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Post by SarahL on Aug 1, 2013 4:37:27 GMT
So glad that this page is up here! Important question -- I just gave Miko his PM injection, and there was the tiniest wisp of blood on the end of the syringe. I only noticed it because I push the plunger afterwards to make sure I got it all (I usually miss a drop or two) and the drop that pushed up was ever so slightly pink. It was probably just from breaking the skin but I haven't seen that before. There was no blood I could find at the entrance point. Do I need to panic that I hit a blood vessel? Could that cause a hypo? I want his numbers to go down, but not like that! In other news my vet wants him to go from 2.25 to 2.50 tomorrow and stay there for 5 days. I'm so worried about him and his levels being so high (and rising). He's got a heart murmur and I can't imagine this isn't putting stress on it. Hope you are all having a lovely evening. Miko's spreadsheet: docs.google.com/spreadsheet/ccc?key=0AhIOOJXDPA2rdDVDNDZ4S1pCdzhaaUQ5N3B1LXJqSlE#gid=0 |
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Post by carl on Aug 1, 2013 4:51:12 GMT
I don't think you need to worry that you hit a blood vessel. You'd have to stick the needle in pretty far to do that, so if you tented Miko's skin like normal, then you should be okay.
The continued high numbers are puzzling to me. I don't think I'd jump up to 2.5u yet, only because you just increased from 1.75u to 2.25u, and that dose may not have fully taken effect yet.
Has the vet ruled out anything else that might be causing high numbers? Any infection going on? And I hadn't been following along closely on the old board, but have you been testing for ketones?
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Post by Tigger's Friend on Aug 1, 2013 5:07:03 GMT
Hi Sarah, I'm a newcomer, too & can't advise you on dosing, but I just wanted to say that Miko is probably ok re. the little bit of blood on the syringe. I used to give sub-q fluids on my ckd cats & would sometimes hit a small vessel - when I pulled the needle (1 " to 1.5") out, some blood would come out with a few drops of the water, sometimes it was pretty pink. It never caused any problems. I don't know if injections are exactly parallel with giving fluids, but it was a needle hitting a vessel.  |
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Post by SarahL on Aug 1, 2013 5:07:19 GMT
I don't think you need to worry that you hit a blood vessel. You'd have to stick the needle in pretty far to do that, so if you tented Miko's skin like normal, then you should be okay. The continued high numbers are puzzling to me. I don't think I'd jump up to 2.5u yet, only because you just increased from 1.75u to 2.25u, and that dose may not have fully taken effect yet. Has the vet ruled out anything else that might be causing high numbers? Any infection going on? And I hadn't been following along closely on the old board, but have you been testing for ketones?Thank you so much, Carl -- I just did a test and he's at 508, so probably no worry. I did tent his skin as usual. Thank you! Sigh of relief. So many things to worry about. I truly don't understand why his numbers are higher now after 13 days on insulin than when he was diagnosed. Nothing else at all popped on his most recent bloodwork -- just his crazy sugar levels. Everything else looked great. He seemed to be a little more chipper this evening and I was sure I was going to get at least a reading in the 400s, but no such look. I am going to bring him back to the vet on Friday to have his thyroid felt up a little more -- I know it can be sometimes hard to diagnose in older cats (He's 10). My vet said it's still fairly early and before submitting him to a barrage of x-rays and scans we should give him a little more time on the juice. I did read somewhere that if the cats have a high. flat curve then moving up every 2-3 days is okay? But I'm guessing that's why my vet just recommended .25 increase and then a 10 cycle wait and see? I have been testing for ketones and only had a trace once that was gone the next day, but he's annoyed by all my urine catching tricks (aluminum boats, boxes with teensy amounts of litter, etc.) and I've not had luck yet today. I did accidentally catch my nondiabetic cat's urine twice, but still working on my sugar cat...
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Post by Marje and Gracie on Aug 1, 2013 5:12:22 GMT
Sarah
The TR protocol on Tillys webpage states:
"However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU. "
I think I'd take his dose up tomorrow to 2.75u and then hold for 4-6 cycles and see if he does any better.
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Post by carl on Aug 1, 2013 5:15:24 GMT
An increase may make sense and hopefully in the morning more of the more experienced people with Lantus will have chimed in. (Some have already found their way here, but many haven't). It's just that he's gone from 1u all the way up to 2.25u in a week, and I can't be sure what's going on. I totally understand wanting to see the blacks and reds go away and start seeing pink numbers or lower. You're feeding raw, it looks like, so the diet seems okay. And you're testing several times a day. And shooting twice, 12 hours apart. So it looks like you're doing all the right things. Miko just hasn't gotten on board with it yet.  |
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Post by carl on Aug 1, 2013 5:17:27 GMT
...or maybe one of those experienced members will show up just before I posted that....lol.
Thanks, Marje!
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Post by Marje and Gracie on Aug 1, 2013 5:31:21 GMT
Sarah
I would encourage you to get at least one test every cycle even if he is high. So at night, if you can get a before bed or a +2, that would be great.
Of course, if he comes down tonight , hold off on the dose increase for a couple more cycles.
you're welcome, Carl!
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Post by sarahandmiko on Aug 1, 2013 5:38:52 GMT
I can't WAIT until Miko gets on board with it! When he first started insulin I was mostly worried about hypos. Now I'm worried about never leaving the red and the black. Thanks, all, for the advisement. I'm torn between upping .25 and .5 tomorrow. It's hard to go against my vet's advice, although it wouldn't be the first time in this process. It just seems like the higher his insulin dosage, the higher his BG...
I did read that exercise with BG higher than 400 can create more blood sugar in humans. Miko's definitely very mellow and laying low, but I wonder if the tiny bit more he is moving -- I wouldn't exactly call it exercise yet -- is having an adverse effect on his BG.
I'll try to start doing some more post PM injection testing.
Thanks, Marje and Carl and Tigger's Friend. Really appreciate your help.
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Post by Marje and Gracie on Aug 1, 2013 5:53:34 GMT
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Post by sarahandmiko on Aug 1, 2013 6:47:16 GMT
Thank you so much, Marje -- these are so comforting to see. I'm dreaming of better colors for my sweet baby. I think I will go to 2.75 tomorrow if no change. (((thank you))) |
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