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5/26 Latte~Fresh start~NO shot 2nite, new dose 1U

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by carolynandlatte, May 26, 2010.

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  1. carolynandlatte

    carolynandlatte Well-Known Member

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    Dec 28, 2009
    Folks,
    I cant even begin to start wrapping my head around HOW I am suppose to give insulin to a cat who already drops like a rock at any given time WHEN she is eating, but HAS to have the insulin because pof the pred. Without being here 24/7 to syringe feed hrly when needed and test, I have no clue how much insulin to give her or how to keep her safe...both out of high and low number I just dont know if this is possible. I really dont.

    I'm so depressed and scared. I cant believe she will not eat at all, aside from bits of baby food. I cant syringe feed enough for her to maintain this weght, let alone avoid drops. And I know she wont do it herself when I am gone.

    She was in 400,s this a.m....now (+6) 214. I have to shoot 30 min early tonight because of work....and I will still end up being late (to work). I brought her back up to the s2.0 this a.m. after 2 cycles because of the increased pred. Now I wonder if that was a mistake.

    This is the most lost and unsure I have ever been with her care. And she is counting on me?!
     
  2. MJ+Donovan

    MJ+Donovan Well-Known Member

    Joined:
    Dec 28, 2009
    Re: 5/26 Latte

    prayers for you and Latte.
     
  3. Linda and Bear Man

    Linda and Bear Man Well-Known Member

    Joined:
    Dec 28, 2009
    Re: 5/26 Latte

    (((Carolyn))) You know best what you are comfortable with, but if I had to shoot early, be away from the house, and thought it was unlikely she would eat, I personally would shoot a bcs or very conservative dose. You have to do what you are going to be comfortable with (or as comfortable as you can be).

    Is it possible to add some omega oils to her syringe feedings? If she is CP prone, she may not be able to tolerate extra fat, but it would give her some extra calories. Have you tried syringing a/d food? It is supposedly quite palatable, especially if watered down and warmed a bit.

    I'm sorry things are so rough for you and Latte these days.
     
  4. carolynandlatte

    carolynandlatte Well-Known Member

    Joined:
    Dec 28, 2009
    Re: 5/26 Latte,+7=93!

    How does she drop 100+ pts in an hr and show no interest in food? I syringe fed 12ml (thats the max she can tolerate) at +6. She only took a spoon of baby food with karo @ +7 (93).

    Would I be crazy to think we should start all over in dosing? 1u?

    Sooooo mad! She just clears this 3 day bounce...and here we will go again.
     
  5. carolynandlatte

    carolynandlatte Well-Known Member

    Joined:
    Dec 28, 2009
    Re: 5/26 Latte

    But what would that be, knowing she will be in the 500's + very, very soon...and stay there for days, I'm so confused!
     
  6. Michelle and Mannie (GA)

    Michelle and Mannie (GA) Well-Known Member

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    Dec 28, 2009
    Re: 5/26 Latte,+7=93!,+7.5=68 EYES

    I wish I could help you - but you are dealing with so much more here that I can fathom. I offer support, wish it could be more. Hugs to you both.
     
  7. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Re: 5/26 Latte,+7=93!,+7.5=68 EYES

    Will she take a bit of Karo?
     
  8. carolynandlatte

    carolynandlatte Well-Known Member

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    Dec 28, 2009
    Re: 5/26 Latte,+7=93!,+7.5=68 EYES

    She was refusing more of baby food with karo, so I just syringed 6ml.
    Will test again shortly..then I guess I might have to put on her gums if she is lower.

    I dont know what to do once she starts bouncing...dose wise.

    And, im sorry my ss is not updated. Will turn puter on and try to do that. Have to leave for work in a few hrs...only on a few hrs of sleep...not thinking most clearly today.
     
  9. CD and BigMac

    CD and BigMac Well-Known Member

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    Dec 28, 2009
    Re: 5/26 Latte,+7=93!,+7.5=68 , +7.75~58 EYES

    Gosh Carolyn, I wish I could help you. I'm glad you got some food into Latte and I hope her BG goes up soon and it sure would be nice if she forgot to bounce off of these lows.

