10/2 Alice no AMPS +15 100 +18 117 PMPS 190 +3 173 +6 145 +9 114 +11.5 177

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by AliceMeowliss (GA), Oct 2, 2020.

  1. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

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    Jan 8, 2019
    https://www.felinediabetes.com/FDMB...-pmps-164-5-85-6-93-vet-for-urine-c-s.236209/

    Good morning!
    I had some very happy purry Alice cuddles late last PM. Couldn’t sleep all night almost but so exhausted. So it looks like I overslept her shot by three hours! :\
    This afternoon I’ll reset the time again, by giving a shot early this PM then the next AM one on time again.

    I think this oversleeping thing has happened periodically with her because I just eventually get so worn out but I can’t always sleep on command in those little windows of free time. I can try my best over and over but eventually I have just a little caregiver fatigue and that can’t be helped entirely.

    But she looks bright and well today! She had interest in licking the food by herself (though I still had to syringe a meal). Her fur looks cleaner and brighter.

    Looks like she had another bowel movement while I was asleep. Good color. A little dry but pretty healthy. It’s good to see her system working and improving. I think I am getting pumpkin in my grocery order today, so that will get added to her food now.

    Tested her when I got up, she was at 100. <3
     
  2. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

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    Jan 8, 2019
  3. JaxBenji

    JaxBenji Well-Known Member

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    Jul 10, 2020
    Love the picture - hugs to both of you. You're doing great with her - try to give yourself some grace too :bighug:
     
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  4. carfurby

    carfurby Well-Known Member

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    Feb 19, 2012
    She looks better and it's great to hear she was licking her food. It sounds like you needed the rest. Take care of yourself so you can be there for Alice. Sending prayers. :bighug::bighug::bighug:
     
  5. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

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    I did really need the rest! But I still feel bad for missing shots. All this time. It happens just once in awhile, my illness and my pushing myself for her. I crash a little. I guess I can be kinder to myself.

    She’s hanging out on the bed today. I got a call in to my regular vet to rattle off questions and prescription requests. (Thanks to @THH for helping me compile a nice and organized list!)

    I can’t get over how soft her fur is today. We are relaxing and taking it easy, doing smaller feeds more often, and just cuddles and TV. Like a perfect Caturday at home only I guess it is Friday.



    The vet has some concerns about how she has had elevated wbc counts on bloodwork now it seems like for ages. Monday I go in with Tang the ginger civvie cat for routine stuff, I will get the file and get pictures of all her labs going back to when she started going to that place. Then we can look more at the history and try and get a sense of what is underlying. Cancer is vaguely tentatively on the table *maybe*, but I’m not freaking out, I would love a prognosis, answers, that’s all. She’s lived a pretty good life and I want her to stay in this world, but only if her body agrees.
     
  6. Pamela & Amethyst

    Pamela & Amethyst Well-Known Member

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    Dec 11, 2016
  7. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

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    Jan 8, 2019
    hi I haven’t gotten to catch up on eve one else since it’s been so hectic and I’m so exhausted! How is Amethyst? :bighug:
     
  8. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

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    Jan 8, 2019
    Even without insulin this morning, and missing insulin Wednesday morning too, PMPS was still only 190. In the midst of all of this, it’s pretty crazy that her pancreas seems to be working a bit!
    We are already up to 45mL today and she just took this last feed pretty well. :)

    As always, I am nervous about doing fluids later. Lately she has been a little wiggly. But she needs it so so badly that I can’t afford to not get enough in her. I have a disabled former vet tech friend about twenty minutes away that said I can bring Alice over if I really need help. Of course I hate to drive Alice anywhere if I can help it. But I’ll do it if she has a bad day and I can’t even get 50mL in!

    The off-putting tech from yesterday suggested I give Alice her fluids in an area that she is less comfortable in, so perhaps she won’t try to move around. Hmm.
     
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  9. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

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    Jan 8, 2019
    Alice is struggling to produce bowel movements still.
    Do you suppose the low potassium is affecting the ability to contract those muscles?
     
  10. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

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    Jan 8, 2019
    100mL subq easily tonight! Whoohoo!
    And for the day we are up to roughly 64mL of food which is over 4 Tbsp, ~75kcal

    I got my grocery order in, I think I’ll give her some pumpkin now. She usually likes it on its own. She hasn’t been able to poop yet but I know she has wanted to.

    Also I love seeing these stable blood sugars. A flay yellow day, a flat blue, predictable, easy, less stressful.
     
  11. THH & Snowcrash (GA)

    THH & Snowcrash (GA) Member

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    Aug 28, 2020
    Yes. Low potassium will make it harder for her to pass stools. Stool softener will help ;)
     
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  12. THH & Snowcrash (GA)

    THH & Snowcrash (GA) Member

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    You're a rockstar! :)
     
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  13. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

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    Jan 8, 2019
    What do you think, miralax, pumpkin, or both? And miralax is 1/8tsp to start and pumpkin is 1/4tsp to start I think??
     
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  14. THH & Snowcrash (GA)

    THH & Snowcrash (GA) Member

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    Aug 28, 2020
    You can try giving her half of the 1/8 tsp Miralax to start or if it's a day she's not cooperating for fluids.

    That sounds like a good starting measurement for pumpkin also.
     
