2. Java, elder cat

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So - he's been high quite a while and probably had glucose toxicity which creates insulin resistance. Think of it as a "glass floor" that has to be broken through to get numbers dropping. Increasing the dose carefully is how you get that "floor- breaking" dose. Once you're through that barrier, they can begin responding to insulin more vigorously and more monitoring is needed.
 
Now I feel kind of bad for giving Java FF quite late, because he went from 206 to 270 in 1.5 hrs., But am also glad I won't have to worry that he'll go too low during wee hours (even more wee hours that is).
 
Those yellows last night aren't bad at all, especially after the PMPS black. That one was expected after the nice greens he had.

Re rubbing the injection site: insulin is a protein molecule and its structure is key in what it does. Protein structure can be denatured by many things - heat (eg. cooking meat, eggs, etc.), mechanical stress (why we don't shake insulin vials), pH, etc. I think rubbing is a mechanical stressor.
 
Kris & Teasel said:
Those yellows last night aren't bad at all, especially after the PMPS black. That one was expected after the nice greens he had.
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Darn, it's back up high again, and he was subdued and floppy this am, not like himself. Am helping friend who's having surgery, will be bouncing between home to test J and the hospital.
 
It's +2 and it's gone up! ::Noises of despair::
606 from AMPT of 564.
Well off to my next stop on my peripetetic day! I had enough time to take him outside to drink rainwater and get a little Sun.
 
As I was driving, I was thinking that I should have said, OUR poor kitties.

Java's labs are back. I don't know what all the functions mean. I don't have time to type it into the SS tab for labs right now, but I will see if I can attach it here. It doesn't look good, lots of high things.
Am going to try to call the vet but first need to call the hospital, see if friend is out of surgery. BTW, her daughter has Down Syndrome, and is Type 1, with bouncy diabetes - brittle diabetes, they call it - and she and her husband haven't slept a full night's sleep in over 30 years. They have to wake up and test her every 2 hours during the night, every night. Daughter's on Lantus among others I think. Okay, more phone calls, less chat, Lois
attachment on edit I think, if I can
 

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Friend still in surgery. Vet with someone. Googling.
It looks like pancreatitis. We got that at the last test, mid Feb. Vet said the treatment was fluids and adequate food. I've been doing that, he has had an appetite, eats, pees, poops okay. He does not look comfortable.
Oh great, this article talks about how painful it is.
http://www.allfelinehospital.com/pancreatitis.pml
Well, the vet will call back. Friend's out of surgery, in recovery now.
Edits. My guess is electrolytes ... Ringer's isn't' doing it. The bupe and gabapentin fiascos... will have to try again with lower doses.
I don't want vet to give up on Java because of his age. He's shown what a remarkably resilient cat he is. But this is definitely wearing him down. Q of what he can recover from.
 
Lois and Java said:
Friend still in surgery. Vet with someone. Googling.
It looks like pancreatitis. We got that at the last test, mid Feb. Vet said the treatment was fluids and adequate food. I've been doing that, he has had an appetite, eats, pees, poops okay. He does not look comfortable.
Oh great, this article talks about how painful it is.
http://www.allfelinehospital.com/pancreatitis.pml
Well, the vet will call back. Friend's out of surgery, in recovery now.
Edits. My guess is electrolytes ... Ringer's isn't' doing it. The bupe and gabapentin fiascos... will have to try again with lower doses.
I don't want vet to give up on Java because of his age. He's shown what a remarkably resilient cat he is. But this is definitely wearing him down. Q of what he can recover from.
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I don't know how to read test results, Lois. @Marje and Gracie is very good at it. I hope she sees this tag.
 
Thanks.
In all that, I just checked his BG, now it's ~+5, it's 656. Crum. Going up. He's so sleepy, out of it.
Susan just went into the recovery room and will be there for at least an hour, hour and a half. I think I 'm going to take him to over there (to vet). Whatever he gave him on Saturday really worked, I want him to get it again.
 
Lois and Java said:
Thanks.
In all that, I just checked his BG, now it's ~+5, it's 656. Crum. Going up. He's so sleepy, out of it.
Susan just went into the recovery room and will be there for at least an hour, hour and a half. I think I 'm going to take him to over there (to vet). Whatever he gave him on Saturday really worked, I want him to get it again.
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Was it a different mix of fluids? Ask about diabetes insipidus. It's uncommon but some cats have to have it! Maybe Java is one of them.
 
Kris & Teasel said:
Was it a different mix of fluids? Ask about diabetes insipidus. It's uncommon but some cats have to have it! Maybe Java is one of them.
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I dont' know. They took him into a back room and then I wandered that way but the fluids were done. It just looked like a bag.... and I was so stressed about the theater thing that I'd forgotten, I wasn't being logical, I was just asking them to get me out asap.
Edit, I will ask! I really have to get a printer. The only bad part about retirement is not having easy access to all the latest and greatest devices... not that a simple printer is that hard ... anyway you get it.
Edit, I was going to give you my cell # so we could text while I was there, but the vet office is in a dead zone, dammit.
 
