1/15 Slashy PMPS 163 +2 156

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Slashy & Rick

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Yesterday viewtopic.php?f=9&t=2540&p=24304#p24304

SS http://spreadsheets.google.com/ccc?key= ... haXc&hl=en

61 at AMPS is unchartered territory for us! don't know what to do/shoot. His regular dose is 5 units. See spreadsheet.

Also please see yesterday.. he has been diagnosted with pancreatitis and is on a variety of meds, including antibiotics. His fPL came in at 50 (off the charts)

I cant be here to test all day. My wife is home on and off but isnt too skilled at testing yet. He is eating fine.

Rick
 
Re: 1/15 Slashy AMPS 61!! Dose advice

I can't give you too much dosing advice, but I can tell you that if your cat does have pancreatitis and is not on antibiotic than you will see some a drop in bg as soon as the antibiotic starts to kick in.

If I were in your shoes, I would probably back off on the dose, going down to 0.25 or .50 for a few days while the antibiotic does its thing. I would also monitor closely to make sure that Slashy doesn't go much lower. It is possible for the pancreas to start working on its own once the antibiotic kicks in.

Understand, that is just my opinion, I am still very new to this, so I would wait until the more veterans come along and confirm or bash my recommendation.
 
Re: 1/15 Slashy AMPS 61!! Dose advice

I just spoke with our vet. She said not to shoot this am. I can stick around and test at +1.

thoughts?
 
Re: 1/15 Slashy AMPS 61!! Dose advice

I don't know about your vet, but mine does not know alot about FD, and I have been giving her info that I have learned from this site.

I can't say a thing as I know nothing about meds interaction, low BG numbers, etc, but someone will come along with good advice. My guess would be to delay not completely omit a shot.

I would go with Heather's suggestion.
 
Re: 1/15 Slashy AMPS 61!! Dose advice

Slashy & Rick said:
vet said dont shoot. I am testing in 20 minutes. Will post then
Click to expand...

I have to agree with your vet. And like I said before I would definitely consider decreasing the dose, at least until you see how Slashy will react.
 
Re: 1/15 Slashy AMPS 61!! Dose advice +1 60

Gave no shot, he is level. Going to feed and go to work. Wife will be home to feed and watch most of the day.
 
Re: 1/15 Slashy AMPS 61!! Dose advice

Hope all will be well with Slashy today--See what his BG is when you return home..ending healing vines to Slashy!
 
Re: 1/15 Slashy AMPS 61!! Dose advice

Just posting to let you know you're in my thoughts...does Mamabean know how to come here in case she needs us? She probably won't need us, because Slash will be just fine, but it would be good to know she can come and post if she needs it.

Best-
Michele
 
Re: 1/15 Slashy AMPS 61!! Dose advice

Thanks All!

Michelle.. yes, she has the browser on the laptop open. Also has my number, vets and knows what to do in case of emergency. As I type she is at the vets with our dog, Dr J and Pyewacket (bean) for routine visit. She will be home in an hour or so. He ate before she left.
 
Re: 1/15 Slashy AMPS 61!! Dose advice

Morning Rick!

For future reference since you said a low PS number is uncharted territory for Slashy, here are the options:

1) Stall, don't feed, and retest in 15 min. You may have to repeat this process several times with the goal of seeing whether numbers are on the rise. You don't want to shoot on a dropping number. (At some point, once Slashy is getting lots of greens, you will want to shoot on a low number, since that will give you a lovely, low, flat curve. Also keep in mind, once numbers are rising, you are not really shooting the PS number but the number where Slashy will be in a few hours.) The down side of stalling is that it throws your shot schedule off since your next shot needs to be 12 hours later from your actual shot time. This option generally has the least effect on the shed (other than a late shot acting like a dose reduction.)

2) Shoot a BCS (big chicken sh*t) dose. This is a reduced dose. How much you reduce the dose depends on your comfort level and ability to monitor over the next couple of hours. This obviously has an effect on the shed. You do not want to both stall the shot and reduce the dose since this is like a double reduction and would have a considerable effect on the shed.

3) Skip the shot altogether. Usually, this is the least best option since it has the most effect of the shed.

I know a situation like this tends to happen when you're most pressed for time. You know who the experienced Lantus users are on the Board and those are the folks who will help you puzzle through what the best option is during any given situation. If it were me, these are the people I would pay the greatest attention to in addition to your vet. (Although, I suspect vets don't think about the stall option since they aren't used to beans who test the way we do.)

