lady_curmudgeon: (Lars)
2016-03-04 10:21 am
Entry tags:

State of the Lars: doing better!

His blood glucose is still a bit wonky, with numbers ranging from the 150s-180s up to as high as the 270s on one stick, but...yeah...very much above the incredibly scary numbers he was clocking in with on Monday night. We're still foregoing any insulin if he measures in over 200 for a few more days, but so far he's only had a couple of sticks where he's actually been over the 200 threshold for giving him any anyway.

He's active, alert, bright-eyed and otherwise his amusing and loving self. His appetite could be a little better, but otherwise he's about back to normal.

His downloading remains okay on the lower doses of Lactulose, so we're slowly tapering him back up to his regular dose on that as we see fit. No need to make him go from the constipation extreme to the other end of the spectrum so...yeah.

So...

Whew. Think we got him through this one...
lady_curmudgeon: (Lars)
2016-03-03 09:47 am

State of the Lars: our first diabetic hypoglycemic event...

We had to go out of state for a funeral (my Uncle Fred, who lives in Ohio, died) over last weekend, so we had to board the kittehs while we were gone. Things went well according to all reports. They did mention that he'd been picky with his wet food but that he'd eaten his kibbles pretty well, and that he'd only needed insulin that morning when I'd come to pick him up.

Brought him home and he was acting normally initially. He disappeared not long after I got home, but that's not unusual for him. J got home from work around 1830, was looking for the kittehs to say hello again after not seeing them since Friday morning, but couldn't find Lars. Weird...

Fast forward to around 1900-1915; we hear one of the cats start howling. Sounded like a Dorene howl when she saw a strange cat outside. Happens again, but it's coming from the den. Look around and find Lars hiding under the Fancy Chair, looking Not Right. Eyes dilated, panting. I ask J--should we take a blood glucose reading? Yes...

Do it, comes back at 23!!! WTF?!?! Shit!!! We know to give him sugar right away, but the only liquid form of sugar we have in the house is maple syrup--okay, that's gonna have to do. Give Lars a bit via syringe while I'm calling up Brookville trying to get ahold of a vet there to let them know/ask how the fuck to proceed as they're about to close for the night and do not offer overnight care. Dr on site says to it's better to use light corn syrup, but maple syrup will work, too. Give 2cc every 10 minutes, then test blood glucose (BG). Call back right after. We manage to get the BG up to 28, lather/rinse/repeat, it goes back to 25.

Time for the e-vet. We bundle a very limp and unresponsive Lars into his carrier and drive him out to Lisle's Emergency Veterinary Services. They do a quick triage on him and determine he needs to stay overnight. We tell them his extensive medical history, give him all the vet information for both Brookville and VCA Aurora, and go home to try and rest so we can get up in time for the 0730 deadline for pickup.

We get a call around 2330 from Dr. S at the E-vet--Lars' BG is not coming up very quickly. In fact it goes up a little bit, then goes back down again. They've been giving bostules (like bursts) of dextrose along with the constant dextrose drip, feeding him, and giving him a high calorie gel supplement. She wants to run blood work on him to rule out any other issues going on--I give consent. All blood work comes back normal, thank Bast. Also, Lars had a couple of bouts of diarrhea--probably related to stress. Probably wouldn't want to give Lars any of his Lactulose constipation medication for a couple of days once he was home...

Lars' BG finally comes up and maintains a low normal in the 150s around 0500. We get sent home with an almost full bag of IV fluids with glucose, a tube of the high calorie supplement, the Cone of Shame that Lars had been wearing because he'd been fussing with the catheter during his stay, and Lars with the capped catheter still in his leg. He's to go straight to his regular vet for further monitoring, so I take him right to Brookville. No docs were in when I got there, but they had the faxed over docs from the e-vet and knew that Lars was to continue on the Dextrose IV drip, so they did that until one of the docs arrived.

I had my pre-op screening with my GP at 1000, so I did that and just drove right back out to Brookville after my appointment was done to get a Lars update in person. Dr. Lyn told me Lars' BG was stable in the 150s and I could take him home, to go back to our regular routine of checking his BG twice a day, and to let him "run hot" as the e-vet recommended for several days, meaning no insulin even if his BG was over 200 to let his body systems recover a bit. Also, reminded me to forego the Lactulose for a couple days, too.

Get home and notice the first thing Lars is doing is fussing with the compression bandage where the now removed IV catheter had been. I knew it was too soon to try to remove same, so I put Lars back into the Cone of Shame for an hour before I called back Brookville to see when I could remove the bandage safely.

