12/13 Asia PMPS 269, +1.5 208, +3 114

[Stacy & Asia]

http://www.felinediabetes.com/FDMB/threads/12-12-asia-pmps-285-2-212.187909/

+9 131, +10 122

Trying to do a little experimenting with food. Wondering if I get ahead of the +1, +2, drop and onset, if things will be a little more even keel and I won't have to resort to carbing her up in those first few hours. Fed 2 tsp of plain Radcat at +10. We will see what happens.

Not sure what she did last night, maybe a dip of green, maybe surfed in blues? Had a +7 alarm set, but my body said no, I didn't even hear it, I wonder if I turned it off in my sleep or if it just stops making noise if you ignore it long enough?

 

[carfurby (GA)]

Good luck with the food experimenting. I hope Asia surfs safely today.

 

[Doodles & Karen]

If you use your phone as the alarm clock, I often had to change the sound or my robotic body would sleep through it. Good luck with the experiment today and surf safely Miss Asia.

 

[Mandy & Rex (GA)]

Those are nice numbers from the greens yesterday!!

 

[Stacy & Asia]

If you use your phone as the alarm clock, I often had to change the sound or my robotic body would sleep through it. Good luck with the experiment today and surf safely Miss Asia.

Thanks for the tip, that's exactly what I do, I never know what sound which alarm is going to make. If I knew the sound, I'd probably tune it out, like I do the sirens and garabage trucks outside. I think it was just built up sheer exhaustion, I'm not normally a sleep through the alarm type and I never press snooze.

 

[Alicia & Maggie (GA)]

Hope the food experiment had good results. Quite a day you had yesterday!

 

[Stacy & Asia]

+11 121, looks like it froze the action, I would have expected a 20 point drop from the +10 to the +11 without food. The real test though will be if I can do this from lower numbers, like greens. An hour until AMPS and then I will see where she is at.

 

[KATIE&ovie]

The alarm received your "representative." My alarm sees my representative more than it should

I hope your experiment works with green numbers.

 

[Stacy & Asia]

AMPS 106, I fed her at +10 and just now, maybe I need to feed her at +11 as well? She just ate some more radcat so will see where she is in an hour.

 

[Stacy & Asia]

The alarm received your "representative." My alarm sees my representative more than it should

I hope your experiment works with green numbers.

Accurate. My zombie self just does what it wants!

 

[Marje and Gracie]

Morning Stacy. I hope you got some rest.

Yesterday, I was a bit under the weather and I kept thinking there was one other reason she would drop at +1 fairly consistently but I had my own NyQuil induced brain fog

After you went to bed, I studied her SS some more and realized the primary reason she has a +1 drop is that she is a very early onset kitty. She does have some days where she gets lengthy duration and the second dip pushes to the right but the more I looked at her SS, I had an epiphany

Take a look at Gabby’s SS (hyperlink is not working on my iPad right now so here's the link: https://docs.google.com/spreadsheets/d/1jBOu0s4cv1XI6_-whkECk_kQGVwhr6Fryw-bFt-SCuE/pub?hl=en&hl=en#. Look at her oldest SSs and you’ll see a very familiar pattern. This was before Sienne learned to control the drops. If you look at her newest SSs, Sienne figured it out and was a master at it. She couldn’t use HC food or gravy because Gabby was allergic so she used LC food and honey or karo....I don’t remember which. When the remarks state “HC”, it was honey or karo.

The difference between the two is that Gabby also could have an early nadir but Asia can push hers out a little further.

If you notice, once Sienne figured it out, with I’m assuming help from one of the gurus that was on at the time, she shifted her testing and always got a +1 so she could control the drop from the literal onset.

The challenge with an early onset cat that is still bouncy is that you don’t have a lot of time to front load the cycle with food. If she starts at 250, for example, you really don’t know where she will be at +1 although with the data you have, it doesn’t look like she is generally a diver like some (e.g. Girlie).

I apologize that my foggy brain didn’t catch that first but it was bugging me because the longer I looked, I realized that some of her +1 numbers were too low to be a second dip.

Also, on a crazy day like yesterday, I like to go back and give an idea...or lesson....of what approach you might take next time this new occurs. And there will likely be a next time.

Once you get past two hours after the food/HC, if she is still rising, you can shoot. I came in late to the discussion yesterday, but had I been on earlier, I would have suggested you shoot at the 87 @ +14.25 with 1.75u.

Normally, we don’t suggest shooting too much later than +2 because it makes it harder to get back on schedule but I knew it was safe for you to shoot at what I thought was +2.5 (I should have looked at time stamps) but it turned out fine that it was actually +3.5 since you had the leeway on catching up and it kept her from climbing too high.

Next time she starts to bounce up again, check her no later than +11 and take advantage to shoot another hour early to help you get back to your normal time sooner.

