22March2020/Maxi/AMPS439/Just Increased to 5 Units

It's going to be okay. Maxi doesn't know he is any different than he was a week ago. Your goal should be to get the glucoses down and if symptoms are or start to present, then address them as needed.

Ollie seems to be one where symptoms are very present and need to be dealt with. I think most here just have the high glucoses, I wish we only had that.

Give it some time to sink in. Concentrate on getting glucoses down and just take things as they happen.
 
Olive & Paula said:
It's going to be okay. Maxi doesn't know he is any different than he was a week ago. Your goal should be to get the glucoses down and if symptoms are or start to present, then address them as needed.

Ollie seems to be one where symptoms are very present and need to be dealt with. I think most here just have the high glucoses, I wish we only had that.

Give it some time to sink in. Concentrate on getting glucoses down and just take things as they happen.
Click to expand...

Thank you, Paula.

Maxi keeps going back to his water bowl and drinking.

He has growth on his face.

He has runny eyes.

He's snory (I forgot the proper word) from narrowed airways.

He's always hungry.

His arms click a lot. You know like when your knee clicks?

He lies on the tile floor a lot as if he's trying to comfort his tummy.

I don't want him to suffer.

But he's still very loving.
 
Once he gets enough insulin to get that blood sugar down, he'll slow down the water consumption.

Maybe if you just try to focus on that for now?

I'm sorry you're agonizing over all the issues just now...but try to focus on him as a loving cat...and let's see if we can get that BG down...he will feel better once that happens...and then you can sort out the other issues...I know it seems like an insurmountable thing just now with the recent acro dx...but it can be managed. Don't give up just yet.
 
Hi there :cool:

I’m not seeing any data on your ss for 03/21/PM.

As Wendy mentioned yesterday, R can be useful to quickly get better BG control while working your way up the Lantus dosing ladder in search of a good Lantus dose.

I know your head must be spinning since the acro dx. Keep the questions coming. Remember that this is the best place for you and Maxi to be.
 
Let's address this one by one. He is uncomfortable right now, not suffering.

Maxi keeps going back to his water bowl and drinking.

That is the diabetes and the kidneys. Ollie drinks huge amounts and gets subqs twice a week. She puts out humongous amounts of urine even when glucoses are in the hundreds of less.

He has growth on his face.

I'm not sure what you mean here.

He's snory (I forgot the proper word) from narrowed airways

Do you know for a fact he has narrowed airways? I don't for Ollie as I never did an endoscope. Her snory sounds are different that my civvie who just snores. Ollie was 24/7 non stop so loud you could hear her in another room over the tv volume which isn't low at all. You could actually see her trying to suck in air. It didn't matter whether she was awake, sleeping, sitting or standing. It never stopped.

He's always hungry.

Acros gain weight easy. And the uncontrolled diabetes makes the more ravenous. I found it best to feed by amount of calories needed for ideal weight so she wouldn't gain.

His arms click a lot. You know like when your knee clicks?

This I have no clue about. Maybe ask vet if it's arthritis and see if something might help it.

He lies on the tile floor a lot as if he's trying to comfort his tummy

This could be any number of things. Nausea, maybe he just likes the cold floor. Gas. The food isn't agreeing with him. Can't say Ollie does this. She prefers heat.

It's a lot of trial and error. Before we knew the acro dx. Ollie from day one of arriving had a rock hard distended belly. Would flop side to side continuously. I was told once insulin was working and she settled into a routine she would be better. She was put on gabapentin for the discomfort. I wasn't convinced it was only being unregulated. I took her to referral center for ultrasound. I was convinced she ate something in the dumpster she was found in. They did find a mass and she had ascities (fluid in abdominal cavity). That doctor said to give gabapentin every 8 hrs because she was very uncomfortable and she did not like being touched at all (this I already knew). Thinking back now that I know about the acro, the gab (low dose) helped with the joints and soft tissue overgrowth. And she did improve.

I have another cat Tripper who has a luxating knee and arthritis in it, so she can click. She is on gab now, and it works for her. Some days are worse than others. But overall she seems fine.

Keep track what you see and when. What he is doing at the time, what you do for him.

I find it easy to track on blank page of ss. Using 2 rows for one day. In my ss link you only see the numbers. On my hard copy besides her glucoses are meds, meals (kind and amount), poops, vomits, subqs, anything and everything. It helps to figure out what works, what doesn't, if it affects glucose. 14 days fit on a page, I do this in excel as it's easier for me. When page is full I transfer to computer, print in color (lot of color coding), print out blank page for next 2 weeks. Seeing it in color helps see the big picture. I make changes as needed. Moving meds around until we got the right fit. Having the start dates of meds in the footer. The calculation formula for determining calories. It might be a bit extra work, but I'm retired. I spend Sunday evening updating it and doing all household paperwork while watching my tv show.

