Sam - Month 4

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It looks like he's doing so well! But how do you even draw up those teeny tiny doses? I'm over here looking at 4u and can't even imagine what 0.2u looks like, hahah.
 
I squint a lot. o_O

Even harder than pulling up the dose is the injection though: Since the plunger barely moves, I never feel entirely sure that he even got the shot until I see his numbers come down.

He is doing well. As my hopes of him going OTJ have faded, I have to keep reminding myself of that: he's healthy, he's active, his legs are strong, his coat is good -- he may need this dinky dose for the rest of his life, but all of the important things about his quality of life are good. So I'm trying to hold onto some gratitude about that part.
 
Djamila said:
I squint a lot. o_O

Even harder than pulling up the dose is the injection though: Since the plunger barely moves, I never feel entirely sure that he even got the shot until I see his numbers come down.

He is doing well. As my hopes of him going OTJ have faded, I have to keep reminding myself of that: he's healthy, he's active, his legs are strong, his coat is good -- he may need this dinky dose for the rest of his life, but all of the important things about his quality of life are good. So I'm trying to hold onto some gratitude about that part.
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Teasel's all over the place still but I keep saying to myself that he feels better on Lantus. That's what gets me through. :)
 
Djamila said:
@Yong Sam is supposed to be 11 pounds. Would you mind figuring out his calories? I've always just gone with the visual approach: Hmmm....he looks chubby (cut back on food). Hmmm....he looks skinny (add more food). Not a very precise system ;)
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Found another formula that gave me quite a different caloric intake, just entering ideal weight / maintaining weight. So re-calculated with Sam's weight 11 lbs. 176 calories per day. Guess we could do averages? lol Would give 197.8/day for Sam :bookworm:
 
176 is closer to what he's getting right now, although he doesn't even eat all of that. The last couple of days he has barely been eating anything. He declares a hunger strike every once in awhile when he wants a change of food. Heading to the store later today to get his royal highness something better suited to his delicate palate. :rolleyes:
 
The hunger strike is over. New flavor of Primal Raw seems to have ended his protest.

And I added a ton of extra water because he's dehydrated from the warmer weather and his refusal to eat all day. I wish I had realized what was happening sooner! Poor baby!
 
Djamila said:
176 is closer to what he's getting right now, although he doesn't even eat all of that. The last couple of days he has barely been eating anything. He declares a hunger strike every once in awhile when he wants a change of food. Heading to the store later today to get his royal highness something better suited to his delicate palate. :rolleyes:
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Have you tried dog food? It's highly recommended by Frank. Lmao.
 
Whoa! All right Sam, just throw us another curve ball! You know what no shot means, right Djamila? You can have a glass of wine and go to bed early if you want. :D
 
He was pretty low again this morning. If I was home, I would have given him a small dose and monitored, but I have to be at work all morning and won't be back until later, so I skipped in the interest of safety. It makes me nervous though because the last time he had NS for two in a row he peed on the reusable grocery bags and ended up at the vet. :nailbiting:
 
Djamila said:
He was pretty low again this morning. If I was home, I would have given him a small dose and monitored, but I have to be at work all morning and won't be back until later, so I skipped in the interest of safety. It makes me nervous though because the last time he had NS for two in a row he peed on the reusable grocery bags and ended up at the vet. :nailbiting:
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His SS looks fabulous to me, Djamila! Of course my reference standard is Teasel's so most SSs look better to me. :confused:
 
Djamila said:
He was pretty low again this morning. If I was home, I would have given him a small dose and monitored, but I have to be at work all morning and won't be back until later, so I skipped in the interest of safety. It makes me nervous though because the last time he had NS for two in a row he peed on the reusable grocery bags and ended up at the vet. :nailbiting:
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Try giving extra attentions and maybe go through the motions as if he were getting a shot? Just an idea :)
 
I would have done the same if I was you! Let's hope he doesn't decide to use a bag as a litter box...if he does, as long as he pees a normal amount, I wouldn't worry too much. If he pees, you know he isn't blocked, and I'd just keep an eye on him then to make sure he isn't feeling crummy. :)
 
He's only at 123 tonight, so he got a little reduction until he gets back up to more normal numbers. And no inappropriate peeing, so that was a relief! @Yong, I like that idea of going through the motions/routine for him! That's a great idea!
 
And just before nadir....Sam pukes the entire contents of his dinner on the floor. :banghead:

Oh, and a hairball too.

