? Should I reduce the dose?

Discussion in 'Prozinc / PZI' started by Georgiana & Perlutz, Jul 6, 2019.

  1. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Jan 24, 2019
    Oh hi, fellow cat stalker :D

    I only got 1 to see how we’re getting along with it, but a 2nd might be added soon :joyful: I have the motion sensor off for now, it makes this police siren noise when triggered and I don’t want to freak Perlutz out, I need to see if I can turn the sound off. My cam came with a cloud trial for a week and it stores all the footage but I will get an sd card instead of that (don’t want footage of my place stored on some server in China :rolleyes:).
     
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  2. Diana&Tom

    Diana&Tom Well-Known Member

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    Brilliant! I'd never heard of anyone on the board using pet cameras but it's such a good idea, it should be suggested more often :)
     
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  3. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Now... Perlutz missed another shot this morning, AMPS 5.2. WHAT IS GOING ON?! :eek::eek::eek:
     
  4. Diana&Tom

    Diana&Tom Well-Known Member

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    It looks as if his pancreas is doing more and more work as he gets into better numbers, but not enough to negate the need for exogenous insulin. Don't know what to suggest about dosing now - see how long he goes on this cycle I guess and make a call this evening?
     
  5. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    I’m lost to how he went from 29.6 to 5.2 on a lowered dose o_O

    Now me being the paranoid that I am I have to ask - can this be a bad sign? That something is wrong? I know normally it’s good that he needs less insulin, but the way it’s been happening the last few days is a bit weird, no?
     
  6. Diana&Tom

    Diana&Tom Well-Known Member

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    It is a bit weird I agree but it could be due to something not bad like a combination of things in terms of the way he's responding to the different doses whilst also producing some insulin of his own. Maybe the inconsistent doses and lower bgs are unsettling him a bit. I know that's no help at all so see if others have any ideas. He's otherwise ok, isn't he? Any more poop colour issues?
     
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  7. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Hasn’t pooped since Friday (it’s his new normal not to poop daily ever since changing to an all wet food diet back in Jan).

    He seems okay, nothing that concerns me. He is his usual lazy ass, sleeping most day but if he is awake and I bring out some toys, he plays. He has been eating normal, yesterday even started meowing demanding dinner right then and there. He goes and chills on the balcony when it cools down in the late afternoon/evening. His head feels a little warm this morning, but that’s it...
     
  8. Diana&Tom

    Diana&Tom Well-Known Member

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    I guess all you can do is keep your usual close eye and see if things start to even themselves out at some point... trouble is FD and insulin dosing is never going to be an exact science, which is why this board and the Facebook groups are always so busy!

    See what others say and meanwhile hang in there. I'm sure you'd know if something was really amiss but for now if it's really the erratic bg that's worrying you, put it down to the nature of the beast...
     
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  9. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    @Marje and Gracie Done! I updated both 12th June results and 1st July.

    The tests done in July weren’t recommended by vets, I asked to repeat the kidney profile to see if there are any changes since the previous one. And there are some changes but the tests weren’t done at the same lab.

    Thank you:bighug:
     
  10. Djamila

    Djamila Well-Known Member

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    Hi there! I'm on vacation, so I've been in and out of town a bit. Loving the break from technology, but sorry to sort of be abandoning ship a lot recently. On Prozinc, when you see long cycles with the nadir around PS time, it often (though not always) means that the dose is too high. The high numbers after skipped doses mean that Perlutz isn't ready to go it alone yet. So it's a matter of continuing to lower the doses until he evens out a bit, and then you might need to raise a little from there.

    You might go ahead and drop down to 1u and see if that helps since even 1.5u is looking like too much. It's just going to be some guessing and trial-and-error for a little bit, so hang in there and try not to stress too much about the seeming randomness. Cats go through periods like this where they get kind of rocky and hard-to-predict. He'll settle down in a little bit :bighug:
     
  11. FurBabiesMama

    FurBabiesMama Well-Known Member

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    I don't know what kind of camera you have, but I have all sounds disabled on mine. It has options for a siren, a barking dog and something else that I cannot remember right now. It also has an LED indicator light on front of the camera that I disabled. I can set three motion zones, and it starts recording (no sounds) when there is any movement in those zones. I have an SD card. I am 100% with you on not having any footage stored on a server somewhere. Since there is an app that I can access the cameras with, I know the potential exists for someone to 'hack in' and look through my camera, but I take the risk for the benefit (and the camera is not in an area where anyone would see me in any compromising position anyway). I could listen in through the camera or even talk through it, but I have both turned all the way down to mute and do not use it for that. (It seems to me that talking to the cats when away is sad. I know they would start looking for me and would not understand why they heard me but cannot find me.)

    I read over this full thread and took a look at your spreadsheet, and here's my two cents. When I start seeing a lot of volatility in the numbers - ping pong ball, all over the place numbers with extreme highs and lows and pre-shot numbers where one is high and the other is low enough that you cannot shoot or have to lower the dose - I tend to think it's important to calm things down. I would much rather see you giving a dose that you can give consistently rather than adjusting the dose based on each pre-shot. Sure, there are some cases where a sliding scale may be the best option, but I would dare say that that is not the norm. Consistency normally goes a long way in helping calm things down, even things out, especially if any bouncing is factoring in. Bounces can take several cycles to clear and can make the numbers 'crazy'. Having the dosing go up and down during that time and having to skip doses just feeds the volatility. It definitely looks like you may have hit some breakthrough point (maybe dropping the food with sugar and/or the SEB working contributed to that). So, this is great.

