? Dosing advice-increase, decrease? Billy Gray Lee 3/27/2019

[Iris Deary]

Oh, and I've read the term bouncing but did not know what it meant. Like rodent ulcers.. Sorry I'm late for second shift.

 

[Deb & Wink]

Thank you for talking to me.

Any time Iris. Keep asking questions.

Chronic pain can keep me up at night too, or wake me up and can't get back to sleep.

Here is a good explanation of Bouncing. For future reference.
"Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles)."

 

[Iris Deary]

Wellll. I understand the bouncing but this morning Lee's AMPS was 352, I gave him 7 U100 units. He would not eat much of his food and 3 1/2 hours later after I got back in he started screaming at me and banging on the door, which he does when he wants something. I thought well the food may not have been okay so I opened him a Friskies tuna and he ate some. I checked his BG and it was 342!! He had nothing else to eat. I always make sure to have him eating his food when I shoot him because he is still. And I am careful to make sure it's injected cause he moved one time and I about got the insulin. He has moved before and I missed or bent needle but generally he is very, very good. He does not care what you do to him as long as he gets fed. So, I'm wondering what is going on. Hw seems fine otherwise. His mouth looks better.His lip has reduced in swelling. He was eating the Friskies so I'll wait a while and recheck. He did not drink much water.

 

[Deb & Wink]

I'm not sure what is going on either Iris.

 

[Iris Deary]

Rodent ulcers is a term for lesions on the lips. The correct term is "eosinophilic plaques."

"The most common site for these lesions is on the lips, especially the upper lip, where they appear as ulcers. They are sometimes referred to as 'rodent ulcers' although this term is technically incorrect. ... These lesions are often called eosinophilic plaques."

From your description of the lesions on Lee's lips, I thought that could be the problem.
This link describes the diagnosis and treatment options:
https://vcahospitals.com/know-your-pet/feline-eosinophilic-granuloma-complex-in-cats

If the sores and ulcers on Lee's lips have still not cleared up, he should have another visit to the vet, so the vet can look and see what is going on.
1. When was the last round of antibiotics?
2. When did you start those antibiotics and when did you stop?
3. Were there any signs that the ulcers were getting better?

I was on my phone trying to read replies and I either missed this or it just showed up this morning. Yes, Lee's "ulcer" is on his upper lip and I always thought it came from his "tusks" always rubbing it. It is the exact shape. I read the information and it sounds exactly like his problem, except for the red streaks on his upper hard palate. That is why the current vet said he thought he had feline aids, but tests were negative. He had me isolate him and that is not fair to him. Or me. That makes another room that I can't use anymore like my garage bay. Lol. And I loved my little porch in the summer.
1. He was on Clavamox in December and end of January and now. I don't think he ever treated him long enough or with right antibiotics.
2. I started last round of Clavamox(generic) on 2/20/20, still giving.
3. Yes ulcers are very much better, white now and swelling went way down.

I will have to make appointment with vet in Wise, VA, I guess. He is very expensive but has a dental suite now.
I was getting help with the Prozinc from DCIN but it suddenly seems to have stopped so I will have to go back to the Wal-mart brand, Novalin, I think it was. Its about and hour to the vet's office and he charged $133 a bottle last time. I got one order from WalmartRX for about $100 but I have not heard anything about reimbursement so I have to adjust something. I have enough to do for a good while now.

Good idea?? It would be so nice to not have something awful wrong with him!

 

[Deb & Wink]

Novolin is a totally different kind of insulin than Prozinc.

The Novolin is not a generic form of Prozinc, but a completely different kind of insulin.
The Novolin N is what is know as a NPH type of insulin.

Very different action in a cat. Very different duration. How to feed and when to test are very different.

Tagging @Chris & China (GA) She is one of the volunteers at DCIN and may be able to help you get some Prozinc insulin.

Iris, how much of the Prozinc insulin do you have left right now? How full is the vial you have?
If you can get your vet to write a prescription, I know that Chewy.com has the Prozinc insulin for about $106 a vial. They would ship it directly to your door. But your vet needs to write the prescription for that insulin.

