Amoxicillin for UTI how will it effect BGs

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Bear and the hooman Ciony, Mar 19, 2020.

  1. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

    Joined:
    Feb 20, 2020
    Hello all.
    Bear just got prescribed amoxicillin to treat a UTI. My problem is the pharmacist said it was the flavored kind you give children so defintely has sugar. He said it shouldnt be too much to make a difference. And that's what the vet is thinking too. She suggest this over clavamox for her gi tract issues. Her dose is 1ml(50mg) every 12 hours, is this too much and how will this effect her numbers? The non regulation really effects my girls arthritis so its hard to watch her deal with this. She just wants to race her sister:(
     
  2. Ann & Scatcats

    Ann & Scatcats Well-Known Member

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    Dec 31, 2009
    Since she isn't going to have that antibiotic for more than a couple of days it doesn't make so much of a difference.

    What do you mean with ''the non regulation btw? She is a Senior Senior 18 yrs. Impressiv :cat:
     
  3. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

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    Feb 20, 2020
    She will be on it for 7 days. Since the amount of sugar is supossed to be so low do you think it will give her higher numbers?should have been more clear! she went back up to yellow from being in the blues for awhile and showing clinical signs first her arthritis got worse, then the uti and now drinking out of her bowl. We had gotten it to where she only drank water on occasion or at her meal times(water mixed in) now she gets a drink from the bowl first thing when she wakes up. Other than that we are full of our usual chirps and playing in boxes with all her toys.
    And thank you!! She is my prife and joy next to my 16 year old gsd. My sassy ol girls
     
    Last edited: Mar 20, 2020
  4. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    This too shall pass. I was worried about the methyl b12 I was giving Trouble. It had sugar in it and his numbers only went up a couple of digits . Once his neuropathy got under control we stopped the b12 and his numbers went back to normal.
    Good luck with Bear. Shes lucky to have such a good hooman as her best friend:bighug:
     
  5. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

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    Feb 20, 2020
    Oh no! That makes me want to recheck mine, vet suggested either RX vitamins b12 or injections and I'd like to spare my precious girl as many pokes as I can since mommy doesnt have the steadiest hands. As you can tell I'm a worry wart and high numbers effect her back and legs but not her engery so at this point in time it's hard watching her play tag with her sister. Thank you for the words of encouragement! We are beyound lucky to have each other and to be apart of such a knowledgeable and supportive group. :bighug::cat:
     
  6. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

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    Feb 20, 2020
    Looks like her b12 does have sugar in it (of course) How did it effect your kitties numbere and diabetic sympotms? Also how long did he need to be on it for you to see a difference. My vet said one to two weeks. I give her 1ml daily. Our goal is to use it for neuropathy as well , we just started on it last Saturday.
     
  7. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    Methyl B-12 is FOR neuropathy. I dont think a regular b12 shot will help her neuropathy . It may be working wonders else where but... I dunno (((please anyone that knows better please correct me))) It took maybe a week of one tablet a day to get trouble off his hocks, it works rather quickly. The numbers only increased by a couple of digits. It was WELL worth it. You'd never know he had a problem at all walking.
    Now that I think of it I crushed up one tablet and sprinkled it on every meal, so 2 tablets a day.
     
  8. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Cyanocobalamin does absolutely nothing for diabetic neuropathy.
    It is the methyl B12 that you want.
    @Diane Tyler's Mom does a wonderful link on using the Vitacost brand pills for methyl B12.
     
  9. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

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    Feb 20, 2020
    https://www.amazon.com/Rx-Vitamins-...x vitamins for pets b12&qid=1584727131&sr=8-4
    I see you guys mentioned tablets, this is what I've been using for her(what the naturopathic vet has reccomend) do you suggest I stop and get thr tablets instead ? I've read about other people who have dibateic cats using b12 injections but those cats more often then not have other underlying issues. She isnt walking on her hocks too bad yet. It was bad before we got her on a lower dose of insulin. But I'm noticing when she was in the red and yellow those few times she has had trouble with her back legs. Arthritis specifically. I use cbd to help her but refuse to give her more than a certain amount in 12 hrs. I don't want her sleeping all day. She is still after all these years so full of engery :joyful:
     
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  10. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Looked up the ingredients list, on Chewy.com and in the answers section of Amazon and on drugs.com. All 3 said the form of B12 in this product was the cyanocobalamin.

