? 6/8 thru 6/15 TiTi has pancreatitis attack. BG in 300s for for 24 hrs.

[Kathy and TiTi]

On June 13 around 10pm TiTI started projectile vomiting with diarrhea. I figured it for a Pancreatic attack. Gave her ondanesetron, and cerenea. That didn't touch it, so I gave her a dexamethasone (cortisone) shot, and that worked. Meanwhile her BG stayed great. Blue. At 7:30 am I woke up with that feeling one gets, and took her BG. It was 74, so I fed her and at 9:30am, her shot time, she was up to 132.

On June 14th, her BG stayed in mid-blues, until it shot up to 303 at 9:30pm. so I increased her insulin from 9U to 10U.
Today she has been in a relatively flat pink all day long up to and including her PMPS shot time.

My question is: Why did she stay in normal blues to green the evening and morning of the 13, and remain fine until the evening of the 14th when she was so sick; and then run up to 303 the late evening of the 14th? It makes no sense, because she's asymptomatic now, yet when she was violently ill, her BG was normal to great (green).
I don't think a bounce, because she was in green to blue for almost 24 hours during and after her vomiting and diarrhea, but I can't see any other reason.

I'm trying to figure this out, and would really appreciate some help.

 

[Wendy&Neko]

With nadirs in the 70's just 2 nights ago (6/13), I would not have increased the dose. Especially not by a whole unit! I suspect she might have gone lower than 74 on the PM 13th cycle, as she did a really big drop of almost 80 points to +3 and then no more testing for 7 hours. Yet you then increased by a large amount, saw some New Dose Wonkiness and no testing last night. Who knows what she did last night. Cortisone (steroids) can also increase the BG's. So there are many reasons for higher numbers now.

As for the good numbers, if she vomited her food, she didn't have any carbs on board to counteract the insulin. She had seen 60's on that dose a few days before hand, so 74 isn't far off that. Also, some cats have delayed bounces. Neko would often hold onto blues for a cycle after going lower and start her bounce a cycle or two later.

Your spreadsheets shows the projectile vomiting on the 14th, not the 13th. Which was it? I hope Titi is feeling better now.

 

[Kathy and TiTi]

With nadirs in the 70's just 2 nights ago (6/13), I would not have increased the dose. Especially not by a whole unit! I suspect she might have gone lower than 74 on the PM 13th cycle, as she did a really big drop of almost 80 points to +3 and then no more testing for 7 hours. Yet you then increased by a large amount, saw some New Dose Wonkiness and no testing last night. Who knows what she did last night. Cortisone (steroids) can also increase the BG's. So there are many reasons for higher numbers now.

As for the good numbers, if she vomited her food, she didn't have any carbs on board to counteract the insulin. She had seen 60's on that dose a few days before hand, so 74 isn't far off that. Also, some cats have delayed bounces. Neko would often hold onto blues for a cycle after going lower and start her bounce a cycle or two later.

Your spreadsheets shows the projectile vomiting on the 14th, not the 13th. Which was it? I hope Titi is feeling better now.

Sorry . Yes on the 13th. I fixed it. Thanks for letting me know.

Yes she seems much better, but that could just be a reaction to the dexamethasone, which is long lasting. I'll know for sure in a week. The idea behind dexamethasone vs pills, is the long action, a more stable release over a longer period of time, or so my vet told me.
As to the increase, I hadn't much sleep and the 303 panicked me. Not a good call. I thought she might be settling into a long case of pancreatitis which does increase the BG.
I wondered about cortisone and BG, Thanks for telling me. Sigh.

I should have just checked in right away after the attack, but I'm in deadline mode with this job, which ends next week, and I'm trying to get in as many hours as possible. Sleep is catch as catch can. Not the best model for clear headedness. I'm usually a better cat mom.

I'm glad you responded. I better watch her carefully, because from what you've said, 10U might well be too high.

By the way, I'm getting concerned about the effect the acro might be having on her joints. She seems stiffer or having more awkward gait, or perhaps just more difficulties walking and jumping; her forelegs seem a bit too long - something I've noticed for over a year now. But the awkwardness is newish.

 

[Wendy&Neko]

Are you giving her anything for arthritis? Neko was on fish oil and a Cosequin equivalent at first. That didn't prove enough and I added Cartrophen (Canadian equivalent of Adequan) and also tried Hyaflex (hyaluronic acid) and Duralactin. I also added buprenorphine to manage the pain and accupuncture helped as well. It's kind of an experiement, what works for one cat doesn't always work for the other. Some cats do better on gabapentin for pain. I also invested in cushy pet beds. Neko loved her memory foam bed.

 

[Tricia Cinco(GA) & Harvey]

Kathy, I have an entire, unopened bottle of Duralactin, plus a dozen or so more capsules, left over from Harvey. I can send them to you if you'd like to try them on TiTi. You might give your vet a quick call and just ask if there is any reason NOT to give it to her. I think I recall someone saying that cats that have high calcium levels shouldn't take it, but I might not be remembering that correctly. Anyway, let me know if you want it.

 

[carfurby (GA)]

 

[tiffmaxee]

How often are you giving dex? Projectile vomiting makes me nervous that some other intestinal issue is present. Vibes.

 

[Kathy and TiTi]

How often are you giving dex? Projectile vomiting makes me nervous that some other intestinal issue is present. Vibes.

3 other times, and a one-off each time.

 

[Kathy and TiTi]

Kathy, I have an entire, unopened bottle of Duralactin, plus a dozen or so more capsules, left over from Harvey. I can send them to you if you'd like to try them on TiTi. You might give your vet a quick call and just ask if there is any reason NOT to give it to her. I think I recall someone saying that cats that have high calcium levels shouldn't take it, but I might not be remembering that correctly. Anyway, let me know if you want it.

Thank you. Probably. I I read up on it and I need to test TiTi on some milk first to see If she is lactose intolerant. I'll try her on it.

 

[Kathy and TiTi]

Are you giving her anything for arthritis? Neko was on fish oil and a Cosequin equivalent at first. That didn't prove enough and I added Cartrophen (Canadian equivalent of Adequan) and also tried Hyaflex (hyaluronic acid) and Duralactin. I also added buprenorphine to manage the pain and accupuncture helped as well. It's kind of an experiement, what works for one cat doesn't always work for the other. Some cats do better on gabapentin for pain. I also invested in cushy pet beds. Neko loved her memory foam bed.

I think she would love a memory foam bed. So far her difficulties are very minor, mostly in her forepaws where they meet her torso. She's stiff and the forepaws are longer than they were.