Sam - Month 6

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Djamila

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Okay, it's a couple of days early to call in Month 6, but close enough...

I'm wondering if y'all could take a peek at Sam's spreadsheet and share your thoughts. Looking at yesterday's AM cycle (no insulin) and today's AM cycle (with insulin)....and also comparing 7/2 and 7/3 AM cycles, it doesn't look like the insulin is doing much of anything these days. It is way way way past its life at this point, so it seems reasonable that it's weaker than it should be. (although he did hit a high lime green on 6/23 PM, so it's not totally dead).

But given that he's hitting pretty much the same mid-cycle numbers regardless of whether he gets a shot, I'm wondering what I should do.

Here are the questions I've been pondering:
1. Is there any reason to consider trying the Lantus? I'm leaning toward no since he's getting so many NS days and Lantus isn't an in and out insulin. My limited understanding of lantus is that he would need to get a shot regularly, and that seems risky/unlikely at these numbers.

2. Should I buy a new vial of Prozinc? It's expensive to do that for an occasional shot, but if he needs it...?

3. Should I stop giving insulin and see what happens? If his numbers rise enough I could then start the Lantus, but am I risking damage to his pancreas if I do this? At what point would we say he's risen enough to try it? 120's? 130's? Higher?

I've been waiting for his numbers to be closer to the 50-80 range, but I know some vets, and some people on here, declare their cats OTJ at higher numbers. During the year Sam was on his honeymoon, he would occasionally give a number in the 90's, but did usually stay under 90, and only went over 100 one time (and it was just a couple of weeks before he got his second diagnosis, so that was clearly not a good thing).

Thanks for your help everyone! We are all kind of guessing here, but it helps to guess together!:bighug:
 
That is a super tough one! I tend to agree on not going to Lantus right now...it seems like it might not be useful where you're at. Kris or Steph can probably weigh in better though since they've both switched!

Options 2 and 3 though....tough call. I think, if he was mine, I'd give him a few days without a shot maybe. Just see what happens. It doesn't have to be long but see if his numbers trend upward over say...3 or 4 days. It seems like just a few days wouldn't do much damage. And instead of focusing on specific numbers look to see if he's staying consistent to his pattern lately or if his preshots start to go higher more regularly.

If not, continue the trial and see what happens. If they do, get another vial of ProZinc and work on him...he might just need another month or 2 of small doses irregularly to get him all the way there.

Of course all this is easy for me to say as I sit here! I won't be one bit offended if you go another way. Just my thoughts since it allows you to do a smaller trial more tailored to Sam than typical OTJ trials on here and move forward from there.
 
Okay, it's a couple of days early to call in Month 6, but close enough...

I'm wondering if y'all could take a peek at Sam's spreadsheet and share your thoughts. Looking at yesterday's AM cycle (no insulin) and today's AM cycle (with insulin)....and also comparing 7/2 and 7/3 AM cycles, it doesn't look like the insulin is doing much of anything these days. It is way way way past its life at this point, so it seems reasonable that it's weaker than it should be. (although he did hit a high lime green on 6/23 PM, so it's not totally dead).

But given that he's hitting pretty much the same mid-cycle numbers regardless of whether he gets a shot, I'm wondering what I should do.

Here are the questions I've been pondering:
1. Is there any reason to consider trying the Lantus? I'm leaning toward no since he's getting so many NS days and Lantus isn't an in and out insulin. My limited understanding of lantus is that he would need to get a shot regularly, and that seems risky/unlikely at these numbers.

2. Should I buy a new vial of Prozinc? It's expensive to do that for an occasional shot, but if he needs it...?

3. Should I stop giving insulin and see what happens? If his numbers rise enough I could then start the Lantus, but am I risking damage to his pancreas if I do this? At what point would we say he's risen enough to try it? 120's? 130's? Higher? Buddy, has never had that low a dose of insulin. I do not know the answer to your questions, but I think it is wonderful that his numbers are so low on such a small dose of insulin.

I've been waiting for his numbers to be closer to the 50-80 range, but I know some vets, and some people on here, declare their cats OTJ at higher numbers. During the year Sam was on his honeymoon, he would occasionally give a number in the 90's, but did usually stay under 90, and only went over 100 one time (and it was just a couple of weeks before he got his second diagnosis, so that was clearly not a good thing).

