? Alex: 2/27 AMPS 513, +2 525, +5 507, +7 532, PMPS 520, +2 558

Okay. I am not saying that eventually he would not need 2 units as a regular dose, who knows, but I am saying that I would not do a .75 unit increase all at once. He had a 76 and an 84 on the 1.25 unit dose before so who knows where 2units could take him when his numbers start to go down.
 
And you say his respiratory rate is still 40? That is too high. I am afraid that they let him go home with too much fluid on his chest. Do they plan to reassess the fluid today?
 
Did you give the two units this morning? I don’t see it on your spreadsheet. Is it even Alex‘s shot time yet as it must only be 6 AM Pacific right now. I support you in whatever you have decided to do with the advice you received from the vet. I will certainly try to help you as best I can with any low numbers that you may encounter (or in any other way) if his numbers do come down today. So I just wanted to say that I will be here for you as much as I possibly can if you need me.
 
He was 524 at AMPS. I gave him 1.75 units.
That was my compromise!! 😂 I gave him his water pill as well. He still isn’t wanting to eat much of anything.. Just took a few bites and walked away.
resting respiratory is 32 so much better!
More ketone strips arrive today.. I’m out right now for blood ketone strips.
I emailed vet the question about the clot meds and will call them when they open.

Also calling cardiologist they recommended.. They gave me a list but the tech recommended one on the list.

Thank you for all of your input and help!! This is so stressful. He hasn’t peed yet this AM.. But he did pee and poo outside of his box last night .. which was new! I changed to fresh litter today.
 
Suzanne & Darcy said:
@Chris & China (GA) what is your opinion about jumping from 1.25 to 2?
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I suggested she got to 1.5 last night since her vet was pressuring her to go to 2U. I explained she hadn't given the 1.25 a chance yet, but with him as high as he was, I thought 1.5 might be OK but not 2.0

There's a lot of stress inside that little body, so I'm not surprised he's running high. I reminded her to keep testing for ketones and as of last night, they were OK.

I would not recommend going to 2.0 either
 
Chris & China (GA) said:
I suggested she got to 1.5 last night since her vet was pressuring her to go to 2U. I explained she hadn't given the 1.25 a chance yet, but with him as high as he was, I thought 1.5 might be OK but not 2.0

There's a lot of stress inside that little body, so I'm not surprised he's running high. I reminded her to keep testing for ketones and as of last night, they were OK.

I would not recommend going to 2.0 either
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I agree with everything you said here
 
Suzanne & Darcy said:
I agree with everything you said here
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He told her to only give lasix every 12 hours. It's my understand that it can be given every 6 (that's actually how it got it's name) but I'm not sure about cats. Since his resp rate is good now, I was thinking maybe she should give Q8hrs. Better to stay ahead of it. Opinion? Since you've dealt with CHF in cats before.
 
i’m going to start a new thread for today… Since I’m well over the 50 comments..
I am picking up nausea meds from the vet in just a little bit… But I can’t give it until tonight since they gave him his meds last at 4 to 5pm last night via injection.

I want to get him eating though… I did mix water and do his food and made it more gravy like..

515 BG at +2.5
 
I used to give the Lasix every 12 hours. Toward the end we were going to add in another diuretic Torsemide, but I was afraid of trashing her kidneys.

I would give the every 12 hours a chance to work. What you need to be aware of, Maria, is that he’s going to start losing potassium through his urine because of the Lasix. Ask the vet about supplementing potassium so his potassium won’t drop too low. I do not recommend the horse pills that the vets usually give. I recommend this Vetoquinol Renal-K powder (potassium gluconate.) have never had a problem with my cats disliking this mixed in their food. They don’t like the gel.
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alexMama said:
i’m going to start a new thread for today… Since I’m well over the 50 comments..
I am picking up nausea meds from the vet in just a little bit… But I can’t give it until tonight since they gave him his meds last at 4 to 5pm last night via injection.

I want to get him eating though… I did mix water and do his food and made it more gravy like..

515 BG at +2.5
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Ask them about the Clopidogrel for blood clot prevention. Ask them about the potassium. You can start with 1 scoop and recheck his electrolytes in a week. He’s going to need the Zobaline for the neuropathy. If his potassium gets too low he will become weak and have trouble with hos legs as well.

Ask for an appetite stimulant. Mirataz can be rubbed on his ear. I can give you more specific instructions on how to use it when you get it.

Are they giving you Cerenia or a prescription for Ondansetron for nausea?
 
