2/7 Rocket AM BG 139=NS/ PM BG 121=NS

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Rocket & his Mom

Rocket & his Mom

Member Since 2010
morning all,
i tried to relax and sleep some thru the night...easier said than done but managed some sleep

i really don't know how i'm going to juggle it all....once the pred is on board i know he will need insulin and therefore the constant testing begins....clearly he gets stressed out even this morning me testing him and i don't get nervous by any means...i'm as calm as always...but he doesn't react to it well...and the tremors begin...also another issue is that he does not eat on command and needing insulin obviously i need to make sure he eats and if he drops i also need the constant testing/feeding....i can see this becoming really problematic...i don't know how he will handle it all....i don't know

AM BG 139 no shot....

i placed a call to the neuro vet and the roads here are awful...so i was told that perhaps in about 2 hrs time he would call me back...and also i don't know if i need to go pick up the med there or if they can Rx it to my nearest pharmacy...not sure how they handle that...

stressful beyond words but trying to determine also the time of all the meds as with the pred and bupe i can not give it too close to the pheno...so insulin, bupe, pred, pheno are a huge deal...also the eating part...and testing part...

please keep me...keep us in your prayers...it's been in the back of my head how this will be juggled...but now that Monday is here...it is very stressful indeed...also the not knowing how he will react to the new med...

not much has changed with him...same as what it's been lately...

yesterday viewtopic.php?f=9&t=36133

keeping Cheryl and Whiskers in my prayers as well as Ele and Blackie....
 
Re: 2/7 Rocket AM BG 139=NS/awaiting vet call back

((((((((((Claudia and Rocket))))))))) I think you will get advice on how to manage the meds and time needed from each other. When Maverick was on the ten different meds it was overwhelming and complicated. I needed a spreadsheet to think it all out and make up a plan that worked.

I am not sure how the standard iphone alarms work. I ditched it after a few heart attack like alarms in the middle of the night.

We now use the app Alarm Clock 4. It allows for a rising volume alarm so its not a shock. I can set them as daily, weekly etc. But also add a label to each one. I am 100% on wifi which I think is the cause of missed alarms though. I can't get cell service at home.

((((((Hugs)))))))
 
Re: 2/7 Rocket AM BG 139=NS/awaiting vet call back

From what I recall, some cats do better with one dose of pred per day others do better if you split the dose. Both Linda/Bear and Carolyn/Latte were using pred and I think they had to do things by trial and error as to what worked best with their cat. The pred should also stimulate Rocket's appetite and, hopefully, he will feel better and testing will be easier.
 
Re: 2/7 Rocket AM BG 139=NS/awaiting vet call back

I hope you can get started on the pred today, and I'm sorry you're stressed out about it. I don't know why Rocket is having a hard time with testing - he didn't used to did he? You may find that he won't need insulin even with the pred - ECID. I only had to raise Blackie's dose a little and he's on a fairly large dose to begin with.

You and Rocket are always in my prayers and thoughts. I hope everything goes well.
 
Re: 2/7 Rocket AM BG 139=NS/awaiting vet call back

Will definitely keep you guys in our prayers .. such a team you guys make .....
 
Re: 2/7 Rocket AM BG 139=NS/awaiting vet call back

once the tremors became more evident and more permanent he started fighting me with the testing...i know he hates it now...and to me it's no picnic seeing him like this...it's upsetting...and i talk to him and i pet him and i offer chicken dust later on...i do whatever but he gets stressed out...

doing fluids it's a hit and miss lately too...sometimes he is good sometimes half way thru he decides he's had enough other times it's a no go...

he surely has changed....in that regards...

i'm still waiting...i guess it's been 1 hr since i called the neuro vet...time is going fast but slow if that makes sense
 
Re: 2/7 Rocket AM BG 139=NS/awaiting vet call back

(((((Claudia))))) Sent you an email on pheno - off another list from this morning. 99.9% chance it doesn't apply to you.

Hope the neuro has called back darnit.
 