    It is hard to make a call on dose right now with the last few days numbers being cuckoo, but I lean towards no more than 1.5. You gave 1.75 two nights ago on a high pre-shot number. I understand totally why you did not give anything the next morning, but now, with the benefit of hindsight, it would probably been fine to give a shot. Since you did not, the PMPS was very high. You gave 1.5. You ended up with another low AMPS today, but again, with the data you have, it appears that it would have been fine to give the dose rather than skip. Let's see what this evening's PMPS is. I would expect it to be high. If it is, I think I would give no more than 1.5 then hold whatever dose you choose for at least three/four cycles to see what happens (with Mia, I found that it actually took 3 to 4 days to see the true impact of a dose; she was a bouncy girl). On the other hand, if the PMPS is not high, that changes things!
     
  12. Djamila

    Djamila Well-Known Member

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    I'm also in the spy-cams camp. It started when I was traveling more for work and was spending too much time worrying about Sam. Huge relief to be able to see that he was eating and resting and playing and doing just fine without me for a few days here and there. Now that I live in a house, I also have a full security system. Sam is quite vocal, whether I'm in the house or not, so a couple of times I've received a fire alarm or carbon monoxide alarm alert from the security system only to look in on the camera and discover that Sam is "singing" on a windowsill. Apparently his caterwauling hits the same pitch as the alarms do! :rolleyes:
     
  13. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    I decided to go for 1 unit tonight. PMPS was 20.5 which, although high, it’s not that high after a missed dose I think? Anyway, can only wait and see now. I’ll test again later, around bed time, and maybe I will manage to get some more during the night.
     
  14. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    I know it’s a little sad but I will need to use this option. When we are out, he sleeps most of the day and even if he does move from room to room, he doesn’t eat from his automatic feeder and I’m trying to get him to. Now I can come at lunch and feed him so it’s not bad, but I’m about to go away for 11 days and, ideally, he will start eating from the automatic feeder if I call him through the camera.

    We went out for lunch today and we’ve been stalking on Perlutz a bit. He has been sleeping and having a little spa time on top of the bed and that’s about it. Such a hard life:D
     
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  15. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Love this :D We live with a furry Pavarotti, he can get quite vocal and his meows are not cute, little squeaks but deep mawwws and he looooves waking us up to the song of his people at 3-4 AM when he goes for a poop:eek:

    Have a nice holiday :cat:
     
    Last edited: Jul 14, 2019
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  16. Diana&Tom

    Diana&Tom Well-Known Member

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    Hahaha!!! Glad your sense of humour is intact amid all the serious number stuff! You're handling all this so well and I do think you really are starting to crack the code now. Perlutz is very lucky to have you!
     
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  17. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Thank you, Diana! :bighug: Although his numbers are not perfect, they are probably the best he’s had and he seems fine, doing his usual cat stuff and it does make me happy and stress less. Happy kitty = happy hoomans :D
     
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  18. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    His June labs show him concentrating his urine really well. Normally when we see an elevated creatinine and BUN, we see if the urine specific gravity is low. If it is, it’s potentially an early indicator of CKD. But his urine was very concentrated in June.

    There is no USG for July but his SDMA is normal even though his creatinine and BUN are elevated. I don’t usually get too worried about elevations in BUN but his elevated creatinine is odd. Dehydration and certain meds can cause elevations in creatinine. The trend is upward, though. It would be interesting to see his USG now.

    I know you did a lot of work loading those labs but we usually put them all on the same sheet. It makes comparing them and looking for trends so much easier. If you look at my Gracie’s lab tab, you’ll see what I mean. If you are very good with SSs, you can cut and paste the columns so they are all on one tab.
     
  19. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    I'm such an idiot, I can't believe I've spread that over 3 sheets :facepalm: when it makes so much sense to have it all in one doooh :banghead: I'll get it sorted soon!

    I'm still not sure what to make of his latest labs in July having a normal SDMA but urea and creatinine still elevated, the vet was rather vague too when he gave me the results - whether it is early ckd or not so maybe it's worth asking for urine tests again.
     
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  20. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Sorry I have been MIA the last couple of days...

    I've skipped yet another dose this morning... After seeing him in pinks and reds for 2 cycles, I think I got a little bit scared that they're back and staying so I went from 1 unit to 1.25 and BAM, blue AMPS :oops: I don't think it was wise to up the dose yesterday, but I think it was the right decision to skip the dose this morning seeing that he was 10.6 at +7 after already having some food 30-60 min before. I'm guessing it will be a 20-25 PMPS but I'll stick to 1u.

    The vet will call later today, he has the results for acro :nailbiting:

    IGF-1 negative
    IGF-1 negative
    IGF-1 negative

    C'mon quantum physics!
     
  21. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Fingers crossed here too for negative IGF-1! I think trying 1u for now is a good idea. He seems to be all over the map BG wise. o_O
     
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  22. Diana&Tom

    Diana&Tom Well-Known Member

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    Ohhhhhhh let us know what the acro test result is. It will certainly be helpful to know one way or another. I keep changing my opinion about the possibility but that counts for nothing of course... let's hope you can rule it out and we can stop wondering.

    I'd say your dosing decisions are sound and no-one could blame you for giving a whole quarter unit more than plan when he went high yesterday. All our instincts say "high number, more insulin" - it's hard to get out of that mindset!
     
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  23. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    I’m hoping the IGF-1 is negative. I think, but would have to verify, whether acro can result in increases to creatinine.
     
  24. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Negative for acro! :bighug:
     
  25. Diana&Tom

    Diana&Tom Well-Known Member

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    Well that's great - breathe a big sigh of relief! Acro can cause wacky numbers like Perlutz has been getting, but now you know they're not caused by that you can carry on as you are in the knowledge that your hard work is not in vain and that you ARE making progress!
     