Chris & China (GA) said:
He told her to only give lasix every 12 hours. It's my understand that it can be given every 6 (that's actually how it got it's name) but I'm not sure about cats. Since his resp rate is good now, I was thinking maybe she should give Q8hrs. Better to stay ahead of it. Opinion? Since you've dealt with CHF in cats before.
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It can be given more frequently if necessary. Sometimes if you see the breathing rate increase you need to give a supplementary dose. This happened with my cat on several occasions. These are things you can ask your vet.
 
Suzanne & Darcy said:
Ask them about the Clopidogrel for blood clot prevention. Ask them about the potassium. You can start with 1 scoop and recheck his electrolytes in a week. He’s going to need the Zobaline for the neuropathy. If his potassium gets too low he will become weak and have trouble with hos legs as well.

Ask for an appetite stimulant. Mirataz can be rubbed on his ear. I can give you more specific instructions on how to use it when you get it.

Are they giving you Cerenia or a prescription for Ondansetron for nausea?
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I believe it’s pill form of Cerenea. The vet also okayed the heart medication for blood clots… But he would rather I see a specialist first before him starting it, but left it up to me.
 
alexMama said:
he would rather I see a specialist first before him starting it, but left it up to me.
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Well all I will say is that most regular general veterinarians prescribe this for their clients’ cats with heart disease. And the vet last night said he’s at risk for a clot.

If he gets a saddle thrombus he would be in a lot of pain and paralyzed in his back legs. I feel like it’s not worth the risk of not treating it.

It is possible to dissolve a blood clot using a supplement called Nattokinase, although many vets don’t even know about it. However, it is a long haul, many weeks of recovery from a blood clot.
 
521 PMPS, seems more with it since nausea pill given.. Climbed stairs and back down.. so RR up a little.. again.Will retest once he’s done eating.. if he eats..
 
Ketone strips are on order and were supposed to arrive today but didn’t and Amazon said were delayed .. so ordered another pack and they will be here today, or so it says… so will test again when they arrive. Urine ketone tested yesterday showed only trace amount..
I got the appetite stimulant.. And the nausea meds.. they only gave me 4 pills for nausea.. but they said to try the nausea pills first.


He did have some moments last night where he was more himself and up and about by end of night was back to retreating to his little house. He did eat a little.. not a lot.

Today need to see if they are giving us potassium for him..
We have an appointment on March 10 for him with a cardiologist. That’s the soonest opening they had. I’m on a cancellation list if something opens up sooner.

RR 24 right now… I was just able to get him to eat more than he has of his fancy feast, turkey and giblets.. I just sat there with a spoon and spoon fed him as much as he would eat, and then he drank a little of water and then went back to his little house. Thankful to get some more food into him.

I’m reading that pro zinc recommends not giving him a full dose of insulin or skipping insulin if he does not eat it all and only giving half of a shot if he only eats half his usual amount .. we are in a delicate dance between the pancreatitis, diabetes, and his heart failure so trying to make sure I’m doing the right thing by him.
Based on the food that I just got into him, I’m feeling more comfortable, but hoping I can get more into him at 7 AM.
 
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Well, March 10 is not too bad for getting in with a cardiologist. I have an appointment on March 11 for one of my cats to be seen by the Internal Medicine Service at University of Georgia. We have been waiting a long time. I keep calling to see if they have any cancellations and they never do — they told me people usually keep their appointments so they have very few cancellations.

I am glad you were able to get him to eat some. Did you give the Cerenia last night? If it was going to work to increase his appetite it already should have. It doesn’t take that long to reach therapeutic levels in the blood. It’s actually great for vomiting and is very effective for car sickness in cats (usually given at a higher dose) but it’s not the most effective anti-nausea medication. Ondansetron (Zofran) is a much more effective anti-nausea medication. For that you need an Rx for 4 mg. tablets and you get it filled ($16.88 in my area for 30 tablets) at a human pharmacy. I give it to my cat with chronic pancreatitis as well as my kidney kitty. Now, Cerenia can help a bit with pancreatitis though, due to a mild anti-inflammatory effect. It helps some cats.

If he’s really not eating much with the Cerenia on board, I would try a small dose of Mirataz (no more than half the length of the 1.5” strip shown on the box.) it is best to start slow with that medication because some cats will have a very strong reaction to it, and it can also build up over a few days. It will make some cats, absolutely crazy with restlessness and meowing, even aggression and some cats I have seen. I always advise people to start with 1/3 to 1/2 of the 1.5 inch strip put on the inner ear of the cat. With several of my cats, I’ve only had to give them that much about every other day to keep them eating, but every cat is different and the effective frequency will vary from cat to cat. Be sure to wear a glove when you put it on his ear.
 
