2. Java, elder cat

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Lois and Java

Lois and Java

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Starting a new thread...
It's been an awful day for Java.
634 amps
Fat 1 unit
549 at +4
555 at +8.5
125 ml subq fluid at +9.5.
I'd swear that wasn't a fur shot.
I don't understand why it's so high. From eating FF? Is a fur shot the only explanation for something like this?
I'm so sad about it. I want to help him feel better right now, yet don't know how.
More immediately, it's an hour to PMPS. Should I use more than fat 1 unit?
 
Lois and Java said:
Starting a new thread...
It's been an awful day for Java.
634 amps
Fat 1 unit
549 at +4
555 at +8.5
125 ml subq fluid at +9.5.
I'd swear that wasn't a fur shot.
I don't understand why it's so high. From eating FF? Is a fur shot the only explanation for something like this?
I'm so sad about it. I want to help him feel better right now, yet don't know how.
More immediately, it's an hour to PMPS. Should I use more than fat 1 unit?
Click to expand...
This is very frustrating for you, Lois. i would say that keeping the dose lower isn't realy helping much. Time to try careful increases - 1.25 u?
 
Kris & Teasel said:
This is very frustrating for you, Lois. i would say that keeping the dose lower isn't really helping much. Time to try careful increases - 1.25 u?
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I'm so sad about it. I so hoped it was going to be the trick that worked to keep him low and feeling good.
Do you think a different type of insulin is worth trying?
His age...Running out of time.
 
Lois and Java said:
I'm so sad about it. I so hoped it was going to be the trick that worked to keep him low and feeling good.
Do you think a different type of insulin is worth trying?
His age...Running out of time.
Click to expand...
You could try Lantus. It has very little flexibility in timing of doses though. You have to stick very close to 12/12. You also can't switch doses often. The shortest interval between dose changes is 3 days.
 
I'm wondering genuinely if there's any explanation for high figures like today or a week ago, a 12-hour run when everything is in the 500 s.
If I'm just wrong and they have to be fur shots, I want to know. I remember each of the three instances on those shots and they seemed good to me but if I'm wrong, I've got to figure out what I'm doing or not doing those times. Thanks!
 
Edit, I think it's okay because I'm using the AT2, not the original, would love a second opinion. Sorry to be such a pita for every little thing, you're my feedback, support, since Java has little to say. Also I can't sleep, am up too late.
--
I'm having a panicked sick feeling. I just read this in the Lantus thread:

"AlphaTRAK meters and AlphaTRAK 2 test strips:
If AlphaTRAK users choose not to upgrade to the newer AlphaTrak 2 meter, you can continue to use your original AlphaTRAK meter with the new AlphaTRAK 2 test strips. However, you must use CODE 7 for all species. For the most accurate AlphaTRAK® test results, upgrading to the new AlphaTRAK® 2 meter is suggested by the manufacturer."

When I switched back to the AT after using the HS meter, I sat down with the manual and went through it. It said to use the code on the strips. This is what is on the cylinder and so I coded 37 and that is what I have been using these last many weeks. Have I been using the wrong setting?

IMG_20170324_021703.jpg
 
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If you're using the At2 and not the original, I believe you want to code based on the vial, like you said you have been. I think that is info specifically for the old meter and the new strips.
 
Hi Lois,

Is your AT meter one that's magenta in colour and says "AlphaTrak2" above the screen? If so, then you have to set the code that's on the current vial of test strips. In the photo above, it's 37. Do you have a bottle of control solution to check a strip each time you open a new vial?

Re fur shots: after every injection I rub my fingers lightly over Teasel's fur where I injected and smell them or I put my nose right into that fur. If it smells a lot of the strong "Band-Aid" insulin smell, then I know there's been a full or partial fur shot. Is your routine similar with Java?

