10/22/10 Squamee AMPS 209 .6U IMPOSSIBLE WITH MEDS!

[judy and squamee(GA)]

Yesterday was AMPS 416--the highest she has ever been. I gave .9 both morning and night and she is down this morning. I gave only .6 because of the big drop from last night to this morning---and I am trying to work out a variable program which gently moves her in the right direction.
THe medication saga continues. She took the pill pockets, and then refused them. I was able to pill her successfully with the phenobarb (which is tiny) for a few times, and then she was spitting out the pills. I got liquid suspension of the gabapentin in fish flavor and she refused it in food. I syringed it with difficulty, but thought I was getting most in. I also tried beef flavor, which she rejected as well. Last night I got the liquid phenobarb (beef flovor) and she also rejected that. I syringed that this morning and afterwards she had a white colored drool hanging from her mouth (a LONG thread of drool). So there is no telling how much medication she is actually getting, and her mouth symptoms were worse this morning. She also seemed more upset, and went into hiding without trying to eat. I ordered a "pill shooter" on line--who knows, maybe that will work better than the liquid! And this compounded liquid stuff is VERY expensive. SUCH frustration!

 

[Gator & H (GA)]

I'm interested to see what .65 does to her [at the appropriate time]. Looks like .6 is a dose that will let he rise back up - potentially by quite a bit. .6 might work out to be I think what Nancy labeled the "BCD" or Big Chicken Dose - the dose you give when you are too chicken to give something else . I used to give lots of those. .7 seemed a bit before like when given in consecutive doses that it would bring her down slowly maybe - or at least at that time.

On paper, I'm not a big believer in "overlap" but I will admit to thinking not only with Squamee but on occasion with H when I would give a dose like you did with .9 [that you knew/expected would bring her down] and on the first dose of it I would get a little bit of a drop then I would give it the next dose too and I would get a larger drop if overlap was not playing a roll in that. So I just thought I might introduce a potential theory to those numbers. Of course [less] food could play something in the larger second drop too. And sometimes too you just gotta get out the Ouija board. :smile:

 

[judy and squamee(GA)]

AMPS 209 .6U
+5 254
PMPS (at +13.5) 227 .6

Hard to understand these numbers. I don't think she was eating that much around +5---but maybe she was. She definitely was not eating before the PMPS. So maybe food accounts for this. WHen I saw the +5 number I thought damn, I should have shot somewhat higher---but then I got the PMPS of 227 ----??? So I did the chicken dose again. (I have adopted a pattern of always going lower when I am unsure---after a few lows that scared me).
Think I got the phenobarb into her OK, and waited a few hours before the gabapentin. THe gab. is compounded so it is twice as much fluid and she seems to react more negatively. Once again she had a long milky white thread of drool shortly after. And she had the most prolonged fit of mouth symptoms that I have thusfar seen.Kills me to watch but I feel I have to stay with her. I brush her and try to distract her. She doesn't object to the brushing, but it doesn't seem to help, either.
I am somewhat amazed that she doesn't hiss (which she is an EXPERT at) or act at all hostile.

 

[Gator & H (GA)]

My input would be to not worry about the cause of the numbers so much and just focus on those PSes [meanwhile just making sure the nadirs do not go too low]. Ahh, but there is always the caveat: if you expect some 'condition' of the moment to continue or begin for the next 12 hours THEN 'worry' [factor it into the equation] about it.

 

[Joanna & Bix (GA)]

:YMHUG: I really feel for you Judy, I wish I had some suggestions. Meds are always a challenge, I can't even imagine dealing with them if they have a mouth/jaw/face issue complicating things. I hope the vets can come up with something that is injectable, or something like a patch (I know I have heard of ear patches, or ear creams, or something like that), just seems like oral meds are a nightmare.

With Bix I've discovered a new pilling technique - I get behind him, and then sort of poke my finger in his mouth from the right side (with the pill on my fingertip - thumb is in there helping somewhere) and toss it as far back as I can. When it goes well, it turns out to be the easiest pilling I've ever done (I've always so far approached from the side/front). Of course when I don't get it back far enough, it's the usual spitting out followed by dirty look routine. For Bix's new chemo pills I put on a disposable rubber glove 1st and those turn out to be the easiest - I think it may be the pill, but I'm wondering too if the glove just makes everything go more slickly. Sometimes w/o that the pill will stick to my finger a bit and I don't get as good a toss back.

Well anyhow, just trying to brainstorm in case anything helps....

 

[judy and squamee(GA)]

Thanks, Joanna. I have been coming at her from the back, pulling her head up, holding her jaw with my right hand, and holding the pill in my left thumb and pointer, then prying her mouth open with my left hand middle finger, and throwing the pill in . Have you ever tried the pill shooters?

 

[Joanna & Bix (GA)]

Yeah, that's basically what I do, but from the other side. And then embarrassingly it was a disaster this morning cuz I didn't toss to the back with enough confidence. Oh well, got it down eventually.

I never got the hang of the pill shooter - tried it once years & years ago, so that's probably not a good indicator, since I didn't have much pilling experience back then. Hopefully it'll work great for you!