    Just wanted to let you know I'm thinking of you and worried about you. (((hugs)))
     
  10. carolynandlatte

    carolynandlatte Well-Known Member

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    Dec 28, 2009
    Re: 5/26 Latte,+7=93!,+7.5=68 , +7.75~58 EYES

    Lets just think about how low she could have gone if I was not here syringe feeding today, and giving karo (which she was still dropping from). How many times do you think this has happened when I was not home and she did not eat?

    Im seriously considering this pm being her last dose of insulin for a while so I can see where she sits w/o it. She spends most of her time in the 400-600+ range with the insulin because of these drops. She couldnt sit much higher with no insulin, could she?


    I have a call into her vet.

    she is very lethargic and not super responsive.

    +8-76
    +8.5~79
     
  11. Libby and Lucy

    Libby and Lucy Senior Member Moderator

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    Dec 28, 2009
    Re: 5/26 Latte,+7=93!,+7.5=68 , +7.75~58 EYES

    Carolyn,

    I’m at work and can’t spend much time studying or thinking about your questions right now, but I did have one thought to share about syringe feeding. This is something I picked up in my foster training for Siamese Rescue. When they syringe feed at the rescue, they make a slurry out of a bunch of things to make sure they can get the maximum calories and nutrition out of the smallest amount of food. They use A/D, mixed with things like Nutrical and Clinicare and some other stuff, and use Pedialyte instead of water to thin it out for the syringe. There were other things she was mixing in, I’ll look at the DVD again when I get home. Those things would make the BG’s go wonky probably (I don’t want to know what the carb count is), but nutrition is probably the #1 concern at this point. Maybe you could ask your vet how they would prioritize her issues – what should be sacrificed in order to keep other things in line? What do they think would be the risks if you lowered her dose and kept her in the 300's or even 400's? Maybe it's worth it, I don't know. Consider that many vets consider 300's to be the preferred range for diabetic cats, maybe it's not so bad for her.
     
  12. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

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    Jan 11, 2010
    Re: 5/26 Latte,+7=93!,+7.5=68 , +7.75~58 EYES

    (((Carolyn))) Thinking of you. Thinking of Latte. I wish I could be there to help you out. I wish I could give advice, but I can't. So I'm just thinking of you both, thinking good thoughts.

    Ella & Stu
     
  13. carolynandlatte

    carolynandlatte Well-Known Member

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    Dec 28, 2009
    Re: 5/26 Latte,+7=93!,+7.5=68 , +7.75~58 EYES

    +9-104

    I spoke with her vet, and here are the new plans. I know some of you will cringe, as I am a little bit too. But I dont know what else to do.

    We are starting over. I am skipping her shot tonight (the one = had to do early). I will start her fresh on 1 unit tomorrow. He usually likes me to keep doses for a week, which I often do when waiting to raise. This time I am going to do the 6 cycles and move a little faster than I normally would...IF her numbers call for it. He said he would like to see her flat...even if high, and procede from there.

    He suspects the other day when I came home from work to vomit everywhere that she went way too low, and possibly the reason for vomiting. I shot her in the 200,. She was 150@ +2 and not eating. Came home and she was HI by +8.5. Look at todays scenario and a few others...it is very likely.

    He is fine with me switching to lev. Not sure if I should do that in the middle of starting fresh or wait.

    I feel better going to work tonight. I work all weekend, but have all next week ooff, and possibly the weekend. If I raise her every 6 cycles, we will be almost back to where we are now by the time I have to go back to work. That makes me feel better, knowing I wont have to keep raising it with little ability to do spot checks.

    A fresh start! I know it will be frustrating in the beginning. But it cant be any more frustrating than now.
     
