01/17 Stormy AMPS 125

Amy and Stormy

Amy and Stormy

Member Since 2021
Link to last post:
https://www.felinediabetes.com/FDMB...lantus-at-193-not-eating.241577/#post-2720914

Edit: he seems really weak today :( he's currently laying under my comforter and when I take it off to offer him food or water, it's like he tries to get up and go back under the covers but he can't get up.

Hey everyone! Second time posting here, and I have a spreadsheet now LOL (though it's sparse because I just started). My cat Stormy (18M) was in the hospital earlier this week with pancreatitis, and he is seeming to not really get better. He's still not eating, and I can tell especially last night/today he doesn't seem to feel good. He hid under my covers with me this morning before I woke up, and he NEVER does that. He looks so tired :( I have been trying to syringe feed him about a 5.5oz can a day, but I still don't think he is getting enough food. He's been having pretty watery diarrhea too, which I know isn't good for his hydration. He got some subq fluids on Friday at his vet which seemed to help him overall for about a day. And he did start drinking SOME water yesterday when I put unsalted chicken broth in it, so that's better than nothing. But I have tried EVERYTHING to get him to eat. Looked at the forums, links, FB page, etc. Except I haven't tried tuna water, because I forgot to buy it. However, he is eating catnip and cat treats I put in front of him, which is more than he was doing on Wednesday and Thursday. Still not wanting to eat real food though, and he is getting less and less tolerant with the syringe feeding every day. It's getting harder to get enough in him, as he pulls away and just doesn't like it.

His AMPS just now was 125 and I called the emergency vet to ask what to do (my vet told me to call and ask what to do if it's below 150). They said not to give insulin and to keep checking him throughout the day. They said if he's below 100 to call them again, but I really can NOT afford another trip to them. I already spent $3700 for 4 days this week and I have nothing left. I think he is so low because I wasn't up to feed him during the night, even though I syringe fed 20mL with insulin. I did get up and check him at 4am, and maybe I should have fed him then, but I felt like he was okay. I'm going to syringe feed him now.

Since I'm not giving insulin, I'm going to set out his non-absorbant litter and box, and check for ketones throughout the day when I can. After he goes once, I just test it and absorb all the urine in paper towels so he can use it again later (sorry if that's gross lol).

Anyway, this is all so scary and overwhelming to me because I am so new at this. Any advice offered would be appreciated.

List of his meds:
-Methimazole (for hyperthyroidism)
-Metoclopramide (for his gut I think - he has IBS)
-Prednisolone (0.4mL 2x/day for (I think???) his eating)
-Cerenia for nausea (I am thinking of asking my vet tomorrow for Zofran instead)
-Mirtazapine for his appetite
-He also has some Entyce for his appetite that I haven't given yet. Might give today instead of mirtazapine and see how he does
-Metronidazole for diarrhea (been on this since thursday and his stool is getting more watery so idk)
(I think his is all his meds. I can't double check right now because he is sleeping on my lap but if he is on more I will edit the post)
 
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Prednisolone is a steroid so that's probably for the IBS.

Butters was in the hospital for five nights with pancreatitis back in October. That was my first experience so I can speak to that.
For panc, butters has cerenia and ondansetron (zofran) for nausea (ondansetron would be the first thing I try), cyproheptadine for appetite stimulant, buprenorphine and gabapentin for pain (bupe is a better option for most but doesn't work that well for butters).

What really sticks out in your post is I can't figure out what medication is for pain? Pancreatitis can be painful so Stormy may need some stronger pain meds. I had butters home for a weekend in between hospital stays and they didn't give her proper pain meds. I was having to syringe feed her and she was just miserable. After her pain got under control when she went back to the hospital, things got much better for her. She came home on fentanyl and gabapentin for pain, along with cerenia, ondansetron and cyproheptadine. She ate on her own once her pain was under control, but she was on the meds for quite a long time. It has been a roller coaster.

