Just a little nighttime drama. Learning to figure it all out ❤️

Discussion in 'Lantus / Levemir / Biosimilars' started by Supurrkitten, May 15, 2017.

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  1. Supurrkitten

    Supurrkitten Member

    Joined:
    May 7, 2017
    Hi,

    I am not sure if I should post here or not. Fergus is on lantus though.
    This morning I decided to take him back to the vet. I had a nagging feeling abut his pupils. They had been bigger, I guess, at least for a day or two. This morning I saw that they were big and the morning sun was coming into the room. I used my flashlight to check his constriction response. It was slower and did not constrict down much at all.

    I had the thought that dilated pupils were bad from something I read on here. I am a newbie and have been reading a lot lately. It runs together. I googled, read more and became very concerned. It was a bad morning in general. Car would not start DH had to come home, he took Ferg and I took our daughter to preschool where I was supposed to be helper mom today.

    I stopped by the vet on the way home from school and they brought him out let me hold him. It was nice because I came unannounced and it was the lunch hour they are usually closed. The reception lady said "Us diabetics need to stick together." she is diabetic and I guess sweet on Ferg so she wanted me to be able to see him. I sent his insulin with him . They had given it and gave him back to me to take home. They all said he is sweet and doing okay. They said that Dr. Buttery(?) was not in yet. Weird because they made an appointment for 1020 am when I called this morning at 0915 and this was at 1215. I don't know. I am getting worried though. He was acting okay when I saw him. A little more responsive eyes I suppose but I did not do a real pupil check with a light. Obviously wanted to go home though.

    I am waiting for a call. I am so worried about blindness, hypertension or worse.

    I am just so upset. It has been a bad week and when it rains, it pours around here.
    I was holding it together because I saw a positive response to uping his dose to 1.25 Units recently. I posted it on Facebook for friends to see and now I feel like I jinxed him. My stomach hurts. I just want this to go away. I want him to be healthy again. I am a grown up. I get things happen. I lost other cats in the past, but I am having a hard time today.

    Thank you for listening.
    Trisha
    AKA Supurrkitten Fergus' Mama
     
  2. Nicole Z

    Nicole Z Well-Known Member

    Joined:
    Apr 24, 2017
    Sending you a hug!!! :bighug: Deep breath...
    Big eyes can be a result of so many things....
    Keep us posted once you hear back from the vet.
     
  3. Supurrkitten

    Supurrkitten Member

    Joined:
    May 7, 2017
    Thanks Nicole. Ferg can use all the vibes he can get right now. I will let you guys know as soon as I find out. Maybe somebody else can get something good from it.
     
  4. Phoebes (GA)

    Phoebes (GA) Well-Known Member

    Joined:
    Jan 16, 2017
    Phoebe has big pupils all the time too. It worries me that she is going blind. But my hubby adopted an Fiv cat that went blind and you could never tell it by his actions. But his pupils stated big. Hers do too. Mind you she is on some heavy drugs. My vet saI'd nothing she could see besides regular aging. Maybe a little dementia, she knows she can see just depends on how much she's taking in and understanding.
     
  5. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    If it is high blood pressure and he is going blind, it can reverse with the blood pressure med Amlodipine. It's likely not so think good thoughts and keep us posted.
     
  6. Supurrkitten

    Supurrkitten Member

    Joined:
    May 7, 2017
    Wonderful FDMB Folks,

    I just got off the phone with the vet.

    Fergus' pupillary response is WNL (within normal limits) NOW and his BP is normal even while at the vet getting his BP taken which is when BPs are usually elevated due to stress. The vet acknowledged when we brought him in that the tech confirmed his big eyes and limited response. He is NOT in kidney failure. These are all things that could cause his big eyes. Hypertension and diabetic neuropathy or retinal detachment related to his diabetes. Also, low blood sugar (hypoglycemia), which they said his was fine currently. So, they will keep him and recheck his sugar a lil before 6pm. It should be close to his nadir (lowest point blood sugar 6 hours after insulin administration) so we should know how low he is getting. Potentially, he could have gotten lower than his norm too quick and been a bit hypo for him or legit hypo. I didn't check at the time I noticed his eyes, but I fed him which can help. He got dosed at midnight-ish last night so around 7:30 he would have/could have been at his lowest.

    Anyway, she will keep an eye on him and I will fetch him later. Current thought I'd potential hypoglycemic moment.

