2. Java, elder cat

Very good advice/prescription from Rachel.

 

717 again this morning....In his lower ear, a good blood drop.
Is there any reason I'd go higher than 1.75? Argh, poor kitty.
Edit-- he had ringers 2 days ago, I can give him ringers again this morning. That helps bring him down.

 

Try not to dose according to bounce numbers. Keep the 1.75 u for now. I think that changing things too much/too often can make bouncing worse.

 

Thanks. Needed that!
He ate well.
He's very tottery.
Neg for ketones also. (The G part of the pee stick works. Over 500.)
He wants to outside to water. That's good. Quick shot, then he can go.

 

433 at + 3 and a half. I've topped him off with 125 milliliters of Ringer's at noon, +4. I have a lot of errands to run but luckily they're in town so I can come and go from the house.

 

Still bouncing ... it'll pass.

 

I hope so. Fingers and toes crossed!

Edit: 222 at almost +7.
I think Ringers helps.
Back out, more errands. He wants to go out, haven't let him yet, to sleep etc. Soon!

300 , +9. His life has narrowed so much in the last couple of days. He doesn't seem to enjoy being outside very much, tho' he did wander around on the decks for about 45 minutes. He'd rather be on his pillow. I wonder if his legs really hurt. I have the gabapentin and bupe. Not fond of how much it made him blotto though. Oy.

 

634.
1.75 would be the usual.
298 at +4
268 at +7
Leaving YA down until amps pretime, taking up FF now, hypo seems remote. Maybe he'll be lower in am. Hoping!

 

He's at 298 at +4. I gave him a Vit B12 shot at +3.
We just got back from an evening stroll down to the little seasonal creek for some water and back.
If only he could stay between 100-300. I can dream.
The Vit B, a miracle drug?
Discovered that I made assumptions about Zobaline that I should not have.
It's only 3 mg. B. What?! Did not do good due diligence.
I have contacted a mobile vet who comes highly recommended, asked for appt, I need more support. I keep effing things up! And I don't know how often to give the Ringers, since the vet's rec to do Ringer's one day and NaCl the next = bad idea. Daily? Ev other day? Should I ask Marje?
On the plus side, I napped with the cats during the 2-hr no-food PMPS period.
It's a rush to get insulin in him in the AM after a test and food. I'm hoping he'll be low, but prob not.
Stay with the 1.75?

 

I'd ask Marje probably. I'm not super educated about the ringers.

I think he's still bouncing, honestly. I'd stick with it for now.

 

Keep the same dose for a bit, Lois.

 

703 at 5:30 am, um, +10
Poor kitty.
Does anyone give insulin every 8 or 9 hours?
Back to sleep, thanks, see you in daylight.

 

Some people do TID dosing (every 8 hours) but it requires a lot more testing and is very hard on the owner wrt having any sort of life. My opinion is that it's best to do what's sustainable over time. The FD journey is hard enough as it is.

 

Picked up more injectable B12 from the vet. Have prescriptions for more ringers, for B12, which the internet tells me is available cheaply; we shall see.
Talked with vet tech a lot; vet was doing surgeries. Pet owner in waiting room who'd been through feline diabetes was very helpful, esp re pain mgmt. in general.
Trying a trace of Bupe with a Java. Filled syringe to .01. Emptied it. I have liquid in a little jar. Rubbed syringe with traces bupe on outside of it on J's gum, filled empty syringe h2o, squirt. Watching.
He appeared alert and interested when I got home. Watch to see if it knocks him out or what.
BG pretty good so far. Hoping it stays this way until PMPS.

 

How much does the injectable B12 cost you, Lois?

 

From the vet, preloaded in syringes, he's charging about $7 per syringe.
The internet tells me a vial of liquid B12 is about ten bucks. I haven't tried to buy any yet.

I think the experiment with bupe was very good. He behaved the way he did before he was ill, for about 2 1/2 hours, instead of sleeping more than being awake. Followed me around, just keeping an eye on things. Went to the top of the stairs to greet me, way he did every day after work. Sat for a long time in the place where he used to get treats.

