31 Oct | Girlie | AMPS 392 Pancreatits? Not feeling well

[Girlie's mom]

Condo: http://www.felinediabetes.com/FDMB/threads/30-oct-girlie-amps-437.186075/#post-2066584

Making some progress: good PM cycle last night with solid yellows from +1 to +4 and nadir of 216 at + 3 and +4.

Problem: She's not really interested in food. I had to open can after can to try to tempt her. It was really hot yesterday and she had acupuncture, which makes her sleepy, but now it's cool again, and she's still not interested. Thank goodness for Mirtazapin in the AM which should kick in soon.

Fortiflora: I have some Fortiflora (never tried it). I'm wondering whether I should try that, especially in the PM when she has less of an appetite as a general rule.

 

[Girlie's mom]

—anything you give her after nadir is going to potentially slow her down. If she absolutely must eat and she won’t eat any FD treats or boiled chicken, you can try a tsp of the absolute lowest carb food you have. If she’s diving, that’s a different story but remember if she’s dropping after nadir, you want to use the lowest carb food that gets the job done so you don’t impact her duration.
—yes, sorry...+7, I made a typo. While some cats don’t seem to lose duration if feeding after nadir, many do and she has an issue with duration. I would start with the MC food early in the cycle to see if we can get her to flatten out and then you’ll have to experiment but you should be able to lower the carbs for her other meals once she gets past the point where she dives. We don’t want to add to her duration issues by feeding too much MC. We just want to find out when and how to feed to slow her down and get her flatter. MC at PS, +1, +2, and +3 might be too much. Again...it’s an experiment so we have to be flexible and find what works.
—with the evening cycle, you’ll also have to experiment. Try the LC6 for the feedings and see how she does.

I was also feeding Gracie late in the cycle on Lantus and she were as totally losing duration so she got all her food by +4 and then just the zero carb treats later after nadir...around +9. If she was clearing bounce, I had to feed differently and longer because she would always want to give me a 50 at PMPS. On bounce clearing days, I would feed her a 5-6% food at +10 so she would stay above 50 and I could safely shoot.

It looks to me like she might be trying to clear a bounce today and that’s why she has continued to drop. We will have to see what she continues to do before we can determine if the way you fed her helped.

@Marje and Gracie , thanks for these tips and info and the PM message. I'm pleased with the progress I saw last night, so we'll see how she goes this AM.

Just some quick questions:

• Lack of appetite: I know it's not good to introduce new meds and things, but she seems to be on a "I'm not hungry" kick. I've never tried Fortiflora, but thought I might sprinkle a bit on her food to see if that helps. You mentioned that it's not good to introduce more than one new thing at a time. Would that be per cycle? Or after a certain number of cycles, do you think?

• LC + gravy? It could be that she's just not that keen on the MC food: she likes soupy, mushy food, and the MC FF has gravy but little flakes of food that she's not that keen on (unless she's doing a deep dive, and then she'll eat almost anything). I wonder if it would be ok to try the LC food she likes (LC 6 and LC8 Wellness) but add some Cats in the Kitchen MC gravy to that to bump those carbs up for the AMPS and +1? She really likes the CIK gravies...just trying to think out loud here...

• Carryover and Overlap: I'm a bit confused about these and how to distinguish this from the numbers on her SS. Because she seems to be having a problem with duration, does that mean that she doesn't really have carryover or overlap? Do you know where I could read more about this so I could try to figure this out on her SS?

• MC at preshot experiment: Shall I just carry on with this until she starts to flatten out? I'm more concerned about the AM than the PM. She went up and down yesterday in the AM like a bit of a yo-yo, and late in her cycle, as well. She's not a big eater (never has been), so I have to try to balance getting enough food in her in the mini-meals from AMPS to +3 and then have her still want to eat something later in the cycle if she does a deep drop (e.g. 85 pt drop yesterday AM from +7 to +8, which is really late in her cycle). And she'd gone up at +7. Not sure why she did such a dive at +8. If she does that big a drop that late in the AM cycle, I wonder if I should just not give food and see how she goes by the PM?

Thanks so much! It feels good to be trying this experiment and to see how being proactive rather than reactive seems to already be helping with Girlie. Just seeing some progress and some flattening out is really, really encouraging.

