Chloe's vet visit

Discussion in 'Prozinc / PZI' started by srk4cats, Feb 22, 2018.

  1. srk4cats

    srk4cats Well-Known Member

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    The vet said that when a cat is difficult to regulate and has DKA's, it means there may be something else going on, perhaps cancer. She also said it's better to shoot in the hip area rather than on the scruff because the scruff is more fibrous and doesn't absorb the insulin as smoothly. She told me that one of her cats went into remission after 4 years of being diabetic. She's a very nice vet, about my age. I wonder why I never see any other patients in her office, maybe because she treats only cats. She told me that if there are ketones at a time when she is open, to bring Chloe in to treat at the office, rather than the hospital.
     
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  2. StephG

    StephG Well-Known Member

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    I tried shooting in the hip/belly area... Chuck hated it. He would swat at me. I gave up on that area and use his chest/shoulder area. He doesn't notice the shot there.
    Glad your vet is willing to help with Ketones. Would the bloodwork indicate cancer if she had it? Any type of infection or inflammation can help cause ketones.
     
  3. srk4cats

    srk4cats Well-Known Member

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    No, the abdominal ultrasound looked clear except for inflamed pancreatitis, but my vet said it could have been too small to see (cancer). She said that the 2 main natural causes of death in cats is cancer and kidney failure.
     
  4. srk4cats

    srk4cats Well-Known Member

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    I did it this morning and not a peep out of Chloe. She didn't like the shoulder area.
     
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  5. StephG

    StephG Well-Known Member

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    Pancreatitis can create the perfect storm for ketones...
    Good to hear she didn't mind the shot!
     
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  6. Teenuh

    Teenuh Member

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    Is this a new vet? Perhaps I missed something.

    Anyway, I'm glad you went to the vet. Keep up the good work!
     
  7. Teenuh

    Teenuh Member

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    The WBC would be elevated.
     
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  8. srk4cats

    srk4cats Well-Known Member

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    I took Chloe to this vet for the first time several months ago. She's a bit of a drive, but sees felines only. In the past year, I think I went through 3-4 vets, not including the hospital.
     
  9. Teenuh

    Teenuh Member

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    I'm guessing you are staying on Prozinc, or did you discuss switching insulins?
     
  10. srk4cats

    srk4cats Well-Known Member

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    I really love my vet! Finally found a good one! She emailed me twice today! She got my spreadsheet, but I'm not sure if it automatically updates after I add data. I'm guessing yes, because it's a link, but she asked me to keep her updated anyway. She doesn't lecture or scold or tell me to do this or that. She just offers advice, like where to shoot. She suggested I stay on the Prozinc for now since the dose increase to 2.5 seemed to help. I had one day of all blues. Besides, the vial is only one month old. She did suggest that I not go so far past the expiration date, though. So, she told me about the different types of insulins, but wants to wait before changing.
    btw, one vet wrote me a nasty letter that they were dropping me because I didn't bring in Chloe when they said and because I was 'emailing them too often'. Boo hoo.
     
  11. Teenuh

    Teenuh Member

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    Yes, that is how "we" are able to see updated numbers in real time.
     
  12. StephG

    StephG Well-Known Member

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    @srk4cats please get a before bed test! 2 units on a 105 can be too much! (Edited to correct dose amount)
    Keep testing for Ketones. Those red preshots could be caused by her going too low at night. Getting a before bed test and feeding her before bed if she needs a boost can help even out the preshots.
     
  13. srk4cats

    srk4cats Well-Known Member

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    @StephG Yes, I was a bit uneasy about it, but I wanted to keep up the routine. This morning, she was too low, but she is eating now. I didn't get your message in time.
     
  14. Djamila

    Djamila Well-Known Member

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    Before bed tests are important every evening. Just make them part of your bedtime routine. Do everything else, and then right before you climb in bed, give Chloe a test to be sure she's safe before you go to sleep.
     
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  15. srk4cats

    srk4cats Well-Known Member

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    She went up over 400 points in just 3 hours!
     
  16. Teenuh

    Teenuh Member

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    If ever in doubt get on here and ask. Put 911 in the subject line, It should generate a quick response. Someone is always up.
     
