6/28: Sammy - AMBG 238; +5 239; PMPS 269

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Tina & Sammy

Tina & Sammy

Member Since 2010
Yesterday's Condo

Well, Sammy is still over 200 this morning, and last night he just went up after his PMBG test. I didn't test after +3, but based on his AMBG this morning I am assuming that he might have dropped down a bit by probably not under 200.

Since there is some possibility that he could be bouncing from his own insulin I am going to wait at least until this evening to determine if that might be what is happening If I don't see him drop down today then I will restart insulin at a .25 unit dose. I know he should be under 100, most of the time but I am still a little freaked out that he was getting way too much insulin and it has affected the way his body responds.
 
Well, unless Sammy makes a miraculous recovery today we will be starting insulin again tonight. When I tested her at +5 he was at 239. He had gone up over 250 after he ate this morning, but then came back down a little bit. I am expecting that he will still be over 200 at the PM test time, so I am already planning on restarting the insulin.

I am planning on going back to .25 unit because he did start to rise a bit when we decreased to .1 unit. Hopefully he will straighten out and not keep throwing me these crazy numbers for no reason. If I don't see some stabilization very soon we will probably go in for more bloodwork to see if he has some sort of infection.

@Amy&TrixieCat You mentioned that you think Trixie might have had a low-grade infection for a long time and you think that once it was cleared up she started to have better numbers. Could you tell me if Trixie was acting like she didn't feel good when she had the infection? Sammy is acting just fine, but I am a little concerned that he might have an infection, because his numbers were so good for the longest time on .1 unit and then all of a sudden his numbers started to go so wonky. Also did the infection show up on the bloodwork. I have been thinking Sammy has had an infection in the past, but nothing every shows up on the bloodwork.
 
I'm glad you are putting Sammy back on insulin tonight. He's really close to, if not over, renal threshold now. When Trixie was bouncing of her own insulin, she was still going down mid cycle. Sammy just looks like he's rising or flat.
 
tiffmaxee said:
Tina, when was his last dental?
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Sammy has never had a dental, but every time I have taken him in the vet says he has some tarter, but nothing that looks swollen or infected. I am so nervous about having a dental done because of the UNKNOWN Costs that come with it. I am not really comfortable with having it done at the current vet we are with, but I am thinking about changing vets and will possibly have it done just to be sure that isn't the problem. But what makes me more nervous is what happen with Milo. I know he had other circumstances as well, and it isn't a common thing, but it still freaks me out.

I am starting my second week at my new job and I am going to off sight training this week, so I won't be doing anything radical this week or taking Sammy to the new vet. But maybe by next week things will settle down a bit and I can think about those possibilities.
 
Wendy&Neko said:
I'm glad you are putting Sammy back on insulin tonight. He's really close to, if not over, renal threshold now. When Trixie was bouncing of her own insulin, she was still going down mid cycle. Sammy just looks like he's rising or flat.
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I have to agree, and after re-looking at his spreadsheet and referring to your note from yesterday's condo about the fact that it could take 4-6 cycles to empty the depot, it is possible that through the entire time that he was on the .25 unit dose (from PM 6/15 - AM 6/18) he still could have had residual depot action. By the 7th dose he was still coming down a bit during the cycle and looked okay, but on the 8th dose his numbers were slightly rising and then I reduced again to .10 unit. So maybe the rising numbers on the lower dose were because he needed more juice not because he was still getting too much. Hindsight is always 20/20 right.
 
Marje and Gracie said:
IMHO, Sammy was given a few reductions close together that he didn't earn. I think the depot has finally drained and he needs insulin. If he were my kitty, I'd put him back at 0.25u and then let him earn the reduction.

Eta: I wrote that yesterday afternoon and thought I hit "post reply" but guess I didn't. Sorry...:rolleyes::rolleyes:
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Thanks @Marje and Gracie No worries on the missed post. I do that quite often. LOL!

I did go back to the .25 unit dose this evening. He didn't come down at all today. I had really hoped that my instincts were correct, but now that I look back it looks like he was doing okay on the .25 unit dose and then I decreased him to .1 unit. He still did okay on the .1 unit dose for a couple of cycles, but now I am sure that it was the residual depot from the .25 unit dose that was helping out.
 
No miracles here today!

Sammy is back on insulin. Hopefully we can get him leveled out and try to figure out what it is that he needs or doesn't need. I seriously need therapy to help with the stress of feline diabetes.

