? 11/25 Jimmy +5 after NS still dropped to 43

This is the second night in a row I've had to skip a PM shot. Of course I'll be reducing his AM shot - but wondering what the medical reasoning is behind these drops?

http://www.felinediabetes.com/FDMB/...nce-stay-put-or-increase.186241/#post-2068518

 

One hour later got him up to 55 using HC food.

 

Generally, there's only one reason for Pre-shots that are too low to shoot.....the dose being too high!

Hopefully this is a good sign for Jimmy!

 

Looks like four nights in a row of skipped shots. The AM shots have also been different the last four days. He definitely needs a reduction, but it's hard to guess what to with all the different doses.

The acro tumour can wax and wane, that's one reason that less insulin may be needed. Anything else change in his meds, food, or behaviour?

 

@Wendy&Neko - Levemir is characterized by its late nadir. Is it possible that Jimmy is just hitting it at +16 or +17, especially when the numbers preceding it are already on the lower side?

 

Something is definitely off with him. His appetite has been decreasing over the past few days. I chalked this up to being in good numbers. But yesterday I noticed his walking being weak. And he’s vomited 3 times since yesterday. I had to bring out all the tricks to get him to eat this morning. Making appt with the vet as soon as I can get in.

 

Hi Susan
I don't see it noted in your SS so I assume you didn't start Cabergoline, correct? Definitely looks like Jimmy needs a reduction. See how the morning plays out and hopefully you can start to stick with the same dose so he stabilizes otherwise its hard to know what a good dose is. Very odd for him to have so many NS and drop like that. I guess it could be just a clear example of why Acro cats need more monitoring than most because their insulin needs can drastically change depending on what that tumor is doing.
I think if he seems off like you say a vet visit sounds like a good idea.
Let us know how you make out. Vetty vines for little Jimmy. Hugs to you

 

Thanks Michelle. You are correct. I have not started the Cabergoline yet...the day I rec’d it his numbers were looking good and I knew with the holiday I would be away from home for longer stretches than usual. Now with his wonky appetite I am holding off a bit longer (I understand a potential side effect is decreased appetite).

The dosing reflects my attempt to drain the depot due to being away and unable to test as often as I’d like.

I truly believe w/ Acros we develop a spidey-sense and with such a high dose it’s such a tough call because the typical diabetes rules don’t apply. So sometimes I had to take a BCS or like lately skip.

I’m noticing his nadir is also happening at +14+15 which has been his “typical” onset.

The decreased appetite has me most concerned as he’s always had a good appetite and when he was first dx with Acro that was a big contention pt for us to determine QOL.

Let’s see how the day goes...hoping he stays in the 100s honestly.

 

Oh boy I just looked at your SS. He’s definitely wanting a reducie but I guess it’ll be a crap shoot as to what dose. What if you gave 15 U AM/PM? Splitting the amount? Traditional rules definitely don’t apply here.
Hopefully he’s eating a little better for you.

 

I’m hesistant about giving him anything tonight. Tomorrow I will be away from his +4 - +7. Gahhhh

 

Holy cow on today's numbers! That is way too large a dose. Maybe even something like 10-15 units tomorrow, just to get something in him. But I would play it by ear based on how tonight goes and his AMPS. Have you tried giving him higher carb LC to give him a a bit of a cushion. I used to feed Neko 8-9% carb LC when her appy was iffy in low numbers. I know, not raw, but better to eat something. Also, soft tissue growth in Neko's mouth made eating raw harder for her, so I had to switch to canned pate.

Neko occasionally nadired as late as +15 on Lev too.

 

He’s just now starting to come up now. One point at a time. We’ve given him HC Fancy Feast food and Karo alternately. And *Gulp* even kibble. Nothing has really worked get his BG up. The other time he was at 33 I gave him Karo and he immediately responded. I think something else may be at play with Jimmy.