And now for the funny story I promised you. We had only been doing this a few months but Gracie was a busy girl at night and I was working full time so I was like the walking dead even with Mike pitching in more than his share. I got up one Saturday morning after a pokeathon Friday night and in my befuddled brain fog, I put the glucometer in the mircrowave instead of the rice sock.

Yeah....that was ugly even though I caught it pretty fast. I had to race to the pharmacy and wait until the doors opened at 7:30, grab a new glucometer, race home, and shot 30 mins late.

BTW, I edited yesterday’s condo with the info above regarding early onset since many were bookmarking it.

I’m clear headed today for questions!

 

[MyTitan (GA)]

Looks like good surfing for Asia today. Yesterday's and today's post are marvelous reading and information.

 

[Stacy & Asia]

Oh my-lanta! +1 128, is that? Could it be? A food spike? I was wary with the preshot that maybe I should give her some HC right then, but since I'm here this morning, I decided to hold off and see if the +10 mini meal would change the course a bit. Really is just one cycle, and a higher one than the ones I've struggled with, but that seems like a new thing to me! Cautiously optimistic.

 

[Stacy & Asia]

After you went to bed, I studied her SS some more and realized the primary reason she has a +1 drop is that she is a very early onset kitty.

So that's what I thought initially, "onset +2, what are you talking about? This cat likes to drop from the plus 2 minutes!

But what you wrote yesterday also makes a lot of sense, because it's not entirely new action, it is carrying over from the previous shot, so I guess we have a perfect storm situation when she gets duration from an earlier shot that smashes into the onset of the new one, rather than a calmer waxing/waning meeting of the two?

Is it not the double dip because the second dip isn't supposed to be lower than nadir? I have to read this whole post and the last one and take them in. So much food for thought. I'm very hopeful I can formulate a plan now and know my cat even better!

Sienne posted to me the other day and I looked at Gabby's SS then, what I noticed is Gabby responded terrifically to food, and I was a bit jealous of that! Will look again with new lenses.

 

[Stacy & Asia]

And now for the funny story I promised you. We had only been doing this a few months but Gracie was a busy girl at night and I was working full time so I was like the walking dead even with Mike pitching in more than his share. I got up one Saturday morning after a pokeathon Friday night and in my befuddled brain fog, I put the glucometer in the mircrowave instead of the rice sock.

Yeah....that was ugly even though I caught it pretty fast. I had to race to the pharmacy and wait until the doors opened at 7:30, grab a new glucometer, race home, and shot 30 mins late.

Oh no! Good thing it wasn't in the middle of the night when stores were closed! Did the microwave survive, at least?

I poked Asia with a lancing device once...no blood, poked her again...no blood, I must have done this 4 or 5 times and was feeling like the worst cat mom ever for making her ears a pin cushion and still no blood to do the test. I decided to take off the top...no lancet in there!

 

[Marje and Gracie]

So that's what I thought initially, "onset +2, what are you talking about? This cat likes to drop from the plus 2 minutes!

But what you wrote yesterday also makes a lot of sense, because it's not entirely new action, it is carrying over from the previous shot, so I guess we have a perfect storm situation when she gets duration from an earlier shot that smashes into the onset of the new one, rather than a calmer waxing/waning meeting of the two?

Is it not the double dip because the second dip isn't supposed to be lower than nadir? I have to read this whole post and the last one and take them in. So much food for thought. I'm very hopeful I can formulate a plan now and know my cat even better!

Sienne posted to me the other day and I looked at Gabby's SS then, what I noticed is Gabby responded terrifically to food, and I was a bit jealous of that! Will look again with new lenses.

Except the “perfect storm” is actually what we like to see. Carryover and overlap are excellent.

Carryover is when duration goes from one cycle into the next.
Overlap is when one cycle is waning as the next is onsetting.

That is what helps get those long, flat, green “curves”.

Correct...for a double dip, the number is typically not lower than the nadir. I was looking at greens and where they occurred and not paying as much attention to the exact number as I should have been. That’s not to say she hasn’t gotten some delayed second dip but I do believe her pattern is more of an “early onset” one.

Also....I didn’t mean for you to feed her at +10 every cycle. Only if she was lower....as in the 60s. What happens when you feed that late is that the duration gets shortened. I know you might be thinking that’s a good thing and it is helpful if she’s low and in danger of dropping too low to shoot by PMPS. But, otherwise, you don’t want to inflate the PS just so she gets a +1 spike. You want to learn to deal with the +1 onset

Did the microwave survive, at least?

It did. Thankfully. And I learned a lesson....always have at least one backup meter the same as the primary one.

I decided to take off the top...no lancet in there!

What a good girl she was but I can see how that mistake could happen esp if you were sleep deprived!

 

[Stacy & Asia]

Except the “perfect storm” is actually what we like to see. Carryover and overlap are excellent

Right, I get that, but my analogy was rather than one cycle gently ending just as the other is starting and picks up and goes from there, these wonky ones for Asia is more like her last cycle is a runaway train full steam ahead crashing into the next one. It's like too much momentum.

