BG Going Up Again - Could Use Some Advice

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G & I

G & I

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Yesterday the bg numbers moved back into red and now I am back seeing black again. Goma also regurgitated food from earlier this morning. What can I be doing now? She drank some water, but I do not see urine in the litter box. She appeared fine in all respects yesterday except for the numbers. Yesterday I had given her more boiled chicken as I had reduced thinking she may be having an allergic reaction to it. She has been scratching herself to the point around her neck is open wounds. She previously had this, but they were healing. Now back to square one. She is eating now and will hopefully keep it down.

UPDATE - She did just urinate after I repeatedly took her to the litter box. Could not get a ketone strip there quick enough. Tested last week and she was clear. Today was the day I was to do the weekly test.

Perhaps I am just overreacting to everything now.

2nd UPDATE - Vomited Again....

3rd UPDATE - Vet opens in approximately 50 minutes - heading there....
 
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Kris & Teasel said:
She might be allergic to chicken. It's also possible that it has upset her stomach. Let us know what the vet says.
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Still home but getting ready. What is the rule for insulin at times like this and what could be causing the higher bg level now?
 
Has she kept any food down at all? If not you'll have to reduce her dose. How much to reduce is always a hard decision. If she's dehydrated from vomiting and her BG numbers are elevated I would not skip insulin because there's a risk of ketones developing.
 
It's still about four hours before her next shot, right? That gives her some time to settle down before you try to feed her again. If she can keep food down by then, I would give her the regular shot. She is running high this week and as Kris said, that puts her at risk for ketones if she doesn't get insulin. You can try feeding her some plain chicken or turkey, or even some meat-only baby food (just make sure it doesn't have any onion or anything else in it - just meat). If you do try to feed her in a bit, I would suggest very small amounts (1/2 T to 1 T), wait 20-30 minutes, and little more, wait, a little more.... and don't worry about the two hour no-food before the shot thing. You already know she's high enough to get her shot, so it's more important to make sure she will eat and keep it down than to worry about that guideline right now.

Let us know what the vet says, and we'll all be sending healing vines to little Goma!
 
Djamila said:
It's still about four hours before her next shot, right? That gives her some time to settle down before you try to feed her again. If she can keep food down by then, I would give her the regular shot. She is running high this week and as Kris said, that puts her at risk for ketones if she doesn't get insulin. You can try feeding her some plain chicken or turkey, or even some meat-only baby food (just make sure it doesn't have any onion or anything else in it - just meat). If you do try to feed her in a bit, I would suggest very small amounts (1/2 T to 1 T), wait 20-30 minutes, and little more, wait, a little more.... and don't worry about the two hour no-food before the shot thing. You already know she's high enough to get her shot, so it's more important to make sure she will eat and keep it down than to worry about that guideline right now.

Let us know what the vet says, and we'll all be sending healing vines to little Goma!
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At the Vet now. About 1 hour from shot time. They could not get any urine for ketones test. Blood has been drawn and waiting for results. She definitely has more strength than the last time they saw her.
 
Thanks to you and Kris for being there. I have only this group to turn to for support
 
White blood cell count way too high so there is an infection somewhere. They are still getting more results but they will be giving her antibiotics at a minimum
 
scs islander said:
At the Vet now. About 1 hour from shot time. They could not get any urine for ketones test. Blood has been drawn and waiting for results. She definitely has more strength than the last time they saw her.
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Looks like I may miss regular dose time.
 
Kris & Teasel said:
Has she kept any food down at all? If not you'll have to reduce her dose. How much to reduce is always a hard decision. If she's dehydrated from vomiting and her BG numbers are elevated I would not skip insulin because there's a risk of ketones developing.
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I don’t believe so. She has vomited a total of two times. About 5 am and again after my first post after giving her a small amount of food
 
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Prozinc has about an hour of grace time. If you need to shoot later than that, we can help you figure out how to get back on schedule. So no worries if you are late getting home.

I'm so sorry to hear she has an infection! Hopefully the antibiotics will help quickly!
 
Djamila said:
Prozinc has about an hour of grace time. If you need to shoot later than that, we can help you figure out how to get back on schedule. So no worries if you are late getting home.

I'm so sorry to hear she has an infection! Hopefully the antibiotics will help quickly!
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I hope you all will be around in another hour or so
 
Critter Mom said:
According to my reading, this is not at all uncommon in kitties with food allergies.


Be sure to let us know which tests they have run.

BTW, remind me; do you have urine ketone test strips at home?


