Skinky update. Not good. Tremors...

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Critter Mom said:
Skinky's spreadsheet is now up and running and she's getting some low numbers.

Is there any chance some experienced members could have a look at Skinky's spreadsheet as well, please, and perhaps give some comments on Lantus dose?

Laura, I hope you don't mind me making the above request. I think it would be helpful for you. :)

Thinking of you both and keeping you in my prayers.

((((Laura and Skinky))))

Nope! don't mind at all. I only gave 1.25 this morning as i could not get much food into her. surprised her +7 is still high. vet had suggested not to give more than 1.5, as she risks going hypo.

The main issue usually w/ insulin administration for her has always been that she doesn't want to eat...and forcing her tends to do more harm than good...I've asked before, but if anyone has a suggestion as to how little food she could take (syringe wise) and still give insulin, that would be appreciated. Vet's POV has been, if that's the case, skip insulin. but i've hoped to get her sugar more regulated to fight infection and preserve her hind legs, maybe help w/ pancreatitis, etc..

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Meya14 said:
The indicators for kidneys on these labs (Urea nitrogen, creatinine, bun/creat ratio) are all normal. They really shouldn't have to put her under anesthesia to do x-rays. If she is really that uncooperative, perhaps you could ask if pre-dosing her with an anti-anxiety medication might make her groggy enough to get them done.

Root infections can get REALLY huge, and are treatable, but the longer an infection is there, the more bone loss there is, and it's harder to fix. Antibiotics won't cut it, it's really got to get drained. The first step is figuring out if it's just the teeth, or something else. It's not fair to you both that you don't have answers.

Also, if there is drainage, this is a good time to ask for a culture of that. It would help her feel better to get the correct antibiotic on board, and might help her get stronger if she has procedures. Many bacteria are resistant to antibiotics, so getting the right one is important.

There is calcium and sodium in the lactated ringers (elevated in the labs). It's probably not helping the electrolytes, so you and your vet will need to keep an eye on those values. It's a balancing act with hydration.

With bone cancer or hard tumors (sarcoma, carcinoma) you may see high calcium and phos, as well as elevated ALP. You likely see chronic elevations in potassium when the tumor is large. Also changes in platelet levels are common. With lymphomas blood counts are all over the place. You'd have significant anemia. Early cancers might not have a lot of changes to bloodwork.
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oh she is VERY cooperative. SUCH a sweet kitty. unless i'm feeding her and she doesn't want it. then she's a feling cujo. my vet has xray, but not dental xray, which goes in mouth. she had referred me out for that. I spoke w/ someone at north shore animal hospital weeks ago who said they would work w/ on dental but first i had to see one of their vets. I schlepped all the way up there, to this no kill animal clinic that had dental, and the vet basically would not approve to go forward to see vet dentist and said i should consider putting her to sleep. another dental place in NJ quoted about 4k for dental, cleaning xrays...would include cost of whole anesthetic team. i don't want to rehash it all, it's been time consuming and frustrating. maybe it's because i'm in manhattan. the consult for a manhattan dental vet at blue pearl is about 200, just for the consult.

the "bubble" is in the middle of her nose bridge. she has a ton of mucus - even her lower gums get slimy. I will ask about a culture of the mucus...

Her hind legs are very weak, the weakest they have ever been. she is very dehydrated. been giving her the methy B vitamin..course she really doesn't want to eat, so getting enough into her has been challenging...but the weak hind legs of course has appeared in conjunction w/ peeing everywhere. ...which is what led me to vet to request a urine analysis..
 
Dyana said:
How much fluids is she getting, Laura?
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hi dyana, fluids seem to make her uncomfortable. but i'm advised to not give her more than 100? i try to give her two 50's, break it up. sometimes i give her a little more if she'll take it. she's not drinking water...
 
I think if you could at least get the imaging done, then you can e-mail vets in your area with pictures of her, the xrays, labs, history, and see what they can offer. Then you won't have to go treking all over the place, and spending money for nothing.

Here are some dental specialists in your area:
http://www.vcaspecialtyvets.com/katonah-bedford/departments-doctors/departments/dentistry
http://www.vmcli.com/veterinarians-dr-carmichael.html

Might be worth calling and telling them the whole story and see what they think? Anything is probably going to be pretty pricy in your area, but you never know.

Also, the hypercalcemia is going to make her pretty lethargic.
 
Nice high green last night. :D
She very possibly could have gone into the green numbers the night before last too, and that's why she was 456 yesterday morning because of the bounce. Lantus likes consistancy. I would just try to keep the dose the same as long as she is eating and she doesn't go too low and you are testing regularly, and you have high carb food or syrup for just in case. High greens are fine, and healing to her pancreas. Just, as I've said over and over, be careful with the insulin. Bounces happen. That's why she got those black numbers after that 37. Please don't adjust the dose according to the high numbers that are just bounces. The dose should be kept as steady as possible, and adjusted according to how low it takes her.
I hope others will chime in.
Hugs.
 