 

[Girlie's mom]

Not sure what's up for Girlie; I'm beginning to wonder if she's not feeling well. She's just not keen on her food, and with Mirtazapin in the AM, that's not like her. I'm wondering if she might be a little nauseated. Can AVJ cause nausea, I wonder? Would Fortiflora help with that?

Nice night of yellows last night. Continuing food experiment with MC early on to try to stall deep dives in AM. Tried to vary with LC 8 at +2 (so no MC 13 from AMPS to +3 as yesterday), but she did a dive of 78 at +3 and then 126 at +4. It looks like AM +4 to +6 are her deep diving times, but I'll have to study this in more detail on her SS. I guess tomorrow I can try to start with a LC 8 or 9 at AMPS and then try MC from +2 or +3? Not sure...

AMPS: 392: MC 13 (not that hungry)
+1: 464 (+72 pts): 13% (not keen)
+2: 515 (+51 pts) Wellness 8% (liked that)
+3: 437 (-78 pts): ate a little 13% (ca 1/4 tsp)
+4: 311 (-126 pts): not keen on 13% food; ate 2 tsp 14% CIK gravy

 

[Christie & Maverick]

Hi Darrah, I'm sorry things seem off with Girlie, with all you are juggling, one thought... have you checked for ketones too? Hope she settles back to her usual self .

 

[Girlie's mom]

Hi Darrah, I'm sorry things seem off with Girlie, with all you are juggling, one thought... have you checked for ketones too? Hope she settles back to her usual self .

Am waiting for her to wee! I was just reading the pancreatitis primer Marje wrote. I think she might be nauseated. I have some Cerenia left over from an ER visit, so I could try that. I'm just not sure what to do. Looks like I might have to take her to the vet, but I'd rather take her in when she's fasting so we can get the specfpl.

I'm sorry I haven't looked in on you lately - things have been insane in my world, unfortunately! Are you doing well?

 

[Christie & Maverick]

Oh gosh, don't worry about that, you have your hands full, , but thanks, Mav is doing very well! Nausea can definitely be the culprit, especially if she turns away from the food. Can you call the vet for some advice, and hopefully in the meantime, some pros will add some thoughts. How much has she eaten today? I've read people sometimes try a bit of Parmesan cheese on the food, to encourage eating.

 

[Girlie's mom]

Oh gosh, don't worry about that, you have your hands full, , but thanks, Mav is doing very well! Nausea can definitely be the culprit, especially if she turns away from the food. Can you call the vet for some advice, and hopefully in the meantime, some pros will add some thoughts. How much has she eaten today? I've read people sometimes try a bit of Parmesan cheese on the food, to encourage eating.

She doesn't like the Parmesan - I tried that a long time ago. I'm so glad to hear Mav is doing well! I'll call the vet, I think.

 

[Girlie's mom]

@LizzieInTexas , I see that Gizmo had pancreatitis. I wonder if you have any thoughts? I can't figure out what's up with Girlie since yesterday...it's odd for her to have dropping BG levels and not want to eat these MC foods. She has been licking her lips a little, but not hugely. I'm clueless here...

 

[LizzieInTexas]

Do you have any nausea meds? Plenty of water and do whatever you can to keep her eating.

Nausea, lethargic, meatloafed, and what I call a pinched face. Gizmo won't make eye contact and will isolate himself.

Cerenia has anti-inflamitory properties so I give that more than ondansetron. Also the Canna helps with the pain/discomfort.

It could be she isn't used to the MC food and it is upsetting her tummy or causing stomach acid. I would bet it is that vs. the AVJ.

See my signature - there is a link on pancreatitis.

 

[Girlie's mom]

Do you have any nausea meds? Plenty of water and do whatever you can to keep her eating.

Nausea, lethargic, meatloafed, and what I call a pinched face. Gizmo won't make eye contact and will isolate himself.

Cerenia has anti-inflamitory properties so I give that more than ondansetron. Also the Canna helps with the pain/discomfort.

It could be she isn't used to the MC food and it is upsetting her tummy or causing stomach acid. I would bet it is that vs. the AVJ.

See my signature - there is a link on pancreatitis.