He has been alert most of the day but his appetite is in the toilet and he’s vomited and had explosive diarrhea...guessing it’s from the “foreign” food and simple sugars. But prior to today he’s been vomiting and had diarrhea for a few weeks. Testing shortly and praying for a steady rise.

As for tomorrow’s shot...I have no clue. I won’t be home between what would be his +5 and +9. And if the tumour has ramped down I’m scared to give him anything in the double digits.

If his appetite is still off tomorrow afternoon I need to make a very hard decision as to next steps.

 

I spoke too soon. Heading to ER.

 

Sending vines and

 

Keep us updated. Usually tumour ramping down isn't that dramatic, but more gradual. A glucose drip sounds like the best thing for him at this point.

 

Vines are on the way for Jimmy.

and some s for you.

 

(((Hugs))) thinking of you and Jimmy

 

Oh no. Thinking good thoughts for you and Jimmy.

 

Just saw this. Sending vines and prayers. Please update when you can.

 

HI Susan, I am just getting caught up. I am sorry Jimmy isn't doing well and please let us know how he is after your vet visit. Sending vines.

 

{{{{Susan}}}} I just read the SS. So sorry about the mass in Jimmy's tummy. Thinking of you.

 

I never thought to look at the spreadsheet. I'm so sorry. My thoughts and prayers continue to be with you.

 

Oh no!!! So very sorry to be reading this..........

 

I'm so sorry, I just hate this for you and Jimmy.

 

Thinking of you and Jimmy.

 

{{{Susan}}}

We are all thinking of you and sending our vines and prayers to Jimmy. Let us know if we can do anything for you.

 

Thank you all for your kind words and support through this hard journey. We helped Jimmy cross the bridge and believe, given the hardship his body was dealing with - we made the tough decision to free him from his sick earthly body.

For Jimmy, food was life and when his reluctance to eat his favorite foods or if he did, he promptly vomited it up, we knew it was time. We weren’t able to administer his pain meds for the last two days and his QOL the past week was rapidly declining - despite the “good” numbers.

Because we were about to start on cabergoline, I am stocked up with supplies and want to pass on to someone who is in need, including the unopened Cabergoline (compounded for a 21 lb cat). I’ll be posting in a new thread under the appropriate forum shortly. Not sure the cabergoline will be of use but I have syringes, lancets, and strips for a Bayer contour meter.

We have Jimmys civvie sister Marley to nurture now. We spent the day in bed with her reading, playing, petting, and just being together. Much of my attention for the past few months have been devoted to Jimmy...she is a little off and I suspect is grieving the loss in her own way.

I am grateful for the support I’ve received through this forum. Thank you truly from my heart and soul.

Extra hugs to all your sugar and non sugar kitties.

 

I'm so sorry that it was Jimmy's time.

 

(((((( Oh Susan)))) I am so very sorry to hear that it was Jimmy's time. We as Beans, that are tuned in as you were, know when it's the time to let our furbabies free of their physical bodies. I so know that it was with a heavy heart that you released your sweet boy. Sending lots and lots of comfort vines to you and yours. Jimmy was so lucky to have you as his bean!

 

I'm so sorry you had to let Jimmy go.

 

Susan I'm so so sorry!! You took the most amazing care of Jimmy. There truly aren't many out there that would do all you have done, seriously! I know there isn't much anyone can say to make you feel better at this point in time. Please know we are all here whenever you need. You gave Jimmy the ultimate gift of love and set him free of any and all discomforts of his failing body. He will always be with you and you with him. He knows how lucky he was to have a bean that took such great care of him. The next few days will certainly be the hardest. Rest assured soon you will be filled with all the wonderful memories of Jimmy Time will heal the pain.
My sincerest condolences to you and your family ((( Susan)))
Chin scritches to Marley

 

I'm so sorry you had to let Jimmy go, it was a very loving decision.

 

I'm very sorry to hear that. I think I would know if something was wrong with Maverick if he didn't have his appetite either. Hugs to your family and Marley.

