Panic Vet Visit June 6th

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Panic

Member Since 2019
Last Post http://www.felinediabetes.com/FDMB/threads/panic-june-4th-amps-257.215265/#post-2385967

Vet visit! Panic read at 504 this morning on Alphatrak in case anyone was wondering. We did a fructosamine test which read as "normal" but after the vet told me that we kind of set it aside and started looking at her spreadsheet. Last Friday I had emailed her some concerns I had about the curve I had done that day (went up to 700s and stayed high all day) so we talked about that.

Vet said that with some of these numbers (like the random 450s number in the middle of the day) could be more from just getting a reading at a bad time (?), she said curves aren't always the ideal textbook curve but more of a roller coaster throughout the day, with peaks and valleys so MAYBE that's what that number meant she said. She also acknowledged the "consistently inconsistent" numbers make her think that there's something wrong with the insulin - like maybe we left it out on accident or it got shaken instead of rolled, etc. It was then that I told her that the Vetsulin vial I had specified to shake and NOT roll it and she said that was weird and she was going to call while I was there to confirm...and I'm just now realizing she forgot LOL.

It was then though when she mentioned potentially getting a new vial that I would rather change her to Prozinc, to at least remove one variable of "is it lasting" in order to get her regulated and she agreed. I then told her where I could order it and she said to go ahead and do that and she'd approve it when they contacted for the prescription, and that Panic should come back in a month after we've started the Prozinc, so it looks like she's letting me start the dose and have me monitor how it's doing and report back to her. ^-^ I think that's all we covered, I totally forgot to ask about feeding syringes or anti-nausea meds but I am going back tomorrow anyway because my dachshund needs her cytopoint shot and her nails done. I also briefly told her about the incident that happened last Sunday after she asked why I was "up so late" at 1am checking her numbers, and told her I was checking based on the advice from the FD forum.

I think we also talked about the variables that could be going on with her - like was Panic outside catching mice or eating something she shouldn't (extremely unlikely I told her) or was I giving fur shots, which I then told her I definitely was here and there, and to be honest I think it's mainly how thin her skin is. This morning I checked after I poked her and could feel the needle had gone right through her skin, so I was able to correct that this time. I'm pretty much never able to "tent" the skin because there just isn't enough to work with. So basically we agreed there was probably a lot going on but we're going to switch to Prozinc to at least rule one issue out!

Panic also tried to bite the vet tech when she removed the bandage from her leg (warning bite, she does it a lot haha) and when the vet was in and talking to me she was talking with her hands and Panic got mad and swatted at her. XD The vet told her, "I'm starting to see you're acting more like what I've heard about" LOL, because the vet techs all think she's adorable but I've warned them when she feels more like herself she's a bit of a no-nonsense girl XDD

@AliceMeowliss&Cassandra I've been considering getting a baby scale for her, just not sure where I'd keep it! That would be really helpful to keep track though, I'm super delighted to see how much she's gained, even if it is just a small amount.

@Tanya and Ducia OH! Yes, I meant to tell you! I managed to catch her last night and was able to get a reading, it showed up the same as before, a shade between Negative and Trace! I didn't think to mention it to the vet though. O:

I'll be visiting the Prozinc forum today for advice on starting her, I am so excited!! <3 <3
 
Thanks for the tag so I can follow new post! :)
I kept her baby scale in the bathroom closet. I brought it to my vet once to make sure it was accurate to theirs, also. We have limited space and a multi-cat (and a bunny) household, so I understand that. But if storage is an issue, really you can keep it anywhere, under the bed even!

Perhaps you can write down a list of questions and concerns when you see vet again, I know I get really scrambled when I see my vet and often forget some thoughts or questions, too.

Alice was super docile with me when she was weaker. Now she expresses displeasure at her ear being pricked. Panic being cranky is a GOOD sign, if that is healthy-normal for him!!! :D

I am so happy for you both that you are going to be able to get another insulin. I like that your vet cares about your SS. Mine said she tried to access it from the email I sent the vet office and it displayed weird so she didn’t put much effort into it. She does have human diabetes experience from family though, and I think that is still helpful.

Vet comment re: the curve with HI etc.
Perhaps she is trying to say maybe Panic bounced?
 
I'll be visiting the Prozinc forum today for advice on starting her, I am so excited!!
do post a bit ahead of actually shooting to discuss the starting dose. Give ppl time to see the post and check out all of the details from prior posts (to get familiar with med history) necessary for dose desicions: what food is fed, how often, etc.