Poor kitty! Glad he got it out though!
 
He only gets like two of them each year - he's not much for shedding (unlike my civvie who is a little fur factory). But yes, it was an impressive amount to come out of a relatively small kitty.

He's now doing his "pre-hypo" routine, although I just tested him and he's still at 86. He might be in for a couple of extra stabs this evening....:nailbiting:
 
Woo Sam! Glad he got that hairball out and I'm dying to see how he's doing this AM!
 
How did things go last night?

And ugh, recently Freya was leaving me small hairballs to wake up to every morning. So gross. But we live in a cool climate, and she was beginning to shed really badly. Once I had a good go at her with the Furminator, no more hairballs! Maybe he just needs extra help getting rid of all the fluff?
 
Sorry I got lazy about updating last night after leaving a comment like that! He got down to 57, so no hypo, but he was pretty actively steering himself through the +3. He free feeds, so he pretty much just stayed in the kitchen by his favorite food dish and kept snacking.

I finally just gave him about 8 pieces of Evo to calm him down and he went to sleep and started to rise a little bit and seemed more comfortable. It was a pretty good size drop on a tiny bit of insulin, so it looks like I need to be a bit careful with him for a few days. I gave the same dose this morning though because he tends to run higher during the day (and I'll be here to monitor until +3.5 this morning).

Brushing Sam can feel futile sometimes because not much hair comes off, no matter which style brush I use. Plus he bites me whenever I brush him. He hates it. Atticus gives up a kitten-sized ball of fur nearly daily during shedding season, so he makes up for Sam's light shedding! Even Sam's hair balls are laughably small compared to Atticus' cigar-sized hair balls if I don't keep up on his brushing! I learned a lot about ECID when I got Atticus. The two look similar, but could not be more different in nearly every way!
 
Help! Someone remind me that it's just a number! I don't know what's going on with Sam's numbers today. I moved him back up to 0.4 again, so maybe I gave him too much? What are these numbers?!?! I was worried he'd go too low with the move back up, but he went the opposite direction. I double checked, and he didn't get into the EVO. The box is still sealed.

He's eating like a ravenous piggy, so I thought he was going low, but definitely not that. Ugh.
 
Djamila said:
Help! Someone remind me that it's just a number! I don't know what's going on with Sam's numbers today. I moved him back up to 0.4 again, so maybe I gave him too much? What are these numbers?!?! I was worried he'd go too low with the move back up, but he went the opposite direction. I double checked, and he didn't get into the EVO. The box is still sealed.

He's eating like a ravenous piggy, so I thought he was going low, but definitely not that. Ugh.
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Does this kitty even need to be taking insulin, his numbers look good to me without a shot. I wish Buddy's numbers were like his.
 
Djamila said:
Help! Someone remind me that it's just a number! I don't know what's going on with Sam's numbers today. I moved him back up to 0.4 again, so maybe I gave him too much? What are these numbers?!?! I was worried he'd go too low with the move back up, but he went the opposite direction. I double checked, and he didn't get into the EVO. The box is still sealed.

He's eating like a ravenous piggy, so I thought he was going low, but definitely not that. Ugh.
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I have no ideas for you, Djamila. Kitties who have been in remission or are headed there again are way out of my league.
 
wolfey said:
Does this kitty even need to be taking insulin, his numbers look good to me without a shot. I wish Buddy's numbers were like his.
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That's a good question, actually! My vet and I were just talking about this last week. I was just starting to think about stopping him for a few days and seeing what happens, but with his numbers going up like this today, I'm not so sure.

I wish @Sue and Oliver (GA) was here!!!
 
Kris & Teasel said:
I have no ideas for you, Djamila. Kitties who have been in remission or are headed there again are way out of my league.
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Out of my league too, unfortunately. I totally know what to do when a kitty is dropping down the scale, but when they've been stuck on the bottom rung for two months, I'm lost. He's likely missing a shot tonight anyway because I'm working a late schedule this evening and probably won't be home until past the hour window. What a lousy day to miss a shot though with his numbers doing whatever it is they're doing right now. :(
 
Djamila said:
Out of my league too, unfortunately. I totally know what to do when a kitty is dropping down the scale, but when they've been stuck on the bottom rung for two months, I'm lost. He's likely missing a shot tonight anyway because I'm working a late schedule this evening and probably won't be home until past the hour window. What a lousy day to miss a shot though with his numbers doing whatever it is they're doing right now. :(
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I'm sure you've searched out any/all info stickies or threads on FDMB about dosing into remission.
 