But like I say, I am pretty new at this and not familiar with all of the meds you listed. Others will be along with more help. I'm so sorry you are going through this:bighug:
 
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@Butters & Lyla thank you so much for the quick reply. I'm so glad Butters made it through okay!
So he actually isn't on any pain meds right now, I have asked his internal medicine specialist and his reg vet and they both said they didn't think he needs it and that he's on enough other meds right now they don't want to add anything not needed. But I at least want to try it so I may call the emergency hospital today and see what the ER doctor says about it. At this point I feel like these may be his last days so I'm willing to try anything.
 
Amy and Stormy said:
@Butters & Lyla thank you so much for the quick reply. I'm so glad Butters made it through okay!
So he actually isn't on any pain meds right now, I have asked his internal medicine specialist and his reg vet and they both said they didn't think he needs it and that he's on enough other meds right now they don't want to add anything not needed. But I at least want to try it so I may call the emergency hospital today and see what the ER doctor says about it. At this point I feel like these may be his last days so I'm willing to try anything.
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Stormy is going through so much. I think I'd be prioritizing pain meds (buprenorphine ideally) and I'd also ask about cyproheptadine for an appy stimulant instead of the mirtazapine (we don't know that it's working anyways since Stormy isn't eating). It was suggested to me by @tiffmaxee whose sugar kitty Max had chronic pancreatitis, and it worked wonders for Butters (along with anti-nausea and pain management meds). The mirtazapine Butters originally was given didn't do much for her.

Cyproheptadine is also a better choice if you're going to ask for ondansetron. I'd try to get some of that too. If they don't have it, ask for a prescription.
 
Welcome. Stormy has so many issues. :bighug: Is he having issues with bowel movements? That would explain metoclopramide. Some give for pain but it didn’t help cats there. I’ve read a lot of very negative things about Entyce. I like cyproheptadine as Lyla mentioned. You need an RX and then can get it at a pharmacy as it’s a human drug. I used ondansetron for nausea.

The insulin dose is too high. We need to find a dose you can shoot every cycle. I would reduce tonight to .75 or maybe even .50 depending on the PMPS bg.
 
Butters & Lyla said:
Cyproheptadine is also a better choice if you're going to ask for ondansetron. I'd try to get some of that too. If they don't have it, ask for a prescription.
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Dang well maybe this was the wrong choice but I just gave some Entyce (capromorelin) an hour ago to see if it would help his appetite, so I'll have to wait until tomorrow to see if I can get some cyproheptadine from his vet. I just put some food in front of him and he gagged so obviously the cerenia doesn't seem to be working too well. Of course I just gave it at 10pm last night so I can't give anything else until 10 tonight.
Do you think I should call his emergency vet back and ask for some pain meds today?? The ER vet there won't know him specifically so I don't know what they would say, as he was under the care of an internal medicine specialist while he was there earlier this week. Should I ask the ER vet for some ondansetron today too? The meds there are SO much more expensive than my reg vet but I don't even care if it makes him feel better. It just makes me nervous to ask the random ER vet to add all these meds when they don't know him, you know? But I'll do anything to help him, he seems so miserable. I just would rather wait and speak with his internal medicine specialist tomorrow, but i don't know if he can wait that long.
 
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tiffmaxee said:
Welcome. Stormy has so many issues. :bighug: Is he having issues with bowel movements? That would explain metoclopramide. Some give for pain but it didn’t help cats there. I’ve read a lot of very negative things about Entyce. I like cyproheptadine as Lyla mentioned. You need an RX and then can get it at a pharmacy as it’s a human drug. I used ondansetron for nausea.

