8/11 Cosmo AMPS HI, +3 508, +6.5 418, +9.5 196 big drop!?! PMPS 193 token dose, +1 238 +2 268

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by thebigfuzz, Aug 11, 2020.

  1. thebigfuzz

    thebigfuzz Well-Known Member

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  2. thebigfuzz

    thebigfuzz Well-Known Member

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    I'm a little worried Cosmo may have one of the high dose conditions. I know we are a while from 5+units, but it's on my mind.
     
  3. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    You are very early in this dance and not at a good dose yet. Try not to worry about what might happen. Does he have CKD? I’m wondering about the renal support and why.
     
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  4. thebigfuzz

    thebigfuzz Well-Known Member

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    Hi!

    No he doesn't have CKD. His brother Marlin had CKD and we gave the renal pro to all 3 at the time. They were all eating FF high protein (Elie was in remission). Marlin ate whatever he was willing to eat - CKD is heartbreaking. After Marlin crossed the bridge we just continued the supplement as preventative care. I suppose we haven't given it in a month after his megacolon issues. I should take it off the signature.
     
  5. Sue and Luci

    Sue and Luci Well-Known Member

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    Take a look at @Sarah and Blaze - not only does Cosmo look like he could be twins with Blaze! Blaze started out with high numbers too...red/black and then the juice kicked in...although he was not as high-dose as your Cosmo, I thought you might enjoy seeing his progress.

    Let's see if you can find a good dose...if not you can always get him tested for other conditions.
     
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  6. thebigfuzz

    thebigfuzz Well-Known Member

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    Cosmo does need to eat HC food to treat his megacolon (royal canin gastro wet and kibble). So.. Essentially 26% carbs, which isn't helping his diabetes... But is definitely a miracle for megacolon. He was unblocked surgically a month ago... Not sure if we can find a happy balance carb wise/fiber needs. We have a phone consult with our vet later today. We will ask about it.

    Cosmo is doing well (eating well, peeing, pooping, purring, and funny), just not reflecting on his SS.
     
  7. Sue and Luci

    Sue and Luci Well-Known Member

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    I'm so happy to hear he's doing so well in all the other aspects of kitty life :)

    I do understand about that high fiber diet and his special needs. You may want to add that info to the top of your SS - just a little note: Needs RC to treat his megacolon, very high carbs, searching for an alternative...otherwise people will continue to question why you're feeding dry and HC at that....I do see the note in your signature but I didn't put it all together until you told me what was going on with the RC.

    Thanks! Have a great afternoon!
     
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  8. Butters & Lyla

    Butters & Lyla Well-Known Member

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    I hope that your meter starts being a lil' less friendly. Nobody needs their meter saying 'HI' to them.
    Hope you and the handsome Cosmo have a good afternoon/evening, Tanya!
     
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  9. thebigfuzz

    thebigfuzz Well-Known Member

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    Whoa... Big drop between +6.5 and +9.5!?!

    I took a nap and looks like Cosmo got the memo :eek: Big drops are not my favorite.

    This afternoon we did take him outside on a leash and then walk all the way back to the office. He wasn't as snacky as he usually is through the day, but just had a nice 1/2 can of gastro.

    We will see what the night brings :nailbiting:
     
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  10. thebigfuzz

    thebigfuzz Well-Known Member

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    Thank you! You too! Lol about the Meter.
     
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  11. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    Whoa, that's strange. Big drop late. Could be a "double" dip. Did you double check to make sure it wasn't a bad strip(not trying to burst any bubbles or anything)?
     
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  12. thebigfuzz

    thebigfuzz Well-Known Member

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    No, didn't double check... Will do.
     
  13. thebigfuzz

    thebigfuzz Well-Known Member

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    Yeah... I got pretty much the same with a second test.
     
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  14. thebigfuzz

    thebigfuzz Well-Known Member

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    Update on the phone check in with out vet before my nap:

    She was super happy about his progress megacolon wise and how he responded to the gastro diet. We all agreed that megacolon was his most urgent issue at the time and that we would need to adjust his insulin accordingly, because the gastro is what he needs.