 

[Marje and Gracie]

Right, I get that, but my analogy was rather than one cycle gently ending just as the other is starting and picks up and goes from there, these wonky ones for Asia is more like her last cycle is a runaway train full steam ahead crashing into the next one. It's like too much momentum.

I can certainly understand how you would make that analogy. It can be grueling to have that pattern.

In fact, many members whose cats have raced down the dosing ladder to go into remission will tell you it was the most grueling part of the “dance” because it seems they are in such a hurry to get off the insulin once they hit a great dose and all other stars align. I’ve had members tell me they just didn’t think they could continue to deal with it but I always tell them if they can, the reward is most likely remission, and then they are done with all the testing, shooting, etc. as long as the cat remains in remission. It’s worth it.

I don’t think Asia is at that point so I don’t want to lead you astray but I want to acknowledge that any time they do that, even if it’s only for a short time, it can seem like a “runaway train”.

 

[Stacy & Asia]

Also....I didn’t mean for you to feed her at +10 every cycle. Only if she was lower....as in the 60s. What happens when you feed that late is that the duration gets shortened. I know you might be thinking that’s a good thing and it is helpful if she’s low and in danger of dropping too low to shoot by PMPS. But, otherwise, you don’t want to inflate the PS just so she gets a +1 spike. You want to learn to deal with the +1 onset

It did. Thankfully. And I learned a lesson....always have at least one backup meter the same as the primary one.

What a good girl she was but I can see how that mistake could happen esp if you were sleep deprived!

Yes, I'm not planning on feeding every +10, it was just a relatively low number without being 20 from the reduction number, so I used the opportunity to experiment when I had more wiggle room. It should work similarly at lower numbers, I hope. It looks like it halted the last cycle for the most part, and that's what I'm going for (not for today, but for when I need it).

Someone posted near after I joined about having a backup meter and batteries and having them klunk out at the worst times, so I got a backup as well. And I have the AT. Triple check!

She is a good girl, I'm so glad she picked me!

 

[Mandy & Rex (GA)]

In fact, many members whose cats have raced down the dosing ladder to go into remission will tell you it was the most grueling part of the “dance” because it seems they are in such a hurry to get off the insulin once they hit a great dose and all other stars align. I’ve had members tell me they just didn’t think they could continue to deal with it but I always tell them if they can, the reward is most likely remission, and then they are done with all the testing, shooting, etc. as long as the cat remains in remission. It’s worth it.

I can 100% attest to this!! I was so sleep-deprived towards the end that I often overslept on the weekends so I stopped going back to bed so I wouldn't miss that critical +2. The first weekend after Rex was officially OTJ, I fed the cats and went back to bed for hours! That felt so good.

 

[Stacy & Asia]

Okay, these are from your posts yesterday and today, lots of questions have been answered in them, thank you! I'm going to study Gabby's SS closely and see how I can apply that to Asia. I hope you feel better soon, sick brain is just as bad as sleep deprived brain, but it didn't seem to keep you from making sense!

11/1 The a.m. cycle was a bounce clearing cycle and I would expect her to keep dropping after PMPS.
11/24: Not a bounce clearing cycle and it was a perfect, flat cycle.
11/29: lovely PM cycle after clearing the bounce in the morning. She was down at +1 but the rest of the cycle might have been affected by the honey (it brought her up so she onsets from a higher number) and then she bounced or lost duration (hard to tell without being able to see how fast she climbed that night).
12/6: She was clearing the bounce the day before. That morning just looks to me like normal waning of the previous PM shot by AMPS and then she onset. PMPS looks like second dip.

What's the deal with bounce clearing cycles? Do they always tend to drop and drop even going in the next cycle when clearing a bounce? I know ECID, but are there any guidelines or specific things to be aware of on a bounce clearing cycle other than “here comes trouble, maybe”? Outside of looking for dramatic drops and monitoring +10s/+1s/+2s?

The 11/24 and 12/6 cycles interest me in particular because they are so similar in circumstance, but outcomes opposite. They both are trailing on a weird yet undramatic cycle that trailed on a bounce cycle. They both have a similar preshot number and neither had a dramatic drop prior to the preshot. Asia did her average 20 point drop in the +1 for both, not overly concerning, but this is where they diverge. 11/24 she stayed flat, without any food intervention other than her regular preshot meal. 12/6 she kept dropping even with more food and 12% gravy in the mix. Is this an absorption anomaly? I know it's probably impossible to know.

I'm open to trying karo, maple syrup, banana pudding (kidding), whatever kind of glucose, sucrose, fructose to see if she responds better to one over another. Maybe she will become a sugar addict, but I doubt she would fixate on that like she would on a new food! Is there any way to know what would make it higher LC, MC, HC? Like one drop is one and 3 drops is the other? Or I just experiment and see how much gives the response I'm looking for?