The insulin dose is too high. We need to find a dose you can shoot every cycle. I would reduce tonight to .75 or maybe even .50 depending on the PMPS bg.
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Yes he has IBS and kind of like chronic constipation so that's why he's on that. But ever since he's been home from the hospital he's had diarrhea :(

I fed him an hour ago and I just tested again (not sure if I tested too early after food or not) but he's now up to 214.
Are there syringes I can buy with smaller increments? I struggle enough to measure out one unit, NO WAY could I tell the different between .75 and .5 with the current syringes I have.
 
With diarrhea I would call the ER and ask if you can stop it. I don’t know if it needs to be done slowly or even if it’s a good idea. Yes. They make syringes with half unit markings. You can get some at Walmart. One hour after eating that will be food influenced. That’s why to get AMPS and PMPS food is not given two hours before.
 
I’m also worried about dehydration. It looks like you weren’t sent home with sub-q fluids. I would also call to ask if that’s a good idea and if yes can you pick some up.
 
tiffmaxee said:
With diarrhea I would call the ER and ask if you can stop it. I don’t know if it needs to be done slowly or even if it’s a good idea. Yes. They make syringes with half unit markings. You can get some at Walmart. One hour after eating that will be food influenced. That’s why to get AMPS and PMPS food is not given two hours before.
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I will call them here shortly and ask about everything.
I thought it would affect it. So then how do I test throughout the day but also syringe feed him throughout the day too? I'm just trying to feed him as often as I can right now. Yesterday I would test every 2 hours and then syringe feed right after. Is that how I should do it today? So it's not influenced as much by the food?

I have syringes with half unit markings but I still think it would be so hard to get it to.75 with no markings for it. There is like a millimeter of space between 1 unit and half a unit so I don't know. Maybe it's just me with the problem LOL.
 
tiffmaxee said:
I’m also worried about dehydration. It looks like you weren’t sent home with sub-q fluids. I would also call to ask if that’s a good idea and if yes can you pick some up.
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He got subq fluids on Friday at his reg vet and I asked her if she thought I should do it at home. She said with the subq he got on Friday he should be fine until Sunday (today) and if it's something we need to do in the future then we can. So I'm sure they will give it to me tomorrow at my reg vet I just don't know if he will be okay for that long. It makes me SO NERVOUS to get it from the emergency vet also because they aren't allowing people in the building so they can't show me how to do it. I've never done subq fluids at home before. I just feel so overwhelmed today. I wish it was any other day of the week so his reg vet would be open and I could just call them.
 
Amy and Stormy said:
He got subq fluids on Friday at his reg vet and I asked her if she thought I should do it at home. She said with the subq he got on Friday he should be fine until Sunday (today) and if it's something we need to do in the future then we can. So I'm sure they will give it to me tomorrow at my reg vet I just don't know if he will be okay for that long. It makes me SO NERVOUS to get it from the emergency vet also because they aren't allowing people in the building so they can't show me how to do it. I've never done subq fluids at home before. I just feel so overwhelmed today. I wish it was any other day of the week so his reg vet would be open and I could just call them.
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Waiting until tomorrow is fine as long as you are syringing food. Will your vet let you in to show you? There are some good videos on this.
 
@tiffmaxee
Oh okay sorry I should have known there would be pictures of that somewhere! I'm just stressing over everything right now. Thanks!
Yes, my reg vet will let me in to show me. I have watched multiple videos and I know it doesn't seem that hard, I just want someone else there the first time I do it so I can practice, I don't know. I just have terrible anxiety about everything but especially with needles because I'm so afraid of accidentally putting them into his muscle or something. I can't even do his montly B12 shot at home. I just want the vet to show me so I can ask questions and see it with my own eyes.

I have a list together now and I'm just going to call the ER doc and see what they say about everything. Hopefully I can talk to an actual doctor instead of the receptionist relaying all the info as a middleman.
 
No apologies. How would you know? Ask as many questions as you have. No holding back. I usually say we all have been in your shoes but in your case some of us have with multiple health issues. FD is a very difficult thing to wrap your head around. We will help you.
 
