Blue AMPS 402 10/12

https://www.felinediabetes.com/FDMB/threads/blue-amps-78-10-11.236761/

Nothing to see here. Blue is 402 PMPS but I'll retest at +2

After posting this, Blue started vomiting up his food. Do I wait and feed some again before I give him his insulin?

 

Hi Patty,

Sorry to hear that Blue threw up this AM. Was it a scarf and barf?

If I was in that situation I'd try feeding again before deciding on whether to give a reduced dose or whether to skip the dose altogether.

Am monitoring your thread. Please can you post an update about whether he manages to eat anything (and hold it down). In the meantime, please can you let me know whether anything else seems 'off', and whether Blue is pooping/drinking OK?


Mogs
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He must have eaten too fast. He threw it all up. He's wanting to eat again but I've been holding off.
He's playing so I think he's okay.

 

The playing sounds positive, and it's good that he still wants to eat.

I'd suggest giving him just 1/3 his feed, wait 5 minutes, give him another 1/3, wait 5 minutes and then give him the rest. It would slow him down a bit. What do you think?


Mogs
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I'm trying Purebites food topper wet food. It has a lot of liquid in it. I think he might have stuffed himself and it all came back up. We'll see if he can hold this down. I did give him his dose since it's already only .5
I'll keep you posted.

 

OK. Fingers and paws crossed he'll hold it down this time. (((Blue)))


Mogs
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Sorry, we cross posted. I hope I didn't give him too much. I guess we'll see soon enough.

Hope you feel better today Mogs.

 

Back to sneezing again.

How are you today, Patty? Is the tiredness easing up at all?


Mogs
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Oh no, he's still puking. Threw up everything he ate.

 

First question, is it a new type of food you've given him this morning, Patty? (Unclear from your earlier post - might be me getting confused so I'm trying to understand better what's happening at your end.)


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Talk to me please, Patty. Worrying...


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No, it's the same LC food he normally eats. He also started sneezing again and has a snotty nose. I'm still giving him medicine for this but he's still congested. I haven't seen him do this in a while.

 

Aw bless...

How far away are you from +1?


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I'm just letting him rest right now. I think I'll try small amounts later today to see if he'll hold it down.
I hope I didn't mess up giving him insulin.

 

20 minutes

 

OK. First up, let's get that test, and then I very much recommend you give your vet a call to see if they can check Blue over today to determine what's causing the GI problems, and hopefully give him something for the nausea/vomiting.

Will monitor thread for test result.



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It sounds like he might need a different antibiotic. I hope he keeps the next snack down.

 

Hi Elise.

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484 +1

I haven't tried feeding him again. I'm just letting him rest for now.

I get a gel shot in my knee at 1:30 today so will be gone for a bit.

 

Will you be able to ring the vet first, Patty? (Just trying to find out what's happening - it's tricky in situations like this when you're trying to help from far away.)


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Yes, but they'll just want me to bring him in and I can't do that until later today. I think I'll email the SS and let them know what's going on. If he's still vomiting I can take him by there on my way to doctor or after.

 

Thanks for the info. Helps.

Will you be able to get a +2 test (and maybe a +3 test) before you need to leave for your doctor?

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Yes. I'm emailing them now.

 

Oh no, he's throwing up again. BB

 

Definitely sounds like vetty bean time, Patty.

.(((Blue)))

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I sent the SS with email and will call now. I can't go into the vet office anyway so could drop him off on my way to the doctor and then pick him up.
Will keep you posted. thanks

 

Obvious things to check for:

- Dodgy tin of food.
- Constipation.
- Pancreatitis.
- Ketones.

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Going to take him to vet on my way to my appt.

 

Could you post the +2 test result when you get it please, Patty, just in case Blue's dropping (the depot from the 0.75IU dose will still be in play at the moment).

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334 +2

 

Thanks, Patty. Looking at spreadsheet. BRB...


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Back again. How long till you need to leave, Patty?


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In case I miss you, I've the following 'belt and braces' suggestions:

- Test a little while before you leave.

- If Blue has dropped further maybe try offering him just a couple of teaspoons of the GRAVY from one of the higher carb FF foods you have in the house. He might be able to keep it down, and it may give a little bit of a boost to his BG levels to tide him over till he gets to the vet.

- If you're in any doubt about Blue's safety, rub a little honey on his gums, and bring the honey with you in case he might need more.

(@tiffmaxee - Elise, if you're around, can you think of anything else that might help?)