The expert opinion might be different than just continue 4U with another insulin.
 
do post a bit ahead of actually shooting to discuss the starting dose. Give ppl time to see the post and check out all of the details from prior posts (to get familiar with med history) necessary for dose desicions: what food is fed, how often, etc.


The expert opinion might be different than just continue 4U with another insulin.

Not an expert, but I likely wouldn’t match it exactly the same if it were me, anyway. I would probably start with less than the 4u, because they act differently. Then I would test often at first to get a good picture of what is going on with the new insulin. As usual, this is always more complex if DKA or other health issues. For awhile I had to increase Alice’s dose. If you want Panic to gain though, as far as I understand it, a higher insulin dose may also help allow for feeding more, and at least in my case it has been the right choice.
 
Yes, a cranky Panic is very much a normal Panic! She's an oddball who swats at anyone she thinks looks at her wrong but at the same time wants to rub up against the other cats who...are scared of the idea LOL. Since diagnosis the other cats aren't really afraid of her because she hasn't been swatting anyone - in fact our little kitten is a bit of a bully to her! So when she IS a bit rude to others that's when I know she's feeling good.

Oh I hadn't thought about the bathroom! Our new bathroom doesn't have a closet (it's tiny!) but I think I could fit a scale under the sink!

I've already started a thread asking about the general questions - dose recommendation (vet said she would put starting dose on the prescription buttttt she has a tendency to jump multiple units at a time), feeding schedules, wiggle room on injection times, etc. I have no idea how long Chewy.com takes to send out insulin orders but I wouldn't think it'd take too long, considering it's insulin? Fingers crossed it gets here before the weekend, I'd hate for it to be sitting at the post office or something on a Sunday.

That makes sense on the higher dose = feeding more, honestly Panic's probably eating like...more than 3 cans of 3oz FF a day, plus her treats. I don't think my 10 lb cats could/would eat nearly that much.
 
That makes sense on the higher dose = feeding more, honestly Panic's probably eating like...more than 3 cans of 3oz FF a day, plus her treats.
it would certainly bee too much for Ducia!

But I think Panic should eat as much as she wants for now and you up the dose until she has good nadirs consistently.
She likely won't need as much food once she achieved better BG levels.
Then feeding becomes the matter of watching for weight to stay around what is called "the Ideal" weight - vets normally a good source for such data but we have Info post on to how to calculate the ideal @L&L. I'll post the link when I find the post.
 
True...it will be hard once her greedy appetite goes back to normal, she is not normally a big eater. That's what makes me wonder, how much food NEEDS to be eaten right before insulin? Prior to this Panic prefers to only take a few bites every once in a while. If you are free feeding though and they're getting a few bites every hour or so then do they not need a particularly larger meal right before their shot?

Hm yes, I would prefer that Panic gain at least 2 more lbs, maybe 3, though the vet wants her to be at 10 lb I don't think it's going to happen.
 
That makes sense on the higher dose = feeding more, honestly Panic's probably eating like...more than 3 cans of 3oz FF a day, plus her treats. I don't think my 10 lb cats could/would eat nearly that much.

Alice eats easily 3 cans of friskies mixed with water each day. And those are 5.5oz. And she is about a third of the weight of my largest cat, now! Don’t be phased by the intake. If she is hungry and underweight and at risk of things like ketones and DKA, I would feed her when she tells you she needs it. Buuut that’s me, and again, ECID etc.

@Noah & me (GA) thanks! I know I can follow, but when @Panic made a new post from the previous thread where it was suggested to do so, I was simply appreciating that it was easier to find because I was tagged. :)
 
That's what makes me wonder, how much food NEEDS to be eaten right before insulin?
depends on how this particular insulin onsets and what is your cat's food sensitivity and appy is like - and that's exactly "why one size fits all" approach or a set of short instruction for newer patients is impossible - very , very ECID.


Vetsulin kicks in really fast - that's why they say feed 30 min prior to the shot.
I think full Tablespoon was said to be the "at least" portion 30 min prior but it is to be checked out. A lot depends on whether or not the cat will be willing to eat later.

ProZ and Lantus onset later and many feed a little at preshot and then the rest. How soon - the ProZ folks should know, I never used. There are very knowledgeable people on ProZ forum, good to hang around with.
They'll tell you all their ProZ tricks.

(I think you, just like I did at the start, may not be aware that insulin is a hormone, not a medicine.
With meds like pills it is legit to expect a patient to respond in an average way - somewhat close to the responses of the same age/weight/general condition/ etc, etc., patients. That was what I thought about Ducia and I drove myself nuts over why my cat was in Pink when the same size/ age/dose cat was basking in blue and green day after day. Then someone told me.