  26. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Yes, it’s a massive relief to know that he doesn’t have it! This and the change in numbers from the last days give me hope, I feel less like Sisyphus and more like we’re going in the right direction :cat:

    His BG went all the way up to 34.2 but gave him 1 unit still. I’ll try to stick to it for a couple of days and not give in the temptation to go 1.25 again.
     
  27. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    smiley-dance013.gif So glad to hear IGF-1 was negative. smiley-dance013.gif

    It really looks like the ideal dose for Perlutz is going to be somewhere in the 1.25 to 1.75u range. If he stays in the black, I'd increase to 1.25u if you can monitor the cycle. You can gradually give the dose at lower pre-shots again when you can monitor. He's definitely being dramatic so all you can do is take it slow. He hasn't been going too low but low enough you can't be sure if it's safe to give insulin. A bit of head scratcher so just take it one day at a time.
     
  28. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Hi Linda,

    He was on red again this morning but I gave 1 u. Do you think I should stick to 1 for a couple of days before going to 1.25? I can only monitor him in the evening, during the day I can only test once at lunch and then I'm gone again for another 5 hours or so :(
     
  29. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    It looks like that black last night was possibly some bouncing. I would stick with 1u for a few cycles to see if he settles more before raising the dose.
    Come on Perlutz......let's stop with the dramatics! :D
     
  30. Georgiana & Perlutz

    Georgiana & Perlutz Member

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  31. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Oh he's a Copy Cat! :woot::woot:
     
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  32. Djamila

    Djamila Well-Known Member

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    First of all, hooray for the test results!

    Looking at the recent data, and that you've been on Prozinc since February, I think it might be time to start talking with your vet about a longer acting insulin. It can sometimes be a bit of a process to convince a vet to try Lantus or Levemir, so it may be worth starting the conversation now, and doing some reading about them yourself if you haven't already. I haven't fully given up on Prozinc for Perlutz, but it's not getting the kind of results I'd like to see at this point, so I think opening the conversation could be a good idea. Then if we suddenly start seeing more stability, you don't have to switch, but if this inconsistency persists, you'll be better positioned to make the change. Just something to think about....:bighug:
     
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  33. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    I haven't had the conversation about Lantus or Levemir yet but I've been told by someone that our vet doesn't prescribe them. If that's the case, it might be a tricky one...
     
  34. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    So my little darling has been sleeping all day, ignoring his automatic feeder but just now he woke up and went and ate everything :facepalm: Luckily, it's not too bad timing for the test and insulin shot, only 10 min or so pheww
     
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  35. Diana&Tom

    Diana&Tom Well-Known Member

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    Well it's pretty warm today so if I was Perlutz I think I'd be sleeping most of the day too :)
    Still think it's so funny that you can spy on him via the camera!
    What was his pmps number?
     
  36. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Another red, 26.4 and I gave him 1.25.

    I can’t blame him for sleeping all day long, I was a little bit jealous of him all sprawled on the bed while I was at work :D I saw he hasn’t touched his food so I thought I’d try calling him through the camera and get him to go and eat but nope, he lifted his head slightly for a moment and then went back to his sleep :oops:
     
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  37. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Ladies I did a big booboo this morning - I forgot to tell my boyfriend I increased to 1.25 from last night and I woke up late today after he already gave Perlutz his insulin and he gave 1 unit :banghead: :banghead::banghead:

    He was still high this morning, mid twenties, despite the increase yesterday. What do you think I should give tonight?

    :bighug:
     
  38. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Don't beat yourself up. We've all done fur shots, slept through shot time, left filled syringe on the counter.....you name it someone has done it! BUT I would strongly recommend you come up with some kind of communication between you and BF to ensure there is never an occasion when Perlutz accidently gets his shot twice and perhaps that could also keep the dose information current.

    As for tonight, I am not sure if Perlutz might be bouncing from those blues and that can last for 6 cycles or more in some cats. The 1.25u and above seems to push lower BG out into the next cycle. While those numbers aren't too low, they were keeping you from being able to shoot twice daily consistently. It could also be that Perlutz was bouncing there and the bounces were breaking making it look like longer duration of the shots. I think I'd be inclined to try the 1u for a few cycles (changing according to pre-shot can muddy the picture) and see if he comes down anymore then if need be you can take him back up to 1.25u. Increasing doses when kitty might be in a bounce can lead to a vicious circle ups and downs.
     
  39. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Jan 24, 2019
    We never give insulin without checking with each other and we talk about the dose too but this time I forgot to tell him :(

    I gave him 1.25 in the end and he is still in blacks :facepalm: He started drinking more water, peeing more and he is very hungry all the time (all these improved when he had those lovely numbers). Tonight he ate his dinner like a pelican, I've never seen him eat so fast o_O and then he threw it all up :facepalm:

    I'll try to get some mid cycles tests tonight, see what's happening. I miss those yellows and blues :arghh: :arghh:
     
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  40. Diana&Tom

    Diana&Tom Well-Known Member

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    Awwww yes such a shame to see these high blacks again after such a nice run... I'll leave the real dosing suggestions to other people but it may yet be a question of a sliding scale of sorts, to try and even out the numbers without going too low to shoot. That may or may not be something to consider for the future.

    The drinking/peeing/hunger is all indicative of high bg as you know, and should all settle down once he's in better numbers again.

    Hopefully you can leave for your trip with some very specific guidelines for your bf to follow... and will he be able to update your spreadsheet as well, just in case you have a dilemma and want to post here for advice?
     