  17. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I agree with Djamila about getting a before bed test every night. This is really important because you're away at work all day and the two PS tests alone aren't enough information.

    ETA: What does the lime green 2.5 mean, Roberta?
     
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  18. srk4cats

    srk4cats Well-Known Member

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    I couldn't get the background of that cell to turn white. It means that, at +3, when she was in the 400's, I gave her 2.5u of insulin. I did that the other day, too. It screws up my schedule, but I don't like seeing her jump by 400 points.
     
  19. StephG

    StephG Well-Known Member

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    Definitely a bounce. I would test for Ketones today.
     
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  20. Teenuh

    Teenuh Member

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    I would test more than once today. And if you can I would get extra Bg readings.
     
  21. Teenuh

    Teenuh Member

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    Update?
     
  22. srk4cats

    srk4cats Well-Known Member

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    315 at +3. She's been nibbling all evening. I need to go back to the 2.5 dose AM and PM. Haven't caught her peeing yet.
     
  23. StephG

    StephG Well-Known Member

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    That's where the before bed tests will help a lot.
    I think she's bouncing from the 50 this morning. So, some people will shoot through the bounce. Give the full dose on a lower preshot because they know those high numbers are coming. BUT the problem with that is, they don't always bounce the same way.
    With the tests you're getting, you will be able to see a pattern in her numbers. See what causes a bounce and when they might happen. It helps show how long they will last too.
    Continue getting the tests so you can see the bigger picture and any patterns.
    If she shows she always bounces after greens-- you can feel more comfortable giving the full dose on the next cycle if it's a blue PS.
    If you decide to try this, testing before bed is an absolute must and it shouldn't be done if you won't be home to test.
    If you insist on giving the full dose no matter what, you still need to get the tests so you can see the patterns and try to predict when she will need extra food to keep her from going too low and bouncing.
     
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  24. srk4cats

    srk4cats Well-Known Member

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    She was ravenous this morning. Do high numbers make it seem to her like she's starving?
     
  25. Rachel

    Rachel Well-Known Member

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    It can. When they're high, their bodies can't use the food as well, so they might feel more hungry.
     
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  26. srk4cats

    srk4cats Well-Known Member

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    Chloe likes the green kitty litter box, maybe because the sides are shorter (IKEA). Anyway, I emptied it and put it in the place where she's been peeing in the dustpans, and voila! I didn't see her pee, but there was a nice bit of urine in the litterbox to test. Negative for ketones, but her pH was slightly on the acidic side. She's so considerate!
     
    Last edited: Feb 25, 2018
  27. StephG

    StephG Well-Known Member

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    Chuck gets VERY hungry when he's high and when he's low. So the only way I can tell for sure is testing.
    Yay for no ketones.
     
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  28. Teenuh

    Teenuh Member

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  29. srk4cats

    srk4cats Well-Known Member

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    I bought the litter box at IKEA over 10 years ago. It's not great if your cat likes to kick up a storm, but Chloe seems to like it.
    @StephG @Djamila
    Chloe just tested at 81 and is eating voraciously, as usual. I would like to give her the 2.5 u in a few minutes. Altering the dose seems to make her bounce.
     
    Last edited: Feb 25, 2018
  30. Djamila

    Djamila Well-Known Member

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    Sorry, I just got home. Did you already give her the dose? It's not safe to give a dose of Prozinc on an 81. If you have not already given the shot, I would recommend feeding and retesting until she is high enough to shoot safely.

    I'm going to make another plug for switching to Lantus. On Lantus you can shoot lower numbers like that with greater safety, and it would help you to stay on schedule without having to fuss so much with feeding and trying to manipulate the cycle for her. It can be scary to make a change like that, but I think Chloe might do better on it since it lasts longer which may help her avoid ketones, and it would almost certainly be easier for you to manage with your work schedule.
     
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  31. Djamila

    Djamila Well-Known Member

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    If you did give her the dose on the 81, you absolutely must test tonight at +2, and at the very very least again at +4. Possibly more than that depending on the numbers you get. I'm very worried about her getting 2.5 with a starting number of 81. You can keep her safe, but you must test and be prepared to steer if she is dropping at +2.
     