I rambled. Just step back for awhile. Regroup. Then tackle one thing at a time. Maxi has had this for awhile and he will continue to have it for awhile. He is not suffering. But you are agonizing over it. You got this, you can do this. Right now just give the insulin he needs. The rest will fall into place. BREATHE BREATHE and BREATHE somemore.



 
I think we all remember how hard the acro diagnosis is on the caregiver when we first get it. :bighug::bighug::bighug: When I got Neko's diagnosis, there was just 1 other regular member here and a couple that posted infrequently, with acrocats. I was lonely. We have quite a few here now. You are not alone.

Neko wasn't a happy camper when she was diagnosed. She was spending a lot of time in reds and blacks with the odd dash down to lower numbers. In spite of that, she wasn't drinking a ton and peed no more than 3 times a day. She spend almost all her time in the kitchen. We did have to keep the counters clean and lock away any food. The microwave is a great storage area. She was not happy with the other cat at all, Only when her numbers starting getting better did she start to relax. I was so happy when I started seeing her play in the living room again.

More frequent smaller meals helped curb the hunger too. I found raw food with water added helped fill her up. The autofeeder was my best investmemt. She hung around "Otto" instead of pestering me for food.

I have heard a couple people say the stridor (breathy sounds) reduced once they started cabergoline. It's something I would seriously consider. Neko's eye goop got better in good numbers. My DH's ankle clicks, it always has. It just means he can't sneak around the house.:p You are probably seeing Maxi at the worst of times. We can help you get him to a better place. Remember that the list of possible acro symptoms are not something all acros have In fact, the majority of acros have no obvious signs at diagnosis.

Good luck with the increase, At 5 units, we move to 0.5 unit increases if you aren't seeing greens.
 
Wendy&Neko said:
I think we all remember how hard the acro diagnosis is on the caregiver when we first get it. :bighug::bighug::bighug: When I got Neko's diagnosis, there was just 1 other regular member here and a couple that posted infrequently, with acrocats. I was lonely. We have quite a few here now. You are not alone.

Neko wasn't a happy camper when she was diagnosed. She was spending a lot of time in reds and blacks with the odd dash down to lower numbers. In spite of that, she wasn't drinking a ton and peed no more than 3 times a day. She spend almost all her time in the kitchen. We did have to keep the counters clean and lock away any food. The microwave is a great storage area. She was not happy with the other cat at all, Only when her numbers starting getting better did she start to relax. I was so happy when I started seeing her play in the living room again.

More frequent smaller meals helped curb the hunger too. I found raw food with water added helped fill her up. The autofeeder was my best investmemt. She hung around "Otto" instead of pestering me for food.

I have heard a couple people say the stridor (breathy sounds) reduced once they started cabergoline. It's something I would seriously consider. Neko's eye goop got better in good numbers. My DH's ankle clicks, it always has. It just means he can't sneak around the house.:p You are probably seeing Maxi at the worst of times. We can help you get him to a better place. Remember that the list of possible acro symptoms are not something all acros have In fact, the majority of acros have no obvious signs at diagnosis.

Good luck with the increase, At 5 units, we move to 0.5 unit increases if you aren't seeing greens.
Click to expand...

Thank you, Wendy.

I will ask for cabergoline tomorrow. I hope by tomorrow the other result (IAA) will be in. Will that result make a difference in Maxi's treatment? Do I still continue as I have been with the Lantus and add the R no matter what the IAA is?

Is this (link below) the right R to buy?
https://standard-products.com/produ...oz3jF3moKqnR6asX_1pGnN5kEKL-TB54aAgleEALw_wcB

It's very good that you told me to start increasing by 0.5 now. I wasn't aware or forgot if I read it in the TR protocol.

Thank you very much, Wendy and all, for your support. I've been feeling like euthanizing myself lately, so I need it. (Don't worry; I'm only joking.)
 
Yes, that is the correct R to buy. There is also Novolin R. I think the same thing, but rebranded. I only used Humulin R.
 
