02/23 Ivana AMPS=284, +2=274 She's not feeling good :-( We have new juice! +8=250, PMPS=263, +2=277

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Tara & Ivana (GA)

Tara & Ivana (GA)

Member Since 2015
Yesterday's post

Ivana was not feeling too great last night - as I mentioned in yesterday's post, she was a pain with her PMPS test, her shot, and her +2. She is normally really good so that was different for her to be so uncooperative. She slept on our bed for some of the night (normal), but I did notice this morning that she still had not touched her dinner or midnight snack, meaning as of this morning she hadn't eaten since lunchtime yesterday.

While I was getting her breakfast ready she was super-purry, like she is when she's really hungry. I gave her tinned salmon which I know she loves, because I had an ulterior motive of hiding extra SEB in it as I suspect she's got an upset tummy again (the salmon does a good job of hiding the taste of the SEB I think). She ate about half her breakfast, but she's still not herself. My poor poppet :( We were going to go out today, but instead we've decided to stay home with her and keep an eye on her.
 
I think it must be the CKD making her feel miserable. I did consider it was that her BGL has been high for a while, but that's never made her feel unwell before so I do think it's a tummy thing. At least I managed to get a reasonable amount of SEB into her this morning.

On another note, where can I find info on what the renal threshold is for BGL? I just skimmed through the Room & Rand paper and couldn't see it. If hubby wants her to run higher, I at least need to make sure her kidneys are protected.
 
Renal threshold is ECID. The way you find out is with use of the Ketodiastix to test her urine to see if she's spilling sugar now. Neko has been in low yellows and gotten negative glucose, but for some it's in the blues.

The other worry for keeping kitty in higher numbers is glucose toxicity. It just means you may have to go higher to get her to turn around again.

Sending vines for the little poppet. :bighug::bighug: And hurry up and get there vines for the new insulin.
 
Wendy&Neko said:
The way you find out is with use of the Ketodiastix to test her urine to see if she's spilling sugar now.
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Ack, I bought some of these to test for ketones and gave them away as we went with the meter test strips instead. Will pick some up tomorrow morning. Given that we test ketones with blood, I assume just the plain Diastix will be ok?

Thanks for the post link on glucose toxicity. I guess that's a case of ECID too (as is most things it seems). Unfortunately I couldn't get access to the UQ links at the bottom of that post (I even tried to use my university database for access, and no luck).

From previous conversations with hubby, he seems happy if she stays in blues. His thoughts may have changed since that particular conversation a little while ago, but I do remember that. I would be happy to compromise with blues (lower blues if possible!) as long as it's not causing further damage to her kidneys. We're not aiming for remission anymore, that went out the window a few months ago :confused: Regulation has never gone off the table though.
 
Bron and Sheba said:
Tara, has Ivana ever had pancreatitis?
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No she hasn't. The vet did check her pancreas about a month ago when she had that bad week of being at the vet every day, as pancreatitis was on the radar then with her symptoms. Nothing showed up in the ultrasound of her pancreas, thankfully. Do you think it could have developed in a month? I don't know anything about pancreatitis.
 
Tara & Ivana said:
No she hasn't. The vet did check her pancreas about a month ago when she had that bad week of being at the vet every day, as pancreatitis was on the radar then with her symptoms. Nothing showed up in the ultrasound of her pancreas, thankfully. Do you think it could have developed in a month? I don't know anything about pancreatitis.
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Tara, I can't answer that question ....I would ask your vet. There is a blood test that will confirm or deny pancreatitis called fPLI.
Sheba's other symptoms are dehydration and lethargy for pancreatitis.
Hope you can get it sorted out.
 
Whatever sticks test for glucose should be OK. I would love Neko to be in just low blues too, but it doesn't work that way. She has to be getting nadirs in the 70's for the bounces to be low enough to avoid renal threshold. Since Neko is an acrocat, I am not so focussed on reductions, but rather matching her dose against the excess growth hormones being pumped out by her pituitary. Having said that, even non Acro cats ate flatter (usually), in overall lower numbers. When I get home I will try to remember to link a post from Think Tank that talks about that.
 
Bron and Sheba said:
Sheba's other symptoms are dehydration and lethargy for pancreatitis.
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Ivana has been drinking a lot the past couple of weeks, though who knows if it's because she's been in high BGL or her kidneys or something else... As for lethargy, well she hasn't done much besides sleep and eat for the past 10 years so that indicator is out. Will chat to the vet when I pick up the insulin to see where to go from here.

It never ends, does it? :(
 
Wendy&Neko said:
Having said that, even non Acro cats ate flatter (usually), in overall lower numbers.
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Ivana has been quite flat in the high yellows/low pinks - she doesn't even seem to have an obvious nadir at the moment, her curve is not much of a curve at all. But still, that's not much consolation as it's obviously still too high. C'mon Ivana, we know you can do it, hopefully the fresh insulin arrives today.
 
