & Sebastian Well-Known Member

    Joined:
    Feb 1, 2019
  5. Bellasmom

    Bellasmom Well-Known Member

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    Feb 12, 2018
  6. Justin & Sebastian

    Justin & Sebastian Well-Known Member

    Joined:
    Feb 1, 2019
    261@+6. Weight is down today
     
  7. Justin & Sebastian

    Justin & Sebastian Well-Known Member

    Joined:
    Feb 1, 2019
    258@+9. Tomorrow AM will be six cycles since the increase, no real change, so if he's not into blues by tomorrow PM I'm going up to 4.

    I'm very much starting to think these ups and downs are due to some metabolic issue. We see almost the exact same thing two months ago where we came down from the starting 7 down to 4.25 during a period of vomiting because he was getting <40, then he jumped up to the 300 area after things normalized and we had to go back up to 5.5 before his BG got under control again. Then vomiting starts again and BG drops and we bring the dosage down, and now that things have started to normalize again his BG is staying high. I think basing the dosing adjustments solely on the numbers and not on the notes of what's going on is only looking at half the picture.

    I get that TR has "safety measures" built in but I think it assumes a relatively healthy cat and I simply don't feel it's agile enough to deal with what we're dealing with. We're not seeing any changes as it is and even though TR says we should only be moving in .25 increments, that's simply not going to cut it and is going to drag things out too long, meanwhile he's building up ketones and at a pretty dangerous weight level.

    So unless someone has some compelling evidence or reasons to the contrary, I'm going to be moving in .5u increments every 6 cycles until we see some movement.
     
  8. Christie & Maverick

    Christie & Maverick Well-Known Member

    Joined:
    Aug 1, 2017
    Hello Justin, I have been following but haven't offered much since there are more experienced members who have given you the benefit of their knowledge and experience including @Wendy&Neko , @Jill & Alex (GA) among others. I tag them here in case they are available to help, but in the short term, I sense your frustration today, and recognize also you are dealing with a combination of variables with Sebastian, including your constant monitoring of ketones. Is it possible that there are some other underlying issues going on? how is Sebastian feeling other than BM issues? Playful, purring? I remember your dislike of the vet you have so I won't suggest that, but often infections can affect BG levels, and past history of pancreatitis makes me wonder if something else is going on which is affecting Sebastian.

    Sometimes patience is required, increasing too quickly can potentially put you in a position where you won't be able to stabilize his BSL when the insulin kicks in, and having a situation where you can't bring BSL up no matter what you do is a possibility that you should be prepared for. I hope you find some answers soon.
     
  9. Justin & Sebastian

    Justin & Sebastian Well-Known Member

    Joined:
    Feb 1, 2019
    His behavior is pretty normal. He's talkative, been attempting to play with our other cat a bit, comes to us for attention and purrs, etc.

    While I don't really put much stock in the vet's advice since it seems to be outdated, I do use them for tests and diagnostics and we've looked at pretty much everything that's been suggested either on here or by the vet. We did a superchem, CBC, and urine cultures about a month or so ago, got the acro and IAA tests, they just drew blood for a GI panel on Tuesday so we're waiting for those tests results, as well as them doing a physical example and not really finding anything out of the ordinary. I'm open to suggestions on what else we could get done beyond that that might help.
     
  10. Christie & Maverick

    Christie & Maverick Well-Known Member

    Joined:
    Aug 1, 2017
    Glad to hear you had some recent tests done, apologies I didn't see them in your labs on your SS so I wasn't sure. I know the numbers aren't great lately, I wonder if there may be some insulin resistance, anything significant in the recent blood work? Happy to hear he is talkative, and seeking attention. The only other thing I can think of is whether you are moving injection sites regularly? I wish I had more suggestions for you.
     
  11. Justin & Sebastian

    Justin & Sebastian Well-Known Member

    Joined:
    Feb 1, 2019
    I forgot I still need to get the latest results in there. There was nothing abnormal though. He does have resistance, IAA test came back at 85%. I still haven't been real clear on whether that is going to result in reduced effects from dosage across the board, or if it acts more like a threshold where we have to hit a certain dosage before we start to see an effect and anything below that is going to look about the same.

    I haven't been changing injection sites recently, just using the back of the neck. I can try a new spot for the next couple and see if that has any affect.

    I've also been considering going to a different vet that's close by just to get a fresh set of eyes on the situation.
     
  12. Justin & Sebastian

    Justin & Sebastian Well-Known Member

    Joined:
    Feb 1, 2019
    PMPS 292. Took two ketone readings, got lo and 0.3. So that's good.

    So are people still thinking the dose might be too high? He's not high and flat, there's a definite curve going on throughout the day for the past several days, so what is the opinion?
     
  13. Justin & Sebastian

    Justin & Sebastian Well-Known Member

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    Feb 1, 2019
  14. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    Glad to see ketones have reduced! You are asking great questions, but just a wee bit above my pay grade ;) . It has been slow today, and we are on a long weekend in Canada so some more experienced members like Wendy might be away. Tagging @Sandy and Black Kitty about insulin resistance.
     
  15. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Sort of. Away today at parents (island away), leaving Tuesday for out of country and swamped. I frankly don't know what to say on the dose. You didn't follow TR going up in dose lately, so all I can recommend going forward is to follow TR. Increase by the amount specified and in the time suggested. If you are overdosed, it will show up by him going low.
     
  16. Justin & Sebastian

    Justin & Sebastian Well-Known Member

    Joined:
    Feb 1, 2019
  17. Justin & Sebastian

    Justin & Sebastian Well-Known Member

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    Feb 1, 2019
    Which he's not.
     

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