1/26 Makoto AM (138)+3.5 (118)+6 (96) +9 (117) PM (200)

[Si am cat mom]

So far, so good... Wish I could grab a +1 in the evenings since that dose is early but I have been leaving MC in his feeder for his +2 and feeding a tspn with his PM shot. Last time, we weren't on this dose long and he's responding earlier that he usually does with increases which was a surprise.

I filled in the labs that were most recent in my SS....and the BUN and Creatinine are much higher than they were in 2016... higher that they were when he was diagnosed in November. His vet said that I have to take into account that he is on a high protein diet, which will drive the BUN up , and that he was dehydrated likely when he was diagnosed and that affects the Creatinine. He said they look at all those factors as well as the ratio, but it's still a bit alarming. His liver values are much better, so I can't complain too much because those we're the ones that I was worried about.

 

[AmandaE]

Makoto is looking really great today! Keep it up Makoto!

 

[Waheeda]

I won’t worry too much. If creatinine goes higher, sub-cut can help. Jebat has been stable at crea of 3.3 for 2 years with daily sub-cut. His bun is higher at 82 cos of his protein diet. I have to watch his rbc cos he does get anaemic now and then so we have to jab him darbepoetin. He also has cardiomyopathy so counting his breathing rate is a daily thing.

His liver value is not that bad. My civvie has her alt at 500+. We did biopsy and she’s now on steroid plus chemo drug which helped bring the liver enzymes down. Burnt a hole in my pocket though.

How do u decide to go on modified SLGS? I want to be a bit more aggressive and change dose earlier than 7 days.

 

[Si am cat mom]

I won’t worry too much. If creatinine goes higher, sub-cut can help. Jebat has been stable at crea of 3.3 for 2 years with daily sub-cut. His bun is higher at 82 cos of his protein diet. I have to watch his rbc cos he does get anaemic now and then so we have to jab him darbepoetin. He also has cardiomyopathy so counting his breathing rate is a daily thing.

His liver value is not that bad. My civvie has her alt at 500+. We did biopsy and she’s now on steroid plus chemo drug which helped bring the liver enzymes down. Burnt a hole in my pocket though.

How do u decide to go on modified SLGS? I want to be a bit more aggressive and change dose earlier than 7 days.

Yeah.... *sigh*
His liver values were only concerning because it was all of them and he was also dealing with thrombocytopenia at one point. Once the nose bleeds started along with the elevated and rising Liver values, we were originally worried about toxins and treated accordingly in 2014. After that .. they didn't quite recover the way the Dr. felt like they should have so I have always been worried about his ALT and AST. I'm just worried the Creatinine and Potassium levels will get away from me a bit. I'm trying not to really worry..his vet said I " need to relax" a bit and stop anticipating trouble with every lab result...which is hard for me. I will likely look into a supplement and give B vits just to make myself feel like I tried something

We are doing the modified SLGS because I should be doing TR, but can't since I work overnights and would not be able to test for 12 hours. Since overnights are when the lower values happen- I don't feel comfortable making adjustments when I won't be around to monitor. He also doesn't have a lot of room for reductions and isn't ready to off insulin, so the parameters for SLGS didn't fit our situation sometimes. Now, we are adjusting the dose as needed but usually 5-7 days ( hopefully) and not taking reduction until he is under (70/68) on the Alphatrak three times. I think what you are doing so far is working...the goal is strong remission not quick remission. I try to remind myself that too ...patience is not my virtue either. I constantly feel like I'm not trying hard enough to get him there most days.

 

[Waheeda]

Yeah.... *sigh*
His liver values were only concerning because it was all of them and he was also dealing with thrombocytopenia at one point. Once the nose bleeds started along with the elevated and rising Liver values, we were originally worried about toxins and treated accordingly in 2014. After that .. they didn't quite recover the way the Dr. felt like they should have so I have always been worried about his ALT and AST. I'm just worried the Creatinine and Potassium levels will get away from me a bit. I'm trying not to really worry..his vet said I " need to relax" a bit and stop anticipating trouble with every lab result...which is hard for me. I will likely look into a supplement and give B vits just to make myself feel like I tried something

We are doing the modified SLGS because I should be doing TR, but can't since I work overnights and would not be able to test for 12 hours. Since overnights are when the lower values happen- I don't feel comfortable making adjustments when I won't be around to monitor. He also doesn't have a lot of room for reductions and isn't ready to off insulin, so the parameters for SLGS didn't fit our situation sometimes. Now, we are adjusting the dose as needed but usually 5-7 days ( hopefully) and not taking reduction until he is under (70/68) on the Alphatrak three times. I think what you are doing so far is working...the goal is strong remission not quick remission. I try to remind myself that too ...patience is not my virtue either. I constantly feel like I'm not trying hard enough to get him there most days.

I’m also paranoid so I go for blood works on my 3 cats every 3 months. Just in case there’s any extreme change, I can catch them and take action. I asked too many questions to my vet that sometimes I think she’s tired of my paranoia! I’m trying to chill as long their kidney values are stable. Vet kept reminding me of their ages but I always argued cats can live till 20. Lol. On top of kidney, heart, liver my civvie has nerve issues and IBD. Honestly, sometimes I feel so overwhelmed.

I really feel an increase will do well for Jebat. Don’t flame me ya but I’ll increase tonight and see where it goes. After 6 cycles at current dose, it’s not taking him low. Let me try cos tmr I am home to monitor.

 

[Si am cat mom]

I hear you .. it is overwhelming.
Look at you...itchy to increase huh?
It's up to you, but sometimes I change something and then after the fact when I am trying to reinterpret then data I wonder what dose was causing what. I usually try not to do increases in between the AM and PM cycles so I can tract trends better. Maybe since your AM cycle is the one where you guys see the most action- it won't make too much of a difference in that aspect

 

[Crista & Ming]

Makoto is doing great despite everything and you are too!

It sure is overwhelming when our kitties have multiple illnesses/diseases.

Vet kept reminding me of their ages but I always argued cats can live till 20.

Lol! That's very true. I think if QOL is good and kitty isn't in pain, age is just a number. You don't give up on old humans, why give up on old cats?

 

[Waheeda]

I hear you .. it is overwhelming.
Look at you...itchy to increase huh?
It's up to you, but sometimes I change something and then after the fact when I am trying to reinterpret then data I wonder what dose was causing what. I usually try not to do increases in between the AM and PM cycles so I can tract trends better. Maybe since your AM cycle is the one where you guys see the most action- it won't make too much of a difference in that aspect

Ya am cycle is where the action is. I prefer to change at pm so if there’s any NDW I can just go to sleep but if it’s active I am around to do few checks. And by am cycle I think the new dose will show the effect. Haha yes I’m itching since yesterday.

 

[Waheeda]

Makoto is doing great despite everything and you are too!

It sure is overwhelming when our kitties have multiple illnesses/diseases.


Lol! That's very true. I think if QOL is good and kitty isn't in pain, age is just a number. You don't give up on old humans, why give up on old cats?

Exactly! Eventho my civvie has many issues, lost weight cos of pancreatitis last month and is walking unsteadily cos of nerve issues, he’s still alert, playful, clingy and looks eagerly for food. How can I give up on him? He will still growl when it’s sub-cut time and paw my hand for rubs. I hope he will live till 22! He’s 16 now.