! 9/16 LANDO AMPS 254; +1 256; +5 43; +5.25 114

Lando demando

Lando demando

Member Since 2021
So Lando has only eaten by syringe for 48 hrs
I think yesterdays calories were under 100

he has lost 1 lb - but was MUCH peppier after last nights bup shot

he has remained in the mid 200’s BG since ive been token dosing… so heres my question:

do i shoot a lower dose for the first time ( like 1u)? The intended new earned unit was 1.5 ( down from 2)

i know its go SLOW but i am trying to not have him bounce so much and keep his stress down since he still hid after his BG test and wont come out again.

THOUGHTS? Thank you!
 
Bandit's Mom said:
Hi Chelsea, yes you can try 1U.

Did the vets not give any anti-nausea or appetite stimulants?

Link to your previous post:
https://www.felinediabetes.com/FDMB/threads/9-14-lando-am-ns-2-275-pm-ns.252965/
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Hi Bhooma! Thanks for the advice. Yes vet really wanted lando to stay on cerenia ( but i will up his dose) and i still have mirataz

i am going to do cerenia in 2 hrs ( after +2 test) and maybe the miritaz?
Thinking of keeping the bup injection at night

so to recap: cerenia ; miritaz ; buprinex
 
Gave high carb, testing again in 15m

i obviously am not getting enough food in him
No signs of hypo + tested urine keytones today ( no sign)
 
Cerenia along with Ondansetron (4mg twice daily) helps control Sabrina's nausea during her pancreatitis flare. SubQ fluids also makes her feel so much better (no more than 10ml per pound).

Need a lil bit patience as it takes longer for older kitties to bounce back. Hope Lando feel better soon!
 
Jia&Sabrina said:
Cerenia along with Ondansetron (4mg twice daily) helps control Sabrina's nausea during her pancreatitis flare. SubQ fluids also makes her feel so much better (no more than 10ml per pound).

Need a lil bit patience as it takes longer for older kitties to bounce back. Hope Lando feel better soon!
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Thank you for your advice Jia, much appreciated. I have been syringe feeding Lamdo and must not be getting enough in him. Right now he tested 46. Im about to test again

if i can not make him swing so much, maybe he will have a recovery :)
 
I pulled this from Dr. Lisa's column. How much should I feed?
Since most people free-feed dry food, the amount of calories consumed in a day is not known. In this case, figure out what you think your cat *should* weigh and plug that number into this formula:

Required calories per day = [13.6 X optimal lean body weight in pounds] + 70

Most female cats should weigh a nice, lean 10 -11 pounds. Most male cats should fall into the 11 -13 pound range.

Using an optimal body weight of 12 pounds as an example, we come up with 233 calories/day as a starting point.

[13.6 X 12 pounds] + 70 = 233
​
Also:
Calculating % Calories from Carbohydrates
 
Red & Rover (GA) said:
I pulled this from Dr. Lisa's column. How much should I feed?
Since most people free-feed dry food, the amount of calories consumed in a day is not known. In this case, figure out what you think your cat *should* weigh and plug that number into this formula:

Required calories per day = [13.6 X optimal lean body weight in pounds] + 70

Most female cats should weigh a nice, lean 10 -11 pounds. Most male cats should fall into the 11 -13 pound range.

Using an optimal body weight of 12 pounds as an example, we come up with 233 calories/day as a starting point.

[13.6 X 12 pounds] + 70 = 233
​
Also:
Calculating % Calories from Carbohydrates
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Thank you! Yes i was no where near that. I guess i need to do syringe every hour or two until he feels like eating on his own
 
Lando demando said:
I have been syringe feeding Lamdo and must not be getting enough in him. :)
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When Sabrina was diagnosed with acute pancreatitis, she was 9.7lb and the internist asked us to syringe feed her 15mlX4 daily. We started at 10ml, multiple times a day, and then increased the amount to 20-25mlX5. She also has access to freeze dried chicken all the time.

