? 2/23-Flame-AMPS=397,+3=333, +6=271, PMPS=352 - Breathing really bad :-(

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Donna and Flame

Donna and Flame

Member Since 2009
http://www.felinediabetes.com/FDMB/...6-226-9-235-pmps-288-3-263-dosecrease.173623/

Good morning L&L,
That number this morning shocked me. I am not sure if he possibly went lower into blue last nite or if this is a result of him just not feeling well. In either case, it's upsetting.
His PS last nite was 288 and at +3 he was 263 - so not a big drop, but he could have hit low yellows or high blues. Seems like he nadirs around +6 and drops a bit more till about +9 or +10 before he starts going up before PS.

He ate barely anything overnight. I tried1/2 can of FF chicken this am and he turned his nose up at it till I put some chicken dust on it and then he at a little bit. But what I noticed lately is, when he eats the food with the chicken dust, he sneezes or coughs afterwards. Wonder if he's either allergic to it or maybe if it's laying on top of the food, its still loose enough for him to sniff it in and inhale a bit. I also gave about 1/3 can Weruva Fowl Ball (chick & turkey) and he did almost all of that - only left a few bites. So, I left him a bit more of the Weruva food as well as the 1/2 can of FF before I went to work.

His breathing was not good this morning. I could hear a wheeze and rattle. Right or wrong, I gave him 1.25mg of Pred this AM. I can not be home with him today and I did not want him struggling with his breathing any more. He has been fighting the inhaler again in a big way so it's been difficult to get the required dose into him. If I can't get the inhaled steroids into him, then he needs something and the oral steroids are the only other choice, so I gave it to him. Had to crush his Pred, famotadine and Zyrtec in baby food this morning and of course, he lapped that up.

Eric is working from home today again thank goodness, so I've asked him to get a +2 or +3 test and a +6 test at a minimum for me today. I also asked him to just check on Flame occasionally and check to see if he's eating and if not, offer him some fresh food.

I honestly don't think he's nauseous - I think he just doesn't like the food he's getting and I think part of it is the breathing issues too. He'll eat his Turkey lunch meat treats and he almost takes my finger off trying to get to it and he'll lap up baby food with no problem, so I know he CAN eat.
I have gone thru this before with him where he was genuinely not feeling well and all I could get into him for a day or two was baby food and then he'd turn his nose up at regular food. I think he's playing me a little bit here, so maybe I need to back off the baby food.
Been using it especially to give his pills and supplements because I'm not sure he'll eat the regular food, but I know he'll eat the baby food, so I know he'll get the full dose he needs.

Let me ask a question... if I did increase his dose tonite or tomorrow AM, doesn't it take a while for the depot to fill? Do you think, based on his SS, that he would really drop on the first day of a dosecrease?
Can I get some experienced opinions on this please? He's been at this dose way too long and if I'm going to start him back on Pred, even every other day, I expect his numbers to go up.

Hope the kitties and beans are all doing well today!! Vines and prayers for ALL in need today. :bighug:
 
I think it looks like flame could do with a dosecrease, unless of course she decides to sho you some low blues or green today.

When I've put chicken dust on georges food he has ocaisionally breathed it in when he has sniffed at it and its made him sneeze.
 
Donna and Flame said:
Wonder if he's either allergic to it or maybe if it's laying on top of the food, its still loose enough for him to sniff it in and inhale a bit.
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Doodles sneezes when drinking water because he sticks his whole face in there. It's possible the chicken dust is contributing to Flames sneezing.

I would've given the pred also this morning. Although yes, it is contradictive with heart issues, but one more day until you get the echo done isn't going to make a difference if it turns out Flame has additional issues besides the asthma/ LAD. (anti jinx).

Flame is pretty "stuck" and may have developed a bit of glucose toxicity. I'd be reluctant though to increase knowing he will likely not be monitored Friday while at the vetty. One more day or two without an increase is not going to make an overwhelming difference IMO. Once you have the tests done on Friday, you can focus on getting his numbers down. While there is usually a 4-6 cycle wait for the depot to fill some kitties will react sooner than that.
 