Thanks for your help everyone! We are all kind of guessing here, but it helps to guess together!:bighug:
 
My two cents, Djamila:
1. I'm not sure there's anything to be gained by switching to Lantus. You might still want the dosing flexibility of ProZinc without a depot lurking in the background. It's still easier to do small fraction dosing with U100 syringes and ProZinc.
2. Unless you can find a place to sell you one Lantus pen, you'll be out of pocket about the same amount of cash buying Lantus from a Canadian pharmacy as ProZinc from your vet.
3. I really can't advise about this because I have zero experience. Maybe you could do a short trial without insulin to see how stable and low his BG stays?
 
1. Is there any reason to consider trying the Lantus? I'm leaning toward no since he's getting so many NS days and Lantus isn't an in and out insulin. My limited understanding of lantus is that he would need to get a shot regularly, and that seems risky/unlikely at these numbers.
I'm leaning towards no and like Kris suggested, might not want the depot lurking when he's been giving NS's at night.
2. Should I buy a new vial of Prozinc? It's expensive to do that for an occasional shot, but if he needs it...?
How soon will you need it? Try your luck at Supply Closet?
3. Should I stop giving insulin and see what happens? If his numbers rise enough I could then start the Lantus, but am I risking damage to his pancreas if I do this? At what point would we say he's risen enough to try it? 120's? 130's? Higher?
I have no idea :oops:

Based on this:
I've been waiting for his numbers to be closer to the 50-80 range, but I know some vets, and some people on here, declare their cats OTJ at higher numbers. During the year Sam was on his honeymoon, he would occasionally give a number in the 90's, but did usually stay under 90, and only went over 100 one time (and it was just a couple of weeks before he got his second diagnosis, so that was clearly not a good thing).
I guess you could try not giving insulin, Sam might be a kitty that naturally runs on the higher normal range.

Have you tried the drop dose consistently? Just for blue PS?
 
The Lantus is already sitting in the fridge, so that money's spent. It stays good for a long time as long as it isn't opened, so I figure it can just hang out there until Dx #3 (yes, I'm a bit of a pessimist).

As far as getting a new vial of prozinc, I don't think the vet will give it to me at these numbers anyway, so I may have to let him rise a smidge before our annual check-ups on the 21st. So he may be looking at a bit of an OTJ trial whether he/I/we like it or not anyway.

Today's numbers were a little strange. Neither cycle showed any action from the insulin at all. I haven't had a blue PM+3 in weeks. Granted, it was barely blue, but his +3's at night are usually in the 60's. Not sure what to make of today. Did the insulin just completely stop working in the past week? Is something going on with him? Were there squirrels dancing on the balcony just before the tests (haha)? Is it just one of those days and tomorrow the insulin will be back to normal? (I promise neither of them were fur shots)

So many questions....

Thank you all for taking some time to think this through and share your thoughts! I don't know how people go through this process without a community! I really appreciate you all!
 
Hmmm...could be that the insulin has just crapped out. You might keep an eye on supply closet to see if any prozinc shows up there. That way, you could grab it earlier if you do need it. :)
 
Curiosity got the better of me, and I gave him a shot this morning. I want to see if yesterday was just odd, or if the insulin is really done. Then I think I'll give him a couple of days off and we'll see what happens. It also turns out that I'm scared if I stop giving him insulin his numbers are going to go higher and it's going to make him sick again. Which is silly because I'll keep testing and we'll see the numbers before it gets that bad. Plus, there is a pen of Lantus sitting right here in the fridge, so it's not like there isn't active insulin within arms reach if he needs it. Fears are funny things...
 
OK. If the Lantus is in the fridge you might end up using it. It's possible that your ProZinc has breathed its last breath. I understand the fear of changing anything significant - on insulin/different insulin/off insulin. I agonized over switching Teasel to Lantus.

You'll be testing Sam often enough to catch it if he starts going up. The should allow you to nip it in the bud. There are lots of people on FDMB who microdose Lantus so you could post about that should it become necessary.

