? Alex:3/6: AMPS 187, +2 127, +4 111, +5 119

Oh no. That is so horrible to hear. I am really sad that this is what they said. They didn’t have any help to offer? They didn’t suggest backing off on the dose of Lasix and adding in some Pimobendan? They had no ideas? How bad are his kidney numbers (BUN, Creatinine, urine specific gravity? Phosphorus?) You probably don’t want to talk about any of it right now and I understand. I will say that if it was caused by the Lasix after just a few days that this isn’t irreversible. I have known cats to improve once things are better managed and renal perfusion is restored (IV fluids or sub-q fluids at home) and other treatments including cardiac meds.

Since you like to research things. I am copying what a quick query to AI resulted in.

Yes—case reports and clinical experience indicate that kidney values (creatinine/BUN) that worsen after starting furosemide (Lasix) for congestive heart failure in cats can sometimes improve after reducing or stopping the drug, addressing dehydration, or optimizing cardiac management.

Key points and mechanisms:

  • Pre-renal azotemia: Diuretics can cause volume depletion, reducing renal perfusion and raising BUN/creatinine. This is often reversible with fluid resuscitation or reducing the diuretic dose.
  • Cardiorenal interactions: Heart failure itself can cause poor renal perfusion; improving cardiac output or relieving congestion may improve renal function even while on diuretics. Conversely, excessive diuresis can worsen renal function.
  • Dose dependency and reversibility: Worsening renal parameters after starting furosemide are frequently dose-dependent and may partially or fully reverse when the dose is lowered, frequency altered, or the drug discontinued—especially if the injury is functional (pre-renal) rather than intrinsic renal damage.
  • Concurrent causes: Other contributors (NSAIDs, dehydration, hypotension, nephrotoxins, acute kidney injury) affect reversibility; intrinsic chronic kidney disease may not fully recover.
  • Monitoring strategy: Frequent rechecks of BUN/creatinine, electrolytes, body weight, urine output, and hydration after any diuretic change are recommended. Consider adjusting diuretic dose, adding/resting with IV or SC fluids, and optimizing heart-failure therapy (ACE inhibitors, pimobendan where appropriate) under veterinary guidance.
Evidence overview (literature types):

  • Veterinary cardiology and nephrology texts discuss pre-renal azotemia from diuretics and reversible creatinine increases.
  • Case reports and clinical studies in dogs and cats document reversible azotemia with diuretic modification and fluid therapy.
  • Guidelines for managing feline congestive heart failure advise careful titration of diuretics with monitoring of renal values.
Practical, actionable steps (veterinary context):

  1. Contact your veterinarian promptly if creatinine/BUN rise after starting Lasix.
  2. Vet may assess hydration, blood pressure, electrolytes, urinalysis, and consider stopping/reducing furosemide or giving short-term fluids (SC/IV).
  3. Recheck renal values within 24–72 hours and again in 1–2 weeks after any change.
  4. Balance heart failure control versus renal function—small dose adjustments or alternate diuretic strategies may be used.
  5. If intrinsic kidney disease is present, prognosis for full recovery is lower; aim for stabilization and symptom control.
 
i’ll have the report within the next couple of hours, but I know his bun was over 150 and it was just 24 on February 3. She wants me to dial back the Lasix to just a half a pill a day instead of two pills a day.. I just still don’t have any answers about how to get him to eat on his own again and don’t know what to do here really very sad and just found out another dear friend just died suddenly today so it’s been a really crappy day
 
Suzanne & Darcy said:
Oh no. That is so horrible to hear. I am really sad that this is what they said. They didn’t have any help to offer? They didn’t suggest backing off on the dose of Lasix and adding in some Pimobendan? They had no ideas? How bad are his kidney numbers (BUN, Creatinine, urine specific gravity? Phosphorus?) You probably don’t want to talk about any of it right now and I understand. I will say that if it was caused by the Lasix after just a few days that this isn’t irreversible. I have known cats to improve once things are better managed and renal perfusion is restored (IV fluids or sub-q fluids at home) and other treatments including cardiac meds.

