9/23 Maxi AMPS 142/+4:221/+8:186/PMPS 222/ MAXI IS NOT WELL

Discussion in 'Lantus / Levemir / Biosimilars' started by bambinaki, Sep 23, 2020.

  1. bambinaki

    bambinaki Well-Known Member

    Joined:
    Jan 22, 2010
    Last thread: https://www.felinediabetes.com/FDMB...7-71-11-76-pmps118-4-231.235729/#post-2641949

    At Maxi's 3:30 am feeding and test, he didn't seem himself. He wasn't ravenous but did eat.

    This morning at AMPS, Maxi was clearly not feeling well. He ate about 1/2 of his breakfast. The very good boy does purr for me, though. It's heartwarming and heartbreaking how he does that.

    I gave him Cerenia and buprenorphine.

    It's kind of amazing how dark this makes me feel, and how light I feel when Maxi feels well.
    It's like a lead weight and affects me emotionally, mentally, and physically. I just can't stand it when he (or his brother or nephew) feels bad.

    Please send good vibes to little Maxi. Thank you.
    --------------------------------------------------------------
    It's now AM+8. Maxi ate 1/2 his breakfast, but now he won't take a bite of his 3:30pm food.
    I'm worried about giving his insulin tonight if he doesn't eat. What do I do?

    I gave him Mirtazepine and Gabapentin.

    By the way, the "tuna-flavored" Gabapentin is a joke. It tastes nothing like tuna. It has a horrible bitter taste.
     
    Last edited: Sep 23, 2020
  2. JaxBenji

    JaxBenji Well-Known Member

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    Jul 10, 2020
    Thinking of you all :bighug: Hope Maxi feels better soon!
     
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  3. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    Hi Karen, so sorry to hear Maxi isn't feeling well this AM. You are doing such a great job of regulating him. His numbers look like that of a totally different cat from when you started out!

    Hugs to you and vines to Maxi! :bighug:
     
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  4. carfurby (GA)

    carfurby (GA) Well-Known Member

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    Feb 19, 2012
    I hope Maxi feels better soon. Sending prayers. :bighug::bighug::bighug:
     
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  5. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Karen, I am going to take off the 911, as it's not a medical emergency. Also, if you want attention, don't edit your first post, but rather add a new one to the bottom to bump it up. It's by luck I found this. I hope Maxi feels better soon.

    You still have several hours to PMPS. And then about 4 hours after PM shot before the Levemir onsets, so you have at least 6 hours to get food in him. You can assist feed if need be. How is his hydration? Is he drinking? Have you tried all the enticements like tuna water (unsalted, cheese on top)?
    Insulin does more than work with the carbs in his food, and cat undergoing anaesthesia who cannot eat can get at least a half dose. He will feel worse in high numbers.
     
  6. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010
    If he doesn't eat and I cant get anything in him, what do I do about the insulin tonight?
     
  7. bambinaki

    bambinaki Well-Known Member

    Joined:
    Jan 22, 2010
    He is extremely lethargic. His eyes look fine. He seems weak. His breathing is slightly more rapid and shallow than normal. I do not want to take him to the ER. I don't want to put him through the stress. Can you think of a good reason to take him? Could he have an ailment that the ER could easily fix?
     
  8. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Have you done a ketones test lately? Have you counted his resting respiration rate? Count the number of in and out breaths (counts as one) per minute.

    Also, could you answer my questions from my previous post.

    What have you tried to get food into him? Have you assist fed? you should be able to do at least a half dose.
     
  9. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010
    I have tried enticements. He licked some fishy water. That's all.

    I haven't tested ketones and haven't been able to today because he hasn't peed.

    I read what you said about giving half a dose after I already gave him his full dose of 9.5.

    He seems very week in the legs although he did stand up and walk to the kitchen when he heard food prep. He went right for his fish but ended up only licking.
     
  10. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010

    I failed with a syringe.

    I force fed him with a small spoon. I got about 2 teaspoons of chicken baby food into him.

    He is very weak - can barely stand unless a wave of resistance to feeding adrenaline goes through him.

    ...He just half stood and took 2 small steps and lay down again.
     
  11. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010
    This doesn't seem to be ketoacidosis, or does it?

    What does this look like to you?

    I haven't seen his legs weak like this.