Lois and Java said:
I dont' know. They took him into a back room and then I wandered that way but the fluids were done. It just looked like a bag.... and I was so stressed about the theater thing that I'd forgotten, I wasn't being logical, I was just asking them to get me out asap.
Edit, I will ask! I really have to get a printer. The only bad part about retirement is not having easy access to all the latest and greatest devices... not that a simple printer is that hard ... anyway you get it.
Edit, I was going to give you my cell # so we could text while I was there, but the vet office is in a dead zone, dammit.
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I wouldn't need your cell number if the vet office had free wi fi, Lois. I'd have to email your phone wouldn't I - sorry if I'm betraying my tech ignorance. Moot anyway ...
 
Am back from getting friend home from the hospital. No complications for her, yay.

Java is acting quite chipper. I think it must be the shock of going to the vet and back, because his BG is up to 697.

Lily has disappeared. Freaked out by sound of pet crate. Could she have darted out by my ankles, unseen, when I went outside with Java before hospital run? There's a deer in my backyard, so coyotes in yard unlikely.

Vet said he thinks fluids, ringers one day and sodium chloride the next day would be helpful for him. He gave Java sodium chloride and a B12 shot on Sat. I'd like to find Lily, first, but I think I'd better give him fluid now and see if that helps.

I guess stick with 1.5? What a day.
 
I hope you find Lily safe and sound, and the fluids help Java boy. Sticking with 1.5U sounds good to me but Maury is making me question everything I have learned lol! :bighug:
 
Yong said:
I hope you find Lily safe and sound, and the fluids help Java boy. Sticking with 1.5U sounds good to me but Maury is making me question everything I have learned lol! :bighug:
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I'm really bad at reading charts, but I just looked at yours and I'm completely jealous of Maury's #s. All those yellows and Blues. Green's. only one black.
What does it mean when you have an F or S in front of unit #?
 
I went outside and called Lily all over yard. When I came in, she came rushing into the kitchen to say hello. She has found one heck of a hiding spot. Java's sodium chloride is warming in a bowl of hot water.
 
I was just reading about injection sites on cats, and in 3 different places, they talked about pulling the plunger back after you put the needle in the cat. when you pull the plunger back if you get any blood in the syringe you should throw it out and get a new syringe. I've never heard that one before. Do you guys do that?
There's some human error that I'm doing in these shots. They're all on Java side. There's something about them that I'm doing wrong. I mean that's just logical, that has to be what's happening.
 
Lois and Java said:
I was just reading about injection sites on cats, and in 3 different places, they talked about pulling the plunger back after you put the needle in the cat. when you pull the plunger back if you get any blood in the syringe you should throw it out and get a new syringe. I've never heard that one before. Do you guys do that?
There's some human error that I'm doing in these shots. They're all on Java side. There's something about them that I'm doing wrong. I mean that's just logical, that has to be what's happening.
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No, I don't pull the plunger back, never have. As far as shot technique, if all the insulin goes in (no wetness or insulin smell) and you don't rub hard, that's good enough. I think Java's erratic BGs are more a function of age, lack of body fat, other health issues, etc.
 
Kris & Teasel said:
No, I don't pull the plunger back, never have. As far as shot technique, if all the insulin goes in (no wetness or insulin smell) and you don't rub hard, that's good enough. I think Java's erratic BGs are more a function of age, lack of body fat, other health issues, etc.
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Don't drive myself crazy trying to fix the bouncing and the highs?
Java peed on the pad in his crate on the way home. Pretty sure he just had to go, and he was prevented from getting to litter. Now I think that's what happened a couple days ago also, and I just didn't notice wetness on the pad when I got home. This is a mostly silent cat. He made 2 or 3 cries I've never heard before on Saturday on the way home, and one today. Suspect he was distressed about peeing. Still keeping the waterproof pad out, but not on top of everything.
Edit, he doesn't have urinary issues, he's happily peeing on his favorite plants outside, and nearly always gets his butt inside the litter pan when he pees.
 
Lois, I'm in awe of how much energy you have for everything! Taking care of friends, theater, taking care of your kitties! I'm so glad Lily came back quickly, and that Java seems to be benefiting from the fluids.

I don't pull the plunger back either. I've always wanted to because I read it was a good idea, but there's no way Samir would hold still for that kind of precision. This morning he ran off with the syringe still stuck in his side! He's a quick one! I was laughing so hard it was tough to chase him down.

I hope you have Java have a restful evening, and bless you for all the love and care you put into the world around you!
 
Lois and Java said:
Don't drive myself crazy trying to fix the bouncing and the highs?
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You'll feel a lot better if you let go of this, Lois. Java is a bouncer and attempts to control it have only a minor effect, if any. Let him bounce. Intervening with food works quite well if they dive too low so save it for that. The rest of the time just let him eat his low carb food the way he likes, be it grazing or many small meals. The focus should be on the insulin dose, increasing it carefully as needed or backing off if he drops too low. BTW - too low means a lime green on the SS.

