9/17 Kitty Cat [AMPS 418, +2 355, +6 299, +8 349 +10 289] dose reduction following hypo, vomit

Christina & Kitty Cat

Christina & Kitty Cat

Member Since 2020
Hello! Was advised to come over here from the main board. Kitty Cat was diagnosed following rapid weight loss, excessive thirst, loss of appetite. We got through some big scares this week and I'm so thankful for this community for getting us through it.

Previous posts on the main board:
1. new member, possible DKA, & hypoglycemia
2. post hypo gameplan
3. dose reduction following hypo

History:
9/1 diagnosed, ketones trace
9/4 started 1u lantus 2x day
9/11-9/13 vomiting, constipation, ketones small
9/14 went to hospital but "not DKA yet" started ondansetron + famotidine
9/15 hypoglycemia
9/16 reduced to 0.5u AM & PM, stayed in high 400 entire day
9/17 (today) 0.75u AM

Previously Alphatrak but switched to One Touch Ultra HUMAN METER on 9/16

Seeking advice on dosage adjustment
PM+11 400
AMPS 418
AM+2 355

More context:
I recently switched to a human meter after almost running out of alphatrak when he went hypo. I tested today's AM+2 with both meters today and got 355 on human meter, 293 on alphatrak. Called vet 1 hr before today's AMPS, she was concerned with the string of high 400s from yesterday so vet advised to go back to 1u today but having consulted with FDMB I opted for 0.75u. Told this to vet who then consulted with internist who advised I stay on 0.5u through this weekend.
Saw this post on human meter vs alphatrak so I don't want the fear of high 400s from yesterday influence his dose, knowing they will seem higher after switching to the human meter.
 
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Responding over here instead of your post from Feline Health:

No fires anywhere near us (thank goodness), just the smoke from far far away. But it's dangerous to be out for any length of time. Thankfully most of us have masks now. :rolleyes:

A +2 is a good test to get at night. If you see it's about the same as the preshot, it'll be a nice Lantus cycle with some downward movement. If it's higher than preshot - then go to bed. If it's quite a bit lower, it can be an active cycle needing more monitoring, or at least enough food out for him to stay safe. Today looks like a pretty quiet cycle. During a bounce, numbers can bobble around quite a bit, but you aren't seeing significant downward movement now. You could do one more test between now and preshot, merely to see what he might be thinking of (data gathering), but he should be safe.

400's and 300's are both "high" regardless of meter types. Manufacturers can be out by 20% (in the US) so that's a significant difference in higher numbers. We also don't make any dosing decisions based on whether they are seeing 300's vs. 400's. What is influencing my suggestion to stick to 0.75 instead of 0.5 is two things. First and foremost, Kitty Cat saw small ketones on 1 units. Ketones and too little insulin are a dangerous combination, we want to stay away from the possibility of DKA. Plus you are good and testing and monitoring, after your baptism of fire the other night. The second thing I'm considering is that is sounds like Kitty Cat had low numbers the other night, and was very hungry, but otherwise had no other hypo symptoms. It sounds like low numbers, but not symptomatic. 1.0 unit is too much, by cats are sensitive to small changes in dose. Cats earn dose reductions here by going below a certain number. That number depends on which dosing method you are using, and if you are using Tight Regulation, the number is different for human vs. pet meters. The dose reductions earned are by 0.25 units. So it's a tradeoff, not too little insulin so you have to worry about ketones, and not enough to worry about him going low. With ketones, and especially DKA, we sometimes use the strategy of giving slightly higher carb food, if it allows us to get more insulin in.

How it Kitty Cat's appetite today? What is he eating mainly? You just need to list his regular everyday food in the signature.
 
Thank you Wendy for this detailed explanation! This is all super helpful as I still try to get a grasp on things.

Wendy&Neko said:
That number depends on which dosing method you are using, and if you are using Tight Regulation, the number is different for human vs. pet meters.
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I've been trying to read more on Tight Regulation via the stickies but I think it's going over my head from the lack of sleep. This is the method I'm on, yes? I just got the ReliOn in the mail today. Is it okay to start using right away or should I continue with my grandma's meter for the rest of the today?