 

(((Susan))), Jimmy knew that it was his time to say "farewell until we meet again". His love for you and his gratitude to you for helping him cross will help your heart to heal.
Fly free, dear Jimmy, on your beautiful new golden wings. You are much loved.

Sending deepest sympathy to you and your family,
Ella & Edward, Rusty, and Stu (GA)

 

So sorry for your loss. I know words can't stop how bad you feel, but most of us know how bad you feel and it is a terrible time for you & your family. You are in our thoughts.

 

I'm so sorry to hear that it was Jimmy's time to leave. That last gift of love is the hardest to give. I hope your wonderful memories of him will help your heart to heal.

Fly free, sweet Jimmy, and land softly at the Bridge

 

I am deeply sorry for your loss of sweet Jimmy. He is blessed to have your love and that you knew when it was time to free him.

Gentle journey, Jimmy.

 

{{{Susan}}}

I am so very sorry. We all understand the pain you are feeling now, and wish we could somehow take it away. You gave Jimmy everything he needed throughout his life, and then you gave him the greatest gift of all - his freedom - even though it cost you more than anything else you could have done for him. Our time with them is never long enough. I know you are hurting now, but take comfort knowing he is free from pain, and will be watching over you from the Bridge, until you are reunited.

Fly free, sweet Jimmy, and land softly.

 

I'm so sorry for your loss Fly Free Jimmy, and give your mom a sign when you can that you are doing fine.

 

I'm so sorry. Fly free Jimmy. Sending prayers.

 

I'm so sorry for your loss. Cherish the time you had with him and know that he loves you for setting him free.

 

Fly free sweet Jimmy. May all of the wonderful memories that you shared together bring you comfort and peace until you see each other again someday.

 

I'm so sorry to hear about Jimmy. You did your best and he knew.

 

Thinking of you Susan

 

Thanks Michelle. It’s been hard...and his sister Marley is grieving for him. She has not eaten with vigor like she used to. She is playing though - I’m trying to stimulate her “hunt kill eat” instinct. We have a vet appt Sat to update her BW and just make sure its nothing physical.

I miss him terribly to go from constant monitoring to no contact is hard.

 

I can only imagine your pain, Susan. Know that you are in my thoughts.

 

This is so sad, I am so sorry Susan. I know you did so much for him, he was a lucky kitty.
Fly free Jimmy

 

It is so true Susan. That is what makes it so much harder.

She is totally grieving. I never gave it much thought until after how Ming would react and feel once Beenie was gone. He kept looking for her for a few days and was definitely off. Beenie and Ming came home together to us 12 yrs ago so he does miss her terribly. They were always together..not so much once Beenie was steadily declining but before that they were always intertwined, slept, ate, and played together.
I'm sure Marley will get back to old self and eat with vigor again sooner than you think. Cats are probably more resilient than us beans

 

Hi Susan
Just thinking of you guys!
Chin scritches for Marley

 

Thanks for checking in on us Michelle. We’re doing ok. Marley is doing much better...started her back on raw last night. Bought her a nice cat tree and new toys just for her. She seems to adjusting to being a single sibling less kitty. It’s funny though in certain lights she looks exactly like Jimmy...she is also so much more chatty with us.

Some days it really hits us hard not seeing Jimmy in his chair...or sitting next to us while we prepare dinner with meats...he loved his pork and turkey!

Christmas won’t be the same for both of us this year huh. Hope they met each other and are frolicking around in their happy healthy bodies...

 

Hi ((Susan))!!
Hope you and Marley are doing well. How are you making out with this cold weather? Does your boat stay in the water even at these temps?
Just trying to catch up as much as I can. I was away on vacation when you posted this, sorry I missed it! I got through the holidays pretty good but lately I've been thinking a lot about Beenie. We miss her terribly. DH and I are always talking about her silly antics which brings smiles to our faces every time. So I guess its bitter sweet.
Here's to a better 2018 Be well and stay warm