Dyana said:
Nice high green last night. :D
She very possibly could have gone into the green numbers the night before last too, and that's why she was 456 yesterday morning because of the bounce. Lantus likes consistancy. I would just try to keep the dose the same as long as she is eating and she doesn't go too low and you are testing regularly, and you have high carb food or syrup for just in case. High greens are fine, and healing to her pancreas. Just, as I've said over and over, be careful with the insulin. Bounces happen. That's why she got those black numbers after that 37. Please don't adjust the dose according to the high numbers that are just bounces. The dose should be kept as steady as possible, and adjusted according to how low it takes her.
I hope others will chime in.
Hugs.
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Thanks Dyana,
gave her 1.25 last night, on minimal amount of food....she just would not eat. she might have gone very low at peak. this morning she tested 66...so no insulin...still waiting on vet, called and left message...

I'd been keeping numbers on her for a while, just haven't entered on spread sheet, kept in a word doc. have gotten different input from vets, such as not to give insulin unless she's over 300, etc... but where she's not fairing well and i have diminished expectations for her, i've hoped that more regulation of her high numbers could help her fight off whatever infection she has and help with her appetite/pancreas...so i guess i'm using 200 as my threshold now...

the first two rows of the spreadsheet take with caution...although she def. did have those high's and lows...it was a bad time as I was leaving for 2 or 3 days and didn't feel comfortable with vet tech giving insulin as she's not really regulated and he was only popping in an hour here, and an hour there. my shots for her are noon and midnight, so it was really three shots that she missed while i was gone...
 
Hi Laura,
I'm sorry I can't help with the blood values, but I echo what Dyana says about the insulin dose: try to be consistent in dosing and don't jump around in dose.
I hope that Skinky is finding some joy in her life and that she is not in terrible pain. I pray that you will know when she tells you that her time has come. It is one of the most difficult things, saying farewell to our companions, but it is an act of love to help them pass.

Thinking of you and your girl,

:bighug::bighug::bighug:

Ella & Rusty
 
Laura, please reduce Skinky's dose of insulin. That LO means she was below 20. That is so dangerous. Please do not give her 1.5 units again. You may even want to go back to 1.00 unit.
I hope Skinky is doing fine. She will probably bounce way up from this LO. A bounce is natural. We base adjustments to the insulin dose on how low they go in a cycle. When she got that 37, that was an indication that her dose was too high. Just please please reduce her dose.
 
I agree with Dyana - Skinky definitely needs less insulin. Remember that dosing is based on the nadir - the lowest point in the cycle. So regardless of what her preshot values are, Skinky needs less insulin! I hope she's eating better for you today...
 
Dyana's absolutely right. The risk to a cat from going too low is huge. You don't want to continue giving any dose that gets Skinky below 50.

I see the 37 on 1.25u and then a dose increase, and then the LO today. I would decrease her dose to 1.0u immediately.

To some extent, Laura, you want to ignore the higher numbers. It's FAR more dangerous to her to go too low than it is if she has some higher numbers. Focus on the low numbers for dosing in order to keep her safe.
 
I'm so upset as I write this and this my get me banned from the site but I can and will not hold my tounge any longer .
I'm reading about now doing dental on this poor helpless cat. I read "she will let you know when she ready"....she's been ready for some time now but is being put through needless poking and prodding. She is in pain and has no quality of life , how can people support these treatments at this point?
I'm not trying to be cruel but someone has to stand up for Skinky . I do know how horrible it is to loose my sweet kitty as I've been through it......she's suffering ! I'm sorry for upsetting you but you seem to be lost and can't see clearly .
I love this board and people her have stood by me and were of great support for me and my kitties.
I pray that Skinky finds peace and her suffering stops , I also pray for you to find strength to do the right thing.
I know you've done your best and I applaud you for your commitment but you need to know when enough is enough.
Take care❤️
 
Hi Laura,

I know from personal experience how hard it is to look at the glucometer and see the high numbers. My heart used to sink when I saw them on Saoirse's meter. That said, I gritted my teeth and got through them and g-r-a-d-u-a-l-l-y they came down.