So going forward, I look for bounces and watch +10s, if low, give her some food and see if she goes up a bit. Then after her shot give some sugar in the +1? +2? As a preemptive, better safe than sorry measure? And look for big drops and feed them. Am I missing anything?

Thanks you thank you and thank you again! This thread and yesterday's have been vastly informative for me and I'm happy to hear for others as well.

 

[Stacy & Asia]

+4 158, looks like a bit of a bounce, I hope I didn't cause that with my +10 food experiment!

On the plus side, I can take a nap, on a Wednesday! Still so tired.

 

[Stacy & Asia]

Asia has a vet appt. tomorrow. Wish us luck, new vet I interviewed a bit ago, but Asia has not seen him yet. My intention is to get bloodwork done when Asia isn't having a medical issue to get a better picture on things that are normal vs areas of concern. All of her labs are in the SS, I've never had any vet really go over labs with me and tell me why they ignore some things that are high, they usually just say something like "this thing is high, there's probably an infection". Doing my own research, it seems like a lot of things that are elevated could point to something like CRF/CKD whatever the du jour term for it is, but could also be elevated due to dehydration? All of her bloodwork was taken when she was having issues going on, UTI, teeth problems, etc. and when you're not feeling well, you probably don't eat/drink as much as you should, so dehydration is not unlikely for all of those labs. She was given sub-q fluids fluids at 3 of those visits, so that settles any guesswork there and the other one she was having tooth issues and wasn't eating so well, so dehydration likely there too.

I'm going to address her arthritis and solutions for that, will ask about:

Adequan, Buprenorphine, Duralactin, and hyaluronic acid

Would like to address both inflammation and pain if possible, and leaning towards injectables or ear paste compounds since those are the most viable options to get meds in to her.

Vet suggested to do an ultrasound to rule out/in CRF and pancreatitis. I'm waffling on this. Would it be definitive and would it tell me anything useful that I would change anything I'm currently doing? I already treat her like she is a CRF cat because I thought she definitely was until recently. Other reason I'm waffling is because he has someone outside come in once a month to do u/s and I'm supposed to drop my cat off in the morning and pick her up in the afternoon. That sounds like a very stressful day or her being in a cage waiting around hours for a 20 minute procedure. I'm not going to do that. The vet is 5 mins away, if they can give me a time guesstimate, I can bring her in at a moments notice and if they would be willing to let me be there and help hold her during the procedure, I will consider. Is that a crazy ask? She is perfectly docile, but her stress would be through the roof if I wasn't there, that much I know and I don't want to do more harm than good.

I've also read (on here) about this SDMA test. Will that give more indication to CRF? Would it take the place of having an ultrasound? She doesn't have this on any of her labs, would I need to request it? Nobody has ever suggested it any time she has had blood work done.

Also going to ask about her few remaining teeth. They have bothered her on and off, I've been told both she's too old to have them extracted and "oh, we do it all the time, she'll be fine" so that's a bit frustrating. One vet suggested pulsing antibiotics to keep oral infections at bay. This option doesn't thrill me because a) how could I get the antibiotics in her and b) previous times on antibiotics have often led to diarrhea, not eating, yucky stuff like that. Just what she needs on top of diabetes, right? But doing nothing is like playing Russian roulette. Those remaining teeth could kill her with systemic infection, and almost did nearly 10 years ago when she had a bunch of extractions.

If anyone has any thoughts or suggestions, I'd appreciate it. It's a big deal for Asia to go to a vet having had a vet come to her for most of her life. I'm not trying to do it very often, so I want to make the most of this visit and tick all the boxes I can.

 

[Tanya and Ducia]

Doing my own research, it seems like a lot of things that are elevated could point to something like CRF/CKD whatever the du jour term for it is

SDMA by IDEXX or Anthech (spell) is the best way to determine kidney problem early - I would order it.. it's about another $40 in CA.

 

[Christie & Maverick]

Sending vetty vines, I don't have any suggestions, but would just say you are taking such a wonderful care of Asia. Based on what you are currently doing, I honestly can't see what extra benefit an ultrasound on the kidneys or pancreas would give you, at this point? good luck

 

[Marje and Gracie]

If that +10 is a correct number, I would shoot now. But monitor tonight, as usual, since you shot early both nights.

 

[Wendy&Neko]

I never had an ultrasound for Neko to diagnose CKD. My vet used Idexx and got the SDMA included in the blood work results. That plus the BUN, Creat, and USG were enough. Antech doesn't do SDMA. And I don't think it's crazy to ask to be there for an ultrasound. Neko's acupuncture vetty and civie Theo's regular vetty (and my go to vetty going forward), also has a visiting U/S vet. I schedule a time when she will be there, and I go in and help hold kitty while the U/S is done. Since Theo was a semi feral, he was much better with me there. Of course, there were certain vets who thought I'd grown horns when I asked to be there. Differing vet opinions on whether kitty is better or worse with their person there. I was also there for bloodwork.