You only need the strips that test the urine ketones. You don’t need the ones that test for glucose as well as ketones unless you can’t find the ketone strips alone. The dual strips are a lot more expensive and if she’s above renal threshold, you already know there’s glucose in her urine.

Sending her many, many vines.
 
Update: I just took the rest of her breakfast to her room-service-style, as she was laying in the sun in our bedroom. She wouldn't eat out of the bowl, but did eat out of my hand. She ate the rest of her breakfast (about half the meal) and some of her leftover midnight snack. Just monitoring her to make sure she doesn't throw it back up. Have told hubby to hand-feed her dinner tonight.
 
And here is the beautiful Princess herself, about half an hour ago.
2016-02-23 11.00.17.jpg
 
Marje and Gracie said:
if she’s above renal threshold, you already know there’s glucose in her urine
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This is what I'm trying to find out - I don't know what her renal threshold is, hence getting the glucose wee strips to see if there's any spillover at this level. For ketones, we test her blood using ketone strips in the meter.
 
Vyktors Mum said:
I syringe Vyktor's SEB 5 to 10 mins before feeding
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I may need to try this I think, especially if she's not eating *because* her tummy feels yuck and the SEB would help. Any tricks to syringing a kitty? She clamps shut whenever we try to put anything in her mouth, do we just quirt between her teeth?
 
I use a 3ml syringe available at most chemists. To get her mouth open you can squeeze the corners a bit. When you syringe aim for the side of her mouth not straight down the back - to avoid aspiration. I wouldn't try squirting this one through her teeth. If the consistency of yours is like mine is it of all sticks together so if some falls out of her mouth it will all follow - conversely if the majority gets in the rest will follow that too. Giving before food might settle her stomach enough to eat better
 
Tara & Ivana said:
This is what I'm trying to find out - I don't know what her renal threshold is, hence getting the glucose wee strips to see if there's any spillover at this level. For ketones, we test her blood using ketone strips in the meter.
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Duh...Of course. Sorry.

I also used SEB syrup before food....about 30 minutes. You want to put it in her mouth sideways and a little up but not straight back. I taught all my cats when they were kittens to take fluid from syringes so I’m not really sure what to do if they are an adult and clamp their teeth down.

She is so beautiful.
 
2016-02-23 13.35.05.jpg


We have new juice! It actually arrived late yesterday afternoon, but I didn't check our phone messages til this morning (duh). So, is there a trick to using these lil ones? I think I read somewhere that I don't need to inject air into it like I do with the vial before pulling out a dose at the purple end, is that right? Do I need to do anything with that black bit on the other end? Looking forward to seeing some better numbers soon :)

Bron and Serryn, do you know if we have any rules regarding disposal of the old insulin?

Also, Miss has kept her lunch in her tummy, so that's good news :D I have syringes to give her the SEB too, and I think if I'm going to do that I might make the slurry a bit thicker so that I can get in more SEB with less actual volume (ie the less time I'm near her teeth the better). Vet was in a consult so I didn't get to ask her about Ivana's tummy.
 
You are correct, no need to inject air into the cartridge (another reason I prefer them). The black bit at the end (I presume that's the stopper), will gradually come down as you remove insulin from cartridge. Here's a picture of the cartridge being used from the Info, Storage and Handling Sticky. And you can follow Julie's video on how to draw insulin, but this time watch the part about drawing insulins from a pen. The cartridge is a pen refill.
lantuscartdraw2-1.jpg


Good luck with the new juice. Good news on Ivana's tummy being better. :)
 
Thanks Wendy! I've already stuck my velcro dots onto the cartridge ready to go for this evening's shot. Is it weird that I'm a bit excited to be drawing from a cartridge for the first time? Yeah, I thought so :p
 
She is just gorgeous - and doesn't she know it! Sorry was in a hurry before - Vyktor's just had his acupuncture.

When I think about it I give the slippery elm more like 15-20 mins before food. If you squeeze the edges of her mouth a little, not hard enough to hurt, the lips will come up a bit and you can gently prise the teeth apart. Use a steady firm force and take your time. Vyktor was not at all keen to start off with but turns out he doesn't hate the taste so he's generally pretty good about me prising him open now and just puts up a token resistance on principal.

I don't know how you stored your vials but the cartridges knock over quite easily so we put it in a glass wrapped in a face washer to keep it steady and that also protects it from the fridge light. I'm not sure what the rules are on disposal when they're empty I just toss them in the bin (but I just toss his syringes in there too :oops:) When I've ditched ones that still contain insulin I've taken them to the vet or the chemist. They will take it for proper disposal whether or not they sold it to you. Maybe don't ditch it just yet though, the results of the new insulin may show you it's still good.

