Need some advice on multiple issues

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Catdaddy87

Catdaddy87

Member Since 2017
Hello everyone. Sam is a 9 year old female tabby just diagnosed with diabetes and we are hoping after losing some weight and a diet change, she will be able to get off of insulin completely. She has eaten dry food her whole life and hasn't taken to canned food yet.

We feed her twice daily with 1/4 cup of Purina DM and give her 2 units of Vetsulin about 30 minutes after she eats. She has finally come around to doing well with the injections. She is still drinking a good bit and urinating a good bit which is why the vet bumped her up to 2 units instead of the 1 unit previously.

Sam has been lethargic and not eating so I tried an ear prick to test her BG because I was worried it was really low being she hasn't eaten all day or taken an insulin shot. Luckily, it was successful after putting her in a kitty burrito. lol The reading was 235 so I didn't give her a shot since she hadn't eaten all day.

Took her to the vet and she has a secondary infection so we have an antibiotic to give her. Her liver enzymes were high so we are waiting to hear back today from another test result. Vet also found she has ulcers in her mouth and it seems like that is why she isn't eating. It looks like it hurts her when she tries to eat the dry food. I tried giving her canned food and she still didn't want it. The only thing she will eat right now is so soft treats from Meow Mix if I break it up into small pieces.

My wife fed her about 10 treats and gave her a 2 unit dose of insulin this morning. I'm hoping to get home and check her BG after work and get her to eat again and possibly give another injection.

Any advice on how to proceed? How to help her get rid of the ulcers quickly? Thanks in advance!
 
Hi Andrew, Cassie, and Sam!
Glad she is getting used to the injections and you got a BG reading, you may not need they kitty burrito every time forever :). Any idea if the secondary infection was present when Vet increased insulin dose? The jump from 1 -> 2.0U is a 100% increase and if her BG was higher due to that infection, may be too high of a dose.

Hopefully you'll see this before you get home, if possible make sure Sam has not eaten anything 2 hours prior to pre-shot BG test so the number is not food influenced. Ideally she would be on all, or at least mostly, wet food.
A few reasons:
  1. Certain canned foods, like most pate, are lower carb than most dry foods.
  2. Canned food has added water supplement, which is important for diabetic kitties.
  3. Vetsulin is an early onset action, so the reason you wait 30 minutes to give shot after eating is so the food is on board when the insulin starts working. This is with canned food though. Dry food can take about an hour to get on board (metabolized in the system).
  4. DM dry food probably won't let her go into remission. There are a couple other dry food options though if getting her on wet food doesn't work.
Here is an article that might help transition her: http://catinfo.org/docs/TipsForTransitioning1-14-11.pdf

My apologies if it sounded like a lecture, that's not my intention :bighug:.
Something a little more helpful: You can try baby food, just meats with broths no seasonings - onions, garlic. There are also some "Flaked" wet foods that are low carb. Friskies has flaked tuna / flaked tuna with egg. There are also Purely Fancy Feast. Just trying to give some healthier options than Meow Mix treats. Also, keep trying to get the Pre-shot tests (30 minutes before shot time and ideally no food eaten 2 hours prior).

Did the Vet have any insight to what may have caused the ulcers in her mouth? Did they prescribe any AB? (antibiotics)
 
Thanks for responding Yong! I can't figure out how to quote you on this forum so I will answer in order of your responses.

Hopefully she wont need the burrito much longer. She doesn't like it! I'm not sure if the infection was present before the higher dose of insulin was made.

Last time she has eaten was about 6:30 am and she had an insulin shot so the BG test when I get home should be a fairly good indicator correct?
I definitely want to get her off of dry food completely she has been very stubborn about changing over.
Thanks for the link on transitioning. I have read it twice and have it bookmarked. lol I have been digesting a lot of info here about her diabetes so I can hopefully manage it will.

No need for an apology. I'm just thankful someone responded. I kind of feel like I'm own my own over here trying to help Sam as much as possible.

The vet did not have any insight on what may have caused them or if anything would help them go away. I specifically asked. She said the antibiotic she is on for the bladder infection should help the ulcers. I feel like the vet isn't really trying to address all of the issues the best way but Sam is our little girl so we are very protective naturally. I just hope the ulcers go away with the bladder infection and she starts eating normally again so we can get back on track with the BG levels.
 
