3. Lois and RIP-Java

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Oh Lois! I'm so sorry about the fur shot, but I heartily agree with your new treatment plan. I love the idea of giving Java the insulin he needs to stay comfortable, and the food he wants. As much as he wants and whenever he wants it. My only caution would be to make sure he's hydrated since dry food is so.....dry. But don't the subq fluids take care of that anyway? Looks and sounds like you had a great day at the march! And don't worry too much about the fur shot. Tomorrow is a new day!
 
Hi Lois, I had a hard time with fur shots too. I know you shaved a small patch, but maybe a bigger patch would be easier? I actually had a huge patch shaved on Colin, across his scruff and a couple inches wide. Wasn't pretty, but it was sooo much easier to see exactly where the needle went in and that it stayed in and didn't stick out the other side. You wouldn't have to go that big of course, but maybe an inch or two square?
In this pic the fur had started growing back, but you can still see what I mean.

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Fur shots happen...and you know Java is in a happy place today with YA back and his favorite water out for him! You'll dose tonight and all will be well. :bighug:
 
Sharon14 said:
Hi Lois, I had a hard time with fur shots too. I know you shaved a small patch, but maybe a bigger patch would be easier? I actually had a huge patch shaved on Colin, across his scruff and a couple inches wide. Wasn't pretty, but it was sooo much easier to see exactly where the needle went in and that it stayed in and didn't stick out the other side. You wouldn't have to go that big of course, but maybe an inch or two square?
In this pic the fur had started growing back, but you can still see what I mean.

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Sharon14, good idea. Maybe I can find someone with a shaver via nextdoor dot com so I don't have to take him to vet.
Up at 5:00 to take up wet food but leave down YA, he was sitting in front of the door, willing it to open. No way was I going out, even though first birds singing. He rejected water, so I tried slurried pate. He lapped some, settled down on heating pad.
This am, 581. Interesting it's not higher. It's better than 700s!
And now we're heading outside for morning water.
 
#@$&*!?&#
690 at +6
This was one that I would swear on a stack of Bibles in court was not a fur shot.
But it must've been unless there's something going on with shooting him on his side.
 
It might not be a fur shot. It might just be where he's at right now. He's gone from 1.2 to 1.75 this week. That's fine and appropriate, but it is a change, and the number you got might just be how his body is responding today. This was his first dose at 1.75 in a while. Give it a couple more cycles, and let's see what he's doing then.
 
https://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7374
"... because it is easier for the owner to mistakenly inject into muscle or skin. Any of these would interfere with proper insulin absorption. The recommendation is to NOT use the scruff as an injection site."
I"m not using the scruff, but maybe I'm injecting into muscle or skin?
I've texted the traveling vet, and contacted the people in the neighborhood who responded me when I was asking for help testing and shooting, when my friend whose house burned down was visiting. I'm really anxious about getting tonight shot's right.
 
Djamila said:
It might not be a fur shot. It might just be where he's at right now. He's gone from 1.2 to 1.75 this week. That's fine and appropriate, but it is a change, and the number you got might just be how his body is responding today. This was his first dose at 1.75 in a while. Give it a couple more cycles, and let's see what he's doing then.
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But why wouldn't it go down? Oh god, have a completely effed him up ? I basically threw the traveling vet's recommendation to only give him 1.2 out the window (she amended to 1.5 on 4/19, said don't go over 1.5, don't test after eating, which I knew). Her whole theory was that a lower dose would minimize the Symogyi.
He looks so bad. As in, this might be it, bad.
 
You did not eff him up! We all adjust doses and do the best we can to figure out what our cats need! You lowered the dose based on a reasonable theory. You gave it some time to work, looked at his numbers, and are now adjusting again. That's how this whole thing works.

I'm up in Seattle. Although I'll be in Oakland next week for a conference (please please please let there be sunshine!)
 
Oakland's 25 miles away. That's where I worked for 25 years. I'm in Marin. You want to try to rendez-vous? Actually, I'll be in Berkeley, near the Claremont Hotel, on Wednesday next week. But I'm guessing you're at the Marriott downtown Oakland.
Edit - or if you have time, I'm happy to be a tour guide.
 