    The methyl form of B12 is the one that helps to repair nerve damage.
    https://www.dvm360.com/view/managing-complications-diabetic-cats

    So yes, I would recommend the B12 that helps with the nerve damage, and that is the methyl form.
    Excess B vitamins are passed or excreted in the urine, so if the other supplement is helping your cat in other ways, it does no harm to give your cat Bear both of these supplements.

    Of course, getting your cat regulated and then tightly regulated and then diet controlled is the best treatment to help with the diabetic neuropathy.
     
  11. Deb & Wink

    Deb & Wink Well-Known Member

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  12. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

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    Feb 20, 2020
    Thank you again for your help! Another lesson learned today. Feeling a little guilty for not doing more research myself, I will stop the b12 liquid and get zobaline. I'm kicking myself for trusting the vets word and not reading the ingredients. I dont want her to be having too much sugar especially with the has a uti.
     
  13. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Check with us for research. We're pretty darn good at it. And may have already answered someone else or we have files in the Health Links / FAQs about Feline Diabetes forum.

    Look in the Sticky INDEX: Health Links/FAQs


    Or do a search in the forum you think might apply.
    Bookmark things you find that are useful. I have so many folders and tabs in my internet browser, I can usually find something fairly quickly.
    p.s. Should have been a reference librarian in a previous life is what I keep telling myself. ;)
     
  14. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

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    Feb 20, 2020
    You guys are beyound phenomenal. And no doubt about it , you are stellar with providing answers and research to back it up. I was wondering if you could maybe help me out once again I'm feeling panicked and stumped not sure if this happend becsuse of the b12 or the amoxicillin or a combo of both. But
    today at +5.5 I tested her and she came in at 94. When I was testing her she was trembling.(this is what she did when she went hypo last week) I began to prepare the hypo kit and i started by feeding her her normal food. Checked 30 mins later she was 109 but acting slow to wake up and sensitive to the light , still very responsive and defintely not confused because she was ready to eat. I gave her honey on her gums as I was paranoid. She is back to her normal sunbathing hour now and her bg has stayed up. Anything you think this could be ?
     
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  15. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    Feeding at a low number usually works well. The honey will raise bg but will wear off quick enough. I am NO WAY an expert. Deb has that pretty much covered :p but she is only one person. A VERY GOOD ONE AT THAT;)

    Try not to beat yourself up for doing what we all have. We've just been there first. This is the best site on the planet to help you help Bear.:bighug:
     
  16. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Good job on getting her BG levels back up quickly and having your hypo kit ready and waiting. Those do sound like hypo symptoms, even though the BG levels were in the 90's.

    On an Alphatrak meter, no lower than about 120 is the lowest you want to see her. I think Bear has a greater sensitivity to lower numbers, and you want to keep her a bit higher than we normally recommend.

    ECID Every Cat is Different. Let's keep her safe, and keep that low threshold a bit higher for now.
    • She could be more sensitive to the insulin, since that hypo last week.
    • She could have an early nadir, so her BG level was even lower before you tested at +5. (Wink's nadir was around +3 to +4).
    • She may have dropped over night and that AMPS was a bit of a bounce. Try to always get a +2 BG test in both the AM and PM cycles, since that is often indicative of what direction the BG's are headed.
    • The amoxicillin could be raising her BG (blood glucose) numbers. When do you give her the antibiotic, in relation to your pre-shot tests?
    • Another possibility, is that your syringes are not the same from syringe to syringe. There can be slight differences in even the same box of syringes. There are differences from brand to brand also.
    • It's really hard to draw up those small doses consistently. You measure the best you can. Some people use calipers to measure the insulin dose.
    • There may have been a bubble of air in the insulin syringe, from one dose to another. Are you doing the "finger flick" technique to make sure the air bubbles are out?
    Those are my "brain storming" ideas for now.
    I think it's time to reduce the dose again. Please try to measure 0.25U in your syringe, the best you can "guesstimate".