You must be exhausted physically and emotionally/mentally. I know what it’s like. Hugs to you. Do something nice for yourself today— even if it’s something small like buying yourself a favorite coffee drink or a treat or taking a short nap or something else. Do you have to go out to show houses today?
 
Suzanne & Darcy said:
Well, March 10 is not too bad for getting in with a cardiologist. I have an appointment on March 11 for one of my cats to be seen by the Internal Medicine Service at University of Georgia. We have been waiting a long time. I keep calling to see if they have any cancellations and they never do — they told me people usually keep their appointments so they have very few cancellations.

I am glad you were able to get him to eat some. Did you give the Cerenia last night? If it was going to work to increase his appetite it already should have. It doesn’t take that long to reach therapeutic levels in the blood. It’s actually great for vomiting and is very effective for car sickness in cats (usually given at a higher dose) but it’s not the most effective anti-nausea medication. Ondansetron (Zofran) is a much more effective anti-nausea medication. For that you need an Rx for 4 mg. tablets and you get it filled ($16.88 in my area for 30 tablets) at a human pharmacy. I give it to my cat with chronic pancreatitis as well as my kidney kitty. Now, Cerenia can help a bit with pancreatitis though, due to a mild anti-inflammatory effect. It helps some cats.

If he’s really not eating much with the Cerenia on board, I would try a small dose of Mirataz (no more than half the length of the 1.5” strip shown on the box.) it is best to start slow with that medication because some cats will have a very strong reaction to it, and it can also build up over a few days. It will make some cats, absolutely crazy with restlessness and meowing, even aggression and some cats I have seen. I always advise people to start with 1/3 to 1/2 of the 1.5 inch strip put on the inner ear of the cat. With several of my cats, I’ve only had to give them that much about every other day to keep them eating, but every cat is different and the effective frequency will vary from cat to cat. Be sure to wear a glove when you put it on his ear.
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Am trying to avoid the emergency room if at all possible… So trying to keep him stable until we can get to the cardiologist on March 10th. I spent a good long while this morning on my Google AI giving all of the descriptions and uploading test results and talking through all of this with AI, which was extremely helpful and helping me understand this delicate dance and balance between his heart, disease and pancreatitis and the diabetes.
Yes, it’s an awful lot after having a cat that has basically been completely low maintenance for all of these years. I am always big on research and use my research to help me help those I care about. I did this with my dad with his brain cancer and with my brother with his cancer and with myself with my own breast cancer back in 2023 to 2024. I ended up working at the neuroscience Institute here locally at the brain tumor center after spending a good deal of time researching. My dad‘s neurosurgeon hired me to go work on his website to help patients get advanced brain trimmer treatment .. so my tendency to research and over research is pretty high. That being said, I learned a lot, and I’m far more educated in making decisions now and have been able to make better decisions for my family members and myself and that now includes our kitty. I am helping educate my husband and son as well so that everybody is on the same page about this delicate dance We are in right now with Alex.
I have Zofran here that was given to me after my recent gallbladder removal… I’ll check with the dosages as I may be able to use that for him?
I did give the Cerenea last night he did have an around 4:30 AM when he spoon licked a bunch of the turkey and giblets fancy face pate. It wasn’t even a quarter can, though I have the Churu’s on order which will be here today. I can also run down to our co-op in town and grab some tiki sticks as I think they have those as well. I do not have to show Homes today thankfully as my clients are out of town for the weekend… so this will allow me to stay close to home and keep a close eye on him.
I have not given the appetite stimulant yet, but will probably for tonight if I don’t see his appetite improved throughout the day.
I am a little concerned about this cough that I saw yesterday three different times. I have not seen it since then, but I was visiting my grandson last night and was not around the house until later. I went to bed after falling to sleep on the couch! Lol I am so exhausted right now and this is an awful lot.
I am holding out hope that we can get this all under control and manage these issues with more education and hopefully his body’s response!!!
Funny point… When I was at the vet, picking up the nausea meds and the appetite stimulant she said that the doctor on call wanted to know if I had done a curve yet or if I needed to bring him in so that they could do it… I reminded her that I had sent in his spreadsheet and I basically am almost doing a curve daily.. and that they have more than enough information on that chart to help them See what his situation is.

Going to go test him now and try to get him to eat some more.
Thank you for all of your well wishes and thoughts and information which is so very helpful! I’m so thankful to have such a great community to look to for help and support!
 