I agree about the value of having a community to help as each of us navigates the FD sea. It's helped me a lot!! :bighug:
 
Who knows, if Sam needs to try the Lantus you may just build the depot with a drop dose and that will be enough to stabilize him into another remission :woot: (antijinx)
 
Oh bless his little kitty heart. He appears to be on a hunger strike again. Apparently it's time to go find him some new food.

It's not inappetance because he keeps pawing at the treat bags, and he'll eat with fortiflora. But once he's licked the top layer off, he goes back to refusing and pestering me for treats.

Or maybe I should just leave the house and go work somewhere else today. He'll probably just eat if he doesn't have someone catering to him!
 
I can't remember if I mentioned here, or just out on the Main Forum, but we are all getting ready to go on a week long road trip at the end of the month. I decided to try bringing the kitties along instead of leaving them with a pet sitter. At this point though, it may have been cheaper to leave them! They now both have leashes, two types of harnesses, a play pen, a double stroller (nope, not kidding), and their regular carrying cases. Along with beds, toys, food, diabetic supplies, litter boxes, and on and on.

Plus we've been slowly getting Atticus used to wearing a harness (no small feat!). Tonight I put the leash on the harness for the first time and he immediately flopped over and played dead. It was kind of hilarious except that I knew he was super stressed and it made me feel bad. Only 20 days left to get him ready to go. Yesterday he went to the park for the first time. After I parked the car and opened the crate to let him out in the car (no way he's ready to get out of the car yet), he dove under a blanket and refused to even look out the window. Poor baby!

Sam has been a leash walker for years and goes to the park every few weeks when I think it will be quiet there, so he's a pro at all of this, but Atty not so much.

If anyone has any tips or tricks for traveling with a scared cat, feel free to share! I'm mostly excited to try this, but I am starting to realize that the pet sitter might have actually been easier on him than traveling will be!
 
I can't remember if I mentioned here, or just out on the Main Forum, but we are all getting ready to go on a week long road trip at the end of the month. I decided to try bringing the kitties along instead of leaving them with a pet sitter. At this point though, it may have been cheaper to leave them! They now both have leashes, two types of harnesses, a play pen, a double stroller (nope, not kidding), and their regular carrying cases. Along with beds, toys, food, diabetic supplies, litter boxes, and on and on.

Plus we've been slowly getting Atticus used to wearing a harness (no small feat!). Tonight I put the leash on the harness for the first time and he immediately flopped over and played dead. It was kind of hilarious except that I knew he was super stressed and it made me feel bad. Only 20 days left to get him ready to go. Yesterday he went to the park for the first time. After I parked the car and opened the crate to let him out in the car (no way he's ready to get out of the car yet), he dove under a blanket and refused to even look out the window. Poor baby!

Sam has been a leash walker for years and goes to the park every few weeks when I think it will be quiet there, so he's a pro at all of this, but Atty not so much.

If anyone has any tips or tricks for traveling with a scared cat, feel free to share! I'm mostly excited to try this, but I am starting to realize that the pet sitter might have actually been easier on him than traveling will be!
Oh my! I'm visualizing all this right now ... especially the double stroller! I wish I could help but have no experience travelling with kitties.
 
The stroller arrives on Tuesday. But it may or may not make the final cut for traveling. It turns out that they seem to prefer staying in their crates while driving instead of being out but tethered to the backseat anchors. I'm driving down alone, and it will be August, so if I need to stop to use the restroom, I can't leave them in the car. I thought that would be easier for getting them both to and from the bathroom with me rather than trying to carry both crates at the same time. But we'll see...it depends on how easily I can get them in and out of the stroller, and how much space it will take up in the car. It's a five hour drive, so I know I'm not going to make it the whole way without stopping at least a couple of times. If the stroller is more of a hassle I will just carry their crates in with me. That would be heavy and awkward, but whatever they like better will win.

I don't suppose I'll get any funnier looks carrying two cat cases than I would pushing cats in a stroller!
 
I'll trade you the five hour drive for about a 10 hour drive to/from airports and the plane ride itself! :p and if you get the stroller I demand pictures!

I can't even imagine trying to take a cat on an airplane. Poor Pita!!! I hope your vet gives you some good drugs to help keep him calm through that!
 