    Here is a picture of what that 0.25U dose would look like.
    025unit-1.jpg
     
  17. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

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    Feb 20, 2020
    Thank you both! It get very traumatic for me at moments. And JT you are completely right. Deb is a master at that but you yourself are a knowledge rockstar!
    Thank you for the brainstorm session defintley gave me a lot to think about and added more double checks to my list. I only rose her dose due to the red and yellow numbers earlier this week. I'm apart of the feline diabetes group on fb and o.lbe of the admins suggested the skinny .5u which resulted in my ultimate fear, this incident. I'm glad to be taking the dose down,though it's so hard to measure out the skinny .5 was nearly impossible for me. I have always done the flick trick since forever. I have worked with syringes for years I used to work at dog day cares and was the only one to do medicine administration of all kinds, got me into that habit but defintely something I need to remember to be diligent about and double check. This am is the first time I have given her the amoxicillin, i gave it to her right after she ate breakfast and before her injection. I think I have some tests at +3 and +4 that suggest that her nadir is sooner as well. I will defintely start testing around +4 and +5 more often since that's where I see the lowest numbers. Also need to start getting more night tests in its just so hard to stay awake. Tonight i will be sure to get one in especially with her being on amoxicillin and today's incident. I hate seeing her numbers all over the place, we have yet to do our first curve yet. This weekend was planned to be our first one after holding a dose. Should I still do one despite switching the dose? I think it's a good idea just to see how the meds effect her bgs throughout the day.
     
  18. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

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    Feb 20, 2020
    As for the syringes, I have not used a different brand.
    Besides using calipers to measure the dose there probably isnt an accurate way to tell the slightest differences between syringes, correct?
     
  19. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    the Zobaline is expensive. 33.90 and you only get 60 tablets , have to crush them up
    Alot of members use this , you can buy it on line from Vitacost
    Vitacost Vitamin B-12 Methylcobalamin -- 5000 mcg - 100 Capsules
    It's 17.99 just be sure this is the one you buy
    The only difference is the Zobaline has 200 mcgs of folic acid
    So I buy the folic acid at the supermarket and crush it up and add it to the B-12
    If you can't find the 200 mcg get the 400 mcg and cut it in half
    The Vitacost brand is a capsule so just open it and pour the powder on the wet food
    Has no taste, no need to crush it up
    Wishing you all the best with your kitty, you have found the best place to be for help and advice
     
    Last edited: Mar 20, 2020
  20. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

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    Feb 20, 2020
    Thank you for that information Diane!
    Do you happen to know if these pills would be a good option as far as folic acid goes and just cutting them in half ?
    https://www.amazon.com/Sundown-Naturals®-Folic-Acid-Tablets/dp/B000LM1BOQ/ref=mp_s_a_1_13?dchild=1&keywords=folic acid 200 mcg&qid=1584750342&sprefix=folic acid 200 mcg&sr=8-13
    I've been pondering giving her glucosamine for her arthritis. Her diabetes effects it so much and her front left wrist is starting to bow/curve. I give her green lip mussle powder right now but not sure how all of them on top of each other would effect her. Should I stick to just the b12 for neuropathy for now? I really think that's what is going on with her wrist right now.
     
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  21. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    No, there isn't. Harbor Freight carries calipers. Other hardware stores carry calipers also.

    Those red numbers you were getting were from "bouncing". Bear is not used to those low blue range numbers, so her BG levels skyrocketed as her body dumped hormones and more glucose into her bloodstream, to protect her. It doesn't always have to be a real dangerous low for a cat's body to react that way. Simply a low that a cat is no longer used to.

    Blacks = bouncing
    Reds also are often bouncing.
    Especially if your cat has been in the yellow ranges. Very good sign that your cat is bouncing, when you go from the yellow numbers, up to the pink, red or blacks.
    Pink PMPS pre-shot 3/17 -bounce
    Red PMPS pre-shot 3/18 -bounce

    Try looking at Bear's SS and seeing if you can identify a couple more bounces and describe why you think so.
    It's a handy skill to have, being able to see the waves of action on the SS and interpret it.

    I found you on FDSG. Not affiliated with this message board. I see the admin that gave you the suggestion for the raise in the dose. Sherry G. That group is still using the original Roomp & Rand dosing protocol from 2008, which has changed over the years and been revised. This message board has taken that revised protocol and taken it several steps farther with the dosing protocols we use here, in reviewing hundreds of cats and input from many experienced members.

    Sticky Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

    That Roomp and Rand study was also done using human meters. The Alphatrak meter you are using is a pet specific meter. Numbers run higher with the pet meters. No exact conversion formula between the two types of meter unfortunately. But you get a "feel" for the numbers when you have looked at enough spreadsheets over the years.

    You are going to receive conflicting advice from the different groups. It's up to you which suggestions to follow.
     
