? 3.5 Rufus AMPS 108, PMPS 198*(back from vet), +2 59, +3 74 (AT2)

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Sean & Rufus, Mar 5, 2018.

Thread Status:
Not open for further replies.
  1. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    Good morning!

    Rufus has specialist appt 45 mins away today, and we have a winter storm going on :) Oh well. Rufus is a little higher today, so wondering if that .75 is too little? Also, this AM shot was possible fur shot, but I can't smell it. There definitely was a drop left in it that he didn't get. And I have 3 strips to last until Wednesday. :( I do have a new human meter, but no control solution. I can use the new strips in my meter but wanted to do more side by side tests. I feel horrible about this.

    Yesterday
     
    Tracey&Jones likes this.
  2. MyTitan

    MyTitan Well-Known Member

    Joined:
    Jul 20, 2017
    Go ahead and use the human meter if you strips for that. Don't worry about side by side tests, that's be done a lot by folks on here and there is no conclusive correlation except that at lower numbers they are closer together and at higher numbers farther apart but that's even a generalization. Just note that you used a human meter and use 50 instead of 68 for shark waters. BTW are you coming into the cities for your specialist visit?
     
  3. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    But don't you need to use control solution before using the first time?

    I live in Delano and the specialist is in Eden Prairie. Usually 30 to 35 drive, today not sure. Almost every school is closed if that tells you how the weather is!
     
  4. MyTitan

    MyTitan Well-Known Member

    Joined:
    Jul 20, 2017
    Have you got snow yet? I have a spare bottle of strips and cud meet you between RF and Eden Prarie later this morn if wx hold off??
     
  5. MyTitan

    MyTitan Well-Known Member

    Joined:
    Jul 20, 2017
    I
    im not sure that's nessary, if the numbers are WAY different then there would be an issue.
     
    Sean & Rufus likes this.
  6. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    Yes, been snowing since before I woke up at 6:30. It's coming down pretty good now and it's real windy. Poor squirrel is hanging on for dear life trying to eat my sunflower seeds. I should shoo him off, but he's trying pretty hard for that food :)

    Thanks! I appreciate that. I think I'll just use the freestyle strips in my alpha trak monitor. Did 3 tests side by side and only one was real off. Just got off the phone with freestyle (abbott) 15 minute wait to be told $14.99 + ground shipping for solution! :mad: And it is only usable for 3 months. I'm wondering if the specialist uses AT2? I brought him to the emergency vet and they used a handheld meter. Maybe they could sell me a couple strips.
     
    MyTitan likes this.
  7. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

    Joined:
    Feb 14, 2011
    I’m away today so checking in from my phone. Good luck at the vet and be safe!
     
    Sean & Rufus likes this.
  8. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    Thanks Amy! I'm thinking numbers will be higher today. Hoping vet goes well :)
     
    Amy&TrixieCat likes this.
  9. Tracey&Jones

    Tracey&Jones Well-Known Member

    Joined:
    Dec 12, 2016
    Sending vetty vines that Rufus is doing just fab!
     
    Sean & Rufus likes this.
  10. Stacy & Asia

    Stacy & Asia Well-Known Member

    Joined:
    Oct 2, 2017
    Thinking of you and Rufus at the vet today, hope all is well. :bighug:
     
    Sean & Rufus likes this.
  11. MJW

    MJW Well-Known Member

    Joined:
    Mar 29, 2017
    Safe trip! I have purchased a few emergency strips from my vet before.
     
    Sean & Rufus likes this.
  12. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    Thanks, it was getting bad around here! I tried 3 different vets today, none would sell me any. The specialist ended up giving me like 6 or 7 for free, so that was nice.
     
    Bronx's dad likes this.
  13. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    PMPS 198. We did just get home from the vet, and was in the car for about 50 mins coming home. So with partial shot today and stress I think that number is ok.
     
  14. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    Does anyone know how long you need to wait between 2 sessions of Anesthesia? Rufus had it about 2 weeks ago, and now will need it again, and was told it is too soon right now for it. How long will we have to wait? I left the specialist more confused then when I went there :banghead:
     
  15. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    What is the second anesthesia for?
    The answer is No. When Neko had her SRT (radiation therapy), she had 4 days in a row of anethesia. Not necessarily easy on ailing kidneys though. And she had a board certified anestheologist on the case.
     