I don't know how to explain those blacks. I have read here that underweight cats are harder to control, likely because fat is a metabolically active tissue that plays a role. My approach when flummoxed by BG numbers is to immediately simplify what I'm doing to reduce all variables to the absolute minimum. So - dose size, dose timing, meal type, meal amount, meal timing, meter used, etc. There are many things that can influence the BG in the cat's physiology and many things in what we do that can also have an impact.

Re dosing: it's very likely that you'll have to try small dose increases. He's never had more than 1.5 u. Their insulin needs change and if they are in high numbers for some time they can become resistant. Add to that a bouncy cat and you have a tricky situation on your hands.

Maybe try:
  • 1.25 u AM and PM today with a plan to increase to 1.5 u tomorrow. This will be the variable to focus on for now
  • use the same meter all the time, no back and forth, double checking, etc.
  • feed him his usual diet in the way that works for him but no food in the 2 hours before a PS test. FF pate is a low carb food and shouldn't wreak havoc with BG. YA is an approved dry food but some people find it can affect BG.
If you can take a deep breath, focus on the dose variable alone (after eliminating any possible issues with test strip viability, injection technique, etc.) and just calmly carry out your routine you'll be much better for that. We do the best we can and that's all that can be asked of us.
 
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Thanks Kris, that's all super helpful.

You can see how bony his butt has gotten. But he's still enjoying going outside to drink rainwater.
 

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Omg. 702 this morning.
That's with all food, meaning YA, up.
His body isn't digesting itself I hope.
I can barely get him to eat any food.
He just wants to go outside and drink water. Well, he has to eat food first, watered down if I have to.
1.5 after he eats sone food.
 
Kris & Teasel said:
Re fur shots: after every injection I rub my fingers lightly over Teasel's fur where I injected and smell them or I put my nose right into that fur. If it smells a lot of the strong "Band-Aid" insulin smell, then I know there's been a full or partial fur shot. Is your routine similar with Java?
Click to expand...

I had been merely feeling for the resistance of his skin or fascia as I inject of the needle, followed by rubbing the spot and feeling for moisture.

Now, I do that and double check the needle before injection to be sure it contains the amount it should have.

This morning, I double check the amount, made a tent on a side, injected, could feel the resistance of his skin, looked down to see the needle in his skin before I pulled it out - it was - pulled the needle out, put my nose down and smelled - No Band-Aid smell, felt - no moisture. We're a little over 1.5 hrs. after injection and it's gone up to 736. I've been urging FF on him but he hasn't eaten all that much. He tends to slurp the wettest parts and leave dry FF behind, which makes it hard to measure.

I honestly don't know what to do or what to think. He gave me the slip in the backyard comma and when I found him he was on top of the shed, which was a huge surprise.
 
Lois and Java said:
I had been merely feeling for the resistance of his fascia as I inject of the needle, followed by rubbing the spot and feeling for moisture. I also double check the needle before injection to be sure it contains the amount it should have.

This morning, I double check the amount, made a tent on a side, injected, could feel the resistance of his skin, looked down to see the needle in his skin before I pulled it out - it was - pulled the needle out, put my nose down and smelled - No Band-Aid smell, felt - no moisture. We're a little over 1.5 hrs. after injection and it's gone up to 736. I've been urging FF on him but he hasn't eaten all that much. He tends to slurp the wettest parts and leave dry FF behind, which makes it hard measure.
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Hi Lois,

Make sure you don't rub the injection site too much after the shot. It can affect the insulin deposit. I really don't know what to say about those crazy numbers. Could he have a UTI or something going on? Dental? Aside from insulin dose, something else might be driving it. Is he due for senior blood panel or similar any time soon?
 
Rachel said:
Have you tried sprinkling some treats on it or maybe adding a bit of tuna juice to make it more palatable?
Click to expand...

I put water in it and make a kind of slurry, and he slurps the watery part leaving behind dry-ish chunks.

He's so focused on going outside, it's hard to get him to eat anything. What I've been doing a lot of spending the entire afternoon with him, and bringing food to him in bed every hour or two. When he gets really hungry he will get up and eat YA.