  14. Ele & Blackie (GA)

    Ele & Blackie (GA) Well-Known Member

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    Dec 28, 2009
    ((((Carolyn))))) You are such a good mom to Latte! I hope this fresh start really helps Latte get her bgs under control. Maybe it's just what she needs. Sending prayers, vines, energies, anything I can think of to help.
     
  15. Pat+Raja+Shadow

    Pat+Raja+Shadow Well-Known Member

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    Dec 28, 2009
    Well, I am glad that this plan is going into effect. Whew. It sound pretty sound to me. And it sounds as if you are more relaxed with this way for now. That's so good. I hope she will get her appetite back soon though. Maybe she will settle down if she has steadier numbers....wishing you well Carolyn!
    ((((Carolyn & Latte))))
     
  16. Linda and Bear Man

    Linda and Bear Man Well-Known Member

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    Dec 28, 2009
    I like the new plan. I think no shot tonight was your only option, with you having to work. I hope you both have a quiet night. (((Carolyn))).
     
  17. Miriam and Putty (GA)

    Miriam and Putty (GA) Well-Known Member

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    Dec 28, 2009
    (((Carolyn)))
    I don't know if skipping the shot is good or not but I do know that I could almost hear the relief in your post when you did decide to skip the shot. She is going to be high which you already know.....fur shots happen. ;-)
    You have to be comfortable knowing Latte is safe and that she is not going low without eating.

    Like Libby said you have to deal with what is most important first.
     
  18. Helene & Tizon

    Helene & Tizon Well-Known Member

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    Dec 29, 2009
    (((Carolyn))) I wish I could give advice, but I can't. So I'm just thinking of you both.. moral support, that's what I'm offering.
     
  19. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    You juggle so many variables with Latte. It's got to be so hard to know what the best decision is. I suspect that in you're heart, you know what is the right thing to do. And you do it. Day in and day out.
     
  20. sehjak (Susan & Lanky)

    sehjak (Susan & Lanky) Well-Known Member

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    Mar 6, 2010
    We're thinking of you two too.
     
  21. paige

    paige Well-Known Member

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    Dec 28, 2009
    Carolyn - I think it sounds like a good start. It will be a relief to have her not drop so low and bounce so high. Maybe keeping her flat (and higher) is the best thing to do at this point. You and Latte are in my thoughts and prayers. I wish there was more we all coul do......I can't imagine how upset you must feel knowing that Latte depends on you. But you always have Latte's health and best interest at heart. NO ONE would ever doubt the decisions that you make. We just always want to hear from you to provide support and a shoulder to cry on (if needed).

    (((((((hugs)))))))
     
  22. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

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    Jan 11, 2010
    Dear Carolyn, I'm very glad you have decided to start anew. It will refresh your spirit and Latte may begin to improve. It's good that you'll have a vacation to work your way through this. Sending all support, vines, etc. etc., and good thoughts your way. Hugs to you both! Get a good night's sleep!

    Ella & Stu
     
  23. Dyana

    Dyana Well-Known Member

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    Dec 28, 2009
    I hope you have a good night, and I hope the new plan works out well.
    (((We're here for you Carolyn and Latte :D )))
     
  24. jojo and bunny

    jojo and bunny Senior Member Moderator

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    Dec 28, 2009
    sorry you are having such a rough time carolyn. ((hugs))
    i haven't been around so major gaps in my knowledge of what is going on with her, but do you think the pred reduction i see posted in yellow across SS on 5/11 has anything to do with the sudden no eating at all? (pred is an appy stim for reading those that don't know). also maybe the higher dose was making her back more comfortable and stopped eating cause of increased discomfort? was there any probiotics given after the Orbax? maybe her g/i tract is under populated and giving her more nausea? just throwing ideas out there. has to be a reason she suddenly just stopped eating on own.
    i know we have talked about this before long ago, however that was then, this is now... but what do you think about a feeding tube? i am getting this sense from your SS and post that you have been spread about as thin as a hooman can be and not fall. yeah there is a risk, not un-doable though, of the anesthesia (no ket/val for induction of course), however man it would really make your life so much easier. give you so much better control and free up time. again just a thought....
    i do not know if the trace ketones on SS from couple of weeks ago are real (says something about bad strips?) but if they were, be very careful with this dose reduction of 1/2 the dose. you do have a cat on immune suppression meds (maybe has/had UTI i saw on SS?), plus less calories, add in too little insulin and danger is real of DKA. i do want to say that if numbers are scary high on the 1.0 unit, they might be better, many cats the amount of food vs. insulin needs are so closely tied, less food = less insulin needs, but if they are scary high or if you see any trace of ketones, you do not need to go up dosing path increment by increment, you can go right back to last dose (s2.0 units), simply treating the 1.0 unit as a failed dose reduction. kwim?
    ~jojo
     
