Pig 8/09 pmps 69

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by LuvinThisPig, Aug 9, 2018.

  1. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Yesterday's

    Has it really been 2 days since my last post? Ugh... Things have been nuts. New classed and corporate politic games at work. I have also been pretty involved in Pig the past few days. These ups and downs are baffling me. I still am not certain if it is bounces or constipation.

    However, it seems that constipation fits a bit better. I mentioned a while ago that the lamb just seemed harder for him to process, but I had not noticed any real signs of it being overly constipating until the other day. I started giving Lactulose and we have been seeing some really good results. His vet has him on 1.5cc BID, but I have been giving 1cc every 8 hours to spread the dose out a bit and it is working great for now.

    In fact, he is looking a bit slimmer which tells me that he was getting backed up some and now things are moving out. Also, his numbers have been sliding down more today (the first day on 3 x dosing of Lactulose).

    From now on, I am going to just verbally threaten a dose increase... I had just decided to up him to 9.5u because I was not seeing enough green action on the dose when he decides to give me a preshot of 69. So, down to 8u. It may have been premature and I might have to take him back up, but at this point better safe than sorry.

    Maybe the constipation from the lamb has been masking his need a bit or maybe he is just hitting another reduction period. He does seem to run a bit higher right before a bout of decreases. Ahhhh.. But, so much of this is only conjecture and filling in the blanks. I don't have to know exactly why, just how to manage it appropriately. That silly Pig. Keeping me on my toes.
     
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  2. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Oh! I recently got a script for the Assisi Loop to see if it can be used as an effective adjunct therapy for pain in Pig.

    He needs a bit more pain management, but the other pain options out there are less than ideal. Bupe is constipating so might not be the best choice for Pig. I will not do Tramadol and NSAIDS are not widely accepted as a pain option for cats in the US, although I have heard of them being used with great success in the places like the UK. Either way, this seems like it might be a good option given it proves efficacy.

    I will continue his Gaba, Adequan, GLM, and Fish Oils - Only use the Loop in conjunction.

    I am curious... Has anyone here tried it and to what results? How long did one loop typically last? They are a bit pricey, but if they can accomplish all they say they are worth the cost.
     
  3. Amanda & Shmee

    Amanda & Shmee Member

    Joined:
    Feb 18, 2018
    Wow nice greens pig :D I am glad the Lactulose is working for him, excellent job mama bean :smuggrin:
    PS - I know this is late but I hope your finals weren't too bad!
     
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  4. LizzieInTexas

    LizzieInTexas Well-Known Member

    Joined:
    Jul 25, 2016
    Just throwing this out there but Gizmo gets Torbugesic (Butorphanol) for pain. It is considerably less expensive than Bupe but seems to work well for him (this bottle was ~$60). I had one small bottle that lasted over 18 months (dosing is/was very small). I recently ran out and the new vet tried to duplicate the strength of the first bottle (the original bottle was compounded/mixed by the vet that dx him with pancreatitis who left the field of veterinarian). This new batch seems to be a bit stronger so I have had to play with the dose but I think I now have it - he gets 0.05mL - a very teeny tiny amount. It is a liquid and is syringed into the cheek pouch (when I can get it there). Any more than that and he is completely spaced out - but now that I have figured out the "right dose" it seems to really be working well for him. With this very small dose I am now giving him he only has a short bit of grogginess. I do not notice any (worse?) constipation on it.

    Since he has been "off" this past few days/week. I have given him a couple of doses because I am never sure exactly what I am dealing with - with him. Last Saturday (08/04) PM (@ +4.5 after his last wet food snack) I have him 0.05mL (look at his cycle 08/05 AM). I gave him another dose last night (08/08) @ +4.5 PM - look at his numbers this morning :eek:. I am really not sure if it is pancreatitis pain or arthritis pain - he is laying down more gingerly so it could be either, but after giving him the meds he acts like there is NO pain. He plops him self down, jumps on the couch, bed, dresser, runs down the stairs and goes UP much easier. Of course, I am very conservative with pain meds (rx), less so with the nausea meds (he gets Cerenia and Ondan daily) and he gets 1/2 capsule extra strength Canna Companion AM&PM daily. As far as the "short-lived effects" they talk about in the article - I may try giving it to him on a more regular basis but for now it is just "as-needed" and that seems to be working for him. I got the rx filled through Diamondback (online) and is sugar free and liver flavored (many flavor choices).