Lando is a big boy and he requires 20kcalx19lb to maintain his weight. If he doesn't eat, you might need to increase the amount for syringe feeding. Some people recommended Hills Recovery food as it's a high calories pate. I didn't try because Sabrina doesn't handle food with high fat content well.
 
Jia&Sabrina said:
When Sabrina was diagnosed with acute pancreatitis, she was 9.7lb and the internist asked us to syringe feed her 15mlX4 daily. We started at 10ml, multiple times a day, and then increased the amount to 20-25mlX5. She also has access to freeze dried chicken all the time.

Lando is a big boy and he requires 20kcalx19lb to maintain his weight. If he doesn't eat, you might need to increase the amount for syringe feeding. Some people recommended Hills Recovery food as it's a high calories pate. I didn't try because Sabrina doesn't handle food with high fat content well.
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Yes 200 cal seems what i just figured. That is a LOT of syringe! I am trying to find med carb higher cal!
 
Lando demando said:
I am trying to find med carb higher cal!
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Royal Canin makes a food that's specifically for tube (or syringe) feeding called "Recovery". It's also low carb which is a plus. You don't want him eating a higher carb food right now...you just need to get more calories into him.

You can also use pretty much any canned pate, add water and blend well. I bought one of these personal smoothie blenders that worked great!
 
Chris & China (GA) said:
Royal Canin makes a food that's specifically for tube (or syringe) feeding called "Recovery". It's also low carb which is a plus. You don't want him eating a higher carb food right now...you just need to get more calories into him.

You can also use pretty much any canned pate, add water and blend well. I bought one of these personal smoothie blenders that worked great!
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Absolutely! I only used the high carb to coax him back from BG 48 today. Ive been watering a bit of weruva slide n serve ( single digits carb) but i think each pouch is 50 something calories. I can barely do one pouch! But i guess its time to put on my big girls blouse!

wondering, does it badly effect the cat when bg goes so low? Ive caused him to plummet 3 times in a month. I feel so bad for him
 
Chris & China (GA) said:
Royal Canin makes a food that's specifically for tube (or syringe) feeding called "Recovery". It's also low carb which is a plus. You don't want him eating a higher carb food right now...you just need to get more calories into him.

You can also use pretty much any canned pate, add water and blend well. I bought one of these personal smoothie blenders that worked great!
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Chris, i take it you went through a syringe period with china? Would love any insight on what to avoid or what is best practices
 
tiffmaxee said:
Poor baby. Not feeling any better? Did you get ondansetron or cerenia?
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Thanks Elise. Well there was a SLIGHT improvement this am ( he let me hold him and purred, also wanted to get weighed / weirdest cat quirk).
But then i didnt feed him enough and he dropped to the 40s in BG and it re zonked him.
Man! I am feeling like im torturing this poor guy.

my vet really wanted to stick w the cerenia for a few but with a higher dosage. We are talking tomorrow.

thanks for checking in, it means a lot to me
 
Lando demando said:
Thinking of keeping the bup injection at night
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Buprenorphine doesn't last that long. Typical dosing is twice a day, though sometimes a smaller dose given 3 times a day.

Good luck with the new dose. And getting more food in him. Ondansetron works tons better than Cerenia for nausea if there is no vomiting. There's a 2017 study that shows how much better but vets might not have seen it. Cerenia has some anti inflammatory properties that might be helpful.

For syringe feeding, tying on a bib, or pinning/close peg something at the back of neck, will help avoid messing fur with the inevitable stuff that comes out the mouth. Take your time. I found it better to do smaller meals more frequently. Maybe even warm the food just a touch before serving.

PS, I merged your two posts of today. It's best to stick to one per day to keep everything together.
 
Wendy&Neko said:
Buprenorphine doesn't last that long. Typical dosing is twice a day, though sometimes a smaller dose given 3 times a day.

Good luck with the new dose. And getting more food in him. Ondansetron works tons better than Cerenia for nausea if there is no vomiting. There's a 2017 study that shows how much better but vets might not have seen it. Cerenia has some anti inflammatory properties that might be helpful.