Post here with any questions you have. There's an amazing amount of experience, advice and support from all the great folks on the forums. We can help you to help Sam. :)
 
Catdaddy87 said:
Thanks for responding Yong! I can't figure out how to quote you on this forum so I will answer in order of your responses.

Hopefully she wont need the burrito much longer. She doesn't like it! I'm not sure if the infection was present before the higher dose of insulin was made.

Last time she has eaten was about 6:30 am and she had an insulin shot so the BG test when I get home should be a fairly good indicator correct?
I definitely want to get her off of dry food completely she has been very stubborn about changing over.
Thanks for the link on transitioning. I have read it twice and have it bookmarked. lol I have been digesting a lot of info here about her diabetes so I can hopefully manage it will.

No need for an apology. I'm just thankful someone responded. I kind of feel like I'm own my own over here trying to help Sam as much as possible.

The vet did not have any insight on what may have caused them or if anything would help them go away. I specifically asked. She said the antibiotic she is on for the bladder infection should help the ulcers. I feel like the vet isn't really trying to address all of the issues the best way but Sam is our little girl so we are very protective naturally. I just hope the ulcers go away with the bladder infection and she starts eating normally again so we can get back on track with the BG levels.
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Could the mouth ulcers be a condition called stomatitis? I have no experience with it but have seen it mentioned here a few times.
 
Catdaddy87 said:
Last time she has eaten was about 6:30 am and she had an insulin shot so the BG test when I get home should be a fairly good indicator correct?
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Ah ok if she is just on 2 feedings a day, then she will not have eaten anything 2 hours prior to your PS test for evening. Unless she found contraband. I opened my spare room last week or something to let fresh air in and my boy found (at least) 5 month old dry food contraband! :facepalm:

Catdaddy87 said:
I definitely want to get her off of dry food completely she has been very stubborn about changing over.
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Some kitties are very addicted to their dry foods so here are the top 2 that are better for diabetic kitties:
1. Young Again Zero / Zero Mature - Order online only.
2. Dr. Elsey's Clean Protein Chicken - Online only right now.
There is a 3rd but last year formula changed so it's closer to 12% carbs, still better than Purina DM at 18%, EVO Cat and Kitten (purple bag) and available in Pet stores.

Catdaddy87 said:
No need for an apology. I'm just thankful someone responded. I kind of feel like I'm own my own over here trying to help Sam as much as possible.
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I am just overly cautious with my tone online :smuggrin:

Catdaddy87 said:
I feel like the vet isn't really trying to address all of the issues the best way but Sam is our little girl so we are very protective naturally. I just hope the ulcers go away with the bladder infection and she starts eating normally again so we can get back on track with the BG levels.
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I might be wrong, so maybe science teacher Kris can clarify :). UTI is more bacterial infection so if AB's are for that and her ulcers are viral, they may not work. I'll see what I can dig up for ulcers. Could you get a picture?
 
Catdaddy87 said:
Thanks for responding Yong! I can't figure out how to quote you.
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To quote, next to "Like" is "Reply". That will quote the entire post. If you want to edit it as I have above just backspace, from either end, what is not relevant.
It's been my experience that ulcers depend on where they are, gums next to teeth as opposed to elsewhere, as well as the cause and subsequent bacteria. My vet's exact words "There's nothing as filthy as a cat's mouth". We had a cat that sent a tech to ER for a double dose of an intravenous drip so it's not an old wives tale or something to be taken lightly. Good luck, the proper meds should clear the ulcers and you're in the right place for help. Our Sam is sending your Sam :bighug: :bighug: :bighug:
 
Did the vet test Sam for ketones? You should be testing her at home too because infection, not eating and not enough insulin(as in skipped shots) can cause a very serious condition called ketoacidosis. You can pick up test strips at any pharmacy. Also, if she doesn't eat you may have to assist feed her using a syringe. She needs to eat so you can give the insulin and avoid ketones.
 
Yong said:
Ah ok if she is just on 2 feedings a day, then she will not have eaten anything 2 hours prior to your PS test for evening. Unless she found contraband. I opened my spare room last week or something to let fresh air in and my boy found (at least) 5 month old dry food contraband! :facepalm:


Some kitties are very addicted to their dry foods so here are the top 2 that are better for diabetic kitties:
1. Young Again Zero / Zero Mature - Order online only.
2. Dr. Elsey's Clean Protein Chicken - Online only right now.
There is a 3rd but last year formula changed so it's closer to 12% carbs, still better than Purina DM at 18%, EVO Cat and Kitten (purple bag) and available in Pet stores.