Mogs
.
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Yes I have strips at home and began testing last week. Today was my scheduled test day but the current situation precluded it.

All blood tests are done now. They show her liver is not well. They will start once a day subcutaneous injections with liver medication and antibiotics. We did this before but stopped when they closed for 5 days and she was doing fine on the medication they gave me.
 
Kris & Teasel said:
Have they given you specifics? Was there any mention of hepatic lipidosis?
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No specifics just high number. I have now asked. They had some food here so I have fed her two tablespoons to see if she will keep it down. BG level was 401. Not the food I would normally give but if she vomits at least I am at the Vet
 
Kris & Teasel said:
That's a relief. Will they give you any meds for the vomiting? She needs to eat even if you have to syringe some pureed food into her.
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They gave medication for vomiting in a subcutaneous injection. The two tablespoons of food have stayed down so far. She is acting quite well now. 100ml fluids with liver med, vitamin c and b12, calcium and potassium.
 
scs islander said:
They gave medication for vomiting in a subcutaneous injection. The two tablespoons of food have stayed down so far. She is acting quite well now. 100ml fluids with liver med, vitamin c and b12, calcium and potassium.
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Was in the injectable med for vomiting called Cerenia?
 
Kris & Teasel said:
I had to Google that. It's drug name is metoclopramide. I've read about other members using it. Is it a long-lasting med?
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Yes that is the one. 12 hour med so I asked for the pill form for tonight.

She is still holding the food down I gave her here. I am headed home now to give insulin and will post prior for any additional advice
 
Metoclopramide is more helpful for speeding up gastric emptying and normalising gut motility. It can be effective when nausea is caused by constipation - but only because it helps solve the constipation problem. The resolution of the constipation is what reduces the nausea, not any direct anti-nausea benefit from metoclopramide: cats are thought to have very few of the receptors it targets for nausea control. Also because of its side effect profile metoclopramide should only be given for a very short period of time (talking days max here).

Ondansetron and Cerenia are specific anti-nausea treatments that work well in cats.


Mogs
.
 
Critter Mom said:
Metoclopramide is more helpful for speeding up gastric emptying and normalising gut motility. It can be effective when nausea is caused by constipation - but only because it helps solve the constipation problem. The resolution of the constipation is what reduces the nausea, not any direct anti-nausea benefit from metoclopramide: cats are thought to have very few of the receptors it targets for nausea control. Also because of its side effect profile metoclopramide should only be given for a very short period of time (talking days max here).

Ondansetron and Cerenia are specific anti-nausea treatments that work well in cats.


Mogs
.
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Okay - All - I am now home with Goma. She has just eaten about 1/2 can of ff pate. Acting very normal - Just to be sure, I did a bg reading. At the vet it was 401 - Here just now it is 274 - Now - My question is, I am 1 hour past dose time - her level is lower than it has been in the past two days - What should I be looking at in regards to insulin dosage and injection given all that has transpired? Oh and where should I put these readings in the ss?

I really can't say thank you enough to everyone -
 
scs islander said:
Okay - All - I am now home with Goma. She has just eaten about 1/2 can of ff pate. Acting very normal - Just to be sure, I did a bg reading. At the vet it was 401 - Here just now it is 274 - Now - My question is, I am 1 hour past dose time - her level is lower than it has been in the past two days - What should I be looking at in regards to insulin dosage and injection given all that has transpired? Oh and where should I put these readings in the ss?

I really can't say thank you enough to everyone -
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Being one hour past her normal dose time isn't a problem. No schedule adjustment needed. That 274 is lovely! Put it on your SS in the pre shot test box. I'd encourage you to give her the full 2.5 u dose and get a test at +2 to see where she's headed. You might have a very nice cycle if you're lucky. I doubt very much that she'll dive low and by that I mean 50 or below at nadir. If you see a dark green above 50 in the +5 to +7 time range don't panic! It's what you want. I'm mentioning this because it's my bed time now (eastern Canada) and I won't be around to see your test results.

Sound like a plan?
 
Kris & Teasel said:
Being one hour past her normal dose time isn't a problem. No schedule adjustment needed. That 274 is lovely! Put it on your SS in the pre shot test box. I'd encourage you to give her the full 2.5 u dose and get a test at +2 to see where she's headed. You might have a very nice cycle if you're lucky. I doubt very much that she'll dive low and by that I mean 50 or below at nadir. If you see a dark green above 50 in the +5 to +7 time range don't panic! It's what you want. I'm mentioning this because it's my bed time now (eastern Canada) and I won't be around to see your test results.