    We want to push his BG down, which Cosmo has now responded at +9.5 :confused:all on his own. He must have been listening! She feels the food is the problem. Vet advised to increase to 3.25 units and we can try to mix his daily food consumption with 25% lower carb wet. We will need to monitor his megacolon closely to make sure he is still doing well in that department.

    I don't think we will increase tonight with his latest test.
     
  15. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    I'm not sure I'd increase his dose that much at once. He has very high #s but, I'm not so sure a big increase is the right thing to do. Try to get some other opinions from the board before you increase by .5u. I understand with his megacolon and tx involved, affects Cosmos' #s greatly. Giving dose increases like that is usually reserved for high dose cats(5u or better).
     
  16. thebigfuzz

    thebigfuzz Well-Known Member

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    So.. We are 193 at PMPS. Ummm... Hmmm... What to do?
     
  17. thebigfuzz

    thebigfuzz Well-Known Member

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    Is it safe to give him a full dose 2.75 units when he dropped like that?

    He ate 1/2 can gastro (HC) at +9.5 and a tiny bit of wetted kibble at +10.5 (we forgot it was down). His PMPS should be food influenced then. Just ate another 1/2 can of gastro (HC)

    Give token (25% normal dose)? Thoughts?
     
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  18. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    This is an unusual PS for him. You're following SLGS. Are you familiar with the guidelines for lower than normal PS #s?
     
  19. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    I was looking around for someone that might feel more comfortable giving you advice in this scenario. Looks like it's just me for now. He has to get some insulin in him. So at least a token. Are you going to be able to test and steer the cycle if needed tonight?
     
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  20. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    @tiffmaxee not sure if you're still around. Suggestion on a dose?
     
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  21. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    Sep 19, 2019
    You can stall. See if the #s are coming up. this might make you feel more comfortable about shooting. If stalling don't feed and re-test in 15min. Can you afford to get off of shot schedule time and then gradually move it back?
     
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  22. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    This is copied from the SLGS guideline sticky

    If the preshot number is far below usual preshot numbers:
    • Do you need to stay on schedule? Then skip the shot.
    • Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.
    • Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.


    I personally don't think I would skip a shot. A reduced dose would be wiser with monitoring. Sorry I couldn't be of more help with this situation. I'll be around for a bit to see what you decide.:bighug:
     
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  23. thebigfuzz

    thebigfuzz Well-Known Member

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    We gave a token dose of 0.5 units since it is not a normal number for Cosmo. We were re-reading the protocol notes when you were posting :)

    Love the support :bighug: Thank you!!!
     
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  24. thebigfuzz

    thebigfuzz Well-Known Member

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    We have 20 mins till +1...ill test again then :)
     
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  25. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    I'm sorry I'm blowing up your condo. I'm having very fragmented thoughts. Thank goodness you shot! I was thinking you don't have the data to support shooting anything near the full dose. There's no telling what Cosmo would do. And especially on a night cycle:eek: Unfortunately the reduced dose can still make him drop so keep an eye on him tonight. I def get that +2 maybe even a +1 since he was flat when you shot him. A mid-cycle test around/before nadir would probably be in order too.
     
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  26. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    good job shooting!!:cool::joyful:
     
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  27. thebigfuzz

    thebigfuzz Well-Known Member

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    Aww thanks!!!! We try to remember we have been complaining about his high fat curves LOL.

    Yes, we aren't sure what he will do from here. Will absolutely get a +1 and +2.

    You can blow up my condo anytime :bighug:
     
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  28. thebigfuzz

    thebigfuzz Well-Known Member

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    +1 238. Will get a +2 as well. The food has kicked in. Cosmo is napping.
     