I am just overly cautious with my tone online :smuggrin:


I might be wrong, so maybe science teacher Kris can clarify :). UTI is more bacterial infection so if AB's are for that and her ulcers are viral, they may not work. I'll see what I can dig up for ulcers. Could you get a picture?
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It's true that ABs don't work on viral infections. I don't know anything about mouth ulcers - whether they're caused by an infectious agent or some other inflammatory response.
 
@Catdaddy87 This is the last place you have to worry about your tone. Communicating a health issue, often in a panic, can lead to spelling mistakes, aggravation and frustration. Personally I hate to sound condescending but posts get too long if we worry about being polite. The abbreviations and lingo can be strange but not to worry, you're among friends. It's better to ask what BUPE is or is Caninsulin the same as Vetsulin than worry about writing a term paper.
 
I have read about ketoacidosis and haven't gotten the strips yet. Do they only enter ketoacidosis if their BG is really low or can it happen at any time? Sam hates syringe feeding and its a chore to get her to take her antibiotic that way. We tried to syringe feed her some Purina AD with water and she only took about half the syringe and had a jaw lock like a crocodile. She just got annoyed and I got scratched up pretty good. She hasn't eaten much other than a few treats the last 3 days and I'm worried about her having serious issues because of it.

I know you use the strips in the urine. Do you have to have nonabsorbent litter to do that?

I will try to get a picture. Sam really doesn't like being messed with.
 
DKA is more likely to occur when BG numbers are higher but yes they can happen at any time. For getting a urine sample you can put little pieces of shrink wrap (I think) in the area she usually pees in. Or buy a long handled spoon, clearly label it hers after ;), and sneak it under her when she goes in. Just need a tiny amount to dip the stick in :). Just make sure to take the reading at given time, most are 15 seconds to show result, otherwise the longer it sits the strip will darken.
 
So the highest she has ever read that I know of is about 360.

Did a pre shot test this morning and she only had a few treats last night. Her BG was 199. She isn't interested in any food we tried or tries to syringe feed her. Should I skip the shot since her BG isn't too bad?
 
Do you have any old food she loved? The important thing is getting her to eat something right now, I think. Hopefully some of the more experienced members will chime in. Traffic can be slower on the weekends. I'm torn as to what to say for shot. Part of me would want to give a tiny dose if you are home today, the other part says go ahead and skip since she's isn't eating much. Sorry I'm not much help :(
 
Besides DKA from not eating enough + not enough insulin + an infection or other stress, there is also the worry of her developing Fatty Liver from not eating enough. I would take her to the vet today. Maybe just some fluids and a B12 shot will help. Maybe they will give you a prescription for an anti-nausea medicine like ondansetron and some bupe for pain. Did the blood tests include one for pancreatitis? If nothing else, I would go buy the ketone test strips and test her for ketones and hopefully they are negative, and get some food into her.
I believe I have heard that slippery elm bark is relieving to mouth ulcers.
 
The vet tested for pancreatitis and it was negative thankfully.

I will call the vet and see what her thoughts are. She gets so stressed going to the vet. They have her subcateneouas fluids and a shot to help with nausea the other day to help and gave me a pill to ramp up her appetitie but she won't take it. I could her Sam hissing and growling back there as they were doing all that.
 
That's good the pancreatitis test was negative.
Even if they did a urinalysis or a blood test for ketones the other day at the vet, they can come on suddenly (like in hours), so please go get the ketone test strips for urine and make sure she doesn't have ketones as they can be life threatening, and so can Fatty Liver from not eating enough. I have heard many times that cats can only go like 3 days without eating or barely eating before they can get Fatty Liver. Here is a video on assist feeding.
 
Sharon14 said:
How is Sam? Have you been able to get a ketone test? Has she eaten?
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Thanks for asking. She still isn't doing well. I'm trying to be positive and I think the ulcers are the reason she isn't wanting to eat. After trying to syringe feed her this morning and not being very successful, I called another local vet that is open 24 hours to get a second opinion and the doctor was concerned the ulcers may be there because of kidney disease and worried about not eating causing fatty liver so we took her in.

