3/18 - Gen, AMPS 305, PMPS 388 :(((((

Allie & Gen

Member Since 2025
Yesterday

Good morning, friends! I hope you're having a nice, calm Wednesday, with smooth surfing for your kitties. 💕

My question today is unrelated to anything about Gen's overall care, etc ... I have very rare evening plans which will keep me away at shot time, and I wanted to ask for input. I'll be away from home from about AMPS +9 to something like (what would be) PMPS +3. I know it's not ideal, but I think given that it's just one night, I should skip shooting altogether. Thoughts?

On to a proper update. Gen was very high this morning (comparatively); I think it's clear, even after just two doses, that his BG is definitely affected by the budesonide. This morning, I increased his dose to 0.75u. He took a bit of a dive, but given how far down he had to go he's in fine numbers. I'm working from home, so I'll keep an eye on it.

The appointment yesterday went well, though it was a little anticlimactic! I met with a new internal specialist who seemed pretty great. She went over Gen's history and recent experiences with me and discussed plans for moving forward with his treatment. She agreed that it made sense to skip or defer the biopsy for now, though she had more nuanced thoughts on when or how it might be important to consider one, which I appreciated. We agreed that we'll trial Gen on the budesonide for the next 2-3 weeks to see how he does, at which point we'll also consider giving the dietary trial another try. She acknowledged my concerns about the budesonide's affect on his BG values, and we talked about the possibility of him tapering off at some point, possibly to see if his GI issues could be managed with diet alone, but we agreed that for now the med seems like the best starting point.

Tentatively, I'm looking at trying to manage his GI issues to the point that my primary vet is comfortable doing the dental surgery at last, with sorting out how to balance managing his guts and his blood glucose on a longer-term basis as the priority after the oral issues are resolved.

When I told her that I felt I had a solid handle on his diabetes treatment and didn't feel I needed input on that right now, she accepted that without question, which I was pleased about. I'll get into it more later, but the research I've been doing has me feeling more confident about my grasp of all of that (both in terms of TR/what I'm doing now, and the broader range of options, considerations, etc) than I ever have. Which is kind of fantastic, actually.

Oh, and Gen's B12 is actually a bit elevated (one plus that came out of his hospitalization: they did a fasted panel), so I won't be proceeding with those injections, unless something changes.
 
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It's quite cold out today (below freezing), and in a dramatic shift from the usual issues with my apartment building, the heat is completely out. (Apparently a boiler problem they're working to repair.) Gen is very kindly helping me stay warm.

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Glad the appointment went well :)

Leroy is .... complicated so he's going to be on budesonide or something for his IBD forever :blackeye:. I just deal with his bgs. Hopefully Gen will be one of the lucky ones who can be managed with diet alone🤞
 
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I am glad you had a good visit with the internist. I’d just skip tonight’s insulin and think of it as a fur shot. Have fun worry free!
 
Glad the appointment went well :)

Leroy is .... complicated so he's going to be on budesonide or something for his IBD forever. I just deal with his bgs. Hopefully Gen will be one of the lucky ones who can be managed with diet alone🤞
That is Indy too. He was on pred long-term and then chlorambucil. He will be on it for the rest of his life.
 
I'm prepared to cope if Gen has to stay on the budesonide, and possibly start chlorambucil at some point (this came up too when discussing further-out future possibilities). But we'll see - I want to explore various possibilities.

@Jessica & Indy With the chlorambucil, was the pred no longer necessary? (Maybe this is standard - I haven't gotten into the treatment info very far yet, so just info-gathering.)
 
I'm prepared to cope if Gen has to stay on the budesonide, and possibly start chlorambucil at some point (this came up too when discussing further-out future possibilities). But we'll see - I want to explore various possibilities.

@Jessica & Indy With the chlorambucil, was the pred no longer necessary? (Maybe this is standard - I haven't gotten into the treatment info very far yet, so just info-gathering.)
He was transitioned off of the pred when he started the chlorambucil. He took both for a short time. He is down to only needing a low dose of the chlorambucil once a week. Keeps his symptoms in check. We have had very few flare ups. But we have to keep an eye on his white blood cell count since it is a immunosuppressant. Thankfully his body responds really well and his white blood cells have stayed in a healthy range.
 
He was transitioned off of the pred when he started the chlorambucil. He took both for a short time. He is down to only needing a low dose of the chlorambucil once a week. Keeps his symptoms in check. We have had very few flare ups. But we have to keep an eye on his white blood cell count since it is a immunosuppressant. Thankfully his body responds really well and his white blood cells have stayed in a healthy range.
Thanks, all good to know. ❤️ I'm glad he's had such a good outcome with it.
 
It's quite cold out today (below freezing), and in a dramatic shift from the usual issues with my apartment building, the heat is completely out. (Apparently a boiler problem they're working to repair.) Gen is very kindly helping me stay warm.

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It's 96 here today! I wish we could send some heat up your way! Stay warm up there. I hope they fix the boiler soon.
 
It's 96 here today! I wish we could send some heat up your way! Stay warm up there. I hope they fix the boiler soon.
Oh dear, I'm afraid I wouldn't trade you for that! 😅 I'm a more temperate sort. I'm really looking forward to the low to mix-60s. But thank you for the thought! And fortunately, the boiler appears to be fixed, so it's a comfy temperature indoors at least.
 
Well, so my evening plans partly fell through, and I was actually able to be home by shot time! Which ... I'm grateful for, because he'd have been up above 400 without a doubt. :/

I'm not sure I should hold this dose for the 3 standard days. I know it's kind of an increase, but we could see the low doses I've been giving him as a temporary illness-based reduction? I hate seeing such high numbers again.
 
He did see a 87 nadir today. Let's hope he breaks this bounce (like he did this morning) and comes back down. Gently, please, Gen.
I'm wondering if it's really a bounce when it seems to be caused by the budesonide? I don't really know how that works.

I think the 87 may have been because he hadn't eaten quite enough. (Possibly because it was so cold in here and he didn't want to get out of my lap? I could be projecting, I kind of didn't want to move for a lot of the day.) It was a steep drop and then a long, slow climb.

But thank you ... I hope he can come down, gently.
 
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