10/27/19 Elmo....AMPS 561...+7 HI. PMPS HI, Dosecrease to 1.25

Discussion in 'Lantus / Levemir / Biosimilars' started by Beth 73, Oct 27, 2019.

  1. Beth 73

    Beth 73 Well-Known Member

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    Aug 2, 2016
    10/24

    Hey everyone ....would appreciate opinions on what to do next for Elmo...tonight will be cycle 6 on 1 unit and as SS shows he is still running high. Acting little sluggish..appy good..ketones negative @MrWorfMen's Mom @carfurby @Wendy&Neko @Gill & George @Bron and Sheba (GA) Advice needed and appreciated ❤️ PS 10 days of 100 2x a day ABs ended 10/22...pulsing 50 3x a week begun 10/25...
     
    Last edited: Oct 27, 2019
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  2. Amanda and a Loudogg

    Amanda and a Loudogg Well-Known Member

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    Hiya Beth! It really sucks to see those blacks and HIs on Elmo's spreadsheet. I really do think it's time for an increase. The lowest he's been is that 283 on the 25th. I really hope he can start coming down soon. I doubt those high numbers feel good. :(
     
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  3. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    How much longer for the TID ABs? Are they pills?

    Looks like he need an increase, but want to make sure his ABs are sugar free.
     
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  4. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Beth

    Did you get a PMPS last night and forgot to enter it? I’m also wondering if he’s getting something with sugar in it or any contraband because his numbers have so drastically changed in a short time.

    Normally, with these numbers, we would suggest a 0.5u increase; he’s only seen one yellow; however, if he’s on antibiotics and has been on them for a few days, we might expect the BG to start resolving a bit.
     
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  5. Beth 73

    Beth 73 Well-Known Member

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    Thanks , Amanda ❤️ Glad he is eating tho .
     
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  6. Beth 73

    Beth 73 Well-Known Member

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    Thank you , Wendy ❤️ His ABs are exact same he has been on for the two week course so nothing new there . Started the pulsing of same ABs (pills) on Friday . Vet has him on 50 mg once a day 3x a week . All is the same ...same food , same ABs , no infection in his mouth . Has me stumped .
     
  7. Beth 73

    Beth 73 Well-Known Member

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    Thank you , Marje, for weighing in ❤️ He ended a two week run of Amoxicillin (pill) 100 2x a day for mouth infection on 10/22.....started the pulsing ( same ABs) on 10/25 .... no change of food ... no change of meds ... all exactly the same . Had a bout of vomiting on 10/20 but resolved by next day . I am stumped .
     
  8. Beth 73

    Beth 73 Well-Known Member

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    @Wendy&Neko @Marje and Gracie if he got into contraband unbeknownst to us , how long would it take to clear ??? As in he found something on the floor ??
     
  9. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Depending on how much and what contraband, it can take up to three days to completely clear. Neko took about 18 hours, but had a working pancreas.
     
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  10. Beth 73

    Beth 73 Well-Known Member

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    Thinking if he got hold of lunch meat or bacon ( both cured with sugar) ...we are very careful but those are both possibilities...if that then would I increase or wait ? I'm always careful ab checking the floor . I know he couldn't have gotten into anything today for sure .
     
  11. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    He’d have to be eating lunch meat or bacon a lot to keep his numbers up this long, IMHO. I would not wait to increase with his history of DKA and infection even though it’s been a while and he’s on antibiotics.
     
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  12. Beth 73

    Beth 73 Well-Known Member

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    Marje, so you would advise an increase of .25 or .50 ? And start tomorrow AM ? Hesitant to start on PM shot ..Think I would rather try a .25 increase and see how he does ...
     
    Last edited: Oct 27, 2019
  13. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    Certainly you can try 0.25u in the morning if you prefer.
     
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  14. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Beth --

    I don't remember what the mouth infection was all about. Was this for an infected tooth or an abscess? Given what Elmo's numbers look like, it doesn't seem like the antibiotics are doing their job. Would dental X-rays be warranted?

    I think you need to increase by 0.5u. With the history of DKA, the high numbers are worrisome. They are telling you the infection isn't. under control. I'd think about getting Elmo to the vet.
     
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  15. Beth 73

    Beth 73 Well-Known Member

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    Marje, thinking I may start tonight with .25 increase instead of waiting til tomorrow AM....see where it takes us ...
     
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  16. Beth 73

    Beth 73 Well-Known Member

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    Thank you, Sienne.....Vet does home visits and has determined Elmo cannot undergo any dental procedures due to aging kidneys. The infection was at front of his mouth and is easily observable and is currently no longer inflamed . We are pulsing ABs now to hopefully keep infection at bay as that is all there is to be done considering Elmo’s kidneys . If inflammation flares we go back to a twice a day 10 day course which took care of last infection. At his age and stage it is the only course of action we are left with.
     