I can't even imagine trying to take a cat on an airplane. Poor Pita!!! I hope your vet gives you some good drugs to help keep him calm through that!
Yeah, that's gonna be a whole new thread pretty soon! I'm so nervous already. Two people, two cats :nailbiting::confused:
 
Yeah, that's gonna be a whole new thread pretty soon! I'm so nervous already. Two people, two cats :nailbiting::confused:

Rescue Remedy seems to help a little for Atty. Although I would think for a plane ride and all the noise and stress of the airport you might be better off getting something vet-strength. Will they ride with you guys, or do they have to go below?
 
Rescue Remedy seems to help a little for Atty. Although I would think for a plane ride and all the noise and stress of the airport you might be better off getting something vet-strength. Will they ride with you guys, or do they have to go below?
They ride with us, thank God! I've heard that once on the plane, most cats are fine, because it's quieter and they get the hum of the plane. But yes, it's the car and airport itself that will be tough. Sorry for hijacking your post now!
 
Oh I have no experience with this, but we do want pictures! And I'll be following anxiously to hear more about it. We're trying to figure out what we'll do when, eventually, we move. How will we move the cats with us??
 
They ride with us, thank God! I've heard that once on the plane, most cats are fine, because it's quieter and they get the hum of the plane. But yes, it's the car and airport itself that will be tough. Sorry for hijacking your post now!
My brother and his wife flew from Philadelphia to San Francisco with two kitties in tow. They were in the cabin with them and it all worked out fine.
 
Djamila, I've stacked two cat carriers on a folding dolly that I keep in my car - bungee cords to secure them. Would that work for you?
 
I thought about that, but was worried about the tippy angle of it when I lean the dolly back. I guess that's kind of a silly concern though now that I type it out. I mean, they're cats. They sleep on top of their own heads. I think they can handle a 90 second ride at a bit of an angle! o_O:smuggrin:
 
I thought about that, but was worried about the tippy angle of it when I lean the dolly back. I guess that's kind of a silly concern though now that I type it out. I mean, they're cats. They sleep on top of their own heads. I think they can handle a 90 second ride at a bit of an angle! o_O:smuggrin:
Mine have had to endure the tippy angle when being rolled out to the car but it didn't seem to bother them. It's quick and easy for the bean too if you had to wheel them into a washroom at a rest stop.
 
Looks like he needs a couple of teeth extracted and probably starting on metro-- for the tummy issues. He's back getting the blood draw now.

$$$ Dentals are so dang expensive $$$

Hopefully that will help with the BG numbers though.
 
Looks like he needs a couple of teeth extracted and probably starting on metro-- for the tummy issues. He's back getting the blood draw now.

$$$ Dentals are so dang expensive $$$

Hopefully that will help with the BG numbers though.
Dentals everywhere right now. Teasel's sister has hers tomorrow and I'm stressing about it. Trying to not let on to her though ... ;) I have to deliver her to the vet clinic by 7:30 AM. :confused: Teasel's insulin might be a tad late tomorrow morning.
 
Okay, it's a couple of days early to call in Month 6, but close enough...

I'm wondering if y'all could take a peek at Sam's spreadsheet and share your thoughts. Looking at yesterday's AM cycle (no insulin) and today's AM cycle (with insulin)....and also comparing 7/2 and 7/3 AM cycles, it doesn't look like the insulin is doing much of anything these days. It is way way way past its life at this point, so it seems reasonable that it's weaker than it should be. (although he did hit a high lime green on 6/23 PM, so it's not totally dead).

But given that he's hitting pretty much the same mid-cycle numbers regardless of whether he gets a shot, I'm wondering what I should do.

Here are the questions I've been pondering:
1. Is there any reason to consider trying the Lantus? I'm leaning toward no since he's getting so many NS days and Lantus isn't an in and out insulin. My limited understanding of lantus is that he would need to get a shot regularly, and that seems risky/unlikely at these numbers.

2. Should I buy a new vial of Prozinc? It's expensive to do that for an occasional shot, but if he needs it...?

3. Should I stop giving insulin and see what happens? If his numbers rise enough I could then start the Lantus, but am I risking damage to his pancreas if I do this? At what point would we say he's risen enough to try it? 120's? 130's? Higher?