For teeth, is there a dental vet specialist near you? They are much more used to senior kitties and their issues, and often have a board certified anethesiologist on hand. I think the anethesia is main question with a senior kitty. As for ABs, do you feed probiotics while she's on them? That can help.

Good luck with the vetty appointment. I've been known to turn on phone recording when I'm asking a bunch of questions, so I don't forget the answers. Has Asia every had her blood pressure tested? I had to do a Feliway spray in kennel/Rescue Remedy drops in the AM combo in order to get a decent BP reading.

 

[Stacy & Asia]

If that +10 is a correct number, I would shoot now. But monitor tonight, as usual, since you shot early both nights.

373 is a +9, +10 is in about 30 minutes

 

[Marje and Gracie]

373 is a +9, +10 is in about 30 minutes

If you test at +10 and she’s still that high and going up, I’d shoot, with the caveat of watching the numbers closely. Shooting that early two nights in a row is a bit aggressive but she can fire up into black and we want to avoid that if we can.

And I absolutely do not believe your experiment caused that. Different cycles. You’re good.

 

[Marje and Gracie]

Asia has a vet appt. tomorrow. Wish us luck, new vet I interviewed a bit ago, but Asia has not seen him yet. My intention is to get bloodwork done when Asia isn't having a medical issue to get a better picture on things that are normal vs areas of concern. All of her labs are in the SS, I've never had any vet really go over labs with me and tell me why they ignore some things that are high, they usually just say something like "this thing is high, there's probably an infection". Doing my own research, it seems like a lot of things that are elevated could point to something like CRF/CKD whatever the du jour term for it is, but could also be elevated due to dehydration? All of her bloodwork was taken when she was having issues going on, UTI, teeth problems, etc. and when you're not feeling well, you probably don't eat/drink as much as you should, so dehydration is not unlikely for all of those labs. She was given sub-q fluids fluids at 3 of those visits, so that settles any guesswork there and the other one she was having tooth issues and wasn't eating so well, so dehydration likely there too.

I'm going to address her arthritis and solutions for that, will ask about:

Adequan, Buprenorphine, Duralactin, and hyaluronic acid

Would like to address both inflammation and pain if possible, and leaning towards injectables or ear paste compounds since those are the most viable options to get meds in to her.

Vet suggested to do an ultrasound to rule out/in CRF and pancreatitis. I'm waffling on this. Would it be definitive and would it tell me anything useful that I would change anything I'm currently doing? I already treat her like she is a CRF cat because I thought she definitely was until recently. Other reason I'm waffling is because he has someone outside come in once a month to do u/s and I'm supposed to drop my cat off in the morning and pick her up in the afternoon. That sounds like a very stressful day or her being in a cage waiting around hours for a 20 minute procedure. I'm not going to do that. The vet is 5 mins away, if they can give me a time guesstimate, I can bring her in at a moments notice and if they would be willing to let me be there and help hold her during the procedure, I will consider. Is that a crazy ask? She is perfectly docile, but her stress would be through the roof if I wasn't there, that much I know and I don't want to do more harm than good.

I've also read (on here) about this SDMA test. Will that give more indication to CRF? Would it take the place of having an ultrasound? She doesn't have this on any of her labs, would I need to request it? Nobody has ever suggested it any time she has had blood work done.

Also going to ask about her few remaining teeth. They have bothered her on and off, I've been told both she's too old to have them extracted and "oh, we do it all the time, she'll be fine" so that's a bit frustrating. One vet suggested pulsing antibiotics to keep oral infections at bay. This option doesn't thrill me because a) how could I get the antibiotics in her and b) previous times on antibiotics have often led to diarrhea, not eating, yucky stuff like that. Just what she needs on top of diabetes, right? But doing nothing is like playing Russian roulette. Those remaining teeth could kill her with systemic infection, and almost did nearly 10 years ago when she had a bunch of extractions.

If anyone has any thoughts or suggestions, I'd appreciate it. It's a big deal for Asia to go to a vet having had a vet come to her for most of her life. I'm not trying to do it very often, so I want to make the most of this visit and tick all the boxes I can.

Let me answer the questions here that I can first and then I’ll go back to the other post and go through those.

If there is no indication she has any symptoms of pancreatitis (and remember sometimes symptoms can be simply “ain’t doing right” like not super interested food...if that is new...more lethargic than usual, etc), I see no reason to do an ultrasound for that. I also see no benefit in ultrasounding her kidneys. If it were me, because her creatinine is elevated and her USG is down below where it should be, I’d ask if they use IDEXX and get an SDMA. That’s the easiest and most reliable way to tell if she has CKD without putting her through an U/S. Her ALT is elevated but it goes up and down and it’s not elevated enough right now for me to worry about an U/S. If you get labs done and it has increased alot and is up in the 300s, I’d think about an ultrasound at that point.

