Bella PMPS/26.3 refusing to eat food, +2/24.2, +3/22.5, +4/20.7 AMPS/22, +2/22.5, +3/20.3, +4.5/15.4

Tara and Bella

Tara and Bella

Member Since 2023
Bella’s PMPS is 26.3 however she is refusing food tonight. My old vet said to halve her insulin if she isn’t eating/eaten.

Should I stay at 1U?
 
One given 1U because her numbers is high. I am struggling with getting her to eat at times. I have an appointment tomorrow with my new vet, see what he suggests for picky eaters.
 
I would try and get a couple of tests in during this cycle if you can Tara. Did you fall asleep last night and sleep through?
I think by the look of the high AMPS this morning Bella probably dropped low last night and then bounced up high. She is still bouncing and at some stage she will drop back down.
If the next test is much lower than the preshot BG I would definitely test again an hour or two later because they can drop quite fast and low when coming off a bounce….not saying she will come off the bounce tonight but she might. Bounces can last for 1 to 6 cycles.

I would ask the vet tomorrow for some antinausea medication. Hopefully the vet will give you ondansetron which is called Zofran here in Australia. He will have to write a script and you get it filled at the chemist as it is a human medication. I used to give it to Sheba. It’s very good for nausea. Better than cerenia. If he won’t give you zofran, then insist on cerenia.
I used to give Sheba 2 mg up to three times a day. The zofran comes in 4 mg wafers which you need to halve. Make sure you have dry hands when doing it as they dissolve in the mouth and will do so on your hand if wet.
I would also test again for ketones in the urine.
Let us know what the new vet says. I hope he is good.
 
Didn’t test further last night. My son was very sick so hubby slept with him and I had a migraine so I slept with Bella so we could check on her whenever I woke but I wasn’t able to get up and test. Not ideal but I’m exhausted and my body just needed sleep.
Last night she had some wet food and some biscuits.

Today she has eaten some home cooked chicken breast. Tonight I tried so many things but nothing other than a few pieces of chicken.
Thank you for that information, I’ll add it to my list for the new vet. I hate thinking she is nauseous.
So +2/24.2
I will try get another ketone test in if I can… that’s not easy. I did just end up letting it sit in the litter on a fresh wee.
 
TaraAllington said:
Didn’t test further last night. My son was very sick so hubby slept with him and I had a migraine so I slept with Bella so we could check on her whenever I woke but I wasn’t able to get up and test. Not ideal but I’m exhausted and my body just needed sleep.
Last night she had some wet food and some biscuits.

Today she has eaten some home cooked chicken breast. Tonight I tried so many things but nothing other than a few pieces of chicken.
Thank you for that information, I’ll add it to my list for the new vet. I hate thinking she is nauseous.
So +2/24.2
I will try get another ketone test in if I can… that’s not easy. I did just end up letting it sit in the litter on a fresh wee.
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It’s hard when you have sick kids and you are not well yourself. I hope you are both better now.
She has dropped a bit at +2 so I would definitely be getting at least another test in tonight.
Dont let the vet increase the dose until we see where she lands after she comes off the bounce.
 
Yeah I had a pretty stressful weekend and my body just pushes through until a migraine sets in to low me down. My sons been sick since mid last week and with Bella my sleeps been very fragmented.

I’m currently looking at getting some fresh raw kangaroo or chicken from a local small pet store tomorrow because I’m struggling.
 
TaraAllington said:
I’m currently looking at getting some fresh raw kangaroo or chicken from a local small pet store tomorrow because I’m struggling.
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If you feed a raw diet, you will need to get supplements to make it complete nutritionally. Its OK for a few days but ongoing you can't just feed raw meat. I feed raw and buy the kangaroo and the chicken from Woolworths in the meat department.
 
Yes I went get some supplements today but the petstore didn’t sell them. I may try pet circle or another one. I’m interested to hear what this new vet says about it all. I’ll get another test in soon,
 
TaraAllington said:
Yes I went get some supplements today but the petstore didn’t sell them. I may try pet circle or another one. I’m interested to hear what this new vet says about it all. I’ll get another test in soon,
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You will need to order the supplements from maybe iherb in the US. No one much has the proper ones here. I can tell you more about it tomorrow…too late tonight! It wont hurt for a week or two if you don’t have supplements.
 
Tara, you might like to have a look at the two dosing methods which are at the top of the LLB page, when you have time and see which one suits you best.
 
