? Vomiting Food

Status
Not open for further replies.
Peppersmom72

Peppersmom72

Member Since 2017
Hi all. I did a curve on Pepper this past weekend. Numbers still don't seem like they are coming down. Last night PMPS her BG was the highest its ever been. Also, sometime around 3am last night she vomited her food. She woke me up this morning like usual to eat. She received her 2u and off I went to work. Why are her numbers climbing instead of coming down? I understand she is not regulated yet, and has not had anything different in her diet. She is finally gaining her weight back and seems very happy. (Except for the first 2 hours after her insulin shot, I think she feels her worst then). Is there a different insulin that won't break the bank? I know alot of people talk about Prozinc (really expensive), but I am away from her for 11-1/2 hours a day and am really nervous about switching. But, I don't know what to do at this point.
 
Actually her numbers at PS time and through the cycle are fairly consistent. There's a 20% meter variance allowed so two numbers that look different might well fall in that allowed range. It looks like you haven't reached her effective dose range yet. She is coming down by mid cycle but not by enough. If you're using syringes with half unit marks, I'd increase by an eyeballed 0.25 u after 2 days or so of similar numbers.

Feeling unwell in the few hours after a shot is something others have noticed too. Sometimes a change of insulin helps that. Yes, ProZinc is expensive. Lantus is a depot insulin that works well for many cats but has a high price tag in the US. Many users order it from a Canadian pharmacy for less than half the price. It's a bit early in Pepper's treatment to make and insulin switch. I'd work with the Novolin a bit longer to see if you can't get her BG into a better range.
 
Peppersmom72 said:
@Kris & Teasel ,

Thank you so much. Should I do the insulin increase this evening or wait?
Click to expand...
Yes, I'd try giving 2.25 u this evening. Is Novolin a U100 insulin? Are you using U100 syringes with half unit marks? If so, it's fairly easy to eyeball a 0.25 u increase. If you only have whole unit marks, draw up a reference syringe of coloured water as close to 2.25u as you can guesstimate and use it as a guide for these doses. Consistency is more important that absolute accuracy.

Give 2.25 u for 4 cycles or so and increase to 2.5 u if there's no significant improvement. The longer she sits in high numbers the harder it gets to pull them down. Eventually you'll reach a dose that gives you yellows, then blues. At that point you'll be closer to her good working dose.

Ask questions here any time you're in doubt. :)
 
Peppersmom72 said:
@Kris & Teasel . Yes, Novolin is a U100 insulin. Her syringes have half unit markings. I was just concerned because the sheet http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-novolin-humulin-nph.186097/ has on it to change dose after at least a week. Its only been 5 full days. I didn't know if the two days would make a difference.
Click to expand...
Oops! I should have read that first. :confused: By all means wait a week if you feel more comfortable. The reason is that Novolin can drop BG hard and fast so extra caution is required. I was coming at it from the high BG range she's in and how she seems to be reacting to the current dose.

Hurray for you for reading those guidelines - they're invaluable. I'll defer to the guideline. Go up to 2.25 u then after 7 days. A half unit increase is a bit too much in my opinion. Are you testing her urine for ketones? It's important at these high numbers. Here are some tips:

How to test for urine ketones at home:
  • put the end of the test strip right in his urine stream as he's peeing
  • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
  • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light. Test strips can be purchased at any human pharmacy.
 
Peppersmom72 said:
Thank you so much @Kris & Teasel , her vet did not say anything about testing urine. I will get some strips on my way home from work today. :cat:
Click to expand...
Few vets recommend it. Mine didn't when I asked and she said she'd worry about litter box avoidance developing. No problem with my guy. Is your kitty a shy girl when it comes to litter box use?
 
I think she might be. She faces out towards the open bathroom when she pees and faces the wall when she poops. Its almost like she is modest. But with that being said, she will go to the bathroom when I am in there, but if my hubby or daughter is in the bathroom she will wait until they leave the room to do her business.

