Elmo 12/19 PMPS 183

Have been without internet since last night..had to come to DH office where I am now ...will be posting as I can til home internet is corrected ...last night +4 was 160....

 

Beth I put a link over yonder on your old post so we don't lose you in the main thread listing. Understand about connectivity so just post when you can. We know you have a busy day today!

 

Bummer on the PM+4.

Sorry to hear about home intertube connection being down.




Mogs
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And I sent you a prezzie.

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Will be posting here on my phone as time permits....can't access SS so will post his numbers here...he is acting fine, ate well, gave .25 minus full drop and will check at +1.5 ...any thots on stalled BG numbers? Ketones negative .

 

When you get a chance let us know you're home safe 'n' sound, Beth.

 

Not yet. Waiting to see what Elmo does today. If you still have the can from the food he ate last night I suggest making a note of the variety, and the batch number.


Mogs
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Thank u for all ur support ....internet still sporadic ...will post as soon as home ...probably not for a few hours and if internet is cooperating .....amps 167...+1.5...141........+2..119.....+3...119.......+4...140......got a feeling dealing with thyroid and may need to up his dose...blood work will tell...

 

He said YES !!! Still here...more info later...o am trying not to do my happy dance !!!

 

You got the green light for insulin change??? (I'm assuming...) If so, YAYY!!!

 

!!!!!

 

Great news! I knew you'd make your case very convincing! and look Menace is excited for Elmo and you too!

 

Hello and huge kudos to you all !!!! You armed me with confidence and information so I was able to go in with the belief that if vet said no then I would just keep at it til I got my yes, there or somewhere else. Oh.... my....goodness....it went above and beyond all I could have hoped, thought or asked. He said yes to Lantus and referred me to a vet clinic about 45 minutes away . Dr Stewart said Elmo needed more than he could give , given his diabetes, thyroid and kidney issues . The vet he referred me to is actually a lady I have gone to over the last 17 years with complicated situations, who was the one who neutered Elmo before I found a vet closer to me. She is wonderful and now to think she will be able to be Elmo's vet is just beyond my wildest hopes. Thank you to each and everyone of you,but especially Mogs, Kris, Linda and Chris for all the hopes, thoughts and prayers that helped this be a successful day. . His numbers are a bit wonky now, in part due to elevated thyroid..vet increased his dose. We are exhausted from the day so will tackle Lantus and new vet call for tomorrow.And yes, rural internet has returned....out for over 12 hours but back now ......again, thank you, thank you, THANK YOU to each of you .As my little niece says" you are my best "!!!!

 

Hello Cass and Gordy....yes, my now former vet not only gave me script for Lantus but referred me to new vet who handles more involved cases. See that you switched from Vetsulin to Lantus so I know I will have a million questions !!!! This has been a very good day !!!!!

 

What a result, Beth! Over the moon for you!!!




Mogs
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Oh thank u, thank u, Mogs !!! Could never have come this far without u all!!! I am speechless, which takes a lot for me

 

Oh, Linda ...dancing Menace is far too cute .....that's what I almost did at the vets today , my very happiest of happy dances

 

I won't be much help, I just switched yesterday But we can do the journey together Its exciting! I got news from my vet when I was at work, then told everyone (not that they cared all that much lol)

 

Journeying together sounds great!!!! And with all these unbelievable helpers on this board we don't journey alone !!!

 

Beth, did your vet give you a guide as to how long it will take for the new thyroid med dose to settle? (Wondering what impact it might have on BG levels.)


Mogs
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But WE do!

 

So so happy for you Beth and very glad to have shared in this journey.

 

I am talking to my holistic vet tomorrow. I believe I remember that thyroid meds help lower BG levels some ...will ask her tomorrow. Thanks, Mogs , for the point. Taking his PMPS in 45 minutes..he may have a minor UTI but will wait for holistic vet direction on that ....

 

Beth, with Elmo having HyperT before he developed diabetes, getting his HyperT under better control will likely make his BG go down. HyperT can cause insulin resistance leading to the development of diabetes. As the HyperT is brought/kept under control, it's possible the diabetes could possibly go into remission. Interesting short video on the subject HERE.

ETA Elated to hear you have been referred to a vet you admire and can work with. It's so much easier when you have full faith in your medical practitioners!

 

Thank you,Linda...I am a bit overwhelmed right now and exhausted...I know u all understand and that helps beyond measure.He has been on a very low dose thy meds for several months but vet doubled it...going to give it tonight and heck with holistic vet tomorrow. They controlled it before with science diet yd which is high in carbs and can't help but think it aided in the diabetes. He had eaten the junk for almost 3 years .

 

When adjusting regimens it's advisable to be extra careful when more than one thing is changing at the same time.

With the increase in the hyperT meds it may possibly show some impact on Elmo's metabolic rate. You need to take that into consideration because it may affect Elmo's insulin needs - or may affect his BG pattern.