The new vet was very nice and through and answered all of our questions. She ran another full blood workup which was another $175 after just having one 2 days ago.:banghead:
BG was 296 even with the stress from being at the vet and her pancreas and kidneys were fine. Bad news is that her liver levels were over 500 and the normal range is about 130. This caused a bit of concern for us and the vet.
Our options were to:

1. leave her over night and they will administer pain meds and nausea meds to hopefully make her want to eat and not have the ulcers bother her and flush her system with an IV to try to get the levels in her liver down. Syringe feed her and watch BG so they could adminster insulin if possible.

2. Do all of the above but put in a feeding tube to bypass the ulcer issue and avoid syringe feeding issues.

We didn't really want to go to the feeding tube for the reasons of the cost being doubled and putting Sam through that. I know I have looked at some things here about the feeding tubes but we just didn't want to go that route unless its absolutely necessary. Once again, we are hoping she will start eating once the ulcers aren't hurting her so she's spending the night with the vet and being syringe fed.

It's disappointing we are dealing with these new issues because we just thought we were getting pretty good at managing the diabetes. The vet seems to think even if we get her liver levels down there is an underlying issue causing all of this that we would need to find and address. As I'm sure many of you know, the vet costs are piling up quickly and I would be lying to say that the cost is not going to start being an issue in our decision making for Sam. :(
 
(((Hugs))) Catdaddy87
I am hoping they can get the ulcers pain low enough that eating resumes and makes this conversation moot.
Breathe, take one thing at a time, and know that leaving Sam to get better at the vet was the right thing for Sam. (The wallet might hurt, but hopefully Sam will be better.)
Of all my cat's I've ever had, when there is an issue I've never second guessed my decision to provide care. My only regrets are the ones I wasn't able to get care for fast enough. During the moment when all the anxiety and stress is heightened the financial stuff feels like it will break you. I think we've all been there. Hang in there.
Signed a gal that just had to deal with ER possibilities this week. You are not alone!
More (((Hugs)))
 
Sam came home with us this afternoon. She had a rough weekend. She received pain medicine and syringe feeding multiple times while she was there. They checked her BG a few times and she never got over 296 and dropped as low as 79 at one point but she had not been eating and they didn't syringe feed her yet at that point.

The new vet seems to think 2 units of insulin twice a day was too much and she doesn't need that much. She doesn't think with her levels staying around 300 or less that she needs that much. She also thinks the increase to 2 units twice a day may have caused the ulcers.

They sent Sam home with some pain meds to give her an hour before eating and some syringes to syringe feed her until she starts to eat on her own again. Plus she has the antibiotic still for the infection. Hopefully the ulcers go away in a few days and we can get back to normal. Vet says to feed her 3 times a day right now just to get food in her system again and hopefully bring the liver levels down. She says to not worry about insulin right now unless her numbers get very high and just focus on her eating and the uclers.

I think we are going to request Sam's records and transfer to the new vet. They seem to have really tried to address all the issues and make sure we have a game plan going forward after she left which we appreciate.

Thoughts and opinions are welcome. Thanks to everyone for taking interest in Sam!
 
Catdaddy87 said:
She also thinks the increase to 2 units twice a day may have caused the ulcers.
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I have been around FDMB a long time and I have never heard of insulin causing ulcers. I'm glad you found a vet you like and got some pain meds, and antibiotics, and hope the ulcers heal quickly from that and she begins to eat like her normal self again soon.
Please remember that ketones are caused by not enough insulin plus not enough food plus an infection or other stress. I would give her some insulin if she needs it, and lots of food slowly throughout the day. In case I didn't post this to your thread before, here is the video on assist feeding.
 
I agree, I think continuing with the new vet is a good choice. You need to know that someone is on your side during all of this.

Best to you and Sam. I hope that things start to turn around for you soon!

Sandi&Whisper.
 
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I'm glad she's home. Hope the ulcers clear up and she starts eating. Please do check her for ketones, as long as she's not eating well she's at a higher risk for developing them.
 
Dyana said:
I have been around FDMB a long time and I have never heard of insulin causing ulcers.
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I don't think she was necessarily saying the insulin directly caused the ulcers, but too high of a dose started the whole rollercoaster we have been on.

Thanks to everyone here for the concern, advice, and well wishes. Sam is jumpy and still not herself but seems to be getting better. I am going to have to head home at lunch the next few days and syringe feed her. Hopefully after a few days of the syringe feeding and ulcers hopefully getting better she can get back to normal.
 