I've been waiting for his numbers to be closer to the 50-80 range, but I know some vets, and some people on here, declare their cats OTJ at higher numbers. During the year Sam was on his honeymoon, he would occasionally give a number in the 90's, but did usually stay under 90, and only went over 100 one time (and it was just a couple of weeks before he got his second diagnosis, so that was clearly not a good thing).

Thanks for your help everyone! We are all kind of guessing here, but it helps to guess together!:bighug:
Your SS looks so pretty :) :)
 
Looks like he needs a couple of teeth extracted and probably starting on metro-- for the tummy issues. He's back getting the blood draw now.

$$$ Dentals are so dang expensive $$$

Hopefully that will help with the BG numbers though.
What are these dentals that I keep reading about.
 
What are these dentals that I keep reading about.
We're referring to a procedure that's like our checkup/cleaning, etc. The kitty has to be anesthetized and there are often X-rays done to look for decay and abscesses. Tartar is scraped off the teeth above and below the gum line and extractions are done if indicated by the X-rays. It's $$$$ but dental issues can have a significant effect on BG in FD kitties. They can even knock a kitty out of remission.
 
Pita actually has a tooth that the new vet suggested be extracted but said it could wait til we moved. Ugh :banghead: and yes, so, so expensive.
 
Pita actually has a tooth that the new vet suggested be extracted but said it could wait til we moved. Ugh :banghead: and yes, so, so expensive.
haha Maury too! He's already resorbed 1 pre-molar and 1 incisor :confused:. Vet would like to get x-ray to see if anything is left under the gumline but said it can wait a month or two if he's not showing any signs of the most recent one being painful.
 
Dentals everywhere right now. Teasel's sister has hers tomorrow and I'm stressing about it. Trying to not let on to her though ... ;) I have to deliver her to the vet clinic by 7:30 AM. :confused: Teasel's insulin might be a tad late tomorrow morning.


I cry when I have to leave one of them at the vet for a dental. I wish it was more like people where you can at least stay with them until the procedure, and sit with them while they wake up. It kills me that they are alone and scared. Fingers crossed that Teasel's sister has a quick easy cleaning with no extra stuff needed!
 
I cry when I have to leave one of them at the vet for a dental. I wish it was more like people where you can at least stay with them until the procedure, and sit with them while they wake up. It kills me that they are alone and scared. Fingers crossed that Teasel's sister has a quick easy cleaning with no extra stuff needed!
I hear you! I've been avoiding thinking about it as much as possible. She's so frightened going to and being at the vet clinic, the poor little thing. :(
 
haha Maury too! He's already resorbed 1 pre-molar and 1 incisor :confused:. Vet would like to get x-ray to see if anything is left under the gumline but said it can wait a month or two if he's not showing any signs of the most recent one being painful.

That's what's going on with Sam too. He has two teeth that have/are/whatever resorbed...or resorbtion...or whatever it's called. I'll be :bookworm: tonight to learn more about this.

Vet said that the teeth can't be why his numbers are rising (oh, vets...). Although it could certainly just be the tummy issues too. I have to run but will post lots of questions for you all about this later!

PS Sam roared so loud from the back room of the clinic that a dog started howling. :woot:
 
Okay, so dental resorption is icky. Too many pictures on the internet you don't want to see. Thankfully Sam's is not that bad, but we'll still get those teeth removed as soon as we can. Vet said to wait for his tummy to settle down, and we are leaving for that road trip in a week so he wants us to wait until we get back so he has more time to recover at home without the stress of being tossed in the car soon after the surgery. He also said that the teeth have been like that for several months and it's a slow progression, so waiting two weeks is fine.

I wish we could take care of it right now, but I do understand that putting him under anesthesia when he already isn't feeling great isn't a good idea.

What do you all think about giving him metronidazole? He's had it before, and I know people on here use it, but I'm wondering if it's necessary? He hasn't had diarrhea in 24 hours, and the SEB seems to have settled his tummy down, so should I give it?