As for why it wouldn't go down, here are my theories:
1. He's 20 years old, and things work differently as we age.
2. He's "stuck" right now (this happens for most cats at different times in the FD journey), and you'll need to systematically raise his dose for awhile to get to his breakthrough dose and get him moving again. Sam was stuck from 2/7 to 3/5, so I had to just keep raising the dose. There are a few cycles in there where his numbers go up instead of down.
3. He's having a flat cycle after a low (this one isn't true for Java right now, but it's another thing that can cause a higher mid-cycle number)
 
Djamila said:
Oh my gosh! I would love to meet you!!! Let me check where we're staying....
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Lots to see in the Bay Area. I know about/can show: Berkeley, esp North Berkeley, UC Berk campus, Claremont Hotel/ College Ave/Elmwood area, Could meet you in SF, me via Ferry, you via BART, at the Hyatt in the Embarcadero area, go on transit to stuff in SF. Pick you up somewhere, show you Marin. How much time do you have? Sonoma, and wine tasting, etc., Napa too for that matter, isn't far away. Muir Woods, Pt. Reyes, Tiburon, Mill Valley, Fairfax, all right here. If you want actual ocean, Rodeo Beach isn't far. Or go sit on the porch at Cavallo Point and just look at the GG Bridge. Lots to do around here. Or come over and hang out with a book with my old cat!!
Edit, I have to be home by 7 to test, shoot Java, and I like to home mid day to test, feed.
Edit, there's a lot to do and see in Oakland, in the old section, Chinatown, and Jack London Square, but you can do that on foot with conference people. Assuming you're downtown Oakland and not out by the airport.
 
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It looks like I left the hotel info is at the office, but the conference is Monday and Tuesday at Preservation Park. We wouldn't have a lot of time (and I definitely understand the need to be home for shots and monitoring!). I haven't been there before, but I imagine the BART wouldn't be too hard to figure out. I'll message you the hotel info tomorrow and we can see if we can make something work out. Everyone else should come too! Everybody fly to SF! We can have a prozinc party! :);)
 
That's the easiest explanation, but there are other possibilities too. Oh, and also if the cat gets food right before a mid-cycle test, especially if it's MC or HC food. So there's a 4th possibility. Or is that 5 if we count fur shot?
 
Oh yeah, we would have Commission retreats at Preservation Park. It's nice. It's just a hair (like a block) out of right-downtown. Have you been to the Bay Area before? Is there anything on your bucket list of must-see?
Also, I'm thinking, like, you're not coming tomorrow and Tuesday, or are you? It's fine if you are, just wondering.
IMHO stuff not to miss: BART to SF Ferry Bldg. Claremont Hotel, though more of a during the day thing. Cavallo POint. Okay, just realized I'd list everything I already listed.
 
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Kris & Teasel said:
Yes! Photos!
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I love to photograph stuff!
Java ate a tablespoon or two of food. We went outside and he gave me the slip while I was hanging stuff on the line, I found him crouched in a kind of culvert between two neighbor's property, keeping quiet so a dog/walker wouldn't see him. Smart cat. I didn't want him in the tunnel though - I think that's where he was when I couldn't find him earlier in the day. I'm a terrible story teller, anyway, he made a beeline for this major storm drain across the street that the raccoons use as a highway. OMG! I honestly am worried that he's trying to End It.
 
736. He slurped maybe a teaspoon or two of food slurry. He wants to go outside, and I did go out with him for 5 minutes, but he barely drank water and wants to walk around, go under decks. No.
I put on my camping headlamp and shot with him in my lap like a baby. I saw the needle go in the skin. I could feel the needle between the pulled up skin. I held the needle in for 10 seconds. Please let this insulin do some good.
Crum, I didn't smell. Off to check.
No smell. Strong heartbeat.
 
Mobile vet text. Thoughts?
The first one is that she didn't get that its literal, the fur shots.
Oh, and I tested for ketones just after doing the blood test, negative.
"He may need regular insulin at the emergency clinic to get under control if you haven't been able to get the pzi in for a few days. It also may be time to try glargine. If he has ketones I would recommend the emergency clinic to get under control. The pzi may not last long enough for him. I can call glargine in tomorrow to a local pharmacy. Also pancreatitis can cause a loss of diabetic control and often needs hospitalization. It can cause decreased appetite and very high glucose. I am not available until Monday evening."
 
