New to the board/diabetes/pancreatitis

[scottmurphy]

Hello,

I've been visiting this site with interest. It's terrific with a lot of avid and concerned cat lovers.
Thanks in advance.

Background:
Evu--10 year old male (great cat and my good friend).
First had a pancreatitis episode in August (his first ever...health was fine before that).
He was given fluids at the vet and put on one unit of Lansulin. Blood sugar levels were high and went a bit lower. He recovered until a few weeks ago. Same process. He was put on two units of insulin twice a day. They claim his kidneys and liver are fine. However, they could not do an ultrasound on his pancreas citing costs.

Around Wednesday he had a relapse. The catch is that I'm between jobs at the moment and money is extremely tight. I put him on a new drip and gave him an appetite pill...little success.

He's moving around but losing weight. He's also drinking a lot of water. I'd estimate that he's consumed 24 ounces in the past day. While he ate a can and then some yesterday, today I have to force feed him. He does not have a fever.

The vets have been helpful, but given my economic situation at the moment, I'm wondering what I can do at home. Should I reduce insulin? Increase it? Continue to force feed him? Appeal to the vets? Home testing for me has been difficult, simply because I can't get the hang of it yet.

I'd appreciate any feedback and will check in to this site regularly. Thank you.

 

[Kris & Teasel]

Welcome! This is a great place for advice and support.

one unit of Lansulin.

Do you mean 1 unit of Lantus insulin?

He was put on two units of insulin twice a day.

Was the dose increased from 1 to 2 units in one jump?

I put him on a new drip and gave him an appetite pill

Could you please explain what you mean by a new drip? Are you giving subcutaneous fluids at home? What appetite medication was prescribed?

While he ate a can and then some yesterday, today I have to force feed him.

What type of canned food are you feeding him? Did the vet prescribe antinausea meds along with the appetite meds?

Should I reduce insulin? Increase it? Continue to force feed him?

You need to know what this insulin dose is doing before you change anything. If you have to force feed him he probably needs a better regimen of antinausea/appetite stimulant meds.

Home testing for me has been difficult, simply because I can't get the hang of it yet.

Unfortunately this is the essential tool in learning how your kitty is responding tot he insulin. There are lots of tips and tricks we can give you to help.

If you repost on the main health forum and answer the questions I've asked here you'll get more people seeing your message and they'll be able to jump in with advice.

 

[scottmurphy]

Hi....(and yes I'll post on the main board)...
He was upped from 1 unit of Lansulin to two units in one go.
I am feeding him Mon Petit canned food and Whiskas tuna.
I gave him one Mirtzapine pill two days ago. He is currently not on anti-nausea meds, though I have been giving him small doses of Temgesic.

 

[scottmurphy]

And yes, I've been giving him subcutaneous drips at home (Lactate Ringer).

 

[Kris & Teasel]

1 unit of Lansulin to two units in one go.

This is a big jump. We recommend small increases of 0.25 u so you don't go right past what might be the good dose.

Mon Petit canned food and Whiskas tuna.

Low carb wet food is best. I don't know the carb content of these. Friskies and FancyFeast pates (no sauce/gravy types - too high in carbs) are economical and used by many of us.

one Mirtzapine pill two days ago.

This med can have adverse effects for many kitties - agitation, vocalization, vomiting, etc.

He is currently not on anti-nausea meds,

They often need both types of meds when they lose interest in food.

small doses of Temgesic

Is this a pain killer? I'm not familiar with it.

 

[Kris & Teasel]

giving him subcutaneous drips at home (Lactate Ringer).

I assume this is part of your at home pancreatitis treatment protocol. There are members here who are experienced in this. I suggest you post a new question on the main health board asking specifically for advice on treating pancreatitis.

 

[scottmurphy]

Temgesic is a pain reliever. Friskies and Fancy Feast are U.S. brands. Since I'm in Asia, Mon Petit is a Japanese brand.

 

[Kris & Teasel]

Temgesic is a pain reliever. Friskies and Fancy Feast are U.S. brands. Since I'm in Asia, Mon Petit is a Japanese brand.

You might want to research the carb content of the wet foods you're able to buy in Asia. I'm not sure there are any Asian members on the forum.

 

[Critter Mom]

Hi Scott,

I'm so sorry to hear Evu has pancreatitis problems. (((Evu)))

If you can get a supply of supportive meds you can do a lot to treat a flare at home. I'm in the UK and I took my sleep meds not long ago so I can't type much at the moment. I'll check in later but in the meantime can you post:

- the name of the appetite stimulant you're using.
- the name of any other meds the vet prescribed for your kitty.
- whether you're giving sub-q fluids at home (it's unclear from the opening post).
- the name of the insulin you're using: Caninsulin or Lantus?

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With the excessive water consumption you really need to find out what's going on with BG levels. To help you with the testing here are some links:

Home testing links and tips

Testing and injecting tips (very helpful diagram of the testing 'sweet spot' here)

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Here are some other tips from the method I use which might help you:


Before warming the ear, remember to smear a thin film of Vaseline or neosporin (ointment, not cream) over the test area.

A rice sock is very good for warming the ear. In the early days it can take quite some time to warm the ear enough.

Try this method once you have the ear well warmed:

1. Put a 1" strip of kitchen paper around your index finger.

2. Curl the ear around the index finger so the kitchen paper provides a supportive cushion.

3. Hold the ear gently but firmly in place using your thumb and forefinger, stretching the ear slightly to make the skin taut. (Also helps reduce head movements.)

4. Make sure the bevel of the lancet is facing you. (Twist it under a good light to see the flat surface.)

5. With the lancet at an angle of about 45 degrees, prick the sweet spot as though you were trying to pop a balloon.

6. If your kitty is a wriggler catch the blood sample on the back of your fingernail and test from there.

7. When the test is finished fold the kitchen paper strip over the test site and apply gentle pressure for 10-15 seconds to stem the bleeding and prevent bruising.

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If you can manage to get a couple of readings in over the next few hours it will help us to help you better.

Here are useful resources I've found invaluable for management of pancreatitis:

- Nausea symptoms and treatments
- IDEXX pancreatitis treatment guidelines
- Persuading kitty to eat
- Stimulating kitty's s appetite

The first easy thing to try is raising food and water bowls a couple of inches up from the floor (helps kitty not to have to bend down to eat or drink).


Mogs
.

 

[Critter Mom]

Scott -

I composed the above post last night but my sleep meds kicked in before I could submit it to the board. Sorry for the duplicated questions.

Is there any way you could get a supply of ondansetron (generic!!! Zofran, the branded one is very expensive) for nausea and some cyproheptadine for appetite stimulation (NB - there is a major drug interaction between mirtazapine and ondansetron so it is not a good idea to use them together. Cyproheptadine's effects don't last as long as mirtazapine but you can give it up to 3 times a day so it can provide a more predictable and controllable level of appetite stimulation than the mirt.)

If you can't get cyproheptadine then don't bother with the ondansetron; ask for Cerenia tablets instead (don't get fobbed off with a one-off Cerenia injection; you need to be able to continue treatment for nausea at home for several days at least.) Cerenia can be used at the same time as mirtazapine.

The anti-nausea meds are really key to helping Evu to eat.

Important Questions:

- When did Evu last poop?

- What was the stool quality like? (Hard, normal, mushy, diarrhoea,)


Mogs
.

 

[Critter Mom]

Scott -

I'm not familiar with the name "Lansulin".

* Does your insulin packaging/labelling have "insulin glargine" written on it?

* What is the name of the manufacturer of your insulin?


Mogs
.