8/16 punkin amps 204 +4/34 4.5/54 +6.6/35 pmps 132

last post 8/11

we've been on quite the rollercoaster this week. i think the pancreatitis might be resolving some.

sunday morning after we'd given him his shot, he refused to eat. he was amps 93 and if he'd been willing to eat it wouldn't have been a problem. saturday he'd been eating so i didn't expect it. anyway, i took him to the vet as soon as it opened and asked for cerenia for his nausea. the e-vet told me (via the tech) that she'd have to examine punkin before prescribing, and that they wouldn't give him cerenia because he wasn't vomiting. i asked for ondansetron and she said they didn't carry that and the compounding pharmacy is closed on sundays. at that point i didn't know i could get it at a people pharmacy. the vet tech said they only had mirtz, which i didn't want to give him because it was obvious to me that he was nauseous. i said he didn't need an appy stimulant, i wanted something for the nausea. ultimately, i left without any help and poked, carbed & begged him to eat all day long. it was very, very aggravating. he'd only gotten the pancreatitis diagnosis a couple of days before that and i spent $300 there in just the previous week, so i didn't want to pay for an exam when the vet told me upfront that she wouldn't give him anything for nausea.

Monday i talked to my vet about it and am writing a letter to them about the experience. apparently that emergency vet is a co-owner.

he got fluids on Tuesday at the vet's (followed by his BG going from 150ish to 26), he's on cerenia to reduce the nausea, bupe to relieve pain, and metronidazole to kill the lingering c diff bugs.

we've reduced the dose, but it's been a bit crazy trying to figure out if shed is causing his numbers to drop or if he needs another reduction. obviously today is calling for another reduction. the poor guy has been poked a million times in the past week, it seems.

on the good side, he's definitely eating better although no CPC yet. :sad: i expect him to get back there soon, though. i've been sprinkling little bits of the fancy feast on his food to get him to eat it. he has returned to normal excitement about his beloved Pill Pockets. he has a funny MRW that he does that is only about those. stares right at me getting them ready, glances at the floor to see if he's missed one, stares back at me, lets out one MRW, and repeats til he gets his pill pockets.

he's feeling better overall also. i picked him up this morning to carry him upstairs to test him and he started purring. still won't let me just hold him, but i will take what i can get.

the fluids at the vet's went fine - he didn't even flinch when the needle went in. but i am a little concerned about when to give him fluids today, especially with him back in low numbers. i don't know if it was a coincidence tuesday that he went so low after getting the fluids or if it was a cause -> effect. so many factors at play in the little guy it's hard to know what is what.

 

Re: 8/16 punkin amps 204 +4/34

(((Julie & Punkin)))

 

Re: 8/16 punkin amps 204 +4/34

+4 :shock: :shock: :shock: :shock:

 

Re: 8/16 punkin amps 204 +4/34 4.5/54

he's coming up. it took me 1/2 hr to post because my dear daughter had to tell me in exquisite detail about her dream while i was trying to post. :roll:

i managed to inadvertently delete a chunk while trying to pretend to listen to her. ohmygod_smile

 

Re: 8/16 punkin amps 204 +4/34

Oh punkin, I'm sorry you're having such a rough time, you and your bean. Sending lots of healing energy to you and hope you feel better soon. You need to come up, though, right now!
Liz

 

Re: 8/16 punkin amps 204 +4/34 4.5/54 advice on subq fluids?

i know some cats seem to have BG drops from the sub-q fluids and some don't. i can't be sure that his drop on tuesday was from the fluids - it's possible it was one of the other factors. but i'm supposed to give him fluids today and with this morning's BGs i'm not sure if i even should or not. perhaps we should decrease his dose tonight and tomorrow morning and then give them tomorrow?

does anyone have any suggestions on that? or on what timing in the cycle would be the appropriate time to give the fluids?

 

Re: 8/16 punkin amps 204 +4/34 4.5/54 advice on subq fluids?

(((((julie)))))

since you don't know if fluids caused the drop on tuesday, i'd err on the side of caution by holding off on fluids until you're seeing higher numbers.

you can also divide up the amount of fluids you're supposed to be giving... give him half/smaller amounts at a time when you see his numbers rising.

based on tuesday's data, like you said... it's hard to tell if it was fluids or one of the other factors that lowered punkin's BGs. it's also hard to tell (based on getting fluids once) the onset of the effect from fluids. since you're dealing with too many unknowns, i'd lower the dose until you can get a handle on whether giving fluids affects punkin. you definitely don't want the drop from fluids (if he experiences one) to coincide with nadir... or possibly even onset of the insulin.

initially, you might want to administer fluids after nadir until you can figure out his reaction to fluids. he may or may not experience a drop from them. some kitties do. others don't.

i wish i could suggest specific timing, but i think this is one of those things you'll have to feel your way through.
wish i could be of more help...