  41. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    I will ask him to update the SS daily and I’ll be posting updates. He will have access to FDMB as well but it will probably be posting :p
     
  42. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Arghhh there’s a sh*t festival in town and they have fireworks 100 meters from us :mad: Poor little thing is hiding under the table and he’s stressed and scared :arghh: Why aren’t they banning these things already :mad:
     
  43. Diana&Tom

    Diana&Tom Well-Known Member

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    Ugh, I don't like fireworks myself and I completely sympathise with animals having to live through all those horrible loud noises... what I usually do if there's something going on around me is to put some nice soothing music on loud, in the hope that it might drown out the screaming of the rockets etc, both for my benefit and Sapphire's who is rightly terrified... it goes at least some way to making the sounds less scary.
    So as stress is known to raise bg, it's not surprising that you're seeing a higher number this morning as he's probably still unsettled... hopefully he will relax and have a nice quiet day. Come on Perlutz, let's see some of those nice yellows at least - you can do it!
     
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  44. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    @Diana&Tom I'm sorry I didn't reply earlier, I must've switched off notifications...

    I do the same, play music or just put the telly on a bit louder to make the noise more bearable but these fireworks were the loudest we've had (it's a yearly
    waste of money this festival :banghead:)

    Perlutz has been in constant high numbers so after few cycles on 1.25 and no improvement, I went with 1.5 units tonight. I hope this will bring it a bit lower but still give 2 shootable numbers. C'mon Perlutz, bring on the yellows!
     
  45. Diana&Tom

    Diana&Tom Well-Known Member

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    Oh crikey Georgiana, no apology needed! I was just rambling anyway (as usual!)

    Gutted to see Perlutz in these high numbers again after such a nice little run but yes, let's hope the 1.5u might bring him down to a better number tomorrow. And I know you're off on your trip in a day or two so I really hope you can leave knowing that Perlutz and bf can manage without you while you're away.

    COME ON, PERLUTZ, BEHAVE FOR MAMA!
     
  46. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    You tell him, auntie Diana :smuggrin: He listened to you before so maybe he will this time too hehe

    I’m off on Wednesday morning so I’m trying to sort out the boys tonight (lists, addresses and phone numbers, supplies etc) so I can pack tomorrow. I’m always last :D
     
  47. Diana&Tom

    Diana&Tom Well-Known Member

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    I will be willing your two boys on mentally from afar, Georgiana! ;)

    I'm sure they will be just fine so you enjoy your trip - you deserve it! Do tell bf though that if he's stuck and can't get hold of you, he can always post here with any questions :)
     
  48. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    I will tell him to post if he's stuck on anything. But I will be posting updates if there's anything to update on (maybe some yellows?) :bighug:
     
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  49. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Ughh what is happening +3 still 29.9 :confused:
     
  50. Djamila

    Djamila Well-Known Member

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    Yikes. Those numbers are icky. Sometimes kitties like to slide up and down on the dosing scale, so looks like Georgiana is simply in need of more insulin again, and after some increases, will likely be in need of less insulin. It's often said around here that it's a dance, and only the kitty can hear the music :). We just have to follow along the best we can.

    Have a good trip!
     
  51. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Very icky numbers :arghh: He was still on 28 this morning, despite rising to 1.5 units last night. Should I continue with the same dose for 3 cycles before another increase?

    I’ll be home for his PMPS and AMPS tomorrow and then the boys are on their own :smuggrin: I’m sure Perlutz will miss me, but I’d be flattering myself to say he will be stressed and have a BG spike :D No comment about the bf haha
     
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  52. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Ladies do you think I should ask bf to rise to 1.75?
     
  53. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Oh my that is quite the change for Perlutz. Yes I would increase to 1.75u and see if that helps get those numbers down some. Anything changed that might have caused the higher BG? Did you leave your suitcase laying around and stress the poor guy out? :woot: How is his demeanor these days?
     
  54. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    We did slowly introduce a new food, low carb and better quality (Nature’s Menu Country Hunter) but this was when the numbers already started to go up and it was fed along the food he was already eating. We introduced this food as he tends to get bored easily and the one he was already on has mostly fish flavoured cans. But being low carb, good quality, no sugars it shouldn’t increase his bg like this, no?

    With all the blacks came the hunger too and sometimes thirst. He is hungry all the time now, poor thing :(

    Other than this, there have been no changes and he is still very much lively and his usual self. Surprisingly, he didn’t even pay attention to my luggage (which I left for the very last minute this time, to avoid him getting stressed). As crazy as it might sound, I think he knew it’s just me leaving :D

    It was very hot yesterday and bf worked from home and gave Perlutz a nice ice pack massage which he really enjoyed I’ve heard. I asked him to start on 1.75 units from this evening and to check him BG before bedtime. Hopefully we will break the blacks again!
     
  55. Diana&Tom

    Diana&Tom Well-Known Member

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    Dec 29, 2009
    The NM shouldn't make any difference unless there's something unusual in it that happens to cause spikes for Perlutz. These are the ingredients of the chicken variety (there are others I know):

    Chicken (75%), Chicken Heart (21%), Raspberry (1%), Cranberry (1%), Spirulina (0.5%), Catnip (0.01%), Yucca Extract, Green Tea Extract, Grape Seed Extract, Rosemary Extract

    Is it possible to look back to when you started feeding NM and see if that coincided with these high bgs? What looks fine at first glance just could be the culprit I suppose.

    Did you say you were due a new insulin vial soon? If so it would be interesting to see if that has the usual mysterious effect and lowers bg. We've queried whether it's being stored correctly etc and it is, but as a new vial seems to make a difference maybe that would kickstart the lower numbers again.