Lois and Java said:
Mobile vet text. Thoughts?
The first one is that she didn't get that its literal, the fur shots.
Oh, and I tested for ketones just after doing the blood test, negative.
"He may need regular insulin at the emergency clinic to get under control if you haven't been able to get the pzi in for a few days. It also may be time to try glargine. If he has ketones I would recommend the emergency clinic to get under control. The pzi may not last long enough for him. I can call glargine in tomorrow to a local pharmacy. Also pancreatitis can cause a loss of diabetic control and often needs hospitalization. It can cause decreased appetite and very high glucose. I am not available until Monday evening."
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Well, she mentioned Lantus (glargine). Do you have the wherewithal to try it? It shouldn't be a difficult transition except that the dosing has to be as close to 12/12 as you can manage. It's gentle, long lasting and might smooth him out.
 
Kris & Teasel said:
Well, she mentioned Lantus (glargine). Do you have the wherewithal to try it? It shouldn't be a difficult transition except that the dosing has to be as close to 12/12 as you can manage. It's gentle, long lasting and might smooth him out.
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All the things going through my head and heart are, different vial makes no difference; every 12 hours can be done tho I have liked the flexibility of +/- one hr w pzi; is he strong enough to make a change like this, will it help him, is he at the end, let him go?
Edit, his respiration and heartbeat are normal, 28 and 132, 144 respectively. He ate another teaspoon of food, I'm warming the LRS, which he was on track to get this evening anyway.
 
Lots of things to sleep on. He's so debilitated, what am I willing to put him through, what are the possibilities a good quality of life. Today's really the first that life seem to suck for him. Is eating teaspoons of food at a time. Could the Lantus actually turn tide, what about recovery from the profound neuropathy, is that even possible at his age, condition.
357 at +5,thank god, he ate a tiny bit more. I'm nearly catatonic with fatigue...
 
I don't know what to say about the Lantus. I do think it might help him smooth out some. Why not post on the Lantus board and kind of give a run down of Java's recent issues and what's going on and ask for their input?

I'll tell you this, Lois, I think you will really KNOW when it's time to say goodbye. I tortured myself over Gypsy for about a month, back and forth over what to do for her. When the end came, I KNEW. She stopped eating completely, went and hid in the house and wouldn't come out at all. She didn't even complain when I took her to the vet....and I knew. I know you're going through a lot right now and you're trying to balance out what Java needs with whether or not it's his time...but I think he'll tell you. Another thing that helped was something Sue told me at the time...Whatever decision you make will be the right one, because it was made from love. I don't know if any of that helps you, but somehow, what Sue said set me free to make that final decision when it was time...

How does he seem besides numbers? Is he acting happy at times? I know he's on a lot of meds, but is he cleaning, sleeping, lying in the sun, doing any of his favorite things? Will he still eat the YA?

Sending you :bighug::bighug::bighug::bighug:, Lois.
 
:bighug::bighug::bighug::bighug::bighug:
It's so hard with an older kitty. As Rachel said, you'll know. I recently lost DJ who was 24. His condition had started to deteriorate in the last few months and I kept going back and forth on what to do. He was still eating and going out in the sun, but losing weight, not too active, but didn't seem to be in pain, so we just did what you are doing now, enjoyed everyday best as we could. He will tell you when he's ready for the next journey.

As for an insulin switch, I'm wondering if you choose to switch to a depot insulin if lev might be a better choice? Only wondering because some say since Lantus is acidic it can sting some cats and in his condition maybe you don't want to risk that slight possibility? If you want I can tag a couple Lantus users that have more knowledge dealing with multiple issues to give you some insight.
 
Sharon14 said:
If you want I can tag a couple Lantus users that have more knowledge dealing with multiple issues to give you some insight.
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Yes, please, could you? That would be very kind. I don't know what lev is. (Which dictation put down as, I don't know what love is, which is making me laugh while I'm crying.)
 
