Newly diabetic cat puking every morning at same time (before insulin)

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Dee1991

Member Since 2020
Hey everyone,

this is my first time posting here but I’m a bit at a loss.

I took my 12 year old cat into the vet two weeks ago because he was vomiting frequently (anywhere from every second day to twice a day). We found out he was diabetic and have been giving him one unit of insulin twice a day and testing his BG before every shot (quite the traumatic learning curve for the both of us).

the vomiting has not changed since beginning his insulin, it’s been two weeks of being on insulin. Only difference is that he is not puking up large amounts of food anymore. He is now puking every morning around 5-6am. His feeding time is 6:30am and we’re pretty consistent with timing. His puke is ranging from clear liquid, hair ball, to brown liquid and at most about a tablespoon or two amount.

I guess my question is has anyone’s cat experienced this? I took him in for puking and the insulin is all my vet has suggested for us to do, but I’m worried his puking is something more serious.
 
Hello, Dee, and welcome to you and your kitty.

Am I correct in understanding that you only feed your little one twice a day? If yes, then the vomiting of clear/brown liquid might be triggered by tummy acid build-up. A simple thing that can help this is to reduce the length of time your kitty fasts between feeds. You could consider giving a few 'mini feeds' between the main feeds before you give the insulin. That's a possible way to alleviate the symptoms but it doesn't really deal with the root cause of the vomiting. Did your vet check your kitty's kidney function? Did they test for pancreatitis? Also for ketones (in blood and/or urine)?


Mogs
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Hello!

yes you’re right about the feeding schedule. The vet told me to feed him half a can in the morning and half a can in the evening before his insulin + 1/8th of a cup diabetic prescribed dry food - my cat is not very fond of the dry food so he rarely eats that. I try to offer the dry food in small amounts throughout the day and shortly before bed.

he did have pancreatitis as well as ketones in his urine when we first brought him in, but the vet informed me that he was a very stable diabetic cat and so she did not want to change his treatment plan. Other than taking pain medication for three days, I was not told to do anything else. I’m starting to wonder if they should have prescribed him something for the pancreatitis? They also didn’t mention anything about his kidney functioning.

I really appreciate you responding and supporting :)
 
Hi Dee,

I'm sorry to hear your little fella had pancreatitis. :bighug: It's an awful affliction. Glad to hear he got past the ketone situation OK. If he still spends any time in higher numbers (>200 on human meter, >250 on pet meter) it's a good plan to regularly test for ketones as a general safety precaution (if you're not already doing so!). Kitties who've had ketones in the past tend to be a little more vulnerable to them, especially when their appetite is a bit off. Here's some helpful information:

Ketones, DKA and ketone meters

Tips for collecting urine samples

If the pancreatitis is chronic, it can wax and wane in severity. Here are two resources that I found invaluable in helping me to manage Saoirse's issues:

Nausea, vomiting and inappetence - symptoms and treatments

IDEXX feline pancreatitis treatment guidelines

The first link is to a site that focuses on CKD but the nausea symptoms and treatments are common to several conditions, including pancreatitis. The second link is from IDEXX Laboratories, a world authority on feline pancreatitis, and it has details of all the appropriate treatments for both acute and chronic management of the disease (a good document upon which to base discussions with vets!).

Many cats with chronic pancreatitis benefit from taking an anti-nausea med as part of their daily regimen. Ondansetron was a lifesaver for Saoirse more than once. (It's a human drug that can be obtained from a regular pharmacy if your vet doesn't carry it.) Famotidine can help with excess stomach acid issues. Neither ondansetron nor famotidine negatively impacted her blood glucose levels.

With regard to the vomiting, what I found helped Saoirse was to feed her small meals every three hours when she was on Lantus. Previously when she was on Caninsulin (aka Vetsulin) I'd feed her a larger meal prior to giving the insulin and then feed small snacks every three hours. If she went any longer than 3 hours she was very prone to throwing up liquid vomitus. Maybe you could try something similar? Which insulin is your kitty being treated with? And what's the little fella's name?


Mogs
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tap on your avatar where it says your name ,then hit profile page ,tap on that ,then go up to the very top, upper right hand side and tap on your name ,it will bring down a drop box, tap on signature, the signature will be under settings, tap on the signature then and you can start to add what I posted above, make sure you hit save ,
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What type of insulin are you using? How you should feed depends some on the type of insulin you're using.

Also, if you can get the diabetic kibble out of his diet, it will help his numbers. Even the "diabetic" kibble is too high in carbs for a diabetic cat.
 
Most of us feed Fancy Feast Classic Pates , try to stay under 10 % carbs
Will post the food chart for you.

Any dry food is high in carbs and no need to feed prescription wet food from your vet.