    They will also repeat a Urinalysis and Urine Culture. She said since he had no signs of Kidney Failure CKD in blood work from Speing 2015 and his last blood work 2 weeks ago, when he was sick and DX FD and had a UTI; that he should be ok now since clinically he seems better.

    Thankfully he is appearing a bit better there now.❤️⭐️❤️

    This was him when I checked in on him around 12:30. His pupils are the same here as the smallest I saw his pupils constrict to earlier. Here he had a bit more response with changes in lighting.

    image.jpg
     
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  7. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

    Joined:
    Jul 9, 2012
    I'm so glad he's okay.

    Big hug for you.....
    Yes...
    it seems when bad stuff happens, it does hit us all at once .
     
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  8. Nicole Z

    Nicole Z Well-Known Member

    Joined:
    Apr 24, 2017
    Excellent news! I'm with you, when the crap hits the fan, it seems like it's explosive all at once!
     
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  9. rhiannon and shadow (GA)

    rhiannon and shadow (GA) Well-Known Member

    Joined:
    Jul 9, 2012
    thanks for that image Nicole....:rolleyes::joyful:
     
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  10. LizzieInTexas

    LizzieInTexas Well-Known Member

    Joined:
    Jul 25, 2016
    Gizmo's too. And the vet has check his eyes, blood pressure, etc. I know he can still see just fine - he was chasing a fly around the back window last week. :rolleyes:
     
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  11. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    Hi Trisha.

    You're the first person that has joined L&L since I've been here that shares my name (even though we spell it differently)! :)

    Yes, this is where you should be posting! You're one of us now!

    Here is a link to your condo from yesterday. We like to add that to each day's condo so people can go back and see what was already discussed.

    I'm sorry things have been tough lately. We all can relate to having a few days when it seems like everything that can possibly go wrong does. The good news is, things will get better! Keep your chin up!

    It's wonderful that you are testing at home! I notice you aren't always getting tests before Fergus gets his shots. I think it's was mentioned to you yesterday, but I know there is a lot of new info coming at you. Testing before you give the shot is the best way to keep Fergus safe. You need to make sure his BG isn't too low to give insulin. Even though you have gotten some high numbers on the tests you have gotten, those could be bounces from his body reacting to lower numbers at other times. It's important for his safety to know what his BG is before you give him his insulin.

    I want to share with you a post we put together for new members, kind of like an FAQ: http://www.felinediabetes.com/FDMB/threads/updated-tips-for-new-members.173572/ Hopefully you'll find some helpful info there. Ask lots of questions! We love to help!
     
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  12. Phoebes (GA)

    Phoebes (GA) Well-Known Member

    Joined:
    Jan 16, 2017
    This is phoebe looking into the 100 watt light in our bedroom 20170509_161800.jpg
     
  13. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I'm so glad to read your news!
     
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  14. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Larger pupils can be a kitty stress indicator. Neko used to get all big eyed if the vet waiting room was noisy. Glad to hear Fergus is OK.

    Large eyes in spite of looking into light can be a symptom of acromegaly. Neko used to shy away from bright light because of that. Her pupils went back to mostly normal once she was treated. Since Phoebe is a big gulper, this is one possibility for her.
     
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  15. Supurrkitten

    Supurrkitten Member

    Joined:
    May 7, 2017
    Giant eyes. Right? She's adorable btw ❤️
     
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  16. Supurrkitten

    Supurrkitten Member

    Joined:
    May 7, 2017
    Thank you for being invested in all the kitties, fellow Tricia. I believe I just read your post for new comers. It was very helpful.

    I am still a little worried but the vet says he is fine. His numbers are good too . I got his labs I need to put on his SS.

    I know I should test before each shot, my vet pushed not to test at home at all. When she saw I was she said he was high so tests are not needed now. She then said when I do I need the animal Glucometer. Grr. Then said he should come in for his curve in 2+ weeks.

    So against my better judgment I did not test him prior to the shot I just gave. Kind of makes me feel bad because she upped him to 2 from 1.25. However he still is 500. Even though the test I took at +6 yesterday was much lower. Her +6 was 500 on her glucometer and she thought that mine was an error then. She said this even though she said potentially his dilated eyes could be from a hypo. ((Shaking my head))

    It is so hard with all the conflicting information between the vet and the logical things that I see on the board. I need to find a happy place between being informed/trusting myself/trusting the vet. Part ofme believes that she just thinks that I don't know what I'm doing, doesn't want me to hurt him or make him have an aversion or that she may not trust or understand human readings for cats. I donno.

