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Hi Sophie,
Thank you so much for rescuing Sid! He's
adorable!!!
(((Sid)))
Another UK bod here.
Here are very helpful links for you:
IDEXX Pancreatitis Treatment Guidelines
Nausea, vomiting and appetite problems - symptoms and treatments
Do you have the ability to run a SNAP fPL blood test at the vet school today? That would give you an immediate yes/no answer on whether pancreatitis is the problem. A Spec fPL lab result will give you an indication of severity of inflammation. If you haven't done so already, it's wise to check B12/folate levels, too.
Have you just changed his food to Hill's m/d? A diet change can cause digestive system problems. It may help Sid to go back to his previous food for the time being. (Word of warning: DO NOT feed Sid SHEBA Fine Flakes food - they've recently changed the formula. I've seen two reports from others about cats having a problem with it, I recently lost my little one after feeding it - triggered a
massive pancreatitis flare - and it also caused GI issues for my non-diabetic cat.)
Have you kept the food the same but started a different batch? This, too can trigger digestive problems. If yes, try a different food batch of the same formulation.
Another thing to try might be to gently poach some chicken breast just in water, mince it up finely and give small amounts along with a tablespoon or two of the poaching water (broth). It's easily digestible and may help to keep a little bit in Sid's tum till the anti-nausea meds kick in.
I've also seen some cats here (my own little one included) who developed nausea/GI issues similar to those you're describing shortly after starting insulin treatment (sometimes with a diet change involved, sometimes not).
Ondansetron is a gift from the kitty gods for treating nausea. Generic Zofran is insanely expensive (and not the best variant) but generic ondansetron is very affordable. The best ondansetron for cats in the UK is the Bristol Laboratories generic. A human drug, you may not have it at the vet school pharmacy. Various generics may be available at local pharmacies but the BL version is less constipating than the other generics. If you need to treat with ondansetron but can't get the BL generic locally, Pharmplex carry it all the time. Here's a link - you need to specify on the written Rx that you need the Bristol Laboratories generic. It costs less than ÂŁ10 for 30 tablets.
http://www.pharmplexdirect.com/ondansetron-tablets-4mg-tablets-p-54595.html
I can't sing the praises of ondansetron highly enough; it saved my little one's life more than once.
As you already know, Cerenia is another anti-nausea treatment which is especially helpful for vomiting. Ondansetron can take a day or two to build up to full clinical effect but the Cerenia should help fairly quickly, even though its effects peter out relatively quickly. Both Cerenia and ondansetron can be used in combination if the nausea is particularly severe. See the following post on another related thread for details:
http://www.felinediabetes.com/FDMB/...ast-yesterday-help.166040/page-3#post-1796242
Another thing to double-check is that Sid is not constipated (another complication of unregulated diabetes) since this, too, may cause nausea and vomiting plus some diarrhoea may leak around a 'stuck' stool. If constipation is the issue any anti-nausea treatment won't help much until the constipation is resolved. A couple of doses of metoclopramide to give a boost to gut motility may be a help. See the IDEXX document for further info on metoclopramide (Reglan). It may help with resolving a gut motility issue but it's almost useless as a standalone anti-nausea treatment. (I can attest to this from experience.) Here's a very useful resource on cat GI issues:
www.felineconstipation.org
Feeding very small meals with a little water added from raised dishes can help a lot with nausea problems. I recognise that this may make Caninsulin administration problematic because of its hard, fast onset. I've no experience of using Prozinc but it is another option available to you. From what I've read here it may not be as harsh on a cat's system as the Caninsulin.
For general information, the veterinary Rx foods are higher in carbs than ideal; the recommendation is to feed a diet with less than 10% calories from carbs. Purina DM canned is the only Rx food in the UK which I know to meet this criterion. Rx foods are expensive, too. For future reference here is a thread with details of UK diabetic-friendly food info. On the thread you'll find a link to the current list of UK commercial foods which are diabetic-friendly (and more affordable):
UK Diabetic-friendly Food Info
Here's a link to the best site on the web (vet-authored) covering general principles of feline nutrition. How I
wish to the high heavens I had known about it when my little ones were kittens. I'm giving you the link to the diabetes-specific page but I always recommend reading the whole site. Without exception the root cause of all the health problems any of my cats experienced to date can be linked directly back to feeding dry, species-inappropriate food. Pointing you in the direction of this site is the greatest gift I can think of to offer you for Sid as you start out on your journey together:
Dr Lisa Pierson's catinfo.org site - Feline Diabetes
Another way to keep cost of home diabetes management down is to use a human glucometer with a cat-specific reference range; the test strips are
significantly cheaper than those for the Alphatrak 2. (If you do opt to do your home testing with an Alphatrak let us know and we can point you to where to get the best prices on them.) You can get good deals on human meter strips at ebay or Amazon (check both every time to see where the best price is to be had) but always check the expiry dates before ordering. One popular human meter with UK members is the Accu-Chek Aviva. (Strips are widely available at the likes of Boots and Morrison's should you ever get caught short with an internet order arriving late.) It's also cheaper to order urinalysis strips on ebay or Amazon but again check expiry dates before placing your business. We can also give you other pointers on how to keep treatment costs down (e.g. for syringes). Just let us know when you'd like more info.
I'm sorry if this is a bit 'teaching granny to suck eggs'; I'm just very keen to try to help you help Sid plus I
hate pancreatitis with a passion that defies articulation so I try to do all I can think of for kitties who may have it.
Once again bless you, Sophie, for saving this
beautiful boy. The relationship you're going to have with your little sugar cat is going to be a-
mazing.
Mogs
.
the best thing Ive seen all week! Before that every day was large bowel diarrhoea. 
worried he's slipping also eating very little