6/25 Ruby AMPS 160/+3 179/+7 221/+10 278/PMPS 279/+3 181

[Katherine&Ruby]

Yesterday on Ruby Duby Du.

Let's both sit on mom and stare at her until she wakes up alarm.
Eating well.
Took Ruby out to explore the stairway outside the door of the apartment last night and she enjoyed exploring.

Took Ruby's dose up a little bit this morning from .25 to .375 and will see how it works today. Will be home all day to monitor.

I've picked up the Libre2 from the pharmacy and will attempt to put it on Ruby tomorrow on my own. It will be good for me to see if Ruby will tolerate it, especially as I start work on July 6 and this will make things easier for me and DBF.

Today is Ruby's 15th day on prednisolone.

Have a beautiful day, everyone.

 

[mosi_yazhi]

Omg, Katherine -- did you put her in a leash and harness to take her exploring? People walking their cats like they're dogs is my absolute favorite thing.

Good luck with the dose increase and Libre2!

 

[Katherine&Ruby]

Omg, Katherine -- did you put her in a leash and harness to take her exploring? People walking their cats like they're dogs is my absolute favorite thing.

Good luck with the dose increase and Libre2!

Thanks! No leash or harness, it was a supervised walk indoors. I have done the harness thing in the past when there was a grassy yard available and she loved it.

 

[Diane Tyler's Mom GA]

Morning Katherine, I'm glad Ruby enjoyed her little adventure
Picturing both kitties sitting on you and staring cracked me up
Good luck with the slight increase and putting the Libre2 on.
I hope you all have a nice day ♥

 

[Margaret and Pearl (GA)]

Any patterns emerging yet? I am not able to figure it out for Ruby yet. Not sure if you'll be able to see easy patterns like Pearl gets with daily administration. How long do you do the Pred daily before you go down?

 

[Katherine&Ruby]

Any patterns emerging yet? I am not able to figure it out for Ruby yet. Not sure if you'll be able to see easy patterns like Pearl gets with daily administration. How long do you do the Pred daily before you go down?

Hi Margaret! I give Ruby the pred with her morning shot. Doing it at +3 didn't seem to work very well for her. The pattern that I can see is her BGs will start rising for about 10 hours after I give it. She's usually coming down around PMPS, though I don't know where that yellow came from last night. It was possibly a bounce from a lime the night before, but I have a strong intuition that it was the pred doing overtime and not a bounce, unless Ruby's liver has become untrained again from these weeks of being in mostly blues. Dosing the insulin is getting tricky, and now she has the runs, poor girl.

 

[Tomlin]

Dosing the insulin is getting tricky, and now she has the runs, poor girl.

If she has the runs, is it possible that, despite the Pred helping to some extent right now, she may have a little bit of a flare going on, hence the diarrhea? That would potentially cause some issues that would result in the some of the higher #s.
If there is insulin resistance caused from the Pred and then any additional resistance being caused by inflammation, you will often see that rise in glucose.
So, instead of it being prolonged effect from the pred or a bounce, it simply could be a result of what is going on in her poor intestine as of late.

 

[carfurby (GA)]

Glad Ruby enjoyed her exploring last night. Good luck with the new dose.

 

[Katherine&Ruby]

If she has the runs, is it possible that, despite the Pred helping to some extent right now, she may have a little bit of a flare going on, hence the diarrhea? That would potentially cause some issues that would result in the some of the higher #s.
If there is insulin resistance caused from the Pred and then any additional resistance being caused by inflammation, you will often see that rise in glucose.
So, instead of it being prolonged effect from the pred or a bounce, it simply could be a result of what is going on in her poor intestine as of late.

That makes total sense. I started her on S. boulardii yesterday as soon as I saw she was pooping outside the box, and she did produce a softly formed poop a few hours ago so I hope she is on the mend. Ruby's rarely ever had diarrhea. Constipation has been her chronic issue, but maybe since we're two weeks into the pred it's having some effect and causing a flare. I dunno, it's feast or famine around here.

 

[Tomlin]

pred it's having some effect and causing a flare.

I don’t think it is causing the flare, but instead, it is not completely able to manage/control a flare if one is occurring. As you know SCL is more often than not treated with combination therapy, so hopefully, once you see the oncologist, the SCL treatment will be optimized and the flares brought under control. The Pred, at 5mgs, has limited effect with respect to its immunosuppressive ability, therefore, if there is a flare, it most likely just is not able to stop it from happening if that makes sense?

The diarrhea/constipation conundrum .

Hang in there Katherine . I am happy it is a formed poop this afternoon.

 

[Katherine&Ruby]

+10 = 278. Ugh.

 

[Wendy&Neko]

unless Ruby's liver has become untrained again from these weeks of being in mostly blues.

That happens, plus you've got some NDW going on, plus whatever is impacting her GI. Poor thing. I hope you can get started soon on the chlorambucil. Did you ask if the oncologist has a cancellation list? It's so annoying you have to wait, you really don't need an oncologist for this. My 1st SCL civvie started out at 10mg pred.

 

[Katherine&Ruby]

That happens, plus you've got some NDW going on, plus whatever is impacting her GI. Poor thing. I hope you can get started soon on the chlorambucil. Did you ask if the oncologist has a cancellation list? It's so annoying you have to wait, you really don't need an oncologist for this. My 1st SCL civvie started out at 10mg pred.

Hi Wendy, there is a cancellation list but they said they would call me if any slots became free. I was mostly ok with waiting, as Ruby has been eating better and her BGs were mostly steady. This doctor is a very good one and has co-authored a paper on SCL becoming LCL in cats, so it seemed worth it for me to wait a few weeks. Now that we’re seeing more yellows, having GI issues and also not eating tonight, I am ever more impatient for this appointment. Sigh.

 

[Tomlin]

I am ever more impatient for this appointment. Sigh.

If you are comfortable, drop an email to your contacts at AMC to make them aware of the recent changes, your concerns and ask if they can assist in any way. I recently had to do that for one of my cats who was waiting to see a particular specialist and his IM helped me out because of the situation.

 

[FrostD]

Geez I took my eye off her for ONE day (Cookie having another very rough day)! Poor Ruby, I really hope she feels better soon and maybe a spot opens up sooner.

Edit- I'm not even going to fix the emoji because it's a window into my brain right now

 

[Our Dolly Girl (GA)]

Goodnight Katherine and Ruby. Hope you have beautiful dreams of things to come. New job, Ruby dealing well with treatments, Ruby healing, eating well and pooping. Olive staying healthy. Two happy cats surrounded in love from Katherine and Frank.

 

[Our Dolly Girl (GA)]

Hi Wendy, there is a cancellation list but they said they would call me if any slots became free. I was mostly ok with waiting, as Ruby has been eating better and her BGs were mostly steady. This doctor is a very good one and has co-authored a paper on SCL becoming LCL in cats, so it seemed worth it for me to wait a few weeks. Now that we’re seeing more yellows, having GI issues and also not eating tonight, I am ever more impatient for this appointment. Sigh.

Hi Katherine, sorry I wasn’t aware that Ruby was having GI issues and not eating. It’s so easy to miss updates unless you read your response to others. Sorry I missed it until now. My prayers from last night are still the same. Sending love and prayers to all and will check on you later. Hugs