Meatball 3/1 - HELP!

HI everyone!

Well, after doing a fair amount of testing this weekend, I have some interesting results and would love to hear your thoughts. Today his numbers seem a bit lower, hmm... I'll try to check at +2 and +4 (if I can stay awake that late.) Thanks!

Also, I'm adding some info about his health history to my profile that will probably be useful! Will be done with that in a few minutes!

Any ideas about if this is type 1 or type 2?? and what that might mean to his treatment?

OMG that title freaked me out!!!! Then I remembered I suggested it, lol. ohmygod_smile Well, it sure is catchy! :lol:

Have you read about Acro? They may have info in a sticky on the high dose forum, or in the Wiki, or maybe the Health Links forum. When you described him as "big-boned" that jumped out to me. When you first arrived I think someone mentioned that some high dosers had checked out his data and didn't think he probably had a need to be a high doser...?

Did I read correctly you are seeing ketones? DARN IT! If so, I'm not sure that you have a choice but to increase the dose, and keep an eye out for unexpected low #s. I am going to do a little PMing and see if we can get some eyes on his data. I'm thinking you may need to get more aggressive and shoot the rebound (if that's what it is) down, but I don't feel comfortable advising you on doing that. I don't like the steep drops & higher PSs that you were seeing on 3.5, but I don't like ketones either!!!!

cat(2)_steam

Can you get any spot tests in this evening? If there was rebound off the 3.5 it looks like things may be settling down, so fingers crossed maybe you will see a better # mid-cycle tonite.

Joanna & Bix said:

Did I read correctly you are seeing ketones?

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Tonight was one of those nights where it is either none, or maybe very small. It's weird, I tested it against water, and it was not the same as water. It night have been a bit more 'pink-ish' than 'peach-ish' I'm going to try to test that again tonight. He has had a bunch of water tonight though, so I should be able to do another test. His PS #'s are a little lower than usual today though.

Can a rebound cause ketones?

UPDATE: There really are ketones. Back up to 3.5u we go tomorrow.

Sorry to hear about the darn keytones. Grrrrr

Not sure but the petdiabetes wiki has all sorts of good info and I'm sure has stuff on acrocats and probably more:
http://petdiabetes.wikia.com

You about blew my [simpleton] mind with the question about rebound causing keytones. I don't know the answer to that question but it's a great one! If you don't get answers here you might want to post that one to the Health forum.

Kind of like questions about time travel blowing my mind too. Like if one travel back in time and tells oneself not to time travel then does one actually time travel or ....man that one always blows my mind too. :smile:

Gator & H said:

Kind of like questions about time travel blowing my mind too. Like if one travel back in time and tells oneself not to time travel then does one actually time travel or ....man that one always blows my mind too. :smile:

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... and the universe. crazy stuff. @-) glad to provide some food for thought!

Wow, his +2 is something I have not seen before. +471 ... higher than PMPS. hmmmmmmmm

Darn it--just wrote a long post and it didn't "take" when I submitted.

Basically it said--I'd get another UTI check and have his teeth checked too. It really seems like something else is going on. However, if they can't find anything, I'd switch him over to Levemir. You can't try the lower doses again because of the ketones, and the higher doses are giving him any relief. To me that says that the PZI just isn't cutting it for Meatball.

Levemir is more flexible than Lantus but will give you longer duration than the PZI.

Normally, with a ketone prone kitty, I'd advocate for PZI since it is more flexible and can be used 3 times a day. But if your work schedule can't take advantage of that flexibility, it serves no purpose and may be putting Meatball in more danger.

Terri,
Meatball is only 1.5 years old. For a cat that young would you still think to pursue the dental avenue?

I've wondered the same thing too about rebound & ketones. I have been told that ketones are from a lack of insulin rather than higher #s per se, but I'm vague on what that actually means, i.e. if the higher #s might be due to rebound and you already on a decent dose (his ketones disappeared before once you got to 3u, right?). I think they also stem from not eating enough and/or infection. If he isn't eating well, I'd definitely push things on that front.

Terri's Lev suggestion makes sense to me. When I wondered about switching Bix to Lev she told me how to use PZI more effectively and didn't think switching was in order, so I know it's not something she would recommend idly. I have seen a couple people here shoot PZI really aggressively when their cat had ketones, but it made them super-crazy (like testing round the clock and shooting every 6-8 hours), and ultimately the ones I saw ended up switching anyway to Lantus or Levemir after a short nightmarish period.

Are you still giving him fluids? I think you were doing that at one point, or maybe I am thinking of someone else. If you have been and recently stopped, maybe that has something to do with the ketones re-appearing?

