? AMPS 164

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Peppersmom72 said:
I'm not comfortable with giving an injection this morning with an amps of 164. I already stalled once.
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I'm only seeing this now. You did a great job last night and she's still surfing in blue. That's fantastic!

Here's where it gets hard on the owner though. You gave a 1 u dose on a PS of 165 on the evening of 19 Jan and she was fine. This is the beauty of having SS data. That 1 u dose would have been fine this AM but you have to do what you're comfortable with, especially after a long and tiring night.

The way forward is to learn by experimenting and taking a few calculated risks (when you have enough data) to see what your no shot number should be. At the beginning 200 is a good one when you're using a human meter. For example, today you could have tried the 1 u dose to see what happens on a day when you're home to monitor. If that had proved to be a safe choice, you'd try 1.25 u the next time a PS in the 160s pops up. Collect the data and if she's safe you'd go for the full dose the next time. If that works out you then know that a PS of 160 is high enough to give a full dose. That's how this all works. Each cat has its own dosing boundaries and the owner has to do a little (sometimes stressful) experimenting to find out what they are.
 
@Kris & Teasel
I really don't understand this spreadsheet. I don't understand how she can be fine one minute and not the next. I go by what I put on a spreadsheet days ago, but she likes to change her mind. I feel like I'm playing Russian roulette with her. If I sound like a bad mom then I'm sorry, but this stress of her unpredictable numbers is causing me to physically feel ill. I get migraines from worry every single day. I have to work and I have no one here to help out except for a possible crisis situation (if she were to show signs, he will test) I feel like a failure that I can't give her what she needs. Yes, blue's we're nice but now she's constipated (seems to be) because i feel the blues stopped her from drinking. The vet doesn't do anything but tells me to take her to a IM specialist to find out why. I can't afford that. I'm missing work AGAIN, to take her to a different vet for a 2nd opinion.
 
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Missy,

No one thinks your a bad mom to Pepper! This is all still so new, and its damn scarey. It is ultimately your decision to give her insulin, or not, and you did what you felt was right to keep your girl safe. It will take time to feel comfortable at the lower numbers, but you will get there as she starts showing them more often. Most of the folks here have been doing this for awhile and no one would tell you anything that would hurt your precious girl. We are all in this together, and want to help you and Pepper as best we can. We'll see what she throws out this evening and go from there :bighug:
 
I won't stop giving her insulin. But with her I notice when the numbers are lower, her constipation and nausea increase. I just gave her 1/4 tablet of metoclopramide and she ate a little more. I'm hoping it helps her to poop since it's used for gut motility and nausea.
 
I can't offer you insulin advice, but what I can offer you is moral support. First, let me say that you are NOT a bad mom. You are doing what you can can for Pepper which is treating her and seeking advice from other people.
I also live on my own and work and go to school. It is stressful--especially when you see other people out there having support from another person. The first advice I was given (not on here) was the change my work schedule. I can't. I felt like everyone was judging me because I couldn't change my life or didn't have tons of extra money to spend to hire someone to come in daily to take care of Gracie. Sorry, I don't have a money tree in my backyard, or some wealthy rich uncle. Gracie's care is completely on me. My family is out out of state. Most of my friends think I'm crazy for even treating a diabetic cat.

Anyway, the point I want to make is you are doing what you can and that is enough. Pepper knows, I promise.
You can do this!
 
Peppersmom72 said:
but this stress of her unpredictable numbers is causing me to physically feel ill.
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This is really hard and we all understand the stress combined with a feeling of urgency to get the kitty regulated NOW. If it's at all possible, try to step back, take some deep breaths and regroup with a plan to:
  • try a dose that's possibly a bit too low but allows consistent dosing AM and PM and produces numbers that don't scare you
  • work at collecting data at that dose and getting her more settled because you won't be driving her volatility with frequent dose changes
  • give yourself some time on this dose to learn to relax and read her patterns.
Peppersmom72 said:
I have no one here to help out except for a possible crisis situation
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You'll be setting up a plan to help you avoid a crisis. A true crisis is a symptomatic hypo - numbers well below 50, visible signs of distress in the kitty like disorientation, stumbling, etc. By being careful and getting help along the way this doesn't have to happen. You do have to get used to numbers in the low blues and dark greens because that's what Pepper needs. This is hard stuff because it requires a certain calm state of mind and the confidence that you know what to do should you see a high lime green (but not a symptomatic hypo). Once you've been through it a few times it'll be easier even if a little stressful. It's like anything else that gets better with practice.

