? 9/19 Ivy PMPS 400, +1 400, +3 400, +5 400 Vomited from Sedation

Staci & Ivy

Staci & Ivy

Very Active Member
https://www.felinediabetes.com/FDMB...59-6-299-8-202-pmps-234-2-5-224-4-209.281692/
As some of you may know Ivy had x-rays done today and was sedated for the x-rays this morning.
At amps I gave her half a dose of insulin which was 1.5 units Lantis and then fed her about six hours later at +6 &+7.

She seemed eager to eat earlier.

She just vomited at +11.

I am due to give insulin and food in one hour.

My vet just said to give Cerenia and wait two hours to give her a small meal and a full dose (3 units) of insulin as her glucose is above 400.

What do you guys advise , if I wait two hours from when I just gave her the Cerenia then I am an hour past normal food and insulin time.
What if she does not eat at all?
My vet said to give her a full dose anyway (if no food eaten) because her BG is high.

Help please.
 
I am not anywhere near seasoned enough to tell you what to do, but I would follow the vet's directives here. She needs to eat and she needs her insulin. Going an hour past isn't going to hurt - you can adjust back to normal time over the next few days. Test her BG before meal time and see how much she will eat to decide on full dose or partial. Cerenia is a wonderful med and truly does need 2 hours to work it's magic.

Good luck, listen to your gut. :bighug:

Tagging for help:
@Wendy&Neko
@Bron and Sheba (GA)
 
allicatmeow said:
I am not anywhere near seasoned enough to tell you what to do, but I would follow the vet's directives here. She needs to eat and she needs her insulin. Going an hour past isn't going to hurt - you can adjust back to normal time over the next few days. Test her BG before meal time and see how much she will eat to decide on full dose or partial. Cerenia is a wonderful med and truly does need 2 hours to work it's magic.

Good luck, listen to your gut. :bighug:

Tagging for help:
@Wendy&Neko
@Bron and Sheba (GA)
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Thanks Alli!
Vet said give full dose if she eats (or not) since bg is very high. That makes me very nervous If she doesn’t eat or can’t hold food down.
But I think giving Cerenia 2 hours to work makes sense from what you said, it agrees with the vet
:bighug::bighug:
 
See where she is an hour after the Cerenia, it doesn't take 2 hours to take effect. When you feed her, don't give her a lot at once. Small amounts, spaced 20-30 minutes apart is better if her GI is upset from sedation.
 
Wendy&Neko said:
See where she is an hour after the Cerenia, it doesn't take 2 hours to take effect. When you feed her, don't give her a lot at once. Small amounts, spaced 20-30 minutes apart is better if her GI is upset from sedation.
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It takes a full 2 hours to take effect in my Penny (ckd cat) and would also take between 1.5-2 in another of mine. I think it's a YMMV and I didn't want her to panic if it didn't work in 1. ;)
 
Wendy&Neko said:
See where she is an hour after the Cerenia, it doesn't take 2 hours to take effect. When you feed her, don't give her a lot at once. Small amounts, spaced 20-30 minutes apart is better if her GI is upset from sedation.
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Ok give it 1 hour to work then??
and if she doesn’t puke after 1/2 hour after feed, do you agree with full 3 unit dose????
 
Well, let’s take it a step at a time. If she won’t eat, stall and try again in 20-30 minutes to start. Does she have a favorite treat or food that agrees with her? Don’t worry if not lc. We just want to know she will hold food down.
 
tiffmaxee said:
Well, let’s take it a step at a time. If she won’t eat, stall and try again in 20-30 minutes to start. Does she have a favorite treat or food that agrees with her? Don’t worry if not lc. We just want to know she will hold food down.
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She really only eats her homemade lamb diet. Doesn’t eat treats.
But she does like when I give FF mc grilled 13% or ff gravy lovers mc 15% for those bg drops.

So you’re saying keep stalling 20/30 min till she wants to eat?
 
Staci & Ivy said:
She really only eats her homemade lamb diet. Doesn’t eat treats.
But she does like when I give FF mc grilled 13% or ff gravy lovers mc 15% for those bg drops.

So you’re saying keep stalling 20/30 min till she wants to eat?
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Yes, for at least a couple of hours. Often my cats will eventually eat. If you get to 2 hours and still not eating, post for help.
 
allicatmeow said:
It takes a full 2 hours to take effect in my Penny (ckd cat) and would also take between 1.5-2 in another of mine. I think it's a YMMV and I didn't want her to panic if it didn't work in 1. ;)
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Alli, how did you know it took full 2 hours to work? (Did they not eat until after 2 hours? )
 
Staci & Ivy said:
Alli, how did you know it took full 2 hours to work? (Did they not eat until after 2 hours? )
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Yes, on multiple occasions refused to eat until after the 2 hour mark. I have also had her vomit between the 0-2 hour timeframe many times. She has to take it every time she goes to the vet (motion sickness in the car), as well as about once a week or so from nausea from her CKD. She's a Cerenia frequent flyer. ;)
 
allicatmeow said:
Yes, on multiple occasions refused to eat until after the 2 hour mark. I have also had her vomit between the 0-2 hour timeframe many times. She has to take it every time she goes to the vet (motion sickness in the car), as well as about once a week or so from nausea from her CKD. She's a Cerenia frequent flyer. ;)
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Did she vomit 0-2 hours till nausea passed, I guess? Or from feeding too soon?
 