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  15. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

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    Jan 8, 2019
    Regarding potassium: if it is this low, is there any risk that I can give too much and create an imbalance between that and other electrolytes?
    I’m not saying I am going to give her a huge bowl of the potassium supplement gel or anything but how fine is the line between supplementing and overdosing to the point of creating a heart and seizure risk?
    It’s one of those things I know enough about to be scared, maybe too scared. Maybe too conservative. But also I want her to feel better. And she is trying again to poop. She jumps down from the bed, lays on one of her mats near it, five minutes or so, then climbs into the box....
    This just happened actually. And her bum has poop at the opening of the anus but none that actually really came out. Looks soft too. Poor baby. I can tell she really wants to go. :(
     
  16. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

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    Jan 8, 2019
    Crud I syringed some water a little too fast and she made a gulpy sound. Hope she didn’t aspirate. :( I’m cringing at myself. I just moved too fast. :oops:

    Anyway gave a rough 1/16th tsp miralax, and several mL of water too.

    So right now she has been sitting near her box... like she is waiting to be able to go... she crawled into my lap just now though. She feels so bad. Poor thing.

    Also I tried to adjust her and she had pain on her under side, her chest. ...yikes. I think the chat with my vet about cancers has me slowly heading into anxiety mode. Noooo.

    I‘m going to need to do more feline cancer research to assuage my fearful mind. :bookworm:
     
    Last edited: Oct 3, 2020
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  17. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Yes you should be following vet guidelines on potassium. You need to be careful with it.
     
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  18. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

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    Jan 8, 2019
    That was kind of what I suspected, thanks. I’m not sure I have much in the way of specific guidelines in place. We are working on getting RenaPlus I think though.
     
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  19. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

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    Jan 8, 2019
    On Alices right side I can palpate a ... for lack of better words... a somewhat log shaped mass... she’s so skinny I can feel the waste there too easily. But she hasn’t been able to move her bowels today.
    And I can tell she is very uncomfortable with this, understandably.

    how long can she go like this, with her potassium so bad? Sigh. How long for miralax to help some.....

    -Oh as I type she just pooped on her mat near her box, where she was laying down waiting to feel ready I think. Definitely a difficult to pass lump.

    after a few minutes rest... she seems a little happier.
     
  20. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

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    Jan 8, 2019
    She weighed 2.5kg which is 5.5lbs
     
  21. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

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    Jan 8, 2019
    What a beautiful blue curve tonight. :cool:

    I’m adjusting her shot time again so even though we just hit +11.5 I won’t shoot for another 3.5 hours.

    I somehow managed to get distracted and forget to sleep. This is a real thing. :banghead:
    I’m going to need to create a more functional feeding schedule since she is getting syringe food.
     
  22. THH & Snowcrash (GA)

    THH & Snowcrash (GA) Member

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    Aug 28, 2020
    The cat at the rescue who was on RenaPlus perked up pretty immediately with treatment.

    The constipation is probably secondary to the dehydration being caused by her kidney issues. So regular fluid therapy should help some too.

    I would consider increasing her Miralax to 1/8-1/4 tsp a day, as long as she's getting her fluids okay. Constipation over time will cause its own issues too, so it's important to get things moving. There's another medication called lactulose that can be more effective than Miralax; but it's sugar-based, so I don't have any experience with using it on a diabetic cat.

    Also EQUALLY IMPORTANT is that you take care of yourself and get some sleep! Your wellbeing is just as important as Alice's!
     
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  23. Bellasmom

    Bellasmom Well-Known Member

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    Feb 12, 2018
    So glad to see the fluid intake as u can see it is making her feel better, great job
     
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  24. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

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    Jan 8, 2019
    vet gave us lactulose in March. She had an episode of constipation leading to anorexia which lead to hypokalemia presenting with ventroflexion of the neck. That was our first low K experience!

    I agree I will continue the miralax, caveat is she must have had roughly 100mL subq that day, and I’m going to try what maybe 3 days at 1/8 tsp? And then see if I want to raise the dose? I did 1/16th this cycle. So tonight I’ll try 1/8th tsp.

    hey @THH , this link suggests b12 may help with megacolon, one of the other things I need to research for Alice as a maybe problem. Oh also I’ve seen stuff suggesting supplementing certain b vitamins with ckd??Any thoughts?https://felinecrf.org/constipation.htm#treatments_chronic

    Summary of day:
    Within AM and PM cycles for this date we got roughly 105mL syringe food, roughly 130kcal for the day.
    She received: Potassium gel, Cerenia, Mirataz, ondansetron, phosphorus binder (aluminum hydroxide), probiotic (S. boullardii), Cosequin, d-mannose, 100mL LRS subq, and antibiotic Zeniquin, and ziwipeak lamb, plus Lantus of course.
    AM shot was missed. All BGLs were flat blue.
    She had difficult bowel movements both AM and PM, one each cycle
    Her weight was 2.5kg/5.5lbs
    She is urinating, however I often help her to the box for her convenience
    Her back legs are very weak and she can’t stand or jump well, she stumbles, more than stumbles
    Sometimes she makes these groaning noises. Sometimes she purrs.
    Her fur is very soft. She is pretty. The end. Hah. :cool:
     
  25. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

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    Jan 8, 2019
    Thank you for all your support, you really have helped us continue! :) How is Bella today?
     
  26. THH & Snowcrash (GA)

    THH & Snowcrash (GA) Member

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    Aug 28, 2020
    Yes to b12 injections. They can really help cats with GI issues and lack of energy.

    I'd probably give her the Miralax as long as you're able to get at least 50mL fluids in. She needs to be more comfortable. I'd increase it today. The main risk with Miralax is too much can cause diarrhea. I don't think she's anywhere near diarrhea right now, sounds like she's still pretty backed up.

    Vets can also give enemas when necessary... but most cats really hate those, but keep that in mind if the Miralax and fluid therapy aren't enough for her to pass everything.
     
  27. AliceMeowliss (GA)

    AliceMeowliss (GA) Well-Known Member

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    Jan 8, 2019
    She had an enema towards the beginning of September I think!
     

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