Peppersmom72 said:
I feel like a failure that I can't give her what she needs.
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But you are giving her what she needs by treating her and coming here for advice. :bighug:

Peppersmom72 said:
Yes, blue's we're nice but now she's constipated (seems to be) because i feel the blues stopped her from drinking. The vet doesn't do anything but tells me to take her to a IM specialist to find out why. I can't afford that. I'm missing work AGAIN, to take her to a different vet for a 2nd opinion.
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Have you added extra water to all her wet food meals? That helps with hydration and constipation. Many cats don't drink enough from a water bowl.

Is the second vet appointment booked yet? If not, why not hold off for a week or so and try the consistent dosing routine? Many vets don't know what to do when a diabetic cat doesn't follow an easy path to regulation. I know mine didn't so I came here and took matters into my own hands.

It is easier if there are two people involved in caring for a diabetic kitty but many of us are doing this alone. Many are working full time too. You can do this. As I said before, you're only a little over 2 months in - very early days. The often repeated mantra is that it's a marathon and not a sprint. I see many newer members torturing themselves with worry because they haven't got their kitty regulated ASAP or they haven't found the one magic dose that fixes the problem. Unfortunately FD doesn't work this way.
 
I always add water to her food. She has always had constipation issues for 13 yrs, but no one ever can tell me why. That's why I scheduled the 2nd opinion vet visit. The first vet just gave me metoclopramide and an appetite stimulant and a RX for insulin and sent us on our way. I think it would be wise on my part to find out and treat the root cause
 
Many many indoor cats have constipation, and the root cause is most often that they aren't running at high speed across a field to catch those sneaky little mice. Physical activity gets things moving. Sleeping in soft squishy beds doesn't. It's an unfortunate side effect of indoor life.

If you do a search for constipation out on Feline Health you'll find no end to discussions about treating constipation. Atticus is a frequent sufferer and I give him a half dose Slippery Elm Bark every other day to keep him regular. Other folks have had luck with a teaspoon of pumpkin (Sam loves it, Atty won't touch it), or Miralax (1/4 t daily to start). And there are tons of other treatments out there as well.

Of course if you suspect there is something serious going on, the vet is always a good idea.

Many many many of us around here are doing this all on their own while working full time. It is hard, but you have good company around here, and lots of folks who understand the stress and difficulty of trying to juggle life, finances, and worry over our fur babies. Hang in there! You're doing fine, and as time goes by, this really does get easier.
 
I give egg yolk powder for constipation...it's supposed to help with motility. I did it alone while working full time too. I KNOW how hard that is. But you're doing a great job...it's such a hard thing to do, but remember you aren't alone. You have us to talk to, complain to, ask for advice, etc. You're NOT a bad cat mom...you're a GREAT one.
 
I suggest you continue with the 1.25 u dose for a while. She's high today but that could change. Remember, this is baseline data you're going for and you need several cycles' worth to assess this dose properly. :)
 
Numbers are high-ish but no problem being able to give insulin and nothing scary happening. :) Keep on this way for now - it'll take several days to get enough data to see if there's a pattern to guide the next dosing decisions.
 
Honestly,. I wouldn't know if anything scary is happening. I just pray every morning when I leave the house. All I know is she's not pooping. Vet visit today.
 
Peppersmom72 said:
Honestly,. I wouldn't know if anything scary is happening. I just pray every morning when I leave the house. All I know is she's not pooping. Vet visit today.
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Short of wiring your kitty to a BG monitor that sends data to your phone all day long you can never be 100% sure of what's going on. It's by gathering as much BG data as possible at a dose on weekends or evenings that we get the info we need to make dosing decisions. That doesn't mean hourly BG tests. It means getting a scattering of data at different times over a cycle day by day - eg., maybe +4 and +6 on a Saturday, +5 and +7 on a Sunday, +2 and +4 on one evening, +3 on another evening. Always AM/PMPS of course. The scattered data builds a picture over time like a jigsaw puzzle and we can then use it to see the patterns, make reasonable predictions about possible responses to a dose, etc. In other words, you're "learning your cat".

