5/20 polly pmps 421+1=391 +3=302 +5=272
- Thread starter Marilyn and Sheldon
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julie & punkin (ga)
Member Since 2011
Re: 5/20 Polly AMPS 403 +2=320 +8=240 Dose increase tonight?
I think that's ok.
When you get a chance to upload the labs, would you say so? I'm just wondering if the original UTI was resolved, or if the infection after the tooth extraction hasn't resolved yet. Were any follow-up tests done to check on either of those?
How is Polly behaving - any indication that she's not feeling totally herself?
It's not typical for a cat to have better numbers off of insulin than on, and it's also a bit unusual to have the same ranges of numbers at every dose when it's increased. We're wondering if any of those original problems might not be resolved yet and if that's the reason she's not responding as much to the insulin as would be expected.
Thanks for doing such a good job of getting tests in here and there throughout the day, marilyn. You've been great at that - it helps to know there are no hidden low numbers lurking about that just didn't get caught. Are you able to go back to sleep with all of those night tests you're doing?
I think that's ok.
When you get a chance to upload the labs, would you say so? I'm just wondering if the original UTI was resolved, or if the infection after the tooth extraction hasn't resolved yet. Were any follow-up tests done to check on either of those?
How is Polly behaving - any indication that she's not feeling totally herself?
It's not typical for a cat to have better numbers off of insulin than on, and it's also a bit unusual to have the same ranges of numbers at every dose when it's increased. We're wondering if any of those original problems might not be resolved yet and if that's the reason she's not responding as much to the insulin as would be expected.
Thanks for doing such a good job of getting tests in here and there throughout the day, marilyn. You've been great at that - it helps to know there are no hidden low numbers lurking about that just didn't get caught. Are you able to go back to sleep with all of those night tests you're doing?
Marilyn and Sheldon
Member Since 2014
Re: 5/20 Polly AMPS 403 +2=320 +8=240 Dose increase tonight?
I've keyboarded the data from March 27th blood/urinalysis labs. Will get it in my signature later,maybe you can access through the tab on her numbers spreadsheet. Have a work function to attend briefly.
Yes, blood work, urine culture done again April 30. I'll input that info later, too...Vet examined the tooth sockets visually, then. No apparent pus or inflammation. No increased WBC on that 4/30 bloodwork.
My vet is stumped. Glucose toxicity? His only guess. I hate taking her in because she's such a fearful kitty. You know, the kind that hunkers in the litter box facing the wall when confined at the vet. A ragdoll type, she just shuts down when scared.
Polly's gained weight. Up from 8.8 to 9.8 pounds. Slight hind leg neuropathy (?) is resolved mostly. She's back to jumping on the couch for secret scritches and is sleeping up by my head again at night. And she's been purring and grooming. Sometimes, when her numbers are high she seems a little squinty unlike her usual big round eyes.
Gotta run. Thanks for your help. I'll try to be more coherent later!
Marilyn and Polly
julie & punkin (ga) said:
I've keyboarded the data from March 27th blood/urinalysis labs. Will get it in my signature later,maybe you can access through the tab on her numbers spreadsheet. Have a work function to attend briefly.
Yes, blood work, urine culture done again April 30. I'll input that info later, too...Vet examined the tooth sockets visually, then. No apparent pus or inflammation. No increased WBC on that 4/30 bloodwork.
My vet is stumped. Glucose toxicity? His only guess. I hate taking her in because she's such a fearful kitty. You know, the kind that hunkers in the litter box facing the wall when confined at the vet. A ragdoll type, she just shuts down when scared.
Polly's gained weight. Up from 8.8 to 9.8 pounds. Slight hind leg neuropathy (?) is resolved mostly. She's back to jumping on the couch for secret scritches and is sleeping up by my head again at night. And she's been purring and grooming. Sometimes, when her numbers are high she seems a little squinty unlike her usual big round eyes.
Gotta run. Thanks for your help. I'll try to be more coherent later!