Wendy&Neko said:
Kitty Cat had low numbers the other night, and was very hungry, but otherwise had no other hypo symptoms.
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Yes, he hit a new low in the middle of the day and was extremely hungry by dinner, but I didn't notice anything else. I saw on one of the posts to do some extra tests following a new low to see how it's moving so I will be sure to do that going forward.

Wendy&Neko said:
How it Kitty Cat's appetite today? What is he eating mainly?
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He ate the usual breakfast amount of 1.5 cans of FF classic chicken pate. Sometimes I'll give him a full 2 cans if he wants it since he's underweight. I do the same at night. Is this okay that he sometimes eats 3 full cans, sometimes 4? I'm so worried about him not gaining the weight back so I just try to feed as much as he'll eat.
 
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If he will eat and keep his food down, at his point, keep feeding him more. Just keep in mind if his numbers drift down that you might want him a little bit hungry. It's also perfectly fine, and even preferable/easier on his healing pancreas, to spread out the meals and give him a couple meals throughout the first part of the cycle.

Don't worry too much about choosing a dosing method at this point. Wait until you've had rest, time to have it sink in, and decide which best suits your life style and objectives. Both dosing methods would have had you reduce to 0.75 units.
 
Hi Christina! I don't have any advice since I am pretty new myself and have not had any of the issues you are currently dealing with. Sorry :(
But i saw your cats name and thought it was almost just like my cats name so I wanted to say "Hi!" Not a common name to see :) I always get funny looks when they call me back for KittenCat's appointments.
Anyway, glad you found this place! Everyone here has been so amazing and I wouldn't have been able to do this without all their help and support! Good luck to you and Kitty Cat! I hope he starts feeling better soon. :bighug:
 
Hi. It’s good yiu are posting here since it’s all Lantus users. I recall Kitten did have a symptomatic hypo and more than just very hungry as some of us were asking about the ER. I know part of our concern was lack of test strips. Would you please clarify as to what you observed? Thanks.
 
AHH I was in the middle of writing up a list of everything that happened on hypo night BUT HE JUST THREW UP!!
I gave ondansetron less than an hour ago with the leftover FF classic beef and some extra FF classic seafood. also been giving a few purebites treats with all the bg tests. he didn't seem extra hungry, I just wanted to give a midday snack. Did he just eat too much?? pooped a few mins before throwing up, looked normal. didn't get a ketone test in yet today.

Edit: few mins later he threw up some more
 
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tiffmaxee said:
Hi. It’s good yiu are posting here since it’s all Lantus users. I recall Kitten did have a symptomatic hypo and more than just very hungry as some of us were asking about the ER. I know part of our concern was lack of test strips. Would you please clarify as to what you observed? Thanks.
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9/15 using alphatrak (concern of not enough alphatrak strips but made it through)
  • PM+11, snack + ondansetron
  • AMPS 336, ate 2 cans FF low carb, shot 1u
  • AM+6 172
  • AM+7 snack + ondansetron
  • AM+11 seemed really hungry so gave a few greenies (high carb) while walking around the house to keep him occupied
  • PMPS 1st try 56
  • PMPS 2nd try 106, 2 mins after 1st try, had already eaten a few bites
  • PMPS 3rd try 121, 10 mins after 1st try, had already eaten a full can FF low carb unusually quickly
  • ate just under another can FF so almost 2 cans total for dinner, unusually quickly, shot 1u 10 mins late (9/13 skipped a dose after series of vomiting and not eating so didn't want to miss again)
  • PM+1 134
  • PM+2 80, leftover FF + ondansetron + famotidine
  • PM+3 55, 1/16 cup purina dry (27%) + <1tsp honey
  • PM+3.5 72, few pieces of purina dry + 1 tsp honey
  • PM+4 143, too full to eat anymore, slept until PM+7.5
  • PM+4.5 158; PM+5 176; PM+5.5 254; PM+6.5 267
  • PM+7.5 ketone test negative

9/16 switch from alphatrak to human meter
  • AMPS 431 WITH ALPHATRAK, held insulin
  • AMPS 525 WITH HUMAN METER 1.25 hr after usual time, shot 0.5u
  • AM+1,2,3,6,11, all high 400s, no significant changes
  • PMPS 481, 1.5 can FF, shot 0.5u
 
Welcome to the LB&L Forum Christina.