Maybe it'll go up and then come back down again. My vet is open until noon, but honestly you guys have been more helpful than he has with regard to the diabetes. I hope I'm just stressing now and then it'll come down later, but it should have come down already!
 
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Kris & Teasel said:
Hi Lois,

Make sure you don't rub the injection site too much after the shot. It can affect the insulin deposit. I really don't know what to say about those crazy numbers. Could he have a UTI or something going on? Dental? Aside from insulin dose, something else might be driving it. Is he due for senior blood panel or similar any time soon?
Click to expand...
Oh no, I didn't know that, yeah I've been rubbing it. But I think I rub all of them.

Maybe I should take him in for a blood panel before the vet closes.
 
Lois and Java said:
I put water in it and make a kind of slurry, and he slurps the watery part leaving behind dry-ish chunks. He's so focused on going outside, it's hard to get him to eat anything. What I've been doing a lot of spending the entire afternoon with him, and bringing food to him in bed every hour or two. When he gets really hungry he will get up and eat YA.

Maybe it'll go up and then come back down again. My that is open until noon, but honestly you guys have been more helpful than he has with regard to the diabetes. I hope I'm just stressing now and then it'll come down later, but it should have come down already!
Click to expand...
Your vet might be useful for non-diabetes issues that can affect BG. A general checkup and blood work might be a good idea.
 
He ate a little more, tested, now +2.
637. It's going down!!
I'm so sorry to bother everyone.
It's time for a blood test anyway though, I'm going to call and see if I'd have the results on Monday.
He's a drop in cat only vet, It's usually crowded on Saturdays with long waits, I might take him on Monday, less stress...
Just called, they're not busy!
 
Lois and Java said:
You've been by my side through all of this Kris, (thank you!) do you think lantis is something I should try?
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Well, Lois, it might be worth trying. I think I said before that it's less forgiving than ProZinc wrt dose timing and changing dose. You have to stick to a strict 12/12 schedule as much as possible and doses have to be held for certain lengths of time. Go read the info stickies on the L&L forum to get a feel for what the depot is and how these insulins work and are dosed. There are two protocols, TR and SLGS, and they're explained in detail.

After you've studied the info, come back and ask any/all questions. I'll try to answer them.
 
Lois, you're NEVER a bother. That's why we're here!

I do think a general vet checkup would be good...that way you're sure nothing like that is affecting the numbers.

I believe Lantus has a flatter cycle, which might be good for Java.
 
Vet
Took blood, results Monday
Dehydrated, which I missed
Gave fluids
I forgot I was supposed to be somewhere at 12:30 akkkk
 
He's really out of it. I followed him around the yard for awhile since all he wanted was to be outside, then made him come inside when he almost gave me the slip. He may feel so cruddy that he wants to go hide somewhere and die, which is not acceptable to me. He's barely eaten anything today. I'm just hanging out next to him on the bed, trying to get him to eat now and then.

I remembered about my theater commitment while I was in the waiting room, so I rushed through the vet exam, as their last patient of the day. He's 8 pounds something, down from 10 pounds something on February 13th or 14. I'll get more information on Monday.

I'm at a stage where it's really hard to tell how sick he is and how close to the end of his life, versus having something that he can recover from or live with longer.

Today is a great example of how confusing it is. His BG was off the charts this morning, and he somehow managed to get up on top of the roof of the shed (he can walk nearly straight across from an uphill neighbors deck to our shared fence, but remember, he fell off it just a few weeks ago, too.)

The vet said it could be as kidneys, it could be that ringers is no longer appropriate and he needs a fluid that has NaCl in it now, we just won't know until we get the blood results on Monday.

And I'm keeping a mental list of how he's doing, in that horrible place of having to decide whether or not he's close to or at the point of being put down, how close or far away is that.
PS I just got him to eat something, and I tested his BG first and it's 101. Crazy.
 
