? Yum AMPS 703 +5 541 +7 557

Previous condo: http://www.felinediabetes.com/FDMB/...her-to-the-er-for-fast-acting-insulin.187534/

My patience pants are worn thin. She has been too high for too long. I have to hold 2.5 for 6 shots?
I know the answer is yes.
I might take her back to the vet to see if she still has a UTI. She had convenia and then 10 days of Orbax.
Her last urinalysis a week ago was inconclusive.
She has severe diarrhea. I am assuming it is a consequence of the Orbax.
She started metronidazole this morning.
I suppose her diarrhea could be painful, which could raise her numbers.
She is maintaining her weight in spite of the diarrhea, but not regaining the 11 oz she lost while she was boarded over Thanksgiving.
She looks skinny and vulnerable to me. She is drinking 10 oz of water a day.

 

I'm sorry Yum is still out of sorts and you are having to look at those ugly numbers for so long. Yes, you would hold that dose for at least 6 cycles (3 days), per the TR protocol, if after 6 cycles nadirs are still over 300, you could increase the dose by 0.5. If you're seeing nadirs in the 200-300 range, you would only increase by .25.

That being said, since you know there is other stuff going on, that can affect the BGs: pain, infection, etc., your numbers could change once that is resolved.

Probably a good idea to check after the UTI. Asia had a really bad one around this time last year (before diabetes), she got a Convenia injection and she seemed right as rain again in a couple of days, until about the 2-3 week mark. Then she started having diarrhea and more symptoms, I took her back in and it was a UTI, probably not an entirely new one, likely that the first round of abx just weakened it but didn't knock it out. I'm pretty sure that older cats and diabetic cats are more susceptible to UTI and they probably take longer to clear it than a younger, healthy cat.

As far as eating and drinking goes, that's part of the disease, they can't properly make use of their food so their brain tells them to eat and drink more (even though it doesn't really help). Since she is underweight anyway, I'd give her bigger portions and let her drink all the water she wants, especially since she is having diarrhea, at the least, she'll stay better hydrated that way.