Sorry your first day here is so pukey - did he wolf down his food? Sounds like he's got an extra-sensitive tummy.

Perhaps try feeding a soupy mixture of a small amount of food?

Also, you may need to start ruling out allergies - some kitties just don't do well with certain kinds of FF.

I didn't review all of your history - but how long has he been eating FF wet? Was he on dry or something different before?

Rather than listing all the details here; you may want to put them into your SS - in the comments section - take a look at how @Butters & Lyla does it...great job with the SS..lots of details in the comments.
 
Jenifer said:
Hi Christina! I don't have any advice since I am pretty new myself and have not had any of the issues you are currently dealing with. Sorry :(
But i saw your cats name and thought it was almost just like my cats name so I wanted to say "Hi!" Not a common name to see :) I always get funny looks when they call me back for KittenCat's appointments.
Anyway, glad you found this place! Everyone here has been so amazing and I wouldn't have been able to do this without all their help and support! Good luck to you and Kitty Cat! I hope he starts feeling better soon. :bighug:
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Hello fellow very-straightforward-cat-namer! Sorry I'm in a frenzy now since he just threw up. Things were looking so promising with the ondansetron for nausea...
 
Sue and Luci said:
Welcome to the LB&L Forum Christina.

Sorry your first day here is so pukey - did he wolf down his food? Sounds like he's got an extra-sensitive tummy.

Perhaps try feeding a soupy mixture of a small amount of food?

Also, you may need to start ruling out allergies - some kitties just don't do well with certain kinds of FF.

I didn't review all of your history - but how long has he been eating FF wet? Was he on dry or something different before?
Click to expand...

He was previously on high carb dry food prior to diagnosis. He lost his appetite so for a few days before diagnosis, I steamed some salmon and gave him that.

9/1 he was diagnosed. Vet prescribed hills w/d. kept giving him the steamed salmon until 9/4 when the w/d arrived. also started insulin on 9/4. To get him to eat more, I would put some of the salmon into the w/d wet food.

9/11 he threw up once, mostly water and the salmon. It was the first time I'd seen him drink water in a while so I thought it was the water but I also stopped giving him the salmon.

9/12 he threw up again, mostly brown liquid.

9/13 he threw up 2 times in the morning 1 hour apart, skipped 9am breakfast and AM insulin, wouldn't eat w/d so gave some FF classic chicken around 2pm, threw up again just before dinner at 9pm so didn't eat, shot 1u, ketones: small

9/14 vet gave fluids and cerenia, transfered to hospital. ultrasound: mild pancreatitis and GI inflammation, prescribed ondansetron & famotidine

9/14 FF classic chicken and purebites chicken only

9/15 FF classic chicken in morning, hypo by PMPS , ate 2 can FF classic chicken, old dry food, honey, greenies

9/16 FF classic chicken and purebites chicken only

9/17 AMPS breakfast: FF classic beef, AM+6 1/2 can FF classic beef with ondasetron, 1/8 can FF classic seafood feast, AM+7 threw up

Trying to be better about recording food in SS.
Note: He has had a variety of FF before. I can't say I remember all the flavors he's had. But he didn't start throwing up until 9/11. Not often but I used to just get a variety pack and feed him FF every once in a while. Didn't know anything about balanced diet.
 
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Ok. So he was low but no hypo symptoms Tuesday night. Good to know. Thanks. Looks like the bounce might be clearing and the .75 is bringing the bg down. Very good. Add the +6 299 to your title please.