    Glad to hear Perlutz is fine despite his high numbers. The heat here yesterday was horrendous, enough to stress a lot of kitties I imagine. I'd have liked an ice pack massage too!

    Hope you're enjoying your trip!
     
    Last edited: Jul 26, 2019
  56. Georgiana & Perlutz

    Georgiana & Perlutz Member

    Joined:
    Jan 24, 2019
    I’m on my way to meet the guys I am driving to the wedding with (it’s in a different country - Bulgaria!!!) and I am struggling to see the exact dates on the SS in the tiny notes on the side (it’s either too sunny and my eyes are tired or someone needs glasses!). Once I settle in the car I’ll try to look when exactly I started giving him NM, but I think it was 2-3 days into already high numbers.

    The new vial is waiting at the vet, boyfriend will collect it this weekend. I don’t know if to ask him to start using it straight away or wait another week until I get home?

    I’m glad to say it was “only” 30 C in Bucharest yesterday so quite comfortable temp compared to back home! Can’t believe we had 39! As for enjoying, oh well! I am so tired and it’s only about to get worse haha. Aprox 5 hour drive to the wedding, driving back Monday, going to my friend’s and grab the rest of my luggage, catch a train to my mom’s and stay there 3 days then back to Bucharest for a night and then flying back home. I cannot wait to go home and rest :joyful:
     
  57. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Well if Perlutz was already in high numbers when you started feeding NM I wouldn't worry too much about ruining your eyesight by looking at numbers on a tiny phone screen. It's probably not the food at fault but something changed, that's for sure :(

    The increased potency of a new vial might just bring numbers down a bit - worth a try, we really don't want him to be in these icky blacks and reds for much longer. Of course it may not make any difference this time!

    Yes it was nudging 40 degrees here, far too hot for most of us but it's cooled down today thank goodness.

    Try to get some sleep on the drive to the wedding perhaps?
     
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  58. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I agree it seems unlikely the food would have that much effect on BG. Doesn't look like there is anything unusual in the food although I always laugh when I see raspberry/cranberry or the like. As if our kitties would go foraging for berries in the wild! :woot:

    I notice BF isn't checking BG as often as you usually do. I would strongly suggest you ask him to check BG before bed minimum and especially if he increases the dose to 1.75u. Also if he does decide to start the new vial of ProZinc, getting a mid cycle test and monitoring the first coupld of cycles when possible is imperative to ensure Perlutz's safety.

    Sounds like you are going to need a vacation to recover from your vacation! Safe travels! :)
     
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  59. Georgiana & Perlutz

    Georgiana & Perlutz Member

    Joined:
    Jan 24, 2019
    After what felt like an eternity, I’m finally back home!

    Perlutz is in very high numbers still, despite increasing the insulin dose a fair bit :( It seems we’re back to the point where it doesn’t even seem to make much of a difference, the numbers are still pretty high even mid cycle. I haven’t tested him much as he is still a bit wary of me despite being back since Sunday :blackeye: I’m trying to give him space and not be too intrusive with testing and such until he forgives me...

    He is very hungry, he would eat non stop if possible! He has had this ravenous appetite before when in very high numbers, but I would say this is the worst he’s been. Despite this, he has lost some weight :( He is drinking a lot of water too, 200+ ml a day. The good news is he hasn’t vomited since I started giving him the SEB which the boyfriend continued to give while I was away (there was only a little bit of grass once he said).

    We’re kind of back to square one with these numbers and I’m finding myself lost and worried sick again. I don’t know what else to do apart from increasing the dose? I’m thinking of making an appointment with the vet to discuss Lantus but 1) I don’t know if they will be even willing to prescribe it and 2) they don’t have much experience/knowledge with controlling diabetes with a pet specific insulin, I fear they don’t know anything at all about Lantus and the thought that they might be even less helpful quite frankly freaks me out a bit! I’m feeling really down about the whole vet situation as I feel Perlutz is not getting anything from them. Yes, they do blood tests and some check ups, but diabetes wise, I’m on my own... And there’s not many others in town that I could turn to either...

    Do you have any suggestions for us? Anything, please :bighug:

    EDIT: I’ve had a look on the SS notes and I’ve introduced the new food from Nature’s Menu after 2 days that he was in high numbers already while on a low dose, trying to get 2 shootable numbers. In theory, it’s a low carb, good quality food that shouldn’t affect the numbers so badly but do you think maybe it could be the culprit? I have another large order of it on the way as Perlutz seems to really like it and I struggle to find something else he enjoys. Currently, he only eats NM, 2 fish flavours from Applaws and 2 chicken/lamb from Applaws that are unfortunately not complete foods so can only give them ever so often, either mixed with the others or as a snack.
     
    Last edited: Aug 8, 2019
  60. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    First of all welcome back. Hope you enjoyed your trip despite worrying about Perlutz.

    Looks like Perlutz is a bit stuck at this point in time. Not familiar with Nature'sMenu food but have to wonder if that has anything to do with the higher BG. It looks like you introduced that food not long before your departure and Perlutz's numbers have definitely been worse seemingly in that time frame. Not making a judgment but a guess.
    It's also possible that Perlutz was not eating the same while you were gone. Nothing BF would have picked up on but these furry creatures can be affected by our absences. I think you might be looking at some glucose toxicity. Kitty gets stuck and all you can do increase insulin dose until the numbers start falling. You've been very methodical about increases so I'd just keep increasing every 4 to 6 cycles until numbers start falling again.
    The other thing I wonder about is whether there could be any dental issue which have a nasty habit of sending our kitties into higher numbers. When is the last time Perlutz had his teeth looked at?
    I'm tagging @Djamila to see if she has any words of wisdom to share as she is definitely more experienced than me with ProZinc.
     