  22. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    I thought of 2 more questions.
    1. Do you use the Alphatrak test strips in your meter, or are you substituting another brand?
    2. Does Bear have anemia? That could throw off the BG (blood glucose) readings.

    Not familiar with the experience level of the admins or mods in most of the facebook groups. Like anywhere you look on the internet, some people are going to be better informed than others. We're not infallible.

    Personally, I only have experience with 3 diabetic cats, and 2 of the insulins. But I've studied, and studied, and studied some more to learn all I can to help people with diabetic cats.
     
  23. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

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    Feb 20, 2020
    I defintely am taking head to your advice over theirs. Although some of the moderates seem like they're more experienced it's hard to know who to trust. Plus I am a research girl myself so when data can be backed up by advice , im all for it! I apperciate you all her so much.
    But she has done well on the .25u dose in the past.
    She bounced last night? If you look at her SS she 303 at 10 pm last night the this afternoon was 195 at +3.5 , 237 at +5.5. Do you think she is doing okay getting used to the dose along with the amoxicillin? I know the other group had mentioned doing a curve and adjusting her dose but I'm unable to be home all tomorrow. I was using the alphatrak meter with the free style lite strips to compare them to the alphatrak strips used with alphatrak meter for about 5 days but I found they were very off even with inputting different cat codes. After her first hypo incident I gave up on them so just alphatrak strips with the alphatrak meter. As far as her being anemic her vet never mentioned it when we ran her blood the first time for her diagnoses. They checked the kidneys and pancreas too. Despite her arthritis she still runs around the house and plays with her toys every day since we started treating her. She never fails to eat since we have lowered her dose as well. We just got constipation issues under control and have had bowel movements every day for a week and they are perfect poops(as perfect as poo can be anyway).
     
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  24. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Yes I think Bear is getting used to the insulin. Weather or not this reduced dose to 0.25U is good for her, time will tell. You should give it at least 6 cycles, unless she drops really low again.

    Yes, Bear is bouncing today and last night, from that low of 94 yesterday morning, 3/20/20.
    But there was another bounce that I did not identify. Look back on the SS and see if you can find it.

    Thanks for letting me know that the anemia was a no. So we won't concern ourselves with that right now.

    Thanks also for letting me know you don't use strips in the Alphatrak that were not made for that meter. I know that some groups recommend that option, off brand strips, which was why I wanted to double check.

    We'll never remember to mention everything. There is simply too much information on feline diabetes to do that. So checking up on what information you receive is worthwhile. Passing anything we say by your vet is also a good idea. You want to maintain that good working relationship with a vet. Think of us as an adjunct or additional resource.

    I tend to be rather conservative on my recommendations on the dosing. After all, this isn't my cat, and although I know what my schedule and life is like, I don't know what your responsibilities are. With my own cat, I'd be more aggressive in the dosing, using TR (tight regulation).

    If you can't do a curve, if you can get some random tests during the cycle, that helps to fill in any blank spots on the SS. A +2 is always a good one to get. Tells you the direction your cat may be headed.

    Get a test before you walk out the door in the morning. Get a test when you come home. Get a test before you go to bed. Set the alarm and get a test at +6 or +7 some nights.

    A timed feeder is a good idea. So you can leave some food out when you are away from home. Many cats will naturally seek out food when their BG is low.

    Read other threads, check out the Lantus ISG group forum. Lot's of good information there. You may want to move over to the Lantus ISG at some point.

    p.s. Noticed the notes on the SS for her "antics" today. Bear has the I'm feeling better zoomies!
     
  25. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

    Joined:
    Feb 20, 2020
    Thank you once again! Still so new to this and reading SS.
    I'm able to do a curve this week after I've held the dose for 6 days I'm just unable to get the curve done today but I'm going to do what you suggested and get a test in at a new time to start filling blanks. Do you think a curve after holding the .25u will be a good idea?
    As far as identifying another bounce I see one on 3/9 pmps was 164 then amaps was 330, am I correct?
    After this amoxicillin is out of her system I am defintely bringing her into the vet to get new blood work and xrays done (I'm concerned about her front left leg, but I think once I start the correct b12 it will help her)
    About the strips, I had read a few threads on here regarding the use of the freestyle lite strips in the alphatrak. I only wanted to test for the cost effectiveness and then my insurance started covering AT strips and that's been a life saver(I love the AT meter and dont want to switch) tried a human meter but she never produced enough blood for a test it seemed. And yes as for her being playful she was full of life all yesterday and last night. Her sister is so happy to have her back on the battle ground haha.
     