Thanks, Lizzie. I've got some Cerenia leftover from an earlier ER visit. She isn't meatloafed, but she's definitely off. It's hard to tell if a cat is nauseated! At least, for me it's hard. Because of the huge dives she's been doing, she's had HC and MC lately to try to stall her, and she usually just wolfs that down. I'm waiting for the vet to ring me back; I'm hoping she'll do that soon and ok the Cerenia; I don't want to give it to her in case the vet wants her to come in for some tests.

I read somewhere that you shouldn't give Cerenia and Mirtazapine: have you heard that? I'm trying to find the post where I read that now...

 

[LizzieInTexas]

I read somewhere that you shouldn't give Cerenia and Mirtazapine: have you heard that?

I don't think you want to give Mirtz if they are nauseated. You want to treat the nausea first so you arn't encouraging a kitty to eat and then possibly throw up. I have given both but Gizmo was eating (just not great).

 

[Girlie's mom]

I don't think you want to give Mirtz if they are nauseated. You want to treat the nausea first so you arn't encouraging a kitty to eat and then possibly throw up. I have given both but Gizmo was eating (just not great).

Thanks, Lizzie: good point. She's eating, just not much or enthusiastically. And she's purring, and she's not a purry cat. She purrs like this when her BG levels are really diving and she's not feeling well. Sigh. We'll see - I wish the vet would call so I could try the cerenia! I suppose it wouldn't hurt.

I keep seeing SEB referred to in other posts: do you know what that is?

 

[LizzieInTexas]

I keep seeing SEB referred to in other posts: do you know what that is?

SEB=Slippery Elm Bark

I hope the get calls soon.

 

[Girlie's mom]

SEB=Slippery Elm Bark

I hope the get calls soon.

Silly me! Of course...

It's strange: she'll have a few bites (just looked excited when I offered her some Cats in the Kitchen), but then she'll only eat a little bit and then turns away. Sigh!

She's not refusing food altogether: just something is off with her. Thank you for replying!

 

[Marje and Gracie]

@Marje and Gracie , thanks for these tips and info and the PM message. I'm pleased with the progress I saw last night, so we'll see how she goes this AM.

Just some quick questions:

• Lack of appetite: I know it's not good to introduce new meds and things, but she seems to be on a "I'm not hungry" kick. I've never tried Fortiflora, but thought I might sprinkle a bit on her food to see if that helps. You mentioned that it's not good to introduce more than one new thing at a time. Would that be per cycle? Or after a certain number of cycles, do you think?

• LC + gravy? It could be that she's just not that keen on the MC food: she likes soupy, mushy food, and the MC FF has gravy but little flakes of food that she's not that keen on (unless she's doing a deep dive, and then she'll eat almost anything). I wonder if it would be ok to try the LC food she likes (LC 6 and LC8 Wellness) but add some Cats in the Kitchen MC gravy to that to bump those carbs up for the AMPS and +1? She really likes the CIK gravies...just trying to think out loud here...

• Carryover and Overlap: I'm a bit confused about these and how to distinguish this from the numbers on her SS. Because she seems to be having a problem with duration, does that mean that she doesn't really have carryover or overlap? Do you know where I could read more about this so I could try to figure this out on her SS?

• MC at preshot experiment: Shall I just carry on with this until she starts to flatten out? I'm more concerned about the AM than the PM. She went up and down yesterday in the AM like a bit of a yo-yo, and late in her cycle, as well. She's not a big eater (never has been), so I have to try to balance getting enough food in her in the mini-meals from AMPS to +3 and then have her still want to eat something later in the cycle if she does a deep drop (e.g. 85 pt drop yesterday AM from +7 to +8, which is really late in her cycle). And she'd gone up at +7. Not sure why she did such a dive at +8. If she does that big a drop that late in the AM cycle, I wonder if I should just not give food and see how she goes by the PM?

Thanks so much! It feels good to be trying this experiment and to see how being proactive rather than reactive seems to already be helping with Girlie. Just seeing some progress and some flattening out is really, really encouraging.

First, I’m sorry to hear Girlie is off tonight. I’d give her the cerenia. It won’t hurt her and might make her feel a little better. Lizzie is right....be sure she gets some extra fluids and if she continues to be inappetent or vomit, be sure and get her to the vet.