  16. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    Well I am confused. Day of ultrasound, tech told me nothing abnormal. Last week I saw a report from a 2nd set of eyes on the ultrasound who said "concerning for IBD or lympohoma. I called the specialist, a tech called me back and said she was not concerned. Now today, she said diabetes is biggest concern and she think he might go in to remission. Ok great! I said I was concerned about the IBD because I read it's not if, it's when it turns into lymphoma. She said something is going on there, but thinks it is from his allergies. I agree. She says he just had anesthesia 2 weeks ago and it would be too soon to do an endoscopy. She also doesn't want to treat what she doesn't know. She doens't want him back on steroids, and I agree to a point. She also doesn't want to dose him with cancer pills because he is already inappentant sometimes and needs antinausea meds that somethimes works, and sometimes not so much. We talked about needing Rufus to eat his novel protein, but how to we get him to do that when he is so fussy right now. We talked about some other meds for allergies and she will get back to me. Ath this point she went to go get something and never came back, a tech did. So know I asked when do we come back, when do we do testing? All I got was if he isn't eating better in a week make another appt. I know the specialsit had a million things going on, and I want to trust her, but she has so much going on that it's difficult know know the next steps. I think I would rather put Rufus on pred, calm the inflammation, get the nausea to subside, and hope he'll eat the novel protein ling enough to wean him off the pred and do another ultrasound to see if got any better.

    I want Rufus to go into remission, beleive me. But if he need pred to not get cancer wouldn't that be the bigger worry?
    Suggestions?
     
  17. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    Ok. So I finally got the report from the 1st visit today, while at the vet. Weird she would email to me instead of just handing it to me. Here is part of it:

    Diagnosis:
    * Diabetes mellitus, poorly regulated
    * Sporadic appetite; r/o primary intestinal disease (food allergies, IBD, etc), dental pain, etc, pancreatitis, etc
    From Dentistry/Oral surgery service:
    - Generalized stage 1 periodontal disease
    - Focal stage 2 periodontal disease (104, 204)
    - Tooth resorption (408)
    - Historical tooth resorption without any remaining crown and resorbing root structures (307, 407)
    - Retained tooth root (401)
    Summary:
    It was very nice to meet Rufus, he is a handsome big guy! All of his vital parameters were within normal limits and his
    current weight is 21.5 pounds. He does have some hairloss on his limbs and belly, but other than being heavy, the
    rest of his outward exam was unremarkable.
    We talked about a number of potential things that can cause insulin resistance and interfere with diabetic regulation.
    His labwork did not identify any other significant disease processes, which is good news. The abdominal ultrasound
    that was performed also did not find any significant abnormalities. The pancreas was not sonographically irregular, but
    it is possible that there is mild disease present. The difficult thing is that if the disease is so mild as to not show up on
    ultrasound, it is hard to think that it would be adversely affecting his appetite. He does have history of suspected food
    allergies, so it is not too unexpected that the radiologist felt that his intestinal tract was mildly thickened. There is no
    loss of wall layering or indication of other more serious disease, such as intestinal cancer. It may become necessary
    to consider performing a more thorough gastrointestinal work-up to definitively diagnose this intestinal thickening,
    which could be related to his sporadic appetite.
    Gastrointestinal disease can certainly have an impact on diabetic regulation, based on how much eats, what he eats
    and how frequently. His dietary intake also impacts the ability to consistently administer insulin, because we don't want
    him to drop too low. The good news is that the dose of insulin that Rufus is currently on (5 units twice daily) is by no
    means excessively high or suggestive of an insulin resistance. This seems like alot of insulin, but he is a pretty big
    guy. Often we will start newly diagnosed diabetic patients on a dose of insulin that is around 0.5 units per kilogram of
    body weight twice daily, so he may just need to have a bit more insulin to stabilize his condition.
    At this point, you have elected to have the Dentistry/Oral surgery address Rufus' dental disease to see if that helps
    with his appetite. He did have some tooth resorption and had a few teeth extracted. We are also going to send him
    with a medication called gabapentin that may be helpful if he has any pain/discomfort that is contributing to his
    symptoms. Please give as directed below.
    We know that it is frustrating to have multiple issues going on, which makes it hard to know what the primary issue is.
    If he is still having appetite issues following the dental evaluation, than we may need to more strongly consider
    additional evaluation (such endoscopy, gastrointestinal panel, etc) to see if there is anything else that we need to
    address. Rufus is really lucky to have someone so committed to his care! Please know that we are here to help with
    Rufus's ongoing care in any way that we can. Please continue to monitor him for any excessive lethargy, changes in
    appetite/water intake, vomiting/diarrhea or any other symptoms that are worrisome to you. Do not hesitate to contact
    us if you have any questions/concerns regarding his ongoing progress.

    So, this GI panel she talks about doing, is that what you had suggested before @Wendy&Neko ?
     