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  26. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

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    Feb 20, 2020
    Also today at Bear's AMPS she tested 147 I have shot a .25u at 148 on 3/13 then had a pmps of 260. do you think it's still a good idea to give her the injection on the 147? or feed and test again?
    UPDATE: I answered my own question we are sticking to the .25u at 8 AM SS shows due to me skipping on the 3/8 her going low to 86 then 4hrs later bounced to 325. I don't want her to go too low while I'm not home
    again am I interpreting this correct?
     
    Last edited: Mar 22, 2020
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  27. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Yes I do. But those random tests when you can are also very useful. And always a +2 if possible with your work schedule.
    Yes, and then again on 3/12 AMPS she went low mid-cycle and then zoomed up at PMPS.
    Actually, you should have stalled, not fed and then test again in 20 minutes. If a rising BG, then it should be ok to shoot. If the BG is not going up (rising a good 10%), you can stall again if that will fit into your schedule. Try that next time.

    You don't want the AMPS or PMPS, the pre-shot tests, to be food influenced. Food raises BG levels, and if you shoot into a food inflated BG, then the BG levels may drop too far during the middle of the cycle.

    If you did skip the shot this morning, then you would put 0 in the U (units) column on the SS.

    Looks like last time you skipped the shot, Bear did not eat well. If Bear will eat her food, then the shot should be ok. It's a balancing act.

    There are actually smaller amounts of insulin you can give your cat. 0.1 units and a drop (or "Some") insulin.
    Pictures of the syringe with those tiny amounts.
    01unit-1.jpg someinsulin-1.jpg
     
  28. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

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    Feb 20, 2020
    I can see why you mentioned the advice will differ between groups. From advice I had gotten from the Facebook group I had assumed the no shoot under 200 was okay for bear if I had shot on a similar number before before she had good numbers. That's how i understood it at least.
    I will defintely try your method next time.
    I had errands to run but am home now my mom looked after her for me for a few hrs, she ate all of her food and was very happy to see me. So far all very good signs for me. I was worried after reading your response when I was out that she would drop. Shes up now and we will get a test in very soon.
    I'm afraid she will bounce at her PMPS because I had given her a dose on such a low bg.
    For future reference would giving her a 0.1 dose on a low number like that be the best idea?
     
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  29. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Here in the Feline Health forum the "pause and think" number is 200 mg/dL. It's more of a "stop and think about what you want to do" than an absolute "No shot, don't give insulin" number. Think of it as a threshold, a stop and ask for advice or stop and review the protocol BG number.

    In the ISG's (Insulin Support Groups) that "stop and think" number varies depending on the insulin used, the experience of the caregiver comes into play, the amount of test data comes into play. If you have to rush off to work, you don't know if your cat will eat food while you are gone, then a reduced dose may be appropriate. With a depot type insulin like Lantus/Levemir/Basaglar, you don't want the depot to drain too much by skipping the dose. If the cat has ever had ketones, DKA (diabetic ketoacidosis), HL (hepatic lipidosis) then you don't want to skip a dose entirely if you can help it. Ketones = fat and muscle breakdown = DKA with not enough insulin.

    For Lantus, the threshold, the initial decision point number is 150 md/dL. Same for Prozinc. WITH EXPERIENCE and some test data. First day here, first week or so on insulin for your cat, you don't know how your cat will react to the insulin, keep that threshold higher. As you gain test data, that threshold will get lower and lower. Our #1 goal is to keep your cat safe.

    On that 147, 148 I would have gone ahead and given Bear the full 0.25U dose. AFTER you have stalled, not fed, and tested again in 20 minutes.

    If she does bounce, then she bounces. Not the end of the world.

    With lantus, there are people shooting insulin at lower and lower pre-shot BG readings, under 100, even lower than that. You have to collect the data to be ready to do that. Here is a good "Sticky" post from over in the Lantus ISG on how to do that. Basically the axiom "Know Thy Cat" comes into play here.
    Sticky Tight Regulation: Becoming Data Ready to Shoot / Handle Lower Pre-shot Numbers


    Some of the other insulins like Vetsulin/Caninsulin and the NPH insulins like Humulin N/ Novolin N have a faster onset and steeper drop, so the threshold for giving insulin is higher, 200, 250, 300. As you gain experience with how YOUR cat does on an insulin and a particular dose, that threshold can be lowered.

