07/18 Mačka AMPS 628 - High during the day, lower at night

[Penelope and Mačka]

We are still in the highs every day, but recently Macka has been more receptive at night with some curves and some blues. Which means I go to bed for 3 hours between 4-7 :/
I wish he would do the opposite, seriously.
His highs are very high, so I guess he bounces every day from the night before? Would it mean that his dose is still too high? Yesterday night I was 1. very tired 2. worried he would drop fast and bounce like crazy so I gave him 1 spoon of gravy, just one, to slow down drop. When you look at the SS, I wonder if it was necessary at all. It's difficult to wait and watch anxiously every hour though. I tried leaving him food for the night, but he eats it up right away every time he does not fully understand the feeder yet.

I am thinking of testing less for the sake of his ears and my own mental health. I haven't been doing good, still too anxious to leave the house for any reason. And still sleep deprived. I hope that by bringing his shooting time at 6:30 I will be able to deal better with it.
Our life at home is somehow miserable at the moment, me sleeping on the couch, always freaking. My husband is very distressed by this life changing situation (he did not know Macka a month ago, since Macka was living in France with my mom). Macka is 100% my baby.
I have a question for you: how do you deal with holidays/going out of town? My birthday is coming up in 2 months and we had plans to go on a 4 day week-end. It looks like our life is on hold and we can't plan anything anymore, because of Macka's disease.

This morning he has his first visit with a specialist. I can't wait to find out what they say about him, and the spreadsheet!

 

[Penelope and Mačka]

I was also thinking I should be more consistant with the food I give him. Right now, I don't make any sense and it's harder to understand variations on the spreadsheet. Should I feed him only 3 times a day? AM, noon before nadir, PM?

 

[Tanya and Ducia]

Hi there,
may I ask you to do some house keeping in the SS first?
It does read wrong because of the reduced shot given at +15 on the PM cycle of July 15th. +15 being 3 ours later than normal shot time. It will make difference on the overall picture.
@Penelope and Mačka

 

[AmandaE]

We are still in the highs every day, but recently Macka has been more receptive at night with some curves and some blues. Which means I go to bed for 3 hours between 4-7 :/
I wish he would do the opposite, seriously.
His highs are very high, so I guess he bounces every day from the night before? Would it mean that his dose is still too high? Yesterday night I was 1. very tired 2. worried he would drop fast and bounce like crazy so I gave him 1 spoon of gravy, just one, to slow down drop. When you look at the SS, I wonder if it was necessary at all. It's difficult to wait and watch anxiously every hour though. I tried leaving him food for the night, but he eats it up right away every time he does not fully understand the feeder yet.

This is exactly how Mowgli is, it's pretty normal honestly. It is just how it is that most cats go lower at night. Macka is really not used to those nice blue numbers, he's bouncing daily and he probably will until his body gets used to them. It's ok, it's progress! I think last night it was appropriate to give some MC gravy, very good instincts as a drop from 367 to 181 is pretty sharp.

RE Macka's eating: You can feed Macka extra food, he is really hungry right now because he spends so much time at higher BG levels. Because of this, his body doesn't quite process nutrients properly which leads to one of the symptoms for diabetes: increased hunger. Until his numbers get down a little further, as long as you aren't close to shot time (2 hour window) I think it is ok to feed him as much as he wants He will learn to understand the feeder! I will send you some patience pants I have to wear mine all the time

I am thinking of testing less for the sake of his ears and my own mental health. I haven't been doing good, still too anxious to leave the house for any reason. And still sleep deprived. I hope that by bringing his shooting time at 6:30 I will be able to deal better with it.

I think this is a very good idea, when Macka is in blues and yellows he is still so, so safe! You are stressing yourself out needlessly in these situations During the day, when Macka is very high, you don't really need many tests at all, maybe try a +2 / +3 so that you can understand what kind of drop he is having, if it isn't much of a drop, you probably wouldn't need another test.

You need to take care of yourself. Instead of testing hourly, start with testing every two hours, try to trust the advice that if the +2 is close to or the same as the pre shot reading that you don't have to worry as much and shouldn't have to stay up late. If you're unsure if it is safe or not to stop testing, post and hopefully someone will give you a little feedback.