Keep us posted on the vet visit.
 
Awesome Vet visit with the new Veterinarian

We just got home from the new vet. Pepper is doing good. She doesn't feel like she needs an ultrasound at this point. She thinks the same thing I suspected all along, that Pepper probably does have scar tissue from her past surgery which may be causing her food to digest slower. She did suggest that we could try to switch to Royal Canin high fiber food, if we wanted to. I said I wasn't going to jump into that yet until I can check the carb content, etc and price. She did not push it on me.

She also said to not use metoclopramide (that it can cause neurological issues).
She prescribed Cerenia 16mg tablet for nausea/vomiting and when she doesn't want to eat.. She said that it is also used as an appetite stimulant, as well as a mild pain reliever associated with GI issues.

She explained that this medicine can cause mouth foaming or drooling and just to syringe some water in her mouth and it is only temporary.

She also gave me a bag of saline to administer sub q fluids when Pepper gets constipated and doesn't want to eat/drink.

She is very happy with Peppers numbers so far and told me that she is happy that I home test and do curves. She said to keep listening to my support group here and that we may see Pepper in remission one day.

She also told me to give thanks to all of you and will tell her FD owners about the FDMD!
 
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Sounds like an awesome new vet! Glad you've found a new member for team Pepper :cat: What part of the country are you in, may need to refer some folks who need help finding vet help to her!
 
I know. She explained to me alot about vet stress and how alot test results can be elevated because of it . That's why she didn't check Pepper's BG. She didn't disregard anything I said. I showed her Pepper's SS and she loved it. She said that it was a good way to keep track of BGs. She was very impressed with this group.
 
By the way, Sam takes cerenia pretty regularly for his pancreatitis and does well. He hasn't done the foaming thing (yet anyway), and he just eats the 1/4 tablet without me even having to pill him. I just crumble up some freeze-dried chicken and he eats it all together. Hopefully Pepper will do well on it too. How much of the 16mg did she prescribe? My vet said 1/2, but everything I read said 1/4 so that's what I usually give him, and then go up to 1/2 when he is having a flare up.
 
Peppersmom72 said:
She also said to not use metoclopramide (that it can cause neurological issues).
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HUGE gold star to your new vet for this!!!

Metoclopramide can be OK for very short term use if motility has stalled temporarily (e.g. a couple of doses to get things moving again following anaesthesia or where there is a temporary issue with constipation) but it's not suitable for longer term problems as it can cause movement disorders (works on the dopamine system).


Mogs
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Djamila said:
By the way, Sam takes cerenia pretty regularly for his pancreatitis and does well. He hasn't done the foaming thing (yet anyway), and he just eats the 1/4 tablet without me even having to pill him. I just crumble up some freeze-dried chicken and he eats it all together. Hopefully Pepper will do well on it too. How much of the 16mg did she prescribe? My vet said 1/2, but everything I read said 1/4 so that's what I usually give him, and then go up to 1/2 when he is having a flare up.
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Well, that concerns me with Pepper. Its a 16mg tablet. She said to give the whole tablet to her. She said that it says its a tablet for a over 10 lbs. And not to be alarmed that it says for a dog, that it was just approved for use in cats. I haven't given her any yet. So, I'm just wondering if I should start out with only a 1/4 tablet.
 
Peppersmom72 said:
Well, that concerns me with Pepper. Its a 16mg tablet. She said to give the whole tablet to her. She said that it says its a tablet for a over 10 lbs. And not to be alarmed that it says for a dog, that it was just approved for use in cats. I haven't given her any yet. So, I'm just wondering if I should start out with only a 1/4 tablet.
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You could post out on Main to see how much other folks give. Or that may be something @Critter Mom can help with.
 
Djamila said:
You could post out on Main to see how much other folks give. Or that may be something @Critter Mom can help with.
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Can't help with Cerenia tablet dosage (only available as injectable here for cats). Here are some helpful links:

http://marvistavet.com/maropitant-citrate.pml

http://vetbook.org/wiki/cat/index.php/Maropitant

According to the info at the second link, dosage for cats is 1mg/kg q 24 hrs. (Note: 1kg=2.2lbs) As with all meds, discuss dosing thoroughly with the vet.


Mogs
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