Marilyn and Polly
julie & punkin (ga)
Member Since 2011
Re: 5/20 pmps 421+1=391 Dose increase tonight. 1.25 to 1.5
yes, i can see the labs on a tab on her spreadsheet - thanks for doing that. i see the thyroid also got checked, which was another possibility. Sometimes hyperthyroid can affect how a cat responds to insulin - but it looks normal.
it could be that we're just not to a good dose yet. this is still a very small dose. so we'll just keep plugging away. i'm glad you had those follow-ups done so we know the UTI and tooth socket infection are cleared up.
Glucose toxicity is a possibility, but that wouldn't explain why her numbers are worse on insulin than before you started giving injections. By not holding doses too long, we should be able to overcome that - if it's the issue.
edited to add - where did you get your insulin? did the vet sell it to you or did you get it at a pharmacy, or ? vial or pen?
yes, i can see the labs on a tab on her spreadsheet - thanks for doing that. i see the thyroid also got checked, which was another possibility. Sometimes hyperthyroid can affect how a cat responds to insulin - but it looks normal.
it could be that we're just not to a good dose yet. this is still a very small dose. so we'll just keep plugging away. i'm glad you had those follow-ups done so we know the UTI and tooth socket infection are cleared up.
Glucose toxicity is a possibility, but that wouldn't explain why her numbers are worse on insulin than before you started giving injections. By not holding doses too long, we should be able to overcome that - if it's the issue.
edited to add - where did you get your insulin? did the vet sell it to you or did you get it at a pharmacy, or ? vial or pen?
Marilyn and Sheldon
Member Since 2014
Re: 5/20 pmps 421+1=391 +5=301 increase tonight. 1.25 to 1.
Vial came from vet. Opened. A client had returned it, unopened. Vet had used a few units in-house. So opened when I got it. Expires Oct. 2014.
Off again for work dinner.
Thanks.
Marilyn and Polly
Vial came from vet. Opened. A client had returned it, unopened. Vet had used a few units in-house. So opened when I got it. Expires Oct. 2014.
Off again for work dinner.
Thanks.
Marilyn and Polly
julie & punkin (ga)
Member Since 2011
Re: 5/20 pmps 421+1=391 +5=301 increase tonight. 1.25 to 1.
hmmm, once a vial has been used the first time, most people have found that they will last 6 months or less, depending on how it was cared for (if it was kept refrigerated and not contaminated, for example). The expiration date is only applicable until you begin to use the bottle. You probably don't have any idea when it was initially used, do you?
Was the bottle repackaged by the vet? There is a picture here of a repackaged vial: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=151
did you watch the video on how to draw up insulin doses? it's on the "care/storage of insulin" sticky that i linked just above. one of the important cautions is to not see-saw the dose back and forth between the syringe and the vial. the syringes have a lubricant in the barrel so that the plunger will move smoothly, and that lubricant doesn't belong in the insulin itself.
i get allergy shots and the nurse always see-saws the dose in and out of the vial - it drives me crazy. I asked her a while ago about it and she'd never heard anything about not doing that. she still does it. the reason i'm mentioning this is because i wonder if your vet/vet tech might've done that and it might have affected the insulin. My guess is that syringes back when didn't have a lubricant and those who learned a while ago may never have heard any cautions about it. Or perhaps Lantus is more sensitive to that than other products that get injected. i don't know. Often when we wonder about the efficacy of the insulin, people will try a new vial/pen while keeping the old one in the fridge. if the numbers don't change, we know it isn't the insulin. Often there isn't a difference after switching to a new vial/pen, but sometimes there is. It's one thing to consider when things seem to be atypical.
Would you hold your vial up to a light and see if it is at all cloudy or has threads or floaters in it? it should look exactly like water, completely clear, absolutely nothing visible in it.
Maybe just keep it in the back of your mind as something to consider checking on later. If we don't see a response from the increase in dose this time, it might be worth getting a single pen from a pharmacy to see if that makes a difference. There is a Lantus savings card that can be used http://www.lantus.com/sign-up/offers (your cat is 18 when you register) and some pharmacies will open a box of pens and sell you just one. There's no rhyme or reason for who will break open a box and sell just one pen - you have to make calls and ask. i found a Save-on pharmacy inside a grocery store chain that would sell me one at a time.