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  61. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    We did wonder about the NM food a while ago, see a few posts up, and thought then that the ingredients were unlikely to spike bg to the extent you're seeing at the moment:

    but then you never know. It may be worth eliminating this food for a couple of days and see if it makes any difference - I'm sure you'd say that anything is worth a try.

    If you're left with only the Applaws complementary foods, don't worry, just add some of the Felini supplement to make them complete foods. It's useful to have some of this on standby anyway.

    And Linda's right - there could be a re-emergence of the recent dental issues. Can you have a look in his mouth to see if there's any inflammation?
     
  62. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    PS ref the vet situation. Have you thought about calling in a mobile vet? There are a few around these days - another member here who lives near me in Surrey used The Cat Doctor recently and can't speak highly enough of them. You could Google some in your area and make contact and ask what experience they have of treating FD, explain a little of Perlutz's situation and see what their response is? Mobile vets are, not surprisingly, more expensive, but maybe even a one-off consultation might give you something else to go on, if you find a good one. I think that would be my next move, if I were in your shoes. Maybe see what any food change does over the weekend and think about this then?
     
  63. Georgiana & Perlutz

    Georgiana & Perlutz Member

    Joined:
    Jan 24, 2019
    Hi Linda :bighug:

    I asked the vet to have a good look at his teeth at the last vet visit at the beginning of July. There was a little bit of redness but he wasn’t concerned and didn’t recommend anything. His last dental was done on May 22nd. I did try to check his teeth the last few days, haven’t managed a good look everywhere but couldn’t see any redness.

    I guess I can try to withhold Nature’s Menu for few days and see if that will make a difference although I have no idea for how long would a food still have some effect on his body.
     
  64. Georgiana & Perlutz

    Georgiana & Perlutz Member

    Joined:
    Jan 24, 2019
    Hi Diana :bighug:

    You’re right, I’m back to everything’s worth a try :blackeye: I know it’s unlikely it will make a difference, but I will try to withhold NM for few days and see what happens.

    As for Applaws, there’s 2 flavours that are complete foods, it’s just that they’re both fish flavoured and I’m worried about mercury poisoning, thiamine deficiency :facepalm: But I’ll go on and order some Felini to add to the complementary ones, thanks for the tip!

    It never occurred to me to look for a mobile vet to be honest. I guess I was somewhat skeptical they will be any good? I’ll look today and see what’s available in Berkshire.
     
  65. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    http://www.thecatvet.co.uk/

    Have a look at this, Georgiana... may be slightly outside your area but not much, and it looks as if the people who run it are real cat people who really care, so you could think about contacting them...?
     
  66. Georgiana & Perlutz

    Georgiana & Perlutz Member

    Joined:
    Jan 24, 2019
    I ran across this at the beginning of the diabetes and unfortunately they are not taking any new patients :( The website still states 2018 so I'm not sure if they're even trading anymore? We did try to call them few times back in January/February but never got an answer. I'll have a look for some others and might try giving them another call too.
     
  67. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Oh that's a shame, they look very good! Try calling again, or send a message and ask if they can recommend any other similar services in the area? Good luck!
     
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  68. Djamila

    Djamila Well-Known Member

    Joined:
    Aug 1, 2015
    Hi there! Saw the tag so just popping in:
    1. I would try changing the food first. If that's the culprit, you should start to see a change within a couple of days. My hunch though is that this isn't the problem (unless it's super high in carbs which seems unlikely given the ingredients). However, since this is an easy "fix" I would try it first. If after three days there is no change at all, you can reintroduce it.

    2. Other health problem: this one is certainly an option. Any sort of inflammation or infection can cause numbers like this, so redness in the gums, even if not severe could be an issue - doesn't seem super likely though since the most recent dental was only a few months ago. Were there any extractions at that time? It's always possible that a tooth fragment was left behind and could be the culprit. That would be very difficult to see from a visual inspection and may need an x-ray. Could also be a UTI, ear infection, arthritis, or any number of things. These are a concern as inflammation/infection can lead to DKA, so make sure you're checking for ketones regularly until this gets resolved.

    3. Emotional health: being gone can definitely impact a cat's health. That should resolve in a couple of days upon return though, so if you've been back for a few days already, this one seems unlikely.

    4. Glucose toxicity: definitely a possibility. And even if it's not this directly right now, increasing the dose is the next obvious step anyhow. And keep going with the increases until you see some movement in the numbers (making sure to getting back to those mid-cycle tests again so we can be sure there aren't any sneaky lows hiding in there anywhere).

    5. Bad match with the insulin: this one is also a possibility. Looking through your entire spreadsheet, I'm not convinced that prozinc is the right insulin for Perlutz. It looks like you switched back in February, which is six months now, and I'm not seeing that at any point you really had a good pattern with it. There are cycles when you had lower numbers, but they were bouncy lows, not consistent curves. It may be that a longer acting insulin will be a better match, so when you talk to your vet about any other possible health issues, I think I would also raise the question of making yet another insulin switch and see if s/he is willing to consider it.
     
  69. Georgiana & Perlutz

    Georgiana & Perlutz Member

    Joined:
    Jan 24, 2019
    I will try it although I too don't think it's what's causing all this.

    He has had 3 extractions back in May. I bought PetSmile toothpaste for him but he won't touch it :mad: I'm about to order another one with a brush that I've seen recommended here but can't remember the name. Hopefully it will help maintain the dental results for longer.

    He seems to be using the litter box as usual, he does wee a lot because of the diabetes but he doesn't seem to struggle, thankfully. There doesn't seem to be something in particular that bothers him but they're good at hiding these things so...