If you can please fill out the signature I posted above. You will see mine or any
other members under our posts, its in grey writing.
 
https://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
Since you are testing you might want to set up a spreadsheet for your kitty.
We all use this to track our cats BG. Take a look at mine or anyone else's.
If you need advice on dosing we need this to look at to give advice.

You should also be testing after every shot both AM and PM to see how whatever insulin you are using to see how it's working and how low it's taking your cat.

If you need help setting it up we have two wonderful members the that will do
it for you. I will also give you the link that explains how the spreadsheet
works


https://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/
 
My boy had chronic pancreatitis and my vet said to always feed small meals more often. If they eat too much at one time they don’t feel well. That’s works better for diabetes too.
 
Thank you all for the feedback, I'll work on the spreadsheet and the signature. I'm still feeling a bit iffy on what everything the vet said means, so doing my research and will include more info once I know what's relevant.

I'm doing a glucose curve today and his BG dropped from 23.9mmol to 4.5mmol within 5 hours (6:45am to 11:45am). Started checking hourly and at 12:45 he was back at 6.2mmol. I don't think it's supposed to be that way?

He's currently on 1 Unit twice a day. I'm going to check his BG in an hour just to make sure he is still increasing.

I also feel like Aboo would prefer eating smaller amounts throughout the day but I was told he should eat half a can in the morning and half a can in the evening, and we had a mini hypoglycaemic scare at the beginning when I tried giving him the majority with the insulin shot while trying to save some to be rationed out between shots.
 
Do you want someone to set you up with a spreadsheet? We have people that can get you set up in minutes. If you hop over to the Lantus forum and read the yellow stickies you will have a better understanding of how depot insulin like Lantus works.
 
Thank you all for the feedback, I'll work on the spreadsheet and the signature. I'm still feeling a bit iffy on what everything the vet said means, so doing my research and will include more info once I know what's relevant.

I'm doing a glucose curve today and his BG dropped from 23.9mmol to 4.5mmol within 5 hours (6:45am to 11:45am). Started checking hourly and at 12:45 he was back at 6.2mmol. I don't think it's supposed to be that way?

He's currently on 1 Unit twice a day. I'm going to check his BG in an hour just to make sure he is still increasing.

I also feel like Aboo would prefer eating smaller amounts throughout the day but I was told he should eat half a can in the morning and half a can in the evening, and we had a mini hypoglycaemic scare at the beginning when I tried giving him the majority with the insulin shot while trying to save some to be rationed out between shots.

Feeding twice a day is necessary for some insulin but not Lantus. That shows a lack of understanding of how Lantus works. I know you are probably wondering why should I listen to the lady rather than my vet. I felt that way at first and my vet does understand diabetes. He just wasn’t with me 24/7.
 
I love my vet going to her for over 20 years, but when it comes to diabetes
I take the advice from the amazing members here who deal with it 24/7
I had printed a ton of info from this board for her and she was very impressed
and trusts me with what ever I do with Tyler .

If I have to take him to her for anything other than diabetes I do.
 
I'm starting to feel that way too. The vet has been so supportive but something still doesn't really feel right.

Aboo's BG are starting to come up again, and he's always hungry! I would just prefer to keep him on a completely wet diet. I guess I'm curious how much wet food he should eat with each insulin shot if i'm going to space out the suggested 1 can of the prescribed wet food. He initially was on 1 can of fancy feast during each shot and then a 2-3 teaspoons throughout the day for snacking.
 
I'm using the "world mmol/L" spreadsheet since that works best with all my glucose monitor. Is that right?
It’s okay. It should convert when I click US but it doesn’t. I’ll just multiply but maybe Bhooma can fix that. I saw the nadir was green and that’s good. Bouncing back up is to be expected.
 
Your spreadsheet shows up but the numbers don’t show up on the US one.
Elise, I can see the numbers in the US sheet! So strange.

upload_2020-12-1_9-1-30.png



Another recently-joined member had the same problem in the last week or so. Wonder whether it might be a problem with the template? (Tagging @Bandit's Mom to alert her to possible glitch.)


Mogs
.

I didn't get this tag again! What's going on?! :mad:
 

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@Dee1991 , most people here look at the US tab - could you drag it to the front - that is, to be the first tab in the SS. Do you need help with doing that?

No changed it! hope that worked. If any questions come up, is it recommended that I start a new forum? I've been asking my vet so many questions and just want to make sure i've got the best practice.
 
No changed it! hope that worked.
Yes it did! Thank you :-)

If any questions come up, is it recommended that I start a new forum? I've been asking my vet so many questions and just want to make sure i've got the best practice.
Yes, it is advisable to start a new thread on a new day. Otherwise these threads become too long for people to read through! If you can paste the link of the previous thread in the current thread, it would make it easier for people to look through your threads for history - that would save them asking you the same questions again and again!
 
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