Your home testing should hopefully aid you in keeping on top of any changes but I think it would be a good idea to check with the vet about precautions you should consider about when to do the insulin changeover. Essentially you've got Elmo in very good numbers on a very small dose of Vetsulin at the moment. If the thyroid med were to reduce his BG levels he may need less Vetsulin. Obviously any changes will also have an impact on Elmo's upcoming Lantus switch-over.


Mogs
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@Kris & Teasel @Critter Mom @MrWorfMen's Mom ......help !!! Just took PMPS and got 183 !!!!....what do I do???

 

Feeding in 30 minutes....shoot in little less than one hour ....

 

Also he has been peeing and drinking extra today due to elevated thyroid and/or possible UTI....told vet today about peeing and he didn't address it

 

ALSO ????? Do I go ahead and increase thyroid meds tonight or wait ??? Maybe increase by 1/4 more pill instead of a full additional 1/2 ????

 

Beth, the increased peeing/drinking could be from the higher BG too so don't despair. I'd start the increased dose of thyroid med tonight as planned. As far as dose is concerned tonight, I'd be inclined to tread lightly right now so stick with the same dose. Other may think otherwise but that's why we tag team! My thinking is that one night or even a few days of being a bit high is better than being too low and we don't know how quickly you will see results of increased dose of thyroid med. Definitely something to discuss with holistic vet tomorrow.

Curious.... I take it Elmo has been drinking/peeing more before today? Did vet suggest possible UTI or is that your speculation?

 

Linda, for past month or so he hits times where he goes several days peeing every few hours then next day would go for 8-10 hours between pee...yesterday he started going little closer together but today got marked worse. Always the same average amount .

 

So so glad I talk with Dr Pat ( holistic) tomorrow...made the appointment a week ago just to check in....she is fabulous ...so calm and reassuring... has helped me for years

 

She does only phone consultations with people all over the world...such a wise lady and a blessing to have in my kitty arsenal !!!

 

His methimazole dose has been very small. Some cats are sensitive to it when the dose is raised - vomiting, inappetance. Just a heads up.

I agree with Linda on this - keep variables to a minimum.

 

Beth, my little sugar used to leave a wet concrete slab on the bottom of the litter pan . Thankfully now it's clumps as opposed to a slab but some days she pees more than others and I see her visiting her water bowl more some days than others. My girl is generally running higher than Elmo and does far more cliff dives into the blue lagoon (where Elmo has spent most of his time lately) without actually heading into shark (hypo) territory (getting you used to Lantus speak here!) I think the BG day to day can have a noticeable effect on intake/output fluid wise but it doesn't necessarily mean there is a UTI at play. Did your vet today check Elmo's temperature or do a full blood panel to check for increased WBC (white blood cells) which could be indicative of an infection?

 

Do u all think I should go with the full increased dose, a doubling of current , or go with1/4 increase?

 

No he did a blood panel which showed elevated BUN and CRE but not higher than 3 months ago

 

Amen....now u all sound like Dr Pat

 

If I recall the methimazole tablets are quite small. What fraction is manageable?

 

Are you going to get your Lantus from the place in Canada that we're all getting it from?

If you've got your script for Lantus, you can take a picture of it and email it to Marks, or if you can scan to email or fax that works too.....the sooner you get it to them, the sooner you'll have the Lantus

 

How long since you got back from the vets? Does Elmo get affected by travel/vet stress? Did he eat a different amount today (more/less)?

(Just covering all bases here.)

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I'd go with the dosage your vet recommended

 

Elmo had low WBC when checked back in August...that's why they started him so low on methmazole...not sure why WBC low but have not revisited it....one kitty ...many issues...

 

So would I.

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I have been crushing and cutting it in half....kinda feel like a drug dealer

 

Beth wrote:

All that stress would have increased BG levels at the vets. I've no idea how long they might take to come down again but there is the possibility of a stress influence on that PMPS number.


Mogs
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Beth a low WBC can be indicative of many things and one of them is an infection which is totally counter intuitive. How much lower than normal was it?

Did you by any chance tell him he was going to the vet? More white coat syndrome?

 

WBC was consistently low from July -August...around 2 instead of 5....holistic vet recommended giving colostrum to guard immune system....have been hit and miss at that with everything else going on...another point to bring up tomorrow....

 

I know, Linda, for real ......he rides like a dream( good since new vet is 45 min drive one way)..my two civvies holler the whole way then purr and roll around once there....go figure

 

Ok , my panel of blessed experts...shot time in 10 minutes....am I to go with .25 minus a full drop with one full methmazole an hour later....an then PJ PARTY

 

Thot about that too, Mogs. He seems relaxed, just ate full half can as usual

 

I say NIX on the PJ party but yes to the full methmazole dose and .25u minus full drop. I doubt the methmazole is gonna "click in" quite that fast but I have to admit I've been bluffed by kitties before!

