Rough Night

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Shelley7

Shelley7

Member Since 2022
Back story: Frankie has been on Gabapentin at 100 mg 2x/d and I decreased it to 75 mg 2x/d about 2 weeks ago b/c he was so altered by it and was falling and having great difficulty walking. (Was able to walk but slow and ataxic). He seemed to tolerate 75 mg better but then recently had about 3 days where he got withdrawn and was isolating in the bedroom. I wasn't sure if this was his IBD/pancreas flaring (we are 2 weeks into a pred wean), his arthritis hurting more due to the decreased gaba or his blood sugars making him feel bad. So at that point (2 days ago) I decided to go back to 100 mg of gaba at night and started Lantus. He came out more yesterday so isn't isolating now but this is what happened.

At 9:00 pm his PMPS was 463, so at 9:15 pm I gave 1 unit of Lantus. He got the gabapentin at 10 pm. I stayed up until 12:15 am to do a +3 and it was quite a bit lower at 354. I decided to retest at +6 and set my alarm for 3am.

We went to bed and about 2:30 am I heard a thump and he was lying on the floor in the bathroom next to the chair that he jumps up to get to his food. He couldn't get up. His back legs didn't work. He seemed alert and not distressed, was grooming himself but just had no ability to walk or manage his back legs. I brought him to the bed and prayed that it was just the gaba really affecting him. Then I wondered if it could be a combo of the gaba plus a blood sugar drop so I tested at about 3 am (+5.75) and it was 225...the lowest it's been so far. Tested again around 4:30 am (+7.15) and it was 181. He had scarfed all of his food by 2 am when I found him on the floor (usually grazes through the night), so I added another ounce of Tiki to the bowl and at that point (4:30 am) he could stand and walk again and ate most of it.

So I guess the good news is that he has his legs back but I'm wondering if the 238 point drop could have created a kind of hypo affect b/c his body is used to being at 400's for the last month or two? Or is that unlikely when the numbers are still in the normal range and maybe it was just all the gabapentin?

My health is challenged as well and not sleeping is very hard for me. I feel like I handled the diagnosis and all the testing/tracking/shots pretty well but did not think about not being able to sleep. Please tell me this gets better and I'm not going to spend every night waking at 3 am or more to test. Even when I try to sleep a few hours I really don't b/c I'm worried about his sugar trending down and know I have to get up soon to check.
 
So sorry that Frankie isn’t walking well. It’s probably not from the glucose drop but rather some diabetic neuropathy: https://www.felinediabetes.com/FDMB/threads/feline-diabetic-neuropathy-weak-back-legs.178252/

You may want to get him some methylcobalamin in powder form to mix with his food. Vitacost sells capsules that you can open and sprinkle.

Good job on the testing and catching those numbers last night. The blue number shows that the dose is working. It does get easier. :bighug:
 
Katherine&Ruby said:
So sorry that Frankie isn’t walking well. It’s probably not from the glucose drop but rather some diabetic neuropathy: https://www.felinediabetes.com/FDMB/threads/feline-diabetic-neuropathy-weak-back-legs.178252/

You may want to get him some methylcobalamin in powder form to mix with his food. Vitacost sells capsules that you can open and sprinkle.

Good job on the testing and catching those numbers last night. The blue number shows that the dose is working. It does get easier. :bighug:
Click to expand...

Thanks for the link. That makes a lot of sense because his back legs are more weak then the front but he also lies on his hocks and doesn’t self correct when you turn his foot over (the way it’s not supposed to be). I thought it was all gaba but perhaps it’s a combination. I thought you had to have diabetes a long time before neuropathy develops, but obviously not.

So I had a 5000 mcg methylcolbalamin sublingual in the cupboard and in my exhausted haze just dissolved in water and gave to him. Then I tasted some of it and it was very sweet. I looked at the ingredients and it said it had “natural berry flavors” so I freaked out that it could be xylitol. Called poison control and they said according to their database that product doesn’t have xylitol in it but they couldn’t tell me what the berry flavor was. I pray that their database is accurate. The company is closed until Monday. I think if I took him to the ER, they’d just call poison control and tell me the same thing, so I guess I just have to pray that they are correct.

It’s never a dull moment around here these days. Do you have any preferred brand of methyl-B12 that doesn’t have sweeteners or fillers?
 