I'm glad you're going home at lunch to syringe feed her. I hope she starts eating more on her own again, soon.
 
The vet has us syringe feeding her 12ml of Hill's A/D three times a day. I looked into the A/D today and it has about 13% carb content which I know isn't great but she seems to need the soft food because of the ulcers. I will try to get a BG level after work today to see how she is doing with the A/D and being home instead of the vet. Sadly I think the Purina DM our original vet prescribed is also about 13% carb content.
 
Catdaddy87 said:
The vet has us syringe feeding her 12ml of Hill's A/D three times a day. I looked into the A/D today and it has about 13% carb content which I know isn't great but she seems to need the soft food because of the ulcers. I will try to get a BG level after work today to see how she is doing with the A/D and being home instead of the vet. Sadly I think the Purina DM our original vet prescribed is also about 13% carb content.
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The Purina DM wet food comes in two types: the pate type is about 6% carbs and the chunky type is around 10% carbs.
 
Catdaddy87 said:
She prescribed the DM dry food because that is what Sam has always eaten. We are trying to get her to swap to wet food.
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OK. I give the DM wet pate to my guy, mixed in with either Friskies or Fancy Feast pate for flavour variety. Most kibbles are too high in carbs, even those for diabetics. Will Sam eat wet food or is she a die hard kibble addict?
 
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Kris & Teasel said:
OK. I give the DM wet pate to my guy, mixed in with either Friskies or Fancy Feast pate for flavour variety. Most kibbles are too high in carbs, even those for diabetics. Will Sam eat wet food or is he a die hard kibble addict?
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Die hard kibble addict! I have tried all sorts of wet foods and flaked chicken and tuna. She wasn't interested at all. I'm hoping after being syringe fed the soft Hill's A/D for a few days she may be more receptive to soft/wet foods.
 
Sam seems to be slowly reverting back to normal behavior. She is finally starting to come around to us I want to be rubbed and has a little bit more pep in her step.

I gave her a pre-shot test a little while ago and the last time she ate was at noon so that's roughly +5 hours. Her BG was 235. She hasn't had insulin since Friday. Would you recommend giving her one unit of insulin after I feed her tonight?
 
Is she is she eating on her own or are you still syringing food? We usually say no shot under 200, and I believe the starting dose for Vetsulin is 1u. @Kris & Teasel or @JanetNJ know more about your insulin.
 
Sharon14 said:
Is she is she eating on her own or are you still syringing food? We usually say no shot under 200, and I believe the starting dose for Vetsulin is 1u. @Kris & Teasel or @JanetNJ know more about your insulin.
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I think that her pre shot is high enough that you could give 1 u of insulin IF she's eating reliably AND you're willing to test her at +2 to see where she might be headed on this dose. I'd encourage you - strongly - to set up a spreadsheet like we use here. It's viewable by all members and is the first thing we look at before offering advice. Without it, it's risky to give dosing advice because we can't see what's happened previously, how she tends to respond, etc. Please consider a spreadsheet. :)
 
She is still not eating on her own yet. She finally ate some soft treats on her own today.

I do plan on filling out the spreadsheet. I just haven't had enough test to fill it in yet.

If I only syringe feed her 12 mL of hills A.D. do you think I should give her one unit?
 
If you have one number on it, it's ready to go ;).
235 is kind of close to the cutoff and if she was on 2.0U I think you should drop down to starting dose of 1.0U and plan on getting another BG test at +2 (2 hours after insulin). Depending on that reading, maybe one more before bed. So if she has a significant drop, you may want to give a little more bites of food and re-test within the hour.

*This is just my opinion, feel free to ignore it*
 
I tested her again when we got home and she was at 287. I figured after eating it will go higher so I gave her 1 unit after eating. I won't be able to check her BG at +2 hours but I doubt it will fall to dangerous levels since it was a little high and she ate. I will check her when I wake up for work which will be about +6.
 
I gave her the 1 unit of Vetsulin along with the 12ml of Hill's A/D last night before bed. Her BG at +6 was 241. I know the Hill's A/D isn't the optimal carb % but it seems to be hovering around 200-240 isn't too bad.

She is on buprenx and carafate for the ulcers and veraflox for the infection. Not sure if these meds have an effect on her BG.
 