Lev is Levemir. It's an insulin very similar to Lantus and the Lev users hang out in the Lantus forum since they are both depot insulins. It's often used for cats with acro or IAA since they require higher doses and it does sting less than Lantus at higher doses. :)
 
First the good news, the shot was successful, and he was 357 around midnight. I just gave him 1.75 repeating the same technique, pretty sure insulin went in. When I got up, he was sitting on the table in front of his water glass looking longingly outside. I'm not sure he could have done that yesterday or last night. He ate his wet food readily, it was a job getting him to eat at all yesterday. I gave him Gabapentin right after the insulin, and he went into the bedroom and jumped up on my bed. He's been staying away from the bedroom in favor of the pillow on the couch. I did 10-15 minutes of outdoor errands before offering to let him go outside, taking him from pillow to door. He looked, turned around and went back to the pillow.
On the minus side, I hear an occasional wheeze or rattle in his breathing that wasn't there before. I think that might be a side effect of Sub-Q fluid? Have to look up.
 
Hi Lois, Sharon asked me to weigh in since we were on ProZinc and switched to Lantus. I skimmed through this thread and my gut reaction is to not switch him at this point. The reason is with ProZinc being an in/out insulin, you are able to adjust his dose more quickly than you are going to be able to do with Lantus since he eats dry, you'd have to follow SLGS method and the dose would be held for 7 days unless of course he would go under 68 on the pet meter. With Lantus the dosing needs to be consistent and with him not eating well right now, you can alter the ProZinc dose accordingly.

Just my two cents worth and I am sending lots of hugs to you and Java. Obviously he is very bonded to you and you to him and it is so hard to see them start to fail. I do want to give you my favorite shot technique video. I was having lots of FS close together and after I saw this one, I didn't have anymore problems.

https://www.youtube.com/watch?v=q_3TLtN8XYo

:bighug::bighug::bighug::bighug::bighug:
 
Just had 30 minute conversation with the mobile vet. I'm feeling more positive. Am starting Lantus tomorrow. Decreasing Gabapentin, see if less sedating. Have things to do before nadir test between noon and one.
 
Lois and Java said:
Just had 30 minute conversation with the mobile vet. I'm feeling more positive. Am starting Lantus tomorrow. Decreasing Gabapentin, see if less sedating. Have things to do before nadir test between noon and one.
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Go read all the Lantus stickies, Lois. You need a totally different mind set. I've often compared it to steering a tank rather than a sports car (the in and out insulins like PZI). Good luck!! I can help if you need it but the Lantus forum is a great resource. I suggest you post there too.
 
Wow! All righty, well I would post in Lantus forum to let them know what's going on (give them kind of a run down) and get their suggestions. I really hope it works well and helps Java be more comfortable! Don't forget to check in with us here when you can...I'll try to check in on you over there, (I lurk over there to keep an eye on my friends who have switched) but sometimes I miss things! :bighug:
 
Lois and Java said:
Yes, please, could you? That would be very kind. I don't know what lev is. (Which dictation put down as, I don't know what love is, which is making me laugh while I'm crying.)
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Since you're going ahead with the switch, write up a post on the Lantus forum and give a little history. I'll tag a few peeps there (if necessary)so they don't have to wade through this long thread. In fact one that I'd tag is Tricia who, I think, lives in your neck of the woods.
 
Just out of yoga, where, removed from everything, I felt that the thing to do is let it be It now, or tomorrow. But I'm not sure either. I'm trying to imagine the future, six months, a year from now, will I be feeling good or bad about lots more blood test sticks to Java, daily subcutaneous fluids, experiments trying to find something that helps with the pain and his hind legs and hips without sedating him to a near comatose state, and somehow trying to get weight on him. He was 10 pounds the last time I saw Dave the vet, and 8 pounds two weeks ago with the mobile vet. I feel sure he's lost more weight in those two weeks.

The problem is, he clearly feels crummy, and yesterday was the lowest ever, but if his BG is handled better, and I'm not effing up the shots, can he go back to his old man Pursuits of sleeping, happily going out in the morning and surveying his kingdom and drinking rainwater..... This totally sucks.
 
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