It's just a number!!!!! And really, those numbers are all around the same. For all we know, could be "oh look a squirrel" syndrome keeping him kind of flat.

I miss Sue so much....especially at times like these! You could certainly try an OTJ trial to see what happens...

I don't really have any good advice for you, but I'm going to try to think about it some...we'll figure something out!
 
This is beyond my comprehension, but I am totally jealous! o_O Hahah. He honestly looks like he's headed in a great direction, so you shouldn't feel bad! Maybe he got Freya's secret message about throwing the odd unexpected number lately... :D
 
All right, here's what I've got so far for you Djamila:
  • Generally a cat is considered OTJ if they range from 40-120 off insulin for 2 weeks (you already know this, I know)
  • Sam's numbers have actually been sliding down the scale fairly consistently. I know it's almost entirely blue, but there have been a few greens lately and if you look at the numbers, you can see at the start of the blue section, he was hitting those higher numbers more often and now he's more often at the lower end of the blue scale, with the occasional green even.
  • Your mid cycles have been about the same throughout. Could be due to the insulin getting old (how old are we talking again?) or could be due to the lower doses being given. There's probably other options but I don't know what they are. :joyful:
Now all of this is stuff I'm sure you've noticed, but I just wanted to list it out for my sake. :) I don't have any brilliant ideas on what to do, but I do have a suggestion. Next time you have a NS if you can...get a +2. Kitties whose pancreas are kicking in often go down at that point rather than up with the food spike. I don't know the science behind it, but it is something we've noticed here. Might tell us something?

As for going OTJ...you could try a trial or you could wait a bit. I don't know what to say really because on those NS days, you really didn't have much change in the BG numbers that evening...which makes me wonder if the insulin isn't really affecting him much. BUT...it could also be that Sam is sliding reallllyyyyyy slowly down the scale and needs the insulin for awhile longer to get him there. Either way, I DO see improvement. I know it's not much, but it is something.

I'm 100% sure that this post isn't really helpful and is mostly me rambling my thoughts out...but I just wanted to share the thoughts I have for now. At least you know you're not alone in being unsure what to do! :)
 
Rachel, thank you so much! Yes, it is helpful! And everyone else too, for the reminders that whatever is happening, we are part of a wonderful wonderful community!

Mostly I don't think he's ready for an OTJ trial given the dose he is still on. We aren't even down to a Drop yet (my favorite dose!). However, it's also occurred to me that maybe his dose is as big as it is because the insulin is so weak at this point. It's five months old on Thursday and the sticky says 3 months. I don't think there's any way to know if it's working or not unless I just go buy another bottle of insulin and see what happens. Although, given the drops he's had, I'm pretty sure it is still working at least somewhat.

I did +4's on two of his NS days, but haven't tried a +2. On the +4's, he had gone up, so I took that to mean he still needed the insulin, but maybe I should try closer to the shot time and see what we get (if he ever gives me another NS).

We decided to cancel the afternoon class today, so I came home on time. His PMPS wasn't as bad as I was expecting. And tonight I'm pretty sure he got away before the insulin got in him, so he may have started his own mini-trial tonight ;). He's been less than cooperative with the shots the past couple of days.

Ugh...I still don't really know what to do, but at least we are all in it together!!! :bighug::bighug::bighug:
 
Djamila said:
Ugh...I still don't really know what to do, but at least we are all in it together!!! :bighug::bighug::bighug:
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I think secretly none of us know what to do half the time, :p and we just evaluate the data and our cats as individuals and do what feels best in weird situations. It can be so confusing and frustrating when you just want to make the right choice. I'm struggling with that too right now, with Freya's own brand of strangeness. But... look at all those nice blue and even green pre-shots compared to all the yellows not that long ago. He's really doing so well! Looks to me like you've been doing the right things.
 
Blair & Freya said:
I think secretly none of us know what to do half the time, :p and we just evaluate the data and our cats as individuals and do what feels best in weird situations. It can be so confusing and frustrating when you just want to make the right choice. I'm struggling with that too right now, with Freya's own brand of strangeness. But... look at all those nice blue and even green pre-shots compared to all the yellows not that long ago. He's really doing so well! Looks to me like you've been doing the right things.
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You hit the nail on the head here, Blair! :)
 
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