Velcro dots?
 
Too late Serryn, I've already left the old vial on the counter for the past hour, and it's a hot day here. Eh, at $66 for a cartridge, I'd rather buy new ones than use the 6 months old vial. I will take it back to the vet for disposal when I'm there next.

I put 2 velcro dots on the vial/cartridge and another two on my fridge at eye height, so that I can stick the insulin to the fridge and I've got two free hands to draw up the dose. It works a treat :-) I've just stored the cartridge inside the box the vial came in.
 
Paws crossed you see some results with the new insulin, but nothing too dramatic, mind! No need to get carried away, Miss Ivana.

Tara, have you tried gently tilting her head back while your fingers are on either side of her jaw? This should cause her mouth to open slightly (less for those that have iron jaw muscles, like my Sasha, and more for those that are more relaxed, like my Cinco).
cat-pill.jpg
Then you can quick squirt the slurry in. I also found tapping the side of her mouth with the syringe made her open slightly.

Good luck getting the SEB in and with the fresh insulin. Sending tummy and appy vines.
 
I managed to syringe the SEB into Ivana tonight without any growling, biting, scratching, or loss of limbs/eyes. I gave her 2.5mL. Most of it went into her mouth, although some did dribble down her chin and down my wrist, but that's ok. She wasn't a fan of being held for this, so I think next time I will try just adding a really small amount of water to the powder to make a thick paste, and then wipe it on her upper lip so she licks it off (that's how we give her honey).

Anyway, the good news is that she ate pretty much all her dinner, yay!! At first, she didn't want it. She just went into the loungeroom to lounge around. So hubby hand-fed her some, then enticed her back into the kitchen where she ate the rest on her own out of the bowl. Hubby had a thought that maybe she doesn't like her food area any more for some reason, seeing that she's willing to eat elsewhere. So we're going to try moving her eating area to the other side of the kitchen and see if that makes a difference.
 
Good to see you have new juice for Ivana! I hope her numbers trend lower soon for you. With the pancreatitis, it can come on relatively quickly, so if she continues to be 'off' it may be worth having her checked again. I know it's very expensive to keep going to the vet though...
 
Thanks for the info re pancreatitis progressing quickly. So I guess it really is a possibility even after the all-clear last month. Damn. Don't you dare have any more issues Ivana, not sure how our sanity will cope!
 
Tara & Ivana said:
So we're going to try moving her eating area to the other side of the kitchen and see if that makes a difference
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I think that's a good idea, I ended up doing just that with one of our dogs, after she had about of gastroenteritis she only wanted hand feeding and didn't want to eat we moved her feeding spot and she started eating normally.
 
Tara --Did you mention a while ago she had early renal issues? If so that could cause nausea and maybe you can talk to your vet about SQ fluids so you have them at home when needed? my 2 cents :bighug:
 
Here the post I meant to give you yesterday. The author is Kirstin Roomp (of Roomp and Rand). The post two after that by Steve and Jock (first cat ever on Levemir) have interesting thoughts about dosing. This is one of my favorite quotes:
I'm most interested in Kirsten's reply, because she brings up an important related issue -- that it's much easier (with Levemir or Lantus) to maintain a cat in euglycemic ranges (say, 75-160 or so), than to maintain them at some randomly chosen range that scares some people less. Blood sugar simply seems to get more stable (in the non-complicated kitties) when you keep it near normal.
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Thanks heaps Wendy, I have some time to do some reading today so will check them out. Perhaps there is more ammunition I can use to convince hubby that greens are not scary.

In other news, the new juice got Ivana down to 216 last night - *almost* blue!
 
Tara & Ivana said:
convince hubby that greens are not scary
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Actually, greens aren't the problem I don't think, it's the dives while getting to greens that scares him. I do remember pointing out when she had that good run of greens and was stable, she didn't have any dives. Man, if only she didn't have that LO we wouldn't even be having this discussion :mad:
 
Tara & Ivana said:
Thanks for the info re pancreatitis progressing quickly. So I guess it really is a possibility even after the all-clear last month. Damn. Don't you dare have any more issues Ivana, not sure how our sanity will cope!
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I'm going on our experience with Max, whose last ultrasound was end Nov '15 where everything was OK, to her being GA 3 weeks later. In hindsight I should have taken her back in much earlier, but her FD diagnosis was new and I attributed her nausea and digestive issues to FD and us using a variety of food types to keep her BG stable, rather than anything else. She didn't have the blood test Bron mentioned but the vet brought it up at her final appointment.
 
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