  18. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Neko had either IBD or lymphoma. We could not do a endoscopy or biopsy because of her heart to determine which it was. She did have the Texas AMU GI panel done. That is a blood test for cobalamin and folate levels. I don't see reference to that on the report. The GI workup they talk about sounds more like an endoscopy or biopsy which is the definitive way of determining IBD or SCL (small cell lymphoma). Don't let the word lymphoma freak you out, cats handle chemo better than humans and most SCL cats go into remission for a period of time.

    Neko was also on budesonide instead of prednisolone. It did not impact her blood sugar like pred would do. She also couldn't have pred due to her heart condition.
     
    Sean & Rufus likes this.
  19. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    Thanks Wendy. I am a little freaked out, but know they can live long with either disease. I guess my concern is her first saying nothing abnormal but then is a little concerned. I'm the type of person that like to have a plan in place. If it was either of these things I would like to get started on it asap. Thing is I've been told (not by her), to take a step back and let things happen. I'm wondering if I should push for endoscopy, of pred, or whatever right now. I'll need to call her, which is a chore, but I don't know what her plan is!
     
  20. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    Should I mention the Texas AMU GI panel to her?
     
  21. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Up to you. The TAMU GI panel should be well known. It can tell you if he needs B12 supplementation. If the vet is not pushing endoscopy yet, maybe that's a good thing.
     
    Sean & Rufus likes this.
  22. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    Hi Sean, as far as the anesthesia, back in 2015 Bubba had a dental done and extraction and 5 weeks later he had to go under again for his right eye removal. Concerned also with the closeness of the two surgeries, when I asked, the vet said he would RX at least 2 weeks between the two procedures and we had 5. But, I am sure that with ECID that advice might be different.
     
    Sean & Rufus likes this.
  23. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    Yeah, I can't tell if she is concerned or not. I read she didn't think it was cancerous, but I do know IBD can turn into cancer. And him eating food that he is allergic and/or intollerant to isn't helping the situation. But this nausea isn't going away. I tried blaming it on being in better numbers, but he's been here for 2 weeks now. I guess we'll see where we are in a week.
     
  24. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    That is good to know. I'll see where we are in a week and talk to her again.
     
  25. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    He's on ondan and pepcid today, and tomorrow will be on ondan pepcid and cerenia. And he'll still be finicky and nauseos I bet :(
     
  26. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    Rufus didn't have a whole lot to eat at PMPS, maybe 50 cals and 4 treats. Now at +2 is 59. Gave him FF gravy. Guessing he'll lick all the gravy and leave the bits as he has never eaten them before. Gonna give a couple more treats too to get him up.
     
  27. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
  28. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    Hi Sean,

    Sorry Rufus is still not eating well. I hope you find a novel protein he will eat. I know how frustrating that can be. We tried it with Harvey, and also with my civvie Sasha, who we thought had food allergies (turned out she didn't).

    Regarding Pred - if there is a possibility that a biopsy may be performed later, you want to avoid starting Pred as it an affect the results.

    Harvey had intestinal lymphoma and it was in remission at the time he crossed (from CKD). He was on Pred (which caused his diabetes) and Leukeran/Chlorambucil. He tolerated it fairly well, but I did have to give him Cerenia, Ondansetron and sometimes Cyproheptadine to keep him eating. When his Pred dose was high, he ate well, but we reduced it after his FD diagnosis, and that's when we had to add in the Cypro. Just thought I'd share my experiences.

    Is this specialist in Internal Medicine? I'm glad she isn't trying to micromanage the FD for you!
     
    Sean & Rufus likes this.
  29. Sean & Rufus

    Sean & Rufus Well-Known Member

    Joined:
    Jan 10, 2018
    Hi! Thanks for the info! She is in internal medicine. She seems pretty sharp, but what do I know. Rufus used to throw up almost every other day starting about 6 years ago and that kind of slowly went way down, to last year or 2 not throwing up at all. But about 4 years ago came the severe licking and scratching. He always ate well. Then last August it started to go down. So not sure if it was from the IBD/Lymp or from his bad dental. Problem is since FD diagnonis in Novermer, he has been eating foods that I am totally postive contribute to the food allergy/intolerance. But now we're at the point where he won't eat anything but the fancy feast. Rufus was on a very low dose of pred from Sept to to his FD diagnosis. He did not lick at all, but still had the eating issues, which probably was from the dental.

    I think my plan is to see how he does the rest of this week (even though I already know the answer), and then make another appointment with her. Whatever is going on, it has been going for far to long. We need to make the next step. She did say that she sees a suture from his dental still there, and then dentist did say before that a suture could cause nausea?
     
Thread Status:
Not open for further replies.

Share This Page