For syringe feeding, tying on a bib, or pinning/close peg something at the back of neck, will help avoid messing fur with the inevitable stuff that comes out the mouth. Take your time. I found it better to do smaller meals more frequently. Maybe even warm the food just a touch before serving.

PS, I merged your two posts of today. It's best to stick to one per day to keep everything together.
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Thank you for the merged post wendy, thats easier. Frankly lando was near unresponsive last night that thought i would have to schedule the in home vet for euthanasia.
This am he was up and wandering a bit. Even tried to eat a pure bite .
Luckily he doesnt mind syringe feeding, so thats going well ( just have to do more)
Today i am discussing with vet: 1 possibility of bad reaction to lantus ( seems like he is extremely lethargic and hides after every shot) he is either sick from eating or lantus
2 could there be something else going on tumor etc.. that we cant see because he is so large?
3 did the fact that he went below 65 BG in three days do permanent damage?

at this point he seems so frail that i am trying to weigh the pros and cons of certain treatments
Thanks so much again for your reply
 
Posting here, since I don't see a post yet for today.

Please keep testing for ketones. Lethargy is a bad sign if combined with not enough insulin (you could have shot 0.5 units today), and inflammation/possible pancreatitis.

If you want to try another insulin, I would recommend Levemir. Similar action to Lantus, though onset and nadir tend to be a couple hours later. But it doesn't have Lantus's acid base, which some cats react to.
Lando demando said:
3 did the fact that he went below 65 BG in three days do permanent damage?
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Unlikely. I only see twice on your spreadsheet and both times you got him up a lot higher really quickly. You don't want cats spending any time below 68. Most of the cats following TR will drop below the equivalent of 68 at some point as that is the reduction point on at AT. I can't speak for the AT, but the human meter BG of 50 was selected to give a little bit of room for safety. We don't want cats on insulin dropping below 50 as that leaves no room for dropping further. Cats not on insulin can test in the 40's on human meters. The 68 for the AT was selected as a number to be used for safety as well.

Lando needs to get on ondansetron ASAP.
 
Wendy&Neko said:
Posting here, since I don't see a post yet for today.

Please keep testing for ketones. Lethargy is a bad sign if combined with not enough insulin (you could have shot 0.5 units today), and inflammation/possible pancreatitis.

If you want to try another insulin, I would recommend Levemir. Similar action to Lantus, though onset and nadir tend to be a couple hours later. But it doesn't have Lantus's acid base, which some cats react to.

Unlikely. I only see twice on your spreadsheet and both times you got him up a lot higher really quickly. You don't want cats spending any time below 68. Most of the cats following TR will drop below the equivalent of 68 at some point as that is the reduction point on at AT. I can't speak for the AT, but the human meter BG of 50 was selected to give a little bit of room for safety. We don't want cats on insulin dropping below 50 as that leaves no room for dropping further. Cats not on insulin can test in the 40's on human meters. The 68 for the AT was selected as a number to be used for safety as well.

Lando needs to get on ondansetron ASAP.
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Thank you Wendy.
Yes i am testing for keytones ( have a strip ready next time lando goes to the box)
I will ask the vet for ondasterone for a third time, but the vet keeps telling me its not a good idea.
My plan isto start the .5u tonight. I looked through my sheet and noticed every time i had a couple NS lando started eating again. Im going to talk with my vet about this.

i completely understand you are urging me with the intent of helping, but since i thought i was scheduling a euthanization today for Lando, i have to follow my gut a bit. Him being not responsive at all last night made me realize it was not just nausea.
I dont want you to think that i am disregarding your expertise advice.
 
Ask the vet why ondansetron is not a good idea. I haven't seen any contraindications for it. Don't worry about following your gut. You are there seeing the cat, we are not. Similarly, I keep asking about ketones cause it's a worry in this case and I don't see test results on the spreadsheet.

Good luck with your consult with the vet. :bighug:
 
Ditto the importance of checking for ketones.

Also (and I’m not sure if this was already asked) but what syringes are you using and where line are you drawing to? Might you be able to post a photo? It never hurts to double check that you’re actually giving the dose you think. A 43 on an AT is concerning, but you got the BG back up quickly so that’s good.