Diane Tyler's Mom said:
I'm sorry Frankie isn't feeling well.
Here is what a lot of us use from Vitacost, it's tasteless ,just empty the capsule into his wet food and add water
https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6
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Thanks for the link Diane. I’m wondering if anyone has tried having it compounded as an injectable. I have given him B12 injections in the past but they weren’t methyl form. But I know human pharmacies can compound injectable methyl-B12 for us (has to be refrigerated). I feel like that would be better for him because the IBD is mostly in his small intestine and the oral form may not be absorbed well in his case because of the gut disease.
 
Shelley7 said:
Thanks for the link Diane. I’m wondering if anyone has tried having it compounded as an injectable. I have given him B12 injections in the past but they weren’t methyl form. But I know human pharmacies can compound injectable methyl-B12 for us (has to be refrigerated). I feel like that would be better for him because the IBD is mostly in his small intestine and the oral form may not be absorbed well in his case because of the gut disease.
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Hi Shelly I really have no idea about having it compounded.
I can tag a few members to see if they know
@Katherine&Ruby

@Wendy&Neko

@tiffmaxee
 
Diane Tyler's Mom said:
Hi Shelly I really have no idea about having it compounded.
I can tag a few members to see if they know
@Katherine&Ruby

@Wendy&Neko

@tiffmaxee
Click to expand...
I actually don't know if injectable B12 works as well on neuropathy as the oral form. If your cat has intestinal disorders, nutrients are not as well absorbed in the intestines. However, what I do know about B vitamins generally is that they are safe to give in higher doses as what is not utilized by the body gets excreted in the urine. I would try it without compounding and adding to food first to see if it makes a difference.
 
I’m suspicious of the gabapentin. 100 mg BID seems like a pretty hefty dose. Can you check with the vet about the dosage and describe to them what has happened re: the ataxia, etc? Those can be signs of a gaba overdose.
 
Chris and Checkers said:
I don't use it but I have seen other users recommend this

https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-60-capsules-5

Or this

https://www.amazon.com/LifeLinks-Zobaline-Felines-3mg-Tablets/dp/B008G3LI2M/ref=sr_1_1_sspa?crid=3ERMJJDMCTRLA&keywords=zobaline for diabetic cats&qid=1640742350&sprefix=zibeline,aps,174&sr=8-1-spons&psc=1&spLa=ZW5jcnlwdGVkUXVhbGlmaWVyPUE4RU0xR1JNSkVQMEomZW5jcnlwdGVkSWQ9QTAwODY4NjAyTTJUSU5JRExJUExQJmVuY3J5cHRlZEFkSWQ9QTAwNTUwNTcxV1NDWEdVN1JNNlVHJndpZGdldE5hbWU9c3BfYXRmJmFjdGlvbj1jbGlja1JlZGlyZWN0JmRvTm90TG9nQ2xpY2s9dHJ1ZQ==
Click to expand...
Thanks for this! I just ordered them both but one is on back order and even the Amazon one will take until late next week. But I’ll start giving it to him and see if it gets better.
 
JL and Chip said:
I’m suspicious of the gabapentin. 100 mg BID seems like a pretty hefty dose. Can you check with the vet about the dosage and describe to them what has happened re: the ataxia, etc? Those can be signs of a gaba overdose.
Click to expand...
Yes, it’s been a fine line getting a dose high enough for pain control but one that isn’t so high that he looks like drunk sailor. My vet is aware and basically lets me titrate the dose based on what I’m seeing. We spent a long time at 25 mg, then 50mg, then 75. But once he got used to 75 mg he was limping again and also because of the chronic pancreatitis my vet wanted to keep trying to get to 100 mg. It’s weird because it always makes him loopy but some doses he seems worse then others so there may be some liver processing or interactions with all the other stuff he’s on. Nevertheless, I’m going back to 75 mg and hoping we don’t have any more nights like last night.
 
Mt cvi Moxie did fine on 50 mg gabapentin twice daily for years. It was for joint degradation. I noticed no real sedation.
I give my Nalos 100 mg before vet visits for sedation and it does a good job. Not bitting vet. She weight about 10 lbs
I give my Mia 100 mg before vet visits for sedation and I wish it had more effect. She weight about 10 lbs. But vet has not been bitten.
I give my Snuffles 100 mg and another 150 mg before vets visits with an hour between doses. It does little sedation. He wighs about 17+ lbs and is aero.
 
Pabay has been on 25mg twice a day for a couple of years. I know that others administer higher doses but 25 does not cause ataxia but in Pabay (underweight and sensitive) it causes very mild sleepiness.
 
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