Help Needed

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by JeanW, Aug 10, 2018.

  1. JeanW

    JeanW Member

    Joined:
    Jul 24, 2017
    I posted in the Main Health Forum when I think I should have posted here - sorry for the double post.

    See responses to my post there - Help

    Pretty Girl's numbers have been in the 500 - 600 range since PMPS last night. I really have no idea why - although I wonder if she didn't eat enough last night when I gave her her shot. It seemed okay at the time but that's what I'm wondering now.

    When I woke up this morning she clearly didn't feel too good. I gave her some food to eat before picking it up for the 2 hour window before AMPS. I could tell she felt some better but not too good.

    I tested for ketones and it is negative. She didn't pee very much - I would guess she's dehydrated.

    What should I do? I had to leave the house and come to work for an hour or so before AMPS - the stress is just too much.

    She was in the 3-400's till last night - and now this spike - what can explain it?
     
  2. LizzieInTexas

    LizzieInTexas Well-Known Member

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    Jul 25, 2016
    Have you tested for ketones?
     
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  3. JeanW

    JeanW Member

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    Jul 24, 2017
    Yes. See in my post. I tested and it is negative.
     
  4. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Dec 12, 2016
    I wonder if there is a particular food that is not really agreeing with her? How long has she been on these foods and is there a particular pattern that you can see?
     
  5. saltycat

    saltycat Well-Known Member

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    Apr 18, 2016
    There are a number of things that can cause numbers to rise, conditions that are painful or an infection are one possibility. Teeth are a common place where an infection can cause higher numbers. Pancreatitis flareups are painful and can also cause higher numbers.

    Is she hiding in different places, meatloafing? Could she have gotten into some high carb contraband? Mine liked to steal things he could get in his mouth, including candy which sent his numbers up.
    What symptoms is she showing that makes you think she is not feeling well? That can help narrow down a bit a possible cause.

    It could just be a bounce from seeing a few cycles of purples. It takes their body time to adjust as the numbers come down and even a drop into the purples can cause a bounce since their little bodies have been used to skyhigh numbers.

    ETA: You can change the 911 tag to a question mark since this does not appear life threatening to Pretty Girl. The 911 tag gets our attention quick and is generally used for things that need immediate attention like an after hours vet visit or very sick kitty. I would put the ? mark tag and add not feeling well to the subject line. As more people check the boards you will get some more eyes on your condo as well.
     
  6. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    I'm wondering if all the duck food has caused a stomach upset. Duck is higher in fat than other proteins. Can you stop that for a few days and see if it makes a difference?

    I don't see a test for this morning, did you get one yet?
     
  7. JeanW

    JeanW Member

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    Jul 24, 2017
    High again this morning.
     
  8. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Dec 12, 2016
    Pretty Girl....you really need to come down now....you are freaking momma bean out.

    I hope she comes down soon.
     
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  9. Beth 73

    Beth 73 Well-Known Member

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    Aug 2, 2016
    Sending prayers for Pretty Girl to begin the descent to lower numbers and peace for you as she does Jean:bighug:
     
  10. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Dec 28, 2009
    We're going in to the weekend. Will you be off work and able to monitor? If so, unless something unusual happens between now and PMPS, I would take the dose up to 2u BID tonight.

    EDITED TO ADD:
    My recommendation is based on experience, the caregiver's ability to monitor, and knowledge of the insulin used. I also don't believe in allowing a cat to remain in such high numbers without attempting to pull them down as quickly as one can do safely when the caregiver can monitor... no matter which dosing method is followed.
     
    Last edited: Aug 10, 2018
    Reason for edit: clarification
  11. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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  12. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    I agree with Jill.

    When was the last time Pretty Girl saw your vet? If she hasn't had a check-up recently, I'd want to make sure there's no infection, dental problem, etc. that's causing numbers to be in a high range. I'd definitely want to make sure her thyroid meds are doing their job, as well.
     
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  13. JeanW

    JeanW Member

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    Jul 24, 2017
    Thanks all for your replies and good wishes. :bighug::bighug:

    I will be mostly at work tomorrow and following a close to normal schedule. I can monitor on Sunday. I agree with not letting her stay in such high numbers. However we don't have a 24 hour vet closer than 3 hours away if there is an emergency and I am hesitant to make that change over night. I will go home 2 or 3 times or more during the work day today to check on her.

    It's unlikely she get into contraband or things she shouldn't eat although I suppose anything is possible. I am very conscious of making sure nothing is left out but like anyone else I am not perfect.

    @Jill & Alex (GA) I will see what the day brings and look at moving the dose to 1.75 tonight - although when I look at the spreadsheet the really nasty numbers have started after increasing the dose to 1.5 units. So I am hesitant. I had lots of pinks, some yellows and a few reds at 1.25 units. The string of black numbers has happened after 1.5.
     