Since you like to research things. I am copying what a quick query to AI resulted in.

Yes—case reports and clinical experience indicate that kidney values (creatinine/BUN) that worsen after starting furosemide (Lasix) for congestive heart failure in cats can sometimes improve after reducing or stopping the drug, addressing dehydration, or optimizing cardiac management.

Key points and mechanisms:

  • Pre-renal azotemia: Diuretics can cause volume depletion, reducing renal perfusion and raising BUN/creatinine. This is often reversible with fluid resuscitation or reducing the diuretic dose.
  • Cardiorenal interactions: Heart failure itself can cause poor renal perfusion; improving cardiac output or relieving congestion may improve renal function even while on diuretics. Conversely, excessive diuresis can worsen renal function.
  • Dose dependency and reversibility: Worsening renal parameters after starting furosemide are frequently dose-dependent and may partially or fully reverse when the dose is lowered, frequency altered, or the drug discontinued—especially if the injury is functional (pre-renal) rather than intrinsic renal damage.
  • Concurrent causes: Other contributors (NSAIDs, dehydration, hypotension, nephrotoxins, acute kidney injury) affect reversibility; intrinsic chronic kidney disease may not fully recover.
  • Monitoring strategy: Frequent rechecks of BUN/creatinine, electrolytes, body weight, urine output, and hydration after any diuretic change are recommended. Consider adjusting diuretic dose, adding/resting with IV or SC fluids, and optimizing heart-failure therapy (ACE inhibitors, pimobendan where appropriate) under veterinary guidance.
Evidence overview (literature types):

  • Veterinary cardiology and nephrology texts discuss pre-renal azotemia from diuretics and reversible creatinine increases.
  • Case reports and clinical studies in dogs and cats document reversible azotemia with diuretic modification and fluid therapy.
  • Guidelines for managing feline congestive heart failure advise careful titration of diuretics with monitoring of renal values.
Practical, actionable steps (veterinary context):

  1. Contact your veterinarian promptly if creatinine/BUN rise after starting Lasix.
  2. Vet may assess hydration, blood pressure, electrolytes, urinalysis, and consider stopping/reducing furosemide or giving short-term fluids (SC/IV).
  3. Recheck renal values within 24–72 hours and again in 1–2 weeks after any change.
  4. Balance heart failure control versus renal function—small dose adjustments or alternate diuretic strategies may be used.
  5. If intrinsic kidney disease is present, prognosis for full recovery is lower; aim for stabilization and symptom control.
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This is the report from today..
 

Attachments

Suzanne & Darcy said:
Oh Maria, I am so very sorry about your friend too!
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Thank you! Shocking! She just lost her daughter last month.., And now she is gone. So sad.

On Alex, he is down to 374 tonight at 6:15pm.
We have to decide whether to stick with the 2.0 dose that we gave today or to move back down to 1.5… his morning dose was almost an hour and a half later because I had to go get the new insulin.
But his usual Nadir is usually +6 to +7…

Regarding some of the meds you mentioned the one that helps the heart muscle. They do not recommend right now and he is not in need of it. She said at this point as his heart is functioning fine right now, even though his heart rate is lower than normal. They do not want me to do anything right now, except to reduce the fluoride to 1/2 of a pill once a day. I have an appointment on Friday with the regular vet to recheck his kidney function levels and see if the reduction in furosemide is helping his kidneys or not.
We are trying everything we can… Went and got fresh chicken tonight and boiled it. He is still turning his nose to that, but our understanding is as his kidney function gets better. He will likely get more hungry again and hopefully we’ll eat on his own. I tried the FortiFlora as well and he only ate a tiny bit of it and then turned it away… I had it on top of the baby food ham.
This is just brutal.🥹🥹🥹🥹🥹
 
I am sorry I didn’t see this last night. With a pink PMPS, I would have recommended 2 units, but you might not have been ready to do that after the day you had. It’s nice to see him have somewhat of a normal cycle where he started going down into at least yellow. I would say if he has a pink AMPS then definitely go with 2 units. If he’s in yellow at AMPS, you could try 1.75 units or 1.5 units, but it depends upon if it’s a high yellow or a lower yellow. Let’s just pray that he doesn’t go into black again.