    He had bupe 12 hours ago and gabapentin 4 hours ago.

    He's had these meds before without this reaction.

    He also had mirtazepine and ondansetron 4 hours ago. And cerenia 12 hours ago.
     
  12. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Can you check his hydration? Lift the skin around his scruff, does it drop right away? Do his gums feel wet or tacky?

    Please test his respiration rate. Use the timer on your cell phone, set if for a minute and count the number of complete in and out breaths in that minute. This is IMPORTANT!

    For feeding, I gave a link to a syringe feeding video. You may not need it, but let's see where he is in a couple hours.

    Please keep your spreadsheet and subject line up to date.

    Too bad you gave mirtz and ondansetron at the same time. They target the same nausea receptors and usually mirtz wins that battle, meaning the ondansetron won't be effective. Maybe try ondansetron again in a couple hours.
     
  13. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010

    He took 51 breaths in 60 seconds
     
  14. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010
    I saw it.

    I can't get the food into the syringe. It sucks in only water.

    I got some tiny spoonsful into him
     
  15. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010
    His scruff seems to drop right away.

    I don't want to stress him by messing with his mouth again yet, so soon after force feeding.
     
  16. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010
    51 breaths in 60 seconds.
     
  17. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010
    This is different from his previous sick days. The weakness.

    It seems like he might be dying. I want him to live but I do NOT want to put him through hell at the vet unless they can fix him easily. I refuse to put him through that. Should I give him more bupe to make him more comfortable?

    Please tell me if there's a good reason to bring him to the ER.
     
  18. bambinaki

    bambinaki Well-Known Member

    Joined:
    Jan 22, 2010
    What do I do about him having gotten 9.5 units with very little food? Do I have to torture him again with force feeding?

    @Wendy&Neko
     
  19. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    If it is just an ordinary 2 part syringe like the one below. Take the syringe apart and put the food into the plunger end.
    If the syringe is small, I found a chopstick helped to load the syringe.

    download.jpg
     
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  20. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Sorry, had a leaking roof to deal with. :eek:

    A normal respiration rate is 20-30 complete breaths per minutes. Count again. If he's resting and doing 51, get him to the vet. This could be a heart issue (common enough with acros). This can be treated with meds, but must be done soon.
     
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  21. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010
    We are at ER now
     
  22. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Keep us posted. I worry about little Maxi. and you. :bighug::bighug::bighug:
     
  23. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010
    If it is a heart issue, is it dangerous for him to get fluids? I was going to ask for fluids since he didn’t eat or drink much at all today.
     
  24. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Yes, a heart kitty should not get fluids, But subq is different from IV fluids. Tell them you suspect it might be heart and they should know what to do. (or not)
     
  25. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010
    I tried and tried to get the food in both ends of the syringe. It was so aggravating.
    Thank you Red and Rover.
     
  26. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010
    I did just tell them that I thought it was possibly/probably his heart and about the fluids. They said that’s why they wanted to do some diagnostics to see what was going on with him, i.e. to see if it was his heart.
     
  27. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010
    Thank you!
    My worst fear is for Maxi to suffer and die away from home. I really hope it was the right decision to bring him here. Please ask whoever is in charge of this cruel world to let Maxi, when his time comes, be at home at peace without pain in my arms.
     
  28. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010
    What meds?
     
  29. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    They will probably xray his chest, to see if there is fluid there. The meds he would get would depend on what is wrong. Hard to guess without a diagnosis. Neko had a couple things wrong with her heart. And I had a previous civvie with heart issues. Anyway, you are in the right place. Better with you and him not in pain at home.
     
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  30. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010
    My baby brother Maxi today
     

    Attached Files:

  31. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Something about those eyes.
     
  32. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010
    The x-ray shows that he has fluid in his lungs and probably fluid outside his lungs.

    they’re going to give him an IV of Lasix.
     
  33. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    I was guessing that would be it. He was breathing fast because the fluid was making it hard for him to get air in. Lethargy and inappetence are also symptoms of heart issues, I know by experience with Neko. The Lasix will help. The issue going forward will be balancing the heart and kidneys. Treatments for one can hurt the other. When I got to this point, I found that an internal medicine vet really helped balance the two conditions. Neko could not have fluids after her heart issues started, but she was further along in her kidney disease than Maxi. I had to encourage oral fluids as much as possible and do soupy food,
     
  34. bambinaki

    bambinaki Well-Known Member

    Joined:
    Jan 22, 2010

    I would like to know your thoughts/best guesses on what the future holds.