  25. Deb & Spot

    Deb & Spot Well-Known Member

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    Dec 28, 2009
    ((((Carolyn&Latte)))) I am so glad that you are feeling better with this new plan of action. I could hear the relief in your words after your talk with the vet. I think the new plan sounds good and I hope that all works out well. Will be thinking of you guys.
     
  26. carolynandlatte

    carolynandlatte Well-Known Member

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    Dec 28, 2009
    So nice of my coworker to let me take the first cut and go home early.

    Latte was 278@ +10.5 and is now HI. i do partially regret not giving 1 unit, even early tonight. But, she would have been HI Even with it after todays numbers. She is going to bounce for the full 6 cycles, no doubt.

    I am beginning to think I want to start at 1.25 in the a.m. I think its a guarantee she will need more than 1u. And since she often requires increases/decreases of drops rather than .25 increments, this will give me time in my days off to do it that way if need be. The goal is to move her back up as quickly as possible where she can stay flat. No more am I pushing anything other than under renal threshold. She can be a flat yellow cat and I would be thrilled!

    Most certainly I am afraid of the things JoJo mentioned - keytones, UtTI. BUt, if you look at her ss, she is already spending very little time under 300's. Its drop fast for a few hrs, bounce 6+ cycles, repeat. I will be checking ketones (yes, those were bad strips I had, Jojo). I also have a/b's on hand in case she becomes symptomatic at a time when the vet is not open. The no food thing does worry me. But it worries me just as much w/ the possibility of her dropping to low. No win situation. Too much, too little insulin...both dangerous.

    Jojo- I did a lot of research and put a lot of thought into the tube. As I have revisited in my heart lately, I still do not think it is the right thing for her.

    I do suspect the reduction in pred may have decreased her appy. Its hard to pinpoint exactly, as I went thru her ss. There may be a lot of factors involved that all came to a head at once...bounces, extreme heat, pred reduction, her other health issues, possible cp flare, pain?? We will see how she does with that little extra pred on board.

    Earlier today I told latte of the new plan. It was the first time all day she talked to me. She responded to all 5 of my ?'s about her thoughts on it. I thinks she agrees. I reminded her it might be tough going to get to a better spot, and reminded her again tonight. I also keep telling her how so many people all over the worl love her. I really hhope she senses the greatness of it all.

    I did come home to some kibble gone. This i a relief in a sense. She wanted to go outside and was very responsive to my pets. She actually looks a little bright! Sadly she is super thirsty. Not a surprise.

    Thanks Jojo for letting me know I can bring her back up if need be. Thats helpful to know that is ok to jump so big. I dont know where she is going to end up....much lower or higher in her dose. I hope we can get close to finding it in the next 12 days. And I pray her appy picks up as well because I cant care for her in the way she would need to be cared for if she continues with such innapetance.

    No more tests tonight. Tomorrow will be a very mellow testing day (for us). Friday -Mon = work, but most days I can get a +3 or +4, come home at lunch, and aa check before pmps. No evening shifts for a week! Next week I expect to be home as much as I need to be round the clock...except when I get out for a bikee ride on my soon to be fixed bike!!

    Thanks for being there everyone!
     
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