I hope you got some sleep last night after that last test.
 
Suzanne & Darcy said:
I am sorry I didn’t see this last night. With a pink PMPS, I would have recommended 2 units, but you might not have been ready to do that after the day you had. It’s nice to see him have somewhat of a normal cycle where he started going down into at least yellow. I would say if he has a pink AMPS then definitely go with 2 units. If he’s in yellow at AMPS, you could try 1.75 units or 1.5 units, but it depends upon if it’s a high yellow or a lower yellow. Let’s just pray that he doesn’t go into black again.

I hope you got some sleep last night after that last test.
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it’s 3:30 in the morning here and he just woke me up meowing for some water and is doing much better right now at 256. He seems more with it for sure. His ketones are .3. If he stays in these mid 200s I would stay with the 1.5 I think. The biggest concern is what is respiratory rate does today with the reduction of the furosemide. We aren’t sure if it will cause his heart to react again and get fluid around his heart. Such a delicate balance, I know his heart disease is a progressive thing and he’s not going to get better, but if I can get him back to close to what the quality of life was even, I would love to try to give him more time. I would not keep him in the state that he was yesterday in the days where he couldn’t walk and was dragging everywhere around the house and couldn’t even interact with anybody and hid. His quality of life is very important to all of us. I’m just praying that his heart Stays under control and that his respiratory rate stays normal right now it is around 24 to 28 and normal.
Praying for a good day… We are long overdue for one!!
 
alexMama said:
it’s 3:30 in the morning here and he just woke me up meowing for some water and is doing much better right now at 256. He seems more with it for sure. His ketones are .3. If he stays in these mid 200s I would stay with the 1.5 I think. The biggest concern is what is respiratory rate does today with the reduction of the furosemide. We aren’t sure if it will cause his heart to react again and get fluid around his heart. Such a delicate balance, I know his heart disease is a progressive thing and he’s not going to get better, but if I can get him back to close to what the quality of life was even, I would love to try to give him more time. I would not keep him in the state that he was yesterday in the days where he couldn’t walk and was dragging everywhere around the house and couldn’t even interact with anybody and hid. His quality of life is very important to all of us. I’m just praying that his heart Stays under control and that his respiratory rate stays normal right now it is around 24 to 28 and normal.
Praying for a good day… We are long overdue for one!!
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We really want Alex to be out of the yellow numbers as much of the time as possible because we want his BG below the kidney threshold. I would like to see him in at least blue BG numbers as much as possible. The renal threshold is the blood glucose level at which the kidneys begin to spill glucose into the urine (glucosuria.) This increases urinary water loss — and for a cat on Lasix, that adds to diuretic-induced fluid/electrolyte losses and increases the risk of dehydration, weakness, and worsening kidney perfusion (blood flow to the kidneys.)

The actual BG number at which this happens varies from cat to cat, but sick or azotemic cats (which Alex is due to his very high BUN) and those with tubular injury (e.g., from kidney disease or drugs) can have glucosuria at much lower blood glucose levels. We generally tell people it’s about 225-250, but it’s probably lower for Alex. You can buy the urine test strips to check if you can also get a BG test at about the same time.