  32. Teenuh

    Teenuh Member

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    I second this suggestion! I know it must be stressful for you to have to worry constantly.

    It sounds like you have a good rapport with your new vet. I would consider emailing her and ask about switching.
     
  33. srk4cats

    srk4cats Well-Known Member

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    She went up a bit to 88 and I need to go to sleep for work tomorrow. I'll leave some food out for her and get up at 5 am.
     
  34. srk4cats

    srk4cats Well-Known Member

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  35. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Huge bounce from those greens. Not much you can do about that. I see that Djamila recommended that you give more thought to trying Lantus. It might possibly help to flatten out these highs and lows. It also works best by keeping a consistent dose AM and PM (numbers permitting) so that part is easier - less guesswork.
     
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  36. Djamila

    Djamila Well-Known Member

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    Yes, unfortunately that's to be expected after that PM cycle. She'll settle down throughout the day today.
     
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  37. StephG

    StephG Well-Known Member

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    I agree. Chuck's been doing great on his new dose. If you look at his SS you can see that I shoot low on lantus. I have a ton of data so I know what to expect. With his dose increase he went a little crazy with it but this morning's cycle is a good example of "shoot low to stay low" with lantus.
    Edited to add: I'm sorry, I didn't get the tag notification yesterday.
     
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  38. Teenuh

    Teenuh Member

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    I don't know what @Djamila @Kris & Teasel @StephG thoughts are, but if you are insisting on giving her the regular 2.5 dose even when she is low--She will need a HC food first.

    Step1: Test
    Step 2: Evaluate number
    Step 3: Based on PS numbers determine what kind of food to give Chloe. I think low carb is better, BUT if you are persistent on giving the same dose then I would give her the HC food to help offset.
    Step 4: Retest and shoot (as long it is safe).


    She requires a more monitoring than the average diabetic kitty right now.

    I'm hardly home sometimes, and if Gracie was doing what Chloe was doing I would make the switch.Would I want to? No, as I dislike change, but I would want to do what is best for her. If it doesn't work--it doesn't work, but at least I could say I tried.

    If ever in doubt POST!!!!!! and put 911 in the subject line. I would post in main. Prozinc tends to get quiet after a certain hour. It will grab attention.

    Also, I'm not a fan of Facebook, but I noticed you are on the Feline Diabetes group. It is frowned upon if they give dosing advice on there. You can post on there and ask for help. You copy and paste your link to SS and post. Someone will help you.
     
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  39. StephG

    StephG Well-Known Member

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    I agree that she will need more carbs or more food. The spot tests will help figure out if she has a pattern and you can feed more or higher carb on the bounce breaking cycles to keep her safe and hopefully keep the bounce from getting so high.
     
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  40. srk4cats

    srk4cats Well-Known Member

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    high? I just tested her at 5:45 pm and she was 28! Well, I don't believe it because she was up yowling for dinner and I didn't get enough blood on the strip. I'll test again in 10 minutes.
     
  41. Rachel

    Rachel Well-Known Member

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    28?!?!?!? Is that her PMPS?
     
  42. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Please retest ASAP! If her BG is still in that range DO NOT give insulin.
     
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  43. srk4cats

    srk4cats Well-Known Member

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    She just tested HI. omg,is it possible to go up 500 in just a half hour?
     
  44. Djamila

    Djamila Well-Known Member

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    Do a third test. You need to find out which one is correct.
     
  45. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, you need a third test to know what the real BG range is.
     
  46. Djamila

    Djamila Well-Known Member

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    I would also recommend that you call your vet tonight and let her know what is happening. Since you're following her advice on dosing, she needs to see the numbers you're getting and make an adjustment to the dose.
     
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  47. srk4cats

    srk4cats Well-Known Member

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    I wonder if the meter is broken. I've been having problems with it the past few days, such as not taking a reading. I put in a new battery recently. Do these $9 Relion meter fail after about a year? I'll test her with the Everpaw next.
     
  48. srk4cats

    srk4cats Well-Known Member

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    Past her office hours. I actually emailed her early this morning but didn't get a reply.
     