Give yourself a break, it's understandable that you're so worried for Macka, trust me, I know just where you're coming from: I too had Mowgli flown out to live with me from my mom's, when I saw him it was so upsetting and such a shock - he was thin and frail, with signs of neuropathy. It's hard not to obsess over them but we have to take care of ourselves too. One thing that other members had told me at that time was that, even though Mowgli was looking bad then, that he was now safe and in my care so, things would only improve for him. Just 4.5 months later, Mowgli is doing much better, we still have a long way to go, but he has gained back so much of his weight, his personality is back to normal, and he has much more energy! This will happen for Macka too! but not if you don't take care of yourself and end up burning yourself out

Our life at home is somehow miserable at the moment, me sleeping on the couch, always freaking. My husband is very distressed by this life changing situation (he did not know Macka a month ago, since Macka was living in France with my mom). Macka is 100% my baby.

This is tough, as your husband gets to know Macka he will understand where you're coming from. I really do think you need to try and relax your anxieties more, try testing a little less, ask for advice if you're feeling compelled to test, and get some more sleep. If you absolutely feel like you need a test, grab your +2, go to bed and set an alarm for +6. that way you can get a little sleep in, check on Macka, go back to bed, and sleep some more.

Please, for your health... stop sleeping on the couch!

In the mean time, ask your husband to be a little more understanding, you're new to this so as you learn more you will settle in and there will be less of an impact to your day to day life . One thing I can mention from personal experience is this: I love our 6am / 6pm shot schedule. I have to get up at 6 for work anyway, and on the weekends i just go straight back to bed after Mowgli's shot. In the evening, it doesn't impact our social life at all, most people plan social events after 7 so I have time to grab a +1 before I head out to see how Mowgli is trending. Additionally with this schedule the +2/+3 is early enough that I can get a really great idea on how Mowgli is trending by 8/9pm, so there is less need to stay up so late Just food for thought an earlier PM shot may help with those late late nights

I have a question for you: how do you deal with holidays/going out of town? My birthday is coming up in 2 months and we had plans to go on a 4 day week-end. It looks like our life is on hold and we can't plan anything anymore, because of Macka's disease.

There are a few things you can do here:

• Ask around on the health forum if anyone lives in your area that would be willing to care for Macka while you're away
• Check with your vet to see if they do boarding and can give Macka his insulin / test his BG
• Ask your friends if any of them would be willing to learn to give insulin and test BG levels, if they are willing to give insulin but not to test BG, or if you don't think Macka would allow someone else to test his BGs, ask for advice here 3 days before you leave and someone will give you feedback on what a good "vacation" dose would be. For example, my BIL was willing to give insulin, but not take BG's Mowgli was on a dose of 1u at the time, but based on his insulin habits I got feedback to have BIL give only 0.5u while we were away. That way Mowgli was still getting insulin support but there was a very decreased chance of a hypo event.
• Ask your vet if any of their vet tech's offer pet sitting services
• Look at pet sitting services in your area, see if any of them have experience with diabetic pets, or are willing to have one of their staff trained to handle a diabetic pet.
• Book a hotel that allows pets and bring Macka with you (last resort ) ... we're taking Mowgli with us on a 2 week vacation to Nova Scotia LOL, a pet sitter was just too expensive

I'm sure there will be other ideas on this as well Your life doesn't need to be on hold, especially for just a 4 day weekend

This morning he has his first visit with a specialist. I can't wait to find out what they say about him, and the spreadsheet!

Awesome! let us know how it goes! Good luck with the specialist

Take a deep breath, please start focusing on yourself and your mental health more, you are doing a great job and Macka is in great hands

 

[Penelope and Mačka]

Hi there,
may I ask you to do some house keeping in the SS first?
It does read wrong because of the reduced shot given at +15 on the PM cycle of July 15th. +15 being 3 ours later than normal shot time. It will make difference on the overall picture.
@Penelope and Mačka

Sure! i just don't know how you want me to proceed? It is clear to me that Macka had a delayed shot because of his low PMPS numbers. If I change it, I am afraid I won't see this event anymore.

 

[Tanya and Ducia]

i just don't know how you want me to proceed?

no problem, I am typing how to rearrange it, give me a minute, pls. brb

 

[Tanya and Ducia]

The changes to be made for July 15th ;

In the AMPS +11 cell type 92/76 @+11.5 (manually color the background Green and letters White;

In the PMPS cell type 513 @+15, manually color in Black/White letters;

In the Units cell type 1.25 Sk.

Adjust the timing of tests for the rest of this cycle.

Next day, July 16th – at what time did you give the shot?

If 12 hours exactly after the delayed shot on 7/15 do not make any changes to the SS.