Another thing that’s damaging to his kidneys is the high phosphorus. I noticed last night that his phosphorus level was much too high. Normally I would tell you to switch his food to a much lower phosphorus food, but right now he needs to eat and is being very picky — and he must eat. If he were my cat, I would order some Aluminum Hydroxide powder from Thriving Pets as soon as possible and start adding that into his food. Thriving Pets has the purest AlOH powder and my kidney cats eat it just fine without complaint. If they didn’t, I would put it into a capsule and give some with every meal because controlling phosphorus is so crucial. Alex’s phosphorus was over 10 I noticed on his bloodwork last night. That’s quite hard on his kidneys that have to filter it out of the bloodstream (and aren’t able to keep up right now due to the kidney damage.) I noticed this last night, but I didn’t want to dump anything else on you. At least have it rechecked on Friday (when you do hopefully full bloodwork.) You want the phosphorus to be optimally in the 4 to 4.5 range. Don’t let the vet try to sell you Epakitin or another calcium carbonate binder because it is a much weaker binder than Aluminum Hydroxide and will not be very effective with as phosphorus level as high as Alex’s is right now.

Have you ever seen the felinecrf.org website? It is an extremely comprehensive and well-documented website about all things kidney related and other diseases that can influence kidney health. I have, unfortunately, a lot of experience with managing chronic kidney disease and acute kidney injury.— and I currently have a precious cat who had an acute kidney injury due to medication to treat her severe lymphoplasmacytic rhinitis that was refractory to all other treatments (including radiation 🙁). She has improved from the initial injury, but seems to have stabilized now to the point where her kidneys are compromised, but her kidney values are not as bad as they were in the beginning. She’s doing great now — eating well and gaining weight— despite the numbers, so you can’t always tell by looking just at bloodwork. My IM vet specialist at University of Georgia said that, after an AKI, it can take up to 3 months for the kidneys to heal and establish their new baseline.

The only other thing about the phosphorus that I will mention now is that high phosphorus is well-known to cause hind leg weakness in cats — and it can happen very quickly as I saw in my own cat (my diabetic cat, Darcy.) I have been suspecting that this, combined with low potassium, was contributing to Alex’s weakness, and I believe I mentioned it before (and that is why I was so disappointed when they didn’t run bloodwork on Alex when he had the episode of rapid and labored breathing.) So that’s another reason to get the phosphorus under control. The control over the hind legs can begin to improve even before you get the phosphorus down to the optimal level.
 
he ate a tiki stick a little earlier around 6:30 AM and drank a good bit of water i’m just trying to get him to eat some more now. We’ve been doing around 8:30 AM shots based on his later shot when I had to get the new glucose but will be dialing it back to 7 AM in the next couple of days.

My biggest fear is him going down and crashing. we were able to get into the blues with a 1.5 dosage just a few days ago prior to the gigantic bounce into the blacks.
 
alexMama said:
he ate a tiki stick a little earlier around 6:30 AM and drank a good bit of water i’m just trying to get him to eat some more now. We’ve been doing around 8:30 AM shots based on his later shot when I had to get the new glucose but will be dialing it back to 7 AM in the next couple of days.

My biggest fear is him going down and crashing. we were able to get into the blues with a 1.5 dosage just a few days ago prior to the gigantic bounce into the blacks.
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True. But that day he started at 205 AMPS, which is almost a blue already.

However, if he’s only eating a few Tiki Sticks here and there it’s best to be cautious. However, I don’t know what his AMPS really was because it’s not on the spreadsheet so I can’t be too specific about anything.
 
alexMama said:
My biggest fear is him going down and crashing
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This is completely preventable. As long as you test and either he is eating at least a teaspoon of food at a time or you have Karo syrup or honey on hand you are in control of what happens during the cycle. I also think it’s highly unlikely, but I am just saying if he dropped low (which isn’t the same as a hypo which he’s never had before) you are in control with testing and interventions given BEFORE he dropped below 50.
 
for the first time, he just ate his regular fancy feast on his own, which I put tiki sticks treat on top of to get him to eat some. He finished one and a half tiki sticks and some of the fancy feast so he’s got more in him than he usually does in the morning. Drinking plenty of water on his own as well. This is the best day we’ve had in a good while. Ketones .4 and pre shot is 284.
My logic on the 1.5 is when looking at his spreadsheet, his body tends to freak out and his liver panics and floods him full of sugar The minute we get down in the blues… I feel like I need to train his body to get used to these lower numbers, even in the 200s before he’s down solidly in the blues and greens … Does that make sense? He’s just notoriously so bouncy and I fear if he drops too low too fast his body’s going do the same thing and overreact. The doctors caution on the low drops and swings to the high and the taxing nature of it on his heart. I’m compromising and doing 1.75.
 
