2/21 Sebastian PMPS 233 +1 236 +2 304 +3 290

Justin & Sebastian

Justin & Sebastian

Member Since 2019
Yesterday's thread

Took two readings, 198 and 239, averaged to 218. Honestly, I'm actually a bit worried about how much the numbers are coming down combined with the fact he's still vomiting a little bit. Would switching to all LC really have that drastic of an effect that quickly? Could the drop be causing the vomiting?
 
Mr Funk said:
Would switching to all LC really have that drastic of an effect that quickly?
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Yes indeed it can.
I don’t think the drop in numbers is responsible for the vomiting though.

Do get a +2 since this is the lowest you have shot. No need to test twice, unless you get a number that is way out of pattern. There’s a variance with all meters.
 
Will do. I'm also wondering if it's eating ONLY the Dr Elsey that's causing the vomiting. This only started when I completely removed the DM Dry from the mix and all he ate was the Dr Elsey, so maybe the extra carbs were balancing it out somehow?

I found a second spot of vomit and it looks like he basically threw up everything he ate, so I put out half a can of the Wellness Core and he ate that up. That's what I ultimately want him eating anyways, so we'll see if he throws up again when there's no Elsey in the mix.
 
I do have some DM Savory Selects, though he's silly and doesn't know how to eat it. He just licks all the gravy off but can't eat the actual chunks. I have a bottle of honey specifically for him and feeding syringes.
 
Is the Dr. Elsey's a different kind of protein that what he doesn't vomit? It's entirely possible that Sebastien has an allergy to a particular protein. I couldn't feed Gabby beef -- she's puke it back up.
 
I was going to say the same thing as Sienne about the protein possibly being different. Bubba couldn't eat beef either, within 20 minutes of eating it he puked.
 
The Dr Elsey is what's making him vomit. It's the chicken & pork recipe. It's weird because he ate it all last week mixed with the DM Dry with no issues, I was up to a 1/4 DM/3/4 Dr mix by the end, and it was only when it was only Dr E on its own that he vomited. I'm wondering if it's the pork. It might also explain why he had a bad reaction to the Vetsulin since that's porcine also.
 
I misunderstood slightly, yes it's different than what he's eating okay. The Wellness Core is Turkey & Duck, and the DM Dry is poultry etc. And I've fed him chicken based ones in the past with no problem.
 
PMPS 110. I'm not, I don't like this at all. I feel like something is wrong. He threw up again right before dinner and hasn't really eaten much. I haven't given him his dose yet.
 
0.2 ketones, so that's still good.

I know when humans cut out carbs, the keto diet, they'll get the keto flu and can get sick and vomit. Do cats get the same thing? Is that whats going on here? I just gave him some DM Dry so he'll eat something.
 
Mr Funk said:
0.2 ketones, so that's still good.

I know when humans cut out carbs, the keto diet, they'll get the keto flu and can get sick and vomit. Do cats get the same thing? Is that whats going on here? I just gave him some DM Dry so he'll eat something.
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Now you will have to stall. If you haven’t shot and we want to see what the BG is doing, we don’t want to feed as we don’t want the number to be food influenced.

With him having had DKA recently, we need to be cautious about skipping shots. Do you have adequate strips, HC food/gravy (I think you said you didn’t have this), karo syrup that you could add to food, and can you be up to test for as long as necessary?

I’ve not heard of cats getting the keto flu but when you are dealing with that in humans, they are typically non diabetic.
 
Woops, cross posted. That's good on the ketones.
Are you able to stay up tonight to test him, if you shoot?
 
Well I've already fed him now. I do have plenty of strips, I don't have any HC food other than the DM dry which is only like 14% I think. I do have honey on hand. I can stay up to test him if necessary.
 
Mr Funk said:
Well I've already fed him now. I do have plenty of strips, I don't have any HC food other than the DM dry which is only like 14% I think. I do have honey on hand. I can stay up to test him if necessary.
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He really needs to have a shot, even if it’s a reduced dose. You’ve never handled low numbers before and we have the policy here that if we advise you to shoot, then we stay up with you to be there with the low numbers. However, I have company coming tonight and so I’m not available to stay with you and advise you what to feed.

Since you’ve fed him DM dry at 14%, then his BG is going to rise and I don’t want you to shoot a food spike right now because he could come back down and drop lower. We usually wait two hours after feeding before we shoot so we make sure we are not shooting a food spike. However, with dry food, it affects the BG slower and tends to stay in the system longer.

How long can you stall knowing you can only back his shot up 30 minutes per day?
 
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Mr Funk said:
And he just threw up again.

Can someone please address the vomiting issue? Is this normal when they're transitioning off HC food?
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It’s not normal just due to the HC food. Vomiting is not normal in any circumstance. If he’s vomiting, there’s an issue whether it be an allergy to the food or something more complicated.

Mr Funk said:
And since when is it 2 hours after feeding he gets the shot? I read it was 20-30 minutes.
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I’m not sure where you read that but it’s likely something you read in relation to Vetsulin. With Lantus and Levemir, we generally don’t shoot food spikes. Can you test him right now and see if the dry has spiked his BG yet?
 
I need to stop this whole process and re-evaluate what's going on because I apparently have a fundamental misunderstanding about what we're supposed to be doing. First thing is to figure out why he's vomiting.
 
