11/01 Butters AMPS 364/+3 353/+8 261/PMPS 284/+3 302/

Butters & Lyla

Butters & Lyla

Member Since 2020
Yesterday Butters was high and flat. She had two numbers in the mid-200s, which is what I get excited about these days. But she never got lower. Today is shaping up to be more of the same.

This morning is cycle 7 of 1.375u of insulin, and I'm thinking it is time for an increase soon, up .25u to 1.625, like tomorrow morning. The last time I saw a green and blue number was on cycle 1 of this dose. It looks to me like she is just high and flat I think I have quite a bit of wiggle room to increase and still have a buffer for her.

I have held her meds steady and she seems to be doing about the same in terms of the pancreatitis and recovery, from what I can tell.

How aggressive should I be with increases right now and does it make sense to increase tomorrow morning?

Thanks so much:bighug:

Have a good day, all.
 
Good morning, Lyla. I don't know how pancreatitis and diabetes work together. Hopefully I never have to officially find out. It looks like you held previous increases for the same amount of time. There does seem to be enough of a buffer. I don't have any official advice to give, not experienced enough for that.
Do you think maybe these two issues will help work each other out? Getting blood glucose under control will help the pancreas not have to work hard, which will in turn help ease the pancreatitis? Going full circle, easing pancreatitis will help get BG under control? Like I said, I don't know much about them together, but in my inexperienced mind, it makes sense. Just thinking out loud.
I do hope Butters continues improving and isn't in pain. Hope you have a good day :bighug:
 
Morning Lyla, as you know I can't give dosing advice, but whatever you do I wish
Butter's all the best. I happy to hear she's still feeling ok.
Have a nice day Lyla and scritches for Butters :bighug::bighug::cat:
 
Good morning Lyla. I can’t open your ss for some reason. I would increase tomorrow morning though based upon what you just wrote. It just worked. I’m actually thinking I would go with a full .25 increase. Once she’s back in Lyla for the smaller increases would make sense again. What do you think?
 
I think you are fine increasing tomorrow morning. That should be more than 6 cycles after the last greens and enough time for her to clear any bounce. The longer you keep her in higher numbers, the worse the glucose toxicity.

FWIW - with diabetes/acromegaly side effects, kidney disease, heart disease, small cell lymphoma, a side helping of pancreatitis, and multiple meds on the go, I never left "wiggle room" or a "buffer". I just followed the numbers as per the protocol with the one exception that for Neko, her idea dose kept her below renal threshold as much as possible. My goal was not earning reductions. Actually everyone's goal should be regulation first.
 
tiffmaxee said:
Good morning Lyla. I can’t open your ss for some reason. I would increase tomorrow morning though based upon what you just wrote. It just worked. I’m actually thinking I would go with a full .25 increase. Once she’s back in Lyla for the smaller increases would make sense again. What do you think?
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I agree with a full increase tomorrow morning and continuing full increases until (or if) she gets regulated again. Thanks:bighug:
 
Wendy&Neko said:
I think you are fine increasing tomorrow morning. That should be more than 6 cycles after the last greens and enough time for her to clear any bounce. The longer you keep her in higher numbers, the worse the glucose toxicity.

FWIW - with diabetes/acromegaly side effects, kidney disease, heart disease, small cell lymphoma, a side helping of pancreatitis, and multiple meds on the go, I never left "wiggle room" or a "buffer". I just followed the numbers as per the protocol with the one exception that for Neko, her idea dose kept her below renal threshold as much as possible. My goal was not earning reductions. Actually everyone's goal should be regulation first.
Click to expand...

:eek: I can't imagine. I feel like I'm constantly doling out meds/meals/insulin/BG tests/ with just the FD and pancreatitis right now.
When I say "buffer", I want a buffer from hovering over her and testing constantly day and night while she stays in low greens (earning reductions?). I hadn't thought of earning reductions as a goal; it just kind of seemed to happen there for a short while. This was my only hands-on experience with regulation, and I'm not anxious to go back to that kind of regulation. I think we talked about "well-regulated". My goal is "well-regulated", or even below renal threshold. Not sure if those two are the same thing.

Glucose toxicity continues to be top of mind for me. Definitely increasing tomorrow morning. Thanks:bighug:
 
Cheryl & Jazzy said:
Good morning, Lyla. I don't know how pancreatitis and diabetes work together. Hopefully I never have to officially find out. It looks like you held previous increases for the same amount of time. There does seem to be enough of a buffer. I don't have any official advice to give, not experienced enough for that.
Do you think maybe these two issues will help work each other out? Getting blood glucose under control will help the pancreas not have to work hard, which will in turn help ease the pancreatitis? Going full circle, easing pancreatitis will help get BG under control? Like I said, I don't know much about them together, but in my inexperienced mind, it makes sense. Just thinking out loud.
I do hope Butters continues improving and isn't in pain. Hope you have a good day :bighug:
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This is my first experience with pancreatitis. What I understand from the experienced ppl is that the pancreatitis can impact the BG numbers. So one thing you need to watch out for is dropping numbers as the inflammation recedes. It also wouldn't be a good idea to keep Butters in higher numbers. If I did manage to push her numbers lower with aggressive increases I'm not sure whether that would help the inflammation subside or not, though.
That's one of the many good things about this board; we all get to think aloud and muse on one another's condos.:D :bighug:
 