Suzanne & Darcy said:
We really want Alex to be out of the yellow numbers as much of the time as possible because we want his BG below the kidney threshold. I would like to see him in at least blue BG numbers as much as possible. The renal threshold is the blood glucose level at which the kidneys begin to spill glucose into the urine (glucosuria.) This increases urinary water loss — and for a cat on Lasix, that adds to diuretic-induced fluid/electrolyte losses and increases the risk of dehydration, weakness, and worsening kidney perfusion (blood flow to the kidneys.)

The actual BG number at which this happens varies from cat to cat, but sick or azotemic cats (which Alex is due to his very high BUN) and those with tubular injury (e.g., from kidney disease or drugs) can have glucosuria at much lower blood glucose levels. We generally tell people it’s about 225-250, but it’s probably lower for Alex. You can buy the urine test strips to check if you can also get a BG test at about the same time.

Another thing that’s damaging to his kidneys is the high phosphorus. I noticed last night that his phosphorus level was much too high. Normally I would tell you to switch his food to a much lower phosphorus food, but right now he needs to eat and is being very picky — and he must eat. If he were my cat, I would order some Aluminum Hydroxide powder from Thriving Pets as soon as possible and start adding that into his food. Thriving Pets has the purest AlOH powder and my kidney cats eat it just fine without complaint. If they didn’t, I would put it into a capsule and give some with every meal because controlling phosphorus is so crucial. Alex’s phosphorus was over 10 I noticed on his bloodwork last night. That’s quite hard on his kidneys that have to filter it out of the bloodstream (and aren’t able to keep up right now due to the kidney damage.) I noticed this last night, but I didn’t want to dump anything else on you. At least have it rechecked on Friday (when you do hopefully full bloodwork.) You want the phosphorus to be optimally in the 4 to 4.5 range. Don’t let the vet try to sell you Epakitin or another calcium carbonate binder because it is a much weaker binder than Aluminum Hydroxide and will not be very effective with as phosphorus level as high as Alex’s is right now.

Have you ever seen the felinecrf.org website? It is an extremely comprehensive and well-documented website about all things kidney related and other diseases that can influence kidney health. I have, unfortunately, a lot of experience with managing chronic kidney disease and acute kidney injury.— and I currently have a precious cat who had an acute kidney injury due to medication to treat her severe lymphoplasmacytic rhinitis that was refractory to all other treatments (including radiation 🙁). She has improved from the initial injury, but seems to have stabilized now to the point where her kidneys are compromised, but her kidney values are not as bad as they were in the beginning. She’s doing great now — eating well and gaining weight— despite the numbers, so you can’t always tell by looking just at bloodwork. My IM vet specialist at University of Georgia said that, after an AKI, it can take up to 3 months for the kidneys to heal and establish their new baseline.

The only other thing about the phosphorus that I will mention now is that high phosphorus is well-known to cause hind leg weakness in cats — and it can happen very quickly as I saw in my own cat (my diabetic cat, Darcy.) I have been suspecting that this, combined with low potassium, was contributing to Alex’s weakness, and I believe I mentioned it before (and that is why I was so disappointed when they didn’t run bloodwork on Alex when he had the episode of rapid and labored breathing.) So that’s another reason to get the phosphorus under control. The control over the hind legs can begin to improve even before you get the phosphorus down to the optimal level.
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OK, several questions here… You mentioned some urine strips to test… Can you be specific about which ones you’re talking about? What am I testing?