I just saw he vomited again. I wonder if too many new foods is the cause? It also could be due to the pancreatitis.. No matter how hungry he seems feed him small amounts often. That’s what my vet said to do with pancreatitis. Poor baby. Poor you!:bighug:
 
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The store didn't have anymore chicken yesterday but mom will go hunt for some more chicken tonight. she's staying with me overnight again in case anything happens.
I do have a beef + chicken, or a turkey + giblets. deciding if I should stick to poultry only? He had 1.5can beef and a tiny bit of seafood today, so I don't know which one it might be but the seafood was less than an hour before throwing up.
 
he's crazy hungry, kept climbing on the counter, first time since moving to this apartment in mid august, wouldn't stop meowing for food or trying to lick things in the sink. gave him a little bit of FF turkey & giblets mixed with water but he's still going crazy
just checked AM+8 and it's 349.
I accidentally poked the vein and got blood everywhere. I'm freaking out, he's freaking out.
Critter Mom said:
check to see whether the stools are very firm/hard
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nope, normal poop consistency. and found another nugget in a non-litter box place :( idk how long it's been there
 
He ALWAYS shakes his head when I prick, it makes me want to cry. Okay I blocked access to the kitchen so hopefully he'll calm down a little... Maybe will feed a little before AM+10 so I can still get a good PMPS reading but he doesn't need to eat as much dinner?

After the 3 days of vomiting this past weekend and then no vomiting for 4 days, I was so happy, but now I just feel really low. Today's BG #s arent out of the ordinary so I thought today would be an easy day.

Edit: totally not calming down still... now screaming in front of the kitchen
ketones negative
 
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Just wondering if he is vomiting or just regurgitating? Vomiting is producing stomach contents- usually digested or partially so with bile or fluids. Regurgitating is spitting up usually undigested food after wretching a bit. A cat regurgitating after eating too fast or too much is one thing...several days of vomiting can be a sign of something else altogether.

When my cat used to get crazed, I would see if he would play/ exercise a bit to burn off some of the energy. Laser pointer, flash light on the phone, cat nip....just something to distract a bit
 
Si am cat mom said:
Just wondering if he is vomiting or just regurgitating? Vomiting is producing stomach contents- usually digested or partially so with bile or fluids. Regurgitating is spitting up usually undigested food after wretching a bit. A cat regurgitating after eating too fast or too much is one thing...several days of vomiting can be a sign of something else altogether.

When my cat used to get crazed, I would see if he would play/ exercise a bit to burn off some of the energy. Laser pointer, flash light on the phone, cat nip....just something to distract a bit
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hmm the previous 3 day puke fest happened hours after eating and I'd say definitely vomit.
AM+7 today it was mostly undigested and happened a little less than an hour after taking ondansetron with a large snack of 1/2 can ff beef and ~2tsp seafood which he hasn't had before or at least not in the last few months. it was a lot of solid. few mins later he moved to a different spot gagging for a bit and and spit out more liquid
AM+8,10 I gave him some soupy mix of turkey equating to half a can total between the two times
PMPS tested 303, shot 0.75u, ate 1 can soupy turkey. He was supposed to get famotidine but I forgot until the end of his meal so he didn't get much of it in. when vet prescribed it, she said it's okay if he skips the famotidine.

I tried distracting him with toys, lasted less than a minute. He hasn't played with me in a long time :( zero interest in toys, even laser. cat nip he just eats right away and then it's gone.

edit: reading up more on vomit vs regurgitate
Regurgitated food having a tubular shape, I've seen that before but this wasn't like that. but it was definitely undigested food and I could even see the purebites treats in it.
 
PM+2 238
I gave 0.5 can FF turkey with his ondansetron which is a much larger snack than usual but he ate less dinner and I'm going to try to space out his food more since he has this history of throwing up. Feel scarred by the hypo night but since he had this snack, I think I'm okay to go to sleep. If I happen to wake up in the night (usually do) I'll get another test for more *~data~*. Thanks everyone for having me on the lantus board now! Today was disappointing to see him throw up after 4 days of keeping food down, but hoping tomorrow is a better day.

Keeping with the 0.75u I'm assuming for the next few days?
@Wendy&Neko sorry if you're busy!! don't have to respond now.
 
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