I think it's better to wait until you can monitor before you increase the dose. I hope Flame eats better today. It does sound like the chicken dust may be making his breathing worse. Sending prayers. :bighug::bighug::bighug::bighug::bighug::bighug::bighug:
 
Doodles & Karen said:
I would've given the pred also this morning. Although yes, it is contradictive with heart issues, but one more day until you get the echo done isn't going to make a difference if it turns out Flame has additional issues besides the asthma/ LAD. (anti jinx).

Flame is pretty "stuck" and may have developed a bit of glucose toxicity. I'd be reluctant though to increase knowing he will likely not be monitored Friday while at the vetty. One more day or two without an increase is not going to make an overwhelming difference IMO. Once you have the tests done on Friday, you can focus on getting his numbers down. While there is usually a 4-6 cycle wait for the depot to fill some kitties will react sooner than that.
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Hi Karen,
I figured he was on the Pred for quite a while and was stable and doing well, so I decided given his recent issues, that it was the best option right now. He may not have heart issues, we don't know yet, I just know he was doing better with it than without it. It was hard for me to do, since when we re-started this journey in Dec. I was always hoping for another remission and I knew getting him off the Pred gave him the best chance for that (and part of that was admittedly selfish on my part because after taking care of my mom for the past 2 years, I was just really praying for a break and some return to normalcy for myself), but if that's not to be, then I will deal with it.

Need the patience pants right now on the dosecrease!! Hindsight is always 20/20 so they say and a part of me regrets holding this dose so long, but I really had no idea how he would react when he came off the pred. Didn't know if he'd drop quickly or not. As it turns out, he did for a day and then went right back up. I do believe his not feeling well has contributed somewhat to the higher numbers also since coming off the Pred. He did hit blue last Sunday, so we know he can do it... just have to find that dose.

Thanks for all your encouragement and insight!! I am so grateful!! :bighug::bighug::bighug:
 
I agree with the others. Wait until after Friday's appointment for the increase. Neko used to react strongly to increases, just some of the time. Seen the same variability with other cats. If you knew he would be home before nadir, that would be a different story. That was one of the benefits of Neko on Lev, she was usually done any vetty stuff and home well before nadir.

Sending tons of vetty vines for tomorrow. I hope his breathing is better when you get home tonight. :bighug:
 
My heart is in my throat right now. My son texted me at his +6 test and said Flame's breathing sounds like hell. He's wheezing and congested. My son said he didn't know if he was coughing at all cause he works upstairs in his bedroom and Flame stays downstairs. He said Flame did eat a bit more but not a lot.

I just want to crumble and cry right now. I'm at work and I can't leave. Ordinarily, I'd tell Eric to try to get another dose of Flovent or Albuterol into him, but Flame has been so resistant to that lately and he gets upset and his breathing gets worse. When he's having trouble breathing already, he is even more resistant to me putting that mask over his face! Eric has never done it before either so I think it would just end up being a battle with Flame and that won't do him any good.

Need help here... I started him out on just 1.25 mg of Pred this morning - that was the dose he was on before we stopped.
He's been off Pred since Saturday, so 5 days off.

Should I give him another 1.25 mg when I get home tonite if his breathing is still bad? He had been up to 2.5mg before, from 12/23/16 to 1/13/17, then reduced to 1.25 daily from 1/13/17 to 2/9/17. In the past, my vet has actually given him a shot to "kick start" the effect and then had me follow with oral Pred.

Experienced folks.... thoughts?!?!?

My vet is not in today and I'm not sure if she'll be in tomorrow b/c her husband was admitted to hosp on Tues.
 
Did you try counting his respiration rate like I mentioned yesterday? Higher numbers, above 30, were my red flag for heart issues.
 
Wendy&Neko said:
Did you try counting his respiration rate like I mentioned yesterday? Higher numbers, above 30, were my red flag for heart issues.
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I haven't done that yet. Honestly, I spent so much time just helicoptering him yesterday with the breathing and eating I forgot. Will try tonite when I get home.
 