Re: 2/7 Rocket AM BG 139=NS/awaiting vet call back

stupid neuro dude has not called....i've left 6 messages and i know he is busy but i need the darn med...i don't know if i need to go get the med there or if i need to go to a specific pharmacy or if they can send the Rx to my nearest pharmacy...this is frustrating...they're so quick to take the money and are more than available then but when i need them for something like this they're nowhere to be found....

i left the first message way before he even started his shift....one would think that out of courtesy he would get that call out of the way first....

i'm upset as i would have loved to start this today...not looking like it...

i asked the receptionist when he leaves and she said 5pm....now 1 pm...not hoping for that call today...and to make matters worse the IM vet is on vacation as of today this is why i need this neuro guy...as both of them are the ones that dealt with Rocket last week....
 
Re: 2/7 Rocket AM BG 139=NS/still waiting vet call back

Maybe you could fax in or call in your questions to one of the vet techs and ask her/him to get the answers and relay them?
 
Re: 2/7 Rocket AM BG 139=NS/still waiting vet call back

i tell them the reason for calling and i go into great length on explaining...

i don't have a fax machine...

this is frustrating cause to make matters worse....Rocket's reg vet doesn't work Mondays so i can't get her involved in it either...
 
Re: 2/7 Rocket AM BG 139=NS/still waiting vet call back

Thinking of you and hoping you get the pred on board today. I know it is difficult juggling meds but I also know what an incredible bean you are and
you will do absolutely fine. I know this in my heart. (((Claudia)))
 
Re: 2/7 Rocket AM BG 139=NS/still waiting vet call back

considering the weather today and what his surgery schedule might be it isn't totally unreasonable even if it is terribly frustrating. It may be that you might not hear till the end of the day if he has a gap between his last appt and when he leaves..that is often when i hear from my vet...
 
Re: 2/7 Rocket AM BG 139=NS/still waiting vet call back

Jen & Squeak said:
considering the weather today and what his surgery schedule might be it isn't totally unreasonable even if it is terribly frustrating. It may be that you might not hear till the end of the day if he has a gap between his last appt and when he leaves..that is often when i hear from my vet...
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i called again and insisted in talking to the head nurse...i don't care at this point on the weather and he is not in surgery as i did ask the first time around...no scheduled surgeries for today...i was told

after asking for the head nurse i was actually transferred to him right away...so now i asked all the questions i needed to ask him and it's retarded he wants me to give ALL meds at the same time...pheno, bupe and pred....i'm no vet but he is wrong and i won't do it....but that's besides the point....

the urgency in all of this is that he too is going on vacation (and he is NOT available TOMORROW as the IM vet told me last week)....so if i don't look into this now and bug them until i get a hold of someone then i'm stuck not being able to give Rocket the medication....

med will be ready for pick up in 1 hr!!!!
 
Re: 2/7 Rocket AM BG 139=NS/finally got a hold of vet!

thoughts, prayers and vines continue to be sent to you and Rocket from Willie and I. Glad to see your persistence paid off and you will be able to start Rocket on his meds shortly!
 
Re: 2/7 Rocket AM BG 139=NS/finally got a hold of vet!

Hi Claudia,

I so glad you finally got ahold of the vet and meds will be ready for pick.

Hoping Rocket will be feeling better. cat_pet_icon .
 
Re: 2/7 Rocket AM BG 139=NS/question to the experts

since i won't be able to give Rocket the pred before his pm bg....i gather that by tomorrow he will have high BGs

what dose should i start him at? with all that's going on with him and the tremors and stress i don't feel comfortable with 1.0u.....or even 0.5u....should he drop like a stone as before....

what then shall i give?

i'm hoping to give the pred at around 12 midnight....i still don't know what time to give it to him separating it enough from the phenobarbital

thoughts?
 
Re: 2/7 Rocket AM BG 139=NS/question to the experts

but you do not know that the pred will cause his BGs to sky rocket. Several people have stated that this wasn't the case with their cats. If BGs do go up, why not go cautiously at first and see how he responds?
 