This morning has been no different…. Refusing food, so I even steamed some chicken to get the smell and she finally ate some chicken. Appointment with new vet today at 12.30pm- my list of things to discuss is growing! Lucky I have an extended appointment $$ but that’s that.
Her numbers are weird today went slightly up at +2 (I started to worry I had done a fur shot even tho it didn’t seem out of our normal for giving her shot) but lower at +3 so not sure.
I’ve read the methods @Bron and Sheba (GA) - I feel the “start slow, go low” method is the most achievable for my lifestyle. I’m doing to read the method again so it starts to really sink in.

thank you @Christie & Maverick i will read that soon, hopefully something there might work but I’ve been warming, adding warm water to make gravy and even stirring in tuna or chicken. Maybe the anti nausea meds are needed.

Is there a documents that explains the physical symptoms or side effects of the different BG number ranges?
 
My list is growing- anything I have missed to ask the new vet.


Dr. Scott Doyle

  • ASK TO RECORD. So I can listen later.
  • Very picky, Food, lately refusing food again???? Diabetes or kidney???? Raw diet, wet or dry food?
  • Anti nausea meds. Side note- I would ask the vet tomorrow for some antinausea medication. Hopefully the vet will give you ondansetron which is called Zofran here in Australia. He will have to write a script and you get it filled at the chemist as it is a human medication. I used to give it to Sheba. It’s very good for nausea. Better than cerenia. If he won’t give you zofran, then insist on cerenia.
  • Insulin script - box 5x pen for chemist, insulin glargine.
  • Thoughts on Bella pre surgery bloodwork and post surgery bloodwork???
  • Result/impact of parathyroid removal???
  • Ketones????
  • Bella is on 1U as she is bouncing up and down. Side note- Dont let the vet increase the dose until we see where she lands after she comes off the bounce.
  • Discussion Bella spreadsheet- BGhttps://docs.google.com/spreadsheets/d/122kuqwMWNe78vVA1q6HDRl8qTvU4MGP5mBBl-aQoGXI/edit.
  • Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR) https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/
  • pancreatitis???
 
Tara and Bella said:
Her numbers are weird today went slightly up at +2 (I started to worry I had done a fur shot even tho it didn’t seem out of our normal for giving her shot) but lower at +3 so not sure.
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This is called a food bump and perfectly normal.
Tara and Bella said:
’ve read the methods @Bron and Sheba (GA) - I feel the “start slow, go low” method is the most achievable for my lifestyle. I’m doing to read the method again so it starts to really sink in.
Click to expand...
OK. You can always swap over if you feel you want to
Tara and Bella said:
Is there a documents that explains the physical symptoms or side effects of the different BG number ranges?
Click to expand...
Not that I know of.
Very low BGs will cause symptoms of a hypo such as staggering, or walking like a drunk or be starving hungry. There is a list of symptoms in THIS link.
High BGs tend to have the cat hungry because they can't absorb all the nutrients in the food, they can lose weight and drink more water and pee more. Also diabetic cats are more prone to UTIs.
I hoe the new vet will give you a good supply of antinausea meds. I would push for the Zofran (ondansetron) and I would ask for an antinausea injection today to try and kickstart her earing again. I would also ask for an appetite stimulant. Just make sure you give the antinausea meds first and give it time to work before giving the appetite stimulant.
Looking forward to hearing an update.
 
Tara and Bella said:
My list is growing- anything I have missed to ask the new vet.


Dr. Scott Doyle

  • ASK TO RECORD. So I can listen later.
  • Very picky, Food, lately refusing food again???? Diabetes or kidney???? Raw diet, wet or dry food?
  • Anti nausea meds. Side note- I would ask the vet tomorrow for some antinausea medication. Hopefully the vet will give you ondansetron which is called Zofran here in Australia. He will have to write a script and you get it filled at the chemist as it is a human medication. I used to give it to Sheba. It’s very good for nausea. Better than cerenia. If he won’t give you zofran, then insist on cerenia.
  • Insulin script - box 5x pen for chemist, insulin glargine.
  • Thoughts on Bella pre surgery bloodwork and post surgery bloodwork???
  • Result/impact of parathyroid removal???
  • Ketones????
  • Bella is on 1U as she is bouncing up and down. Side note- Dont let the vet increase the dose until we see where she lands after she comes off the bounce.
  • Discussion Bella spreadsheet- BGhttps://docs.google.com/spreadsheets/d/122kuqwMWNe78vVA1q6HDRl8qTvU4MGP5mBBl-aQoGXI/edit.
  • Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR) https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/
  • pancreatitis???
Click to expand...
A good list. I will be very interested to hear vet's responses. Vet probably hasn't heard of the 2 dosing methods. Most vets know only basic things about feline diabetes sadly.
The back leg walking, if it has only happened since the diabetes, then it is probably diabetic neuropathy. We can tell you how to treat that. The vet wont have the medication used for that. Also once you get the BGs back down to normal range, the neuropathy normally resolves.
Vet will probably want you to feed dry diabetic food. I would just nod and say you will think about it... all dry food is bad for diabetic cats...all cats really.
As long as you are testing for ketones, feeding low carb food and giving insulin, and hometesting...you are in control. :)
 