 

Be careful what you wish for, Beth!



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Oh that we could all pj party together

 

While it would be much more fun to do it in person, you know we'll do it with you virtually if it becomes necessary! I'm still betting it won't be!

 

I agree.

 

How often check BG tonight ???

 

Told Elmo all his precious godmomma's have weighed in and Elmo said"yeah, I feel better !!!"

 

I'd stick with the regular routine. IF (and that's meant to be big) there is any excess activity by +1.5, you'll be able to steer Elmo soon enough to avoid a PJ party.

 

What is my regular routine ....I do usually check at +1.5 then +4 or so it more depending o. +1.5.....I am sorry but I am brain numbed right now...

 

Check as you usually do at 1.5 and let's see where he's at then

 

You're just coming in to land after all the build up to today's consult - and all the excitement at the great result!




Mogs
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Ain't that the truth, dear Mogs. This ole gal is in her pjs ,curled up with 3browm tabby kitties. Praying ur night is peaceful and sweet Noodlebug's GI tract stays calm and at rest

 

Thank u, oh lady of Versailles

 

Forgot to update ye all: we've had solid, healthy-odoured poops since Thursday night! The bit of Smilla food in with her home-cooked chicken made a difference in less than 72 hours. You say some very powerful prayers, Beth; thank you from both of us!


Mogs
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Oh My Goodness !!!! What a praise report!!! Elmo and I will keep it up . I am so glad for you !!! Makes my heart happy !!!!

 

Delighted to hear that the Noodler is doing better. That must be such a weight off your shoulders! You and Lunasa get a Happy dance too!

 

Just a bit.


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Linda ,you and ur dancing felines are a hoot !!! Elmo +1.5....136. Today at vet was showing him Elmo SS and said " look at these 50 point drops in just an hour and a half!" To which he replied "well that's what it's supposed to do". I snapped"well, that's not good !!!".....I think that's when he realized to send me to another vet would make his professional life much easier

 

Beth, your job as a pet parent is to be an advocate for Elmo and if your vet doesn't like that, so be it.

I was once summarily dismissed from my Mother's doctor's office and told never to come back because I argued with him about the difference between "guidelines" and "rules/regulations" regarding her BP. She was in a retirement home where her BP was checked daily and if she sneezed twice in a row, they wanted her to see her doctor, so I knew if her BP got out of control, I'd hear about it immediately. He still insisted that he wouldn't write any more scripts for her BP meds unless she visited every 3 months. This was no easy feat and royally expensive for a woman with major mobility issues. The stupidity of it all was that he then had the audacity to try to collect money for transferring her medical records to a new GP when he knew full well, she could not get to his office without me. Needless to say I never paid the bill.

I get into some rip roaring good discussions with my vet because Menace is such a rarity to her that she doesn't even attempt to tell me how to deal with her diabetes. She in fact has emailed me for info saying I've done a lot of research she just doesn't have time to do. I love my vet and often wish she looked after us humans too!

 

Oh,Linda, what a blessing to have a vet like that. I experience similar things when I take my 94 yr old momma for checkups. Love it when they say"well she is 94 years old" . I've replied that I am fully aware of my mom's age and what does that have to do with it, like she has an expiration date! I may not have their intelligence and advanced degrees but I have good ole common sense. I respect them but do not worship them and believe them beyond being questioned. I'm sure they love seeing the back of my head each time !

 

Add me to the "NO, I won't worship the ground you walk on" club!!

I've fired 3 vets and more doctors than I can remember!!

 

One of my brothers refers to M.D.s as "medical deities" with a note of scorn in his voice ...

 

Amen! Preach it , sista! You take care of your momma too so you have first hand experience !! We are all a hand full, huh?!? Ain't it fun !!!!

 

Oh that's good !

 

I'd be interested in this....could you share her contact info? Also, is she expensive for a consultation?

 

I have a thyroid condition. I am not sure if the thyroid meds metabolize the same in cats as they do in humans, but FWIW...it takes weeks (up to 6 weeks) for thyroid meds and dose changes to take full effect in humans. So says my endocrinologist.

 

My kitty is also on vestulin and we are still slowing figuring it out and trying to get him regulated. What is a normal healthy drop in BG in +1.5 on vestulin for a regulated kitty? Again, I understand we are not there yet and Ozzy is early on, just wondering what 'normal' looks like. Thanks! Sorry I'm spocking your tread Beth!