Re: 2/7 Rocket AM BG 139=NS/question to the experts

Claudia & Rocket said:
since i won't be able to give Rocket the pred before his pm bg....i gather that by tomorrow he will have high BGs
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No one knows if this will be the case. Some cats have absolutely no reaction to steroids, other cats mild, and others more obvious. You just DONT know and reallly cant plan until you have given it. Even then, it may take a few days for it to settle in. You may actually see a DECREASE in bg's *if* any higher numbers are caused by pain/discomfort and the steroid is helping.

Claudia & Rocket said:
what dose should i start him at? with all that's going on with him and the tremors and stress i don't feel comfortable with 1.0u.....or even 0.5u....should he drop like a stone as before....
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I really believe its a wait an see. Kind of like what you are doing ever day. You were only giving .5u before right? I dont think I would personally start any higher if you chose to go into it blindly (ie/not waiting to see what bg's do). The last thing you need to do is fight low numbers right now.



Claudia & Rocket said:
i'm hoping to give the pred at around 12 midnight....i still don't know what time to give it to him separating it enough from the phenobarbital
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Most of us who used pred for extended period of times have found giving the setroid @ shot time is most ideal. This way the peak of the pred is often matched or possibly passed when you hit nadir. If you shot around 6-8pm with a nadir around +6 (say 1am), and gave pred @ 12am....pred would peak in his system past nadir, while insulin is petering out. POSSIBLY resulting in higher a.m. numbers. Depending on if you are giving the pred am/pm or just pm, you could end up with some very lopsided numbers (low numbers a.m/ high numbers p.m.).

Of course ECID. If I were in your situation, I would give the pred at regular shot time. Use the same guidelines you used before (no shoot numbers) to determine if you will shoot tonight. Get a +2 or +3, then a +5 or +6. Test again in the a.m. If much higher than usual, then consider resuming a LOW dose of insulin in the a.m. Its much easier to start low and go slow, than go high and fight those numbers with a cat that is not eating well and/or QOL if affected by too much testing.

I hope that helps. Im kinda sick myself so a little cloudy. I have to run out in an hour or so and will be back later tonight to check in. Maybe linda/bearman will chime in as well.
 
Re: 2/7 Rocket AM BG 139=NS/question to the experts

Just to put into perspective...vets do not prescribe insulin every time they prescribe steroids to a cat, right? Its because not all cats react to it. IF the cat then shows w/ high BG's after using it, THEN they make decisions based on the reaction.

Does that make sense? :mrgreen:
 
Re: 2/7 Rocket AM BG 139=NS/question to the experts

Claudia --

I have no experience with pred. I'd suggest taking a look at Ele/Blackie's condo from today. Blackie seems to have a paradoxical response to the pred and Linda happened to mention that she'd had a similar experience with Bear. Like with everything else, ECID.
 
Re: 2/7 Rocket AM BG 139=NS/question to the experts

I agree wait and see how Rocket does. Even if he goes a bit high - say 160 or even 175 - is that enough if its one time to start insulin? I would wait and see what he does and post daily. It is good to be prepared, but like they are saying every cat really is different. Use tonight to try and get some sleep.
 
Re: 2/7 Rocket AM BG 139=NS/question to the experts

i know i'm getting ahead of myself here...but here is the situation

Rocket's am/pm shot times is/was 5:30 am/pm
pheno/zofran/pepcid at 6 am/pm

leaving no room to give the pred....at shot time as i can not give too close to the pheno...

so i would have to move the shot time to a different time and if i were to move it let's say even 10 am/pm leaves me be in the wee hrs should he go low trying to bring him back up...and with no one to help me should i encounter such situation...also he usually hit low early in the cycle...first 4 hrs...

it's separating the pred with the pheno that is causing a headache...and the rx says to give every 12 hrs of the pred

i will wait for sure...but what would be considered safe BG # to leave...of course tonight he won't get insulin...bupe is in 1/2 hr and by the time he gets pm bg is another 1 1/2 hrs...and i've noticed bupe lowes the bg...at least it did last week...
 