I heard about the bonding experience you can have with your sugar baby once you start to care for them with FD, but I wasn't thinking that included potty time. haha
 
@Kris & Teasel ,

Just to let you know, I am totally in shock right now. The vet just called and wants to up her dose from 2u to 3u. I am not comfortable with this giant increase. :-o
 
Peppersmom72 said:
@Kris & Teasel ,

Just to let you know, I am totally in shock right now. The vet just called and wants to up her dose from 2u to 3u. I am not comfortable with this giant increase. :-o
Click to expand...
That's a 50% increase. Too big I think. My gut tells me you could likely try 2.5 u and be OK because her numbers are high right now. Here's what I'd do: I'd boost her to 2.5 u this evening if you can monitor starting at +2 and continue to +5 at least. If not, try 2.5 u tomorrow AM if you're home during the day. Start testing at +2 because that's when you might get advance notice of a big drop - ie. if she's down 100+ points then, you'll want to monitor actively until after her nadir which could be as late as +6.
 
Her biggest drop has been close to 200 points. When she first started on 1u. I am gone all day from 630am - 545 pm.
 
Checking in to see how you and Pepper are doing. Those two yellows last night are a positive sign. Are you planning to try 2.5 u on the weekend?
 
@Kris & Teasel ,

Yes, I am planning on trying either Friday night or Saturday. Peppers appetite was very poor yesterday until I got home from work. She was constipated (which is not uncommon for her). So, I think that is why I got lower numbers, because she started out in the 400's instead of 500's and 600's. I honestly think it is her food that is causing the higher BG's. She's been on Friskies her whole life and I'm wondering if I change it to a lower carb food, if her numbers will decrease even more.
 
Peppersmom72 said:
@Kris & Teasel ,

Yes, I am planning on trying either Friday night or Saturday. Peppers appetite was very poor yesterday until I got home from work. She was constipated (which is not uncommon for her). So, I think that is why I got lower numbers, because she started out in the 400's instead of 500's and 600's. I honestly think it is her food that is causing the higher BG's. She's been on Friskies her whole life and I'm wondering if I change it to a lower carb food, if her numbers will decrease even more.
Click to expand...
Hard to say. In general the insulin dose is the bigger factor so I would focus on that first. Do you feed her only the low carb Friskies pates? Do you add extra water to her wet food? That can help with hydration, constipation and cystitis.
 
Yes, only Friskies Pate's since she was a kitten. She cannot eat anything but pate's. I've always added water to it because she had emergency surgery at a very young age for a 5" long hairball was lodged in her small intestine. She has been on lactulose most of her life also. The vet seems to think she probably could have scar tissue.
 
I honestly didn't know that there were a difference in the friskies pate's. We stay away from the Salmon and Whitefish flavors (they make her vomit). She gets mixed grill, Turkey and Giblet, and Chicken and Liver flavors only.
 
Many people here use Friskies pates successfully, but my cat has huge food spikes from them. Perhaps some cats are more sensitive to certain ingredients. Wouldn’t hurt to try a different brand such as Fancy Feast or Sheba, but as Kris said the insulin is probably the main factor in your case.
 
I'm not questioning the fact that she definitely does need the insulin, and probably a small increase.

What I am concerned with is the possibility that her food is what is causing her higher numbers and I have read that some sugar babies have a decrease in insulin when a food change is made. Yes, this is primarily when they go from hard food to pates, but as you stated above some cats are more sensitive to certain ingredients, and I'm hopeful my baby could be one of them. My sugar baby has been on Friskies Pates her whole life and I would hate to keep fighting a losing battle giving her more and more insulin increases when I keep feeding her the same food that could be causing some of the issue. I would hate for her to have to go through a hypo and possibly not survive because I work an hour and a half away from home. The thought scares me to death every time the vet says increase insulin. I'm trying to stay strong for her and pull up my mom britches and take charge, but my heart aches inside for her. I haven't had a good night sleep in a month.
 
When do I make the food change? Do I try it after she has her insulin increase this weekend or do I start the gradual change in food today? I'm so lost. Sometimes I feel like I take 1 step forward and 2 steps back.
 
Peppersmom72 said:
I'm not questioning the fact that she definitely does need the insulin, and probably a small increase.