If earlier than that then correct accordingly ( if an hour earlier – put +11 in the AMPS cell along with the BG; if two hours earlier – put @+10, etc).

You do not really need all of the preshots taken on July 15th – you can store them in the Remark section but the SS better be less clotted.

If we can see clear picture as to how things went we’d be able to assess the dose and foods easier.

 

[Penelope and Mačka]

Here's what I learnt at the new vet's (specialist, internist):
- Macka does not have neuropathy (yet) but has arthritis
- his blood pressure is fine
- no lymph nodes
- he is well hydrated
- vitals are normal

From the ultrasounds that he had 3 weeks ago, she saw that his small intestine is thickened and she suspects a disease: IBD or small cell lymphoma at the worst. But we are not going to do exploratory surgery. She thinks he is not well regulated because of this disease. It would be consistant with periods of loss of appetite, diarrhea etc. If he consistantly loses weight and appetite, then it's most likely cancer. But right now, he's not doing too bad.
He is going to receive treatment for that: vitamine B12 shots weekly and then twice a month, then monthly, and also steroids that are not too bad for diabetes. She said that even if they increase BG a little bit, we need to treat the intestine issue if we want to regulate him.

She wants me to continue on the 1.25 unit for at least a week and then do a curve at home. Also asked that i feed him more at shot times, and less during the day (small snacks ok), in a consistant way.
She asked me to stop obsessing over his BG. She wants me to back off testing all the time, that he and I need sleep and less stress. I said I was afraid of stopping completely, so we agreed on testing him at maybe +4/+5. I will still do the pre-shot test, but she was ready to let that go too. She said I could leave food for him so that if he's a little low, he will eat by himself at night. This goes in the direction I wanted, but I know I can't stop testing altogether, just not 10 times a day. I am not mentally and physically solid enough for this pace, and I also need to go back to sleeping, and most importantly working. Money needs to come in.

Give yourself a break, it's understandable that you're so worried for Macka, trust me, I know just where you're coming from: I too had Mowgli flown out to live with me from my mom's, when I saw him it was so upsetting and such a shock - he was thin and frail, with signs of neuropathy. It's hard not to obsess over them but we have to take care of ourselves too. One thing that other members had told me at that time was that, even though Mowgli was looking bad then, that he was now safe and in my care so, things would only improve for him. Just 4.5 months later, Mowgli is doing much better, we still have a long way to go, but he has gained back so much of his weight, his personality is back to normal, and he has much more energy! This will happen for Macka too! but not if you don't take care of yourself and end up burning yourself out

Wow, I did not know they had a similar story Was Mowgli your cat or your mom's? Yes after only one month, Macka looks already way better than when he arrived here.
I can't wait for him to have more energy. So happy for you that Mowgli is doing much better, and inspired to see that you manage to take care of yourself too.

ust food for thought an earlier PM shot may help with those late late nights

Yes! That's the plan, have shots at 6:30 am/pm, check points at +3 or +4 (I used to go to bed at 9 though... Hope I can do it again) and try to have a good night sleep.

 

[AmandaE]

Here's what I learnt at the new vet's (specialist, internist):
- Macka does not have neuropathy (yet) but has arthritis
- his blood pressure is fine
- no lymph nodes
- he is well hydrated
- vitals are normal

From the ultrasounds that he had 3 weeks ago, she saw that his small intestine is thickened and she suspects a disease: IBS or small cell lymphoma at the worst. But we are not going to do exploratory surgery. She thinks he is not well regulated because of this disease. It would be consistant with periods of loss of appetite, diarrhea etc. If he consistantly loses weight and appetite, then it's most likely cancer. But right now, he's not doing too bad.
He is going to receive treatment for that: vitamine B12 shots weekly and then twice a month, then monthly, and also steroids that are not too bad for diabetes. She said that even if they increase BG a little bit, we need to treat the intestine issue if we want to regulate him.