To answer your questions above:

• I’m not a Fortiflora or Purina anything fan. They put animal digest in the fortiflora to attract (and addict animals). If you decide to use it, it’s ok to use at any time because it isn’t a med and it won’t affect her BG.
• I find it to be difficult when you have to start mixing one carb food with another or add gravy from one carb food to a food with another carb level. But...if she won’t eat and you need to up the carbs, you can add the gravy. Just be sure you are mixing it so you are getting a MC food.
• Yes, these two are difficult concepts. While I haven’t specifically looked because I do see she has a lack of duration (and you wouldn’t see carryover or overlap on any cycle where she loses duration), it’s good to know what they are so you can look for them. Carryover is when the duration is long enough that the effects of one shot continue past the next shot. Overlap is also indicative of duration as one shot is waning just as the other is onsetting. Typically, you would see a cat with “normal” duration rise a bit at the end of the cycle until the next shot onsets. However, if they get overlap, the duration extends it so the first shot is waning as the next one onsets.
• Yes, I would. We don’t want her to stay at higher numbers longer so I’d say if she doesn’t see some blue numbers by tonight, I’d increase the dose to 1u tomorrow morning provided you can monitor her. I’d like to take her up more but it doesn’t make sense to have you trying to dose between the lines and if we get her to 1u and she needs an increase, it’s easier to take her up to 1.25u. How does that sound?
• Insofar as feeding later in the cycle, if she is not overweight, I think I’d get as much of her food in her as possible earlier in the cycle. If she drops late in the cycle but she’s still at high numbers like she was yesterday, I’d let it ride. If she’s hungry, just feed her something really LC.

Let me know how she’s doing. Sending vines. Poor Girlie! She has the best mom, though!

 

[Girlie's mom]

First, I’m sorry to hear Girlie is off tonight. I’d give her the cerenia. It won’t hurt her and might make her feel a little better. Lizzie is right....be sure she gets some extra fluids and if she continues to be inappetent or vomit, be sure and get her to the vet.

To answer your questions above:

• I’m not a Fortiflora or Purina anything fan. They put animal digest in the fortiflora to attract (and addict animals). If you decide to use it, it’s ok to use at any time because it isn’t a med and it won’t affect her BG.
• I find it to be difficult when you have to start mixing one carb food with another or add gravy from one carb food to a food with another carb level. But...if she won’t eat and you need to up the carbs, you can add the gravy. Just be sure you are mixing it so you are getting a MC food.
• Yes, these two are difficult concepts. While I haven’t specifically looked because I do see she has a lack of duration (and you wouldn’t see carryover or overlap on any cycle where she loses duration), it’s good to know what they are so you can look for them. Carryover is when the duration is long enough that the effects of one shot continue past the next shot. Overlap is also indicative of duration as one shot is waning just as the other is onsetting. Typically, you would see a cat with “normal” duration rise a bit at the end of the cycle until the next shot onsets. However, if they get overlap, the duration extends it so the first shot is waning as the next one onsets.
• Yes, I would. We don’t want her to stay at higher numbers longer so I’d say if she doesn’t see some blue numbers by tonight, I’d increase the dose to 1u tomorrow morning provided you can monitor her. I’d like to take her up more but it doesn’t make sense to have you trying to dose between the lines and if we get her to 1u and she needs an increase, it’s easier to take her up to 1.25u. How does that sound?
• Insofar as feeding later in the cycle, if she is not overweight, I think I’d get as much of her food in her as possible earlier in the cycle. If she drops late in the cycle but she’s still at high numbers like she was yesterday, I’d let it ride. If she’s hungry, just feed her something really LC.

Let me know how she’s doing. Sending vines. Poor Girlie! She has the best mom, though!

I'll give her the Cerenia; it can't hurt, surely... Have you hear of a contraindication of Cerenia and Mirtazapin? I know I just read that earlier today in a post, but now I can't find it.

Also, another question: do you think the AVJ could possibly be causing her to be odd with her food? She's just been off yesterday and today, but I can't seem to see anything else that's different.