What I am concerned with is the possibility that her food is what is causing her higher numbers and I have read that some sugar babies have a decrease in insulin when a food change is made. Yes, this is primarily when they go from hard food to pates, but as you stated above some cats are more sensitive to certain ingredients, and I'm hopeful my baby could be one of them. My sugar baby has been on Friskies Pates her whole life and I would hate to keep fighting a losing battle giving her more and more insulin increases when I keep feeding her the same food that could be causing some of the issue. I would hate for her to have to go through a hypo and possibly not survive because I work an hour and a half away from home. The thought scares me to death every time the vet says increase insulin. I'm trying to stay strong for her and pull up my mom britches and take charge, but my heart aches inside for her. I haven't had a good night sleep in a month.
Click to expand...
Here's an idea: why not leave her dose as is for a bit and try introducing some Fancy Feast pates over the next couple of days. Monitor her BG in the evening. She has a lot of room to drop so even if the FF affects her BG she should be safe. Check out the food list for lowest carbs FF:
http://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
We all understand fear of a hypo. The best antidote to that is experience, BG testing at strategic times, a good SS data record to consult and learning to be comfortable with a little uncertainty. :bighug:
 
I do to. But she's hardly eating and I think she's still constipated. She will not eat the canned pumpkin and she is avoiding her food that has the lactulose in it. I don't know what to do.
 
Peppersmom72 said:
I do to. But she's hardly eating and I think she's still constipated. She will not eat the canned pumpkin and she is avoiding her food that has the lactulose in it. I don't know what to do.
Click to expand...
Is she vomiting? Showing signs of pain? Yes, it could be constipation but pancreatitis is another possibility. Have you tried syringing some puréed food into her?
 
She's eating, but doesn't finish. (She gets 1/4 of a can of friskies at a time and only finishes half of her serving). She skipped her 2pm meal all together, then ate 1/2 of her 6pm meal, just enough for me to giver her her pm shot. She's not vomiting.
 
She still did not have a very big appetite. I sprinkled some parmesan cheese on her food to get her to eat enough so I could give her her am shot. She did not pee at all last night, but went this morning after she ate. She definitely isn't her usual self. She pooped 1 little piece yesterday, it seemed very dark. Nothing since.
 
My gut tells me that something else could be going on, but it seems like all the vet wants to do is raise her insulin level from 2u to 3u. Can the insulin be causing these issues?
 
Peppersmom72 said:
My gut tells me that something else could be going on, but it seems like all the vet wants to do is raise her insulin level from 2u to 3u. Can the insulin be causing these issues?
Click to expand...
My opinion is that it isn't the insulin. Pancreatitis is common in diabetic cats and can cause lack of appetite, etc.
 
You said she’s had trouble with constipation in the past, does this seem the same symptoms wise? I know you’re afraid of the vet telling you to raise your dose, but when mine would say that I just smiled and nodded then came here and got advice. He never knew what I was giving. Whether it’s constipation or pancreatitis, you may need to take her in so you know for sure. The longer you wait, the worse things can become and the weekend is coming up, you don’t want an emergency call!
 
So Pepper needs the fPLI blood test? Or an ultrasound to r/o pancreatitis?

Yes, symptoms are the same with her constipation, except she's not vomiting right now.
 
Last edited:
@Sharon14
@Kris & Teasel

I wanted to say thank you for your help this morning. Pepper and I just got home from a vet appointment. She does +1 ketones in her urine. Her insulin is getting increased to 2.5u instead of 3u. The vet agreed that it would be too drastic of an increase for her. She gave her a shot of an anti-nausea medication, she received sub q fluids, a tube of Cat Lax, and a prescription of Mirtazapine to help increase her appetite. She has gained weight and is almost 11 lbs. now. The vet would like to do a ultrasound of her abdomen in the next couple weeks to get some answers on Peppers nausea, vomiting and to look her organs. Pepper came home and ate a bit and seems very alert.
 
Peppersmom72 said:
@Sharon14
@Kris & Teasel

I wanted to say thank you for your help this morning. Pepper and I just got home from a vet appointment. She does +1 ketones in her urine. Her insulin is getting increased to 2.5u instead of 3u. The vet agreed that it would be too drastic of an increase for her. She gave her a shot of an anti-nausea medication, she received sub q fluids, a tube of Cat Lax, and a prescription of Mirtazapine to help increase her appetite. She has gained weight and is almost 11 lbs. now. The vet would like to do a ultrasound of her abdomen in the next couple weeks to get some answers on Peppers nausea, vomiting and to look her organs. Pepper came home and ate a bit and seems very alert.
Click to expand...
I'm glad your girl seems to be feeling a little better. An insulin dose increase is a good idea and kudos to your vet for not insisting on an increase to 3 u. My recommendation would be to work on urine ketone testing right away (my post #6 above) in light of the presence of ketones. You want to nip that in the bud and it's easier to treat if caught early.
 