 

So glad to hear that the bupe seems to be helping!

 

Now I'm getting worried that he's experiencing the known side effect of agitation. He's having a hard time settling.
Maybe I'm just being jumpy, I don't know. His pupils weren't huge before, now they are.

 

I haven't used bupe before. How long does it last? Hopefully he'll settle down soon. Here's some music he can listen to....

 

I don't remember. Catster says, A standard dosage takes about half an hour to 45 minutes to start working, and its effects on a cat can last from four to eight hours.
He's sleeping now.
Soothing music, plus great cat photos! Thanks. He can only hear a little bit now, but I enjoyed it.

 

Having him so near his old self this afternoon made me realize how much he isn't, much of the time now.

Edit:. 172 at +5 and 1/4.
He's awake, hunching, I wish he'd lie down and sleep...There he goes lying down. not interested in YA food. Suspect hungry. Wish I could keep him from carbs, keep BG down, but he's so skinny.
He's had some FF, BG prob high thus coming am. Back to sleep. He looks comfy now. Hope he is.

 

Gotta feed him what he'll eat. I'm glad he was able to lie down and get some rest...hope he was comfy! I tend to think if they look comfy, they probably are.

 

You're getting some decent overnight cycles right now. Just look past the bounce numbers and focus on the yellows/blues because they tell the story about the dose. His BG is unstable and he's unpredictable, probably because of myriad physiologic processes associated with age and other health issues. That probably won't change, Lois. Just do the best you can to keep him comfortable and able to enjoy his little old man pleasures. That sounds sad but it isn't, really. The fact that he's as old as he is is a testament to the great care you've given him.

Now this part is much easier said than done: if you hover over him too much in a state of anxiety over whether this moment is "it", he'll sense that and it won't be to his benefit. The more you can just enjoy every moment even as you treat his FD and other issues, the better off you'll both be. Aim to be as "zen" as you can.

 

Excellent advice, Kris, yes, some of the easier to do than others.
I read somewhere maybe on the grief page in re euthanasia, "better a moment too soon than a minute too late" and now am worried that I might be making him suffer with pain or discomfort. Wish they could talk, darn it.

I'm unsure whether to try bupe again or not.

I haven't settled on how often I should do the ringers. Off to read more at Tanya's.

We're having more rain again, unbelievably, and so Lily has decided to warm herself on Java. Photo, including my sleeve. All in bed together.

 

Very sweet!

 

Lois, I can't even imagine how difficult it is to make this decision. My neighbor, the absolute image of the "crazy cat lady" has told me for years that they can talk to us, if we quiet ourselves and listen. I know it sounds funny, but I kind of believe her. I pray that Java would be able to "speak" to you about what he needs right now, so that you can have wisdom and peace with each day's decisions for him.

On a lighter note, your picture of Lily and Java is adorable!

 

Uck, another of those days when it appears as if the am shot was a fur shot, yet I'd swear it wasn't.
577 AMPS
1.75 U
654 at +4
On the positive side, we all went outside after the +4 test, and he got up to one of his favorite lookout spots under his own steam.

The vet I wanted to consult with hasn't called me back. I need to follow up on that. Reading more at Tanya's, I'd internalised that the use of subq fluids was in essence washing them out. She (via cited vet info) makes it pretty clear that that isn't the case, and to a certain degree, processing the fluids is hard on them. Damn it I need a vet that's more help.

 

This is really interesting. Dogs, but that's fine.
https://brightside.me/article/how-d...nd-deeply-touching-photography-project-11005/

 

Wow, those are so touching! What beautiful images! Thank you for sharing that.