I don't usually make any posts about dosing because, although I managed to treat Saoirse successfully, I don't think I've sufficient experience to make comments about other people's cats. I may have a view but I wait for other experienced members to review how a cat's doing. Now that experience people have reviewed Skinky's progress I feel more comfortable about making a comment. I agree with Dyana. I also think her suggestion about dropping down to 1.0 unit of Lantus is a sound one. It can be a bit tricky (and frustrating) seeing the high numbers after the low ones, but these tend to clear after a few cycles (when a cat's system calms down) and then the numbers get better again. Raising the dose to try to bring 'bounce numbers' down ain't the way to go, no matter how tempting the thought. We all want to help our little ones as fast as possible but their little bodies take time to adjust, and there's no way round that. (We do a roaring trade in patience pants here! :) ) All going well, keeping to the lower dose through the bounce will hopefully see Skinky's blood glucose settling in better, safe numbers.

Keeping you both in my prayers.

((((Laura and Skinky))))
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Robin-S said:
I'm so upset as I write this and this my get me banned from the site but I can and will not hold my tounge any longer .
I'm reading about now doing dental on this poor helpless cat. I read "she will let you know when she ready"....she's been ready for some time now but is being put through needless poking and prodding. She is in pain and has no quality of life , how can people support these treatments at this point?
I'm not trying to be cruel but someone has to stand up for Skinky . I do know how horrible it is to loose my sweet kitty as I've been through it......she's suffering ! I'm sorry for upsetting you but you seem to be lost and can't see clearly .
I love this board and people her have stood by me and were of great support for me and my kitties.
I pray that Skinky finds peace and her suffering stops , I also pray for you to find strength to do the right thing.
I know you've done your best and I applaud you for your commitment but you need to know when enough is enough.
Take care❤️
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Robin-S -- Seriously - WHO DO YOU THINK YOU ARE to say this? ARE YOU WITH MY CAT? To see her when she plays? or cuddles? or walks in the hallway so curious to see my neighbors and listen to all that is going on? You don't know JACK about my cat. You might THINK you're being "helpful" but you're just being ignorant and cruel - and let me emphasize the IGNORANT part. Even dangerous. Comments like yours make me think twice about even coming to this forum for any suggestions. I"ve been posting less and less because of the sometimes well intentioned "please stop her suffering" comments from people who are not with her, but your comments here really take the cake. This should be a forum where I can come for advice about her diabetes and get helpful suggestions from people who have experience with cats who might have some of the same issues my cat is experiencing and I can get their input. IGNORANT, CRUEL and DISRESPECTFUL comments like yours will definitely make me think twice about posting her and asking for suggestions. You're really out of line in posting your cruel and dangerous comments.

Let me repeat - YOU DON'T KNOW JACK about my cat and I wish you had just kept your petty, inappropriate and judgmental comments to yourself.
 
Laura, please don't stop posting and asking questions. We are all worried about both you and Skinky.

Part of the problem IS that we DON'T see Skinky. So you are right, we don't know jack about your cat. All we know is your descriptions of her. But all we are hearing is the bad stuff, and we really need to hear about the good stuff too. I for one am thrilled to hear that Skinky is cuddly, playing and interested in life. Here at FDMB we always try to emphasize that our cats are not just tests and numbers. Those all are important, but their attitude and behavior matters too.

So please keep posting and getting help, because we care about you both. But also let us know how good Skinky is doing. It will paint a better picture of the whole cat, not just her problems.
 
Laura, I hope that you keep posting. I don't think that it is advisable to try to talk someone into euthanizing their pet. It is so important that the caregiver be at peace with a decision like that. Like many people here, I have cared for my very sick kitties, even when others thought it was too much. I think that only the person who is with the cat every day is in a position to decide what is best for the pet. I know that many here have posted about knowing about when it is time to let go, but I think that they just want to show their support and empathy for what they know is a very difficult decision. I know that you make every decision for Skinky out of love. You have many supporters here. I hope you know that.
 
Linda and Bear Man said:
I don't think that it is advisable to try to talk someone into euthanizing their pet. It is so important that the caregiver be at peace with a decision like that.
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I agree completely. It's a decision that can never be taken back. Only the caregiver has full visibility of how their cat is doing overall.
 
Laura as I have said before maybe I am over optimistic but I cannot help thinking that Skinkys problem is infection, either dental or sinus and even if she is an older cat if you could get the infection cleared up she might make it so I keep cheering for you guys, if you ever decide it is too much for her I would understand but until then I will keep feeling great every time she has a little victory so hang in there, I am an old lady who really does not get into social media and I have spent more time in my whole life replying to yours and Skinkys thread because I want to see her make it so badly so please keep letting all those of us who care so much know what is going on.
 
Those of us who devote our waking time and life to our furkids know far more about how they are doing than anyone else. I have been through hell and back with my Tuxie over the last 4 months and he is still here with quality. Those of us who are SO close to our kids know the signs..good or bad...in the meantime we keep fighting with all we have to give quality and time to our kids. My prayer go with you and each day is a new chance of hope!
 
Hi Laura
So happy she is doing well. Her picture looks great. Is it a recent one? She looks awesome- so much better !!!
 
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