3/15/21 - Squeaky - AMPS = 322 +6=135 Confusing: PMPS=505 retest 570 retest 487 What A Day

[Jan D & Squeaky]

https://felinediabetes.com/FDMB/thr...s-164-3-271-amps-369-7-310.244653/#navigation

Where does a cat go when it loses its tail? The retail store!

Squeaky is sleeping behind the sofa, which is telling me he feels really lousy.

We are an hour away from preshot. It's now 9:30.

 

[Jan D & Squeaky]

I wrote this message to the vet this morning. They are on vacation for two weeks March 22 to April 2.

Hi Claire,

His ups and downs are so hard on both of us.

Sometimes I think, if I stop giving him all his medicines he would pass into the light very quickly. Instead of dragging on with shots and pills.

He looks terrible this morning. He's asleep behind the sofa which means he's not feeling well. Yet, last night, he played a little and he ate all his food.

It is hard to know what to do.

Best,
Jan


Oh, his little head popped up. Whew. I am so reactive. I am starting with a therapist on Thursday to help me get through this.

 

[Katherine&Ruby]

I find being present to my breath when I start to worry or panic to be very calming, Jan. Forces one to be in the here and now. Glad you are getting some help.

 

[carfurby (GA)]

Sending prayers.

 

[tiffmaxee]

Does your vet refer to another one while away?

 

[Jan D & Squeaky]

I find being present to my breath when I start to worry or panic to be very calming, Jan. Forces one to be in the here and now. Glad you are getting some help.

Thank you, I need to figure something out. It's been a rough week. Broke my little toe, stubbed a bench trying to get Squeaky out from under the computer where he was hiding from his shot. Then...He got tired of the homemade beef jerky kibble, so yesterday I made him some from pork (it has to be boiled to the point of extreme tenderness and then dehydrated). He likes it (at least for now) This morning during our routine when I was holding him, he made some strange movements that I've never seen before. Not exactly like a seizure but well, not healthy-like. Scary.

I gave him a B12 shot this morning. Hey THH, @THH & Snowcrash (GA), the time before the morning preshots always seem to be harder than evenings. He always looks really droopy and rarely plays nor tracks the movement of the toys with his eyes. Do you think it might be because the gabapentin or cerenia has worn off before 24 hours have passed? Maybe he needs a bigger dose?

Somehow we will get through this. I just keep trying to give him all the love I can. And all the care I know how to give. Oh I do breathing practice too, I just have a hard time watching someone else suffer. I can't even watch movies.

 

[Katherine&Ruby]

 

[Olive & Paula]

He's feeling crappy. Have you thought of doing TR method? He could use an increase. Are giving gabapentin every 24 hrs? How much? Is there a reason it's not more often?

 

[Jan D & Squeaky]

Sending prayers.

Does your vet refer to another one while away?

He's feeling crappy. Have you thought of doing TR method? He could use an increase. Are giving gabapentin every 24 hrs? How much? Is there a reason it's not more often?

Thanks everyone. Yes they have other vet clinics on standby. (Not housecall vets though).

Paula, whoops I said gabapentin. I mean budesonide. He is getting 1 mg of budesonide every morning at preshot, along with 7.5 mgs of cerenia. I grind them up and put them in a capsule. Then after shot and whatever he will eat, (sometimes he doesn't eat at this time, I think the whole medicine thing upsets him despite the massage, singing, loving, and treats), he goes to sleep. Then seems better after that. (He mostly eats in the middle of the day and in the middle of the night).

I am giving .2 mgs of buprenorphine twice a day, pre-shot. I have a question out to the vet, how much of this can a cat tolerate? (They are so slow to answer.)

His poops are good and he's drinking and peeing A LOT. He seems preoccupied lately, I know he's not doing great.

I was doing TR before, but he basically can only tolerate 4 ear pricks and two shots a day before becoming neurotic and doing things like running away if I look at him and hiding in his litter box. Also I have health issues and the sleep thing is a big problem. Sometimes I set 2 alarms and still can't get up. TR would be dangerous so people here talked me out of it. I feel safer and more relaxed with GLGS, although his numbers are so high right now, I'm almost wondering/wishing he gets an increase sooner.