    Is your cat a food spiker? Is your cat a picky eater? Know Thy Cat.

    Highly recommend that you print out and read the "becoming data ready" sticky I linked above.
     
  30. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

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    Feb 20, 2020
    Thank you for the clarification and the link. I'm definitely doing my homework today and taking notes for the future.:bookworm:
    Again I'm so glad to have this community as a resource.

    Last night she had PMPS of 189. ( I did not read your message until this AM) However, what I should have done was waited 20 mins ,tested again and then gave her a dose based on that BG?
    She without a doubt eats her breakfast/dinners on a dime. Though she is a grazer she finishes it and gets a snack in the day and a bed time meal for the night. She has been throwing up water/hairballs the last couple of AMs and I think it could be due to her grooming more lately she has gotten her long haired cat grooming regimen back. I was curious to see how it effected her BG so the hubby got a test on his way out and it was 205 BUT she did get into her sisters food(Ziwi peak lamb air dried jerky) the last two nights as well. :rolleyes:
    I think she's starting to feel better because her sister's food is in a 'hard to get to' spot, looks like we will be relocating her bowl.
     
  31. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Sort of, but not exactly. You do not want to adjust the dose of insulin based on the pre-shot BG value.
    You want to test at pre-shot to see if the BG is high enough to give insulin.

    Stall point with Lantus is 150. Until you gather more data, then the stall point gets lower and lower and lower. There are people here that give lantus if their cat is >50 AND they have the test data to know how their cat reacts.

    You adjust the dose based on the NADIR, which is the lowest point during the cycle that a particular dose of insulin takes your cat.

    On that 189 BG, I would have given Bear the dose without hesitation. No need to stall at a BG test >150.

    p.s. You'll need to manual color the +2 cell for today, since you put the time in the cell as well as the BG reading. The formatting behind the cells, expects only a number for it to color code correctly.
     
  32. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

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    Feb 20, 2020
    After reading through that link a few dozen times I understand a lot better now. Not fully because like you said I need to gather more data.
    Will I be able to figure out her nadir when I do a curve ?

    I plan to do a curve this Saturday after she will be off of the amoxicillin.
    I'm hoping to learn more so I can help my girl as much as I can.

    Done and done! I changed the one as well.
     
  33. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    You'll at least get a better idea of her nadir.
    Unless she is in a major bounce cycle.

    The thing is, the nadir doesn't always stay static from cycle. It can change slightly from cycle to cycle. Might be 1 hour later one day, or 30 minutes earlier another. Amount of food eaten, cat's activity level, a bit higher or lower carbs on the food, eating at a slightly different time can all have an impact. Most cats are going to be somewhere in the +5 to +7 hour range for a nadir using lantus. Some a bit later, some a bit earlier.

    You test to find the general nadir time for YOUR cat.

    Wink was an early nadir kitty, his was around +3 to +4.

    There is a chance when Bear comes off the Amoxicillin, that her BG's will drop a bit. No extra sugar from the antibiotic. Watch out for that possibility.
     
  34. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

    Joined:
    Feb 20, 2020
    I think I have an idea of her nadir now but a curve this Saturday is planned, I would do it earlier but I want her to be off the amoxicillin. When I do the curve should I do the normal feeding cycle so numbers are as accurate as possible?
    Also today Bear's numbers were below 120 at what I believe to be her nadir. She showed some signs of low blood sugar and I fed her. Her blood sugar did start to rise. But with her numbers low like this even on amoxicillin , it worries me for when she will be off of it. Do you think the amoxicillin could be effect her bgs a bit?
     
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  35. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Yes, feed normally when you do a curve.
    It's only the pre-shot tests, AM and PM, that you don't want to se that food influence for 2 hours before the shot. So you don't give the insulin into a BG number that is higher because of the food, and may drop as the insulin onsets, or begins to work.

    That onset usually takes 2 hours or so with lantus.
    I'm a bit concerned too, with Bear showing symptoms of low blood sugar, even at the 112 BG reading.

    Yes, the amoxicillin could be keeping Bear's BG numbers a bit higher than normal.
    You might consider dropping the insulin dose down to 0.1U when Bear comes off the antibiotic.
    Or even stopping the insulin for a little bit.
    Recommend you discuss this with your vet.
     