Amy and Stormy said:
@tiffmaxee
Oh okay sorry I should have known there would be pictures of that somewhere! I'm just stressing over everything right now. Thanks!
Yes, my reg vet will let me in to show me. I have watched multiple videos and I know it doesn't seem that hard, I just want someone else there the first time I do it so I can practice, I don't know. I just have terrible anxiety about everything but especially with needles because I'm so afraid of accidentally putting them into his muscle or something. I can't even do his montly B12 shot at home. I just want the vet to show me so I can ask questions and see it with my own eyes.

I have a list together now and I'm just going to call the ER doc and see what they say about everything. Hopefully I can talk to an actual doctor instead of the receptionist relaying all the info as a middleman.
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Don’t take advice from the receptionist. We will help you if a vet won’t get on the phone. It’s good you can talk to your vet tomorrow.
 
They said everyone is too busy right now, so they'll have to have a tech call me back. I don't really expect them to know much about my questions, I really wish I could just talk to a doctor. I don't even know if his regular vet is in tomorrow, I'm just hoping she is. Or at least one of her colleagues will be. I just hope they have time to talk to me or fit me in for an appointment. Thank you so much for your help
 
Amy and Stormy said:
They said everyone is too busy right now, so they'll have to have a tech call me back. I don't really expect them to know much about my questions, I really wish I could just talk to a doctor. I don't even know if his regular vet is in tomorrow, I'm just hoping she is. Or at least one of her colleagues will be. I just hope they have time to talk to me or fit me in for an appointment.
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This is when you push hard, tell them it’s an emergency, cry if you have to. Your vet or a colleague needs to see him. :bighug:
 
tiffmaxee said:
This is when you push hard, tell them it’s an emergency, cry if you have to. Your vet or a colleague needs to see him. :bighug:
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Oh I cry without even trying now LOL i'm so worried about him. I just talked to a tech at the emergency hospital and she was really nice. The ER doc can't prescribe anything without seeing him again, which I don't have money for. So she texted his internal medicine specialist (even though she's not supposed to) and he said we can start ondansetron and bupre. He said he didn't think the cyproheptadine would help him. So i'm going to do his afternoon meds and then head that way to pick up those new meds. Thank you all! I'm hoping at least the pain meds will help because he just seems so miserable, it breaks my heart. I literally feel like he is dying right before my eyes.
 
:bighug::bighug::bighug::bighug::bighug: Just don’t give Entyce. I dint have time to search fir the negative posts on it but in addition it makes them foam at the mouth. I don’t understand why they they you that and mirt but won’t give cyproheptadine which is old school and simply an antihistamine. I’ve been seen my cats’ appetite increase with Zyrtec allergy, another antihistamine.

Keep us posted.
 
tiffmaxee said:
:bighug::bighug::bighug::bighug::bighug: Just don’t give Entyce. I dint have time to search fir the negative posts on it but in addition it makes them foam at the mouth. I don’t understand why they they you that and mirt but won’t give cyproheptadine which is old school and simply an antihistamine. I’ve been seen my cats’ appetite increase with Zyrtec allergy, another antihistamine.

Keep us posted.
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Welllll I already gave entyce before I posted anything here he had it last time he had pancreatitis and I thought it helped some, so I gave it. But I will probably continue with the mirtazapine in a day when I can. Thank you!!
Edit: forgot to add I am going to ask his reg vet tomorrow about the cyproheptadine. I was just grateful I could even get these meds today so I didn't push it.
 
I've used Zyrtec for Butters too.

I'm out doing errands but just wanted to check on you and also say when i talk about the meds, they worked really well for my cat but that doesnt mean other meds wont work for stormy.:bighug:
So glad it looks like you're getting bupe and ondansetron. Will look for further updates.
 
tiffmaxee said:
I found the info on Entyce. It can increase bg.
https://www.elanco.com/insights/elanco-elura-capromorelin-oral-solution-gains-us-approval
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Oh wow I had no clue. And it's made by Elanco, I used to work for them LOL they are like 20 mins away from my house. But that's good to know, thank you!! I definitely will not give it again. They also gave it to him while in hospital, I wonder why. But thanks for the info!