I used Duralactin with no success and adequan didn’t help my arthritic cat either but ECID. You have to be careful with the Duralactin because some forms of it have sweeteners like maltodextrin (or used to; I haven’t looked at it in a while).

Boy the teeth issue is a tough one. I did have to have a major extraction done on an 18 year old cat and she breezed through it just fine. What I would suggest, since you are in NYC, is seeing if there is a board certified veterinary anesthesiologist. I never do any dentals without one because my cats have had underlying issues (Gracie...diabetes; Tobey...heart; Livia...respiratory). It will be a lot more expensive but a good one is worth their weight in gold. That way the dental vet can focus solely on the cat and not all the other stuff.

 

[Stacy & Asia]

I never had an ultrasound for Neko to diagnose CKD. My vet used Idexx and got the SDMA included in the blood work results. That plus the BUN, Creat, and USG were enough. Antech doesn't do SDMA. And I don't think it's crazy to ask to be there for an ultrasound. Neko's acupuncture vetty and civie Theo's regular vetty (and my go to vetty going forward), also has a visiting U/S vet. I schedule a time when she will be there, and I go in and help hold kitty while the U/S is done. Since Theo was a semi feral, he was much better with me there. Of course, there were certain vets who thought I'd grown horns when I asked to be there. Differing vet opinions on whether kitty is better or worse with their person there. I was also there for bloodwork.

For teeth, is there a dental vet specialist near you? They are much more used to senior kitties and their issues, and often have a board certified anethesiologist on hand. I think the anethesia is main question with a senior kitty. As for ABs, do you feed probiotics while she's on them? That can help.

Good luck with the vetty appointment. I've been known to turn on phone recording when I'm asking a bunch of questions, so I don't forget the answers. Has Asia every had her blood pressure tested? I had to do a Feliway spray in kennel/Rescue Remedy drops in the AM combo in order to get a decent BP reading.

This is a new vet, so I don't know what lab they use, but if they use Antech, does that mean I can't get the SDMA? Can they do it special if I ask and sent it to a different lab? I will find out tomorrow, but curious if you knew. I don't care what they think of me, I can either be there, or she won't have it done. I know my cat better than they do and she can't talk so I have to do the talking for her.

I would definitely go to a dental specialist and there is one here, yes. Her last extractions were done by a great oral surgeon that worked on the animals at the national zoo. Tried to do probiotics, she took one sniff of her "tainted" food and refused to eat it. And I read somewhere that fortiflora is like kitty crack? Not for this kitty.

That phone recording idea is brilliant! I kick myself when I leave because sometimes I forget some things they say. I try to take notes and write things down that I don't understand, but it's hard to do that and listen at the same time. Thanks for that! Never occurred to me. Not sure about the blood pressure, would they tell me if they did it when they whisked her away? I don't recall them ever saying anything. She's been to vets/ERs 3 times these past few years and all were for emergency situations so I wasn't in a position to say "I go where she goes" but I will be tomorrow. Thanks so much, Wendy!

 

[Ella & Rusty & Stu(GA)]

Sending good vetty vines for tomorrow. I hope you get helpful answers to your questions.
Give your girl a few scritches from us. (and let me know how you like your new vet, please!)

 

[Wendy&Neko]

If they use Antech, they'll need to send a separate sample to Idexx to get the SDMA. Neko's IM vet didn't use Idexx and offered that to me, but it wasn't really of value by that point.

I wouldn't use Fortiflora for any reason, full stop. Use a human probiotic, many use Renew Ultimate.

 

[Stacy & Asia]

Let me answer the questions here that I can first and then I’ll go back to the other post and go through those.

If there is no indication she has any symptoms of pancreatitis (and remember sometimes symptoms can be simply “ain’t doing right” like not super interested food...if that is new...more lethargic than usual, etc), I see no reason to do an ultrasound for that. I also see no benefit in ultrasounding her kidneys. If it were me, because her creatinine is elevated and her USG is down below where it should be, I’d ask if they use IDEXX and get an SDMA. That’s the easiest and most reliable way to tell if she has CKD without putting her through an U/S. Her ALT is elevated but it goes up and down and it’s not elevated enough right now for me to worry about an U/S. If you get labs done and it has increased alot and is up in the 300s, I’d think about an ultrasound at that point.

I used Duralactin with no success and adequan didn’t help my arthritic cat either but ECID. You have to be careful with the Duralactin because some forms of it have sweeteners like maltodextrin (or used to; I haven’t looked at it in a while).

Boy the teeth issue is a tough one. I did have to have a major extraction done on an 18 year old cat and she breezed through it just fine. What I would suggest, since you are in NYC, is seeing if there is a board certified veterinary anesthesiologist. I never do any dentals without one because my cats have had underlying issues (Gracie...diabetes; Tobey...heart; Livia...respiratory). It will be a lot more expensive but a good one is worth their weight in gold. That way the dental vet can focus solely on the cat and not all the other stuff.