Re: 2/7 Rocket AM BG 139=NS/question to the experts

I understand. What I meant though, is do you have to give insulin right away even with rising numbers, or can you wait? So even day one on pred, and you see a trend upward, can you just wait for near PM time instead or AM time. And especially if the numbers are still blue or lower yellows? You don't have to shoot right - waiting won't hurt him will it?
 
Re: 2/7 Rocket AM BG 139=NS/question to the experts

carolynandlatte said:
Just to put into perspective...vets do not prescribe insulin every time they prescribe steroids to a cat, right? Its because not all cats react to it. IF the cat then shows w/ high BG's after using it, THEN they make decisions based on the reaction.

Does that make sense? :mrgreen:
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DH is picking up the med so i'm told he has to sign a waver regarding the potential risk of Rocket becoming diabetic again...as he is considered on remission as of today...

i don't think they do...not sure...but he did give me the speech over the phone regarding the diabetes part
 
Re: 2/7 Rocket AM BG 139=NS/question to the experts

since i won't have the pred on time for when i used to give insulin (5:30 pm) then i don't think he will be getting insulin tonight...and i still don't know when to give the pred....
 
Re: 2/7 Rocket AM BG 139=NS/question to the experts

i had asked Linda and she advised to give all three....pred, bupe and insulin at the same time....but once again the time i currently use for insulin is TOO close to the phenobarbital (by half hr)....i would have to move the TIME of it all....and i can NOT move the phenobarbital time....so if i were to give insulin at say 9 or 10 pm tonight....leaves me NEVER to leave my place as i would be up in the wee hrs with him (as is i am anyways but not as stressed out if he were to drop)...and all by myself to deal with low numbers...

again i'm getting ahead of myself...i always want to have plan B....and it's not working out the way i thought

this week i have dr's apts i would have to cancel if i were to move the insulin time...i'm just trying to prep ahead...and i know ECID...so who knows
 
Re: 2/7 Rocket AM BG 139=NS/question to the experts

Youre vet said to give it all at once, right?
Im not seeing any drug interactions on my search other than:
http://www.drugs.com/interactions-check.php?drug_list=1846-0,1933-0 From what Im understanding it just means due to the pheno Rocket *may* need a higher dose of pred (remember this is a human site, tho).

Aside from that Claudia, I dont know what to say. Im sorry. I offered the best thoughts I had to make it easiest on you and Rocket, based on my experience. My experience doesnt involve pheno, tho. Im sure how ever you manage or work it out, will be just right for him. I hope the pred helps.
 
Re: 2/7 Rocket AM BG 139=NS/question to the experts

I think I'm getting it LOL.

So you have to work around the pheno and the bupe. Those two are a given. I think you will be able to give insulin at the same time as the Pred (if its not too early based on the pheno). You will have to probably be around 24x7 the first week and then can figure out how he reacts, builds the shed etc so you will be able to leave the home.

I would assume no insulin for 24 hours post Pred though. Pred is the priority not the diabetes for this period right? Unless he goes high - I would find out what this threashold is 250 for example. And what dose do you start with. I am like you needing to have a plan. It makes me feel in control.

So what would this threashold be - is 250 a reasonable number? If he hits this in 24hours at shot time? You may not need it. And what dose would you start with?
 
Re: 2/7 Rocket AM BG 139=NS/question to the experts

I don't know
With the pheno in his system and him being super sensitive to drugs the bupe needs to be given every 8 hrs. I can't do bid. He can't hold it past 8 hrs, the tremors start up... And Internist said to give the lowest dose for him as we could always go up. But this dose is working for him...any higher and he stops eating...at least with this dose I manage to get some food into him
 
Claudia, Blackie is on 2.5 mg Pred bid and I've only increased his dose by .5 in the first week. And I'm going to be decreasing .25 tonight so the increase was really only .25. And Blackie is on 3.25 units. So if I were you I would not give insulin until after you've started the pred and can see if it is going to increase his bgs. I know ECID, but I wouldn't give him insulin without knowing what the pred is doing, especially since you are having a hard time testing him now.