    https://www.drsfostersmith.com/Rx_Info_Sheets/rx_butorphanol.pdf

    https://www.vetinfo.com/cat-pain-relief-torbutrol.html
    05dose.JPG
     
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  5. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Thanks Amanda! Yes, they went fabulous! I was a bit worried after last semester... I had to call off a few classes because of our trip to WSU. I have a 3.825 GPA with only 2 B's in my whole academic career, but the classes I took during our trip (did online for travel) were not looking anywhere near as nice. I had to really ramp things up for this semester. I take accelerated courses, so that means a typical 4 month class is only 2 months. Which means a LOT of busy work and reading! Good thing Pig likes me to be awake at night! :woot:

    How is Schmee? But, really... How are you? I know the nerves are setting in this close to the big day. Just know we are all here to support you and Schmee! You are making the best decisions! :bighug::bighug::bighug:
     
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  6. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Once again you are full of amazing advice! :bighug: I never even heard of this. Apparently, neither has my vet because she never even suggested it. I wonder if it is just a difference in compounds that avoids the constipating factor?? I will read this article and do some digging around to see what I can find. He certainly needs more pain management. He does that ginger ploppy thing you described in Gizmo. He is also so careful in the LB, sometimes sitting down before mustering the courage to give a good push. I will say this, though... I tend to lean on the side of pain over weakness because I have seen him do some pretty amazing things when food was involved. Like jumping to the top of the water heater :eek:! But, he still favors those back legs. Everyone just writes it off as a side effect of his unique neurology. I agree, he has some neuro issues, of that I am certain, but I am not convinced that those back legs are all due to Manx Syndrome. He has been walking on them his whole life. Consequentially, he has been a Manx his whole life as well. I do see some shape variances in his spine about 2/3 down from the base of his skill. He is super sensitive there as well. I am leaning more to developing arthritis as a cause for his favoring those legs. Meaning, pain management and rebuilding atrophied muscles from lack of use, not chalking it up simply to neuro issues that can't be addressed.

    I tend to agree with you. It certainly seems as if Gizmo's pain is influencing his numbers. I have seen it time and time again in Pig. This bout of constipation is a great example. Abdominal discomfort kept him in the 300 ranges on a dose that hypoed him out last night once the constipation was resolved. With Pig so much is diet and consistency. Maybe Gizmo is reacting similarly? I am not sure, but arthritis does a lot as well. I noticed when I was out of Adequan for a month and could not afford more... :( Pig was not a happy camper and his numbers spoke to that effect. I know you added the GLM in, but have you considered the Ultra Pure MSM Powder from Holistic Horse?
     
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  7. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    So, I learned a very valuable lesson last night and even though it was awful, I gathered some great data about how Pig works.

    Well - for starters, he began to immediately decline in numbers with the Lactulose, telling me that he was, indeed, a bit constipated. Or rather, passing of even the slightest solid poo is a discomfort and overly difficult to his gi.

    I have also maintained that the honey I use to bolster BGs in the event of a hypo was causing some gi distress. Last night when he slid into a 59 at +3 before his cycle even began, I gave a even 1/4tsp of honey - much the same as I normally would. Well, his glucose shot up over a 100 points :eek: and he became immediately lethargic and nauseous. He started drinking water like a mad man. I could barely rouse him, but he was still down to gobble some food if I brought it to him. This increase and behavior hung around for about 2 hours and I was really starting to worry. He was acting like he did when he ate that dirt!

    At about 3 hours after the honey he started to feel better and his numbers started to come back down. His cycle was kicking in, but his behavior was what told me the story. I continued to test and check all night. At +8 he went hypo and I, again, gave a bit of honey. I know - after the first reaction I should not have done this, but I needed to know if it was actually the honey or something else as he got more food than he normally would have (the distress could have been an overly full tummy). It was not even 30 minutes post second honey administration that Pig puked his guts up! :eek: He did not even throw up with the dirt! He has not thrown up in I can't even remember how long.

