Zeke to ER yesterday

Discussion in 'Lantus / Levemir / Biosimilars' started by BonnieZeke, Feb 25, 2021.

  1. BonnieZeke

    BonnieZeke Member

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    Aug 17, 2019
    Zeke ate only 1/2 food in am and no food at +6 yesterday, vomited x3, and was lethargic and I didn't think he had peed, but had pooped. Sugar up high 30s. Took to ER vet. They checked his mouth at my request and confirmed @Wendy&Neko , that he does NOT have Stomatitis. They checked his sugar and found 525!(Stress!) I had just checked at home 1 hr before, was in the 300s. Also 300s after home. They wanted me to Leave him and do a curve!!. No DKA, no masses palpated. I declined ultrasound and hospitalization. He was given LRS, and Cerenia inj for nausea. He was ravenous when we got home and ate well. Gave normal 1.5 dose before going to work. This am down to mid-200s and at +6 no change at 200s. I am getting ready to increase his dose by.25 tonight. Am I correct?
    Also, he appears to feel much better, pooping, peeing, purring with touch, eating normally.
     
  2. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Cerenia will only last 24 hours so you might need some pills for home. No check for pancreatitis yet they want to do a curve. :banghead:
     
  3. BonnieZeke

    BonnieZeke Member

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    Aug 17, 2019
    Right! And when I asked about pancreatitis , was told no way to tell without ultrasound, X-rays ? Is this true? Do I should increase tonight, right?
     
  4. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Absolutely not true. There’s the SNAP test that is run in house and gives only a positive/ negative result. The problem is if in the gray zone you won’t know. The SpecFPL is sent out to the lab with results in a day or two. An ultrasound doesn’t always give a clear picture. I would not get one unless symptoms persist. I would have your vet do a SpecFpl if symptoms continue. I can’t believe they said that to you. Money grabbers.
     
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  5. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    Agree do the Spec FPL that will tell you if the pancreas is inflamed. If you are dealing with Pancreatitis, supportive care options to help at home: daily Cerenia, Buprenex or other pain reliever for pain (it's often quite painful that is why cats won't eat during a flare), appetite stimulant if needed, and sub q fluids at home.

    Ultrasound may also be used to diagnose (not really x rays) - it can see degeneration in the pancreas and may light up in an acute attack. I would get the ultrasound IF you are worried about other organs and need to image those also, in that sense it is more cost effective. But if just the pancreas, Spec FPL is the fastest and a sure way to figure out. I would also ask the vet about the supportive care above and get some of that going daily. If it works, well then you have more evidence that you've got Pancreatits or possibly another inflammatory thing going on.
     
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  6. BonnieZeke

    BonnieZeke Member

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    Aug 17, 2019
    Thank you! I have an appt for my no diabetic at his reg vet Mon. Will use this for him and ask for the test and go from there. Thank you so much!
     
  7. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    I am so sorry to hear he was in the hospital, and am glad Zeke is perking up.
     
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  8. BonnieZeke

    BonnieZeke Member

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    Aug 17, 2019
    I really need someone to tell me if I should increase by .25 tonight. It’s time for his shot. Thanks
     
  9. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    When you say increase, do you mean go to 1.75U? I am not an expert, but you just started seeing some green NADIRS in the PM cycles the past couple of nights. When this happens, you have to hold the dose longer. And you just got a reduction 2 nights ago.

    I don't know why you adjusted dose twice in the past few days. If a pro was helping (not me) then please disregard my message and wait for someone else to chime in! But from what I see and my own experience, based on getting a recent reduction and having NADIRS in the low greens in the past 3rd cycle, then no you don't increase. You hold this dose for 8-10 cycles. I will try to find the Sticky to explain.

    @tiffmaxee are you around to verify my response?
     
  10. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    Here is the Sticky note on increasing under TR:

    Increasing the dose:
    • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
      • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
      • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
    • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
    • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
     
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  11. BonnieZeke

    BonnieZeke Member

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    Aug 17, 2019
    @Wendy&Neko told me : 3 times between 40-49 for long term diabetics. That means I should not have reduced him on the 18th when he had those greens. I really think he needs it and I should put it back to that, as that reduction was a mistake.
     
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  12. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    I’d give it a little longer because you shot less on 1/22.
     
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  13. BonnieZeke

    BonnieZeke Member

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    Aug 17, 2019
    Ok then.
     
  14. BonnieZeke

    BonnieZeke Member

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    Aug 17, 2019
    Thank you much.
     
  15. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Cause of that 47 a couple nights ago on 1.5 units, I'd keep holding the dose.

    Good news on the no stomatitis!
     
  16. BonnieZeke

    BonnieZeke Member

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    Aug 17, 2019
    Just shot. Dose held at 1.5. Yes! Very glad about that no S. Now on to see if he may have pancreatitis .Do his symptoms sound like a flair to you?
    I’ll be getting the lab Monday.
     
  17. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
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  18. BonnieZeke

    BonnieZeke Member

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    Aug 17, 2019
    Sure sounds like it. Great comprehensive article Thanks.
     
  19. RachelG

    RachelG Member

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    Jan 8, 2021
    Hope Zeke feels better soon! ER visits are no fun, and it sounds like Zeke let you know he was very happy to be home after. :bighug::bighug:
     
  20. BonnieZeke

    BonnieZeke Member

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    Aug 17, 2019
    Thank you! It was a difficult afternoon for everybody ! Yes, he’s pretty much back to his old self. Hopefully we can find out what’s going on and get his numbers down again.:cat:
     

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