2/24 Fortune PMPS 393 +2 481

Yesterday

DH learned a new lesson today - don’t bring the food near Fortune before getting his BG! Fortune wouldn’t sit still so there were a few extra pokes, but he is munching away now.

@Wendy&Neko The expiration date on the insulin is April 2022, so it should still be good - it’s also clear. I’m just beside myself that he is over 600 for so many days! It can’t be good for his one kidney.

Only two more cycles til we can increase. He did dip below 300 one time that we caught, that was also the only cycle his +2 wasn’t over 600

Today Marty has the vet, but then Fortune has two days of appointments! I wasn’t able to get the oncologist and the internist on the same day

 

I hope Marty's vet visit goes well. Glad Fortune is still eating well. I hope he slides down today. Sending prayers.

 

Good luck with Marty's vet visit and lots of healing vines to Fortune FWIW, if Jax is demanding food at test time, I'll test him while he eats a freeze-dried chicken treat (I'll crumble it onto the ground like Hansel and Gretel ).

 

This is the fourth cycle where Fortune has had a 400+ PS number and a 600+ at +2.

I think we need to consider bumping by .5. Could the lower cycle a few days ago be from the remaining 3IU depot? This doesn't feel like new dose wonkiness, because it's consistently high. But I'm still very inexperienced/learning.

Fortune has the vet tomorrow (oncologist) and Friday (internist) where I think they will also want to bump him up since it is likely exacerbating his kidney issues. I would prefer to be able to monitor him for a time on the new dose prior to him being observed. Tomorrow morning I am dropping him off at 7:30 so they will need to give him his insulin, so I am thinking to keep it at 2.5 and then in the evening bump it, even though that means staying up/waking up.

What do you think @tiffmaxee @Wendy&Neko ?

 

No. He only had one dose at 3 units so he didn't have a 3 unit depot built up. Plus the larger depot depletes after 4-6 cycles, so that was all 2.5 units talking. New Dose Wonkiness is typically just in the first few cycles of the new dose.

Did you give insulin this morning? There is no dose on the spreadsheet.

I also wouldn't give an increase then drop him off at the vet.

 

Thankfully as I was pondering this Wendy replied. There’s also no guarantee whether an increase would effect the first or second dose and I wouldn’t want to increase and drop him off either.

 

Yes, oops! I forgot to enter it - just updated. And I agree- I think I should hold the dose tomorrow at 2.5 since they will need to give it to him (he has to fast and drop off is at 7:30), and we then increase it tomorrow night. He will be at the vet on Friday again, so I won't be able to monitor him as much, but more than tomorrow (shorter visit with the internist). I'm worried about the impact of not increasing him at all.

That's good to hear it wasn't the 3 units, I just don't know why he is staying so high!

 

Fortune, please come down from the moon, otherwise you'll be getting an increase soon. The threat is out there.
Sending vines to both Marty and Fortune for their appointments.

 

So he came down a smidge at PMPS but his back legs are so severely dropped I expect the vet will increase his insulin tomorrow even though I cannot monitor him.

I’m so heartbroken looking at him. He didn’t get mirtazapine today and I had to hand feed him because he was nauseous (he ate almost all of his can that way though, so I’ll take it). He appears to be in more pain this evening and I’m sure the high BG numbers are not helping him feel well on top of everything else.

Trying to figure out when to do the increase. I think tomorrow night after the oncologist go up to 2.75 and I’ll be able to monitor him late. I also expect the internist visit to be on the briefer side, so I can check his BG in the car (heading there, in the parking lot; when he is released and when we get home) to see how he does. I feel like that’s preferable to keeping him on an inappropriately low dose.

Thoughts?

 

Let's see where tonight's slide takes you to. Unless you see blue, increase by 0.25 units tomorrow, at time of your convenience. If you can test at AMPS then at the parking lot, you'll have an idea if he's dropping and whether you need to tell the IM vet clinic to keep an eye on his sugars.

 

Drop off is at 7:30 tomorrow, and he usually gets insulin at 9 (we are trying to move it back after the stall), so I’m not sure we can give it to him before the appt.

He just started slipping on his front paw. I scooped him up and we were about to run to the ER but then after a few minutes he started pushing against me and went to his food bowl. I’m not sure what that is, but I’m calling the hospital to see if I should bring him in or if it can wait til tomorrow morning.

 

Sounds like tomorrow the vet clinic doses him.

Poor Fortune, I hope you can stay home tonight.

 

Spoke to the ER tech, we are dragging him in out of an abundance of caution. He is fine now, but he has so much “going on,” that they want to see him.

I’m a wreck. I really hope he comes home. I’m just worried if we don’t have him checked out, something tragic will happen.

 

Better to err on the side of caution for sure. Keep us posted. Sending a tonne of vines and prayers your way.

 

Many prayers, vines, and healing light for your sweet boy

 

Update: I’m neurotic and Fortune seems fine, though his BP is slightly elevated (200)

TL;DR Fortune isn’t exhibiting the symptoms we saw at home, running blood work to be cautious, and taking him home for the night.

Longer version:

We discussed that it could have been a seizure, but unlikely because the event didn’t last very long.

He isn’t hypo (derp) which can cause seizures, and it’s unlikely it’s from liver problems just based on presentation.

So who knows why it happened, but it was really scary!

We are running blood work to be cautious and based on that hopefully taking him home for a few hours til we have to hop back into the car for our 7:30am oncology appt. But I prefer he be at home than in the hospital overnight if it’s not necessary.

I was crying when I was kissing him goodbye in the car and he kept comforting me. He is such a special kitty.


Oh I explained that he was at 2.5 because the 3 units he was discharged on plummeted his numbers fast and she was very nonchalant. I said he is due for an increase soon, but when she asked if we were going up to the 3 I explained that we dose up in .25 increments.

She was impressed, and commented on how “dedicated” we are. Idk if it was good bedside manner, or if she was calling me a crazy cat lady lol but yes, we are very dedicated to Fortune and helping him feel well!

She is going to get me his + 2 number from the blood work lol. I asked

 

I’m glad he will come home.

 

His creatinine (4) and BUN (94) are MUCH higher than they were when he was discharged last week (c was 2.9, BUN 57).

But the good news is his Hematocrit is improved and he isn’t anemic anymore!!

He is getting SubQ fluids then coming home for 5 hours!

Ugh I had really hoped his numbers would improve the poor little kidney he has left is struggling.

 

Darn it. He might need fluids at home. Did they say he was dehydrated?

 

Nope. He probably is though - he has been drinking a lot, which could be from the CKD or high BG.

I expect at the follow up appt with the internist we will be moving forward with the SubQ at home. The plan had been to recheck his values and evaluate after being home for a week.

I just want him to go longer without a vet visit! Though the folks at the hospital all know him now...yeesh

 

I hope he’s going to be home soon and have a restful night.