I'm sending prayers and healing vines for Rocket. I really hope the pred gives him more quality in his life.
 
after careful consideration and weighing everything....
i will give the pheno along with the pred...DH just got home...so no insulin tonight....i won't test the rest of the night until tomorrow for AM BG....see where the pred took him....

i'm very nervous but i know he needs it....
 
Ele & Blackie said:
Claudia, Blackie is on 2.5 mg Pred bid and I've only increased his dose by .5 in the first week. And I'm going to be decreasing .25 tonight so the increase was really only .25. And Blackie is on 3.25 units. So if I were you I would not give insulin until after you've started the pred and can see if it is going to increase his bgs. I know ECID, but I wouldn't give him insulin without knowing what the pred is doing, especially since you are having a hard time testing him now.

I'm sending prayers and healing vines for Rocket. I really hope the pred gives him more quality in his life.
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thanks Ele

i left the pc to go quickly give the pred as DH had walked in the door....
my heart is in my throat...i really want what's best for him even if for a little while longer he gets to stay with me...i'm hopeful for QOL...as i know there is no cure for what he has...

Rocket has been Rx 2.5 mg pred bid as well....the balancing act becomes with the bupe...he ate EVERYTHING i gave him soon after i tested him...i had to wake him up from his deep deep sleep as he got the bupe 1 1/2 hr prior of testing....

i will be watching him closely for any side effects...and i will start the weigh in tonight after he wakes up from being all high....i hope this makes him comfortable and ok

we are scheduled to go see the neurologist on Feb 15 (he is back from conference or something...so at least he gets to see someone to follow up on the pred)....

thank you guys...for your help...and yes i will withhold insulin until i see where this is going...but i still have questions....

and i know everyone hesitates on the what ifs....so i will write my questions down and when the time comes will ask away...

he did come out today to the dinning room....and stayed relaxed laying down on his side for a whole 10 mins....i was on the floor with him trying to take my cat nap..but got interrupted by the phone (my mom) so when i got up to answer he got up and went back to the spare room....still no bedroom yet...i hope he makes it there eventually...i'm hopeful they made a mistake on the results...as without an actual biopsy it's not a for sure dx...i want so bad to hope...
 
Could you explain what the requirements are with respect to giving pheno in combination with other meds? I don't think any of us here have pheno experience, and it may be the part that is confusing me, if not others.

What can you give with pheno, what must be separate from pheno, and by how many hours must it be separated? (It looks like you want a minimum of two hours). I apologize if you have explained this before, and I missed it. If it's too much for you to go through again, I understand.

I know Bupe is tid. Pheno, insulin, zofran, pepcid, and pred (as the vet Rx'd it) are bid.

It is OK to give pheno with zofran and pepcid.

You wish to separate both pred and bupe from pheno (but pred and bupe should be OK together).

Current schedule:
4 am - bupe
5:30 am - insulin
6 am - pheno/zofran/pepcid
noon - bupe
5:30 pm- insulin
6 pm - pheno/zofran/pepcid
8 pm - bupe
Also complicating the issue: feeding and phosphorus binder times.

My suggestion: Give pred at 8 am and 8 pm (or, if you prefer, 9 am and 9 pm). Would this work for you? You cannot possibly meet all constraints. The drug timing must be adhered to, so you don't have the luxury of trying to time pred and insulin nadirs. There aren't enough hours in the day. I would love to see 9 pm - 4 am be reserved for Claudia sleep time. This might work out. At 8 am (am+2.5), BG is starting to head down. You add in pred, which may then start to bring the BG back up. Over the next few hours, insulin continues to try and lower BG, while pred continues to try and bring it up. Maybe he will stay nice and flat?

We don't know how pred will affect his BG. We will only know once you start using it.

I hope this is helpful. I hope I'm not completely out to lunch. (((Claudia))).
 