 

So hey, I'm now at + 10, and poor Java's BG is up to 681. Can I give him insulin early? How early? He normally gets test/ food/ insulin between 7 and 8 my time... It's 5 p.m. my time.
Edit, he was tested at 7:30 am and got a shot at 8 am.
I think if I test at 6:30 pm and shoot at 7 pm, that's 1 hr early and should be okay. But can I do it 30, 60 minutes sooner? Get some insulin in the poor boy.

 

Remember though, even if you change time a little, it's not going to kick in right away

 

I'm torn between wanting to get insulin as quickly as possible, and wanting him to have dose that lasts through the night.

Just want to vent about these shots! I swear they're not fur shots. Never gotten an answer to this question though, are there any situations where insulin is ineffective. In other words, does it have to be a fur shot, there is no other explanation? I'm very careful. I know we all are and that they happen. Yong, when you had fur shots did you know it right away, or only when you could see that insulin wasn't working? If you don't mind being an example!

 

Not at all . I've only had 1 100% confirmed fur shot because there was resistance in the syringe and I thought I pulled it out a little to avoid whatever was block and insulin went on his fur. The one on 26 Feb was a guess because of his numbers.

 

I've known mine were fur shots because there was a tiny little bit of fur clumping together from being wet, and when I stuck my nose in it, it smelled like bandaids.

 

I squirted a little bit of insulin out last time I was being cranky about a fur shot so I'd know what the smell is. I smelled him this morning, no moisture, no smell. Frustrating.

What would happen if a human accidentally stabbed themselves and got some prozinc in their system?

 

I don't know the answer to that, but I don't think it's a good idea. Maybe inject a piece of fruit if you just want to practice.

 

Well, it's a recombinant human insulin so I don't think a couple drops from a self stabbing would hurt us lol

 

That's a good idea, although I wasn't thinking about practicing shooting. I feel pretty confident about that although maybe I should practice!

I was putting the cap on the end to carry the syringe to him, and just wondering what would happen if I accidentally stabbed myself. Does it become a medical emergency for the human? Or it is the difference in body weight so significant that you can eat a teaspoon of honey and not worry about it? Just curious.

 

I thought it was made out of pork enzymes or something. Recombinant human insulin is clearly a term of art that I should Google sometime. But it is now 6:30 and I am going to jump the gun test and feed the boy and give him some insulin by 7.

 

That's Vetsulin . Easiest way to describe recombinant is synthetic, I think.

 

I'm pretty sure prozinc is from pigs, and maybe beef.
700. Poor baby.

 

Ooooh...I thought you were worried about the fur shot thing. I think if you just poke, but don't inject the insulin, you'd be fine. And isn't PZI made from pigs?

 

ProZinc Insulin for Cats:
Active Ingredients per mL
Amount
Recombinant Human Insulin
40 IU (International Units)
Protamine Sulfate
.466 mg
Zinc Oxide
0.088 mg
Glycerin
16.00 mg
Dibasic Sodium Phosphate Heptahydrate
3.78 mg
Phenol (added as a preservative)
2.50 mg
Hydrochloric Acid
1.63 mg
Water for injection (maximum)
1005 mg
Other: pH is adjusted with hydrochloric acid and/or sodium hydroxide.

I could be wrong but I would hope they would have had warnings like Vetsulin.

 

Ah...PZI used to be derived from bovine or pig, but now is compounded from human insulin.

 

So it's made out of humans?
Okay, my bunny has food and insulin in him. Time to make a salad.
My musings went as far as wondering what happened if you had an injection of prozinc. Awesomely fast research there, Yong!

 

The super great vet ER in town also recommended the same vet that that my friend recommended, for pain management, hospice, and diabetes....And.... I just heard back from that vet. Her mother broke her hip and she has to help her, and she's not taking any new clients. Bummer.
She did give two referrals, so I'll check those out.

 

I think, Lois, that it's just a combination of things that makes Java have wonky numbers. I know you're going through so much right now..just remember that you are amazing! You take care of Java and you deal with the crazy numbers and his other issues and do a wonderful job.

