911 WHAT IS WRONG??? Jai Jai: AMPS 407; PMPS: 31

I am scared, really really scared. Jai Jai has quite high BGs these two days. But his PMPS is a lot of astonishment.

WHAT is wrong with him? He does not show any sign of hypo, no, nothing. He has eaten his food rapidly.

(((Normal injection time: 19:30)))
19:00 Food ate: 70g
19:20 PMPS: 31
19:30 Feed more food: 40g
19:50 BG: 61
20:30 BG:95
21:00 BG: 115
21:45 BG: 165

I need help, and million thanks for your help.

 

I am new to the FDMB also and am hoping someone with experience will jump in to advise you. That is a very low number and they usually will suggest to get some higher carb food into the cat and /some honey in the food to bring the numbers back up and retest every 20 minutes or so to make sure the numbers are coming back. Keeping good thoughts and keep posting. Tag your next post with 911 alert.

 

Thank you for your reply. I am now holding the dose, and retest to make sure this is not the problem of my glucometer. I can't imagine what had happened with Jai Jai during the day-time when no body was home.

I am lucky that I can see him jumping up and down even though he had come across such a hypo episode. Thank you to God for keeping him.

 

If the numbers don't rise soon, please get your cat to the vet right away! Yes, and do not give any more insulin with a number that low. Usually for a new diabetic cat the no shoot dose is 200

 

His BG has increased to 61 after 30 minutes, I am going to test him 15 minutes later. Thank you for your advice. I need it very much.

 

You are so welcome. I hope someone experienced will jump in soon. 50 and below is of concern. I'm glad to see her coming up. Keep testing her to make sure she is continuing to rise. Don't give the insulin. Someone with more experience will guide you about that. Keep posting.

 

How's is Jai Jai doing? And I just realized that Jai Jai is a he not a she. Sorry I said "she" in my previous post.

 

Thank you for asking. I have just tested him half hour ago, he is now 115, still moving upward.

I am thinking of giving 0.75 unit tomorrow morning, as I am afraid that 1 unit is already too much for him.

 

Hi; sounds like he's going up, and 115 is a decent, safe number but you may want to post in the Lantus/Levemir forum in order to get some more experienced eyes as far as dose goes. http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/.
Jai Jai looks a bit like my Oren, and in my experience the orange creamsicle kitties are extra sweet, even w/o the diabetes! Good luck with him!

 

I am so happy that he started moving upwards; that was scary. I am sure someone with more experience with dosing will help you out. And yes, orange cats are the sweetest even without diabetes.

 

Very true, cheers to the orange babies. Oren and Bubba look so sweet too (((hugs)))

I have created a post in the L & L forum. I hope that someone out there help me too........I have come across so many astonishing events and I have already lost. Need some guidance to help to get over it.

Thank you for dropping by. Have a nice day!!!

 

You have a nice day too. I know that after this episode you will!!! And you did great in averting a crisis. Job well done!!!

 

Hi Hollis,

I've just logged in. You definitely need to reduce the dose. That 31 means you need to decrease. I'm very glad you got Jai Jai's numbers up. You did really well.


Mogs
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Hi, Mogs. Thank you for your kind words. I agree that there should be a decrease for a few cycles, and see how Jai Jai is doing.

Thank you for dropping by, please have a nice day (((hugs))).

 

Try to get some readings in between the shots so we can see what is happening with the sugars. We base the doses on the nadir numbers which can happen anywhere from +6-+10 or even later, so it's important to have readings during the day/night. Also, he may be going pretty low during those times.

I'm concerned at the reduced appetite, when do you see the vet? Your cat has a history of dropping low when he wasn't eating as much. Sometimes, if you are feeding a very low carb food <3%, it can be helpful to find a food that has a little more carbs (~6-8%). When you do get to the vet, can you ask for copies of the blood work results and post them here?

Also, can you explain the sodium chloride solution you are using? Is this subQ or oral? What is the history behind this or what are you using it for?

 

Glad to see Jai Jai went back up. He's definitely shouting out loud that he wants a reduction in insulin!

 

Following on from Meya's earlier post, I strongly recommend that you get at least a PM+2 test every evening (and PM+3 if you can manage it). I get the sense from looking at your spreadsheet that Jai Jai may tend to run lower at night (many cats do). The PM+2 and PM+3 tests should give you a better idea of what his levels are doing at night.



Mogs
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I will try getting his PM numbers. I was very tired these days and I did not do my job. Feeling bad about it but I could not keep my eyes open after 23:00

We had some feelings that in previous days when we fed him 130g (4.3 oz) in the evening was a bit too much. He did have low activity level at night, and he felt full in the morning. As such, it is apparent that he could eat up all the food in the evening session, but not the same in the morning meal. We had made slight adjustment, and each meal we now give 110g (3.67 oz). He eats all the food. So far so good.

We will visit the vet tomorrow morning (i.e. 24 hours later). He will not be happy when we take him out.

You are right, Thrive Complete does not contain any fillers and I assume that the carb content is less than 3%. I can feed him more carb food, provided that they are not pate type.