The pancreas stuff was just a stab in the dark because I read the PSL LIPA being high could point to that. She got diagnosed with diabetes in September because she was sitting on the couch and made the most horrible scream, twice. I've never heard her make a sound like that and she's an extremely vocal cat. She got up from the couch, went to the litter box, strained to do something (pee and poop came out at the same time) then proceeded to vomit up all of her food (probably due to straining). I highly suspected UTI as she has had one twice earlier this year. Took her to the vet, they gave convenia before the culture came back: negative! She didn't have a UTI. She did have diabetes, that was a shock. But we never figured out what the scream and straining was from. She wasn't constipated either. In hindsight I think it was her way of telling me "I need help" but as lovely as that sounds, diabetes doesn't explain any of it.

That's the only type of dental I would consider and that's what I had before and is also the reason I left the 2 unaffected premolars in her mouth, the extractions were like $500 per! Yikes! And I was in no position to afford having them out prophylactically at the time. Kick myself for not putting in on a credit card and just dealing with it then. But oh well.

Thanks, Marje!

 

[Marje and Gracie]

I do agree with Wendy that it’s worth the extra step to ask the labs be sent to IDEXX if your new vet uses Antech since Antech doesn’t do the SDMA. Also a good idea to get a baseline BP. And...I also agree with her on the Fortiflora. It’s not something I would ever allow my kitties to have. It has animal digest in it which makes it addictive but it has nothing with any benefit. And it’s made by Purina

I read the PSL LIPA being high could point to that.

I’ve never seen that test on Antech labs and that’s the lab my vet uses. Antech's pancreatitis test is called “Precision PSL” so I’m thinking it is the same as the PSL LIPA. However, it is not nearly the same as having a snapfPL or specfPL done. Those are the gold standard and even they can give false positives. I don’t put a lot of stock in the Precision PSL. And, like the other tests, it can be elevated if the liver enzymes are elevated.

 

[Stacy & Asia]

+10 344 @Marje and Gracie its coming down (from 373) should I wait until +11, +12?

 

[Stacy & Asia]

I do agree with Wendy that it’s worth the extra step to ask the labs be sent to IDEXX if your new vet uses Antech since Antech doesn’t do the SDMA. Also a good idea to get a baseline BP. And...I also agree with her on the Fortiflora. It’s not something I would ever allow my kitties to have. It has animal digest in it which makes it addictive but it has nothing with any benefit. And it’s made by Purina

And so is FF, and here I am doing that Do the human probiotics have a taste? If they don't she might not notice it.

 

[Marje and Gracie]

And so is FF, and here I am doing that Do the human probiotics have a taste? If they don't she might not notice it.

I don’t think so....my cats take them mixed in food. And my boy is very suspicious if there is anything in his food that he can taste or smell.

+10 344 @Marje and Gracie its coming down (from 373) should I wait until +11, +12?

It’s basically the same number with meter variance but wait if you are more comfortable. It’s ok.

 

[Stacy & Asia]

I don’t think so....my cats take them mixed in food. And my boy is very suspicious if there is anything in his food that he can taste or smell.


It’s basically the same number with meter variance but wait if you are more comfortable. It’s ok.

It was still coming down, I waited until +11 it's 269

That's great to know, I didn't know if cat's had the same gut flora as people and if it was safe or not

 

[Marje and Gracie]

Good. You might just hold off shooting early tonight. Great job keeping an eye on it.

Cats and people do not have the exact same gut flora but there are not a lot of studies on exactly what constitutes a healthy cat’s gut flora. They likely have some strains identical to human’s but not all as they are obligate carnivores.

Most pet probiotics don’t have enough CFUs to make it through the cat’s stomach acid. That’s why it is better to use a human probiotic with many more CFUs.

 

[MyTitan (GA)]

I can 100% attest to this!! I was so sleep-deprived towards the end that I often overslept on the weekends so I stopped going back to bed so I wouldn't miss that critical +2. The first weekend after Rex was officially OTJ, I fed the cats and went back to bed for hours! That felt so good.

 

[MyTitan (GA)]

Asia is getting an A in instructional cat !

 

[Marje and Gracie]

Here are the responses to your questions today from yesterday’s condo.

What's the deal with bounce clearing cycles? Do they always tend to drop and drop even going in the next cycle when clearing a bounce? I know ECID, but are there any guidelines or specific things to be aware of on a bounce clearing cycle other than “here comes trouble, maybe”? Outside of looking for dramatic drops and monitoring +10s/+1s/+2s?

Yes, they quite often do. They tend to be very active cycles, in general. There aren’t specific guidelines on how to handle them except to be vigilant and expect exactly what you said. Although, when one gets uber savvy about their cat, and if the cat typically gives a high BG before the break, then the CG can start testing at +1 and feed the drop to get it to slow down and flatten out. Or, perhaps another pattern easily picked up on is that the cat tends to bounce a set number of cycles before it clears. However, this changes.