    That being said I probably will test him at +6 later. He lays right next to me so he'll be right with me and I'm going to set my alarm for every two hours. He ate well and he has food. He comes to me right around the time that we have set up his new feeding schedule and shots. So he seems to be excepting the new routine.

    Thank you so much for the info and support. I was freaking out earlier admittedly. I'm going to try and keep together a little better.

    I got a copy of his labs and first thing in the morning I plan on updating his spreadsheet. He is 13.9 pounds up from almost two weeks ago from 13.6. Down from last year by 3 pounds still though.

    Truly thank you all ❤️
     
    Last edited: May 15, 2017
    Reason for edit: Phone error
  17. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    It sounds to me like your vet is not familiar with Lantus. A cat can go from 400 to 40 and back to 400 in a 12 hour cycle (yes, we've had them do that). That is why we test, even if we get high numbers. The key is to figure out when you need to test.

    Now that you are testing, save your money and tell the vet you will do the curve yourself. Curves done at the vet are often inaccurate because most kitties have higher BGs from the stress.

    Sorry, but you do NOT need an animal glucometer. The strips are ridiculously expensive, and if you run out you are just out of luck because no stores carry them - you have to order them. The guidelines on this forum are written based on human meters. They are perfectly acceptable for use on animals using these guidelines.
    While we do have people here that successfully use the Alpha Trak, the majority use a human meter with no problems.

    Testing does not hurt the kitty. Nor will he develop an aversion. It helps to get them used to your fiddling with their ears, and to always give them a treat, whether you manage to get blood or not. That way they associate the test with good things. Sounds like Fergus is already learning the drill, so this should be a no brainer for him.

    Many of us have had similar experiences with our vets. The way to deal with it is to show them results. When you get Fergus consistently into better numbers, safely because you are monitoring, hopefully your vet will realize you DO know what you are doing!

    An increase of .75 units is a big one for a cat, especially with no data to back up the need for it. We do dose change here in increments of .25, because even that small of an amount can make a big difference.

    I know it is hard to know who to trust, a bunch of strangers online or your vet, but I hope you can do some more reading here on the site, read some other people's condos and look at their spreadsheets and come to a decision. We'll do our best to help you, whatever you choose to do.
     
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  18. LizzieInTexas

    LizzieInTexas Well-Known Member

    Joined:
    Jul 25, 2016
    :D

    When I took Gizmo in I took my tablet with the SS available offline and was showing it to the techs that were taking info and getting ready to draw blood. Before I knew it there were 5 techs, the office manager (which is the lead tech) and two of the vets in the office all in the exam room looking at it and discussing it. One of the techs commented that Gizmo was doing better than her cat that had FD for over three years.

    Then when they asked what meds he was on and I switched over to the meds tab it blew them away. One asked if I was a nurse - lol.

    They are high until they are not! You will find that as you go through this your knowledge and experience will far exceed your vets. Sad, but true. You need to become your cats advocate, just no other way around it.
     
  19. Phoebes (GA)

    Phoebes (GA) Well-Known Member

    Joined:
    Jan 16, 2017
    Thank you I think she's pretty cute :) looks like she's always up to something.lol
     
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  20. LizzieInTexas

    LizzieInTexas Well-Known Member

    Joined:
    Jul 25, 2016
    I snapped a picture of Gizmo this morning showing his "big" eyes.
    eyes.jpg
     
  21. Phoebes (GA)

    Phoebes (GA) Well-Known Member

    Joined:
    Jan 16, 2017
    I have had your exsperience not even a month and a half ago. I too believed everything my vet said, because she is the vet and has seen my kitties for 15+ -years. She is known as the cat lady at the practice. We got up to 5units and 6 units and I took phoebe back for a fructose test. She found out I was on that many units and freaked out. Then convinced me that I needed to go back to 4 units. Any amount above 5, 6 units was too much for any cat. The kind people on here tried to convince me to not go backwards. I was so afraid if I went against her idea if something were to happen to phoebe the vet wouldn't treat her. We started over at 4. She only continued to go higher in numbers and stalled. These knowledgeable people convinced me I know my cat best, I hold the syringe, I am with her 24/7. I then decided if I continue to listen to the vet we would never get anywhere and high 200s would be "ok". So I decided to have that conversation with my vet. It was so hard, I finally just said, I trust and respect these people with my life, I am going to due it their way, and if you want to help me treat her great, if not then I will find a vet who will help us. Do what You need to do to protect your kitty. These people here love my kitty almost as much as I do. They will not let you down and above all you are not alone.:bighug::bighug::bighug:
     
  22. Phoebes (GA)

    Phoebes (GA) Well-Known Member

    Joined:
    Jan 16, 2017
    Omgosh Gizmo is adorable
     
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  23. CassAndGordy(GA)

    CassAndGordy(GA) Well-Known Member

    Joined:
    Sep 23, 2016
    Gordy had the same issue for awhile - pupils never undulating. I finally brought him to the Vet and they told me he had the start of cataracts. Poor guy :( It was good to know it wasn't something serious. (Well... cataracts are serious, but there isn't much I can afford to do for them. He doesn't seem to be in any discomfort.)