I’m a big time researcher too. You do have to be careful with AI though. I have had it give me conflicting information in the past, and I have caught it in errors many times. I usually call it out on the errors — and it will say — I am sorry I was mistaken. As long as you read the veterinary journal articles and scholarly papers that are associated with your search, though you will probably learn a lot like that.
 
Will have his blood thinning medication filled today and ordered the gel caps to double coat it and then will put in food.

We are concerned about leg weakness we are seeing..
So will get that picked up this AM and get started as soon as possible based on directions..

He only ate a little more this AM, not much.. i grabbed the Glycobalance as he wouldn’t eat the FF that he just liked at 4;30am! This is so Not like him! He usually eats Anything! ughhhhhhh😑 Ny fridge has like 6-7 cans of barely eaten food in it currently!!!!

He did finally pee again and i tested urine with ketone strip, still just a trace..
 
Poor Alex. That’s so bad for him stay in black. I think you should have given the full dose. His illness is making him insulin resistant I believe.
alexMama said:
and ordered the gel caps to double coat it and then will put in food.
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It tastes awful indeed and is best given in a gelatin capsule. I always did. You aren’t able to just give him the 1/4 tablet directly with a pill shooter? Like this:
1772213531083.png
 
What did your vet say about the Vetmedin (Pimobendan?) Has he ever used it before? Even in dogs? What about the emergency vets?

I guess they’re waiting to see what the cardiologist says? It literally saved my cat’s life. There are a few contraindications for it’s use however. I hope he can take it because it will help his heart muscle to contract much better.
 
Suzanne & Darcy said:
Poor Alex. That’s so bad for him stay in black. I think you should have given the full dose. His illness is making him insulin resistant I believe.

It tastes awful indeed and is best given in a gelatin capsule. I always did. You aren’t able to just give him the 1/4 tablet directly with a pill shooter? Like this:
View attachment 77097
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yes, this is what AI and my husband are both saying as well… Because of his pancreatic issues with pancreatitis and then the diabetes and enlarged heart and swelling around the heart and fluid, etc. it’s basically negating all of the insulin …
You think I should give him the 1.75 I was on? The concern is that he is not eating much at all and ProZinc says to back off the dose if he’s not eating.
 
I just got a call from the vet who had been on call last several days and it’s been reviewing all of Alex‘s information.
He is more concerned about the diabetes right now than the heart and wants to get his numbers down out of the Black ASAP. He wants me to go up to 2 1/2 starting tomorrow. He said because I’m monitoring him so closely and I’m here with him. He feels very comfortable in doing that and said that those instructions are for the people who are not monitoring him as closely as I am.
he said I could even give more now, but his concern would be that he may go low during the night when we may be asleep.
We will get started on the heart medication today for the anticoagulant
 
alexMama said:
yes, this is what AI and my husband are both saying as well… Because of his pancreatic issues with pancreatitis and then the diabetes and enlarged heart and swelling around the heart and fluid, etc. it’s basically negating all of the insulin …
You think I should give him the 1.75 I was on? The concern is that he is not eating much at all and ProZinc says to back off the dose if he’s not eating.
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Well if a cat is having a normal response to insulin then yes, I do typically recommend to our ProZinc members to shoot a reduced dose. In Alex’s case, the inflammation is causing insulin resistance and he doesn’t seem to be getting out of the black or red. You still need to check him though to make sure. So I would say this situation is an exception to the rule.
 
alexMama said:
He is more concerned about the diabetes right now
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Well maybe that’s because he doesn’t specialize in cardiology and doesn’t seem to know what to do.

Obviously the heart has to trump diabetes since it keeps us alive, but I also share his concern about the blacks. There’s a saying among cardiologists that the heart trumps kidneys (for the same reason.)

These blacks are indeed very distressing… and it really just became this way in the last few days. I do believe it’s the heart condition that is causing the diabetes to get out of control. I understand the urgency to try to get the numbers down until he is seen by the cardiologist. I also do worry that his numbers could be erratic and drop unexpectedly. When he gets proper treatment for his heart, I believe his diabetes will be easier to regulate. I am so sorry that this is happening to Alex and to your whole family. I know you are doing everything you can to help him!
 
Oh, and a housekeeping matter that I hate to even bother you with right now. When you get a chance, please remove SLGS from your spreadsheet and signature. Obviously we are not following SLGS, and there are many people on this forum who look at others’ spreadsheets to try to figure out how to dose their cat (they don’t post for help.). This could be confusing for them.