I don't know at what point vet treatment is recommended with ketones, so please don't take any of my advice to mean you shouldn't head over to the ER if that might be warranted. If not here, I'm sure you can get more advice on that angle of things on Health. And you've been through this before I guess :sad: , so hopefully you already know where to draw those lines.

Thanks for checking in Terri & Gator. I've lost several posts tonite, not sure if it's my internet or the board. Not that I still haven't left plenty of reading for everyone, lol.

On the losing posts thing. Sometimes if you are writing a post [particularly a long one] and someone else comes along and posts then when you press "submit" it will show their post [but still keep your input]. You just need to scroll down and press "submit" again [or until you are the last poster] and it will go though. Also if you press the "back" button on your browser it should preserve what you wrote.

Yeah, actually I got a weird thing tonite (first I've seen this) where the screen refreshed just back to the blank entry form - no new post from anyone else, & mine gone (I got in the habit on the old board of copying everything before submitting anyhow, so no biggie really). Or just flat out browser error message - page not found or something. Probably a sign I shouldn't type so much. :lol:

I lost a post, too, and I've never had hat happen before - maybe something is a little wacky tonight.

Joanna & Bix said:

Are you still giving him fluids?

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I am, I had cut back a couple of days ago to 50ml 1x per day. I gave him a full 100ml tonight, and will continue to do this 2x per day till we get rid of the ketones... and even a few days after that.

Joanna & Bix said:

I think they also stem from not eating enough and/or infection. If he isn't eating well, I'd definitely push things on that front.

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He is definitely eating very well. I almost think his appetite is bigger since he was rid of the ketones last time. Between the two cats, they eat 8 cans of FF/day.

Terri and Lucy said:

I'd get another UTI check and have his teeth checked too.

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Does it matter that he actually had a urine culture (not just a urinalysis) done and there was no infection? If he did have some sort of an infection, would he not have some symptoms? When he had the UTI, there was absolutely no way I could have missed it. He had all the symptoms, but now he has none. Even thought his BG is crazy and he has small ketones, he is still wrestling. And when Meatball is not feeling well, he lays on my face while I'm sleeping and pokes me with his paws... there has been none of that.

Molly, if you do think about moving to Levimir I would put the folks on notice over in that forum and make sure you have together a good game plan for the switch since ketones are a very prescient issue for you guys.

Glad to hear he is acting well & eating well, that at least is a relief!!! I don't know enough to help with your other questions, but I'm hoping the fluids will chase out the ketones overnight! nailbite_smile

Yes, even though he's only 1 1/2 years old I would still have his teeth checked. Something is going on with him. It would be a shame to spend the extra $$$ to change insulins and have the same problems. What does your vet think? Have you posted on Health to ask for opinions other than here on PZI?

My first post on FDMB was late one night, shortly after being diagnosed as diabetic, when Lucy was screaming at the top of her lungs. I was petrified. We went to the ER vet and they told me she had a slight UTI. Six years later, she doesn't blink at a UTI. When it finally gets bad enough, she'll pee on something outside her litterbox as her signal (when I'm looking of course). Our kitties are such funny communicators. :roll:

I thought I heard that the Ls are more time sensitive, that you had to keep to a strict 12/12 schedule with them, that there's lots more leeway with PZI. Do I have this straight? In my life that would be a big consideration, and if Molly is working multiple jobs, it might be for her too.

When Lucy stopped responding to PZI, I switched to Levemir. I've used it much like I did PZI--shot it TID, shot early, used a split dose. But I prefer to stick with the 12/12 schedule when I can. That's why I would never consider using Lantus. My life doesn't conform to a strict 12/12 schedule.

Donna: There are a few people (maybe more?) who can't stick to a 12/12 schedule on Lantus, but for the most part, it really does need to be given on that schedule. Cindy + Mousie are trying out Lantus (just switched on Friday) and she can't do 12/12 but is doing 13/11. It's too soon to tell if it's working out for her, I think.

Some LL people posted on her first thread when she said that she couldn't really do a 12/12, saying that some people do do it. It is definitely far less flexible than PZI, and it does have to be a consideration if a switch is a possibility. Sadly bosses don't really care that our kitties need shots at certain times.

Gator: I cannot stop thinking about your time travel question now! And while I was thinking, "I Need to Know" (Tom Petty) came on my iTunes and blew my mind that it knew I had an unanswered question I needed to know about...

Joanna: I do the same thing with posts now (well, with long ones, anyway); just highlight and copy in case something goes wrong. Not much in this world is as frustrating as losing a good post. Ok, that's not true, but it is really annoying.