    It's been nearly a week but I haven't been forgiven yet :arghh: He is normally over it in a day or two, never took so long. He even started sleeping under the dining table since I got back and sometimes runs away from me! He's happy to cuddle, be brushed etc but sometimes just runs if I walk towards him, try to pick him up for testing etc. :(

    I'll keep increasing and I'm hoping he will be back to not being bothered by testing.

    I will discuss Lantus at the next appointment :cat:
     
  70. Georgiana & Perlutz

    Georgiana & Perlutz Member

    Joined:
    Jan 24, 2019
    The cat gods gave me a yellow PMPS tonight! :woot: Stopping Nature’s Menu didn’t seem to make a difference so I've reintroduced it yesterday and got this lovely yellow today.

    I still gave him the same dose though, 2.75 so I’ll keep an eye on him tonight. I’m thinking to test him twice before bed time to have an idea how fast/slow bg is dropping and take it from there whether I need to stay up or not.
     
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  71. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Yay for yellow! Maybe he's finally forgiven you for going away! Keep going, Georgiana - let's hope that this signals the start of a better phase :)
     
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  72. Georgiana & Perlutz

    Georgiana & Perlutz Member

    Joined:
    Jan 24, 2019
    He has finally forgiven me on Saturday, a week later:eek: He came to sleep with us at night and then finally stopped being so wary of me :cat:

    In other good news, his hunger seems to be slightly less ravenous and he even leaves few bits in the bowl sometimes.
     
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  73. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Lovely! This is looking good. These l'il babies are sensitive little souls so it could just be that it was your absence that triggered those nasty reds and blacks. He's got you under the thumb that's for sure lol!
     
  74. Georgiana & Perlutz

    Georgiana & Perlutz Member

    Joined:
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    There’s no doubt there :smuggrin:
     
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  75. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Jan 24, 2019
    We’re back all the way up to 3.25, the highest dose he’s been on :(
     
  76. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    You're definitely getting some better numbers now albeit not consistently. Sometimes they just get stuck in higher numbers (glucose toxicity) and all you can do is increase dose until the numbers finally start coming down and then the dose starts dropping again. Looks like you're starting to get closer to a break through.

    One thing you could try is keeping food in the earlier half of the cycle. I noticed you've fed Perlutz around +9 on some occasions and while his numbers aren't consistent on days with the later meals, meal times can have an effect on how the cycles play out. Is it possible to perhaps try feeding those snacks between +3 and +6/7? Sometimes changing feeding times can change the way the insulin is utilized.
     
  77. Georgiana & Perlutz

    Georgiana & Perlutz Member

    Joined:
    Jan 24, 2019
    I’ve been testing new feeding times the past few days, trying to keep him from feeling too hungry. He isn’t as desperate for food all the time, but he goes and waits by the bowls a lot and would like a little more than he is getting. But I can go back to +3 and +7, those were more or less his feeding times before.

    Apart from these pesky numbers, he seems fine. I’ve been completely forgiven for going away (phew!) and he’s back to his cuddly self (so enjoying this).

    Haven’t seen the vet yet but I think we will go next weekend. I want her to have a good look at his teeth, he won’t let me do it.

    I’m really hoping we can get past this glucose toxicity again!
     
  78. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Sometimes you just have to play with feeding times. Every cat is different. If you are home to accommodate his hunger during the day, maybe keeping track of when he seems to want food most will provide some clue as to what times to try.
    Glad he finally decided to forgive you for leaving without him!
    Tooth issues can definitely have an effect on BG so getting that checked is a great idea.
     
  79. Georgiana & Perlutz

    Georgiana & Perlutz Member

    Joined:
    Jan 24, 2019
    Here’s the little food thief eyeing something on my plate :joyful:

    D69BA763-4859-4F48-B474-88AE38DBB5A8.jpeg
     
  80. Georgiana & Perlutz

    Georgiana & Perlutz Member

    Joined:
    Jan 24, 2019
    He would like food every 1-2 hours to be honest... I’m away all day but I set the autofeeder during the day. From watching him on the camera, he does seem to get hungry at +5/+6 and +8/+9. He’s not too bothered in the morning, once I’m out the door, he moves around for 10min then goes to sleep until meal time.
     
  81. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    He is adorable. Those eyes look like they're pleading for some of what you've got. :)
    So given when he gets hungry perhaps moving the food times back just a half hour or an hour to get him used to when the food magically appears. He might learn to get it while the gettin's good!
     
    Last edited: Aug 20, 2019
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  82. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    Oh my God , he is so adorable
     
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  83. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    I don't have any suggestions I'm afraid, Georgiana, but keep smiling - Perlutz is happy and playful, and that's the main thing. It's so much harder to see our babies in pain and distress.
    Good idea to ask the vet to look in his mouth again - it could just be that something wasn't completely sorted out there a few months ago and that is contributing to the high bgs.
    Rooting for you, as usual!
     
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  84. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Jan 24, 2019
    Thank you @Diana&Tom, I feel like I've been away for ages, we haven't talked in so long! :bighug:
     
  85. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Well I'm still around and happy to chat any time! Work gets in the way sometimes but not always ;)
     
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  86. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Jan 24, 2019
    I fed him at +2.5/+3 and at +7 today and will keep it for few days at least. He has been sleeping most afternoon but got up 10 min ago and as he was passing by he sniffed the autofeeder but then moved on. I think he is sleeping again :smuggrin: but he's in a blind spot and can't see him :smuggrin:
     
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  87. Georgiana & Perlutz

    Georgiana & Perlutz Member

    Joined:
    Jan 24, 2019
    I just shot 3.25 on a yellow 12.3 :nailbiting:

    We’ve had some interesting last few cycles, looks like we could be breaking through the toxicity again. On the 25th he surprised us with a blue 9.2 and we ended up not shooting at his usual time since he didn’t seem to be eating all but then later he had whatever food was left and went all the way up to 27.4 :eek: so we shot 1.5 hours later than usual and adjusted the times a bit the next shots (luckily we had a bank holiday in UK the next day). I think I’ll test him again at +2 and +4 before bedtime and see if I need to stay up or at wake up during the night for some more tests. Although I wouldn’t be too surprised if he bounces again...