Sorry things are so difficult right now. I hope the visit with the vet provides some answers and that Lando begins to feel better soon.
 
I can't speak from a cat's point of view but I can speak from a human's point of view. I have chronic pancreatitis. Ondanestron is an absolute lifeline for me during an attack.
 
Wendy&Neko said:
Ask the vet why ondansetron is not a good idea. I haven't seen any contraindications for it. Don't worry about following your gut. You are there seeing the cat, we are not. Similarly, I keep asking about ketones cause it's a worry in this case and I don't see test results on the spreadsheet.

Good luck with your consult with the vet. :bighug:
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Thank you so much. I will ask the reason why no ondan. Also hmm weird that my keytone results arent showing ( my mistake i saw i quickly jotted it down in my notebook and never transfered) Maybe i logged them somewhere else. I JUST syringe fed and caught him in the litterbox. negative keytones. I am grateful that you are reminding me. It helps a lot!
 
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JL and Chip said:
Ditto the importance of checking for ketones.

Also (and I’m not sure if this was already asked) but what syringes are you using and where line are you drawing to? Might you be able to post a photo? It never hurts to double check that you’re actually giving the dose you think. A 43 on an AT is concerning, but you got the BG back up quickly so that’s good.

Sorry things are so difficult right now. I hope the visit with the vet provides some answers and that Lando begins to feel better soon.
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Thank you JL. Sure, ill post the syringe photo. I assume you mean the insulin syringe and not the food syringe ;)
Yes the 46 reading was upsetting! But i only saw lethargic and maybe dialated eyes
 
upload_2021-9-17_11-47-11.jpeg

since lando was in the middle from downgrading from 2 - 1.5
 

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Red & Rover (GA) said:
I can't speak from a cat's point of view but I can speak from a human's point of view. I have chronic pancreatitis. Ondanestron is an absolute lifeline for me during an attack.
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Thank you, i am sorry you are experiencing that and i will clarify with my vet that ondanestron has other values other than just anti nausea.
Perhaps its the combo of miritaz and ondan? Lando has miritaz, buprenex and cerenia
 
Ok i dont have the science to back any of this up, but Lando is the most alert ive seen him since the attack MON PM. He even ate a half dollar amount of churu on his own ( a first since MON)
Its either the pain meds, or taking a while to bounce back, or eating the amount of calories he needs ( via syringe) or his dip below 68 2xs that caused such a bad week.
Weight is stable today 18.2 lbs / no keytones / on cerenia + bup
I will start w the .5 u dose tonight.

i have seen no documentation that landos extreme lethargy, inappetence or dialated eyes could be cause by Lantus so im moving forward

thanks everyone for your help ( fingers crossed… again)
 
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Just a FYI, I also belong to a feline small cell lymphoma group. Ondansetron is very commonly used. That group also has an internal medicine vet who stops in and offers comments. One of his phrases today was "there's no ceiling to dose", it's very safe. If you give a nausea med like ondansetron, you might not need to give miritaz.

Glad to hear Lando's a bit perkier today, and has neg ketones. :) Pain meds can make a huge difference.
 
Wendy&Neko said:
Just a FYI, I also belong to a feline small cell lymphoma group. Ondansetron is very commonly used. That group also has an internal medicine vet who stops in and offers comments. One of his phrases today was "there's no ceiling to dose", it's very safe. If you give a nausea med like ondansetron, you might not need to give miritaz.

Glad to hear Lando's a bit perkier today, and has neg ketones. :) Pain meds can make a huge difference.
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Oh! That is beyond helpful! Ok. Well my vet still hasnt called today so i will get a bit pushier. It seems like something is just setting him off frequently and ondanstertron seems like it would be good to have on hand.
Its SUCH a tough balance right now. Its extremely difficult to talk/ see a vet right now, so i hate risking the relationship I DO have.
FWIW i did tell him that many members of this board encouraged me to ask for it
 
I JUST got back home and found him out of his hiding place for tge first time since monday!
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