Freckles has that ravenous appetite as well. I too have an autofeeder. She gets half of her supper at shot time and the rest of her food is divided up into 4 sections in the autofeeder for her to eat during the cycle. Her bed is on the dresser that her autofeeder is in (I had to put the autofeeder in the top drawer of the dresser because she figured that if she knocked the feeder down, it would spill a little bit out - she's too smart). I add water to her food so it helps make her feel more full. I weigh her food. If I let her eat as much as she wanted we would need a crane to lift her. :eek: I'm thinking that it isn't great for human diabetics to be overweight so it's probably the same for kitty diabetics. She gets weighed weekly (I have a baby/toddler scale that I weigh all of the cats). Sometimes she will get freeze dried chicken treats, but I put them in either the treat ball or the treat tree so she has to work at it to get the treat out. I should probably do the same thing for me!! :rolleyes:

Doing TR will expedite finding the right dose for Maxi. You are surrounded by people who can honestly say "We know how you must feel!" During the craziness of the world right now you've got "e-support" - which is about as good as you can get it. It's perfectly ok to have a pity party once in awhile... we all do. Chin up and give that Maxi a scratch on his chin. :bighug:
 
Thanks a lot for the kind words, Judy. :bighug:

Freckles looks thin in the photo...?

I've been feeding Maxi 4 times a day. He gets a regular meal every 12 hours and a snack in between. When Maxi lived with my mom, he was very fat. Since he's lived with me (2.5 years), he's lost quite a bit of weight (he lost weight before diagnosis -- I feed him less than my mom did). He's still a little overweight, but the vet seems not to want him to lose. I guess because of the kidney disease? I know overweight is not healthy, especially for diabetics, so I feel stuck between getting him to a perfect weight and keeping meat on him. I've also learned that diabetic cats need to consume more calories relative to non-diabetics, so I don't want to decrease his food.
Re. eating 4 times, I'm still confused about proper binder dosing (because of phosphorus because of kidney disease). I've been told that it's ok to give the binder per the instructions on the container --1 scoop twice a day mixed into food-- and I've also been told to divide those scoops up into 4 parts and mix into his 4 feedings. The vet said he just needs to get that dose in him twice a day, but another trusted source said he needs binder in everything he eats. So I still need full clarification on that.

Please correct me if I'm wrong on anything here.
 
@Wendy&Neko

What dose of R should I give?

How long does R stay good?
I'm having a hard time getting R from online sources! If I do get it online, I have to wait a week of more because there are delays all over. I can buy a big vial from Walgreen's for $180. They don't have the 100 units, only the bigger one. If R keeps a long time, I'll buy the big vial for $180. But the pharmacist told me it lasts only a month. I can't afford to throw all that money away.
I'm very anxious to get Maxi on R. Do you think it's important to get him on it ASAP?

Thank you
 
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I can't help with dosing, I never used R insulin.

It shouldn't cost that much, no more than $40 dollars tops. And just like other insulins, kept in fridge it will lasts for months. You can get it without script, I think Wal-Mart advertises it for $25.

Have you thought about increasing lantus dose every 2 days instead of 3? That's what was suggested with Ollie until she started moving down.
 
Olive & Paula said:
I can't help with dosing, I never used R insulin.

It shouldn't cost that much, no more than $40 dollars tops. And just like other insulins, kept in fridge it will lasts for months. You can get it without script, I think Wal-Mart advertises it for $25.

Have you thought about increasing lantus dose every 2 days instead of 3? That's what was suggested with Ollie until she started moving down.
Click to expand...

Oh, really? @Wendy&Neko , do you think I should sothat (increase Lantus every 2 days instead of 3)?

I ordered R from Mark's Marine Pharmacy in Canada. I haven't been able to find a price close to $40. And I sure don't want to go to Walmart (self isolation for safety). I just hope I get it, and get it soon. They, like everyone else, are backed up.

I spoke with a Walgreen's pharmacist who said Humulin R lasts only a month. But maybe it's like Lantus - it lasts a lot longer if stored properly. Do you rest of you (@Wendy&Neko) agree that I can keep Humulin R for months in the fridge? How many months?
 
bambinaki said:
Freckles looks thin in the photo...?
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That photo was taken the day that we joined this forum. She had not been on insulin very long. The voracious appetite and weight loss is what prompted going to the vet in the first place. She has gained some of her weight back - not all - she was too much of a chunk before, so I didn't want her to gain it all back. I think she is at a good weight now and holding. I should update her photo...lol

bambinaki said:
I've also learned that diabetic cats need to consume more calories relative to non-diabetics, so I don't want to decrease his food.
Click to expand...
I did not know this. My 3 civvies and Freckles all get the same amount of calories and all are staying at their same weight.
 
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