We are giving powerful hormone insulin to the living/breathing - and most important hormone producing body and cannot expect one hormone on top of the rest to work steadily as pills do. Hormone production fluctuates greatly even in healthy organisms, let alone a cat whose overall endocrine system is already sabotaged by diabetes.
 
Prior to giving shots on NPH I gave Alice a quarter can minimum, and I waited a bit to shoot.

Now I test and as long as numbers are safe I shoot, and then feed, all in the space of 5 minutes (on a good, normal day). I could feed first but this distracts her and makes her wiggly. Bad for shot time. But she also always has an appetite and if she seemed lethargic or anorexic that day I would definitely modify my approach. As Tanya said, the ProZ people will be better equipped to advise.
There were also times as post-DKA that Alice was too weak to get up and feed. Sometimes I fed her directly off a spoon or from my hand (vegetarian holding wet cat food barehanded, yuck :p), or held the bowl in front of her face. Also since cats are motivated by the smell of the food (learned this when my herpes cat got too much congestion and quit eating for a couple of days, which made her very sick!), I can do things like stir it or add something extra “smelly” if I need to pique her interest. I still do this with the other cats sometimes.
 
Baby scales can sometimes be found at used baby stuff stores, strollers and other things the little brats haven't pooped on. Usually bought by the same nervous first time moms you see in emergency every time the kid sneezes. :oops: No one ever died when their hot dog got some dirt on it, it's a character builder. :rolleyes: :smuggrin: o_O
Right Tanya?
 
@Noah & me (GA) I think I'll stick around! :P

If the tablespoon portion is in fact true for Prozinc (I will poke around and see if I can confirm) that makes me feel a LOT better, that's about the amount of food Panic would eat for breakfast pre-diabetes.

Interesting to see all the ways everyone does their morning/evening routine! For me I feed, test as soon as she's done a few minutes later (if I do it before her meal she won't cooperate because she's hungry), wait 30 min, shoot.

You're so right Tanya, and it's a dangerous hormone at that. It's scary to think just a bit too much can kill you. :eek:
 
Baby scales can sometimes be found at used baby stuff stores, strollers and other things the little brats haven't pooped on. Usually bought by the same nervous first time moms you see in emergency every time the kid sneezes. :oops: No one ever died when their hot dog got some dirt on it, it's a character builder. :rolleyes: :smuggrin: o_O
Right Tanya?

I had a friend on Facebook who had recently had a baby and had some weight gain issues at first pass hers on to me. (Said she was glad to be done with it.) If you use things like Facebook, try marketplace on there.

Dickson, you think kids haven’t pooped on strollers and whatnot?? Haven’t been around tiny humans in awhile, eh? :p (I was working in childcare until a couple of months ago. Kids are cesspools. Every time I worked (substitute teacher) I would have the “baby crud” for a couple of weeks after, no matter how much sanitizing products I used. Even my vet says she is more freaked by human microbes than anything a non-human species has.)
 
pooped on strollers
Yechh! I thought hotel rooms were dirty but airplanes are worse. Fecal matter on trays and arm rests? Last year I had to board Noah and that alone made me ill but then I took EIGHT flights in nine days and got really ultra sick. I got out of my car one day wearing sandals on a scorching hot day and stepped on/in a disposable diaper in a parking lot. Now you know who to ask about boarding a cat and why your hair turns white the next day. :blackeye:
 
Yechh! I thought hotel rooms were dirty but airplanes are worse. Fecal matter on trays and arm rests? Last year I had to board Noah and that alone made me ill but then I took EIGHT flights in nine days and got really ultra sick. I got out of my car one day wearing sandals on a scorching hot day and stepped on/in a disposable diaper in a parking lot. Now you know who to ask about boarding a cat and why your hair turns white the next day. :blackeye:

My god I don’t want to imagine stepping into a diaper of poop. I was thankful daycare stocks latex gloves for diaper changing.
Eight flights in nine days would probably kill me.

That being said, as a health indicator from an analytical/academic standpoint, I find feces interesting. :p Don’t get me started on explaining what kind of fecal matter rabbits eat and how it is produced and why. (Cecotropes!) I also have a lot of pics of Alice’s bowel movements, because after FD she started losing bile color in her stool and fecal score worsened. No one wanted to see them but my vet. Pout.