Regarding the phosphorus… Is it the fancy feast that is high in phosphorus or is it the tiki treats and the churu’s? Or both? Can you recommend a low phosphorus food?

Is there any danger with the ALOH for heart ? I will run this by his cardiologist as well.
All good information to have and I so appreciate all of the detail.

Alex is resting now after having some good stretches of sleep and eating and drinking and going to the bathroom.
 
alexMama said:
Regarding the phosphorus… Is it the fancy feast that is high in phosphorus or is it the tiki treats and the churu’s? Or both? Can you recommend a low phosphorus food?
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The Fancy Feast is high in phosphorus, but that's why you want to use a phosphorus binder like the ALOH....yes there are lower phosphorus foods (Weruva has a lot of them in different flavors and textures) but right now it's more important that he eats, no matter what it is. If you have a Petsmart/Petco, other pet food supply store, you should be able to buy individual pouches/cans of Weruva and see if you can find some that he likes. Weruva is also one of the few companies that puts the nutritional breakdown for every one of their foods on their website. You want foods under 200mg of phosphorus (lower is better). Here's their Nutritional Information
 
alexMama said:
OK, several questions here… You mentioned some urine strips to test… Can you be specific about which ones you’re talking about? What am I testing?

Regarding the phosphorus… Is it the fancy feast that is high in phosphorus or is it the tiki treats and the churu’s? Or both? Can you recommend a low phosphorus food?

Is there any danger with the ALOH for heart ? I will run this by his cardiologist as well.
All good information to have and I so appreciate all of the detail.

Alex is resting now after having some good stretches of sleep and eating and drinking and going to the bathroom.
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Here is a list of foods appropriate for cats with diabetes and kidney disease. You want to pick the lowest phosphorus he will eat.
https://www.bizave.com/foodlists/CKD Diabetes Food List.pdf
 
Chris & China (GA) said:
The Fancy Feast is high in phosphorus, but that's why you want to use a phosphorus binder like the ALOH....yes there are lower phosphorus foods (Weruva has a lot of them in different flavors and textures) but right now it's more important that he eats, no matter what it is. If you have a Petsmart/Petco, other pet food supply store, you should be able to buy individual pouches/cans of Weruva and see if you can find some that he likes. Weruva is also one of the few companies that puts the nutritional breakdown for every one of their foods on their website. You want foods under 200mg of phosphorus (lower is better). Here's their Nutritional Information
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Yes. I buy Weruva from PetsMart.
 
alexMama said:
You mentioned some urine strips to test… Can you be specific about which ones you’re talking about? What am I testing?
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Like these. They test for glucose in the urine.

1772577129386.png
 
I found the Weruva chicken breast dinner packets at my local co-op and just grabbed seven of those so hopefully he likes those… Most of what they had was all tuna based, but I did find that one that was on the list.
 
Chris & China (GA) said:
The Fancy Feast is high in phosphorus, but that's why you want to use a phosphorus binder like the ALOH....yes there are lower phosphorus foods (Weruva has a lot of them in different flavors and textures) but right now it's more important that he eats, no matter what it is. If you have a Petsmart/Petco, other pet food supply store, you should be able to buy individual pouches/cans of Weruva and see if you can find some that he likes. Weruva is also one of the few companies that puts the nutritional breakdown for every one of their foods on their website. You want foods under 200mg of phosphorus (lower is better). Here's their Nutritional Information
Click to expand...
my cardiologist agreed with you on the supplement for dealing with the high phosphorus… She just wants me to wait to start it until after his blood work is done on Friday. She wants to make sure that the lower furosemide dose alone is doing what she wants it to do in regards to lowering all of his kidney function numbers.
 
alexMama said:
my cardiologist agreed with you on the supplement for dealing with the high phosphorus… She just wants me to wait to start it until after his blood work is done on Friday. She wants to make sure that the lower furosemide dose alone is doing what she wants it to do in regards to lowering all of his kidney function numbers.
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Yes. This makes sense. I was thinking the same thing about getting the bloodwork on Friday.
 
