? Yemala 12/4 AMBG 70 No shot; +6 79; +7 93; +7.5 97; PMBG 118; +4 127; +6 121

Discussion in 'Lantus / Levemir / Biosimilars' started by Hroswitha, Dec 4, 2018.

  1. Hroswitha

    Hroswitha Well-Known Member

    Joined:
    Apr 11, 2011
  2. Hroswitha

    Hroswitha Well-Known Member

    Joined:
    Apr 11, 2011
    Mala got no shot today. Without any insulin, she's in the greens. She may rise into the low 100s before her PM meal.

    We'll continue to watch her, but should we just call this her OTJ trial? She just won't follow the rules for diabetic kitties. Her pancreas seems to have decided it was done with all the extra insulin, and for now, is on line.

    We can give her a drop at evening mealtime, if recommended. I want this to be a strong remission. It would be her third, and we want it to hold.

    Advice?
     
  3. Hroswitha

    Hroswitha Well-Known Member

    Joined:
    Apr 11, 2011
    Holding at 97 for 7.5. Because she won't hear "no", she's getting 1 T of lc food.
     
  4. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    Wow, she is being stubborn, isn't she? Let me get some others to weigh in on whether or not to start a trial. Like you, we want it to stick this time.
     
  5. Hroswitha

    Hroswitha Well-Known Member

    Joined:
    Apr 11, 2011
    STALLING. Shoot or not, ya think? If I did a drop, Renee would be home at about +2 to monitor the nadir. Or we could just go for the OTJ? What should I do Abby? Signed, Anxious.
     
  6. Mandy & Rex (GA)

    Mandy & Rex (GA) Well-Known Member

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    Mar 22, 2017
    I wish I could give you advice, but I'm leaving it up to the experts.
     
  7. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    IMHO noting that Yemala has been going up through out the day without her morning shot, I'd shoot the drop dose and monitor closely to nadir, feeding a bit higher carb food to avoid any deep dives.
     
  8. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    Did you shoot?

    If you can get her to eat a slightly higher carb food, I think you should continue with the drop dose for a while. We'd really like to see those mid- to high blues go away before doing a trial.
     
  9. Hroswitha

    Hroswitha Well-Known Member

    Joined:
    Apr 11, 2011
    Dave stalled as long as he could. We typically shoot at 6 AM/PM central time, and he waited to get feedback until about 6:30. At that time, facing an immanent insurrection and immediate rebellion that only needed yellow safety vests to make more visible, he broke down and fed the cats. Including Mala.

    I know it's preferable to see lower blues and more greens before a trial. Mala doesn't follow our rules. She writes her own.

    No adult would be home between her +1 and +4, and we didn't want to take a risk.

    Depending on where she goes this evening, we may put her back on a drop tomorrow.
     
    Last edited: Dec 4, 2018
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  10. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    I'm sorry you didn't get an answer in a more timely manner. Safety should always be your first consideration. If testing wasn't going to be possible, skipping was the right call.

    Going forward, I have talked to some other veterans and the consensus seems to be that it would be preferable if Yemala's preshots were lower before starting a trial.

    Do you think you can find a food with a slightly higher carb content that she will eat? That way you can safely continue insulin for a while and give her time to get those numbers down. I understand she has very definitely opinions about her food, so if you don't feel this is doable, a trial is your other option. It's up to you - you know her best. Keep in mind that we all want the next remission to hold.
     
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  11. Hroswitha

    Hroswitha Well-Known Member

    Joined:
    Apr 11, 2011
    Right now, a food change isn't going to be possible. We were really fortunate to find any food Mala would eat that was low in carbs and phosphates, but didn't have gravy in any form. She won't eat anything chunky, she prefers pate, and we tried three different foods before finding one she would accept. I currently have 2 month supply of her much loved Weruva, at a considerable expense. A month's supply of her food is more than the cost of food for the other 7 put together.

    I can mix some medium carb food that she will tolerate in and she'll eat some of that.

    Six hours after feeding, her bgs are in the 120s. Her PMBG was 118. She's holding remarkably steady despite no insulin.

    Tomorrow, we will go back to a drop and see what happens. Someone can check in on her during onset and nadirs.
     
    Last edited: Dec 5, 2018
  12. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    Then, for Mala's safety, I suggest you start a trial.


    ETA: Preferably, if you can get her to eat the mix, continuing with the drop would be the way to go. Remember, we are most concerned with her safety, as I am sure you are.
     
    Last edited: Dec 5, 2018
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