Linda and Bear Man said:
Could you explain what the requirements are with respect to giving pheno in combination with other meds? I don't think any of us here have pheno experience, and it may be the part that is confusing me, if not others.

What can you give with pheno, what must be separate from pheno, and by how many hours must it be separated? (It looks like you want a minimum of two hours). I apologize if you have explained this before, and I missed it. If it's too much for you to go through again, I understand.
Click to expand...

pheno in essence makes those drugs...bupe and pred useless per se...i have spoken to my local pharmacist and she said that taking all 3 drugs together in essence is pointless as the pheno lowers the strength of the other two requiring higher doses which Carolyn pointed out...so she strongly suggested to separate them by at least 2 hrs...so you are right...2 hrs seems to be the norm

she went into the detail explanation of blockers/receptors and whatever else...it all sounded Greek to me...and so i asked her to tell me in plain English...

i have noticed with the bupe that giving him the dose at 12 midnight works better with the tremors than the two other doses (8am and 4 pm) being so close to the pheno...and these two doses are already separated by the 2 hr window...

It is OK to give pheno with zofran and pepcid.
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yes they don't interfere with each other...even if he were on zantac instead of pepcid is still ok

Current schedule:
4 am - bupe
5:30 am - insulin
6 am - pheno/zofran/pepcid
noon - bupe
5:30 pm- insulin
6 pm - pheno/zofran/pepcid
8 pm - bupe
Also complicating the issue: feeding and phosphorus binder times.
Click to expand...
you almost got it right :-D
5:30 am insulin
6 am pheno/pepcid/zofran
7:30 fluids
8 am bupe
2pm Denosyl/fish oil
4 pm bupe
5:30 pm insulin
6 pm pheno/pepcid/zofran
12 midnight bupe

yes feeding...he doesn't eat on queu...or command...and yes the dreaded binder plus miralax to help him not get constipated and the cosequin....


My suggestion: Give pred at 8 am and 8 pm (or, if you prefer, 9 am and 9 pm). Would this work for you? You cannot possibly meet all constraints. The drug timing must be adhered to, so you don't have the luxury of trying to time pred and insulin nadirs. There aren't enough hours in the day. I would love to see 9 pm - 4 am be reserved for Claudia sleep time. This might work out. At 8 am (am+2.5), BG is starting to head down. You add in pred, which may then start to bring the BG back up. Over the next few hours, insulin continues to try and lower BG, while pred continues to try and bring it up. Maybe he will stay nice and flat?
Click to expand...

unfortunately i didn't see this post and i gave the pred at the same time as the pheno...but did not give the zofran or pepcid...will have to give it later...and in his SS you can see he pretty much used to dive at +1 to +3 so perhaps your suggestion will prevent that...and yes it would be nice...a flat cycle

We don't know how pred will affect his BG. We will only know once you start using it.
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true...so tonight due to him being still stressed out and i'm having a hard time testing in the best of times i didn't give insulin and his number is ok to still withhold insulin...

I hope this is helpful. I hope I'm not completely out to lunch. (((Claudia))).
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it is very helpful...you are Godsend...thank you for helping me out....i will give the pred tomorrow morning at 8 am even if he still doesn't get the insulin at 5:30...will be off by 2 hrs and i hope it's ok...

i don't think i did the quote thingy right...so hopefully you guys can follow what i'm trying to explain...sorry...not too computer savy here...
 
Dear (((((Claudia and Rocket)))))

Oh my, you have sooo much going on. You are such a great bean to Rocket. I am really hoping he will feel better with the Pred. Did you get the Prednisone or Prednisolone(spell?). I thought I recalled Tuckers bean saying the Prednisolone is easier on the kidneys.
Thank you for keeping Whiskers and I in your prayers, especially with everything you are coping with.

I hope you all get some rest tonight. I wish I had more experiance, but it sure seems like Linda had some wonderful insight and advise :razz: .

I'll talk to you tomorrow :YMHUG: .
 
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