 

Thanks for your positivity. It helps.
He's at 636 this morning.
Assume still 1.75.
Edit, yes, because we got to yellow on 1.75 yesterday PM.
Ultra careful shot this am. Think I'll change where I do it, instead of going to him, bring him to my lap.
What locale, position, do you shoot?

 

I prep my syringe at my desk under good light, put it in a little basket and carry it to my bathroom (same floor) where all the Teasel testing/shooting happens.

 

The second mobile vet left a message, giving a bunch of dates for an appointment. I left a message back asking for the first one, this coming Monday between 1 and 3. Hope it works out.

Java just got under my throw, and then lay on my belly for a while. He is not a cuddly boy, so that was nice. Presumably a good combination of squishy and warm for him. He's looking for food, has to wait an hour.

 

Aw glad he came to snuggle with you!

 

337 PMPT? That seems wrong. I should try on the other ear.
I'm pretty sure he's dehydrated. That I didn't see until now. I'm warming up the Ringers.

327 on the other ear, juicy drop. I have to review things, he still gets 1.75?
@Yong @Djamila @Steph what do you think? Reduce from 1.75 for pm shot? Do 1.5? Fat 1? I don't understand why it's down this low. I'm grateful but I wish it made sense.

 

Sorry, Lois, no sense to be made of a single number with a bouncy cat. Maybe try 1.5 u? You could leave it at 1.75 u if you want to be brave but they tend to go lower at night. Don't drop the dose too much. You know what to do if he gets into green too early.

 

Hey Lois! Have you shot yet?

 

No, not yet. Just reading these posts.
I'm leaning g towards fat 1, but was seriously considering a 1.25.
Kris, et al., it's such a bummer that the none of this makes sense.

 

Your call, Lois.

 

I wish I had a better decision tree. I still feel like I'm stabbing in the dark on this! My rationale for a fat one is that I've only had a handful of other pre-shot magentas, and he's gone down into Greens on all of them.

 

Whatever makes you most comfortable. And you can monitor and you know you can steer with food...and even if no one is in this forum, you'll almost always have company on health if you just want someone to chat with while you steer (if you needed to).

 

I'm going to go with a fat one, and give him ringers. Just hope it doesn't end on a big cycle lots of blacks again.
I was reading that Yong and Djamila have been here for 2 months. I think I have too. You guys are so much more confident I am!

 

It's hard to say, Lois. Looking back, you have gotten some low numbers shooting fat 1 on magenta numbers before. If you feel most comfortable with that, go with it.

 

Yep that was my thought process too. He's eating a fair amount, mostly YA, I'll get some FF in him too. I'm so grateful he has an appetite.
Thanks very much, all. Omg, it took me almost an hour to decide on this. I think I'm just really slow, dumb, scared!

 

Nah, it's a hard thing to deal with! Doesn't make you dumb or slow...as for scared, heck you fit right in with the rest of us!!

 

It scares you too?

 

Every time Gypsy went low, I was terrified. And when she was high I was terrified. I think it's natural since they are our babies. But you gotta learn to savor the sweet moments and not let the disease scare you too much. That's why you have this forum. You're not alone with it.

 

Oh my goodness, yes. Did you see my post earlier about how I was second guessing Sam's dose?

And as for confidence....look at my spreadsheet: Sam is pretty simple and consistent (antijinx). I'd be curled up in a ball crying if I had one of the many, many complicated cats on here. I'm in awe of you all every day. Also, this is my second time here. Sam already had FD once and then went into remission. And during the year he was in remission, I still logged in and read posts fairly regularly. So it's really more like two years that I've been here.

 

Wow, Sam's SS is beautiful. You're so lucky! Good work, Sam!
Thanks Rachel, Djamila, Kris.

I just gave Java 100 ml of Ringer's subq. When I went to give him a shot I realized that his skin was tenting. Gotta grab some dinner myself, it might be a little longer g night.