    But I'm noticing that the more "normal" his BG is, the better his pupils work.
     
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  24. Supurrkitten

    Supurrkitten Member

    Joined:
    May 7, 2017

    Tricia,
    Thank you for continued support. I appreciate your understanding. I find the information here extremely valuable and would not be as empowered as I feel at times without it.

    I did not sleep well without the test and worried on and off today. I checked him a bit prior to giving his AM dose today so +11 (later in the day for us than most I know, d/t my night shift work schedule) he was 325. I know I will never know how low her got last night. I have been trying to scoot him up a little earlier each time so that his Nadir will fall earlier in the day. I know I need to be careful d/t the increase/ decrease action of the dose by giving early and late so it is only by 10 min at a time. I will check him at 1730 to see his low. .75 is a big jump. It is hard to trust professionals when they have a calm unconcerned attitude about your loved ones health. They actually told me no need to worry about a day or two of starting the insulin when I was frantically trying to find $ and potentially a donation of lantus. I was told "he did not become diabetic in a day. He will be fine." I get the healthcare provider perspective but diabetes is serious stuff.

    Again thank you for the support. I meant no offense in my honesty about all the differing info. The Alpha track is an added expense. I may, and I say may, get it if Fergus needs curves for the vet a few times a year for the rest of forever. I may also just take my glucometer to the vet and compare results next time. As a nurse, I seriously wonder about the difference in meters. Is it readings that are different or is calibration or both. you would think human meter would be at better or exact standards really. I have a friend who is in PA school with a history as a lab manager at the ER I am at, who prior to that was a vet tech. I am going to speak with her about the differences.

    <3 Trisha & Fergus
     
  25. Supurrkitten

    Supurrkitten Member

    Joined:
    May 7, 2017
    BTW guys,
    You are mentioned in this article. FDMB compared the meters. :)
    http://petdiabetes.wikia.com/wiki/Glucometer
    it links to a dead link of a graphed and numerically charted comparison done here. I wonder if that is still in here somewhere.
     
  26. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    Hi Trisha,

    I'm glad you're thinking about getting a human meter instead. When I first started this dance, my vet told me it didn't matter what kind of meter I used, as long as I stuck with that meter so I'd be comparing apples to apples. She had me bring it into her office, and when compared to the Alpha Trak, the numbers were different (sorry, it was almost 6 years ago - I can't remember by how much), but when she compared it to the numbers from the "big machine", as they called it, my meter was actually closer than the AT was!

    The readings you get on an AT will be higher than on a human meter, but the difference isn't consistent. The two measure pretty close together at lower numbers and the difference increases as the BG rises. We recommend that people use one or the other, as comparing them to each other will drive you nuts. We give you the reference numbers for a human meter, so your kitty is just as safe using that as with a vet meter.

    Here is a comparison that @Marje and Gracie did between a human meter and an AT2, just as an example. Others have done them and gotten different results. As I said, it isn't important that they register differently because you are using different reference number for each. For instance, in TR, the reduction point on an AT is 68, while on a human meter it's 50 (unless the cat is a long term diabetic, in which case it's 40).


    FYI, a 20% variance on any human meter is considered acceptable, so you could test the same cat with two different meters and get two different numbers. Heck, I've tested my cats twice in a row with the same meter and gotten different readings! Don't get too hung up on the exact number. It's the range where it falls that is more important (ie: under 50, or over 250, etc.).

    None taken! Most of us felt the same way. It's completely understandable. We're asking you to take a leap of faith. You have to do what makes you the most comfortable.

    One other thing I forgot to mention: My Harvey's pupils were dilated during his last couple of years, and the vet sent us to an ophthalmologist. He found that Harvey had cataracts and glaucoma. The cataracts weren't bad and remained stable the rest of his life, but he did have to have drops to treat the glaucoma. It might be worth it, if your budget allows, to have your kitty checked by an ophthalmologist. Untreated glaucoma can lead to blindness (that's what happened to Cinco). @Gill & George works in the field, for humans, and might have more to add.