Sound like a plan?
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Okay - Than tonight I can go at 1 hour earlier? Or 1/2 hour earlier to get back to the 11:00 am./pm. area by tomorrow. Now 12:12 (noon) here.
 
scs islander said:
Okay - Than tonight I can go at 1 hour earlier? Or 1/2 hour earlier to get back to the 11:00 am./pm. area by tomorrow. Now 12:12 (noon) here.
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Your current dose is going to be an hour late, right? You can do the next dose at your normal time so there ends up being 11 hours instead of 12 between this late dose and the next one at the normal time. ProZinc allows this type of occasional schedule change.
 
Critter Mom said:
Metoclopramide is more helpful for speeding up gastric emptying and normalising gut motility. It can be effective when nausea is caused by constipation - but only because it helps solve the constipation problem. The resolution of the constipation is what reduces the nausea, not any direct anti-nausea benefit from metoclopramide: cats are thought to have very few of the receptors it targets for nausea control. Also because of its side effect profile metoclopramide should only be given for a very short period of time (talking days max here).

Ondansetron and Cerenia are specific anti-nausea treatments that work well in cats.


Mogs
.
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Tomorrow I will ask about a different med for the vomiting if she continues to do so. I obviously need to do more research on my own. This Vet is not used to clients asking what the name of a drug is that they are prescribing.[/QUOTE]
 
scs islander said:
Tomorrow I will ask about a different med for the vomiting if she continues to do so. I obviously need to do more research on my own. This Vet is not used to clients asking what the name of a drug is that they are prescribing.
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[/QUOTE]
Not sure if anyone is here at this time. I received, as usual, excellent advice from @Kris & Teasel, @Critter Mom, and @Djamila this morning. I am at a +2.50 reading of 91 and while I understand this is okay the full effect of the dose has not taken hold so I think it will probably be going further down so I am concerned it will be below the 50. I have already provided a bit higher calorie food to hopefully steer this abit but not sure if this was the right thing to do so early on.
 
You will be able to tell with the next test. Surfing the curve involves feeding using the lowest carb food that will do the trick. This knowledge will come with experience. Document what you fed this time so that you know what does or doesn't work next time.

Off to bed. Holler for help if numbers drop dangerously low (under 68 on AlphaTrak).
 
Red & Rover (GA) said:
You will be able to tell with the next test. Surfing the curve involves feeding using the lowest carb food that will do the trick. This knowledge will come with experience. Document what you fed this time so that you know what does or doesn't work next time.

Off to bed. Holler for help if numbers drop dangerously low (under 68 on AlphaTrak).
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Okay - Thank you - Have a good night
 
Not sure if anyone is here at this time. I received, as usual, excellent advice from @Kris & Teasel, @Critter Mom, and @Djamila this morning. I am at a +2.50 reading of 91 and while I understand this is okay the full effect of the dose has not taken hold so I think it will probably be going further down so I am concerned it will be below the 50. I have already provided a bit higher calorie food to hopefully steer this abit but not sure if this was the right thing to do so early on.[/QUOTE]



Whew! This is much lower than I thought she’d get so soon after a pre shot in the high yellows. Perfect example of a cat’s unpredictability. I also mentioned the take action number as 50 when it’s 68 on an AlphaTrak. I’m very sorry I made that mistake.

If you could update your SS with any extra test numbers you have since your post that would be very helpful. I’m having a little insomnia right now and decided to check FDMB. When I saw your post I was very concerned. We try hard to give good advice but I certainly misjudged this. I’m very sorry.

How is Goma doing right now? Please let me know ASAP.
 
I see you’ve just added a BG of 81 at +4.75. Are you giving her small snacks of higher carb food intermittently to keep her “surfing” as we call it? That means her BG stays in a narrow range for several hours. So far so good but you still have a few hours of monitoring ahead. Her SS shows some late-ish nadir times. I suggest you make notes on your SS about what carb level of food you gave her in what amount at what time. It can be a valuable reference.
 
It seems you’re not online right now. I hope you can steer Goma’s numbers successfully through this surprise incident. Again, I apologize for getting this so wrong. I know it took you quite a while to trust advice that was very different from your vet’s and I hope my mistake hasn’t ruined that.

Signing off now. Will check first thing when I get up. Post a 911 in the main health forum if you need advice in the hours ahead.
 