    In other news, boyfriend dropped the insulin vial yesterday :facepalm: luckily it didn’t break and it looks normal still but we’re a bit paranoid now since it took quite the tumble and we’re not even supposed to shake it at all... I ordered a new vial just in case anyways and we should be able to pick it up tomorrow. I don’t think the boyfriend is winning himself any fans here with his little mishaps :joyful:

    We booked an appointment with a different vet in the practice for the 7th. She’s their dental expert so I’m hoping she’ll have a proper look at his teeth and discuss Lantus. I’m hoping for a quiet Friday at work this week:rolleyes: and hopefully I can prepare a bit for this chat :bookworm: I think there’s serious persuasion needed:facepalm:
     
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  88. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Been wondering how you're doing Georgiana so thanks for the update. L'il Perlutz is certainly keeping you guessing, isn't he. It's a shame that there isn't an obvious pattern to his occasional drops into better numbers - if you could identify when they are likely to happen it would be interesting to analyse why they're happening. Knowledge is power and all that.

    So 3.25u on 12.3, hmmm. You'd imagine he'd be rising at shot time so this could be a very good call - let's hope so. In any case you have an excellent all-round knowledge of FD now and what to do in any situation, so I know P is in good hands.

    Can't remember any other misdemeanours by the BF so we'll still think he's an ok kind of guy!

    And good news about the appt next week with the dental expert vet. If there's an unresolved issue she should be able to spot it, if not she may not want you to leave the surgery without some kind of possible progress so maybe she will be amenable to Lantus. There's absolutely no denying the evidence of your data which does suggest that something needs to change after all this time.

    Good luck tonight! Hope you're about to enter a better phase again :)
     
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  89. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Jan 24, 2019
    I know, I’ve been bad posting updates lately :( But there wasn’t much to say, constant reds and occasional blacks :banghead: My office has been under refurb the last few months and I’m part of the Facilities team in charge of it so work has been hectic and I came home physically and mentally tired :D

    I’ll post an update in about half an hour when I test Perlutz:bighug:
     
  90. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Looks like you are getting a bit of a breakthrough and I think you did exactly the right thing dropping the dose tonight to 3.25u. I'd stick with 3.25u now as long as pre-shot I high enough for insulin. You've been shuffling between 3 and 3.5u on different cycles recently due to numbers being lower at PMPS and it's far better to find a dose you can shoot consistently. You don't need to reduce the dose jut because get a pink pre-shot instead of a red. Both are high enough to shoot a full dose. Even tonight, BG is high enough you shouldn't have an issues but they can surprise us and you have a plan. for testing to be sure. :)

    I doubt one drop of the vial would spoil your insulin. Just keep an eye on it for any little white floaties. Might be an idea to wrap the vial in some bubble wrap, rubber shelf liner material or put it into an old prescription container with some padding around it to prevent breakage if clumsy hands should prevail! :woot:

    Hopefully the vet will be on board with a switch to Lantus but with her being dental specialist, she may not be willing to make that call. Specialists here tend not to want to cross the borders into other specialist's territory.:rolleyes:
     
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  91. Diana&Tom

    Diana&Tom Well-Known Member

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    Dec 29, 2009
    That's ok Georgiana, there's no pressure or expectation to post any more than you can or want to! And there's no point posting when there's nothing to say, it's true. Hope you're managing to get some R&R in as well as all the other stuff going on...
     
  92. Georgiana & Perlutz

    Georgiana & Perlutz Member

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  93. Georgiana & Perlutz

    Georgiana & Perlutz Member

    Joined:
    Jan 24, 2019
    Hi Linda :)

    Yes, I’ve been shuffling a bit between 3.25 and 3.5. After the blue PMPS, I lowered to 3.25 despite the pink because I was worried 3.5 might end up in a non shootable number, like we’ve had before, and when it didn’t go low, I went back to 3.5 as I was scared if I don’t, we might lose the momentum to break through the toxicity. The anguish these numbers bring sometimes :p

    The vial slipped between his fingers just as he was about to withdraw it in the syringe. We have the new vial on its way, just in case. I hate to be wasteful like that, especially now when we’re going through a phase where we’re trying to stop waste, be even more careful with plastic use, I’m swapping more and more of the brands we use for cruelty free etc but better safe than sorry with this one :cat:
     
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  94. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Jan 24, 2019
    Someone’s enjoying a back rub and after he’s getting a little snack of boiled chicken thighs (organic free range of course :p)
    0E21A6E3-C858-440F-8633-9C34374DE05E.jpeg
     
  95. Diana&Tom

    Diana&Tom Well-Known Member

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    Dec 29, 2009
    Such a love bug!
     
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  96. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Jan 24, 2019
  97. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Hmmm wondering what this cycle is going to look like by morning.
     
  98. Georgiana & Perlutz

    Georgiana & Perlutz Member

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  99. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Pretty flat right now. :rolleyes:
     
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  100. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Jan 24, 2019
    Still pretty flat but I’m liking the yellows :cat:

    15.4 @ +7.5 (tested 20 min after he had some food)
     
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