There were 3 items on tonight's Assembly of Governments meeting: relocating the IFC shelter operations from downtown, solid waste update, and a small area plan for Rogers Road. I expected the IFC discussion to be the same old same old, but I was very pleasantly surprised. The chair of the IFC board laid out the predicament by explaining how much funding they have lost over the past 3 years (HUD) and how much they need and want to provide the same type of quality facility and programming for men as they do for women. But to do that they need the 3 local governments to work with them. It went round and round (Eubanks Road too far out, don't want to run water/sewer into the rural buffer) with none of the elected officials addressing the request for partnership, until Steve Halkiotis pointed out that all the services that shelter residents need are contained at the Southern Human Services center and that there is plenty of room to put the shelter there. It was such a simple, obvious solution to a problem the community has agonized over for nearly 20 years. Everyone recognized the beauty of the solution and the partnership was formed. The IFC folks left very happy (and surprised).
The solid waste discussion focused on methane. Earlier today I had heard about the fact that the landfill doesn't generate enough methane to make it attractice to the utilities or to justify the investment in capture for onsite use. The elected officials have a very different opinion. They think the new transfer station, the animal shelter, and something else could be powered by landfill methane. And supposedly UNC has contacted the commissioners about piping it to Carolina North. It should be interesting to see which story lies closest to reality. In the meantime, OWASA is already doing it.
Thursday, March 30, 2006
Saturday, March 25, 2006
Feline Diabetes: Ketones & blood glucose levels
Edited from a post by Hilary & Zug (GA)
Ketones are a serious side effect of diabetes. Caregivers must test their cat's urine for ketones daily when blood glucose (BG) levels are high (over 300) and a couple of times a week as long as exogeneous insulin is being given. The explanation describes 3 conditions in which high blood glucose levels can lead to ketones and 1 condition in which high blood glucose levels rarely leads to ketones.
1. Insufficient insulin. Insulin allows glucose (energy) to enter cells. Without insulin, cells starve because they don't get glucose. Insulin's like a door key -- if the key's missing, you can't open the door, and all the glucose stays on the wrong side. If the cells don't get enough glucose, they try and compensate by breaking down lipids (fat) for energy, and that causes ketones.
2. Infections. The immune response to the infection can impair insulin usage. So it's like the doors are partly barricaded, and not enough glucose can get in to feed the cells. That's why things like UTIs or bad teeth can cause ketones, even at relatively innocuous numbers.
3. Insufficient food intake. This one often seems counterintuitive, and even grasping the physiology, it took me a little while to bend my brain around this. Because even at high numbers, a cat needs a fresh infusion of nutrition-wrapped glucose for the insulin to let into the cells. kind of like the cells are watching a stale buffet get staler, and waiting for the good fresh stuff to come out of the kitchen. when it doesn't, they start looking at ways to get more/better "food", and that can mean breaking down fats and causing ketones.
4. Too much glucose. Rebound is the bodies response to an insulin dosage that is too high over time (a positive feedback loop). In rebound, glucose still enters the cells at a good rate, but MORE glucose is being dumped into the bloodstream (well, technically, more glucose is being produced via glycosis, but...). So the cells aren't starving, and they don't "feel the need" to break down fats into metabolic products they can use. Plenty of food's coming in the door, there's just a lot more out there. So the physiological mechanism that creates the high BG levels is a very different underlying physiology that won't lead to ketosis. If your cat has high BG levels and you suspect it is due to rebound, you have a little more leeway to experiment without the threat of ketones hanging over your head.
So, to put it in really simple terms there are 3 ways to get ketones:
(Note that the latter 2 issues make it possible for ketones to appear at relatively "low" BGs e.g., under 300mg/dl)
When you start combining these issues, you increase the probability of developing ketones, ketosis, and potentially fatal ketoacidosis.
Thanks to Hilary & Zug(GA)
Ketones are a serious side effect of diabetes. Caregivers must test their cat's urine for ketones daily when blood glucose (BG) levels are high (over 300) and a couple of times a week as long as exogeneous insulin is being given. The explanation describes 3 conditions in which high blood glucose levels can lead to ketones and 1 condition in which high blood glucose levels rarely leads to ketones.