@Wendy&Neko would counting his resps for above 30 per minute still be valid if he's having trouble breathing? I'm thinking his breathing pattern may be different. Just wondering....
 
I don't know. I would see shallower breaths if the RR was high. Combined with lethargy and little appy.
 
{{{Donna}}}} I am sending you hugs and hope that Friday can get here fast enough. :bighug::bighug::bighug::bighug::bighug::bighug: I don't know the answer to your pred question as I don't have experience with it. Do you think your vet would guide you from just a phone call?
 
Donna, I'm so sorry and not sure about pred dosing either. You probably know more about that since Flame was on it for some time.

Since we know now that some of Doodles breathing/ coughing issues is LAD (not the CHF although it has been) I do hear his breathing often (like a bronchitis/ asthma would sound from his mouth...sounds heavy). It has not raised his RR or at least that I've caught. I would try and get Flame's RR tonight when he's sleeping (that's the tricky part). It's good information for the cardio vetty too.

Hang in there :bighug::bighug::bighug:
 
When my vet would start one of my cats on Pred for an acute issue, she would always start high and then slowly decrease. What was the initial dose Flame was started on? Does your vet have any partners in her practice that could look at your file and tell you whether or not you should give more?

Sending vines, prayers and :bighug:s.
 
Bobbie And Bubba said:
Do you think your vet would guide you from just a phone call?
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Unfortunately, my vet is not in today. Her DH is in the hospital. I could call and try to speak with another vet, but they don't know Flame's history and would probably just glance at his chart (maybe).

My son just texted and said he's been sleeping a lot, breathing mostly thru nose but still sounds really stuffy. If not more Pred, my vet did say I could give him another dose of antihistamine. Her email from Tuesday said:
Ok. U can give him famotidine twice a day. If you are only giving zyrtec once a day, you could give the app. stim 12 hours later, or replace one dose of zyrtec with the app stim if your giving zyrtec BID. But id hold on app stim unless he stops eating all together

I have Zyrtec (and I did give him an increased dose of that yesterday - gave 5mg instead of his usual 2.25 mg) and I have Cyproheptadine which is also an antihistamine, but also acts as an appy stim. However, her email said to hold off on appy stim unless he stops eating all together, which I'm not sure I agree with because from what I've read, it can take several days to take effect.

I just don't know what to do any more.
 
Tricia Cinco(GA) & Harvey said:
When my vet would start one of my cats on Pred for an acute issue, she would always start high and then slowly decrease. What was the initial dose Flame was started on? Does your vet have any partners in her practice that could look at your file and tell you whether or not you should give more?

Sending vines, prayers and :bighug:s.
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If I've brought him into the office when he was having issues, she would initally give him an injection and then follow with oral pred. His starting dose this last time was 2.5 mg per day. Then we decreased it to 1.25 mg per day cause he was doing so well and I'd started the flovent inhaler, and then decided to try to wean him over 10 days so we lowered to 1.25 every other day.
 
Just got off the phone with the vet's office and spoke to another vet. He's seen Flame once or twice. He said to bring him back up to 2.5mg Pred for now until he stabilizes, so I guess I can give him another 1.25 mg when I get home and he also said the inhaler is probably the best option for a quick response, but I explained that he's been fighting that horribly lately, so I'm not sure I can get a full dose into him. If he needs it, I can try to give him the Albuterol "rescue" inhaler - he only has to take 5 - 6 breaths on that as opposed to 10 - 12 breaths on the flovent.

I can get out of here soon, thank goodness.
 
Tricia Cinco(GA) & Harvey said:
When my vet would start one of my cats on Pred for an acute issue, she would always start high and then slowly decrease. What was the initial dose Flame was started on? Does your vet have any partners in her practice that could look at your file and tell you whether or not you should give more?

Sending vines, prayers and :bighug:s.
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Hi Tricia,
I just called the vet's office and spoke to another doctor who said I could bring him back up to 2.5 mg until he's stable. He's never been higher than 2.5 mg per day, unless of course, he got a steroid shot in the office. This is killing me to have to go backwards with him and put him back on Pred, but if that's what it takes to make him comfortable and allow him to breathe easier, thats' what we have to do.