How do you all do it? Day in and day out for YEARS! If I didn't have to work it might be doable, but it really takes a lot out of me.
 
Tina & Sammy said:
@Amy&TrixieCat You mentioned that you think Trixie might have had a low-grade infection for a long time and you think that once it was cleared up she started to have better numbers. Could you tell me if Trixie was acting like she didn't feel good when she had the infection? Sammy is acting just fine, but I am a little concerned that he might have an infection, because his numbers were so good for the longest time on .1 unit and then all of a sudden his numbers started to go so wonky. Also did the infection show up on the bloodwork. I have been thinking Sammy has had an infection in the past, but nothing every shows up on the bloodwork.
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This is another area where things were a bit "odd" with Trix. She's had her share of ups and downs over the past year and a half. When we took her for her routine check up in January, her kidney values had once again skyrocketed into Stage 4 with no visible symptoms, but shortly after that visit she started behaving unwell yet again, just like she does after every vetty visit. We did a C&S and she did test positive for enterrococous in her urine even though she had no urinary symptoms A month of amoxicyllin (on top of the Zeniquin) cleared that.

Since we believed the main root of her illness was yet another p-titis flare and not the eterrococous, vetty suggested we try Zeniquin since studies are now starting to show that about 50% of all p-titis cases actually are caused by bacteria. Within 24 hours, she made a remarkable turn-around! At the same time, though, she still had ups and downs, and was still bouncing up but coming back down mid-cycle.

She also does have dental issues but she can't have a dental because of her kidneys, so vetty suggested we do pulse ABs on an as-need basis. Trix was shaking her head a lot when she ate, so we started a 2 week course of Zeniquin yet again. It helped with the head shaking, so it seemed to help with her teeth. At the same time, again, she was still bouncing.

After being off ABs for maybe a month, her appy started getting crappy again, so we once again started a 2 week round of Zeniquin, since it seemed to help quite a bit. And it did. And, this was the time that she finally stopped bouncing (and, knock on wood, we haven't had to run a course of ABs again since). I don't know if it's a coincidence or not, but it DOES make me wonder. She had been on ABs for a good chunk of time this year (two of them at once for a while), so did she have a stubborn low-grade infection that wasn't making her REALLY sick, but was causing these flare-ups and bouncing? I don't know. Her BW didn't show an infection, but her response to ABs did imply one.

There are notes in her SS if you want to check out the course we followed. All of the AB stuff occurred this year, but she went OTJ last April. I wish I had a solid answer about why things happened the way they did with her, but there really is no straightforward explanation!
 
Amy&TrixieCat said:
This is another area where things were a bit "odd" with Trix. She's had her share of ups and downs over the past year and a half. When we took her for her routine check up in January, her kidney values had once again skyrocketed into Stage 4 with no visible symptoms, but shortly after that visit she started behaving unwell yet again, just like she does after every vetty visit. We did a C&S and she did test positive for enterrococous in her urine even though she had no urinary symptoms A month of amoxicyllin (on top of the Zeniquin) cleared that.

Since we believed the main root of her illness was yet another p-titis flare and not the eterrococous, vetty suggested we try Zeniquin since studies are now starting to show that about 50% of all p-titis cases actually are caused by bacteria. Within 24 hours, she made a remarkable turn-around! At the same time, though, she still had ups and downs, and was still bouncing up but coming back down mid-cycle.

She also does have dental issues but she can't have a dental because of her kidneys, so vetty suggested we do pulse ABs on an as-need basis. Trix was shaking her head a lot when she ate, so we started a 2 week course of Zeniquin yet again. It helped with the head shaking, so it seemed to help with her teeth. At the same time, again, she was still bouncing.

After being off ABs for maybe a month, her appy started getting crappy again, so we once again started a 2 week round of Zeniquin, since it seemed to help quite a bit. And it did. And, this was the time that she finally stopped bouncing (and, knock on wood, we haven't had to run a course of ABs again since). I don't know if it's a coincidence or not, but it DOES make me wonder. She had been on ABs for a good chunk of time this year (two of them at once for a while), so did she have a stubborn low-grade infection that wasn't making her REALLY sick, but was causing these flare-ups and bouncing? I don't know. Her BW didn't show an infection, but her response to ABs did imply one.