Sorry to hear about the pancreatitis diagnosis. Gabby went through a bout of it when she was diagnosed with FD and there are lots of beans here whose cats deal with chronic pancreatitis. Both the ABs and the pain meds will help Slashy feel better. It's impressive that his numbers have been very consistent despite the pancreatitis. I'd really encourage you to make good use of the pain meds -- the condition is very painful. I believe that someone (Cassandra?) sent you the link to Jojo's post on pancreatitis. If you can't locate it, PM me and I'll send it to you. If you have questions, there are a number of beans who can fill you in on what to expect. Gabby did well on a combo of ABs, pain meds, Pepsid, and an appetite stimulant.
 
Re: 1/15 Slashy AMPS 61!! Dose advice

Thank you Sienne,

Very helpful advice. I posted here before I called the vet.

The summary of today's progression is as follows:

5:30 am - gave him pepcid and the med that has to be given on empty stomach (can't recall the name).

6:30 am - Our routine is that he eats and I test immediately after he finishes. Today AMPS was 61

We typically shoot at 7 but today I posted here and called the vets. I did let him eat again.

7:15 or so.. gave him the rest of his meds, diltazem, antibiotic, one whose name eluding me and pain medication.

8 am - retested - 61

Hope I did ok. Would certainly prefer to err on the side of caution.

Rick
 
Re: 1/15 Slashy AMPS 61!! Dose advice

You did great! Theoretlcaly, skipping may be the least best option but sometimes is it the only safe and sane option given the situation. Right now Slashy has a lot going on. Frankly, I'd have been surprised getting this low of a number given the pancreatitis. But, Slashy is a cat and by definition, unpredictable. Whatever momentum may have been lost by skipping, you will easily make up.
 
Re: 1/15 Slashy AMPS 61!! Dose advice

Sienne and Gabby said:
You did great! Theoretlcaly, skipping may be the least best option but sometimes is it the only safe and sane option given the situation. Right now Slashy has a lot going on. Frankly, I'd have been surprised getting this low of a number given the pancreatitis. But, Slashy is a cat and by definition, unpredictable. Whatever momentum may have been lost by skipping, you will easily make up.
Click to expand...

He does keep me on my toes!! :) We have alot of history.. His first day at our house he nearly strangled himself on a flea collar I put on too loosely (Not knowing what I was doing). He tore open my hands and forearms while I got it off.. a couple of months later I was diagnosted with cat scratch fever.. Hence his name.

He was a stray, now approx 12 years old. He was quite young when diagnosted with cardiomyopathy. In 2006 he stopped eating and got fatty liver disease. Feeding tube save his life. Diagnosted with diabetes in 2008. Did not start home testing until Oct of this year when he developed neuropathy.

The things we do.. Sign :)
 
Re: 1/15 Slashy AMPS 61!! Dose advice

You are doing great. You are very good beans to Slashy. All crossed for a speedy recovery. BREATHE, remember don't worry about yesterday or tomorrow, worry about today. You made a decision you are comfortable with and recommended by your vet. That is okay. You can regain if you lost anything. The shed will rebuild. Have a good day and keep us posted.
 
Re: 1/15 Slashy AMPS 61!! Dose advice

Rick, I'm sorry to hear that Slashy has chronic pancreatitis (CP), but it is very common among diabetic cats and very treatable. Please make sure that they provide you with a pain medication - pancreatitis is incredibly painful and while Slashy may not be exhibiting signs of pain as cats are very stoic, pain meds are crucial to breaking the cycle of pancreatitis. The pain med of choice around these parts for pancreatitis treatment is usually Buprenex.

From the VIN segment below:

Analgesia is of critical importance in the comfort of the patient, but also in the progression of the disease/inflammation through the negative physiological effects of pain. Pain causes disease and prevents healing.

Here is the pancreatitis information I posted before:

Jojo's Pancreatitis Post
Idexx Pancreatitis Roundtable Discussion
WSAVA/VIN Pancreatitis Proceedings
 
Re: 1/15 Slashy AMPS 61!! +7 97

Hello.. Wife just accomplished her first solo test.. 97.

Yes, we do have pain meds and am administerng 2x/s per day. They will give me more too.

Already have JoJo and Idexx.. thanks for hte wsava.
 
Re: 1/15 Slashy AMPS 61!! Planning for PMPS

Hello... Will be confiring with Vet as well as the group but want to toss out there..

he was 97 at +7.. Say he is 150 at pmps, what dose should I give. We have been at 5 units. No shot this am.

Any help is greatly appreciated!
 