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I'm sorry for what you are going through, Lois. :bighug::bighug::bighug: Just keep in mind the wonderful 20 years you have had with him and make him as happy and comfortable as you can. I lost my last boy to cancer and he waited until I went to work before he set a paw on the rainbow bridge. I was hoping he would pass in his sleep the night before, in my arms. *Paws crossed* though that the Vet will see something to give you more time. We are never prepared to let them go.
 
This is such a difficult thing to wrap your head around, Lois. Try to put the worst case scenarios in the back of your mind at least until you get the blood work results on Monday. Who knows where that lovely blue came from?

Sensing you all the positive energy I can muster ... :bighug:
 
Oh Lois...this is such a tough time, I know. I agree with Kris. Try to take it one day at a time, and just enjoy being with him until you get the blood work. Hopefully that will give you some ideas on how to keep him comfortable...I believe you will know when it's time.

Sending you tons of hugs and love.
 
Kris & Teasel said:
This is such a difficult thing to wrap your head around, Lois. Try to put the worst case scenarios in the back of your mind at least until you get the blood work results on Monday. Who knows where that lovely blue came from?

Sensing you all the positive energy I can muster ... :bighug:
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Thank you Kris, Yong, Rachel and Djamila. While it's true I have a tendency to get hyper and catastrophize what's going on.... That reaction is not entirely unfounded.

The time difference. Hoping to catch you.
30 minutes before p.m. pre-shot.
At +10, was 204.
FF right before +10, most he ate all day, not much.
Wondering if 1.5?
 
I kept smelling urine, and he's had a couple of instances where he didn't get his butt the whole way into the litter box, and peed on the plastic litter catcher outside. ( Hooray for that thing). I thought maybe he had a little bit of urine on his butt. Couldn't entirely place it.

I'm assuming it was him, figured out there was urine all over the warm pads. It's a layer of three things, so it didn't get through to my bedding. I'm washing it all now. I bought some big washable and waterproof bed pads that I never used when my mother was in hospice. Might be time to get one of those out.
 
262 PMPS
Stick with 1.5?
Edit: I'm answering my own question, I'm sticking with 1.5. The Skyrocket to 700 BG this am is unexplained, and every time I vary from a planned dose, it's been a mistake. I'm here to test him, steer if I need to.
 
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262 PMPS
+2 - 388
+4 - 309
Small urine dribble on just-cleaned pillowcase & pillow, found at midnight. Time for pads. He's using the box. Not sure why the incontinence.

Question + thinking out loud. Tomorrow afternoon has gotten complicated after a request for help from a sick friend. I'll be gone ~noon to ~7 pm. I can test until +4. Neighbour can take food up 2 hr before PMPT. Still shoot 1.5?

+6 - 255
+8 - 193
 
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You're right, hey, those are!
311 for AMPT too.
He had a snack of YA before I took everything up ~5 am... I wondered then if that would make it go high.
I carried him to near / in sight of the litter box then and after a little indecision, he decided to use it.
He's having some FF now.
 
Kris & Teasel said:
Have a read:
http://www.petmd.com/cat/conditions/endocrine/c_ct_diabetes_insipidus
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Oh that's interesting, could be it for sure. Already knew his kidneys were weakly failing, and he had high #s on the ___ test that indicates pancreatitis too.

I put his Feb Labs at the lab tab already, will add new one. I have the last 4 or 5 years of annual labs, add those? Curious, are there lab results readers here?

I wonder if a big diff is not rubbing the insulin. That was my habit, sometimes more vigorously than others. Will have to look up what that is. I'd never heard that until you mentioned it Kris.
 
Uh oh, 74 at +4.5
70. 35 minutes later.
Anyone around d?
He's eating, I just got two pill pockets in him, 1)2 Zobaline. He's eating ya on his own.
I have to leave in about 20 minutes. If it isn't coming up when I get out of the shower, I think I should break out the gravy food, yes?
 
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