Just put “custom” where it asks about dosing.
 
Suzanne & Darcy said:
Well maybe that’s because he doesn’t specialize in cardiology and doesn’t seem to know what to do.

Obviously the heart has to trump diabetes since it keeps us alive, but I also share his concern about the blacks. There’s a saying among cardiologists that the heart trumps kidneys (for the same reason.)

These blacks are indeed very distressing… and it really just became this way in the last few days. I do believe it’s the heart condition that is causing the diabetes to get out of control. I understand the urgency to try to get the numbers down until he is seen by the cardiologist. I also do worry that his numbers could be erratic and drop unexpectedly. When he gets proper treatment for his heart, I believe his diabetes will be easier to regulate. I am so sorry that this is happening to Alex and to your whole family. I know you are doing everything you can to help
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I just picked up the anticoagulant medicine and I’m on my way home with it. I also did get some good news that there was a cancellation for the cardiologist and I’ll be going there Monday with him at 1 PM so that was a huge relief… I was really feeling like we may not be able to wait for a whole week after that.
He’s still in the 500s today so we are starting the 2.5 tonight after I just hung up with the vet. I’d rather stay up with him through the night and make sure he gets out of the 500s then wait and make him suffer all through the night. he is very weak and not able to really clean or do much but just sleep. His legs also seemed like they’re getting weaker. This is not going in a good direction. His respiratory rate is still good and he still has no ketones or at least just a trace according to the urine strip the blood ketone strips should be there by the time I get home Home and I will check those as well.
I’m praying we can get this turned around and get him back on the road to stability and being more comfortable and interactive again. This is very hard to watch and the tears come easily! He’s such a good boy and I don’t want him to suffer or be in pain.
This is hard on a mama‘s heart!🥹🥹
 
ketones .9 on blood ketone test… highest he’s been.
I did get Two Churru’s down him and made him Churru soup with some warm water. I finally carried him to litter box and he peed. His gait has changed a lot., walking like he’s drunk and a bit sideways.. Definitely seeing things change.
I have his meds Clopetagril, but the little gelatin caps won’t arrive until tomorrow.. I want to give him that 1/4 pill, but they say it needs to be double coated..I don’t have anything else to coat it in..??
 
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alexMama said:
I just picked up the anticoagulant medicine and I’m on my way home with it. I also did get some good news that there was a cancellation for the cardiologist and I’ll be going there Monday with him at 1 PM so that was a huge relief… I was really feeling like we may not be able to wait for a whole week after that.
He’s still in the 500s today so we are starting the 2.5 tonight after I just hung up with the vet. I’d rather stay up with him through the night and make sure he gets out of the 500s then wait and make him suffer all through the night. he is very weak and not able to really clean or do much but just sleep. His legs also seemed like they’re getting weaker. This is not going in a good direction. His respiratory rate is still good and he still has no ketones or at least just a trace according to the urine strip the blood ketone strips should be there by the time I get home Home and I will check those as well.
I’m praying we can get this turned around and get him back on the road to stability and being more comfortable and interactive again. This is very hard to watch and the tears come easily! He’s such a good boy and I don’t want him to suffer or be in pain.
This is hard on a mama‘s heart!🥹🥹
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Oh it is hard on you! I really understand what it’s like. I do hope he gets out of the 500s! But I am very very happy he has an appointment with the cardiologist on Monday. What a Godsend.
 
alexMama said:
ketones .9 on blood ketone test… highest he’s been.
I did get Two Churru’s down him and made him Churru soup with some warm water. I finally carried him to litter box and he peed. His gait has changed a lot., walking like he’s drunk and a bit sideways.. Definitely seeing things change.
I have his meds Clopetagril, but the little gelatin caps won’t arrive until tomorrow.. I want to give him that 1/4 pill, but they say it needs to be double coated..I don’t have anything else to coat it in..??
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A single layer of a gelatin capsule will completely prevent him from tasting it if you pill it into his mouth (by hand or with a piller.) But if there’s a risk he will chomp down on it, he could be foaming at the mouth. Some pill wraps are things like cream cheese, liverwurst, pill pockets of course. I don’t know if that will work. Maybe you should wait until tomorrow?
 
I’m concerned about his ataxia. I think you mentioned it even before you knew that he had heart disease. I don’t think any of his current meds could be causing the ataxia. Low potassium can contribute to that, but again, you mentioned his walking prior to any of those meds. High phosphorus can do that, but he doesn’t have kidney disease so I doubt that as well.
 
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