I’m sorry, I’ve tried to catch up a little on the history and it may have been mentioned before but is she on any pain meds? I wonder if she is having some appy issues because she is in pain. Most definitely the vet needs to determine the cause for inappetence, I hope the vetty visit goes well and you can get some definitive answers.
 
Summary from the vet appointment

Took a recording, with his permission, so much to take in. Need to listen again to take more thorough notes as this is just from memory. It was a whirlwind!
  • 3/7/2007 - date of birth, Bella is 16 soon.
  • Gave hemoplex injection
  • Ondasetron- half tablet morning and night (didn’t have the wafers)
  • Feed Bella whatever she wants, he want her eating verses not eating (hopefully the medication will help and also bought some raw kangaroo/complete diet-big cat).
  • Looking at the bloodwork, he suggested her kidneys are not causing great concern- shows she was dehydrated and Creatinine levels had normalised. No need for prescription diet or renal.
  • Wasn’t worried about ketones but suggested a life smart monitor that does BG and ketones.
  • Gave a script for insulin, with continuous repeats.
  • Glargine insulin, he said due to its late on set- he can only assume over three cycles Bella is getting overlaps of insulin. He believe her cycle might be longer than 12 hours.
  • Want me to do an hour by hour curve on the weekend on 1U, our aim is to get Bella at AMPS/PMPS ideally 15, low point 5-8. Which sounds very much like “start low, go slow”
  • He believes Bella may only need 1 shot, (slightly higher, he believes it will most likely be 1.5-2U) of insulin per day depending on her to avoid her having over laps and then getting into the low numbers a few cycles in.
  • He would like to stay as what I’m doing with 1U twice daily for now and do curve but then look at the 1 shot per (I need to re listened to how he wanted that transition to happen again)
  • Wants to give it a month on glargine and if it’s not working move another insulin catsulin.
  • Still wants to keep looking into parathyroids removal impacts (consult was going long, he wants to research more and he actually apologised because he wasn’t informed this was my appointment).
  • Another concern with her eyes but main focus is to get her regulated first (need to listen to that again).
  • We have caught this early so still in the early days.

Recording link.
https://schoolsnsw-my.sharepoint.co...tFqTtTAReZ6S8BBpIMBTAgy8FqW079tSLQPQ?e=2cNef1
 
Bron and Sheba (GA) said:
A good list. I will be very interested to hear vet's responses. Vet probably hasn't heard of the 2 dosing methods. Most vets know only basic things about feline diabetes sadly.
The back leg walking, if it has only happened since the diabetes, then it is probably diabetic neuropathy. We can tell you how to treat that. The vet wont have the medication used for that. Also once you get the BGs back down to normal range, the neuropathy normally resolves.
Vet will probably want you to feed dry diabetic food. I would just nod and say you will think about it... all dry food is bad for diabetic cats...all cats really.
As long as you are testing for ketones, feeding low carb food and giving insulin, and hometesting...you are in control. :)
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We didn’t actually talk about her back legs/movement- so any advice would be good.
 
Christie & Maverick said:
I’m sorry, I’ve tried to catch up a little on the history and it may have been mentioned before but is she on any pain meds? I wonder if she is having some appy issues because she is in pain. Most definitely the vet needs to determine the cause for inappetence, I hope the vetty visit goes well and you can get some definitive answers.
Click to expand...
We didn’t get to talk about pain meds. I’m not sure if she is in pain but definitely must be the diabetic neuropathy.
 
Glargine/Lantus does not work at its best on a once a day dose. Even with the long acting nature of glargine, you need to give insulin twice a day due to a cat's fast metabolism.

I would NOT recommend a switch to Caninsulin under any circumstances. It has not been recommended for the treatment of feline diabetes by the American Animal Hospital Assn since 2018. I linked a copy of their guidelines.