Fingers and paws crossed that Blue's just got a temporary tummy upset. Be sure to let us know how the two of you get on.

(((Patty and Blue)))


Mogs
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I was just going to suggest honey on the gums.

 

Thanks for having a look-see, Elise. There's nothing else I could think of.


Mogs
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I would likely use honey on gums vs even gravy as it is less likely to cause vomiting I would think. Thoughts?

 

I could go along with that.

FYI, the reasoning behind the gravy suggestion was based on the observation that sometimes nauseated kitties will lick a little bit of gravy from a feed but not touch the meat, and also because it might last a bit longer in the system than honey on its own.


Mogs
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Suggestion for when you're out and about, Patty:

Sometimes a queasy kitty will eat a little cat-friendly baby food (no onions, no garlic) when they won't eat their regular food. Here's a link with a list of some suitable products:

Tanya's Site - Persuading Cat to Eat - Baby Foods, etc.


Mogs
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Oh my, I just dropped him off and I haven't done anything you suggested. I was trying to shower, dress, test etc. I then left in plenty of time and road was blocked.
Anyway, he's there and they will call. I am heading straight back after the injection.
Will keep you posted. I do think he's feeling bad because he didn't make a peep in the car. He usually howls the e tire way.

 

If he's at the vet they'll be able to watch his BG levels so all's good on that front.

Poor boy. I hope he feels better very soon. (((Blue)))

Keep safe while you're out and about, Patty. Will check in later to see how you got on.




Mogs
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I wasn’t against it. I was worried he might vomit it up. I’m glad he’s at your vet’s as try will surely give a shot if cerenia right away.

 

I'm home. Blue is with Dr. Bruno and he is my normal vet. Dr. Johnson works for him and I like her, but Dr. Bruno has been watching Blue since he was a baby. Even tried to adopt him from me! NO

Anyway, he called and wanted me to come on home while he does some blood work. He suspects pancreatitis.
He was a little dehydrated as well. Just waiting for him to call. He did say his blood sugar was still in the 300s.

 

It's always awful when our little ones are at the vets, but it sounds like Blue's in very capable and caring hands.

(((Patty and Blue)))

Maybe take this chance to get some rest for yourself, Patty?




Mogs
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Prayers for Blue, I hope he will start to feel better and they can figure out what's wrong . rest up ♥

 

I spoke with Dr. Bruno again and just dropped off Blue's insulin, syringes, food, treats and a blankie.
He has a pretty bad case of pancreatitis and needs IV antibiotics for a couple of days. Since he hasn't
been adjusting to the insulin that well apparently this is a sign. I'm so scared for him and hate him being away from me. He thinks if we can cure him he might not even need the insulin. I'm not sure I understand all this. Did he not have diabetes?

 

Sending prayers and vines as we say around here. I wish they could figure out why so many kitties are getting pancreatitis.

 

It is possible that an infection is raising his bg. Are the antibiotics for what you have been treating already? Poor Blue. Take it a day at a time but know he's getting the best care there is IV antibiotics are needed. I wonder if he was not on the correct ones all this time.

 

I know you are scared and hate being away from him, but he's being well taken care of.
I would feel the same way you do.
Sending more prayers for Blue and that he makes a full recovery
Try and get some rest so you are ready for when Blue comes home ♥♥

 

I'm sure not. Dr. Bruno mentioned he shouldn't be on the antibiotics by mouth I was giving him. I wish I had more time to talk with him. Blue just hasn't been well since developing the URI. He's been on a good many different things to knock it out but nothing has worked. In the middle of all that is when he was diagnosed with diabetes. I'm really hoping the IV antibiotics will help him and clear everything up.

 

Thank you. Prayers are welcomed.

 

Sending prayers for Blue and for you, Patty. I know it's so hard to be away from your beautiful boy, but try to focus on knowing that he's where he needs to be right now to help him feel better.

Be sure to keep us updated with Blue's progress.


Mogs
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Another thing I thought about is Dt. Bruno ask me 3 separate times if Blue got down to 44 yesterday. I think he was shocked he would go that low on such a small dose.

 

I think many general practice vets don't see anything like the volume of data we see here, Patty, and many diabetic pet parents only loosely regulate their animals, relying on periodic curves to check dose safety. If those curves are vet-run then they are likely to be influenced by stress - less chance of seeing lower numbers (and also being prescribed higher doses).

How are you holding up?



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I'm worried. He's special to me. I love them all but he's always had my heart.

 

Blue's without doubt a soul cat, Patty. I can relate.