  36. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    It's also possible, that the subq fluids could be affecting the absorption of the insulin.

    Do you administer the Subq fluids in a part of her body, that is as far away from where you administer the subq fluids as possible? For example, subq fluids in the scruff, insulin shot in the flank.

    I'm wondering if the subq fluids are "disrupting" the insulin "depot" or storage area for the lantus. Lantus forms microcrystals below the skin and those crystals slowly dissolve. If the fluids are "breaking up" those crystals, and releasing the insulin a bit early, that could be causing some of the issues with lower blood sugar and hypoglycemic signs and symptoms.

    That Ziwipeak food that Bear's sister eats is fine for a diabetic cat to eat also. Low carb, freeze dried food. I suppose it's possible, that the Ziwipeak food is contributing to Bear's lower BG levels also.
     
  37. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

    Joined:
    Feb 20, 2020
    Wonderful. Thats what I had thought but love to double check myself.

    She has been doing great besides those symptoms and its only if she hasnt eating I'm noticing when I look at her notes once i feed her an ounce or more it goes away completely.
    Do you think that has anything to do with her symptoms? I know in humans diabetics when they approach low blood sugar become sensitive to light. The vet who I thought would be a good pick for us actually recommended I up her dose to 2u every 12 hrs when shes on the antibiotic. I obviously chose not to because I know she does NOT do well on high doses.

    I pondered that about the SubQ aswell. I only give it to her for dehydration recommended by both vets.
    But thinking I may stop since her constipation seems to be doing well and has been going to her water increasingly less. Due to those thoughts i had previously on the subQ absorbing or interrupting the depot I have been administering the insulin her planks for 2 days after(or at least until I see the fluid has absorbed).
     
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  38. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

    Joined:
    Feb 20, 2020
    PMPS now was 134. Lowest pre shot number ever. Stalling for 20 mins like we did last night to see if BG raises. If it doesnt meet the 150 threshold should I give no insulin or some? Based on her numbers today I am leaning towards none? But again I am really new to this and could be wrong
     
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  39. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Sorry, I'm not on that late at night.
    What did you end up doing?
    Did you skip, or stall again?
    SS not updated to see.

    I really think you need to move over to the lantus ISG group. Lots of people there that could help you when you get a low number like that. More people there later in the evenings too.

    "Better too high for a day, than too low for a moment.
     
  40. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Yes, not eating well before the insulin shot, or not eating enough food after the insulin shot and when it onsets could be causing the sensitivity to light.

    Do her pupils become nonreactive to light? What happens if you shine a small flashlight directly into her eyes? Do her pupils contract at all?
     
  41. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

    Joined:
    Feb 20, 2020
    I ended up skipping the dose. Checked her 2 hours after what would have been the time for her shot and she was 170 and doing very well. This morning her PMPS was 189. (Not sure why my ss isnt updating bit I did fill out a but of info)

    I have a speaking suspicion that the timing of the food is the issue. When she looks into the light her pupils contract and when I make the room darker or close the blinds they contract again. She is still response during these times as well. This morning was her last dose of amoxicillin so I am going to keep a close eye on her tomorrow to see if that effects things a bit.
    Should I make a new post in the lantus group about her low numbers and symptoms?
     
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  42. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Yes, posting in the lantus ISG forum is a good idea.
    Maybe someone there will have other ideas.

    They like to see a Daily thread with the date, your cat's name, AMPS (or PMPS) BG, additional + time BG tests. Keep updating your thread title throughout the day with additional BG readings. Put the ? icon prefix on your post for a question, to let people know you are seeking an answer. Include a short part of your question in the title. So something like this, replacing the xxx with your specific info.

    ? 3/26 Bear AMPS 189 + 2 xxx, +6 XXX help needed on xxxxxxxxxxxxx

    p.s. SS says you gave 0.25U dose this morning, 3/26/20
     
  43. Bear and the hooman Ciony

    Bear and the hooman Ciony Member

    Joined:
    Feb 20, 2020
    I defintely will post over there. Thank you for telling me the format of the threads! I will do my best to stick to it.:cat:
    And yes this AM she got .25 u. Last night was a skip. I tested her at PMPS she was below 150 stalled for 20 mins tested again and she was 143. She was screaming at me to eat so I didnt stalk any longer. Though now I'm kicking myself for not doing so.
     
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