    What this tells me is that when it comes to his gi I am right on track. He has sensitivities or rather, adversities to change, and the longer I continue a random addition to diet without proper acclimation the worse his reaction to the addition becomes. It is cumulative. All of this sits very inline with a dx of IBD. For Pig, it is consistency and biologically appropriate diets that are the trick.
    The problem now is that I have to find a way to bolster his BGs without inciting a reaction. I am going to try plain jane sugar and see where that goes... Unless someone has any other suggestions… Because I am open to any at this point.
     
  8. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    Corporate political games - yeah I dislike them too. There are fewer of them in smaller companies, but politics seem to be in every group.

    Pig is doing pretty good. That is too bad about his hypo. It seems Pig and Leo are synched, since Leo had an almost-hypo today (57 on alphatrak2). If you gave me some honey, I would probably feel kinda bad too...although not that bad since I really like honey. Especially Tupelo honey, yum.

    For Leo's SCL, we give daily pred. It can have some bad side effects. But for Leo it provides good hunger, and good intestinal relief. Just saying.

    Hi Lizzie - I like that syringe pic. Too bad we can't have those for U100's!!! That is a nicely designed syringe.
     
  9. Amanda & Shmee

    Amanda & Shmee Member

    Joined:
    Feb 18, 2018
    Haha wow that is a lot to handle! I HATE not getting sleep, I don't know how you do it! I am glad it went well though for you and they are over with!
    Shmee is doing well other than not really much of a big appetite lately. It's not significant and he also gained weight (up to 15.9 last vet visit from 15.5 about a month prior) so hopefully he is fine just being picky. I am ok, I will be a lot worse in two weeks when it starts to feel more real. I'm still doing lots of online training for the new second job (Disney travel agent, woo!), and I am super curious to see how it's going to pan out. I now Disney World pretty well but the selling part is making me nervous. I am excited to give it a try though :) I have a big to do list for what to bring to NY. I skimmed the "how to travel with a diabetic kitty" when you or Wendy linked it, but I am planning on starting to really go through it tonight. He likes his crate already, I have it set up in the dining room and have caught him napping in there a few times. I also ordered a harness for him, it came today but it was too big so I am sending it back for the next size down. He has never been on a leash before, and I really don't know if I am going to take him out during the ride at all on the way there, but I thought I should have it just in case, especially for the ride back since that will be during the day and he will probably be more ancy then. All in all I just hope he does well, I am the most worried about him. I still have my doubts but overall I feel like I am doing the right thing... It helps to have this community for support.
     
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  10. LizzieInTexas

    LizzieInTexas Well-Known Member

    Joined:
    Jul 25, 2016
    I just grabbed that off the internet but it is very simular to the one I am using. It came with the meds, no needle. The bottle is awesome too. It has a one-way rubber "valve" on the top that you poke the syringe into to pull the dose. No spills!
     
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  11. LizzieInTexas

    LizzieInTexas Well-Known Member

    Joined:
    Jul 25, 2016
    I am finding all kinds of things tonight.

    http://www.felinecrf.org/treatments_general_health.htm#arthritis_physical_therapy

    .
     
  12. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
  13. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Was Pig showing signs of hypo, or was it just a low numbers event? My non diabetic civie tested at 49. We just don't want cats on insulin to go below 50. But ECID, and for some cats that is too low. We have seen the odd cat here show hypo symptoms at higher numbers. Then there is Neko who was often sleeping in the 30's and even 20's. :rolleyes: Thankfully not a lot of data points on that latter one.:eek:

    Congrats on the reduction. I hope you can solve the input problems. Remind me, did you try potato flour for HC?

    It definitely sounds like Pig is showing the classic acro arthritis symptoms. :( The Assisi Loop sounds expensive for something that might work. Can buy a lot of Adequan for that. I was giving Neko a product with MSM in it for a while, but after a while it wasn't enough.
     
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  14. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Actually, Pred was the go to for kittehs with IBD because of its soothing effects to the gi. However, much of the current and upcoming research points to healing the gi as a long term solution. As in, treat the problem and not the symptoms. Now, for Leo, it is absolutely different and necessary. But, for Pig at the moment it may not be the best solution. His vet wants to go through all our options before considering pred for him. Really, we have made tremendous progress with his gi system. His poos tell me this. There is a mass amount of research and evidence that point to a raw, biologically appropriate diet and probiotics as being healing for the IBD kitty, but you cannot make changes overly fast.