(((Blue)))

I'm sure they'll look after him very, very well for you, Patty. Sounds like his main doctor has a major soft spot for your boy.

And not one single word I can say is going to stop you worrying, is it?

Keeping you both in my prayers. Please keep us updated: we're worrying along with you.

(((Patty and Blue)))




Mogs
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I know exactly what you mean when you say he's special Patty
Tyler is my diabetic and I love him dearly
His brother Perry was my heart kitty, he had kidney disease and I had to let him go
last week. So I know exactly what you mean
Patty he will be ok ,he will recover and be home with you waiting for lots of kisses
Prayers are still coming ♥♥

 

aWWWW (((((Patty))))) (((((Blue)))))
continued prayers

 

I'm so sorry about your Perry. I'm sure you're still in pain. It's always difficult losing our babies.

 

Thanks Jeanne. It's nice having people around that know the sadness and can lift you.

 

I wish I could say I wasn't worrying but I am trying not to. I'm sure he's on an IV and pain meds by now. I'll check on him in the morning. I hope he doesn't have to stay again but I think he needs to be on this IV for two days. As long as he's better I'll feel better too.
Thanks to you and everyone for being here for me.

 

Dr. Bruno doesn't want him on antibiotics by mouth. I'm not sure if it made the problem worse or not. I hope to learn more tomorrow. I have wondered why if he's taking these meds why doesn't he get better. In the middle of all this he was diagnosed with diabetes. I don't want to think the other vet made a mistake but I'm kind of leaning that way.
Thanks for helping me through yesterday along with Mogs.

 

take one of your worn shirts to leave him with to comfort him with It will have your scent on it.

 

I think you might be right about the other vet. I’ve wondered about that.

 

She's very young. Hasn't been out of school long. I'm going to be upset if that's the case.

 

I took him a little pink baby blanket.

 

Hi Patty,

Just a quick note to ask how you're doing and to send more prayers for your beautiful Bluebird.

(((Patty and Blue)))




Mogs
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Thanks Mogs. I'm trying to not call to check on him but don't think I can hold out much longer. I was hoping they would call with an update.

 

Give 'em a ring, Patty. The vet might not be available to give you a full update till later, but it's a very human thing to want to ask the general staff how your beautiful boy got on overnight. I'm sure they'll understand that.

I'm worrying along with you. Got a massive soft spot for your Bluebird.

(((Patty and Blue)))




Mogs
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Thanks for giving me permission. I guess that's what I needed, a little push. He's up eating and drinking and seems to be feeling a little better. This was a technician but a doctor will call me when one of them is free. I feel better now.
Still wish he were home. I miss that boy!
Thank you and I'll keep you posted.

 

OMG with the bill you are paying? CALL!

 

Very glad to hear this, and good that you're feeling a bit better for the positive update, Patty.

Will check back later (going back to bed - cold isn't shifting and fatigue's really bad).

Fingers and paws crossed that Blue will be back home with you before long (with plenty of supportive meds so you can continue his treatment as needed at home!).

(((Patty and Blue)))




Mogs
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Be well Mogs

Progress good progress Patty

 

Since he is eating I would think he can come home today. Max generally just stayed one night. Only question is if Blue needs more IV antibiotics and for how long. I like this report a lot.

 

I called to check in Bluebird and Dr. Bruno will still call me with an in-depth update. In the meantime, they are monitoring him closely as well as taking a BG reading hourly.
He's doing ”okay” is what I was told. That wasn't reassuring to me. I look forward to talking with Dr. Bruno. I'll update after I speak with him.

 

Keeping positive thoughts.

 

Dr. Bruno called and Blue is doing well. He's keeping him another night. He is monitoring his BG closely and he wants him to get 1 unit once a day. He wants him to stay around 200. He said he'd explain it tomorrow. He said less stress and more rest. Siamese are predisposed to pancreatitis and he feels he's had low grade for a while. He’s on fluids, antibiotics and something for pain. He's eating well. That's about it. I’m not sure why he wants Blue to have insulin only once a day but should know more tomorrow.
All I know is I miss my Blue. Hoping he'll be home tomorrow. Thanks for being here and going through this with me.

 

Awww we miss him too!

 

Is there a vet there over night?

 

No. That's why I hate leaving him. There's an animal hospital close but I’d have to pay a lot more.
It's an ER and hospital and you pay $350 just to walk in the door. They do have specialists there.
I'm sure he’ll be fine but still hard.