Thank you everyone for caring!!!!! I couldn't be doing this without you.

 

[Suzanne & Darcy]

Did you do the sub-q fluids again today? Or has he been hiding all day and you didn't want to disturb him? I'm so sorry. Does he/can he get buprenorphine if he's in pain from the pancreatitis? You mentioned giving him cerenia. Have you tried adding in Ondansetron for nausea that may be from the panc? It can be very effective and can be given 3 times a day for a panc flare.

 

[Suzanne & Darcy]

Oh, I see your reply crossed with my questions. I'd check with the vet on the bupe. I would consider adding in Ondansetron for nausea. I've had great success with it. It is a very tiny tablet and you probably only need half of one -- it can be put into a gel cap with other meds (which I see you are doing already).

 

[Katherine&Ruby]

I second @Suzanne & Darcy 's suggestion of ondansetron. I find that it works better than Cerenia for Ruby's nausea, it's a smaller pill, and it's less expensive. You might have to give it more often though because Cerenia is just once a day whereas you can give ondansetron every 6-8 hours as needed. That's the drawback. I know how worried you are about giving him too many meds.

 

[Jan D & Squeaky]

Did you do the sub-q fluids again today? Or has he been hiding all day and you didn't want to disturb him? I'm so sorry. Does he/can he get buprenorphine if he's in pain from the pancreatitis? You mentioned giving him cerenia. Have you tried adding in Ondansetron for nausea that may be from the panc? It can be very effective and can be given 3 times a day for a panc flare.

Oh, I see your reply crossed with my questions. I'd check with the vet on the bupe. I would consider adding in Ondansetron for nausea. I've had great success with it. It is a very tiny tablet and you probably only need half of one -- it can be put into a gel cap with other meds (which I see you are doing already).

I have been giving him fluids around 4 pm after his mid-cycle BG.

I am not sure that he is nauseous. Usually when he is, he wants to go outside and eat grass, and/or he tries to eat strands from his sisal scratchers. He hasn't been doing that. Mostly he's just very droopy. And not so cuddly.

 

[Jan D & Squeaky]

I second @Suzanne & Darcy 's suggestion of ondansetron. I find that it works better than Cerenia for Ruby's nausea, it's a smaller pill, and it's less expensive. You might have to give it more often though because Cerenia is just once a day whereas you can give ondansetron every 6-8 hours as needed. That's the drawback. I know how worried you are about giving him too many meds.

Thanks Katherine, I have an email out to the vet nurse about ondansetron. I'm more worried about giving him too many pokes (firstly) and definitely neither one of us like shoving pills down his throat..... He's really a big boy about it though, he tries to help.

THANK YOU

 

[Olive & Paula]

So it seems everything is pretty much preshot. Have tried moving the budesonide 6 hrs after the Buprenorphine, so it covers him if the Buprenorphine is wearing off?

I don't know if TR is more dangerous or not. With my 1st I was scared stiff of it, but I worked full time then.

When Ollie came, SLGS was not going to work and that was before the acro dx. Did TR and then ended up fast tracking because Ollie stayed pink.

TR is increase every 3 days, you need minimum 4 tests (2 per cycle). So AM then another mid cycle, PMPS, then one right before you go to bed. Once numbers get better and stay there, you can switch to SLGS again.

SLGS is every 7 days. There is a slight chance of glucose toxicity setting in. If it does happen, it will take longer and more insulin might be required to break through.

Another option, and I know I will hear about it, how about meeting in the middle and do 5 days?

 

[Jan D & Squeaky]

So it seems everything is pretty much preshot. Have tried moving the budesonide 6 hrs after the Buprenorphine, so it covers him if the Buprenorphine is wearing off?

I don't know if TR is more dangerous or not. With my 1st I was scared stiff of it, but I worked full time then.