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  17. Beth 73

    Beth 73 Well-Known Member

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    Going with an increase to 1.25 tonight’s shot .... will keep y’all posted ....thank you for all your wisdom and advice ❤️❤️❤️
     
  18. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    While I tend to agree with Sienne that he needs more than a 0.25u increase, you hold the syringe.

    Obviously giving a dose increase warrants close monitoring. It needs to be your decision. We can offer our input but, ultimately, you have to be comfortable.
     
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  19. carfurby (GA)

    carfurby (GA) Well-Known Member

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    Good luck with the increase. I hope it brings Elmo's numbers down. Glad his mouth no longer looks inflamed. Sending prayers.
     
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  20. Beth 73

    Beth 73 Well-Known Member

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    Thank you, Marje... I’d like to at least give the .25 a try...a month ago (9/20) it was the dose that helped. Also if you have any wisdom when it comes to pulsing ABs please share .... seems from 2 vets I consult it can be customized and no iron clad “ this is how it’s done”.... I am increasing to 4x a week for now ... I am walking a fine line with him due to age,kidneys,thyroid as well. It is a constant balancing act but worth it ❤️
     
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  21. Beth 73

    Beth 73 Well-Known Member

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    Thanks, Carla❤️ Wanting and needing those prayers ❤️ Tomorrow early we are having our sweet office kitty, BC , put to sleep due to failing kidneys . Need your prayers for that as well :bighug:
     
  22. Beth 73

    Beth 73 Well-Known Member

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    PS....he is on 4x a week low dose AB as maintenance from now on ... i have option of switching from amoxicillin to clindamycin ( excuse sp) if I see amoxicillin is not working . His system ie stomach tolerates the amoxicillin so sticking with that for now .
     
  23. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    @Beth 73 hi Beth wishing you good luck with Elmo tonight with the increase and /I'm so sorry to hear about your sweet office kitty. It's never easy is it. Prayers for everyone
     
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  24. Beth 73

    Beth 73 Well-Known Member

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    ❤️Thanks, Diane ❤️. Needing and receiving those prayers :bighug:
     
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  25. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Just seeing this now. Sorry to see Elmo still in those high numbers. Hopefully the dose increase will get him back to business.

    (((HUGS))) for you and scritches for BC. They are never with us long enough. :bighug::bighug::bighug::bighug:
     
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  26. Sonia & Leo

    Sonia & Leo Well-Known Member

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    Good luck with Elmo's dosecrease Beth. I'm so sorry you have to say goodbye to BC. Sending comfort and hugs to you at this very sad time. :bighug::bighug::bighug::bighug::bighug:
     
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  27. Beth 73

    Beth 73 Well-Known Member

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    Thank you, Sonia ❤️ He is a gentle soul who never saw a stranger :bighug: Will miss him ❤️
     
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  28. Beth 73

    Beth 73 Well-Known Member

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    Thanks, Linda ❤️ No, they aren't ...second one in last few months ... this stinks ...
     
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  29. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    So sorry... :( :( :( :(

    Hope the dosecrease helps. Elmo, come down off the rafters, nothing to see up there.
     
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  30. Beth 73

    Beth 73 Well-Known Member

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    :bighug:❤️ Thanks , Nan ❤️:bighug:
     
  31. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I wish I had better insight on pulse dosing antibiotics but I don’t. I hope it works very well for Elmo, though.
     
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  32. Beth 73

    Beth 73 Well-Known Member

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    :bighug:❤️ Thank you , Marje :bighug: He had his bedtime snack and is snuggled down beside me . We shall see what tomorrow brings . Thank you for your " eyes" on us :)
     
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  33. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    You’re welcome. I hope each day is better.
     
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  34. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Sorry to see all those high numbers with Elmo. Hope the increase in dose helps.

    So sorry about your office kitty BC leaving you. It is never easy. :bighug::bighug::bighug:
     
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  35. carfurby (GA)

    carfurby (GA) Well-Known Member

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    I'm so sorry to hear this. Sending prayers as you say good-bye and for a peaceful crossing. :bighug::bighug::bighug::bighug::bighug::bighug::bighug:
     
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  36. Beth 73

    Beth 73 Well-Known Member

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    :bighug:❤️ Thank you, Bron ❤️
     
  37. Beth 73

    Beth 73 Well-Known Member

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    ❤️Carla❤️. Prayers are carrying us .
     

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