Staci & Ivy said:
Did she vomit 0-2 hours till nausea passed, I guess? Or from feeding too soon?
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Both. She would vomit bile if she hadn't eaten or food if she had. She will also display all classic nausea signs for those 2 hours (lip licking, etc) until they subside. She will usually eat around the 2.5-3 hr mark.

Also, sedation can really make them lethargic and not want to eat for quite a while. It's very normal. Diabetes just complicates that recovery and your decision making so much.
 
allicatmeow said:
Both. She would vomit bile if she hadn't eaten or food if she had. She will also display all classic nausea signs for those 2 hours (lip licking, etc) until they subside. She will usually eat around the 2.5-3 hr mark.

Also, sedation can really make them lethargic and not want to eat for quite a while. It's very normal. Diabetes just complicates that recovery and your decision making so much.
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Ugh. That’s not good.
I just offered her regular lamb food and FF 13% and she turned her head away from both. I am at around 1.5 hours past giving Cerenia now.
 
Staci & Ivy said:
Ugh. That’s not good.
I just offered her regular lamb food and FF 13% and she turned her head away from both. I am at around 1.5 hours past giving Cerenia now.
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Have you tried hand feeding? Do you have a food syringe if needed?

I think she will come around to eating but it's going to take time. You may need some guidance from the experts on how many units to give if she won't eat.
 
allicatmeow said:
Have you tried hand feeding? Do you have a food syringe if needed?

I think she will come around to eating but it's going to take time. You may need some guidance from the experts on how many units to give if she won't eat.
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My vet said give full dose even if she doesn’t eat. Sounds terrifying.
I’m afraid to force her to eat which may cause her to vomit again.
@tiffmaxee @Wendy&Neko
Your thoughts? I’m almost at 2 hours from giving Cerenia. No interest yet in food.
What to do next?
 
Echoing the question above, do you have a feeding syringe and can you assist feed her a little? Sometimes getting a bit of food in them will make them feel better and feel more like eating. Syringe/Assisted Feeding (Video and Tips)

What is her blood sugar now? She'll probably feel worse with no insulin on board and in high numbers too.
 
Staci & Ivy said:
My vet said give full dose even if she doesn’t eat. Sounds terrifying.
I’m afraid to force her to eat which may cause her to vomit again.
@tiffmaxee @Wendy&Neko
Your thoughts? I’m almost at 2 hours from giving Cerenia. No interest yet in food.
What to do next?
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She shouldn't be able to vomit now that you are at 2 hours. Cerenia is an antiemetic - it stops the brain from telling the body to vomit (substance/binder/receptor sciencey stuff). So not only is it stopping her nausea, it is stopping her ability to vomit.

What dose Cerenia did you give and what does Ivy weigh?
 
allicatmeow said:
She shouldn't be able to vomit now that you are at 2 hours. Cerenia is an antiemetic - it stops the brain from telling the body to vomit (substance/binder/receptor sciencey stuff). So not only is it stopping her nausea, it is stopping her ability to vomit.

What dose Cerenia did you give and what does Ivy weigh?
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Gave 1/2 tablet of 24 mg. She’s around 13ish lbs
 
Wendy&Neko said:
Echoing the question above, do you have a feeding syringe and can you assist feed her a little? Sometimes getting a bit of food in them will make them feel better and feel more like eating. Syringe/Assisted Feeding (Video and Tips)

What is her blood sugar now? She'll probably feel worse with no insulin on board and in high numbers too.
Click to expand...
I’m syringe feeding now. Do I wait a bit to see if ok. If so what dose do I give her?
 
tiffmaxee said:
Yes, for at least a couple of hours. Often my cats will eventually eat. If you get to 2 hours and still not eating, post for help.
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She still not eating. I just did some syringe feeding but she’s not interested in good on her own.
I guess I should wait about 20 minutes and then do you think I should give her her shot and if so, do I give the full 3 units or reduced?
bg is High/over 400 on Libre.
 
When is the last time you tested her for ketones? With ketones in the past, lethargy, not eating enough, I'd be reluctant to do anything besides her usual dose of insulin.

I would wait 20 minutes before the next feed. Remember, you have until onset, which looks like +2 for her, to get a good meal in. I was happy if Neko got 2/3 of her needed calories for the cycle.
 
Wendy&Neko said:
When is the last time you tested her for ketones? With ketones in the past, lethargy, not eating enough, I'd be reluctant to do anything besides her usual dose of insulin.

I would wait 20 minutes before the next feed. Remember, you have until onset, which looks like +2 for her, to get a good meal in. I was happy if Neko got 2/3 of her needed calories for the cycle.
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I test for ketones with urine strip daily. Always negative.
Are you saying give full dose 3 units now and then feed every 20-30 min small amount until + 2 after she’s been given insulin???
 