When Ollie came, SLGS was not going to work and that was before the acro dx. Did TR and then ended up fast tracking because Ollie stayed pink.

TR is increase every 3 days, you need minimum 4 tests (2 per cycle). So AM then another mid cycle, PMPS, then one right before you go to bed. Once numbers get better and stay there, you can switch to SLGS again.

SLGS is every 7 days. There is a slight chance of glucose toxicity setting in. If it does happen, it will take longer and more insulin might be required to break through.

Another option, and I know I will hear about it, how about meeting in the middle and do 5 days?

Paula, you are so kind. So I try to minimize how often I have to pick him up and do something to him. Once in the morning he gets his inhaler, BG test, capsule with budesonide and cerenia, buprenorphine and then his shot. Everything all at once, then we're done for 6 hours...... So then nothing until +6 mid-cycle BG test.

The night is the same, except zobaline instead of budesonide. Nights, if his number is higher I sometimes skip so I can get some sleep. So we have to have medical interactions only 4 times a day, less if possible.

Now we're doing fluids so that adds an additional medical interaction. So I'm trying to do it right around the afternoon BG time so he then has another 6 hours free from medical stuff until PMPS.

I **really** like your idea of going back to TR until his numbers drop. I switched from TR to GSGL because we were flirting around in the 50s to 100s and I couldn't test him frequently like others do. Everyone was scared that he would go hypo.

But now, it makes sense with his numbers so high to be able to regulate the dose every 3 days...., so I will switch back immediately. Thank you for your prompt to do this. THANK YOU THANK YOU THANK YOU.

So we have not seen any nadirs under 200 since Wednesday the 10th. When I increased him on Friday the 12th, I was unable to get nadirs that day because I wasn't feeling well (I think we could estimate that the depot had not been filled and his numbers were over 200). Do you think I can go ahead and increase to 2 units tonight? (He did have a blue 164 but it wasn't a nadir and it was after fluids). @Wendy&Neko @THH & Snowcrash (GA) @Bandit's Mom

I have to go to the doctor for my broken toe now so I'll do BG as soon as I get back. I guess I should give him fluids again. He perked up a little after getting fluids yesterday, but not a lot.

THANK YOU.... everyone. For all your help.

 

[Olive & Paula]

Can you give the zobaline crushed in tiny amount of food, when he eats that give him rest of food? That's one less down the throat.

Do you give fluids daily? Cerenia comes injectable and you can give in fluids. It does sting but if given some fluid first then slowly push cerenia through line it helps a lot.

Is the b12 the zobaline you speak of? If you give b12 by injection, you can give that through the fluids also.

 

[THH & Snowcrash (GA)]

How many mLs of fluids are you doing? Do you have any idea of his hydration level?

The hiding is odd and has me concerned.

 

[Jan D & Squeaky]

Can you give the zobaline crushed in tiny amount of food, when he eats that give him rest of food? That's one less down the throat.

Do you give fluids daily? Cerenia comes injectable and you can give in fluids. It does sting but if given some fluid first then slowly push cerenia through line it helps a lot.

Is the b12 the zobaline you speak of? If you give b12 by injection, you can give that through the fluids also.

Well the zobaline crushed in food didn't work, he doesn't eat it. In pill form, I know it gets down.

I hope we can stop the fluids after he's doing better. Actually this afternoon, he has bounced back and is doing well again. He just did some tricks with me! Jumped through hoop, beg, and turn around. Is feeling good now........ I don't know what it is about MORNINGS.... except maybe the cerenia and budensonide has worn off???? Or maybe as you are suggesting, that he is nauseated in the mornings?

THH said, often IBD kitties aren't getting enough B12 through oral, so I did one B12 shot today. I did it right after insulin shot and he didn't even notice.

This up and down is so hard. THANK YOU THANK YOU for all your help and support.

Now the question is, can I increase to 2 units tonight?

 

[Jan D & Squeaky]

How many mLs of fluids are you doing? Do you have any idea of his hydration level?

The hiding is odd and has me concerned.