 

Glad to hear that Blue's doing well, but I can relate to how very much you're missing him, Patty. Please God, he'll be back home with you soon.

(((Patty and Blue)))



(Sorry for not replying sooner - feeling really sick. )


Mogs
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Mogs, I'm worried about you. This has been going on a while now. You should be getting better.
Do you have a doctor you could call?
I hate you are so sick. Don't worry about us. Just take care of yourself.

 

Update: He gets to come home today. I pick him up at 5:15. No news yet on aftercare but Dr. Bruno will call.

I was researching the one shot of insulin. I'm not sure his reasoning for this. It doesn't sound like something that's done very much.

 

I’m glad he’s coming home! Lantus only works for 12 hours with cats. If he gets one shot a day I think he will bounce around a lot and not stay under renal threshold. I suspect that your vet thinks you can’t give the small doses we give accurately. Max was about as sensitive a cat as one can find but he never minded tests and he was tightly controlled and had chronic pancreatitis. I think 200 might make sense on a pet meter but not on a human meter. If you do this I would get a fructosamine test in a few weeks to see if he’s controlled.

 

Hi Patty!

Great news that your Bluebird will be home soon! I know how much you're missing him.

I, too, am very curious about what your vet's reasoning is on the single insulin dose per day. To me, it especially doesn't make sense with a depot insulin, and even less sense with a cat as bouncy as Blue is. If he advises dosing at 1IU once a day then, in simplified terms, it will be too much insulin for 12 hours a day and not enough for the other 12 (and it will play havoc with the depot).

Keep safe when you're out and and about, Patty. Blue's going to be so happy to be back with his mama.

(((Patty and Blue)))




Mogs
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The crazy thing is you would be giving the same dose all at once.

 

Exactly my thought.


Mogs
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Those are exactly my thoughts. When he called yesterday he asked again about the 44 and thought it was a fluke. I assured him it was not because of all the numbers that came after. He asked about the meter I was using and how I was testing. I guess he doesn't have many people that do this. He is an old vet so maybe not up to date on the new approach to treatment of diabetes in cats. Also, maybe set in his ways. I will listen to see his thinking but Blue is ultimately my cat and I'm responsible for his care.

 

Mogs, how are you feeling?

 

((((PATYYYYYYYYY))))))

WELCOME HOME BLUE

 

I'm also very curious as to your vet's reasoning for this too.

I suggest asking your vet whether he means 200 as measured on a veterinary meter, reason being that a BG of 200 as measured on a human meter is likely to be breaching the renal threshold. (FYI, renal threshold on veterinary meter is 250-290 according to the Merck Veterinary Manual, but range would be lower if measured on a human meter.)


Mogs
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Hopefully more info to come but I'm leaning towards a new vet

 

Why oh why is it so hard to find good vets? It’s the same in Los Angeles and with Covid it’s s hard to communicate let alone switching when you can’t even meet the vets face to face. If your vet is good with everything except FD, use him for other stuff and the fdmb for FD. My vet stopped giving dosing advice once I was following TR. I made him a tad nervous when he saw some of the lows and he wanted me to email the ss every couple of weeks but felt I managed Max just fine.

 

Cold's still ongoing but tummy not as bad as yesterday. Thank you for asking, Patty.

Might as well tell the sun not to rise.

(((Patty and Blue)))




Mogs
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Elise, did you give Max supplements for his pancreatitis? I was just reading an article about it and it lists several supplements that are helpful.
Did he have it before diagnosed with diabetes or after?

 

You know, I feel like the young doctor was willing to work with me better. She was really open to me testing and loved the spreadsheet. Dr. Bruno is questioning what I'm doing and isn't as fast to go along with it. He might just be to set in his ways. Still dismissing the 44 reading is on my last!

 

I'll be back in a bit. I have an eye doctor appt.

 

Elise is right. Once my vet learned about this place she gave us her blessing. the only time Trouble went back was for annual checkups.

 

This is important. YOU have to be able to put your faith in your vet. Sorry but Bruno sounds like a vet set in his ways no matter if its a dog or a cat.

 

From Blue's spreadsheet:

09.09 - AM+5 - 50 - Dose: 0.75IU BID
09.23 - AM+6 - 48 - Dose: 0.75IU BID
09.29 - AM+4 - 48 - Dose: 0.75IU BID
10.05 - PM+3 - 50 - Dose: 0.75IU BID
10.11 - AM+3 - 44 - Dose: 0.75IU BID

Yeah, sure that 44 was a fluke.


Mogs
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