5/20 Ruby AMBG 58/+3 61/+7 64/PMBG 70/+3 64

Katherine&Ruby

Katherine&Ruby

Very Active Member
Yesterday on Ruby Takes Katherine on a Rollercoaster Ride. :eek:

Ruby dropped to the 50s :confused: after spending the day not eating much and even after I gave her a drop dose rather than .1. When I tested this morning and saw her number, decided not to shoot. I can't have a repeat performance of yesterday not knowing if she will eat, although she was a hungry hungry hippo and cleaned her bowl of raw turkey and bison, topped with a small spoon of 12% because otherwise she won't eat it. :rolleyes: Let's hope she stays steady and I won't regret skipping.

Healing thoughts for all the sick kitties and hugs to you beans. Thanks everyone for hanging in there with me and Ruby for this wild ride. :bighug: :bighug::bighug:
 
Summer and Susie said:
Prayers for a safe and uneventful day for your girl and for you, Katherine.

By the way, I like her new picture. I can see more of her pretty face now. Hope she isn't still "meatloafing".
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Thanks, Summer. Ruby did a lot of meatloafing yesterday, but now she is sprawled on her side on the bed napping after her hearty breakfast. I don't know what is causing these flares that make her feel so bad and what more I can do to prevent them from happening. Her vets seem hesitant to treat her for IBD or lymphoma unless she gets really bad, and given her diabetes I understand this and agree, but I also worry about her quality of life. Hate seeing my sweet girl suffering.
 
PerfumedCatMom said:
Her vets seem hesitant to treat her for IBD or lymphoma unless she gets really bad, and given her diabetes I understand this and agree, but I also worry about her quality of life. Hate seeing my sweet girl suffering.
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Are you sure the hesitancy isn’t being driven more by the lack of information (aka endoscopy & biopsies?) vs DM? This is one reason why talking with the IM who has a special interest in GI and does intestinal biopsy would be very helpful at this point. With his level of experience, knowledge and the fact that he actual does endoscopy and sees what the intestines often look like in cats like Ruby, he will be in a better position to help decide the timing of moving forward with diagnostics vs continuing with your current plan.

I find that it is always best and most helpful to get opinions Re: diagnostics & treatment from IMs who subspecialize in a particular area—like GI/endoscopy, vs a more generalized IM or one who specializes in an area outside of the disease state you are trying to manage. They typically don’t think the same way or make decisions the same way because they simply don’t have the enormous amount of info/experience (& passion) that the subspecialist has.
 
Ruby wants to go "you know what" perhaps. I'm sorry to hear about the meatloafing. It must be very uncomfortable for her if her innards are inflamed. She really seems to have bad days and good days. So glad that today she's in the stretched out comfortable position! Hugs to you because you have to figure out all this stuff.
 
Tomlin said:
Are you sure the hesitancy isn’t being driven more by the lack of information (aka endoscopy & biopsies?) vs DM? This is one reason why talking with the IM who has a special interest in GI and does intestinal biopsy would be very helpful at this point. With his level of experience, knowledge and the fact that he actual does endoscopy and sees what the intestines often look like in cats like Ruby, he will be in a better position to help decide the timing of moving forward with diagnostics vs continuing with your current plan.

I find that it is always best and most helpful to get opinions Re: diagnostics & treatment from IMs who subspecialize in a particular area—like GI/endoscopy, vs a more generalized IM or one who specializes in an area outside of the disease state you are trying to manage. They typically don’t think the same way or make decisions the same way because they simply don’t have the enormous amount of info/experience (& passion) that the subspecialist has.
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Her IM is not recommending the diagnostics that would give us the information to proceed with treatment right now because these flares are happening few and far between. I think what happened to Ruby yesterday was a continuation of last week. She's not over that flare yet. If she does not respond to the supportive care I am giving her at home over the next week, then they are recommending a biopsy. If she didn't have diabetes they might have jumped on the scoping while she was at the hospital.

I would LOVE to get the perspective of a specialist. I'd call Dr. Palma, but would he talk to me on the phone or by email if about her case if Ruby is not in front of him? I also don't want to offend the attending resident who took care of Ruby.
 
Suzanne & Darcy said:
Ruby wants to go "you know what" perhaps. I'm sorry to hear about the meatloafing. It must be very uncomfortable for her if her innards are inflamed. She really seems to have bad days and good days. So glad that today she's in the stretched out comfortable position! Hugs to you because you have to figure out all this stuff.
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Ha! :joyful: Ruby did "you know what" overnight. There was a nice sized prezzie in the litter box for me when I woke up (yes, I can tell the poops from my two cats apart :p). I haven't inserted the emoji into her SS yet. :D It's a possibility that needing to pass that caused her pain and discomfort yesterday, but she's been pooping pretty regularly since she arrived home on Sunday from the hospital. Three times in four days--a veritable poop streak for Ruby-doo! :woot:
 
No... I meant that three letter abbreviation that nobody wants to say to jinx their cat. But glad she's been pooping. What's that other red and white icon on your ss?
 