If your vial was repackaged, i would take it back to the vet and tell him it's not good and ask for your money back.
hmmm, once a vial has been used the first time, most people have found that they will last 6 months or less, depending on how it was cared for (if it was kept refrigerated and not contaminated, for example). The expiration date is only applicable until you begin to use the bottle. You probably don't have any idea when it was initially used, do you?
Was the bottle repackaged by the vet? There is a picture here of a repackaged vial: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=151
did you watch the video on how to draw up insulin doses? it's on the "care/storage of insulin" sticky that i linked just above. one of the important cautions is to not see-saw the dose back and forth between the syringe and the vial. the syringes have a lubricant in the barrel so that the plunger will move smoothly, and that lubricant doesn't belong in the insulin itself.
i get allergy shots and the nurse always see-saws the dose in and out of the vial - it drives me crazy. I asked her a while ago about it and she'd never heard anything about not doing that. she still does it. the reason i'm mentioning this is because i wonder if your vet/vet tech might've done that and it might have affected the insulin. My guess is that syringes back when didn't have a lubricant and those who learned a while ago may never have heard any cautions about it. Or perhaps Lantus is more sensitive to that than other products that get injected. i don't know. Often when we wonder about the efficacy of the insulin, people will try a new vial/pen while keeping the old one in the fridge. if the numbers don't change, we know it isn't the insulin. Often there isn't a difference after switching to a new vial/pen, but sometimes there is. It's one thing to consider when things seem to be atypical.
Would you hold your vial up to a light and see if it is at all cloudy or has threads or floaters in it? it should look exactly like water, completely clear, absolutely nothing visible in it.
Maybe just keep it in the back of your mind as something to consider checking on later. If we don't see a response from the increase in dose this time, it might be worth getting a single pen from a pharmacy to see if that makes a difference. There is a Lantus savings card that can be used http://www.lantus.com/sign-up/offers (your cat is 18 when you register) and some pharmacies will open a box of pens and sell you just one. There's no rhyme or reason for who will break open a box and sell just one pen - you have to make calls and ask. i found a Save-on pharmacy inside a grocery store chain that would sell me one at a time.
If your vial was repackaged, i would take it back to the vet and tell him it's not good and ask for your money back.
Marilyn and Sheldon
Member Since 2014
Re: 5/20 pmps 421+1=391 +5=301 increase tonight. 1.25 to 1.
Sorry, no. It was refrigerated at the vet, though.
Not repackaged. Came in original box. Had the blue protective top on it. Original label on the vial.
Yup. I don't see saw. If I draw up more than I'd planned, I squeeze excess out (only a few times) and if I'm not confident with the draw (again only a few times), I'll squeeze the load out and start anew.
Hmmm? Good thought. I asked my vet to check into ordering the pens for me earlier. I kinda think I might need a scrip for insulin. Vet could do that, I guess. For a fee!
Clear. No threads. No floaters. Looks like water. I keep it in a small glass, bottom shelf of fridge, corner.
I'll check into the pens.
Thanks.
Marilyn and Polly
julie & punkin (ga) said:
Sorry, no. It was refrigerated at the vet, though.
julie & punkin (ga) said:
Not repackaged. Came in original box. Had the blue protective top on it. Original label on the vial.
julie & punkin (ga) said:
Yup. I don't see saw. If I draw up more than I'd planned, I squeeze excess out (only a few times) and if I'm not confident with the draw (again only a few times), I'll squeeze the load out and start anew.
julie and punkin (ga) said:
Hmmm? Good thought. I asked my vet to check into ordering the pens for me earlier. I kinda think I might need a scrip for insulin. Vet could do that, I guess. For a fee!
julie and punkin (ga) said:
Clear. No threads. No floaters. Looks like water. I keep it in a small glass, bottom shelf of fridge, corner.
I'll check into the pens.
Thanks.
Marilyn and Polly
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