Thanks THH he doesn't feel well in the mornings. I am wondering if his cerenia and budesonide have worn off by then? Like it's been every morning (because I've cried the last two mornings, he was so lousy).

He has improved this afternoon (energetic, did tricks, greeted me at door, happy) and I haven't given him the fluids yet. But I did give him a B12 shot this morning, so maybe that helped his energy and how he is feeling.

Vet has me giving 75 ml of fluids. So I can kind of tell by his scruff and how it feels. When his fluids are low, his fur actually feels kind of dry and the scruff is kind of minimized and feels kind of hard almost. Yesterday when I gave him fluids, he felt like that and there was a bit of an improvement after that last evening, but not much. This morning, his scruff was good. Soft, fluffy, and easy to pierce with the needles. I gave him the B12 shot and he didn't even feel it. And he has doing really good this afternoon.

Yes the mornings have not been good. I'm going to test his BG now and then go for a walk before I give him fluids. I need a walk break.

 

[Jan D & Squeaky]

So I'm putting him back on TR until numbers drop. Can I increase him to 2 units tonight? It's been at least 6 cycles over 200.

Edit: His =6 was 136 so that cooks that goose right? Um, could it have been the B12 shot that helped him do so well this afternoon?

This up and down (half dead, then doing great) is so hard on me...... and him...... What's causing it?

 

[THH & Snowcrash (GA)]

Cerenia and budesonide both should last 24 hours, so I'm not sure why mornings are harder for him.

I'd ask your vet if you could increase the fluids to 100mL? Maybe 75mL isn't quite enough?

 

[Suzanne & Darcy]

I have been giving him fluids around 4 pm after his mid-cycle BG.

I am not sure that he is nauseous. Usually when he is, he wants to go outside and eat grass, and/or he tries to eat strands from his sisal scratchers. He hasn't been doing that. Mostly he's just very droopy. And not so cuddly.

Oh, I thought you were giving him Cerenia for either nausea or vomiting.

 

[Suzanne & Darcy]

Cerenia and budesonide both should last 24 hours, so I'm not sure why mornings are harder for him.

I'd ask your vet if you could increase the fluids to 100mL? Maybe 75mL isn't quite enough?

Yes. As long as they know your kitty’s heart is working well, then the vet could approve the increase to 100 mL. How much does your kitty weigh? That also has to be taken into consideration.

 

[Jan D & Squeaky]

Cerenia and budesonide both should last 24 hours, so I'm not sure why mornings are harder for him.
I'd ask your vet if you could increase the fluids to 100mL? Maybe 75mL isn't quite enough?

Oh, I thought you were giving him Cerenia for either nausea or vomiting.

Yes. As long as they know your kitty’s heart is working well, then the vet could approve the increase to 100 mL. How much does your kitty weigh? That also has to be taken into consideration.

He weighs 13.2 lbs. Because of my own health issues, I regularly forget why I'm doing things. I can't remember why he gets cerenia. Probably because it can't hurt and might even help. Or perhaps at once point he had digestive issues and we hoped they would help.

THANK YOU FOR YOUR CARING AND HELP!!!!! It's fluid time now. We are late. It's 7 pm.

 

[THH & Snowcrash (GA)]

Cerenia can act as a pancreatic anti-inflammatory. It's a good medication for cats with chronic pancreatitis to be on long-term; I have two cats on it.

 

[Suzanne & Darcy]

Bless your heart! I'm sorry. BIG HUGS!!!!!!

 

[Suzanne & Darcy]

Cerenia can act as a pancreatic anti-inflammatory. It's a good medication for cats with chronic pancreatitis to be on long-term; I have two cats on it.

Yes. I'm sure that must be why Squeaky is on it. In fact, Cerenia, kind of like Metronidazole, has these anti-inflammatory properties that I am not sure are well-understood ... we just know that they do work. I was just hoping that Squeaky was having a flare it would pass soon.... but that maybe some anti-nausea meds might help, too.

 

[Wendy&Neko]

If following TR now, you can increase by 0.25 units.