Katherine , I'm happy to see that Ruby had a good appetite this morning.
I hope they can figure out why she has no appetite at times
We worry so much when they don't eat.
I'm happy she pooped, please Ruby we all want you to continue to eat ♥:bighug::bighug::bighug:
 
Suzanne & Darcy said:
No... I meant that three letter abbreviation that nobody wants to say to jinx their cat. But glad she's been pooping. What's that other red and white icon on your ss?
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Ah, ok! Yes, I'm wondering about the three letter word myself. :nailbiting: I'm really hesitant to give Ruby insulin until she has several consecutive days of consistent eating. I do not want to give her insulin with preshots in the 50s and see another number in the 30s while her her flare continues. However if her BGs begin to climb in a worrisome way, I'd start with a drop dose again and work my way up as needed. That 54 she got last night was still the .25 unit dose doing its thang.

The icon is a little wrapped candy that is my cutesy stand-in for the snack I feed her at +8/+9 when she is on small doses to lower her preshot numbers.
 
PerfumedCatMom said:
Yesterday on Ruby Takes Katherine on a Rollercoaster Ride. :eek:

Ruby dropped to the 50s :confused: after spending the day not eating much and even after I gave her a drop dose rather than .1. When I tested this morning and saw her number, decided not to shoot. I can't have a repeat performance of yesterday not knowing if she will eat, although she was a hungry hungry hippo and cleaned her bowl of raw turkey and bison, topped with a small spoon of 12% because otherwise she won't eat it. :rolleyes: Let's hope she stays steady and I won't regret skipping.

Healing thoughts for all the sick kitties and hugs to you beans. Thanks everyone for hanging in there with me and Ruby for this wild ride. :bighug: :bighug::bighug:
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Hi Katherine, I hope today mellows out for you and Ruby. You and Ruby need a break from this long, sometimes scary, ride you’ve both been on. I hope her appetite improves and there are no limes :D Coming to visit. Surf safely sweet Ruby. Hope it’s a good day. Sending loving prayers and hugs :bighug::bighug::bighug:
 
PerfumedCatMom said:
I would LOVE to get the perspective of a specialist. I'd call Dr. Palma, but would he talk to me on the phone or by email if about her case if Ruby is not in front of him? I also don't want to offend the attending resident who took care of Ruby.
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One option is to reach out to the attending resident and ask them if they would assist you with talking with Dr Palma—can even be a joint call or email :). I have found very few residents who are offended by requests to get the IM involved. It’s actually an opportunity for them to learn as well.
Every setting is different in how they manage these situations, so it never hurts to ask. If they say no, you haven’t lost anything :rolleyes:.
 
Tomlin said:
One option is to reach out to the attending resident and ask them if they would assist you with talking with Dr Palma—can even be a joint call or email :). I have found very few residents who are offended by requests to get the IM involved. It’s actually an opportunity for them to learn as well.
Every setting is different in how they manage these situations, so it never hurts to ask. If they say no, you haven’t lost anything :rolleyes:.
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OK. I will give it a shot tomorrow. Thank you, Amy, for helping me navigate the veterinary world!
 
PerfumedCatMom said:
Ah, ok! Yes, I'm wondering about the three letter word myself. :nailbiting: I'm really hesitant to give Ruby insulin until she has several consecutive days of consistent eating. I do not want to give her insulin with preshots in the 50s and see another number in the 30s while her her flare continues. However if her BGs begin to climb in a worrisome way, I'd start with a drop dose again and work my way up as needed. That 54 she got last night was still the .25 unit dose doing its thang.

The icon is a little wrapped candy that is my cutesy stand-in for the snack I feed her at +8/+9 when she is on small doses to lower her preshot numbers.
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Okay, so I am an ignoramus about this feeding to keep numbers lower. I've only every fed to get numbers to go higher. My cat has either been a totally piggy eater who ate everything in sight, to now, unfortunately, not wanting to eat or to grazing all day. I can't time any feeding. He eats when he wants to eat, and that's it! But do tell me about how you feed Ruby to lower her pre-shot number. Just today I saw Bhooma telling Summer to feed Susie at +9 to keep her from having too low of a preshot number.
 
Suzanne & Darcy said:
Okay, so I am an ignoramus about this feeding to keep numbers lower. I've only every fed to get numbers to go higher. My cat has either been a totally piggy eater who ate everything in sight, to now, unfortunately, not wanting to eat or to grazing all day. I can't time any feeding. He eats when he wants to eat, and that's it! But do tell me about how you feed Ruby to lower her pre-shot number. Just today I saw Bhooma telling Summer to feed Susie at +9 to keep her from having too low of a preshot number.
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The late cycle snack is recommended for kitties on low doses to get those preshot numbers down. The reasoning is that if the cat is on such a low dose, there is a possibility that the pancreas is doing its job on its own and the presence of food in the system would spur it to make its own insulin and lower the BGs. If the snack doesn’t work and preshots remain blue, chances are the cat is not ready for OTJ.

Susie is not quite there yet. Feeding her food will push BGs up because her pancreas still needs help from exogenous insulin.
 
PerfumedCatMom said:
The late cycle snack is recommended for kitties on low doses to get those preshot numbers down. The reasoning is that if the cat is on such a low dose, there is a possibility that the pancreas is doing its job on its own and the presence of food in the system would spur it to make its own insulin and lower the BGs. If the snack doesn’t work and preshots remain blue, chances are the cat is not ready for OTJ.

Susie is not quite there yet. Feeding her food will push BGs up because her pancreas still needs help from exogenous insulin.
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Thank you for explaining this. I will never be in that situation, but it is interesting, and I understand this now.
 
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