Thank you for being here for us!! :bighug:
 
If it helps him, then it's not really going backwards. I know someone else mentioned @Melissa & Tarragon because T also has asthma. I remember a few years ago, Melissa couldn't get prednisolone for a while, so she had to use prednisone. T's asthma backslid big time - almost as if he wasn't getting anything at all, but once she was finally able to get his prednisolone back, he improved pretty quickly. Hopefully you'll see the same for Flame. As I mentioned the other day, the one "nice" thing about FD is that you can adjust his insulin around his other health needs....it is flexible that way. I know you'd love him to go OTJ, but at least you have a lot of great tools to deal with FD - including a lot of support and knowledge! And I totally understand the desire for the return to normalcy...I also helped care for my Dad through is cancer battle for 2 years as well until he passed away last summer (and now I still have to help my Mom who has never been on her own before)....it's hard and exhausting, but somehow we are able to do what we need to do for those we love.
 
Well, the pred seems to have helped his appy, but not the breathing yet. He sounds horrible. Really congested and I can see his chest rising and falling, esp on exhale where it seems he is forcing air out - a little while ago he was coughing a bit - and then I could see his lips/jowl area puffing out on exhale. Not good. I also noticed he's doing that thing where it looks like a hard swallow.

I rushed home from work and he was asking for food, but it was too early to feed him so I gave him another 1.25 mg of Pred and another 1/4 tab of Zyrtec with some liverwurst and turkey lunch meat and he almost took my finger off trying to get to it, so I know he was hungry. He sounded like he was snorting when he was eating it.

I tried to give him his flovent and i knew it was going to be a challenge because when he can't breathe already and you put the mask on his face, he has a hard time with it and I can understand that. I could not get enough breaths into him and he was getting stressed and his breathing got worse. So, I stopped, gave him some turkey lunch meat as a treat to reward him, tried to calm him down, loved on him for a bit, and then pulled out the "rescue" inhaler (Albuterol). It was a struggle again but I think I managed to get about 4 - 5 breaths into him. Nothing is working fast enough and he still sounds awful. This is so upsetting, for him and for me. I'd do anything to take this away from him... anything to make him feel better. He's resting now. Just nibbled on some more food.

His PMPS # may have been influenced by stress tonite. By the time we got done with the inhaler stuff, it was t/f/s time and I didn't want his shot to be late, so I tested him. He came down nicely today. Was hoping Eric could get a +8 or +9 test in but he had conf calls, so he wasn't able to. I'm just grateful he was here this week. I have no idea what I'm going to do next week. I might be able to work from home a couple of days, but don't want to push my luck with my so far, understanding boss.

Please keep those prayers and vines coming for my sweet boy and if you can spare one for me, it would be greatly appreciated and gratefully received.

I truly hope that all of your furry loves are doing well and I keep you all in my thoughts and prayers. :bighug::bighug::bighug:
 
Aweee momma bean, take some breathe try to be calm. It's scary. Tons of vines coming your way. Wishing tons of breathing vines for Flame. :bighug::bighug::bighug::bighug:
 
Donna and Flame said:
Unfortunately, my vet is not in today......
.....I just don't know what to do any more.
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((Donna)),
I'm sorry that I haven't been very active lately but I want to send you heaps of healing and support vines.

I've felt the same way as you do now many a time. It's a horrible state to be in but who wouldn't under similar circumstances? So, please take some comfort and be gentle on yourself. you've got amazing support with both your family at home and here!

Tons of :bighug::bighug::bighug: for a gentle night tonight, a better day tomorrow with good vetty vines, and that Flame feels better soon.
 
I haven't been online and didn't see your post until now. I know how horrible it is when they can't breathe. Tarragon is a hard core asthmatic and is on an inhaler and prednisolone. Like Amy mentioned, one time we ran out of prednisolone and they gave us prednisone. It didn't help him at all and he was only getting worse. I found out that cats don't have the enzyme in their liver to break prednisone into prenisolone so it was as if he wasn't getting anything at all.