  14. JeanW

    JeanW Member

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    Jul 24, 2017
    She saw the vet about 6 weeks ago and was at the animal hospital and then medical boarding for the month before that. She is not on thyroid meds or any other meds.

    The vet had her on 2 units morning and 1 unit night.
     
  15. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    FYI: I've merged today's threads in order to keep all relevant info in one place.
     
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  16. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Dec 28, 2009
    That was then. This is now. Pretty Girl needs more insulin to break through these high numbers.
    You're in control if you have a well stocked hypo kit and are monitoring carefully. The data you've accumulated does support an increase of 0.5u BID. That said, all any of us can do is make suggestions and/or recommendations. Ultimately, all decisions are yours to make.

    I'll be honest, I am very concerned about her developing ketones given the high numbers (inadequate supply of insulin), poor appetite, your concerns about her being dehydrated, and your observation that she's not feeling well. The ingredients are there. The circumstances are screaming for a vet visit/check-up and an increased dose.

    Just my thoughts...
     
  17. JeanW

    JeanW Member

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    Jul 24, 2017
    Thanks for all the thoughts and the advice. I checked for ketones this morning and it was negative. However I made a vet appointment for 2 this afternoon.
     
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  18. JeanW

    JeanW Member

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    Jul 24, 2017
    Started out really high at 552.

    Now 4.5 hours later down close to 100 points at 461.
     
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  19. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    We typically stick to one post per day. If you have a new questions or concern, just change the subject line and add a new post at the end with the new issue. Here is the other new post you started today.http://www.felinediabetes.com/FDMB/threads/08-10-pretty-girl-amps-552-4-5-461.200944/

    I'm glad you've got a vet appointment today. I hope it goes well. I do agree with Jill and Sienne that Pretty Girl needs more juice and an increase to 2.0 units is warranted. For what it's worth, I was once in your shoes. In the early days (2012), my Neko showed me more black that I liked to see. Jill and Sienne and Marje were the ones that got me increasing faster and into better numbers. Although it's not part of SLGS, I think the 0.5 unit increase is a good idea for Pretty Girl. We don't want her lingering in these high numbers. For one, it's hard on the kidneys.
     
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  20. Beck and Grandpa (GA)

    Beck and Grandpa (GA) Well-Known Member

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    Jun 4, 2018
    Super high numbers here today, too. Thinking he's eating too much. Not something I expected to say.

    How are things with Pretty Girl?
     
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  21. JeanW

    JeanW Member

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    Jul 24, 2017
    Not the best. We are going to the vet this afternoon - which I truly hate to do but is necessary.
     
  22. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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  23. JeanW

    JeanW Member

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    Ok, thanks, for everything. :bighug:
     
  24. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Going in the right direction!
    Probably a good idea. Let us know how things go...
     
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  25. Manu & Porto

    Manu & Porto Member

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    Apr 14, 2018
    Hope all goes well for Pretty Girl, try and test before vet, just so you know the numbers she has before the visit. Sending good luck wishes and hugs! :bighug::bighug:
     
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  26. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    Hi Jean, I sure hope the extra juice is going to get Pretty Girl down into some nicer numbers. If it were me, I would test for ketones just to be safe. As Jill said, a kitty in higher numbers, not eating well, and possibly an illness or infection could be the perfect storm for a DKA event. Not trying to scare you, just want you to be informed.

    Is she hiding? Is she posturing like she's in pain in the meatloaf position? All those little signs can indicate an illness. Also, is she pooping ? Any diarrhea. Sleeping in a different spot? All those things can indicate an illness or pain.

    Glad you have a vet appointment and hope the vet can get to the bottom of it.
     
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  27. JeanW

    JeanW Member

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    Jul 24, 2017
    Thank you all for the good wishes and happy vibes. :bighug::bighug::bighug::bighug::bighug:

    Thank you., Yes, a good suggestion and I am planning to do that.

    Going to the vet causes me terrible awful horrible anxiety :eek::eek: - I can hardly do it - but I do and will today too.
     
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  28. JeanW

    JeanW Member

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    Jul 24, 2017
    Thanks for the input. I hope her numbers come way down today. I did test for ketones this morning and it was negative.

    No, she isn't hiding. A little bit meatloaf sitting but only a tiny amount. Yes pooping and no to diarrhea. Sleeping in her favorite spots.

    Lots and lots of purring.

    Appreciate all of y'all's good wishes. :):):)
     
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  29. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

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    Dec 28, 2009
    Please update us after you see the vet. You're not alone at the vet -- we're all with you and have your back.
     
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  30. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Dec 12, 2016
    Sending vines for a good vet visit.
     
