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? 9/13 Yoshi amps 437 +3 377 +7 454 +9.5 456 pmps 468 +4 394

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Stressedcatmom, Sep 13, 2019 at 8:04 AM.

  1. Stressedcatmom

    Stressedcatmom Member

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    Mar 16, 2017
  2. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
    I still think Yoshi needs an increase - numbers are too high.
     
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  3. Bellasmom

    Bellasmom Well-Known Member

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    Feb 12, 2018
    Totally agree with @Sue and Luci definitely needs an increase, numbers are high
    I would go to 1.75 tonight
     
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  4. Beth 73

    Beth 73 Well-Known Member

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  5. Nan & Amber

    Nan & Amber Well-Known Member

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    If you can test today, plan on trying to spread out during the day. Maybe a +3, +6, +9 (kind of a mini-curve) as the initial plan, adjusting as needed during the day. For example, if the +3 looks like he's getting some action from the insulin today, you might want to do more midday testing to see just where it takes him.

    Hang in there. :bighug: :bighug: :bighug:
     
  6. Tina Marie and Jan

    Tina Marie and Jan Member

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    Jul 24, 2019
    Sending you stress relief vines, Jennifer:bighug::bighug:
    And maybe some patience pants like someone sent me!
    You did as advised here, and went up to 1.5 from 1U. It is still possible you'll need to still go up, maybe to 2 units, but you are going slower, safely, instead of jumping to 2U like your vet said.
     
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  7. Stressedcatmom

    Stressedcatmom Member

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  8. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Those blacks you are seeing could be from some bouncing you aren't catching with the testing you are doing but it's a bit hard to tell. Even a pink or yellow BG sometime during the night could set off a bounce to a higher AMPS and there are some nights recently you have no data. If you are still following SLGS, you should hold the 1.5u dose for a week unless BG drops below 90 at which point you'd reduce by 0.25u. You dosed 2u on the night of 11th so your week of 1.5u starts again the morning of Sept 12th.

    I'd be sure to grab a test at +2 or +3 at night every night along with a before bed test. So many kitties go lower at night that missing that night data means you are missing half the picture of what's going on and it might be key data you need to figure out the best dose for Yoshi.
     
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  9. Stressedcatmom

    Stressedcatmom Member

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    I feel like I should do 2 u tonight. I can test all weekend. And get in at least 3-4 tests during the week. What are your thoughts? I just got syringes with .5 markings btw
     
  10. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I think you would be premature to increase the dose just yet. IF there is bouncing involved it can take up to 6 cycles to clear and increasing the dose now could cause you to jump over the best dose. Normally dose increases are only 0.25u and while it was suggested that you could increase by 0.5u last time because nadir was still high, that doesn't mean future increases should necessarily be any more than 0.25u. I realize it's frustrating and you want to see the numbers coming down but quite frankly going too fast with dose increases can end up slowing you down rather than solving the problem at hand. The last time you shot 2u, you didn't do any mid cycle testing and ended up with a black pre-shot the following AM suggesting BG may have dropped down to levels lower than you've been seeing setting off a bounce. Commonly used here.....this is a marathon not a sprint and throwing more insulin at the numbers right now isn't the right answer. You need to give the 1.5u dose enough time to see what effect it is having and 3 cycles just isn't long enough.

    It looks like BG is coming down today. I'd hold the course and give the 1.5u dose a fair chance.
     
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  11. Stressedcatmom

    Stressedcatmom Member

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    Thank you very much. I do have one more question. I’ve been using bacitraycin plus for his ears. The ingredients are 500 units of bacitracin and 40mg lidocane. Is this ok? Or is there something bad in it that could be elevating his glucose. Thank you again. I’m going to run him to the vet today to see if the uti is cleared or if he needs another shot
     
  12. Stressedcatmom

    Stressedcatmom Member

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    He’s drinking a lot and freaking me out
     
  13. Wendy&Neko

    Wendy&Neko Well-Known Member

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    To answer the question on why the numbers seem higher at a higher dose, it’s because the depot isn’t stable. There is a phenomenon we call New Dose Wonkiness that happens in the early cycles after an increase, that can result in temporarily higher numbers. Plus you shot two units a couple night ago, further disrupting the depot. Lantus teaches patience. You haven’t been at 1.5 units long enough to know what it will do. Even if you were following TR, you wouldn’t increase yet.
     
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  14. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    He will drink more with those high numbers because his body is trying to eliminate excess glucose through his urine. As BG levels reduce, the drinking and peeing will reduce too.

    I don't think there is anything in that ear med that would increase BG however any infection or inflammation will so perhaps some of what you are seeing is from the ear issue and the UTI if that has not been cleared up. If the vet gave Yoshi Convenia for UTI and it isn't cleared up, I'd ask for another antibiotic. Convenia is meant for skin infections not urinary tract infections but vets are using it for pretty much any infection these days and sometimes it just doesn't work.
     
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  15. Stressedcatmom

    Stressedcatmom Member

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    Thank you all so much. I will shoot 1.5 tonight as that seems to be the consensus. I honestly can’t thank you guys enough. I keep crying
     
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  16. Stressedcatmom

    Stressedcatmom Member

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    She did give him convenia. She probably will again because i can’t afford the culture, just the urinalysis. She will say that this is a broad spectrum antibiotic and unless I do the culture she won’t know what antibiotic to give (she mentioned that when she gave him the shot) I will push for something else. Do you have any suggestions on what to ask for?
     