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Sam&Milo&Singha said:
I hope Butters slides down for you. It makes sense that this pancreatitis has knocked her for a loop and she'll take a while to get back on track. How's she seeming otherwise?
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It sure is taking a long time! I need patience pants. I know ECID but it's pretty amazing that Milo stayed pretty on track throughout his pancreatitis. The hospital messed with Butters' insulin, which I'm sure didn't help matters. There were many days where they didn't give her any at all. :banghead:

She is doing okay. I'm trying to interpret her behaviour to determine whether she is improving or not. I hope Milo and Singha are doing well!
 
I agree with Wendy. My goal with Ollie who was acro, chronic p'titis, hcm, murmur, abdominal mass, high blood pressure at the end, was to keep her under renal threshold which for Ollie was glucose under 223. Even more important was that she was comfortable and acro symptoms were diminished. She had short periods of staying blue and that's when she felt her best. It isn't easy and at times be grueling for parent, you do the best you can. At times you want to give up (I know I had many), you sit and cry because you don't think anything is helping. Then one day, your kitty is back (for me Ollie went running through the house), had a few days of playing with shoelace and flipping toys in the air. I'm like YES. It's all worth it. Even if it only a few days. Hang in there, your doing great. When you need to vent, we are here.
 
Hi Butters and Lyla :bighug: Hope you all have had a wonderful weekend. Hang in there :bighug: You are doing great and giving Butters so much love and support :cat: and, really, that's always what is most important - more than any medicine :bighug::bighug::bighug:
 
Olive & Paula said:
I agree with Wendy. My goal with Ollie who was acro, chronic p'titis, hcm, murmur, abdominal mass, high blood pressure at the end, was to keep her under renal threshold which for Ollie was glucose under 223. Even more important was that she was comfortable and acro symptoms were diminished. She had short periods of staying blue and that's when she felt her best. It isn't easy and at times be grueling for parent, you do the best you can. At times you want to give up (I know I had many), you sit and cry because you don't think anything is helping. Then one day, your kitty is back (for me Ollie went running through the house), had a few days of playing with shoelace and flipping toys in the air. I'm like YES. It's all worth it. Even if it only a few days. Hang in there, your doing great. When you need to vent, we are here.
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That's a wonderful, loving goal. :bighug:
Thank you for this. I recognize my having to manage some pancreatitis and FD in a non-acro cat isn't nearly as challenging. But I do feel very up and down right now.I know I have to sit tight with her BG numbers, increase, and wait out the bounces/high numbers. It's hard knowing that the high numbers make her feel like crap and I can't do anything to help her. I don't know how much of her not feeling good right now is because of pancreatitis symptoms/recovery from hospital stay and how much is because of high BG numbers. I hope I see some of her old playfulness return at some point. :)
 
Hi.

When is your next follow up with the vet? Forgive me if you mentioned it and I have forgotten :banghead:but has there been any discussion about changing Butters pain medication? That would be my first thought given that you needed to increase it but then the side effects were an issue. The fact that you had to increase it within the past few days, decreased it and then she stayed on the bed for 75% of the time, along with the higher BGs....all pretty good indicators of continued pain/discomfort—even if lower level. My personal opinion/focus would be to get that managed. The BG is definitely high enough to go ahead and increase the insulin (I would go with increase and decreases .25 at a time), but then if you are able to get an alternative medication for pain and start it, just watch for any decreases in BG in case you need to adjust the insulin again.
 
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Good morning,
Butters had her follow up with the IM on 10/20. She said that she wouldn't see her again unless there was another crisis, basically, and to follow up with her primary care vet in a month to re-run labs and address anything else that Butters requires at that time.
I don't have a primary care vet for Butters. However, this morning I was able to book a video interview with Dr. Folosea (from the 2nd vet clinic you mentioned) on 11/19 and a placeholder appointment for her on 11/25. So that will be her next follow up with a vet. I agree that I need to get her pain managed as a number one priority. I'm trying. I've reached out to the IM to see if she will prescribe something else. I've tried the bupe. I'm thinking of trying 25mg gabapentin q6.
 
Do you know what the concentration of the Bupe was and what was the dose? Again, just trying to rule out if it was the concentration &/or dosing which may have resulted in it not working well for Butters.
 
The Bupe is 0.4mg/ml and dosed in prefilled syringes: 0.2ml per dose. The original instruction from that ER (the first one, prior to getting gabapentin from the second ER/IM vet) was to give it q8.
 
It wasn't near enough for her when I brought her home from that first ER where it was prescribed. She was visibly in pain for the rest of the weekend, before I took her to the other hospital. I will never go back to that first hospital.

Hopefully the IM will get back to me and be willing to give something more appropriate. The gabapentin dose she prescribed is giving Butters side effects.
 
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