There are notes in her SS if you want to check out the course we followed. All of the AB stuff occurred this year, but she went OTJ last April. I wish I had a solid answer about why things happened the way they did with her, but there really is no straightforward explanation!
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Just this sort of thing is making me think Sammy has an infection that just isn't showing up in the blood work. EVERY time prior to this time when Sammy's numbers went up we started antibiotic and his numbers fell back in line. This time we wanted to hold off until we could prove that an infection was present, and because nothing has shown up in bloodwork or urine we didn't start antibiotic. I am starting to wonder if we should do a round just to see if it helps.

Like I mentioned above I am probably going to be changing vets in the next week or so, and that will be the first thing I bring up to them.

Thanks for this information, I know Trixie was a strange situation, but sometimes hearing what went on with other cats can help narrow down the actual problem with your own cat. I am not saying that Sammy is going through anything like Trixie, but there might be some similarities. Thanks again.
 
Anything certainly is possible...the last year and a half of Trix's journey has been the biggest guessing game in the world. If you are finding that ABs bring Sammy's numbers down, it MAY be worthwhile considering doing a long course, since his numbers seem to go back up again after finishing a round. If he does have some sort of low-grade infection, maybe it's not fully clearing with a shorter course of ABs. Overall, Trix was really on ABs for a good 3 months this year, with a break of a week or two in there a couple times. At this point, I think it's been close to 2 months since her last dose.

For us, nothing was really showing up in Trix's BW, but she was obviously having a positive response to the ABs. When we first tried the Zeniquin, vetty really left the decision up to us as to whether or not we wanted to try an AB. At that point she was so sick, and it was pretty obvious that the illness came on as a result of her vetty visit, that we figured it couldn't hurt to try. We were all amazed at what a difference just one dose made. With Trix, no matter what we go to the vetty for, she just always gets really sick a couple days later...even for something as simple as a BP check and nothing else taxing like blood or urine draws. We haven't gone back after his last round of ABs because vetty knows her pattern and is willing to work with us over the phone as long as we aren't looking at any sort of emergency situation.

Between Trix and my Dad, I have learned far more about medical anomalies than I'd ever thought I'd see!
 
Tina & Sammy said:
No miracles here today!

Sammy is back on insulin. Hopefully we can get him leveled out and try to figure out what it is that he needs or doesn't need. I seriously need therapy to help with the stress of feline diabetes.

How do you all do it? Day in and day out for YEARS! If I didn't have to work it might be doable, but it really takes a lot out of me.
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Well....I don't know the alternative. Or I guess I do but it isn't an option for us. I was lucky enough to be able to cut my schedule back to part time until I could retire. But the absolute biggest thing is the fact that Mike is a totally equal partner. He does everything I do when it comes to Gracie. When he's home, I do the morning "shift" on T/F/S and first three breffis's. We share mid day stuff and then he does the night stuff although many days I'll draw the dose and shoot but he can and does. I really don't know how I'd do it without him and I don't know how members like Carla and Elise do it. ...or anyone who doesn't have a partner in "crime".

I'm glad you went back to 0.25u. Let's hope his depot refills quickly. And FWIW, I wouldn't attempt an OTJ trial unless he is looking pretty solid green on 0.1u and earns a reduction. IMHO.
 
Tina & Sammy said:
So maybe the rising numbers on the lower dose were because he needed more juice not because he was still getting too much.
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I think this is probably the case. Most of the time high numbers indicate a cat needs more insulin. Don't be hard on yourself, though. You're trying your best to take care of Sammy and sometimes you just have to try out things. Everyone here understands that. I don't see anything that would suggest he's bouncing off his own insulin. Trixie's situation was very unusual, and without looking at her ss i'm just ballparking the numbers, but typically she was over 100 at ambg/pmbg, then dropped to 70 at +3 or so. So she was spending most of her cycle in green numbers.

Milo's situation was tragic. In the 4.5 years I've been on here, I've known of 3 kitties that died from the anesthesia and many kitties have a dental done. There are no guarantees, but most cats handle them just fine. I have seen dentals help many, many times, and even seen several kitties go OTJ after a dental. If he's got tartar, I'd assume it might be a factor. Punkin had something like 7 anesthesias, including 2 dentals. The last dental I had done by an accredited veterinary dentist - I felt like punkin was fragile with his acromegaly and I wanted him to be safe. I do think the skill of the dentist matters tremendously.

On the "Where Can I Find" post there is a link in the second half to finding an accredited vet dentist. Maybe that would relieve your anxiety some.

:bighug::bighug::bighug:
 
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