Breathing is first. Do what you have to to get his breathing under control and you can deal with the blood sugar numbers after that. Tarragon is on 10 mg of prednisolone a day and I have to give him 20 mg during allergy season. I just adjust his insulin upwards every 3 days when he is on the higher amount until his BGs stabilize.

Please let me know if I can do anything for you!!
 
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Melissa & Tarragon said:
I haven't been online and didn't see your post until now. I know how horrible it is when they can't breathe. Tarragon is a hard core asthmatic and is on an inhaler and prednisolone. Like Amy mentioned, one time we ran out of prednisolone and they gave us prednisone. It didn't help him at all and he was only getting worse. I found out that cats don't have the enzyme in their liver to break prednisone into prenisolone so it was as if he wasn't getting anything at all.

Breathing is first. Do what you have to to get his breathing under control and you can deal with the blood sugar numbers after that. Tarragon is on 10 mg of prednisolone a day and I have to give him 20 mg during allergy season. I just adjust his insulin upwards every 3 days when he is on the higher amount until his BGs stabilize.

Please let me know if I can do anything for you!!
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Hi Melissa,
Wow, that is a lot of Pred. Flame is on 2.5 mg - that's the highest dose he's ever had and was well controlled on that before but not so much now. The problem is that he now has multiple health issues that require treatments that can be contradictory to on another.
He has FD and asthma, but he also now has CKD (most likely stage 2) and this past Friday he was diagnosed with Restrictive Cardiomyopathy.

If it was just the FD and the asthma, it might be easier to manage, but now with the kidney issues AND the heart issues.... increasing his Prednisolone is really not an option. I even have to be careful with fluids now. Because he is having such difficulty breathing, he is absolutely REFUSING to use his Flovent inhaler. I've tried. I've had to resort to Albuterol the past few days to give him some relief and I'm not sure how often I should use that.
I've even borrowed a nebulizer machine from a friend who has asthma and she gave me some of her albuterol pre mixed vials to use until I can get something from my vet. I've used it last nite and this morning and emailed my vet in the mean time, to ask more about this.

He was doing so well. We got him down to 1.25 mg Pred per day with the Flovent inhaler and he was pretty stable. He started having issues when we tried to wean him off the Pred. Both his vet and I thought it was safe to do because he was doing so well. We weaned him slowly, over 10 days where we went to 1.25 mg every other day and the minute we stopped the Pred he tanked and the breathing issues have returned. (Stopped Pred on 2/18)

I put him back on the Pred on 2/23 and have been giving him 2.25 mg daily since, but I can't seem to get his breathing under control again.

Any suggestions or words of wisdom you may be able to share would be greatly appreciated.

Thanks Melissa!! :bighug::bighug::bighug:
 
Hi Donna - Melissa's T actually has HCM, too. I know Melissa isn't able to post as much as she used to, but I sent her a note asking her to recheck in with you when she has a chance - hopefully she'll be able to offer some more insight from her experience.
 
Tarragon has HCM, IBD, asthma, and FD so I understand the multiple issue juggle.

I have no ideas for the inhaler issues. Tarragon doesn't like his but puts up with it for the treats. Of course, the inhaler really doesn't do a whole lot for T so all the extra pred. He has had asthma for 11 years so it has taken awhile for us to build up to this dosage but asthma usually gets worse over time. I would only use the albuterol a couple of times a day, especially with the heart condition.

We have tried decreasing T's pred dosage as well and it usually ends up coming back and having to up the dosage. The vet and I decided to just leave him on it long term and it has worked well for the last few years. Is Flame on prednisolone or prednisone? You might be able to get away with upping his pred for a day or two just to get the asthma back under control.
 
Melissa & Tarragon said:
We have tried decreasing T's pred dosage as well and it usually ends up coming back and having to up the dosage. The vet and I decided to just leave him on it long term and it has worked well for the last few years. Is Flame on prednisolone or prednisone? You might be able to get away with upping his pred for a day or two just to get the asthma back under control.
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Melissa,
How has the pred affected T's heart issues? How often do you have his heart checked? Bloodwork done? Flame is on Prednisolone. I'm really afraid to give him more Pred because of the kidneys and heart.