Lab work should be back today for the blood work and that UTI test ($$) that we ran again just to be safe. Because why not spend as much money as possible? ;)

Atticus has his annual appointment today at 2pm, and he's going to need a dental cleaning as well, so this is going to be an expensive month around here!

Sam hit his first yellow number in months this morning. Looks like his flirtation with remission is officially over and we're back at the dance. Oh, our fragile little sugar babies!
 
I'm a research junkie but there are times it's best not to go rooting around on the internet. o_O Good idea to wait on Sam's dental. Maybe wait a day or two to see if the SEB does the work before trying the metro?

Ah, yes! The money we spend on our animals ... good care costs $$$$. Teasel's sister is at the vet clinic right now awaiting her procedure. I hope that it's a fairly straightforward thing but who knows? My critters tend to be complicated. :(
 
What is Teasel's sister's name? Does your vet keep her until later this afternoon? Or do you get to pick her up as soon as she's finished? My vet always makes us wait until closing so they can make sure they are hydrated and eating before releasing them. Although one time they let me pick Sam up early because he was being soooo loud that they decided he would have a better recovery at home. :D
 
What is Teasel's sister's name? Does your vet keep her until later this afternoon? Or do you get to pick her up as soon as she's finished? My vet always makes us wait until closing so they can make sure they are hydrated and eating before releasing them. Although one time they let me pick Sam up early because he was being soooo loud that they decided he would have a better recovery at home. :D

Her name is Meadow. As I commented on my LL thread, my vet called to say a heart murmur was detected. This hasn't been detected before and she was there only a week and a half ago for her annual checkup. Mind you, I know they can be hard to hear especially when kitty is purring from anxiety. Teasel has a murmur that can be heard sometimes and sometimes not.

My vet recommended an echocardiogram be done to assess before going ahead with anesthesia for a dental. I agreed. There's no sedation involved and I can pick her up once it's done. Not sure when today because they have to fit that procedure in. The data is sent out to be read and the result should be in tomorrow. That will determine what dental, if any, is safe for her.

Needless to say this is stressful but I know that I'll feel calmer about it all once the physiologic responses quiet down ...
;) Ever the scientist!
 
Oh, Meadow! It really is always something with our kitties, isn't it? Hopefully it's not anything serious. I love her name, by the way! That's so pretty!
 
Okay, so Sam was crying again so I started the Metronizadole. Sometimes I am too impatient to wait for answers to my own questions. Sigh.

He took his first pill like a champ. Well, first he bit, hissed and ran away. But then I explained to him that he needed to take it, and the second attempt was a win on the first try! ;)

Can you say that? The 47th attempt worked on the first try! (haha)
 
Okay, so Sam was crying again so I started the Metronizadole. Sometimes I am too impatient to wait for answers to my own questions. Sigh.

He took his first pill like a champ. Well, first he bit, hissed and ran away. But then I explained to him that he needed to take it, and the second attempt was a win on the first try! ;)

Can you say that? The 47th attempt worked on the first try! (haha)
What a character! I hope his tummy settles. :)
Oh, Meadow! It really is always something with our kitties, isn't it? Hopefully it's not anything serious. I love her name, by the way! That's so pretty!
It suits her - she's a pretty little cat. My three are litter mates that came home with me from the stable where I bought my horse 7 years ago. The place is called Teaselwood Stables, hence the names Teasel and Woody for the two boys. I stuck with the pastoral theme and named their sister Meadow. Three wonderful kitties! :smuggrin:
 
It's dental day! :nailbiting:

My kitties have been fasting since 10pm last night. They usually eat breakfast at 4am, and it's now 7:15. It would be fair to say that they are hungry, confused, and unhappy. I've heard vocalizations this morning that I have never heard before.

I skipped breakfast too since it seemed a little cruel to sit here and eat in front of them, but refuse to give them any. Thankfully, only about 30 minutes left before I can crate him and head out the door. Of course, then I have to abandon him at the vet, so that isn't really going to make things better. Sigh. Poor little guy. Plus, he's going to wake up to mysteriously missing teeth. This has to be so scary and strange for them!

Someone who has had a kitty with teeth extractions, pretty please reassure me that he's going to adjust to the missing teeth and be okay? :(
 
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