I have uploaded the photo of the sodium chloride solution I am using. This is taken by subQ. The vet recommended Jai Jai using it because he showed some signs of dehydration previously.

 

At the vet, since you are using the fluids, have them check electrolytes. Fluids can cause these to be off and it may be contributing to some of the bowel and other symptoms.

 

PMPS of 31??? ....I suspect someone's trying to go OTJ here....

Just looked at your ssheet - I see you've already got him out of that well again....another good job! Gosh you're getting put thru the wringer aren't you?

HUGS!

 

Thank you, @Meya14 , do you think using fluids a good idea? We have found that Jai Jai is more active when he is with the fluids. And, forgot to say, Jai Jai has high UREA that the vet wanted to relieve the workload of the kidneys.

 

It really depends on the labs, so discuss with the vet again after they review the labwork. Any time on fluids, you should get them checked regularly.

Basically, they are going to look at the kidney values (bun-urea, creatinine) as well as potassium, sodium, magnesium, phosphorous, as well as hematocrit if dehydration is an issue. The fluids help with maintaining hydration in kidney disease, but sometimes, the electrolytes get too low or high, and you need to supplement or reduce the fluid amount. Potassium and sodium are the electrolytes that can cause the most noticeable symptoms when out of range. Too much potassium can cause diarrhea, too little can cause weakness. Either low or high can cause heart arrhythmias. Too much sodium can cause nausea or fatigue, to little can cause seizures. It's important that everything is in balance.

Fluids can also lower the blood sugar temporarily, so don't give them when your cat has low blood sugar. You also may want to put the time you gave them and amount into the spread sheet comments, so you can track how the fluids affect the blood sugar.

 

Someone said it seems you have IDEXX labs in Hong Kong. They run the pancreatitis test in case you feel it is necessary. The fluids are a good idea.

 

Hi, @Meya14 , @tiffmaxee, @Critter Mom and all. We visited the vet this morning, the vet assessed Jai Jai and thought that he did not have the symptoms of pancreatitis. I asked whether his pancreatitis was very mild so it was not noticeable, she said that if it was so, he had chronic pancreatitis and there was nothing to do if the blood test result confirmed this.

We then came to a conclusion that if we needed to proceed with the spec fPL test, they would arrange in our next visit. I had to agree with the vet since she was not happy with how we fed Jai Jai and how we adjusted the dose.

About Jai Jai's dose, she said 0.75 was too little for him, but she knew that 1 unit had dragged his BG too low some days before. She suggested having injection one time a day, the starting dose would be 1 unit. I did not respond to this, because I did not think it was a good idea.

The vet also suggested Jai Jai continuing the subQ fluids, he had slight dehydration and the fluids will keep him in a better condition. Regarding the blood test results, I will upload them later.

Today's visit was not impressive....there was some tension between us. I think I have to take care of Jai Jai's dose adjustment by myself.......it is not a bad idea as I have joined this wonderful community for the steadfast support!!!! Thank you all for your great help so far, I definitely need your help in the near future.

 

Hi Hollis,

I'm sorry to hear about your vet stress. (Doesn't just apply to our kitties! )

The people on the Lantus forum should be able to help you with dosage. Sometimes you need to 'fatten' or 'shave' doses to fine tune them. They should be able to help you with this.

With regard to chronic pancreatitis there are most certainly treatments that can be used to manage the condition should Jai Jai test positive at some stage (but I hope he doesn't). Here is a link to the IDEXX pancreatitis treatment guidelines in case you may need them. Elise's cat, Max, has chronic pancreatitis and so does Saoirse (and a number of other cats on the forum). Should the need arise, we'll be able to give you more information and suggest things to help.


Mogs
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EDITED TO ADD:

It would help a lot if I had actually included the IDEXX link above. (I am such a numpty... )

IDEXX Pancreatitis Treatment Guidelines

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Because you have been running high since that reduction, it's possible that 0.75U isn't quite enough, but at this point, try to get more tests during the day so you can see what the dose is doing. Try for at least a +7 to +9 in each cycle. I'm sorry about the vet disagreement, that can be frustrating.

 

Hi, @Critter Mom and @Meya14 Right, when the vet said that I changed his dose and food amount so frequently that I was not really happy about her comments. I was trying to explain that the changes were necessary because of Jai Jai's BGs and energy need. Once again, she said that I tested too much, even though I told her that I pricked at the sweet spot, and caught a hypo episode of Jai Jai. Sigh.....

Jai Jai is very grumpy today. I had hard times testing his BG. He really can bite and scratch....we two adults could hardly hold him and we both ended up had some wounds on the hands......probably I will get a PM +4 today, and no more until next morning.

 

It's possible the higher numbers are making him a bit cranky, Hollis. He's possibly feeling a bit cruddy. Sorry to hear you both got war wounds.

(BTW I edited my earlier post to add the link to the IDEXX pancreatitis guidelines - sorry for the oversight. )


Mogs
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