 

Sorry I wasn't around, and again I had no alert I was tagged. Just unchecked that setting and re-checked, hoping it will fix. Luckily, the others were on. Looks like he was ok with the fat 1.0U last night. I get SS envy too, Lois

 

Don't talk to me about SS envy!!

 

Haha, very true, Kris

 

I have no idea what to make of this. Still in 200s at AMPT!
Fat 1?

 

I'm inclined to say skinny 1.0U. Just basing that off his previous yellow AMPS cycles with yellows. I tend not to treat AM and PM cycles as acting the same, if that makes sense.

 

It was convenient just now to test ketones (none) and you know how there's a glucose strip too? It read "none" also. Blood test more reliable, he's got glucose! And just had some FF.
Well, I appreciate the low numbers. It would be great if they stayed! (No Jinx!)
I just shot a fat 1 and reread your post @Yong (we can test it) and realized you suggested a skinny 1. Confirmation bias on my part.

 

Would it make sense to give him a tsp or tbsp of gravy now?

 

As they say, you hold the syringe . I was just looking for previous AM cycles with yellow PS numbers. Yeah the I think the lowest on glucose strip after 0 is like 250. So if 243 is his blood glucose reading, there isn't much excess left to go into urine, if any, so it will probably read 0 if their BG is under 250.

 

I don't think so. The insulin is still going to take 1-2 hours to start working. Your usual monitoring should be fine.

 

I know I blew that. I'm now wired to be hyper to get insulin into him asap to get those high numbers moving down, and should have paused.
There are so few PT yellows. I'm coming up with myriad explanations for the yellows, which I should just let go, too little info.

 

Does he seem to be feeling better today with lower numbers? May be too soon to tell.

 

That's a lovely AMPS. Just carry on in normal mode, not panic mode.

 

At least half the time, my normal IS panic. The other half is, I'm trying my best, his body is doing its best, it's okay to be calm. Sometimes it isn't even on my mind for awhile, and I feel so guilty when I realize that, "omg, what if something bad happened while you weren't worrying!"

 

We think that if we worry it'll prevent bad things from happening. Magical thinking. Problem is, it just robs us of coping energy and has no influence on events whatsoever.

 

It's hard to tell, and I've also learned I have both accurate observation, and confirmation bias based on his numbers. Something interesting to me is that he didn't have an excessive amount of peeing overnight, which I might have expected with the ringers. The vet had told me, variously, to give 125 ml twice a week, and more recently, 125 ml daily - alternating with the NaCl fluid. I shut that down after yet another reading through Tanya's website. So that 100 ml last night was my best guess for an adequate amount of fluid, and I didn't want to go up to 125 in the hopes that 100 wouldn't "wash away' whatever is causing the streak of yellows... Even though Tanya's site, with references, says there is no such thing as "washing away."

Well that was an elaborate answer to a simple question! He did do this thing that I love, he paws at the ground when he first drinks water, that I haven't seen him do in a while.

 

Exactly.
I'm normally much calmer about medical things. Lots of first aid etc training and drills.
With all this stuff with Java, it's as if none of ever happened, except that I'm comfortable with medical equipment. Because it's Java, no doubt, and he can't talk.

 

I hope your kitty feels better! I'm wondering though, what is a fur shot?

 

I'm hoping that he does, and thinking that he does, because his numbers are between 100 and 300 this morning.
A fur shot is when the insulin doesn't get into the body of a cat. The needle goes through and out the other side of the skin tent, or something about the injection goes awry, and insulin isn't delivered inside cat. The safe protocol is to wait out that 12-hour cycle without giving any additional insulin. The reason is that going low, a hypo, is dangerous and potentially life-threatening, but a cycle or two of high BG is not life-threatening.

 

When you inject insulin but it ends up mostly or partially on the fur, therefore, kitty gets none or little. Never try to re-shoot because there is no way to confirm how much or little actually went in.

 

Or what Yong said much more succinctly!
I can't stop coming up with reasons for the yellow! I wonder if it has anything to do with changing the way I'm doing injections. That would be terrific, and horrible, all at the same time!