Sounds like an overall solid report from the vet, I hope that he doesn't have small cell lymphoma but it definitely seems like Mačka typically has a great appetite and is a good eater

I think most members on the board would agree that if Mačka has an underlying issue that it would be causing his increased BGs. A really good example of that is @AliceMeowliss&Cassandra, Alice had SUCH high BGs and was on a large dose of insulin when she had her mammary tumour. Now, after having surgery it seems like she is really doing so much better! lower BGs lower Insulin dose

Some members may have a different opinion on the steroids but I have no experience in this area

She wants me to continue on the 1.25 unit for at least a week and then do a curve at home. Also asked that i feed him more at shot times, and less during the day (small snacks ok), in a consistant way.
She asked me to stop obsessing over his BG. She wants me to back off testing all the time, that he and I need sleep and less stress. I said I was afraid of stopping completely, so we agreed on testing him at maybe +4/+5. I will still do the pre-shot test, but she was ready to let that go too. She said I could leave food for him so that if he's a little low, he will eat by himself at night. This goes in the direction I wanted, but I know I can't stop testing altogether, just not 10 times a day. I am not mentally and physically solid enough for this pace, and I also need to go back to sleeping, and most importantly working. Money needs to come in.

Your specialist sounds really great! and supportive, I think in your heart you already knew about the testing and sleep

One thing I might suggest is to follow her testing advice for the morning cycle (AMPS and +5) but maybe consider doing a +2/+3 after the PMPS instead of a +5, only because it is such a great indicator of how the rest of the cycle will go, potentially if you get a good +2 or +3 you wont have to stay up to test all the way at +5 Maybe someone here will have a more experienced opinion on this ... but I agree with her that you don't need as many tests as you've been taking

It sounds like you had such a productive and informatice appointment, I hope you've been put at ease a bit

Wow, I did not know they had a similar story Was Mowgli your cat or your mom's? Yes after only one month, Macka looks already way better than when he arrived here.
I can't wait for him to have more energy. So happy for you that Mowgli is doing much better, and inspired to see that you manage to take care of yourself too.

Yes! That's the plan, have shots at 6:30 am/pm, check points at +3 or +4 (I used to go to bed at 9 though... Hope I can do it again) and try to have a good night sleep.

Mowgli is both mine and my younger sisters, not my moms at all, so I didn't blame her for not wanting to take on the responsibility of a diabetic cat The fact that you notice a difference in Macka says a lot, you've done such a great job with him

Having the 6/6 schedule is key for my quality of life, I think you will find it much easier on you and your husband, at least, I hope so

 

[Wendy&Neko]

His highs are very high, so I guess he bounces every day from the night before? Would it mean that his dose is still too high?

Nope. It means he's a cat and likes to go lower and night, then bounces during the day. And it looks like his dose is too low, all you are seeing is high blue at best. Hold the 1.25 unit dose for a week, unless his ketones start creeping up.

he does not fully understand the feeder yet.

Are you feeding all of his meals from the feeder, even during the day or other times you are home? I would still try to spread his food out a bit in the first part of the cycle to prevent big drops. Try to feed the same way in the AM and PM. The autofeeder lets you do that even if you are away.

am thinking of testing less for the sake of his ears and my own mental health.

Awesome news! I have suggested testing less before and given you thoughts on when you can stop testing. You need your sleep. You must be healthy to take care of Macka. Does you husband test? If not, he needs to learn how. That way you can take turns, he can learn more about feline diabetes and can help give you a break. It is the one big thing that allowed me to get out of the house more.

As for holidays, Amanda gave you great options. My petsitter gives shots and to my surprise Neko came with us and did great in hotels.

From the ultrasounds that he had 3 weeks ago, she saw that his small intestine is thickened and she suspects a disease: IBS or small cell lymphoma at the worst. But we are not going to do exploratory surgery. She thinks he is not well regulated because of this disease. It would be consistant with periods of loss of appetite, diarrhea etc. If he consistantly loses weight and appetite, then it's most likely cancer. But right now, he's not doing too bad.

Can I ask why you aren't trying to diagnose which disease he has? It can be done with a simple endoscopy, does not have to be surgery. I am on my third cat with small cell lymphoma. Neko didn't do so well, but she had heart and kidney diseases at the same time too - it wasn't the small cell that did her in. And the disease did not prevent her from being well regulated. The other two cats did great on treatment and went into remission with chemotherapy. The type of chemotherapy is well toleterated in cats and is one steroid pill a day plus one other pill once every two weeks. If you know it's IBD (it is not IBS), then a diet change to novel proteins, plus a good probiotic will help control the problem.

Did the vet say what type of steroids he will go on? Budesonide is my guess, it didn't impact Neko's BG, but does for some cats. The thing about starting steroids, you won't be able to get an endoscopy or do other tests to find out what is causing the thickened bowels once you've started steroids. The treatments for the two conditions (IBD and small cell) are different. Knowing what you are dealing with let's you know how to treat. If IBD, you may or may not need steroids. If lymphoma, you need to add chemo pill.