If you want to try to address diabetic neuropathy, methyl-B12 is helpful. You can find it online or at a vitamin store. You want the methyl version and not general B12. It is available (at least in the US) on Amazon in a preparation for cats called Zobaline but you can buy the generic.
 
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Tara I was interested to hear what your new vet had to say. I was really happy to see he gave you the zofran. I hope it helps Bella eat more.
With the Ketone testing, there is no need to get another meter that does both the BGs and ketones unless you are finding the urine catching too difficult. The blood ketones strips are quite expensive…like $1 a strip. As you move further away from the diagnosis and the BGs come down, you won’t have to test nearly as often, as long as they don’t reappear., which hopefully they won’t…but it’s up to you.
Tara and Bella said:
Want me to do an hour by hour curve on the weekend on 1U, our aim is to get Bella at AMPS/PMPS ideally 15, low point 5-8. Which sounds very much like “start low, go slow”
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15 is much too high a BG to aim for as being ideal. You need to get the BGs to be under the urine threshold so that urine is not spilling over into the urine all the time…That is hard on the kidneys. Vets always aim for higher BGs than we do…probably because most people don’t test the BGs.
Tara and Bella said:
He would like to stay as what I’m doing with 1U twice daily for now and do curve but then look at the 1 shot per (I need to re listened to how he wanted that transition to happen again)
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I think after 7 days if the BG is not coming down under 150 (8.3) you need to increase the dose (as per the SLGS method) otherwise you will get glucose toxicity and you will need more insulin to bring the BGs down. And definitely dont go to once a day with glargine. Cats have a fast metabolism and they twice a day insulin. It is actually good if the insulin lasts a bit longer than 12 hours and it overlaps…that is how you get down into lower numbers, get the cat regulated and if you are lucky, get them into remission. You won’t get regulated or into remission if you aim for 15 (270).
Remember if you are home testing you are in control and can manage drops in the BG by feeding food.
Also Caninsulin is a backwards step. As the name suggests it is a dog insulin and not suitable for cats. It is a much harsher and faster acting insulin and will drop the BGs fast and won’t last 12 hours. Glargine is far superior for cats.

I hope you liked this vet better than the last. He sounds better, although I can’t agree with him on some of the points around the insulin and BGs.:) Sadly vets have so many other animals and illnesses to content with, they don’t have time to update themselves on the latest on feline diabetes.
 
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Yeah- I have read that the insulin we are on is great… and that the canininsulin (which is what he said not catsulin- a lot to remember- I’m listening to the recording again).

In a way- I got the injection, anti nausea meds and script (my other vet was charging me $46 dollar per tub/ I just got 5 tubs for $55 dollar from the chemist). So I am happy with that! I also got a monitor that can do both glucose and ketones bonus the 100 strips for the glucose are far cheaper then my current monitor, so in the long run each 100 strips I’ll save $25 ($45 verse $19) and I can purchase the ketone strips if I choose.

Advice to feed her what she wants is harder said than done but hopefully the meds help over the next few days.
I’m basically running my own race here I feel and I’m learning so much- I know I can’t do this! I’m going to continue to follow SLGS method, giving twice daily shots and I’m doing a curve Saturday. I get what you are saying about the overlap being helpful too… I feel in hindsight if I lowered her dose a little more last Sunday she may not have spiraled down too low. Honestly that morning I tested her at when she was 9.3 she was laying on me purring like her old self, she just seemed better within herself.

Tonight she was PMPS/29.1 I gave her 1U and I’m not going to test tonight because she has had a big day. I plan to print out the SLGS method tomorrow and give it a read hot go!!! And continue with the anti nausea meds. Fingers crossed her appetite increases. A lot to take in, I’ll continue to inform myself (thank you both for your feedback on the vets points-greatly noted) but ultimately it’s up to me not the vet!
 
Bron and Sheba (GA) said:
15 is much too high a BG to aim for as being ideal. You need to get the BGs to be under the urine threshold so that urine is not spilling over into the urine all the time…That is hard on the kidneys. Vets always aim for higher BGs than we do…probably because most people don’t test the BGs.