    It is of utmost importance that Maxi not suffer or struggle through the rest of his life. I absolutely do NOT want his last moments to be away from home in a horrifying place feeling bad and scared. I think (know) sacrificing more time and guaranteeing that his last moments be comfortable at home wrapped in love is better than prolonging his life and risking that he pass in pain and fear.

    My biggest wish is that Maxi never know any more pain or fear. If that means I have to say goodbye to him sooner rather than later, that's the way it is. I will be destroyed (I already am) no matter what, and I'll be deeply wounded for the rest of my life, but I will have far less agony and PTSD if he goes in peace (assisted over the bridge).

    Thank you for your help, concern, and support.
     
  35. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    It's really hard to guess the future, without a complete diagnosis from the vet, and even then ECID. Neko lived another 7 months after her heart diagnosis, but she also was diagnosed with small cell lymphoma at the same time, her kidney disease was further along, and she had more wrong with her heart than just fluids in her chest. When the time was right, I had her acupuncture vet come to our home and release her. @Susan&Felix has been over a year from his heart diagnosis, and Felix is still around. I can't remember now long @Olive & Paula Smokey had after his diagnosis, but he was an older cat that Maxi. I strongly recommend a consult with a cardiology vet, if you can do it. They will get Maxi on meds that will make his life much better. Neko was noticeably better within three days of starting her meds. And the vet will also tell you what to look for, what are the signs that the heart is having difficulties. The resting respiration rate or RR, is something I did practically daily. For Neko, it was a really good indicator of how she was doing.
     
  36. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    So sorry Maxi isn't well, he is in the right place to figure out what is happening. Yes, Smokey was 17 yrs old when diagnosed with HCM. I forget why I had him at the ER, it wasn't anything that was true emergency but it was a weekend and only place open, they picked up a murmur so cardiologist was seen. Sometime in the previous 6 months Smokey had a heart attack, silent one as no symptoms of behavior changes, nothing to indicate one. He was out on numerous meds. Had recheck in 4 months, Dr is doing the echo and out loud days holy s**t". I thought this is the end. I say, it's that bad. He turns around and says no, he has improved greatly, no signs of any damage to heart, blood flow has significantly improved. Smokey then had his 1 yr echo, now he was 18 1/2 yrs old. Continued to do great, stay on the meds. I say, he will see his 19 yr then. Dr said yes. One month later, Smokey had a thrombosis and I let him go. He had wonderful 1 1/2 yrs after diagnosing hcm. Diabetic 6 yrs. Not acro.

    Ollie was different. She was diagnosed with hcm 3 weeks after I got her. She had grade 2 murmur, galloping heart, abdominal mass, ascites (fluid in belly). Started her on benazepril for her heart. Then the acro diagnosis 6 months later. It was the abdominal mass that caused her to decline so fast in 48 hrs. Ascites returned, her bg kept tanking, murmur now grade 6. Could have admitted her for the weekend, for specialists to see her on Monday, ER said she would probably go into congested heart failure from fluids they would have to give. Honestly, I didn't think she would survive the weekend there or at home. We don't have Laps of Love here or anyone who would do house visit. They let me in so I could hold her, she was still limp and weak even after 6 hrs (reason I took her in, she didn't have the strength to walk out of her litter box that morning) she wasn't alone and actually nuzzled in my neck and started purring to let me know she was ready. No she wasn't at home, but I was with her so not alone. She was with me 2 1/2 yrs after all her diagnosis which were many.

    I hope they figure it out and you will make the right choice for both of you. :bighug::bighug::bighug:
     
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  37. Jan D & Squeaky

    Jan D & Squeaky Well-Known Member

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    Sep 3, 2020
    Sending you hugs. This is a hard place to be. You have a long history of love and I'm sure your furry friend knows this.....
     
  38. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010
    Thank you, Wendy
     
  39. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010

    Thank you, Paula
     
  40. bambinaki

    bambinaki Well-Known Member

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    Jan 22, 2010
    Thank you, Jan
     

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