  29. thebigfuzz

    thebigfuzz Well-Known Member

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    Glad I re-read the protocol for SLGS on pre-shots (and for anyone browsing Cosmo's condo :)):
    • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
      • a.) give nothing
      • b.) give a token dose (10-25% of the usual dose)
      • c.) feed as usual, test in a couple of hours, and make a decision based on that value
    • Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.
    Not sure if you want to head to bed @Briere Fur Mom? I know it's late there and we aren't in danger. (always love the company though!)
     
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  30. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    Sorry you did not get the shot advice, Tanya. It's quiet on the board tonight.

    I'm off to bed but just want to put something out there. The amino b-plex contains sugar. I tasted it once to see. It's quite sweet.
     
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  31. thebigfuzz

    thebigfuzz Well-Known Member

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    Yes, we heard that. Cosmo is eating HC wet and kibble anyhow as TX for megacolon, so...why not the vitamins too? LOL.

    And it's ok... We figured it out. This time of night, it's usually me, @Butters & Lyla and @Briere Fur Mom. It's a few hrs before others wake up on the other side of the earth. All good. Thanks for checking in
     
  32. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    I'm glad he's doing good and came up...in this instance I'm glad he's up a lil:rolleyes:
    I'm going to head off to bed if you're sure your ok. I'm thrilled that Cosmo got to get some insulin...you followed protocol beautifully. I just hate that you could have missed a chance to get him down to some better #s tonight. Although if he would've dropped too low you would have had to reduce. So, I think you did a great job with your decision. Safety first:)
     
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  33. thebigfuzz

    thebigfuzz Well-Known Member

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    @Briere Fur Mom yep! We are good! You've been up late a lot lately!

    Team UK should be up soon, if I need help:bighug:
     
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  34. Briere Fur Mom

    Briere Fur Mom Well-Known Member

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    Maybe we'll both learn something tomorrow if there were better options in this situation(limited data/late night/flat cycle leading to PS). I need to learn these little nuances as much as you do;)
    Have a great evening Tanya. I think Bron should be around shortly.
    Be good Cosmo:cat:
     
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  35. thebigfuzz

    thebigfuzz Well-Known Member

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    It's tougher with a cat that eats high carb or kibble, because we don't have as many tools in our toolbox if he goes lower.

    Have a great sleep!
     
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  36. Frogster

    Frogster Member

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    Jun 25, 2020
    They say later nadirs on Lantus happen when the kitty is braking a bounce. So. I don't know what you are supposed to do with this information :banghead:
     
    Last edited: Aug 12, 2020
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  37. thebigfuzz

    thebigfuzz Well-Known Member

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    +2 268.

    Cosmo - what a surprising end to the day with that drop of yours! :cool:
     
  38. thebigfuzz

    thebigfuzz Well-Known Member

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  39. Frogster

    Frogster Member

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    I admire your patience, Tanya. My pants would have burned to ashes by now. And probably my house too. And then, when the show was over, I'd have just lied down on the rubble and died...
     
  40. thebigfuzz

    thebigfuzz Well-Known Member

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    LOL
     
  41. thebigfuzz

    thebigfuzz Well-Known Member

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    I'm off to bed, and will leave food out (Cosmo eats a lot overnight usually). Might do a.+6, or +7. Thinking he should be fine on his token dose.

    Cosmo is full of surprises.
     
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  42. Frogster

    Frogster Member

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    Just a random thought. What if he eats a lot at night because he feels low? Not necessarily really low, but for him?
    I'm just obsessed with bouncing these days, never mind... but give it a thought :blackeye:
    Have a good rest :bighug:
     
  43. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Go to bed!!
     
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  44. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I agree with Chris. I would go to bed
     
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  45. Butters & Lyla

    Butters & Lyla Well-Known Member

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    Whoa what a night for Cosmo. Look at those beautiful numbers for him. Great job, Tanya!
    I'm sorry I missed hanging out with you and @Briere Fur Mom. I start work early this morning and had already gone to bed. Of course, I wouldn't have been any help at all, just some extra company. :)
     
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