1. Insufficient insulin. Insulin allows glucose (energy) to enter cells. Without insulin, cells starve because they don't get glucose. Insulin's like a door key -- if the key's missing, you can't open the door, and all the glucose stays on the wrong side. If the cells don't get enough glucose, they try and compensate by breaking down lipids (fat) for energy, and that causes ketones.
2. Infections. The immune response to the infection can impair insulin usage. So it's like the doors are partly barricaded, and not enough glucose can get in to feed the cells. That's why things like UTIs or bad teeth can cause ketones, even at relatively innocuous numbers.
3. Insufficient food intake. This one often seems counterintuitive, and even grasping the physiology, it took me a little while to bend my brain around this. Because even at high numbers, a cat needs a fresh infusion of nutrition-wrapped glucose for the insulin to let into the cells. kind of like the cells are watching a stale buffet get staler, and waiting for the good fresh stuff to come out of the kitchen. when it doesn't, they start looking at ways to get more/better "food", and that can mean breaking down fats and causing ketones.
4. Too much glucose. Rebound is the bodies response to an insulin dosage that is too high over time (a positive feedback loop). In rebound, glucose still enters the cells at a good rate, but MORE glucose is being dumped into the bloodstream (well, technically, more glucose is being produced via glycosis, but...). So the cells aren't starving, and they don't "feel the need" to break down fats into metabolic products they can use. Plenty of food's coming in the door, there's just a lot more out there. So the physiological mechanism that creates the high BG levels is a very different underlying physiology that won't lead to ketosis. If your cat has high BG levels and you suspect it is due to rebound, you have a little more leeway to experiment without the threat of ketones hanging over your head.
So, to put it in really simple terms there are 3 ways to get ketones:
- High numbers (not enough insulin/ineffective insulin) --> possible ketones.
- Inappetance/insufficient food intake --> possible ketones
- Infections --> possible ketones
(Note that the latter 2 issues make it possible for ketones to appear at relatively "low" BGs e.g., under 300mg/dl)
When you start combining these issues, you increase the probability of developing ketones, ketosis, and potentially fatal ketoacidosis.
Thanks to Hilary & Zug(GA)
Sunday, March 05, 2006
Tarheels Beat Duke 83-76!
They came close at the Dean Dome, and succeeded at Cameron!
"The freshman-heavy squad of No. 13 North Carolina handed the senior-laded team of top-ranked Duke its second loss in as many games with an 83-76 victory in the ACC finale for both teams.
Tyler Hansbrough scored a game-high 27 points and added 10 rebounds as North Carolina's four freshmen outscored Duke's four seniors 55-51 in a game that again showed why ranking, statistics, age, beauty and credit rating mean nothing in college basketball's craziest rivalry."
http://www.newsobserver.com/122/story/414847.html
Too bad David Noel's leadership role isn't recognized in the N&O's reporting on this win. He's been my favorite player since he joined the team. Clearly Roy Williams feels the same:
"Carolina coach Roy Williams didn't recruit Noel, but he might just adopt him if Noel's family wants to share permanently. Williams was nearly in tears in describing what an unselfish and heroic effort Noel has given since the end of last season until now.
"I have a saying on my desk at my house," Williams said. "It says, 'Statistics are important, but relationships last a lifetime.' And the relationship I have with players has always meant more to me than anything.
"David Noel has done as good a job -- no one has ever done anything better than David Noel."
"The freshman-heavy squad of No. 13 North Carolina handed the senior-laded team of top-ranked Duke its second loss in as many games with an 83-76 victory in the ACC finale for both teams.
Tyler Hansbrough scored a game-high 27 points and added 10 rebounds as North Carolina's four freshmen outscored Duke's four seniors 55-51 in a game that again showed why ranking, statistics, age, beauty and credit rating mean nothing in college basketball's craziest rivalry."
http://www.newsobserver.com/122/story/414847.html
Too bad David Noel's leadership role isn't recognized in the N&O's reporting on this win. He's been my favorite player since he joined the team. Clearly Roy Williams feels the same:
"Carolina coach Roy Williams didn't recruit Noel, but he might just adopt him if Noel's family wants to share permanently. Williams was nearly in tears in describing what an unselfish and heroic effort Noel has given since the end of last season until now.