    I was actually researching raw diets and IBD long before the Acro and diabetes dx. I had always been slightly suspicious of it owing to random bouts of foamy spittle throw ups. Typically, when we see this in a kitty it is because 1) they have acid on their tummy or 2) their colon is flaring up and causing some distress. For Pig, it was his colon. So, I started to research how to meet that issue and everything I could find led me right back to raw. My issue was, until I found onlynaturalpet.com, I did not have a reliable source of meat. Of course, I am learning how to shop and prepare meat from local supermarkets now and that has helped a ton.

    It is so sad, especially considering how a little transparency can go a long way to bolster a company and likewise, strengthen the loyalty and production of staff....
    I have half a bottle of dollar store honey I will send you... Actually, my Dad raises bees. If you like honey I could see about getting you a bottle and send it to you! Seriously... Would you like some OK native honey?? Fresh from the farm?
     
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  15. PussCatPrince - GA

    PussCatPrince - GA Well-Known Member

    Joined:
    Nov 25, 2017
    :nailbiting: am now allergic to bee stings......and hair dye as a by-issue.

    I could send Mānuka honey. Sposed to bee <--- see what I did there - rather specialistantistic.
     
  16. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    Let me know if you want a primer on clicker training! I would love to help. It might provide a good outlet for some pent up anxiety for both you and him. Plus, it works great to teach a lease. I have Pig 'trained' to do all sorts of things, but not in the way most think. For me, the clicker is a way for me to communicate with Pig and Pig with I. Its also a way to keep him safe. If you watch the VLog, you will see in several of the videos that when Pig is on the lease he will always move back towards me. That was part of his initial training. I also have a recall command set up so that if him or Tail bolt I can issue the command and they will return. Its about communication and safety. Yet, for Pig... Its all about those treats! :p

    You will always have doubts, but you ARE doing the right thing. I do not think the reality of the thing sunk in until we were actually on the road. After we got home it all seemed like a dream because, for a while, nothing changed. Yet, every time we hit a reduction it becomes that much more real. When all of this is said and done and Schmee is healed and healthy, you will look back with confidence and know you made the right decision. :bighug::bighug::bighug::bighug:
     
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  17. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    You know, Tail did this the other day. He tested at something like a 46, but was totally normal. No, I have not ever seen signs of a hypo from Pig except for that 36 he threw me the other week. He was very shaky and it was so scary! :nailbiting::nailbiting::nailbiting: I am just erring on the side of caution because his numbers have been a bit erratic and the lows he has thrown have happened pretty fast. At least his dips are seeming predictable around the +5 / +6 and +8 / +9 hours. Of course, he threw me that ps curveball which reminded me of pre-SRT cycles. I will just spend my weight in test strips.

    You know, this is something that Dr. Fidel mentioned. She said that a lot of research is now pointing to the fact that many cats do not even really suffer from 'hypos' and that rather than exhibiting signs they just quietly go sleep it off. Of course, this is not for all cats as there are cases that prove otherwise, but maybe some cats are just more tolerable to the lower numbers.

    I have not. I did try the flakes and then tried rice flour, but neither seemed to even make a dent in his numbers. I did the FF gravy lovers for a few times, but quickly stopped that because it threw his whole digestive (poo) process off. Now the honey is making him nauseous... I got some plain cane sugar and want to see where that goes, but it may come down to going to Walmart and purchasing the pure glucose solution they offer for human diabetics. I just do not know if that is an acceptable option for kitties...

    It is an expensive gamble, but I have a really good feeling about it. Theoretically, the science is there. Its not a permanent solution, but maybe a supportive measure to help heal some. Besides, its an early birthday present for me... :p Can't turn down a good ole fashion present. I have a good supply of Adequan and MSM, plus the GLM.. But I want to try something a little more aggressive on the healing end before we go with another rx. He is already on so many... :(
     
  18. LuvinThisPig

    LuvinThisPig Well-Known Member

    Joined:
    Dec 8, 2017
    :p:p:p I love a good pun...

    I have heard some good mumbo jumbo about Manuka. But, here in the states we just put in in our body wash... :rolleyes::rolleyes::p:p

    Yikes! This is nooooo good! Those bees can do some damage if you are allergic!
     

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