 

What did you change about the injections?

And try not to drive yourself too crazy ....I think it's good to be trying to think of causes and patterns, but one day's numbers can just be an anomaly, so you'll really need a few more cycles to start to determine cause-effect.

 

243, 231, now 152. Nadir in an hour or so. Unbelievable. His eyes have stopped weeping brown goo. He let me clean the crust off with contact lens solution and tissues. He's happy to eat, well, he always is.

Now I understand why sports people have all kinds of superstitions. Special socks, special ties, touch this touch that. Man if there is anything that I could do to keep this this way I would do it. Knock wood that it continues!

After the last fur shot a few days ago, which I would swear was not a fur shot (evidence-based rather than observational), I've been bringing him to my lap in the dining room where I test him, and injecting insulin in a tent on his side belly. It's the same thing I've always been doing, but on my lap. I was taking the needle to him, and shooting into a tent on his side or belly while he was lying on his pillow. So, I don't know.

And yeah, I'm getting way too excited about this. Steady on the expectations, girl.

 

This is wonderful, Lois!

 

Well, whatever happens next, at least he's having a really nice cycle right now.

Does this mean you aren't going to change your socks anymore?

 

Better socks than underwear!
155. Amazeballs.
He just came to see what I was doing, and ate a little bowl of chicken. His eyes are weeping goo again though.
I'm a little bit afraid to think about what dose to do this evening, afraid I'll jinx it. But if it stays in the 200s, flat 1, skinny 1?

 

How long before shot time?

 

Well if you can't change your socks, at least your feet will be warm!

 

351 at 8.75, let's call it 9. He just had FF. So it'll prob go up more, still, better than last several weeks.
Food up now, PMPT in 2 hrs, shot in about 2.5 hrs.

 

I read on the fdmb Facebook page that FF was reformulated, and several of the classic pates are now higher carbs. I'd have to dig to find it again. After, looked at Dr. Lisa's list to double-check it, and all Pates are low carb. Dr. Lisa list is definitive, we agree? It was a screen cap of an iPhone app for cat food. Anyone heard anything different about food list?

 

I'd agree that Dr. Lisa is definitive. She spent countless hours on the phones with companies and has no personal gain from a lie (not saying you were saying she did lie...just making a case for why I find her definitive).

I believe people were finding FF giving their cats higher BG but no one ever concluded that they changed formulas for sure.

 

I would go with Dr. Lisa's list over an iPhone app for sure. Companies do reformulate, so it is something to keep an eye on.

 

Yes, that's exactly why I'm way more inclined to believe Dr. Lisa than someone's app.
It's like having a hangnail, I'm still picking at ideas of why this teeny tiny little honeymoon for Java.

 

442. Sigh. It couldn't be one pill pocket for his Zobaline?
Not sure dose to give.
What do you look for?
I'm looking at every past PS that was in 400s, it looks like more had 1.5, sound about right?

 

It's so important to remember that you hold the syringe and can ignore advice anytime you want. It doesn't hurt mine, nor anyone else's feelings.

That beings said, I think I would go with 1.75u

Here's why:
-I'm a fan of keeping the dose consistent, unless the numbers and reactions indicate otherwise. Our bodies change from day to day, and the variations in number shouldn't be weighted too heavily unless the responses to those numbers force you to.
-You monitor closely, so if anything goes awry, you will catch it.
-He has a lot of room to drop before he's anywhere near a lime green.
-So far, 1.75 has always been safe.
-He was low today, and a "typical" response would be to stay flatter tonight. This one I put less weight on though given Java's age and other factors -- he isn't necessarily going to respond in a typical way.

Okay, that's how I thought about it. But here's the thing: I think there is a lot of logic and science around dosing....but I also think there is some art. Sometimes it just comes down to looking at your cat and going with your gut. So if 1.75 feels too strong tonight I think it's fine to go with a lower dose.