Do I do a special diet for presence of ketones? I am going to the store tomorrow to get dip strips. I will try to test since she is shy.
 
How is she doing this evening? Has she eaten any more?
To keep the ketones at bay make sure she gets enough calories and enough insulin. So if she’s not eating well you may have to syringe feed her.
 
She's eating and acting like she's starving now. I guess the appetite stimulant worked. How often should she eat? Because now her BG numbers are not really going down.
 
Peppersmom72 said:
She's eating and acting like she's starving now. I guess the appetite stimulant worked. How often should she eat? Because now her BG numbers are not really going down.
Click to expand...
Let her eat as much as she wants in small meals. Just take away food for the 2 hours before the pre shot tests. She needs food and she needs insulin to keep ketones at bay. Her BG is still high because you haven’t reached the good working dose yet. I’d increase to 2.5 u tomorrow AM.
 
Ok, so I gave Pepper her insulin this morning and 15 minutes before I left for work, she threw up all of her food (Friskies). I cannot miss anymore work, so I woke hubby up to take care of her. (He wasn't too thrilled after he only got 3 hours of sleep). I gave her 1/2 can of FF Tuna and Shrimp (she loved it) before I walked out the door, I haven't heard from him so hopefully she hasn't thrown up again (because he's probably fallen back to sleep). This is the whole reason why I asked the vet to give me an anti nausea medication to take home and they said I didn't need it. He is testing at 2+ and 4+. He has karo on hand, just in case, but I don't think there will be an issue since her BG was still high this morning.
 
Last edited:
I do all of that and she only gets 1/4 can of friskies. I really think she hates her food. She won't finish any of her servings.
 
Do you know what anti nausea shot they gave her? Hopefully she’ll do better on the Fancy Feast
 
I can't find the food I fed Pepper on the sticky for foods. Its tuna and shrimp fancy feast (it was classic, NO gravy). I don't know if I should be watching for certain things other than carbs on a cat with ketones now.
 
Last edited:
Be sure to pick up those ketone test strips today

If the vet wont give you anti nausea meds, maybe ask her about Pepcid. Not sure if that will help, what do you think @Kris & Teasel ? I don’t have any experience with nausea, so I’m not sure.
 
Ok, I put in a call to her to ask. I will let you know what she says. On another note, hubby must have fallen back to sleep. Still no answer. I'm praying Pepper is ok, after this mornings episode.
 
Peppersmom72 said:
Metaclopramide
Click to expand...
Metoclopramide is typically useless for general nausea and vomiting in cats (unless poor gut motility/constipation are the culprits). Cats have very few of the receptors that metoclopramide works on. Much better treatments are Cerenia and ondansetron. See the following link from Tanya's site for very helpful info:

http://felinecrf.org/nausea_vomiting_stomach_acid.htm

I found that while Cerenia may initially get to work a bit faster than ondansetron the ondansetron tended to be better for management of chronic nausea issues.

It can help to be quite firm when requesting certain treatments from a vet; not all of them are familiar with ondansetron but it's a great help to cats with nausea issues. (Note: Ondansetron can be a little constipating so if you treat your kitty with it make sure your kitty keeps properly hydrated and keep an eye on her bowel movement regularity/consistency.) Maybe show them this IDEXX document (very useful info on anti-emetic therapy):

https://www.idexx.com/files/small-a...pec-fpl-treatment-for-feline-pancreatitis.pdf

IDEXX Laboratories are a highly respected organisation and their information should have some clout with your vets. The document above touches on why metoclopramide is not a great med for nausea management in felines (and because of its potential negative effects on the nervous system it's contraindicated for anything but very short term use.)

(Note: Generic ondansetron should be much cheaper than the branded Zofran version; that's certainly the case in the UK.)


Mogs
.
 
Last edited:
Status
Not open for further replies.
Back
Top