On Facebook sometimes people do this “post the x# pic in your phone, whatever it is” thing....... mwahaha. :D

ETA @Panic sorry to derail. Lol.
 
Yechh! I thought hotel rooms were dirty but airplanes are worse. Fecal matter on trays and arm rests? Last year I had to board Noah and that alone made me ill but then I took EIGHT flights in nine days and got really ultra sick. I got out of my car one day wearing sandals on a scorching hot day and stepped on/in a disposable diaper in a parking lot. Now you know who to ask about boarding a cat and why your hair turns white the next day. :blackeye:

EIGHT flights in nine days?!
That vision of stepping in a disposable diaper may give me nightmares.

I also have a lot of pics of Alice’s bowel movements, because after FD she started losing bile color in her stool and fecal score worsened. No one wanted to see them but my vet. Pout.

ETA @Panic sorry to derail. Lol.

By all means, a good laugh does the heart good! Speaking of feces then you would have loved to have seen Panic's when I first brought her into the vet. Very pale, goopy, yet looked light and airy. Right up your alley apparently! Now she makes big beautiful chocolate brown poops and I awe every time.
 
Now she makes big beautiful chocolate brown poops and I awe every time.

Haha! I know exactly the weird poop you were describing, and I get excited when Alice has a good, solid, brown poop, too. :joyful: Should’ve seen me when I had my first bunny. Those are the cutest. They look like Cocoa Puffs.
 
I am so perplexed..
in traditional Chinese medicine poop examination was very important part of diagnose. (probably still is)
The little boy in the clip is the last emperor of China and his physician sniffed the poo to check over all well being and to advise the cook as to what the emperor should be fed/avoid eating. I do not know why but I thought you'd seen that movie, The Last Emperor. I meant it as joke and I hope you are not perplexed in the negative way.
 
in traditional Chinese medicine poop examination was very important part of diagnose. (probably still is)
The little boy in the clip is the last emperor of China and his physician sniffed the poo to check over all well being and to advise the cook as to what the emperor should be fed/avoid eating. I do not know why but I thought you'd seen that movie, The Last Emperor. I meant it as joke and I hope you are not perplexed in the negative way.
No not negative at all! I would have made the emoji with the laughing and crying face. That’s pretty much my life, laughing until I cry or laughing while I cry. Thanks for the explanation. :)
We don’t talk about it much in western culture but seriously, poop is one of those things that has... ahem.. loads of information........ hahaha.
 
Well since we're already on this topic...
dx_poop01.JPG I'm making a poopoo!
 
Oh man the extra stinky ones makes me wonder what they got into! XD

@AliceMeowliss&Cassandra Gotta question for you! Since Alice is/was so tiny, where were the best spots to shoot that had enough skin/fat to work with? I just spend a solid five minutes trying to find a spot and each time I checked the needle just went right in and back out the skin!
 
Oh man the extra stinky ones makes me wonder what they got into! XD

@AliceMeowliss&Cassandra Gotta question for you! Since Alice is/was so tiny, where were the best spots to shoot that had enough skin/fat to work with? I just spend a solid five minutes trying to find a spot and each time I checked the needle just went right in and back out the skin!

Hahaha I don’t wonder what Alice gets into because she doesn’t have access to anything but what I give her! But I do wonder what is happening in that poor colon of hers. Haha. :p

Sooo.... she probably did not always have enough fat to work with. But we shoot her sides and alternate sides between AM and PM....
Probably not very helpful, sorry. :\ When she was very skinny it was easy for a bit because her skin was looser. When she put a little weight on, it was difficult for a minute, but then she has put on more weight and I think I have learned to just be a little tougher about it.
I wish I had a photo of pinching her skin up when she was emaciated.....
 

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Also, feeling around, there’s still not a lot of padding under the skin and the rib cage is very easy to palpate, but it’s a million times better than before.
Is the 5.6lbs in your signature up to date? I can’t remember right now, sorry.
 
Yes, 5.6 lb was her weight yesterday at the vet. I can still feel every single vertebrate in her spine but it's not as creepy-gross-feeling as before. I'm noticing in your pics that you grab quite a bit more mass than I do (I usually just pinch a bit) so maybe grabbing more will help, thank you for posting those. There's literally no fat to work with and her skin is paper-thin. The rolling method doesn't help much either because her skin is taunt. I'm sitting here with my 13 lb tomcat and pretended to pull up skin to shoot - it's a LOT easier than doing Panic. I can easily tent his skin, Panic simple doesn't have enough!
 
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