I double I'll see blue tonight, especially if she's starting from a MC food. I might start from LC6 tonight with AMPS and see how she drops. She's still in yellow numbers, so that's good. Fingers crossed she doesn't go up too much by AMPS. I can monitor tomorrow, so I'll go up to 1 Unit tomorrow am if there are no blues tonight. She would drop to blues in the AM if I weren't giving her the MC food, but then there would be the dreaded bounce.

Thanks again so much, Marje!

 

[Marje and Gracie]

I'll give her the Cerenia; it can't hurt, surely... Have you hear of a contraindication of Cerenia and Mirtazapin? I know I just read that earlier today in a post, but now I can't find it.

Also, another question: do you think the AVJ could possibly be causing her to be odd with her food? She's just been off yesterday and today, but I can't seem to see anything else that's different.

I double I'll see blue tonight, especially if she's starting from a MC food. I might start from LC6 tonight with AMPS and see how she drops. She's still in yellow numbers, so that's good. Fingers crossed she doesn't go up too much by AMPS. I can monitor tomorrow, so I'll go up to 1 Unit tomorrow am if there are no blues tonight. She would drop to blues in the AM if I weren't giving her the MC food, but then there would be the dreaded bounce.

Thanks again so much, Marje!

There isn’t a contraindication between cerenia and mirtz. It’s just you need to give the cerenia plenty of time to work before you give mirtz. Imagine if you were nauseated and then someone gave you an appy stimulant....your body would be telling you to eat but you’d feel nauseous. So I would hold off on the mirtz for at least 12 hours or so and let the cerenia start to do its job.

I never say “never” so stop the AV juice and see what happens. You have to be giving her a very specific kind. It has to be distilled. You can’t just buy any AVJ and give it to her. What is the brand you are giving her?

You can give her LC6 tonight and see how she does. It might give her a little lower place to start in the morning. I won’t be on when you increase so use your best judgment. If she gives you a much lower PS than normal, hold off on the increase and see if she comes down. I don’t want you to battle numbers esp if you have to leave in the afternoon.

You’re welcome!

 

[Girlie's mom]

There isn’t a contraindication between cerenia and mirtz. It’s just you need to give the cerenia plenty of time to work before you give mirtz. Imagine if you were nauseated and then someone gave you an appy stimulant....your body would be telling you to eat but you’d feel nauseous. So I would hold off on the mirtz for at least 12 hours or so and let the cerenia start to do its job.

I never say “never” so stop the AV juice and see what happens. You have to be giving her a very specific kind. It has to be distilled. You can’t just buy any AVJ and give it to her. What is the brand you are giving her?

You can give her LC6 tonight and see how she does. It might give her a little lower place to start in the morning. I won’t be on when you increase so use your best judgment. If she gives you a much lower PS than normal, hold off on the increase and see if she comes down. I don’t want you to battle numbers esp if you have to leave in the afternoon.

You’re welcome!

I ordered the George's "Always Active" 100% Aloe Vera Juice from the U.S.: I think that's the right kind? I started giving 1/2 tsp AM and PM on the PM of 27 Oct; no change in appetite on 28 or 29 October. She had acupuncture yesterday, but that's never affected her appetite. I did stop the Miralax when I started the AVJ, but I wouldn't think that that would set her off. Maybe I should keep using the Miralax until I know how the AVJ affects her constipation?

I can stay in all day tomorrow, but I have to head out the following afternoon. Here's hoping she eats tonight!

 

[Gussie's mom (GA)]

Eat your fuds Girlie!

 

[Marje and Gracie]

I ordered the George's "Always Active" 100% Aloe Vera Juice from the U.S.: I think that's the right kind? I started giving 1/2 tsp AM and PM on the PM of 27 Oct; no change in appetite on 28 or 29 October. She had acupuncture yesterday, but that's never affected her appetite. I did stop the Miralax when I started the AVJ, but I wouldn't think that that would set her off. Maybe I should keep using the Miralax until I know how the AVJ affects her constipation?

I can stay in all day tomorrow, but I have to head out the following afternoon. Here's hoping she eats tonight!

AVJ isn’t a laxative (unless it is the aloe Vera latex variety) like Miralax so I wouldn’t I’d stop the Miralax. The George’s is the correct one.

 

[Alicia & Maggie (GA)]

Hope Girlie is feeling better and she gets back in the blues soon.