 

[Iris Deary]

Thank you. I'm sorry I had to leave in a hurry and go to hospital yesterday 1 1/2 hours away. "Husband" was moved to ICU and I'm trying to help. I could not do otherwise, I find. His 02 is 75% without oxygen and 89-90 with 6L. Not good. I did not get back until really late.
I had to hurriedly try to find someone to check Lee at 9 and feed cats and horse and put up. Cats were okay but person checking Lee could not work meter even though she did last Spring. She is 74 and could not remember. Lee did not get checked and get his shot until 11PM at least. His BG was 495.. But he is so tolerant it is scary. And he was stressed. He had a lower BG yesterday before I left and I lowered him to 6.5units. Even thought that BG was awful high. He was 232 or close a few minutes ago. The vet would have said up insulin a lot.
I had already been getting prozinc from DCIN but I figured that has stopped. I go no reply(I have not checked today). I had a chance for a reduced rate at WalMart RX for first order and I grabbed it. $96. But that was a one time thing. The vets is $133. Walmart's would include another $25 for refrigerated shipping normally. I will look at chewy. Vet had ordered me one, too and I felt obligated and went ahead and got it thinking I'd be reimbursed. So I have a full bottle and half another one. I'm good for a while.
Right now I am trying to figure who can test him properly.

 

[Deb & Wink]

Going to check on your husband in the ICU was absolutely what we would have expected you to do Iris. Don't think anyone would have been able to do otherwise.

No apologies needed Iris. We all have sudden events that crop up in life and need to prioritize what we do each day.

Been away myself for quite some time today, taking care of some much needed errands.

p.s. Chewy has no additional shipping fee. It's covered under their $49 free shipping guarantee.

 

[Deb & Wink]

How are you Iris?

 

[Iris Deary]

HI.
Very tired. Pulled in a dozen different directions. I just sat down to try and order cat food. Is there nothing else in the world???? LOL
Husband is still in hospital but moved to rehab but still on 6L oxygen. I'm scared they will want him to go home with a family member. And I can't lift him or deal with him, I don't think, and his son works two jobs. Sooooo. Now market dropped so that my retirement with UMWA is about half and I won't be able to take more out. I told advisor that I needed enough for my final expenses at least. !! He's too young to know. So the little bit I had left should not be drawn on. That was my horse feed, hay, farrier charges, vet charges and cats food for 7 cats PLUS Lee's insulin, vet charges, strips, food... money....
So I am trusting the Lord that He will work things out. I cut TV off and have only internet because my phone is tied to it. Otherwise I am dealing and now on a big diet.....LOL! Cats including Lee just went on a diet, too. I cut Lee down to three cans a day. Others prefer dry a lot. That helps. But still I give them some wet every day.
On a new note, I did get Lee into the new vet at Wise. She wants me to do pet meter so their testing will jive with their's. She also wants Lee to go on Science diet DRY food M/D because of the omega 3's. She says to try for a while and see if mouth ulcers clear up and hence diabetes can come under control thus saving me money on both...... I am skeptical of everything now a days. I have been having some success lately with reduced food it seems. ???????? His BG is up in morning and at night. ????????? I reduced dose to 6 U-100 units. That totally confused that vet. She kind of treated me like I was dumb and every time I tried to explain she talked over me. I just waited. I explained costs and lack of funds and she asked me to try this. I still had some M/D canned food from last year so I am giving him that until SS check next week.
Boy it's hard getting old. If my husband would have taken care of his own horse I'd be better. LOL.
So.........how are you? and What are your thoughts????????

 

[Deb & Wink]

My thoughts?

Lee looks ok on that 6U dose. It does look like he is bouncing right now. Give it a day to settle down.

I'm scared they will want him to go home with a family member. And I can't lift him or deal with him, I don't think, and his son works two jobs.

If you can't physically lift your husband, you can't bring him home and take care of him. No matter what the VA hospital wants you to do. Someone younger and more physically able needs to take care of him, like his son. Cold, hard fact. 2 jobs or not. Time for his son to step up to the plate.

She wants me to do pet meter so their testing will jive with their's.

Tell her that the test strips for the pet meter are $1 each. Tell her that you test at home. Tell her you test multiple times a day. Tell her you will continue to use the human meter and test strips you can afford and she can learn to deal with it, like vets had to do before pet specific meters existed. Tell her you can't afford to bring Lee into the vet for them to do a curve test because it's too expensive. Tell her you can do a curve test yourself at home for about $2.