"I have a saying on my desk at my house," Williams said. "It says, 'Statistics are important, but relationships last a lifetime.' And the relationship I have with players has always meant more to me than anything.
"David Noel has done as good a job -- no one has ever done anything better than David Noel."
Getting Started with Feline Diabetes
The initial diagnosis of feline diabetes (FD) can be overwhelming. It adds a new dimension of caregiving to the relationship we have with our cat as well as changing the day-to-day routine we have all established around feeding. But FD is not a death sentence and the changes it introduces into our households can be routinized fairly quickly. It is a complex disease though, and there is a lot to learn. The best sources of information are the Feline Diabetes Message Board FAQs and the Pet Diabetes Wiki.
You should also read and post on the message board. Ask questions, then ask more questions. Also check out Making the Most of Your FDMB Experience.
In the meantime, you must still care for your sugar cat. Here are a few tips to help you get started. As you learn more about feline diabetes, each of these tips can be customized for you and your cat.
Remember, this is just a quick reference to help you start caring for your diabetic cat until you have time to read and understand the more technical information contained in the FAQs and the Pet Diabetes Wiki.
You should also read and post on the message board. Ask questions, then ask more questions. Also check out Making the Most of Your FDMB Experience.
In the meantime, you must still care for your sugar cat. Here are a few tips to help you get started. As you learn more about feline diabetes, each of these tips can be customized for you and your cat.
- If you are already using insulin, don't switch your cat to low carbohydrate diet unless you are hometesting. A low carbohydrate diet has a high probability of reducing your cat's insulin needs so when and if you do decide to switch, do so carefully. For details, read 10 Good Reasons NOT to Change that Diet Just Yet!
- If your cat is on insulin, don't adjust dosages upward until your cat's body has had time to adjust to the current dose. This usually requires between 3-5 days. You can adjust downward at any time. Dose adjustments should be made in .2 or .5 unit increments.
- Most FD cats benefit by being on a schedule, but don't be daunted by the prospect; most of us work and have a life, yet are able to manage our FD kitty by making a few adjustments in our day-to-day lives. If you choose to hometest, you can either test, feed, shoot OR feed, test, shoot. With fast acting insulin, such as NPH, you may need to wait for 30 minutes to an hour after feeding before shooting. Over time, you may refine this sequence to meet the needs of your unique kitty.
- If you choose not to hometest, don't expect your vet will do everything for you. At minimum you need to know the clinical symptoms of hypoglycemia and be prepared to act quickly. Following a set schedule will help you recognize any odd behavior following an insulin shots.
- Don't forget to test urine for ketones (weekly). If your cat has had ketones or DKA, you should test daily or every other day. Ketones and hypoglycemia are the most dangerous side effects of feline diabetes. Be sure to learn about both early on in your studies. -
- Don't hesitate to ask lots of questions on FDMB. We've all been in your shoes, we like to share our experiences!
- FDMB members have varying degrees of experience and knowledge regarding feline diabetes and often have differing opinions. Don't assume that what someone says is the one and only "right" answer. If you are asking for advice and getting divergent opinions, ask posters to explain why they are recommending a certain course of action. "Why" is an excellent question. Only you can decide what is right for you and your cat.
- Don't piss off your vet over diet or hometesting. Your cat will need medical care beyond what you can do at home. Of course it is better to have a vet who will work with you on hometesting and dietary adjustments, but if you live in a small town and don't have choices, you need to find a way to work with the vet you have.
Interviewing Vets for the Treatment of Your Diabetic Cat and
Questions for Vets. - Don't feel like you are in this alone. FDMB is a community. We care about you and your cat. If someone doesn't answer your question right away, it only means no one is around who knows the answer. Be patient. If your question gets lost, repost it. Be persistent!
- Don't worry yourself sick about feline diabetes. It is a manageable disease, especially if you don't stress yourself out. Go to the movies now and then. Take walks. Have fun. Your cat will be OK and you'll both be happier if you take as good of care of yourself as you take of your sugar kitty.
Remember, this is just a quick reference to help you start caring for your diabetic cat until you have time to read and understand the more technical information contained in the FAQs and the Pet Diabetes Wiki.
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