This advice comes from someone who has an extremely bouncy cat! ;)
 
Djamila said:
Lois, I'm in awe of how much energy you have for everything! Taking care of friends, theater, taking care of your kitties! I'm so glad Lily came back quickly, and that Java seems to be benefiting from the fluids.

I don't pull the plunger back either. I've always wanted to because I read it was a good idea, but there's no way Samir would hold still for that kind of precision. This morning he ran off with the syringe still stuck in his side! He's a quick one! I was laughing so hard it was tough to chase him down.

I hope you have Java have a restful evening, and bless you for all the love and care you put into the world around you!
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Thank you.
Oh Sam, that's not what to do! Poor guy.
One of these days I'll try stabbinating Lily's ear, see how she handles it, or not, we'll see. She's such a scaredy-cat, so different from Java.

Wow his BG has gone down almost 300 points in 2 hours. Looks like I'll be up every couple of hours tonight!
669 PMPS
1.5 U, then 150 ml nacl fluid
392 at +2
184 at +4
He's been eating FF readily; I'm putting it in front of him often. It's nice to see him eat, because he's lost weight the last few weeks.
He also had 7 fiber treats, and a pill pocket with Zobaline; I am steering in a small way, I think. He looks really good at this BG. Setting alarm and the gravy food ready to open in the kitchen if I need it.

231 at +6. Well, would've been nice to keep it low, oh well looks like steering worked, now don't have to worry so much Tonight.

352 at 3:50 am, +8. Darn it, up so high already.
 
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Just a bounce...not that surprising at all, Lois. I know it's not FUN, but it happens. Heck, we had a cat on here once who bounced for 2 years...until suddenly one day, he just needed less and less insulin and went into remission!

I'm with Kris. You can't control it unfortunately, so you just have to accept it and remember that Java is older and you're doing what you can to keep him happy and comfortable.
 
Hi Lois,

Exciting times! He's not staying that long in high bounce numbers at this dose. Focus more on how low the dose takes him over the time he's on it. If he doesn't go below mid blue after several cycles, increase by 0.25 u. That's what I have to focus on for Teasel. His highs are almost always inflated from bouncing ("fake" highs? ;)).
 
Two years of bouncing and then stopped? Wow, that's amazing.

<< Exciting times! He's not staying that long in high bounce numbers at this dose. Focus more on how low the dose takes him over the time he's on it. If he doesn't go below mid blue after several cycles, increase by 0.25 u.

How can I trust what the dose does, when all I have to do to change it to feed him more food? Or is that a faulty premise?

I'm very lucky that he nearly always will eat when I bring him food. The key is, bringing him food. He isn't just habituated into having food brought to him (I think of it as bringing grandfather his meals on a tray rather than making him come downstairs to the dining room), he often will go without eating if I leave him alone to develop hunger. And of course that's not a sure thing either, because I will happen upon him eating YA that's always out, except now it's taken up two hours before PS.
 
Lois and Java said:
How can I trust what the dose does, when all I have to do to change it to feed him more food? Or is that a faulty premise?
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Faulty premise. A diet of low carb food shouldn't drive BG into a crazy range. Yes, food does influence BG which is why we say no food at least 2 hours before AM and PMPS. Those tests give an idea of the effectiveness of the dose. If you feed scheduled meals and avoid food 2 hours before a nadir test, that also gives good non food influenced info.
 
I'll get back to the above.
Argh, gone all afternoon to dentist across the bay. Haven't infused him with Ringers today. I think it should be okay to skip it?
I have a normal day tomorrow for a change!
Poor Java is looking for food. I feel so bad for him, why does he wait to get hungry until right around when I take the food up?
 
I can't resist what I suspect is an only in California story. After taking Susan home from the hospital yesterday, I stopped at a market in Point Reyes for a small salted caramel soft serve gelato ice cream made from water buffalo milk.
 
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Rachel said:
Wow...California is sounding good to me right now!
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I'm from Penna. California is better. Well, it's beautiful right now, between spring and summer. It's the only time of the year that the hills are green. Everything is blooming. And the Central valley is one of the world's greatest growing regions, so, excellent food, farmers markets.
 
Kris & Teasel said:
Hi Lois,

Unless he surprises you, I'd try 1.75 u starting tomorrow morning.
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It seems like the sodium chloride fluid helps him, and helps bring his BG down, but the ringer solution does the opposite, it makes it as if there's no insulin at all. I'll call the vet tomorrow and find out why, but I think Ringers is out of the equation from this point on.

I plan to do the NaCl fluid tomorrow, and he had blues before with that. Which makes me wonder about 1.75.
 
I feel so bad, he's coming again at this time to look at me, wondering where food is. This is a skinny kitty, getting skinnier. And I'm in the 2-hour window before testing and a shot. I understand one might say well, start doing your shots earlier, so that he could have food now. But man, some mornings it is so hard to wake up and get him tested and insulin in him already, I can't imagine doing it one or two hours earlier than I am now. I'm setting an alarm to get up and pick up all the food at dark o'clock already. End of whinging now.
 
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