  49. StephG

    StephG Well-Known Member

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    I had one that went bad before a year. I dropped it a lot though.
    Please use the ever paw and see what her reading is.
     
  50. Rachel

    Rachel Well-Known Member

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    Please get another test in.
     
  51. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I'll repeat here what I said on your main forum post: DO NOT give insulin until you do a third BG test.
     
  52. srk4cats

    srk4cats Well-Known Member

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    I'm out of Everpaw strips. A few months ago, I bought an Accu-Check Aviva Connect for $5. I just opened it and it doesn't have any test strips either. I think I'll test with the Relion one more time and if it's still HI, I'll give her 2 units.
     
  53. Teenuh

    Teenuh Member

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    I just saw your post in main. Please disregard my Bg question.
     
  54. Teenuh

    Teenuh Member

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  55. srk4cats

    srk4cats Well-Known Member

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    She seems fine. She was very hungry. Her BG read 58, so I'm wondering what dosage I should give her tonight. I'm thinking of testing her again in about an hour before I give her any insulin.
    btw, a young woman just came to my door with a flyer. She lost her cat. The picture looks just like Chloe. I'm taking it as a bad sign.
     
  56. Teenuh

    Teenuh Member

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    You were thinking about testing before giving her insulin? It is mandatory, or at least strongly advised.

    Before we can give dosing suggestions we will need to see where she is post meal. I would test at +1 and update us.

    Oh, goodness. I can't imagine losing Gracie. I'm sure she is heartbroken. I hope she finds her kitty. :nailbiting::nailbiting::nailbiting:

    Why are you taking it as a bad sign? Is something else going on?? Try to put your energy into focusing right now. Pets can sense energy from us.
     
  57. Djamila

    Djamila Well-Known Member

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    When you called your vet about the numbers you're seeing, did she have a recommendation for changing the dose?
     
  58. Teenuh

    Teenuh Member

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    Did your vet ever email you back? I think she needs to know what is going on--number wise.
     
  59. Kris & Teasel

    Kris & Teasel Well-Known Member

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    We're getting concerned, Roberta.
     
  60. srk4cats

    srk4cats Well-Known Member

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    no
     
  61. srk4cats

    srk4cats Well-Known Member

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    She's going up slowly. She's been eating for an hour straight and still going. It's almost 7:30 and I need to decide what to do NOW or I won't be able to give her insulin before I go to work tomorrow. Please advise.
     
  62. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Try 1 u and get a before bed test for sure.
     
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  63. StephG

    StephG Well-Known Member

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    I think 1 unit is a safe dose too.
    Check her in the morning at the normal time. If she's high, like over 300 you could probably give her a 1 unit dose.
    She needs the insulin so check in with her AMPS send we can help you decide.
     
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  64. Teenuh

    Teenuh Member

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    I would try getting a ketone test today.
     
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  65. srk4cats

    srk4cats Well-Known Member

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    negative for ketones, negative for vet reply, getting annoyed. I gave her 2.25 tonight because she was over 500. You probably won't believe this, but she pees in the empty kitty litter box every day so I can get ketone tests.
     
    Last edited: Feb 28, 2018
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  66. Teenuh

    Teenuh Member

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    Glad she is negative for ketones. Sorry about the vet getting back to you. I'm sure it is frustrating. My vet gets busy too and usually doesn't call me back the same day. I generally have to nudge her. Maybe call tomorrow? I was going to suggest stopping by, but if I remember right she is a little more out of your way.

    If she will pee in an empty litter box---and you are able to test for ketones then I am all for it. Although it might make a little messier clean up.
     
  67. Teenuh

    Teenuh Member

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    How is Chloe today?
     
  68. StephG

    StephG Well-Known Member

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    Try to get a before bed test tonight. It can tell you if she's dropping fast or a lot and causing a bounce or if she's stuck in the high numbers.
    Encourage her to drink water so she's not getting dehydrated and keep testing for ketones as often as you can. These high numbers are a recipe for ketones and DKA.
    If she's stuck in the higher numbers she might need an increase BUT YOU CAN'T DECIDE until you get some proof that she's stuck high and flat (with little to no fluctuation in BG). Before bed tests and mid cycles will show you what you need to know. :cat:
     
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