 

[Bron and Sheba (GA)]

Sound advice from Wendy finding out definitely what you are dealing with as far as IBD or lymphoma.
Your specialist sounded pretty good except for not testing Preshot. I’m very glad you insisted you would still do that.

With the feeder, I fed all Sheba’s meals in the feeder when I bought it so she realised that was what it was for. She got to recognise the sound of the rotating of the
machine and at the first sound she would race to it from wherever she was in the house.

I agree with Wendy. Try and get your husband involved with testing. Mine resisted for ages but eventually learnt and it was so much easier for me and allowed me to get out more and feel normal again.

I’m sure it has been a shock for your husband. Do try going back and sleeping in bed. You will get better sleeps. I found sleeping on the lounge very hard and the sleeps were poor quality. If Sheba was having a low numbers night I would sleep in another room so I could get up without disturbing my husband.
Honestly getting enough sleep is really important otherwise you won’t be able to do this long term and I’m sure your husband won’t be happy with the current arrangement and the complete disruption to his lifestyle.
But I think you sound better and calmer and that is great.

 

[Sam & Oscar]

I have a question for you: how do you deal with holidays/going out of town? My birthday is coming up in 2 months and we had plans to go on a 4 day week-end. It looks like our life is on hold and we can't plan anything anymore, because of Macka's disease.

I feel like I'm still too new to all of this to answer any other questions, but for this one I was very relieved to find out my vets office does boarding and can take good care and keep a close eye on Oscar while we are away. It's also a good opportunity to have a curve done by someone else just to verify the numbers I'm getting.

I understand how stressful this is and have been a foggy mess too...I have been skipping out on our weekly league night (I play disc golf) so that I can keep on schedule with Oscar, but I know that we have to maintain some semblance of daily life to stay emotionally strong for the kit and ourselves.

Definitely try to encourage your husband to help with testing so that if his schedule allows you a break, you get it! Mine is willing to learn I just have some control issues...

You're doing great and we're all just learning what this new normal is going to look like!

 

[Penelope and Mačka]

Hi all,

I'm so grateful for your replies and insights.

Today, after the vet's visit, I tried to lift up my spirits and see life in a new perspective. Not ure how long it's going to last, and it is entirely possible that night I go into panic/sleepless mode again. But for now, I try to be calmer and more philosophical about life, end of life, disease, death and life with a pet. What I mean is, my greatest issue here is not accepting that Macka ages, faster than me. I want him eternal and young. But also, my husband struck me yesterday by mentioning Macka's quality of life, and how with my stress I was making everyone's life pretty stressful too. Macka looks happy enough if I don't bother him too much, he likes to eat, he likes to chill, he likes to smell flowers in the garden... And he does all that with high blood sugar. I want the blood sugar to go down more than anything else, but I need to step back a little and let him breathe. And accept.

but for this one I was very relieved to find out my vets office does boarding and can take good care and keep a close eye on Oscar while we are away.

I asked, but they do not. I know a facility that boards and is really cool with real big rooms and private patios, but they do not monitor at night. Actually nobody's there at night. So I'd rather have someone house sit. I'll keep asking around though.
Be strong and good luck with Oscar <3

With the feeder, I fed all Sheba’s meals in the feeder when I bought it so she realised that was what it was for. She got to recognise the sound of the rotating of the
machine and at the first sound she would race to it from wherever she was in the house.

I bought the feeder with the microchip reader, not the timer one :/ The other cat, Chou-Fleur, would eat it all otherwise.

Does you husband test? If not, he needs to learn how.

He learnt how to give shots, which is already great. He's not opposed to testing, he's just not home at all during the day, and impossible to wake up at night.

Can I ask why you aren't trying to diagnose which disease he has? It can be done with a simple endoscopy, does not have to be surgery.

Of course! Vet said that her endoscope would not go to the small intestine. And surgery is out of the question for him. That's why.

The other two cats did great on treatment and went into remission with chemotherapy.

This is amazing info. Yes, the vet told me of chemotherapy. We're not there yet, but it's good to know it works.
We'll see if we get better regulation with the Vitamin B12 and steroid treatment. His BM are fine now, and he's hungry. However he lost 1 kg since may 29th (his diet completely changed though, dry food>wet LC food).

If you know it's IBD (it is not IBS), then a diet change to novel proteins, plus a good probiotic will help control the problem.