I think after 7 days if the BG is not coming down under 150 (8.3) you need to increase the dose (as per the SLGS method) otherwise you will get glucose toxicity and you will need more insulin to bring the BGs down. And definitely dont go to once a day with glargine. Cats have a fast metabolism and they twice a day insulin. It is actually good if the insulin lasts a bit longer than 12 hours and it overlaps…that is how you get down into lower numbers, get the cat regulated and if you are lucky, get them into remission. You won’t get regulated or into remission if you aim for 15 (270).
Remember if you are home testing you are in control and can manage drops in the BG by feeding food.
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I definitely agree with you here! I want to achieve healthy regulated numbers - otherwise what is to point of doing all this, if not to make her feel better and healthy. Honestly, weirdly Bella diabetes has brought us closer together again. I can’t explain it but it has, being a busy mum- she would always sit on my lap every night after my son went to bed and she sleeps with my son and I at the bottom of his feet every night but caring for her through all of this has made me more thoughtful about her again. My son decided tonight be are throwing her a sixteenth birthday next month!
 
Tara and Bella said:
My son decided tonight be are throwing her a sixteenth birthday next month!
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How gorgeous!
Tara and Bella said:
Honestly, weirdly Bella diabetes has brought us closer together again. I can’t explain it but it has
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We have all found the same thing. I grew much closer to Sheba after she was diagnosed. And she would follow me around the house all day. And she would talk to me all day….I miss that a lot!

I would get one test in tonight because if she is bouncing, they often go up higher before they drop down and that higher PMPS tonight could be the high before the drop back down…..but cats love to prove us wrong, so we will see….!
 
Bron and Sheba (GA) said:
How gorgeous!

We have all found the same thing. I grew much closer to Sheba after she was diagnosed. And she would follow me around the house all day. And she would talk to me all day….I miss that a lot!

I would get one test in tonight because if she is bouncing, they often go up higher before they drop down and that higher PMPS tonight could be the high before the drop back down…..but cats love to prove us wrong, so we will see….!
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That’s beautiful
 
Bron and Sheba (GA) said:
I found it hard to get methyl B12 tablets here without any sugar in them. I used to order them from lifelink.com. They are called Zobaline for cats. They come from overseas.
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Looking at purchasing- and I’ve been reading a thread from 2020 about how long it takes to work… how often to you give, once twice daily… just might buy a few bottles with only one shipping?
 
Tara and Bella said:
Looking at purchasing- and I’ve been reading a thread from 2020 about how long it takes to work… how often to you give, once twice daily… just might buy a few bottles with only one shipping?
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I gave it once a day. I sprinkled it on the food and Sheba never noticed.
Sheba had the neuropathy quite badly. She would slip and slide on the wooden floors, couldnt jump up on the bed, would have to sit down every few steps. Once the BGs came down into more normal numbers it gets better more quickly. I suppose it took about 6 months for Sheba to get back to more normal walking. She eventually got back to normal and she could jump up on the bed again etc.

Have you decided which dosing method to follow? If Bella is still eating dry, it will have to be SLGS.
Have you looked at the ZiwiPeak air dried food ?(that is not counted as dry food.) You
https://ziwipets.com/en-au/products/air-dried-mackerel-and-lamb-cat-food
 
Bron and Sheba (GA) said:
I gave it once a day. I sprinkled it on the food and Sheba never noticed.
Sheba had the neuropathy quite badly. She would slip and slide on the wooden floors, couldnt jump up on the bed, would have to sit down every few steps. Once the BGs came down into more normal numbers it gets better more quickly. I suppose it took about 6 months for Sheba to get back to more normal walking. She eventually got back to normal and she could jump up on the bed again etc.

Have you decided which dosing method to follow? If Bella is still eating dry, it will have to be SLGS.
Have you looked at the ZiwiPeak air dried food ?(that is not counted as dry food.) You
https://ziwipets.com/en-au/products/air-dried-mackerel-and-lamb-cat-food
Click to expand...


Sounds like Bella on our timber floors. So I have removed the dry food and looking a raw complete diet (big dogs- cat range but currently on roo), along with FF wet food and had some suggestions of purr sachets/meat lover treats from Facebook. I looked at the pet store but they didn’t have any so I might look online first- I will get some ziwipets for sure!

Yes I’m going SLGS seems like less testing and I can do curves on the weekend when I’m not at work. I assume there is no right or wrong? Just what you can manage in your lifestyle.

I’ve just check FF and loads of methyl-B12 products. Lifelink is $$$ but better because of the other ingredients?
 
Kiwipets - Pet quarters didn’t have any the other day but saying now in stock again! So I will pick some up tomorrow if I can! Might ring before I drive to the shop!
 
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