 

[Jan D & Squeaky]

Cerenia can act as a pancreatic anti-inflammatory. It's a good medication for cats with chronic pancreatitis to be on long-term; I have two cats on it.

Bless your heart! I'm sorry. BIG HUGS!!!!!!

Yes. I'm sure that must be why Squeaky is on it. In fact, Cerenia, kind of like Metronidazole, has these anti-inflammatory properties that I am not sure are well-understood ... we just know that they do work. I was just hoping that Squeaky was having a flare it would pass soon.... but that maybe some anti-nausea meds might help, too.

If following TR now, you can increase by 0.25 units.

Thanks everyone for support and comments!! Squeaky was doing GREAT this afternoon and evening. Really really great. My cat!!!! He's the best!!!! The most loving! The most playful! The most beautiful! Did I mention the smartest?

When I tested and saw 505 at pre-shot, I was shocked......, I used the same blood hole.... one minute later.... it was 570. Whoa! So I tried another poke and it was 487. Well isn't that something. I sure haven't seen anything like this. Anyway since he is so high, I will follow Wendy's advice and increase right now. Thanks so much @Wendy&Neko.

Of course I am happy again because Squeaky is doing well again. He actually seems to like the fluids even though he made me chase him.

I suspect he will be punk again in the morning....

 

[Suzanne & Darcy]

Thanks everyone for support and comments!! Squeaky was doing GREAT this afternoon and evening. Really really great. My cat!!!! He's the best!!!! The most loving! The most playful! The most beautiful! Did I mention the smartest?

When I tested and saw 505 at pre-shot, I was shocked......, I used the same blood hole.... one minute later.... it was 570. Whoa! So I tried another poke and it was 487. Well isn't that something. I sure haven't seen anything like this. Anyway since he is so high, I will follow Wendy's advice and increase right now. Thanks so much @Wendy&Neko.

Of course I am happy again because Squeaky is doing well again. He actually seems to like the fluids even though he made me chase him.

I suspect he will be punk again in the morning....

I’m so happy to hear that Squeaky perked up in the afternoon and evening!

As for the different numbers on your meter, that’s definitely possible because of the 20% meter variance. You can test the same drop of blood five times and you may get a different number each time. I have tested this out myself. I don’t like it because I wish these meters had less variance. And, of course, the higher your numbers, the greater 20 percent number seems. For example, one of your numbers was 570. 20 percent more than that would be 684!

I am still pondering why Squeaky doesn’t do mornings! Poor baby. My kitty does not feel well when his glucose is too high (and he’s never away from the water bowl). He gets very lethargic. Sometimes he will hide.

 

[Jan D & Squeaky]

I’m so happy to hear that Squeaky perked up in the afternoon and evening!

As for the different numbers on your meter, that’s definitely possible because of the 20% meter variance. You can test the same drop of blood five times and you may get a different number each time. I have tested this out myself. I don’t like it because I wish these meters had less variance. And, of course, the higher your numbers, the greater 20 percent number seems. For example, one of your numbers was 570. 20 percent more than that would be 684!

I am still pondering why Squeaky doesn’t do mornings! Poor baby. My kitty does not feel well when his glucose is too high (and he’s never away from the water bowl). He gets very lethargic. Sometimes he will hide.

Thanks so much for your insightful reply!!!! Wow 20% sure leaves a lot of room for error.......

 

[Jan D & Squeaky]

I’m so happy to hear that Squeaky perked up in the afternoon and evening!

As for the different numbers on your meter, that’s definitely possible because of the 20% meter variance. You can test the same drop of blood five times and you may get a different number each time. I have tested this out myself. I don’t like it because I wish these meters had less variance. And, of course, the higher your numbers, the greater 20 percent number seems. For example, one of your numbers was 570. 20 percent more than that would be 684!

I am still pondering why Squeaky doesn’t do mornings! Poor baby. My kitty does not feel well when his glucose is too high (and he’s never away from the water bowl). He gets very lethargic. Sometimes he will hide.

He's doing better this morning. Must have been the B12 shot!