The 11/24 and 12/6 cycles interest me in particular because they are so similar in circumstance, but outcomes opposite. They both are trailing on a weird yet undramatic cycle that trailed on a bounce cycle. They both have a similar preshot number and neither had a dramatic drop prior to the preshot. Asia did her average 20 point drop in the +1 for both, not overly concerning, but this is where they diverge. 11/24 she stayed flat, without any food intervention other than her regular preshot meal. 12/6 she kept dropping even with more food and 12% gravy in the mix. Is this an absorption anomaly? I know it's probably impossible to know.

The biggest difference I can see is she was still clearing that huge bounce that started on 12/5 but the cycles were fairly similar. In truth, I really don’t know why those cycles were so different.

I'm open to trying karo, maple syrup, banana pudding (kidding), whatever kind of glucose, sucrose, fructose to see if she responds better to one over another. Maybe she will become a sugar addict, but I doubt she would fixate on that like she would on a new food! Is there any way to know what would make it higher LC, MC, HC? Like one drop is one and 3 drops is the other? Or I just experiment and see how much gives the response I'm looking for?

Many members use honey with no issue and it controls the numbers. You can try karo, if you want to just see but it might not be any different. There’s no way to tell unless/until you try it. There’s no real way to know how much would put you at a LC, MC, or HC food once you add it to the raw. Generally, giving any syrup or honey would at least make it a MC food. And yes...you have to learn when one drop works and when she needs more.

So going forward, I look for bounces and watch +10s, if low, give her some food and see if she goes up a bit. Then after her shot give some sugar in the +1? +2? As a preemptive, better safe than sorry measure? And look for big drops and feed them. Am I missing anything?

Correct. Control dropping, lower +10s with a little LC. If you shoot low and you know she will continue to drop, add in the syrup/honey to try and keep her from earning a reduction. And yes, preemptive feeding to flatten big drops will help but she’s not a diver like some.

Thanks you thank you and thank you again! This thread and yesterday's have been vastly informative for me and I'm happy to hear for others as well.

You’re welcome. It’s truly my pleasure. Any time someone wants to learn, there are many of us willing and happy to share our knowledge as was done for us by others.

 

[Girlie's mom]

Wow - Stacy, I'm sorry you're having such dramas with Asia - I can well understand how you feel given Girlie's antics over the past few months. But this post and the last one have given all of us such valuable information, so thank you, Asia, for being a bit of a drama kitty! Now, be good and let your momma get some sleep!

Re: the arthritis: I can well vouch for the benefits of acupuncture if you can find someone who really knows what they're doing. That has really helped Girlie.

Good luck, good luck with the vet visit and all of the advice and your experiments!

 

[Stacy & Asia]

Wow - Stacy, I'm sorry you're having such dramas with Asia - I can well understand how you feel given Girlie's antics over the past few months. But this post and the last one have given all of us such valuable information, so thank you, Asia, for being a bit of a drama kitty! Now, be good and let your momma get some sleep!

Re: the arthritis: I can well vouch for the benefits of acupuncture if you can find someone who really knows what they're doing. That has really helped Girlie.

Good luck, good luck with the vet visit and all of the advice and your experiments!

Thanks, Darrah, I think Girlie's had some pretty informative threads as well. She could trademark her brand of drama! I'm so glad to hear Asia's thread is helping others too.

So we've been having weekly catupuncture appointments since late August, it did help with some things, she stopped sitting with "foldy under paws" for awhile and she's doing that again. She was squatting her hind quarters down if you pet her on the back whilst she was standing and that has resolved a bit. Her back legs would turn out and she was near going in to the splits at the food bowl and that is also better. But she has declined in areas as well, since acupuncture, she's stopped attempting to jump on the couch since October (she used to do it with great effort and would occasionally fall, but still did it several times a day). She even hesitates sometimes to walk up the cat stairs I have by my bed and will either ask me to pick her up, or lay on the area rug next to my bed. She gained her weight back that she had probably lost because of the diabetes and I think that's just made it harder. The accupuncture is pretty astronomically expensive to do weekly and if the results were overwhelming, that would be one thing, but I think she just needs more than it can do for her right now. Some of her symptoms kind of overlapped diabetes things too, so it's hard to see how great the impact of the accupuncture is because of that, some of the back leg issues could have been very early neuropathy that has resolved from diabetes care. Probably some pain management is in order because the less she gets around, the worse it's going to get. If you don't move, you rust!

 

[Wendy&Neko]

The accupuncture is pretty astronomically expensive to do weekly and if the results were overwhelming, that would be one thing, but I think she just needs more than it can do for her right now.

I went down to monthly acupuncture treatments, but vetty showed me how to do acupressure, which I did daily. The "massage" was part of Neko's post shot morning loving. I got lots of purrs through it. It seemed to help extend the effects of the acupuncture.