Yes, IBD sorry What are novel proteins? I hate fortifiera at home. Would that work?

Did the vet say what type of steroids he will go on? Budesonide is my guess, it didn't impact Neko's BG, but does for some cats.

Yes that's the one, a conservative dose she said.

One thing I might suggest is to follow her testing advice for the morning cycle (AMPS and +5) but maybe consider doing a +2/+3 after the PMPS instead of a +5, only because it is such a great indicator of how the rest of the cycle will go, potentially if you get a good +2 or +3 you wont have to stay up to test all the way at +5

Thank you for the suggestion, sounds good. I am not sure what a good +2/+3 is honestly, because he always starts from so high, and then drops quickly at night, and that's when I panic and stay awake until 4am. What's the threshold? Experience?

It sounds like you had such a productive and informatice appointment, I hope you've been put at ease a bit

Yes, she actually looked very knowledgable. She also has a diabetic cat at home. I had a 1 1/2 hour appointment with her, crazy!

@AmandaE thanks for all the boarding suggestions, I'm going to work on it right away. Should I post a thread on the forum under general questions?

 

[Wendy&Neko]

Fortiflora is not a good one. Many people use Renew Ultimate, I use Visbiome which is a probiotic specifically for IBD. A novel protein is a type of meat he isn’t used to eating. It could be something like lamb, venison, duck, rabbit, pork. Chicken, beef, and fish are common allergens for cats. This website has a lot of good information about IBD and food. https://www.ibdkitties.net/

As for vitamin B12, did the vet test for deficiency first? It’s a blood test. No need to give it his B12 is fine.

Endoscopy can reach two out of three parts of the small intestine, but if the inflammation is only in the part that can’t be reached, then you are right, surgery is the only solution. Most cats can be diagnosed with endoscopy as the inflammation isn’t localized. Neko could also not have surgery due to her heart.

I got budesonide compounded into a chicken flavoured liquid, it was much easier to give that way.

Take your cue from Macka. If he is happy and out sniffing the flowers, then he feels good. Cats are so much more than their numbers. Make sure you spend time with him just cuddling and letting him be just a cat.

 

[Bron and Sheba (GA)]

Penelope I can see you have come a long way on your journey with Macka. I’m so glad he seems happy. He doesn’t know he has diabetes!
That’s good your husband will give the shots. Even if he’s not home a lot, when he is home you can pop out for a breather to refresh yourself.
I can see thinks are starting to fall into place for you and you are becoming more relaxed or at least conscious of the fact you need to chill. We all had to learn that so you are not on your own there.

 

[Penelope and Mačka]

Fortiflora is not a good one. Many people use Renew Ultimate, I use Visbiome which is a probiotic specifically for IBD. A novel protein is a type of meat he isn’t used to eating. It could be something like lamb, venison, duck, rabbit, pork. Chicken, beef, and fish are common allergens for cats. This website has a lot of good information about IBD and food. https://www.ibdkitties.net/

Thank you, I am going to read about it. What brands do you know that offer good novel proteins?

As for vitamin B12, did the vet test for deficiency first? It’s a blood test. No need to give it his B12 is fine.

She did not. I didn't know she had to, so I did not ask. She was pretty confident about it

Endoscopy can reach two out of three parts of the small intestine, but if the inflammation is only in the part that can’t be reached, then you are right, surgery is the only solution.

She did not specify where she saw the thickness on his small intestine. But she said her endoscope could not reach it.

I got budesonide compounded into a chicken flavoured liquid

I ordered mine with three fish flavor, hope it tastes good enough. Do you add it to the food?

I can see thinks are starting to fall into place for you and you are becoming more relaxed or at least conscious of the fact you need to chill. We all had to learn that so you are not on your own there.

Let's see how I feel after I take tonight's +3 in 15 minutes If it's another active cycle, I don't know if I will be able to sleep??

 

[Wendy&Neko]

I just squirted the budesonide into the side of her mouth, I didn’t want to risk her not getting full dose if she wasn’t eating enough. Lots of brands that are novel protein and low carb. The catinfo list contains a number of them, including Ziwipeak, Koha, Nature’s Variety. Those are the ones available in Canada, I think there are others you can get. I fed raw, which had a lot more options, including kangaroo, elk, buffalo.

 

[Penelope and Mačka]

PM +3 337 = going to bed, good night <3

 

[Zorro's mom]

we're all just learning what this new normal is going to look like!

@Sam & Oscar you've put into words the thought I've been having the past few days.