 

Re: 8/16 punkin amps 204 +4/34 4.5/54 advice on subq fluids?

Sorry to hear punkin is going thorough all this, hard on both of you. I can't advise on dosing. We had 2 CRF cats we treated with fluids, Jill's suggestion to spread out the fluid into smaller portions seems like a good step until you know if/how they will affect punkin. Sending you both postive thoughts and Jasper sends punkin a telepathic suggestion on the cat channel to please get his numbers up.

 

Re: 8/16 punkin amps 204 +4/34 4.5/54 advice on subq fluids?

+5.25/34
+6/66
+6.5/35


ok, thanks for the input, jill. he keeps sliding back downward. we're an hour or so past his usual nadir and he's just now at 35.

i hadn't thought of dividing the fluids up - that's a good idea. if it is making a difference that will reduce the impact. i think i'll reduce the dose tonight and tomorrow morning and then perhaps give him the fluids tomorrow afternoon. he got it at +9 on tuesday, well past what should've been his nadir but he'd been flat 150ish all day.

hahaha leslie, punkin is very telepathic, so it just might get through!

 

Re: 8/16 punkin amps 204 +4/34 4.5/54 +6.6/35

Oh, Julie -

I'm so sorry you and Punkin are going through such a rough time. Reading about the 'help' you received from the weekend vet made me cat(2)_steam ! I hope they really read your note and take the appropriate action for the future.

I hope Punkin feels better soon and you figure out some of the variables.

BIG HUG -

Libby (& Hershey, too!)

 

Re: 8/16 punkin amps 204 +4/34 4.5/54 +6.6/35

I hope punkin is feeling better soon! poor fella! and poor Julie - all that stress!

come on silly boy, eat something. and maybe hanging out with Rupert and the bad kitties today wasn't such a good idea!

 

Re: 8/16 punkin amps 204 +4/34 4.5/54 +6.6/35

Sorry to hear Punkin and you are going through such a hard time. Hope things get better soon.

 

Re: 8/16 punkin amps 204 +4/34 4.5/54 +6.6/35

I'd have been ready to take someone's head off at the vet's office. I hope these numbers are a sign that Punkin is feeling better (although, he could be less dramatic about it).

 

Re: 8/16 punkin amps 204 +4/34 4.5/54 +6.6/35

they will get a letter from me. i was ready to take off someone's head. it took all i had to remember that the vet tech was just the messenger, but honestly, that is the first time i have ever just shown up at a vet's wanting help. i was really unhappy & angry to not get it.

the vet called late this afternoon to check on punkin, which i thought was really nice. we talked for 15 minutes and ultimately, she thought cutting his dose in half, from 9u to 4.5 or so, and holding it so he's not getting so low so often is the way to go. i am just as tired of doing the poke-carb dance as punkin is, so because he was just 132 at pmps, we dropped him to 3u instead and may come back up to 4.5 later if he needs it. i don't want to have to stay up all night tonight if it can be avoided. she thought it was more important that he get the fluids, so if less insulin is needed to make that happen, that's ok.

so . . . tomorrow afternoon we'll do the fluids if he's at least 150 around +10.

 

HEALING VINES, FEEL BETTER VINES, ALL SORTS OF VINES FOR YOU, PUNKIN!!

Your pal,
Rusty

How about some chicken soup tonight? I'll whip up a batch and be over with it later.

 

(((((Julie))))) and bunches of scritches to Punkin. You must be exhausted. I took a peek at your spreadsheet yesterday and blinked at that 26 in it. After today, the reduction sounds like a very good way to go.

Punkin eat, you've got a reputation to maintain!

 

Oh Punkin :YMSIGH: :YMSIGH: :YMSIGH:

 

We are sending heaps and heaps of healing vines to our buddy punkin. And hugs of strength to the world's best bean. :YMHUG: cat_pet_icon

 

Julie - what I was told about timing for fluids is to NOT give them within 2 hours before or after a shot. That was when we were on Prozinc, but I would assume that applies to the L's also.

Wishing you both a good day today!!!