Oldtimer Karre --- Relapse Condo. Please advise.

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Jane & Jack & Karre the Emperor

Jane & Jack & Karre the Emperor

Member Since 2009
Greetings, LL!

It's been a while. The last condo Karre had here was his 3-Year-OTJ Condo last November! He was doing beautifully up until a few days ago, the evening of the 4th of July, when he got sick with what was most likely a case of pancreatitis. We realized it when we did a spot check of his BG on a hunch, since he seemed apathetic, and got back a not-so-beautiful 19.7/354.6 so woke up our vet and got him to supply us with some emergency Lantus. We started him on 1u that night and took him in the next morning to be seen by the vet and tested to see what was actually going on. The fPLi-test isn't back yet to confirm pancreatitis, but the vet was quite sure that's what was happening given his abdominal pain, dehydration, inappetance and lethargy as well as a fever. He was put on pain meds, a Ringers Lactate drip to rehydrate him and replenish his electrolytes, and antibiotics.

Since then, Karre (now 16) has been doing much better. He is almost through with pain meds (one more dose tonight) and has a week left on his antibiotics. We weren't sure if we'd even need to take up precious LL space with a condo - some of you will have seen us posting on Facebook's LL group with this situation - but we thought we'd check in and see what you guys felt about his progress.

Obviously we're hoping to get Karre back OTJ, since he was doing so beautifully for three and a half years. I'm going to try to link to his spreadsheet, but it's been a while so please bear with me if I get it wrong and please tell me how to do it right! As you'll (hopefully) see, the 1u dose we started on gave him that big drop at the start of the PM-cycle on the 5th, and we just weren't happy with it, so we took him down to 0.5u and have been shooting that since then. He's coming down wonderfully on that dose, even giving us an almost green, lovely and flat cycle today.

We're just wondering what sort of advice (and experience) you all have with pancreatitis-related relapses. We're doing ok, I think the numbers are saying, but we're not feeling very sure of ourselves. Barring any significant incident, we'd probably wait for a dip into very low numbers or a couple of back-to-back all-green cycles to reduce his dose again (to 0.25u). Just like we did last time, when he was first diagnosed, and just like the TR protocol suggests. BUT if any of you feel differently or have further input, please let us know.

And of course, please let us know if the SS-link doesn't work or isn't the right one. Gosh, it's been too long since I knew how to do this! :-)

Thanks!
Jane of Jane, Jack and Karre

SS-Link: https://docs.google.com/spreadsheet/pub ... utput=html
(I think with this link, you'd have to right-click on it and select "Open in New Tab", so you don't get redirected away from FDMB.)
 
I hate to see you back but welcome! Hopefully, Karre is just renting a condo so he could visit LL for a bit but plans to return to the Falls.

FYI -- the SS link works fine. There's also a "World" version of the SS now. It converts the numbers between international and US formats. Otherwise, the one you're using is just fine and it's good to see that Karre is seeing blues and greens so quickly.

I think you need to provide some photos of the Emperor. There probably aren't that many people who remember Karre (or your garden and other kitties).
 
Thanks for the welcome, Sienne! We're glad LL will let our Emperor rent a condo for what will hopefully just be a few days.

I'm glad the SS-Link is working, too, thank goodness. I've update it to include the pre-shot just now, but even so, here's a quick summary of today's beautiful flat cycle:

AMPS 6.8 / 122 --- Shot 0.5u Lantus
(+1) 5.4 / 97
(+2) 5.2 / 94
(+3) 5.3 / 95
(+6) 5.6 / 101
(+10) 5.9 / 106
(+11) 5.9 / 106
PMPS 6.4 / 115 --- Shot 0.5u Lantus

Please bear with me, LL - I will try to get a proper signature back, and also some photos of our cats, I'm just still battling this dreaded flu and I can't manage it tonight.

In the meantime, a quick background overview: Karre is a black neutered domestic shorthair tomcat. He is 16 years old. He was diagnosed with FD and severe DKA in October 2008. Thanks to the fantastic support of FDMB, Karre went OTJ just 5 weeks later and has stayed that way for 3,5 years until this (hopefully brief) blip. He eats ONLY canned/wet food and occasionally raw food as well and has no other medical conditions.

Karre is the Emperor to a feline family of four: Karre Himself, and Magpie a.k.a. "Maggie" (4, black and white tuxedo spayed queen), Luca (1, black and white neutered tomcat) and Henry (3, ginger neutered tomcat). We beans are Jane (me) and Jack (my husband). We live close to Cape Town in South Africa.

Thanks for reading! I'll be back tomorrow to sort out the signature and pictures :-)
Goodnight from Africa for now!
Jane
 
always good to see you, but I'm sorry Karre has decided he needs some juice again. From the looks of things, hopefully this will be a short visit.