 

Hi Momma of Ozzy...I'm sorry if I've missed your human name ....anywho, holistic vet website is drpatbradley.com ...it is a bit pricey(to me) at $60 for one hour consultation. That's why I only use her for the complicated or for specific homeopathic remedy situations. I have called her for years and have learned a lot to where now I can treat simple stuff on my own. She loves it when I call and say "well I tried such and so first"...feels like she is kinda training clients in simple homeopathy. As far as Elmo's +1.5 drop it is now usually 50 points at least. More experienced members could let you know what it should be. Elmo just drops like a rock, stays low for a few hours in healing numbers then goes back up around +8 or 9. That's why we r in process of switching to Lantus,although it is requiring me to switch vets too. Vetsulin worked for a while but was not the insulin that was going to give us a shot at remission. We really currently on .25 minus a drop and it still drops him like a rock. Hope that helps !

 

....glad to share the little I know

 

No pj party for us tonight.....+1.5 ..136.,thyroid meds given.......+4...133....what a day

 

Good to know...had a thyroid kitty few years back but couldn't remember

 

It's Joanna...

Saw all your replies above. Thanks. I'm curious to see what happens with your sweet Elmo once he switches to Lantus. Will be following your posts. I am just a few months behind you on diagnosis so seeing what you are going through may be a look into my future (vestulin here too). I know all kitties are different, but it gives me some sort of real life reference point if that makes sense.

I am learning a lot here and the members have been so wonderful.

I have to admit that this site is somewhat of a new obsession for me. All the info you need to know about your diabetic pet in one place with tons of experts. How great is that!!?

 

Ah! I see he's met my brother ...

As medics go, my brother is extremely knowledgeable and skilled but ye gods! is he an arrogant piece of work. A case of, "Here's my ego; the rest of me will be along in five minutes."


Mogs
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Actually, $60 for a 1 hour consult on the phone is not bad at all. You can exchange a lot of info in that time. Look at what we pay for in clinic vet visits that might only be 15 minutes. Sounds like you've been able to get a lot of help from her, Beth.

 

Hi Joanna... I do so help Elmo and my journey can help you and Ozzy. That would thrill my heart

 

This cracks me up! Two of my brothers, including the one who made the medical deities comment, are PhDs but don't seem to have the need to fling it in anyone's face ...

 

Very true, Kris...I always make sure I have definite points I'm covering written down and fax those points plus relevant records to her. In process of doing that this morning for this afternoons phone appointment . She really is amazing.

 

That's awesome...like anything , it's good to not paint all with a large brush

 

My vet yesterday was so honest and humble in admitting Elmo was beyond his experience to help. This admission with a vet student standing there. I was very impressed.

 

Hi Joanna,

The drop varies based on the overall BG range at the time, the dose, what has been eaten and, of course, the cat. Following the BG data helps to determine how an individual cat responds to the particular insulin being used. For example, given the same dose, same BG range, and same feeding, a cat who tends to metabolize insulin quickly may show a larger drop at +1.5 than a cat who metabolizes it more gradually. Also for the same cat on the same dose of Vetsulin but looked at over two days you might see a situation where one day there's an unusually high preshot BG. The same dose that drops the cat from a 'typical' PS BG to its current 'typical' mid-cycle level could also drop the unusually high PS BG to the same 'typical' mid-cycle level (i.e. a larger drop in BG is observed for the same dose in the second case). For example from Elmo's data:

* 17 Dec 2016: Dose = 0.25 - full drop Vetsulin; AMPS - 144; AM+2 - 111 (a drop of 33 points).

* 17 Dec 2016: Dose = 0.25 - full drop Vetsulin; AMPS - 166; AM+2 - 114 (a drop of 52 points).

It's very much a case of ECID although the action profile of the insulin being used can give a rough idea of what is statistically likely to be the 'style' of response. This is where the spreadsheets come in: as more data is gathered for a kitty it helps to reveal the pattern of that kitty's individual response to that particular insulin.


Mogs
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That, in my book, makes him a great vet. He works for his patients' best interests and finds ways to help them when more specialist knowledge is needed.

I wish I had had your vet last year when I was seeking to restart Saoirse's Lantus treatment. Even though her BG was in the normal range (the higher end) various of her clinical signs disimproved when insulin support was withdrawn. A so-called diabetes specialist at a referral centre blocked any chance of my getting an Rx to reinstate her treatment. (Her opinion took legal precedence so our own vets had their hands tied.) Lack of that little droplet of basal insulin put strain on her little pancreas which could have been safely and straightforwardly avoided. Saoirse might not had to go through eye surgery. She might still physically be here ...


Mogs
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Oh, dear Mogs..I am so so sorry..All we can do is what we know at the time. There are so many instances with my kitties that I could look back at and beat myself up. I work very hard at not doing that for it can weaken me physically , emotionally and mentally. We do the best we can with what we know at that moment. You were and are an extraordinary kitty Momma....just look at ur Noodler....u r like a bull dog with a bone, determined to get her little GI tract operating as it was created to function. Your devotion is amazing .

 

Holding on to guilt and regret is poisonous to all of our domains - mental, emotional ...