Low ketones today. That’s great.
I’m a little disappointed in the numbers, but on the other hand it’s much better to see yellows than blacks. He could be trending downward toward PMPS.
 
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alexMama said:
Ordered!
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Good So what we are hoping to find out is his BG number at about the same time that you get a glucose reading. This will help find the BG number at which Alex starts spilling glucose into his urine because his kidneys aren’t keeping up. Then we hope to keep his BG below that number as much as possible. Since it’s not a perfect world, he won’t be there all the time, but it will at least give is a goal where we want to keep his glucose.
 
Suzanne & Darcy said:
Low ketones today. That’s great.
I’m a little disappointed in the numbers, but on the other hand it’s much better to see yellows than blacks.
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188!!!! BG! Finally down in the 100s again… I was looking back a couple of days ago and right about now as when his liver started flooding and with sugar again so these next couple of hours will be crucial to see if his body calms down. I’ve been having him drink and eat as much as he can handle today and he’s been really doing well with eating on his own. I haven’t had to spoon feed him all day.

The sad thing is that his back legs are like curling under on his feet now when he walks, he’s literally walking with his toes underneath him folded under. It’s so sad and he is really struggling to walk. I really hope we can get this turned around quickly. Other meds you had me order for his legs for the neuropathy comes tomorrow, but I’m not sure if I should wait to start that until after the labs on Friday. The Zobaline…

Anyway, today’s been a much better day than we’ve had in a while, which is a relief, but I am cautiously optimistic waiting to see what these next couple of hours show for his BG!.
 
alexMama said:
188!!!! BG! Finally down in the 100s again… I was looking back a couple of days ago and right about now as when his liver started flooding and with sugar again so these next couple of hours will be crucial to see if his body calms down. I’ve been having him drink and eat as much as he can handle today and he’s been really doing well with eating on his own. I haven’t had to spoon feed him all day.

The sad thing is that his back legs are like curling under on his feet now when he walks, he’s literally walking with his toes underneath him folded under. It’s so sad and he is really struggling to walk. I really hope we can get this turned around quickly. Other meds you had me order for his legs for the neuropathy comes tomorrow, but I’m not sure if I should wait to start that until after the labs on Friday. The Zobaline…

Anyway, today’s been a much better day than we’ve had in a while, which is a relief, but I am cautiously optimistic waiting to see what these next couple of hours show for his BG!.
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Suzanne & Darcy said:
I saw that. Maybe— and hopefully— he will trend downward toward PMPS (like when a bounce is clearing.)
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He went up from 188 to 205… 😑😑
 
4:30am bg going up to 264. Ketones.3. He’s purring again since last night, his coat is smooth again. Eating tiki stix thru night x2. Legs not so good.. He seems much more himself, other than the legs. Will stick at 2.0 this AM at 8am .
 
He probably will do OK with two units unless he is kind of on his way upward, but he really didn’t drop particularly low yesterday. I don’t think he should have a bounce, but Alex has been so unpredictable recently so who knows. If you really want to, you could try maybe 2.25 units. What do you think?
 
Suzanne & Darcy said:
He probably will do OK with two units unless he is kind of on his way upward, but he really didn’t drop particularly low yesterday. I don’t think he should have a bounce, but Alex has been so unpredictable recently so who knows. If you really want to, you could try maybe 2.25 units. What do you think?
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I did a little over 2.0, about 2.25.. so that works! He is eating better again today on his own! Had a good night too. Just those dang legs.. Purring when he’s with us, good resp rate, 24-28. ..
He got his 1/2 furosemide. He has not had a BM in like 5 days though.. so worried about that!!!
 