I got the all clear around 1215. Take the Cone of Shame off of Lars so it's not in the way and get to work. It was a bitch to get off. In fact...Yeah...I couldn't get it off. I tried to find the loose end on the wrap, but it was so tight I couldn't get it off. Lars was uncomfortable and showed it with gentle licks and nips until...all of a sudden...CHOMP!!! Bit my left thumb in the middle of my cuticle line very VERY hard--so hard I thought I heard a crunching noise. I leave Lars where he is on the bed, grab the phone with my good hand, and race to the bathroom to go put my thumb under hot water to start flushing the wound. It was bleeding quite well and it hurt like a mother fucker.

GPs office tells me to go directly to Urgent Care, where they've got more means to care for me than their office. I go, get seen right away. Betadine soak immediately after initial exam, then x-rays of my thumb at my stern prompting to make sure no bone chipping happened from the bite because of the crunching sound I heard. X-rays came back clean. Get a scrip for high dose Augmentin for ten days, instructed to soak thumb at least twice a day in warm water, to wash it at least twice daily with antibacterial soap and to keep it bandaged up for at least the next 2-3 day and then to leave it unbandaged overnight thereafter.

Go home and find that Lars has partially chewed some of the compression bandage off his leg. I'm out of give-a-fuck calories at this point and decide to just let him chew at it until his daddy gets home. :o/ Once J gets home we try again, have no luck, and finally dig out the first aid snub nosed safety scissors and do what I should've done in the first place and cut the fucking thing off. We're all happier for the fact that the bandage is finally off.

How's Lars doing now? Yesterday's BG numbers were in the mid 150s again, but this morning he turned in somewhere in the 270s if I'm remembering correctly; I don't feel like getting up to look at his log book, so...yeah, LOL. He's acting like his normal self for the most part. Active when he should be, seeking out attention. His appetite could be better, but it's not terrible by any means. Downloads are still a little soft, but coming around. J gave him 1 Cc of his laxative this AM, so we'll gradually ramp him back up to his normal dose on that.

That was some scary fucking shit. I hope we don't have to go through that again any time soon... :o/
lady_curmudgeon: (Lars)
2015-12-08 03:25 pm
Entry tags:

State of the Lars: Possible verge of diabetic remission?

We had to make a somewhat impromptu trip up to Minnesota for a funeral for J's family over Thanksgiving weekend (J's Aunt Linda died on 20 Nov and her funeral was up in Bagley on the Friday after Thanksgiving), so we therefore had to board three out of the four kids while we were away. Ulysses gets severely anxious and upset at the vet/in caged situations, so we had friends take care of him here at home. We boarded Dorene to make feeding time easier for our friends and because Dorene takes boarding like a champ anyway, and we have to board Harlow and Lars because of their medical needs.

A little pre-story: we'd not been testing Lars' blood glucose per instructions from VCA Aurora internal medicine; they'd said that at his very low dose of insulin it wasn't necessary. We'd told them that at Brookville when we brought him in (and in his copious medical and feeding instructions notes), but we toted along his glucometer in case they decided to go ahead and test his blood glucose anyway.

They did, and it's a good thing they did. In doing so, they discovered that our boy was turning in normal to almost low normal blood glucose numbers when they tested him before his feedings and thereby didn't need any insulin at all while in their care!! :) To say we were pleasantly surprised was an understatement! :) They encouraged us to let VCA know of their results and to continue regular blood glucose testing at home, which we have been. VCA was happy to hear the news and also encouraged us to regularly test and record his numbers. He's largely been turning in great numbers since he's been home, although the past couple of days he's been in the low 200s, which meant he needed his one unit of Lantus insulin before his meal(s). This seems to have some correlation with his still slowly tapering prednisolone taper--his BG numbers go up after he gets the pred, which does not surprise us at all as pred is known to increase blood sugar in all species who've ingested it and have had their blood tested.

We're hoping the Pred Taper That Never Ends will end with the current dosing regimen of .5ml every third day. He's really on so little of the stuff as to basically be inconsequential anyway, so...yeah...We shall see in about a week when I call back for new instructions.

The best news is that Lars' asthma is under decent control with the negligible dose of oral pred and the primary controller being the steroid Flovent inhaler. I do notice a slight bit of a wheezy purr every now and again, but nothing to be really concerned about in my mind. So at least there's that going for us, which is nice. I've talked to Dr. Lehal at Brookville about Lars' asthma; he says if Lars has symptoms after he's off the oral pred we can increase the Flovent puffs and add an albuterol rescue inhaler if needs be to avoid going back on the oral pred if at all possible, so we've got other options in that regard, too. Good to know... :)

So, yeah. We're hoping that once Lars is completely off the oral pred that his diabetes will largely be under control and hopefully his need for any insulin will be negligible to completely unnecessary! :)