Whether you wait 20 minutes before the shot, or give it now is up to you. She shouldn't vomit with the Cerenia on board, but if you want to wait to make sure, that's OK too. Then feed every 20-30 minutes a small amount, until she's had what she normally would have at PMPS. Or starts eating on her own.
 
Wendy&Neko said:
Whether you wait 20 minutes before the shot, or give it now is up to you. She shouldn't vomit with the Cerenia on board, but if you want to wait to make sure, that's OK too. Then feed every 20-30 minutes a small amount, until she's had what she normally would have at PMPS. Or starts eating on her own.
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Ok I just gave her the full three unit dose. Will continue to feed small amounts until approximately +2 from now.

Will I continue as usual to offer snacks through the evening as I normally do to prevent her from dropping or is that not an issue since she’s so high and had 1/2 dose this am?

Since I delayed 2 hours tonight, how do I handle tomorrow morning schedule?
Do I wait a full 12 hours from now to feed and give insulin? Then walk back her schedule 15 min each cycle until back to normal?

Or, If she is still high over 400 BG in am, will I go back to her normal schedule and essentially shoot early?
 
Can you give her small snacks through the night? It might be best since she hasn't eaten much.

Tomorrow morning ,I believe you give full dose no sooner than 11hrs 45 mins from your PM shot (walking back 15 per cycle) because it has the possibility of acting as a dose increase if you shoot too soon. I cannot speak to shooting early if she is over 400 due to the circumstances, too new here. I am sure someone will chime in soon for you though.
 
allicatmeow said:
Can you give her small snacks through the night? It might be best since she hasn't eaten much.

Tomorrow morning ,I believe you give full dose no sooner than 11hrs 45 mins from your PM shot (walking back 15 per cycle) because it has the possibility of acting as a dose increase if you shoot too soon. I cannot speak to shooting early if she is over 400 due to the circumstances, too new here. I am sure someone will chime in soon for you though.
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Yes, I can give small snacks. I guess if she doesn’t want to eat on her own I can syringe feed through the night. Good idea Allie.
Boy, for a new member, you’ve caught on quick! Great advice. my brain turned to mush today when she puked everywhere!
It’s been a very long day.

I appreciate you chiming in and giving great suggestions and checking on me tonight.
Sending you and your gang huge hugs :bighug::bighug::bighug:
 
Staci & Ivy said:
Yes, I can give small snacks. I guess if she doesn’t want to eat on her own I can syringe feed through the night. Good idea Allie.
Boy, for a new member, you’ve caught on quick! Great advice. my brain turned to mush today when she puked everywhere!
It’s been a very long day.

I appreciate you chiming in and giving great suggestions and checking on me tonight.
Sending you and your gang huge hugs :bighug::bighug::bighug:
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I am not well versed in diabetes yet (hope to be!), but I can speak to almost any other feline medical situation or catastrophe... I've run the gamut of diseases and procedures it seems. One of my cats reacted so poorly to anesthesia - it would take him 3 days to recover and he had 8 different surgeries in his lifetime. I know how scared and helpless you can feel, when you just want one thing to go right so you can keep moving forward.

Sending you lots of hugs too!! You got this!! :bighug:
 
allicatmeow said:
I am not well versed in diabetes yet (hope to be!), but I can speak to almost any other feline medical situation or catastrophe... I've run the gamut of diseases and procedures it seems. One of my cats reacted so poorly to anesthesia - it would take him 3 days to recover and he had 8 different surgeries in his lifetime. I know how scared and helpless you can feel, when you just want one thing to go right so you can keep moving forward.

Sending you lots of hugs too!! You got this!! :bighug:
Click to expand...
You have more experience than any cat mom should. And I thank you for caring and sharing your experience with me :bighug:
 
Can you keep your subject line updated with the PMPS and latest numbers, so we can see at a glance if she's getting into any trouble. Looks OK so far.

As far as tomorrow morning, if she is well over 400 at +11, you could post for help on the decision if it's OK to shoot that early. It is only something you could do once though.
 
Wendy&Neko said:
Can you keep your subject line updated with the PMPS and latest numbers, so we can see at a glance if she's getting into any trouble. Looks OK so far.

As far as tomorrow morning, if she is well over 400 at +11, you could post for help on the decision if it's OK to shoot that early. It is only something you could do once though.
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Of course, I will update the subject line.
Seems it may be best to just stick to the 12 hour schedule and walk her back.
 
Wendy&Neko said:
Seeing her numbers, I'm glad you shot the full dose. This morning's half dose, plus stress of the day, poor girl.
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I know. I’m still feeding her a few tsp every 30 minutes just to get her calories into her. (It’s after midnight here). I’ll be at this for a while.

She’s just lying in a corner wanting to be left alone, zoned out. So sad to see.

I never imagined it would be such an awful day for her. Last time we did this for the X-rays she was fine, 6 weeks ago.
*I hope she will want to eat in the morning. Any idea what I should do If she doesn’t want to eat again?
Thanks for checking in with us :bighug:
 
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