You can't afford to do what this new vet wants you to do. You've already cut expenses to the bone. I think you're between a rock and a hard place, with not many options.

I reduced dose to 6 U-100 units. That totally confused that vet. She kind of treated me like I was dumb and every time I tried to explain she talked over me.

Tell her to divide the dose by 2.5. That is a simple arithmetic problem. U40 * 2.5 = amount of insulin drawn up in the U100 syringe.

As far as Lee goes, you have to do the best you can. Cat food shortages everywhere, and other supplies too. If you have a farm and feed store near you, that may be an option to find some cat food.

Ordering on-line is ok, but all the places are backed up in shipping things out. Amazon, Chewy, Target, Walmart, all the big on-line retailers are sold out or have major delays on most pet foods that people usually feed their pets. Third party retailers are price gouging, charging twice as much as you would normally pay. Expect it to take a week to 14 days or longer to get anything delivered. Some pet foods they won't have back in stock until the first week in April or later.

Boy it's hard getting old.

I hear you. Your body can't do what it was able to before, and your money runs out but the expenses keep on coming.

I'm ok. Not dealing with as much as you are.

 

[Iris Deary]

Okay, then. I will try to order to keep ahead. As the weather warms this "virus" stuff should see a dramatic decrease if my medical training was worth anything. And I did tell her the conversion info on syringes. I just hate that "you are doing what??"" look on a Vet's face. Doc Fuller had same and his new assistant. LOL I wanted to say, "you know, some people are smarter than they look and then again..."
I am going to try and check Lee's BG three times a day and set my phone to wake me about 3 in the morning for a test a couple of times. If I cant go back to sleep afterward Ill be in trouble. With the Epstein Barr, which I think is easing up(I pray), I would try to fall asleep sitting anywhere or driving or at the barn or garage. Not as bad now.
I guess someone to help clean is out too. Guess this old lady will be washing stuff down herself. Gotta figure that out. I can't stand on a ladder long. LOL Replaced knee locks and needing to be replaced knee buckles.
Thanks for listening, hearing and supporting. I don't get that much.
The thing about son is right. He has never had to help someone else. He lives close to me, has an extra room, and we could help each other. You made me really think. I was looking at what would be expected of me.........of course. Before husband was "removed" from my home I was going to a counselor. She said I felt I need to fix him and make life better for everyone. She made me read "Women who Love too Much". I'm remembering that now. Thanks.

 

[Lisa and little]

Hi Iris, I know this is hard on you especially now with all going on in the world. Im sure you want to do the best for everyone, the animals and your husband. But take a step back and think about where all the pressure you are feeling is actually coming from. Does everyone really expect you to handle all of this on your own or are You maybe putting these expectations on yourself? It sounds like you are and always have been a take charge strong woman and maybe you are expecting too much of yourself.?? It IS OK to ask for help. I learned that myself recently although it’s hard to implement. I understand feeling and being alone but you may be surprised that if you put your need for help out to the universe you may be surprised. Please do not put all that pressure on yourself and really think about having a conversation with your husbands son. Maybe he just thinks you’ve always done it and don’t need help. You have to let him know. Peace and love to you. Keep us posted

 

[Deb & Wink]

The thing about son is right. He has never had to help someone else. He lives close to me, has an extra room, and we could help each other. You made me really think. I was looking at what would be expected of me.........of course.

As women, I think we take on the role of caregiver and sometimes we simply are not able to do all that is expected of us or all that we want to do. As difficult as that is to realize, we still want to be that strong caregiver, supporting our families as much as we always have. Definitely agree with Lisa, that it's time to have a serious sitdown talk with the son.

Thanks for listening, hearing and supporting. I don't get that much.

Anytime Iris.

Replaced knee locks and needing to be replaced knee buckles.

No knee replacements yet, but I do have one knee that both locks and buckles sometimes. I do leg lifts every morning before I get out of bed. The exercises seem to help, especially with the locking up part. Need to do stretching exercises in the morning too, for my back and so I can reach down and get my socks on!

 

[Iris Deary]

Wow....we must be related...LOL
I've been pulling myself up hayloft steps(so I can hang onto rail)every morning and doing leg lifts. Trying to stay strong. Weight has crept on since Epstein Barr thing.