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  31. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Jean, how did things go at the vet's? Is there anything we can do to help?
     
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  32. JeanW

    JeanW Member

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    Jul 24, 2017
    A big huge THANK YOU to all of you for the love and support. It has been the longest day . . but not in a bad way.

    I just finally got home and in front of the computer. Things went very well at the vet.

    I had never seen this vet before - she is a relief vet - and I hadn't been to this clinic in a year since I've been going to the animal hospital 3 hours away. But this place is 15 minutes away. It's also the place where the vet told me a year ago to take my diabetic kitty home and be prepared for her to die. :blackeye: However, new vet owners and she's no longer there thank God.

    Anyway I took my spreadsheet and a can of the food I'm feeding. The vet knows some about FD and the vet tech has a diabetic kitty also. Pretty Girl's BG was 452 before we went. The vet strongly thinks I should hold the dose of 1.5 for a while longer because she says it's too soon to change and changing too soon is also bad. But she thinks in 5 or so days that I should increase to 1.75 with plenty of testing first to validate that.

    Also she recommended testing just a little bit less often because she says that stresses Pretty Girl and may be reflected in her numbers. They gave Pretty Girl sub-q fluids and in the fluids some liquid Vitamin B12. She was a little bit dehydrated but not that much. Pretty Girl has gained 1-1/2 pounds since I brought her home from the animal hospital 6 weeks ago!!!!! This made me very happy indeed!!!!!

    The vet tried very hard to get me to agree to feed the prescription MD food and tried and tried. I repeatedly said "no, I'm not doing that" and she finally accepted it.

    Pretty Girl seems exceptionally good tonight.

    Thanks again for having my back and holding my hand today while I freaked out! :bighug::bighug::bighug::bighug::bighug:
     
    Last edited: Aug 10, 2018
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  33. Susan&Felix

    Susan&Felix Well-Known Member

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    Sep 4, 2017
    Thrilled to see Pretty Girl is feeling so much better--and that you are, too!

    Five more days seems like a long time to wait for an increase with these numbers. I hope that as she's feeling better her numbers come down some.
     
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  34. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

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    Dec 28, 2009
    Awesome! It'll be so much easier to see a vet that's only 15 minutes away!
    I strongly disagree. It's definitely not too soon to increase the dose. I would increase the dose as suggested, but I understand following the advice of a vet rather than following an unknown on the Internet. After all, they have DVM after their name. Remember, if things aren't looking good, you can always change your mind and increase as suggested.

    However, if you choose to hold the dose despite the high numbers, please continue to test for ketones... everyday. They can and do develop quickly. For example, when Alex was diagnosed ketones weren't a concern. However, within 24 hours, she was in DKA, hospitalized for a week, and we almost lost her. It's imperative to remain proactive when it comes to ketones... especially given this particular set of circumstances.
    It's possible... anything's possible. Although, based on observations made in this group over the last 12 years, I'd have to say the more one tests, the faster kitty becomes used to testing and it simply becomes part of the routine between cat and caregiver.
    Wonderful! The B12 and fluids should perk her up for now, but the results are usually temporary unless one addresses whatever issues kitty is dealing with at the time. Were any diagnostics done today? It would be good to know if there's a problem causing the inappetance, not feeling well overall, high BG numbers and why they're not coming down.

    If she should continue to need fluids, ask them to show you how to administer fluids and possibly B12 at home. You'll save yourself some money! A 1.5 pound weight gain is certainly cause for celebration! I hope her appetite improves and she continues to gain weight!
    That's music to my ears! Undoubtedly, the fluids and B12 helped. I used to give both to Alex at home and it helped her immensely.
    It's why we're here. :)
    Others have had our backs. All we're doing is paying it forward...
     
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  35. JeanW

    JeanW Member

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    Jul 24, 2017
    It was too late when I was posting last night. I didn't mean to worry or upset anyone here.

    I did increase the insulin this morning. I'm not necessarily going to follow what that vet said - just reporting what happened - she's never seen Pretty Girl before yesterday.

    Yes, agree. But doubtful this will become our primary vet. Actually I'm sure she won't since she was a temporary relief vet.

    It has nothing to do with a vet and them having DVM after their name vs following the advice of the wonderful folks here. Pretty Girl and I have history of bad experiences with faster increases that you all wouldn't know about since it was before I started here. I checked for ketones yesterday and will check again today.

    No diagnostics were done yesterday. I just yesterday paid on the $3500 bill at the animal hospital - and yes those tests were a while ago - and I do understand how important it is.

    I have sub-q fluids at home sold to me by a previous vet - but I haven't had enough training and feel uncomfortable doing it myself.

    Thank you!!!!!
     

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