Kris & Teasel said:
Not sure if anyone is here at this time. I received, as usual, excellent advice from @Kris & Teasel, @Critter Mom, and @Djamila this morning. I am at a +2.50 reading of 91 and while I understand this is okay the full effect of the dose has not taken hold so I think it will probably be going further down so I am concerned it will be below the 50. I have already provided a bit higher calorie food to hopefully steer this abit but not sure if this was the right thing to do so early on.
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Whew! This is much lower than I thought she’d get so soon after a pre shot in the high yellows. Perfect example of a cat’s unpredictability. I also mentioned the take action number as 50 when it’s 68 on an AlphaTrak. I’m very sorry I made that mistake.

If you could update your SS with any extra test numbers you have since your post that would be very helpful. I’m having a little insomnia right now and decided to check FDMB. When I saw your post I was very concerned. We try hard to give good advice but I certainly misjudged this. I’m very sorry.

How is Goma doing right now? Please let me know ASAP.[/QUOTE]
Sorry for the delay in response, I am feeding and caring for a multitude of other cats in addition to monitoring Goma. She appears to be resting comfortably at present. I will be performing another test in a few minutes and will post. I see you posted again after this so this will be the response to both. I have been documenting what I am feeding her at these low readings. I gave her 1/2 can of FRW at the 91 reading (+2) in hopes it would slow down the slide. At +4.25 I gave her ff and a tablespoon of FRW when I saw the number was 81. I will test now and place the number in the ss. I will also comment on the spreadsheet what I fed her.
 
Kris & Teasel said:
I see you’ve just added a BG of 81 at +4.75. Are you giving her small snacks of higher carb food intermittently to keep her “surfing” as we call it? That means her BG stays in a narrow range for several hours. So far so good but you still have a few hours of monitoring ahead. Her SS shows some late-ish nadir times. I suggest you make notes on your SS about what carb level of food you gave her in what amount at what time. It can be a valuable reference.
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I am trying to give small high calorie food. I am concerned though. I will make the notes as you suggested when this is over and I have more time. I am keeping track of the food I am giving but not sure of the carb level. Will sort it out when this is over. I sincerely appreciate your help and additional guidance which is, as always, welcome. Get some rest...
 
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Kris & Teasel said:
It seems you’re not online right now. I hope you can steer Goma’s numbers successfully through this surprise incident. Again, I apologize for getting this so wrong. I know it took you quite a while to trust advice that was very different from your vet’s and I hope my mistake hasn’t ruined that.

Signing off now. Will check first thing when I get up. Post a 911 in the main health forum if you need advice in the hours ahead.
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donnalea said:
Looks like you did everything right. Your a great pet parent,
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Thank you for the thoughtful comment. I'm doing the best I can with what I have. Desire is not lacking, but the old brain factory is a bit lacking at times.
 
Kris & Teasel said:
It seems you’re not online right now. I hope you can steer Goma’s numbers successfully through this surprise incident. Again, I apologize for getting this so wrong. I know it took you quite a while to trust advice that was very different from your vet’s and I hope my mistake hasn’t ruined that.

Signing off now. Will check first thing when I get up. Post a 911 in the main health forum if you need advice in the hours ahead.
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There is absolutely nothing to apologize for. It never entered my head there were any mistakes made so please let us not go down that road. I continue to hold you in the highest regards and respect and commend you for being so helpful to me and everyone else. We are all lucky to have members such as you.

In regards to trusting the vet - I can read instructions and guidelines provided with medications (ProZinc) - my trust went out the window when he wanted to dose once a day and feed her small morsels. That is why I turned to you all and Goma is, all in all doing quite well. She has already gained nearly 2 lbs and I hope once I get these glucose levels stabilized her energy level will return.

You and the others have warned me there would be rough seas at times. This was just one of the storms. She had a rough day and there were multiple things going on in that tiny feline body that I will never begin to grasp. But I can sure try...

I will be asking for dosage advice for this evenings injection. I am completely lost at this point in time in regards to which way to go. I understand it will depend on bg numbers, but at what number do I lower, raise, hold off, etc. Still got a long learning curve going here.

Kindest Regards to you. And again, thanks for being there.
 
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Looks like you surfed in greens...With luck Goma will stay there for a bit and then gently come back up. Are you at the midway point of your cycle still? How's she feeling today?
 
Rachel said:
Looks like you surfed in greens...With luck Goma will stay there for a bit and then gently come back up. Are you at the midway point of your cycle still? How's she feeling today?
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Been a tedious day but she has handled it well. A bit on the quiet side, but a good appetite which has helped and thank goodness she kept everything down. I am now at +8 and will be doing a test in the next 15 minutes or so. Keeping my fingers crossed for a smooth transition...
 
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