Here are my concerns:

  • DKA not that long ago; ketones are normal now but he’s vomiting so he doesn’t have food or insulin on board and he might be dehydrated all of which can set him up to develop ketones
  • We need to be able to get food in him
  • I don’t know if the 208 is a dry food spike; how quickly did he vomit and did he vomit everything he ate?
 
Mr Funk said:
I need to stop this whole process and re-evaluate what's going on because I apparently have a fundamental misunderstanding about what we're supposed to be doing. First thing is to figure out why he's vomiting.
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I’m one of the most experienced people on this board now; I haven’t posted to you but have read some condos. I’ve also helped many, many CGs with their cats with DKA. I just tell you that so you’ll have a little confidence in my advice.

The most important thing to focus on now is getting insulin into him safely. Yes, you need to know why he’s vomiting but unless you take him to the ER, you aren’t going to know that tonight.

If you can pls let me know how quickly he vomited after he ate and if he vomited all he ate, then I can go forward with advising you on shooting.
 
Marje and Gracie said:
Here are my concerns:

  • DKA not that long ago; ketones are normal now but he’s vomiting so he doesn’t have food or insulin on board and he might be dehydrated all of which can set him up to develop ketones
  • We need to be able to get food in him
  • I don’t know if the 208 is a dry food spike; how quickly did he vomit and did he vomit everything he ate?
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I haven't seen him drink anything today but he did get a sub-q bubble yesterday around 5PM.
It was probably about 10-15 minutes after he ate that he vomited. Mostly undigested.
 
Mr Funk said:
I haven't seen him drink anything today but he did get a sub-q bubble yesterday around 5PM.
It was probably about 10-15 minutes after he ate that he vomited. Mostly undigested.
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In post 18, you say he vomited....was that the Wellness or what had he eaten?

Here’s what I’m thinking: pls test him again 20 mins from the last test. Then if he’s still on the rise, I’d like you to feed him what you think he has the best chance of keeping down and see if it stays down 15-20 mins. If it does, then we should give him some insulin.

Sound like a plan?
 
It was the Wellness with a little bit of the DM Dry I had to put on top to get him to eat it, but he didn't really eat that much of it.

Sounds like a plan.

How much dosage? His usual 7 or reduced?
 
Mr Funk said:
It was the Wellness with a little bit of the DM Dry I had to put on top to get him to eat it, but he didn't really eat that much of it.

Sounds like a plan.

How much dosage? His usual 7 or reduced?
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Let’s see what his BG is, ok? If he’s still headed up, I’m leaning towards a full dose since we’ve stalled but I’d like to know he can keep food down.

I’m wondering if this is another pancreatitis attack. Has he had cerenia today?
 
Yes, I gave him half a tab after the first time he threw up tonight, though he threw up again maybe 20-30 minutes later so it's possible it didn't get fully digested.
 
Mr Funk said:
Yes, I gave him half a tab after the first time he threw up tonight, though he threw up again maybe 20-30 minutes later so it's possible it didn't get fully digested.
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I wouldn’t give him another. He might have absorbed some.

Do you have a food he will eat that he hasn’t vomited before? I’m also standing by for the BG.
 
Also, as far as the "when to shoot time", I did read it here. Here and here. Like the people in those threads, I had always heard 15-20 minutes after eating. I'm pretty sure I read somewhere else 30 minutes, so that's what I've been doing. All I ever heard was you just want to make sure they've eaten. I've never heard anything about a "food spike" before.
 
BG is still coming up, 236 now. He's usually pretty good with the DM Dry. He ate some more of it right after I tested him 20 minutes ago at the 208 and has kept that down so far.
 
Alright. Because this might be a food spike and he could vomit again, and because you have no HC food or gravy, it would be wise to shoot a reduced dose. This is not how we’d normally do this. Normally we stall with no food and shoot the full dose as soon as numbers rise. But we have some unknowns here.

I’d suggest shooting 5u. Once you shoot, see if he will eat a bit more DM; not a lot. We just want to try and hold numbers up.

Since you are dealing with a 7u depot, you’ll need to be on your toes with the testing. I’d be sure and get a +1 to start. Since no one else is around, I’ll sneak off from the company and check in with you. It’s very close friends who were with us through Gracie’s diabetes so they would understand.

Sound good?

Pls let me know when you’ve shot so I’ll know when to check back.
 
Mr Funk said:
Also, as far as the "when to shoot time", I did read it here. Here and here. Like the people in those threads, I had always heard 15-20 minutes after eating. I'm pretty sure I read somewhere else 30 minutes, so that's what I've been doing. All I ever heard was you just want to make sure they've eaten. I've never heard anything about a "food spike" before.
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With the longer acting insulins like Lantus, the onset is usually around 2 hours after the shot, although ECID (every cat is different).
Normally, if you get a test at PS time that is lower than you are used to or may concern you, you can wait without feeding for 20 to 30 minutes and test again to see if he is going up or down or staying the same. The waiting without feeding is called stalling.
If he has been fed, then there could be a food spike (raise in his BGs) from the food. Dry food takes longer to works its way through the system then wet food.
As Marje asked, how off schedule can you be? If you shoot 60 minutes or 90 minutes or whatever late, can your shoot schedule handle being off by that much time (you will need to shoot 12 hours or so, after you shoot tonight, tomorrow morning. You can adjust back slowly to your regular time in 15 minutes per cycle or 30 minutes per day, from there).
 
Maybe, if you have a grocery store nearby, you could pick up a couple of jars of all meat baby food (just meat and broth), that would be easy on his tummy.
 
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