Also I just realized tomorrow is a holiday here in the states so I am REALLY hoping my vet is open. If not I may just come to the emergency vet to get subq fluids if it's not too expensive. I'd rather pay for them to do it one more time and then have my vet show me how I can do it at home later in the week. But I just picked up his meds so hopefully these will help. I'm glad I don't have to wait to give the Ondansetron until the cerenia wears off. Sorry this is getting really long lol but thanks so much for all of your help!
 
Butters & Lyla said:
I've used Zyrtec for Butters too.

I'm out doing errands but just wanted to check on you and also say when i talk about the meds, they worked really well for my cat but that doesnt mean other meds wont work for stormy.:bighug:
So glad it looks like you're getting bupe and ondansetron. Will look for further updates.
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That makes sense. I really do trust his internal medicine specialist here, so I'm hoping with these new meds we won't need to try another appetite stim. Who knows though. But thanks for checking in!
 
I forgot it’s MLK day! I’m in the US too. If the ondansetron works and syringe feeding gets enough food in you might not need the fluids. Play it by ear.
 
Amy, I'm not sure I'm so sorry. Im hoping it is something straightforward. You and stormy are both in my thoughts. Sending prayers that they can do something for him. I'm checking on your thread so please keep us updated. :bighug::bighug::bighug:
Sorry I can't be of more help with this symptom.
 
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No you’re okay!! He can’t even hold in his diarrhea anymore. It’s all over him in his cage rn. We are waiting at the emergency vet now but he’s so miserable and just getting worse. I really think he’s ready, even if I’m not.
 
Oh Amy just reading all this, I am so sorry, I am tearing up right now reading all of this. It just makes me sick to my stomach that Stormy is in pain. You did do all you could, you are the best mama to Stormy. Sending prayers and hugs . ♥♥:bighug::bighug::bighug:
 
Thank you all so much. I just got back out to my car after being with him for the final time. He was ready, even if I wasn’t. I’m glad he’s not in pain anymore and I hope I gave him the best 18 years of his life. He was such a trooper through everything. Thank you all for all your support and love.
 
I am so sorry Amy. We just met but I am positive you gave Stormy a wonderful 18;years. He was so well loved and he didn’t live to 18 without the best of care. I hope your memories of better times will help ease the pain. Take care of yourself. :bighug::bighug::bighug:
 
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Amy:bighug::bighug::bighug::bighug::bighug:
I'm heartbroken to read that your sweet Stormy has gone to the bridge. You gave him that final gift of setting him free from his failing body, even though you weren't ready. It was an act of true love and selflessness. He was such a lucky cat to have been loved and cared for by you for his 18 years. Be kind to yourself. Grief doesn't have a timeline.
Fly free, sweet boy. :bighug::bighug::bighug::bighug:
 
(((Amy))). My deepest condolences. You weren’t here long with us but I could tell how very much you love this boy and were just trying to keep him comfortable. I am so terribly sorry for your grief. I hope that, I’m time, you will find peace knowing you did the very best for him right up to the end.
 
Oh Amy I am so sorry to hear about Stormy. I am sure he had a wonderful 18years with you.
You cared for him deeply that was obvious.
Fly free Stormy:rb_icon:cat_wings>o
:bighug::bighug::bighug:
 
Oh Amy I am so so sorry to hear about your precious boy Stormy.
You did give him the best 18 years, you did everything you could for him.
Same thing happened with Tyler's brother Perry who had CKD ,I had to let him go this past Oct. I know it's hard. I didn't want to let him go but I know it was for the best. My heart breaks for you. Fly high sweet Stormy, you will be missed ♥♥♥:bighug::bighug::bighug:cat_wings>o
 
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