Re: 1/15 Slashy AMPS 61!! Planning for PMPS

Rick you shot a 142 and a 135 on the same dose.
I noticed you ss only appears in your first post of the day......could you add it to your signature so it is in all of your posts. Thank you.
 
Re: 1/15 Slashy AMPS 61!! Planning for PMPS

I don't know what to advise you, but you definitely should go to the top post in your thread and click "edit" then add "help" or advice" to the subject line. That will get someone's attention.
 
Re: 1/15 Slashy AMPS 61!! Planning for PMPS

Will not give dosing suggestions but this will bump you to the top. Also, add HELP to your subject line and bump yourself up.
 
Re: 1/15 Slashy AMPS 61!! Planning for PMPS

Lydia and Basil said:
I don't know what to advise you, but you definitely should go to the top post in your thread and click "edit" then add "help" or advice" to the subject line. That will get someone's attention.
Click to expand...

Thank you.. having trouble w/ this new website format.
 
Re: 1/15 Slashy PMPS 163 Never mind. Giving 4

Slashy & Rick said:
Not waiting any more. Giving him 4, testing at around +2 or 3
Click to expand...


Hi Rick,

Sorry you haven't gotten a lot of responses today, everyone must be busy :)

I just got around to looking at your SS, and was not aware you are a high doser. I have some things to help you with, and also some questions.

1. We normally recommend not to completely skip a shot during a pancreatic attack, however, based on the information you had and the working schedule you have, you made the same decision I would have made in your situation. Next time, just shoot half. The pancreas is as its weakest during pancreatitis and really needs the insulin to prevent ketones/dka. With the fluids I read about in your yesterday's condo, his numbers should come down, so by morning you with either find him at a decent number or pretty high due to the reduced shed. My advice for tomorrow morning is if you find him at a decent number (75-200) give him 1/2 dose. If you find him higher, repeat the 4u.

2. Are you going to be continuing fluids at home? If not, I recommend you talk to your vet about it. It's easy to do and is tremendously helpful to be able to give fluids throughout the attack. I know you have a heart (cardiomyopathy) kitty, I do too, so you do have to be very careful with giving them fluids. My vet recommends only to give 50cc at a time or so, but you will need to talk to your vet and decide if it's the right thing for your kitty. Pancreatitis is a chronic thing and it's best to be prepared to treat it at home because it's both more economical and easier on the cat. Here's a great read on pancreatitis and what it will mean to you. http://www.felinediabetes.com/phorum5/read.php?8,876722,876722 (page will load slowly) I had a pancreatic cat, and he had several flares, usually 1 every month or 2. I see you've got an arsenal of meds, and I think that's a great thing. Your vet has really hooked you up :)

Now to my questions..
1. does he eat any dry food?
2. why is his dose so high? does he have another condition causing it? has he been tested for any of the conditions known to cause higher doses?
3. noticed you said in yesterday's condo he'd lost weight. this is not necessarily a bad thing. we may think our cats are average or normal when really they are overweight, so he might be headed for a better weight for him. if he's starting to look bony, or lose muscle, that could indicate a problem. dr lisa's site has a great writeup on what a cat should actually look like, for those of us who are challenged LOL http://www.catinfo.org

I think I have probably stressed you out enough LOL I will add you to my list of kitties to check. Nice to meet you and slashy! I'm very glad to see your vet's proactive response to the pancreatitis dx.
..Carolyn
 
Re: 1/15 Slashy AMPS 61!! Dose advice

msarobix said:
I can't give you too much dosing advice, but I can tell you that if your cat does have pancreatitis and is not on antibiotic than you will see some a drop in bg as soon as the antibiotic starts to kick in.

If I were in your shoes, I would probably back off on the dose, going down to 0.25 or .50 for a few days while the antibiotic does its thing. I would also monitor closely to make sure that Slashy doesn't go much lower. It is possible for the pancreas to start working on its own once the antibiotic kicks in.

Understand, that is just my opinion, I am still very new to this, so I would wait until the more veterans come along and confirm or bash my recommendation.
Click to expand...

Hi tina,
This is not quite actually true, and I hope you don't think I'm bashing you. We watch for when the infection clears, not when the antibiotic kicks in. It's entirely possible there will be no fluctuation in bg's in respect to any infection treatment.. for instance, if there is not actually an infection. This is why we don't recommend dosage adjustments based on antibiotic treatment. If the treatment doesn't work, or there is not an infection, the cat may wind up in distress from not enough insulin. In this case, Rick needed to reduce/skip the dose, so no harm done this time.
 
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