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alexMama said:
I did a little over 2.0, about 2.25.. so that works! He is eating better again today on his own! Had a good night too. Just those dang legs.. Purring when he’s with us, good resp rate, 24-28. ..
He got his 1/2 furosemide. He has not had a BM in like 5 days though.. so worried about that!!!
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This is good! Sounds like he is improving. With regard to the BM, you can start giving him a small amount of MiraLAX mixed in with some food or one of his tiki stix. I would start with a very small amount like 1/8 of a teaspoon once a day for a few days —if that doesn’t work, increase to twice a day or increase to 1/4 teaspoon once a day. MiraLAX is what they call a “dose to effect“ medication. You can ask your vet what they think about giving him a little MiraLAX. We do not want him ending up really constipated and having to be taken to the vet for an enema… that would be so bad for the poor baby. MiraLax doesn’t have direct cardiac effects, but you can still ask your vet.
 
Big day! He had two BM’s today all on his own and took himself to the bathroom and is eating great!
At 5:30 PM he is down to 187 for BG.. He was going up at this time yesterday and today’s going down so we’ll be watching this closely.
 
alexMama said:
Other meds you had me order for his legs for the neuropathy comes tomorrow, but I’m not sure if I should wait to start that until after the labs on Friday. The Zobaline…
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Zobaline is just B-12 which is a water soluble vitamin and any the body doesn't use should just be peed out. It can take quite some time to work (if the problem is diabetic neuropathy) so I don't know any reason you couldn't start it. @Suzanne & Darcy ?
 
Chris & China (GA) said:
Zobaline is just B-12 which is a water soluble vitamin and any the body doesn't use should just be peed out. It can take quite some time to work (if the problem is diabetic neuropathy) so I don't know any reason you couldn't start it. @Suzanne & Darcy ?
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Exactly. Chris is right. It is only B-12 and you aren’t having his B-12 levels tested. That would be a part of a specific GI panel of labs that is commonly done when GI problems like IBD or EPI are suspected.

However, it’s already Thursday, so if you really wanted to wait until tomorrow then I can’t see it making much difference.
 
OK, thank you…
We’ve had a very unique day from any that we’ve had so far… He has been steadily staying in the 140s since his Pmps…
I just tested him at 4:30 AM and he actually went down to 140 from 144 at midnight.
If we are in the hundreds at his AMPS, I’m concerned about giving him two units at a starting number like that… I’ve never been in this situation where he’s been steadily in the mid 100’s… not sure if I reduce the dose down to 1.5 again or even lower?
 
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alexMama said:
If we are in the hundreds at his AMPS, I’m concerned about giving him two units at a starting number like that… I’ve never been in this situation where he’s been steadily in the mid 100’s… not sure if I reduce the dose down to 1.5 again or even lower?
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Well you shot a 189 last night with 2 units and it worked out nicely. So let’s see where he is at AMPS. have you gotten back to his regular 7 AM shot time yet?
 
Suzanne & Darcy said:
Well you shot a 189 last night with 2 units and it worked out nicely. So let’s see where he is at AMPS. have you gotten back to his regular 7 AM shot time yet?
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working my way back to the 7 AM time… Will be doing 7:30 AM this morning and then hopefully 7 PM tonight or tomorrow morning we’ll do 7 AM. He is doing great! Eating out of the dish again on his own! Happy fellow purring his heart out right next to me!!
all of this lack of sleep and my husband being sick now has me sick so that’s not so fun. Terrible timing is I have a new listing coming on this next week! Not a good time for me to be sick. Such a good boy.
Suzanne & Darcy said:
Well you shot a 189 last night with 2 units and it worked out nicely. So let’s see where he is at AMPS. have you gotten back to his regular 7 AM shot time yet?
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174 AMPS
 
alexMama said:
He is doing great! Eating out of the dish again on his own! Happy fellow purring his heart out right next to me!!
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This makes me super happy!!! I know what this is like. I struggle with one of my cats. When he doesn’t eat, I despair. I have to syringe feed but he never gets enough to not lose weight.

Great AMPS! Good job shooting 2 units this morning!!
 
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