I like the 0.5u dose for now. Usually we find it works best to be pretty aggressive when a cat returns from the Falls, so if he doesn't turn to all green after another cycle or two then you might want to nudge the dose up a bit. However, so far his numbers seem to be coming down each cycle so that might not be necessary. As he starts to feel better, the numbers should come down and so should the dose.

Lucy said to say hello to the Emperor! She got poked in his honor (whenever I see one of her buddies come back on the juice, I get nervous and test her. She is still OTJ - whew!).
 
Thank you, Libby, KT and Julie!

Libby - It's great to read from you, even in a relapse-condo! Karre sends some congratulatory purrs to Lucy and says 'Well done for staying OTJ!" Thanks so much for the dosing-feedback. Karre's cycle today is green green green (his first green pre-shot since the relapse on the 4th of July), I'll post the update in a bit when I've got the (+3). Karre must have snuck onto the internet and read your post in here :-)

One question, since I'm so FDMB-rusty after such a long break:
- Did I get the signature and the SS-link right?

I'm still trying to get an avatar picture sorted, but so far I've failed. I'll ask Jack to help me later today. For now, I'll try adding some photos in here, as per Sienne's request :-)

This Karre, our Emperor, in the garden. All our cats have outdoor-access at all times. For those of you who don't know us: We live in South Africa, close to Cape Town, in a moutain estate. We're lucky to have a large garden, and since there are few cars here and it's a private security estate where all drivers know about possible cats, kids, dogs, mongoose, porcupines and so on that might suddenly show up on the roads, the ourdoors are quite safe for our furbabies. They love being able to enjoy the garden.
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This is Karre's sister, Magpie a.k.a. Maggie. She is, basically, Jane in a cat.
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This is Luca, our youngest. He joined us about a year ago. All our cats are rescues.
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This is Henry, our newest addition. He's most likely a Maine Coon, and a gentle giant.
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Alright, now that you've seen our cats, here is the update on Karre's cycle so far. (On the +3 I did a counter-check on myself, to make sure the meter wasn't malfunctioning.)

Sunday, 8th of July 2012
AMPS 5.2 / 94 --- Shot 0.5u Lantus (This was our first green pre-shot so far, hooray!)
(+1) 4.7 / 85
(+2) 4.7 / 85
(+3) 4.7 / 85

Flat flat flat, green green green. Pretty purrfect so far. Karre is an early onset Lantus-User (generally between +1 and +2) with early though travelling nadir (generally between +3 and +5). Somewhere in the sticky-collection, you should still be able to find the 5-week sequence of graphs we made of all his BG-cycles, to help visualize how a cat can progress through regulation to OTJ. Looks like he's working his magic again - the Karre-Cycle is back :-)
 
What a gorgeous family :smile: Good luck getting Karre back OTJ, he's certainly heading in the right direction.
 
The signature and SS link are working perfectly!!

I love the photos! I don't know that I've seen pictures of Henry before. He's quite handsome. I'm not sure his head shape looks to be Maine Coon, though. Take a look at the photos in my signature. Gizmo is a Norwegian Forest Cat. The head shape is triangular. The breed is just a bit smaller than a Maine Coon but otherwise, very similar.
 
Hi Jane, just wanted to say Good Morning and welcome you. Maggie is a returning from the Falls kitty, too! Your family is so beautiful and I love all the pics. I wish I were doing what the sleepy ones are doing right now! :-D Have a nice day. What time of day is it there now?
 
I hope Emporer Karre goes right back to OTJ, but I do love the condo, and your pictures are always a treasure :-D

Have a good 85 type of day, Karre :mrgreen:
 
Thanks, Dyana, and great to see you again!

Ok, LL, here is the recap of the recent developments - Libby, as you can see, we just missed the all-green cycle... But it's Karre's lowest mid-cycle dip so far (presumably anyway, since his nadir is likely to have been lower than the +7 we got), and his lowest, almost-green late-cycle numbers (that is, hardly any liver-panic bounce). It's also the 2nd time we're hooting a dropping number, i.e. the second time he's started coming down at the tailend of Lantus-duration on his own. All in all, I feel like the 0.5u dose is holding. I hope you guys agree!

So, the numbers recap:

From the AM-cycle:
(+10) 6.3 / 113
(+11) 6.3 / 113
PMPS 5.8 / 104
(+1) 5.3 / 95

From what we've seen the past couple of days, I'd say, let's hold the dose for another 2 cycles and hope for an all-green run. We're open for suggestions, if you think that's not aggressive enough. I work from home now, so I can monitor anytime, and I'm happy to babysit lower numbers.

Thanks again for all your input!
Jane
 
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