BG Going Up Again - Could Use Some Advice

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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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I really appreciate this information. I obviously have a lot of homework to do. I have guides for human medications, do you or anyone else know of a good guide for animals (cats in particular)? I need to obtain it if it is out there. Currently, I think if she has stopped regurgitating they will stop giving the medication for it. And, thus far - no regurgitating since this morning - Thank Goodness.
 
I’m very relieved you got Goma through this safely! Be prepared for some mighty bouncing. Please post when it’s time for her next dose and we can help figure it out. I’m still surprised at how her numbers came down so much after the vet intervention yesterday. Could be coincidence ...

Thank you for your kind words. I felt bad that you ended up in this situation because I advised the full dose last shot.
 
I’m very relieved you got Goma through this safely! Be prepared for some mighty bouncing. Please post when it’s time for her next dose and we can help figure it out. I’m still surprised at how her numbers came down so much after the vet intervention yesterday. Could be coincidence ...

Thank you for your kind words. I felt bad that you ended up in this situation because I advised the full dose last shot.
Since this thread has gotten rather lengthy and the evening dose will be off topic I will start a new thread in this forum requesting dosage advice for this evening. I will not be giving this until 11:30 pm (approximately 2 hours from now) so I plan on taking the bg and entering into the spreadsheet at approximately 11:00pm my time (1 1/2 hours from now). Will then post the new thread. Hope you can be around to assist.
 
Wow you had a dramatic day! You did an absolutely perfect job of feeding that curve! Well done!

Cats who have been up in the really high numbers often seem to feel quiet, even lethargic, when they first hit the lower numbers. It's okay, it just takes their bodies a good long while to start to adjust to the lower BG. Did you notice any of that? Or did she seem to handle it okay?

Just like the last time she had a green, she will likely be quite high and flat for the next few cycles. There are two options for your next dose, and I'm afraid either one of them is going to be a bit of a guess. You could hold the dose at 2.5u and wait for the next low-ish PS to reduce the dose to 2.25. The reason for that is because usually after a low there are high flats and she doesn't necessarily need a reduction yet. The other option is to reduce to 2.25 now. I don't think 2.25u is really enough for Goma right now, however, you're going into your PM cycle and you need to sleep, so if that feels safer, and so you won't need to keep waking up to check on her, then go that route.

If she gives you a lower PS right now (yellow to mid-pink), I would go with the reduced dose (2.25). If she gives you a high PS (high pink to black), I would probably hold the 2.5u dose. Again though, we know that the 2.5u dose can sometime bring her a strong response, so it's really up to you and what will make you comfortable tonight. You certainly have the skills now to manage whatever she does, but sleep is important!
 
Great advice from Djamila. I do think the 2.5 u dose is the one that gives you some good BG lowering action but it can be stressful to monitor and "feed the curve". You did a very good job at it last cycle. The hope is that exposure to these lower numbers will help Goma respond better to insulin and feel better too. Unfortunately, a dosing breakthrough like this is a necessary step even though it can be hard on the care giver.
 
Wow you had a dramatic day! You did an absolutely perfect job of feeding that curve! Well done!

Cats who have been up in the really high numbers often seem to feel quiet, even lethargic, when they first hit the lower numbers. It's okay, it just takes their bodies a good long while to start to adjust to the lower BG. Did you notice any of that? Or did she seem to handle it okay?

Just like the last time she had a green, she will likely be quite high and flat for the next few cycles. There are two options for your next dose, and I'm afraid either one of them is going to be a bit of a guess. You could hold the dose at 2.5u and wait for the next low-ish PS to reduce the dose to 2.25. The reason for that is because usually after a low there are high flats and she doesn't necessarily need a reduction yet. The other option is to reduce to 2.25 now. I don't think 2.25u is really enough for Goma right now, however, you're going into your PM cycle and you need to sleep, so if that feels safer, and so you won't need to keep waking up to check on her, then go that route.

If she gives you a lower PS right now (yellow to mid-pink), I would go with the reduced dose (2.25). If she gives you a high PS (high pink to black), I would probably hold the 2.5u dose. Again though, we know that the 2.5u dose can sometime bring her a strong response, so it's really up to you and what will make you comfortable tonight. You certainly have the skills now to manage whatever she does, but sleep is important!
Not sure I really have the skills yet, beginners luck is more like it...I appreciate the information in regards to the next dose. I do need some sleep - However it is much more important to me that she receives what is best for her. I would like to minimize the bounce if at all possible.

She was very quiet all day and yes, to the point of being lethargic. However, she ate when I presented food then just laid back. She just now got up for the first time and used the litter box and then ran back to her spot under my desk. So I guess she is ok. Doing her cat thing... Will post number in a half hour or so in ss and a new thread in about an hour to confirm which way to go with her benefit in mind.

Thanks so much for taking the time to provide such detailed info.
 
Great advice from Djamila. I do think the 2.5 u dose is the one that gives you some good BG lowering action but it can be stressful to monitor and "feed the curve". You did a very good job at it last cycle. The hope is that exposure to these lower numbers will help Goma respond better to insulin and feel better too. Unfortunately, a dosing breakthrough like this is a necessary step even though it can be hard on the care giver.
Okay - We'll see where we stand in about 20 minutes or so - I'll then post in new thread requesting advice -

Thanks again.
 
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