Catdaddy87 said:
I gave her the 1 unit of Vetsulin along with the 12ml of Hill's A/D last night before bed. Her BG at +6 was 241. I know the Hill's A/D isn't the optimal carb % but it seems to be hovering around 200-240 isn't too bad.

She is on buprenx and carafate for the ulcers and veraflox for the infection. Not sure if these meds have an effect on her BG.
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Congrats on getting the spreadsheet up! It'll be so helpful. Did you give 1 u of insulin this AM? Whenever you have a minute, pleas add that to the SS. Is she eating?
 
Kris & Teasel said:
Congrats on getting the spreadsheet up! It'll be so helpful. Did you give 1 u of insulin this AM? Whenever you have a minute, pleas add that to the SS. Is she eating?
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My wife did not give her the insulin because her last shot was at 10:30 pm and she fed her at roughly 6:30 am. I need to try and slowly get her back to the normal shot times of 6 am and 6 pm. Our work schedules are tough because I leave the house a 5:40 am and my wife leaves at 6:45. I get home about 5 pm if I come straight home (We play in a beach volleyball league twice a week and try to go to the gym) and my wife gets home at anywhere between 6-7:30 pm. Suggestions?

We are still syringe feeding her. I plan to try and visually check the progress on her ulcers after work. I have some Dr Elsey's coming in soon to let her eat until we can get her on wet so it will be at least low carb.
 
Catdaddy87 said:
My wife did not give her the insulin because her last shot was at 10:30 pm and she fed her at roughly 6:30 am. I need to try and slowly get her back to the normal shot times of 6 am and 6 pm. Our work schedules are tough because I leave the house a 5:40 am and my wife leaves at 6:45. I get home about 5 pm if I come straight home (We play in a beach volleyball league twice a week and try to go to the gym) and my wife gets home at anywhere between 6-7:30 pm. Suggestions?

We are still syringe feeding her. I plan to try and visually check the progress on her ulcers after work. I have some Dr Elsey's coming in soon to let her eat until we can get her on wet so it will be at least low carb.
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Do your best to get a regular shot schedule set up that's as close to every 12 hours as you can manage. Yes, treating FD will put some constraints on your routines but many people here have found ways to work out those kinks. Vetsulin is an "in-and-out" insulin so that after 12 hours it's gone. There's no overlap between shots to speak of. That means you have a bit of flexibility in shot timing - I'd say up to an hour (max) plus or minus. With more data collected you'll learn how to adjust dosing to compensate for that. Generally speaking, though, consistency is the key to successful treatment.
 
Yea, that's what I'm learning. I finally feel like I'm understanding the broad picture here and dealing with FD. It was a ton of info at first but it's starting to make sense. I feel like I have an understanding of the cause and effect of most things and how to act.

Thanks to you and everyone else here who has helped me the past week!
 
Small breakthrough at lunch. Sam was looking for more food after the first little bit of food I gave her in the syringe. She ate the rest of off my finger as I squirted it onto my finger. Hoping this means she is getting her appetite back and adjusting to the texture of wet food.

So glad she did that! Put me in a better mood instantly! lol
 
Catdaddy87 said:
Die hard kibble addict! I have tried all sorts of wet foods and flaked chicken and tuna. She wasn't interested at all. I'm hoping after being syringe fed the soft Hill's A/D for a few days she may be more receptive to soft/wet foods.
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Chase was the same way. He had only ever eaten dry food his whole life. When he was diagnosed he was very sick... wasn't even interested in eating much, which is why I took him in. When I found out that dry food is HORRIBLE for cats, I knew I had to never feed it to him again. I tried every soft food out there, with no luck. Then I tried boiling chicken, which he liked but ate very little of. I was beside myself. Then someone suggested baby food. BINGO... worked like a charm. He ate straight baby food and then I added a little wet food with it, slowly, and finally until it was all cat food and no more baby food.

Through this process I have found that Chase is very sensitive to texture. Sometimes I have to mix his food in a Nutri Bullet to make it runny, and he loves it. I've been told that doing that won't hurt him in any way.

This boy is as sensitive as some girls... I SWEAR. LOL. But he's MY boy, and I don't know what I'd do without him... or this group of fantastic people who have ALWAYS been here to help me. I hope Sam gets better and better. :) Hang in there. You're in the right place. :bighug:
 
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