     
    Last edited: May 16, 2017
  27. Supurrkitten

    Supurrkitten Member

    Joined:
    May 7, 2017
    Thank You again, Tricia,

    I do have a human glucometer now. A ReliOn Confirm. I am using that now. I probably will not get an Alpha track. If the vet pushes it. I will bring him in for occasional checks but I will come armed with my curve in advance. If he is doing well symptomatically and numerically, I will probably just check in with her. I appreciate the support.

    The eyes I think were a fluke. I will check him often and if I see them again I will follow up with a specialist after an emergent vet visit. I know dilated pupils in humans mean increased inter-cranial pressure so I am not messing with that. I will proactively seek a veterinary ophthalmologist along with the surgeon I need to find to have his PU revised once his BS is under control. I hope his PU holds until then I am afraid of what will happen if he needs emergent PU repair and has wacky sugars.

    His +4 BS was 265 and the +6 was 216. I imagine the jump of .75 was a little taxing on him, but i am happy to see the lower numbers. I am also happy I am going to be home until I work friday night. I am gone all weekend, so I am glad my DH is here for shots but, BS testing is something he needs to learn still. I have had him watch me a few times and will have him do the PMPS tonight.

    Be well,
    Trisha, Fergus and Diego
     
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  28. Supurrkitten

    Supurrkitten Member

    Joined:
    May 7, 2017
    Old condo: http://www.felinediabetes.com/FDMB/threads/first-bs-testing-day.177874/#post-1962655

    Plus today's condo.

    Well as Tricia said and i will sum up, Lantus can drop a cat fast sometimes and be a bit all over. I suppose Ferg did not eat as much as he had yesterday, today, but still eating. his dose is up also.

    Delima, I read slgs advice and while he is NOT under 90, the vet had me definitely NOT go slow when we jumped to 2 from 1.25.

    He tested just now PMPS at 168 at 1057 pm eat then I recheck since he had never been that low and one min later he was 198 at 1058 est USA.

    He is acting fine. He actually was in the bedroom when I got up to give his shot and when he got wind it was not just food but a sugar check he found a spot to hide and it took a min to find him.

    I checked twice, offered food, he took a little. Then I re-read a thread about what to do. Since I already fed I blew the wait and retest without feeding in an hour option. It was just a little but he ate but I know it will mess up the number.

    So I feel reluctant to give 2 units. I ran out of syringes. I got a new script, but have been so tired and honestly broke given the recent costs, that I fell asleep and just woke to test and shoot.

    Now, I only have the pen needles which do only whole unit options. Lesson learned. I will scrounge $ for syringes and needles in the morning but NOW I need advice.Edit to Add: I called a 24 hour pharmacy to try to see if I could get a syringe tonight and the cost is double the Walmart cost. so tonight it is either 1 or 2 units.

    I think doing 1U is the option. I am going to wait till 1200 am at least before I give. It is 1134 pm now EST USA.

    Advice appreciated.

    T & Fergus
     
    Last edited: May 16, 2017
  29. Supurrkitten

    Supurrkitten Member

    Joined:
    May 7, 2017
    OK,

    I know he needs something for the next 12 hours. I know what I give, is what he gets, and no adding more later.
    I cannot do 2 units even if he is up now from the PMPS (I don't think I could trust a reading over 250 mow anyway, in my heart, esp given he ate, I offered another food).
    So I am going in and giving 1 unit. I don't want to mess up his getting to a healthy low and staying healthy low, but tonight I cannot do 2.
    I will retest tomorrow and get the syringes somehow. I will probably go to 1.5 and sit there for the required few cycles.
    I don't know how folks stay at a dose when testing so often. I want to commit to 2 but it is scaring me that I will come home, and honestly, find my cat dead.

    This is exactly like being a kid parent. I cannot be high stakes/risk it all, even with my fur kid.

    Night everyone.
    Lots of lovely purry furry vibes to all you late night SugarCats
     
  30. Supurrkitten

    Supurrkitten Member

    Joined:
    May 7, 2017
    I gave one unit at 1258 AM.

    When I went back in he had vomited liquid & liquid food. It made the decision easier. I tested twice and got 173 & 177 around 1245 AM est USA.

    Thanks for following along. I sat up with him and he is acting really well. I am sure a bs of 177 feels a heck if a lot better than the 650 bs he had the begining of the month.

    Night all ❤️
    image.jpg
     
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