He was having such a hard time on Saturday that I called my vet and brought him in for a steroid shot (hated to do that, but we've done it in the past to kind of "kick start" the effect of the steroids), a nebulizer treatment and he spent an hour or so in oxygen. All of that seemed to make him feel much better for the rest of the day on Saturday and into the night, but Sunday AM he was breathing loudly and sounded congested again.

I worked with him for weeks initially getting him used to the inhaler and he was really good with it for a while. BUT, his breathing was much better then. Now, because he is struggling already, putting that mask over his face must make him feel like he is suffocating because he REALLY fights it and I can understand how it must make him feel. I have tried many different positions to try to get the mask on his face where i can keep it there but he struggles so badly it's nearly impossible.

Thanks again Melissa!!
 
I know you are trying it all, but have to tried burritoing him and just hold the mask at his face or under so you can see the mist going in? Or putting him in the carrier and just putting it up to his face thru the door, not actually putting it in him.
 
Donna, did you talk to the AC yet? I'm wondering if she could communicate to Flame how the inhaler will help him. I totally understand how if you're having problems breathing already that putting a mask over your face would be scary.
 
We get T's heart checked every year. He was diagnosed with HCM in 2012 and it hasn't gotten any worse thankfully. He has been on prednisolone full time for the last 5 years so I don't really think it has affected his heart condition. We have always been of the mindset that breathing comes first and we will work around FD, HCM, whatever as long as he can breathe. I know how truly scary it is to see them struggle for breath.

We used to do the pred shots. I believe that is how Tarragon got FD to begin with. He would get a shot every 6 - 8 weeks for years and then came down with FD. We did do a shot once after he was diagnosed and he had a bout of pancreatitis and DKA from it. Since then, we haven't had a shot. We discussed this with our vet who believes that pills are safer. I'm not sure on the dosing of the shot, but you can adjust the pill dose up or down if need be. Once they get the shot, they are super dosed. I hope the shot helps him out!!
 
Dyana said:
Donna, did you talk to the AC yet? I'm wondering if she could communicate to Flame how the inhaler will help him. I totally understand how if you're having problems breathing already that putting a mask over your face would be scary.
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Hi Dyana,
Session is tonite. We've tried to tell him this in previous sessions and sometimes he turns into, as my AC puts it... "a grumpy old man" who doesn't want to listen to anything. However, it did get better for a while, so we're going to try to get thru to him again tonite. Hopefully, he'll be receptive.
 
Phoebes said:
I know you are trying it all, but have to tried burritoing him and just hold the mask at his face or under so you can see the mist going in? Or putting him in the carrier and just putting it up to his face thru the door, not actually putting it in him.
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Hi Angela,
I have no problem giving him the nebulizer, it's the inhaler he won't accept and that mask has to go right on his face and covers his mouth and nose. With the nebulizer, I can just hold the end near his face and he can breathe in the mist.

My son and I tried the burrito last week and he got even more upset. Fortunately, or unfortunately, Flame is a very sensitive little soul. He is very mild mannered and VERY sweet, but gets upset easily.... yet on the other hand, he can also be very stubborn! Ya know, he's a cat!!
 
Donna and Flame said:
Hi Angela,
I have no problem giving him the nebulizer, it's the inhaler he won't accept and that mask has to go right on his face and covers his mouth and nose. With the nebulizer, I can just hold the end near his face and he can breathe in the mist.

My son and I tried the burrito last week and he got even more upset. Fortunately, or unfortunately, Flame is a very sensitive little soul. He is very mild mannered and VERY sweet, but gets upset easily.... yet on the other hand, he can also be very stubborn! Ya know, he's a cat!!
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Now I understand. Sorry my head is thick sometimes. You can see his sweetness in that picture. What a cute little guy. Massive healing hugs sent your way from phoebes and I.
 
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