  17. Stressedcatmom

    Stressedcatmom Member

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    We have an appt for 2pm tomorrow.
     
  18. Stressedcatmom

    Stressedcatmom Member

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    Also the ear issue is just trying to relieve the pain and heal the ear from all the poking
     
  19. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Doing a culture now wouldn't help anyway because the Convenia would have to be out of system for at least 10 days and it tends to last quite some time. I can't tell you what antibiotic would be more appropriate offhand but if Convenia didn't work the first time, it seems logical to try something different rather than throw the same med at the problem if it didn't work the first time.
     
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  20. Stressedcatmom

    Stressedcatmom Member

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    Geez why doesn’t the vet know this.

    Thank you.
     
  21. Stressedcatmom

    Stressedcatmom Member

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  22. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Same reason most human physicians don't know a lot about the meds they prescribe either...they don't get a lot of pharmacology training....they get it from the drug reps. Vets use Convenia quite freely I think largely because cats can be difficult to pill. They do it for the convenience of the CG hoping it works. When it doesn't work, another shot may serve to make it more difficult to eradicate the infection. You should also be aware that because Convenia is so long lasting, if there are any side effects, they can cause serious problems because you can't just discontinue the drug like you can with a regular antibiotic. I for one, have a note on all my cat's files that Convenia is not to be given without express permission from me.
     
  23. Crista & Ming

    Crista & Ming Well-Known Member

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    Jun 10, 2018
    Sorry to hijack Yoshi’s condo, but can you explain more about why you recommend against Covenia? Is it just because it’s long lasting? Thank you!
     
  24. Stressedcatmom

    Stressedcatmom Member

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    Hijack all you want @Crista & Ming :bighug:
     
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  25. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    There have been reports of severe reactions and fatalities from the drug. It seems to be widely used for infections of any type these days despite being developed and marketed specifically for skin infections. Whether the reports of fatalities can be 100% directly related to the Convenia in a formal scientific manner or not I don't know. Nor do I know what the statistics are for adverse reactions.

    I do however have a major concern about the inappropriate use of antibiotics and often it seems this drug is being used as a matter of convenience with little if any consideration of whether it is the optimal treatment for the condition being treated. Ideally a culture would be done before any antibiotic is prescribed however it seems rare for human physicians much less veterinarians to bother going to those lengths to ensure they treat the appropriate offending organism. They use a broad spectrum antibiotic and hope it works and Convenia is broad spectrum and convenient.

    If you have an allergic reaction to a pill or liquid medication you can simply stop taking it, treat the allergic reaction symptomatically and if need be flush the drug out of the system because with a normal antibiotic, you have to keep taking it possibly 1+ times per day over a certain number of days to keep the necessary amount of active drug in the system. If an allergic reaction or severe side effect occurs, you discontinue the drug and it's out of the system in a relatively short period of time during which supportive treatment can be provided to deal with the adverse reaction.

    The problem is that Convenia was developed to be long lasting and as such it is not totally eliminated from the body for a month or more (can't recall exact time frame). Since the drug is formulated to remain in the system for a prolonged period there is no way to get it out of the system quickly if there is a severe adverse reaction to it.

    One of my cats was given the drug before I was aware of the potential issues and there was no problem at all. If there were a lot of animals suffering from adverse effects, I'm sure the vets would have stopped using it ages ago. That said, I am not willing to take a chance on it again unless it is the best and only option knowing it takes a month or more to be cleared from the body, because I might not be so lucky next time.

    My point here is that if Convenia didn't clear the infection the first time, it seems pointless to try it again. Repeating a failed treatment doesn't make sense under any circumstances but particularly with a drug that cannot be withdrawn once given should an adverse reaction occur.
     
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  26. Crista & Ming

    Crista & Ming Well-Known Member

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  27. Stressedcatmom

    Stressedcatmom Member

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    She did offer to do the culture first, but I couldn’t afford it on top of the 800 I spent. She offered it again tomorrow when we go in, but I still can’t afford it. She told me it lasted two weeks in the system and two weeks is tomorrow.
     
  28. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    It's most active for 2 weeks but doesn't totally clear the system for another 2 weeks or so according to information I've read so a culture right now would not be conclusive.

    ETA - Does Yoshi show any signs of straining to pee, excessively frequent peeing and/or peeing tiny bits at a time?
     
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  29. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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  30. Stressedcatmom

    Stressedcatmom Member

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    He’s peed about 3 times today that I witnessed. They’re pretty hefty.
     
  31. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    3 times a day and hefty pees don't sound like an infection but anything is possible. Just keep an eye on him.
     
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  32. Stressedcatmom

    Stressedcatmom Member

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  33. Stressedcatmom

    Stressedcatmom Member

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    All she said was he had “a lot of bacteria in his urine” idk anymore
     
  34. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Probably looked at a sample under a microscope? What were his symptoms when she gave him the shot of Convenia? If they have disappeared now, maybe the infection is gone.
     
  35. Stressedcatmom

    Stressedcatmom Member

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    Mar 16, 2017
    Pretty much the same as diabetes. Peeing a lot, drinking a lot — except he did spend a lot of time sleeping in the closet, and he wouldn’t let his brother NEAR him without hissing which was odd. He doesn’t do that now mostly.

    I think she just prescribed it based off what she found in the urine. She wanted to do a 225$ culture but I just couldn’t.
     

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