I need help with everything!

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1964catmom

1964catmom

Member Since 2023
I have a few questions I hope you can help me with. First, I don’t have my dosing information up because it has been somewhat of a nightmare with Twig’s insulin. My vet never taught me anything about dosing or adjusting doses or even at home monitoring. Everything I’ve learned so far has been from this forum. For instance I had no idea I could adjust her insulin according to her numbers. I have always been told to give her X as her dose and that’s that. I had to read about home monitoring myself.

Recently Twig started to show signs of pancreatitis, vomiting, loss of appetite, lethargy, etc. I had a dog with this so I was familiar with the signs. A blood test from the vet showed she had slightly elevated liver enzymes, so the vet said with her symptoms that I was right in thinking it was pancreatitis. Her full blood panel came back clear other then the slightly higher liver enzymes.

So this is where things have just gone crazy. She recently had a uti, Twig seems more prone to them as she’s aged. I had covid at this time so the doctor gave me a prescription over the phone that was the same as she used for her last uti. It worked, but since she finished those meds she seems to be in a full blown pancreatitis flair. The problem is I was never given anything for her pancreatitis. No meds for pain or nausea, nothing. He just told me to get their RX food and that was it. I now have a cat that isn’t eating, her numbers are sitting at 20 ( they were about 10-14 before this flair) and she just seems miserable. A called and asked for cerenia and he said no because she wasn’t vomiting currently. I’ve been giving her Pepcid and self dosing her with left over Gabapentin she had for vet visits. In between I’ve been giving her milk thistle and slippery elm.

I finally called and said I have to have her looked at and want b12 shots and sub q for her and some sort of anti nausea med, she seems to do well in Gabapentin so I’m fine to leave that.
She has an appointment tomorrow.

Where I need help is insulin dosing while she is so high. I have her at 3 units of Prozinc now, I bumped her up from 2 1/2, but it isn’t touching her numbers. I know the flair can raise her numbers but I need some guidance for dosing and any other help with her tummy issues would be greatly appreciated. She is breaking my heart right now she feels so crappy!
 
I am so sorry you and Twig are going through this and your vet sounds unpleasant.
Pancreatitis treatment is pain medication, antinausea medication and sub Q fluids if needed which they often are.
For your vet to say she doesn’t need antinausea meds because she isn’t vomiting is really showing up his ignorance. Most cats with pancreatitis have nausea and need anti nausea meds. Not all cats with pancreatitis vomit.
Another good anti nausea medication is ondansetron.
If your vet will not cooperate with you and give you the treatment needed for pancreatitis I would go to another vet.
It is very important that diabetic cats are treated for any infection or inflammation immediately and they are given antinausea medication so they can eat.
I would also buy a bottle of Ketostix if you don’t have any, so you can test her urine for ketones. This is important.
Regarding food…you certainly don’t need Rx food for pancreatitis. Give her whatever she will eat at the moment as it is important she eats.
Are you home testing yet. I can’t see any data on the spreadsheet?
 
Thank you so much! I’m beside myself trying to get her on track.

So in regards to Ketostix, which I was not aware of, is this just a dip in her urine? If it is high what action would be needed then?

I’ve been home testing for awhile. Her dose was originally 3 units in the morning and 2 1/2 at night. I’ve bumped it to 3 and 3 now because her numbers took such a drastic jump. I am totally lost as to how the spreadsheet works, lol! I’ve never been told by the vet that I can adjust her units, so I wasn’t totally sure if the spreadsheet was going to help me since nothing was ever being adjusted.

I sound like a moron but we have been left so alone (this is vet number 2!) that we are just hanging on by our fingernails at this point.

So just so I’m clear, can Cerenia be used if she is not vomiting?

Thank you so much for you response, it is truly appreciated.
 
1964catmom said:
Thank you so much! I’m beside myself trying to get her on track.

So in regards to Ketostix, which I was not aware of, is this just a dip in her urine? If it is high what action would be needed then?

I’ve been home testing for awhile. Her dose was originally 3 units in the morning and 2 1/2 at night. I’ve bumped it to 3 and 3 now because her numbers took such a drastic jump. I am totally lost as to how the spreadsheet works, lol! I’ve never been told by the vet that I can adjust her units, so I wasn’t totally sure if the spreadsheet was going to help me since nothing was ever being adjusted.

I sound like a moron but we have been left so alone (this is vet number 2!) that we are just hanging on by our fingernails at this point.

So just so I’m clear, can Cerenia be used if she is not vomiting?

Thank you so much for you response, it is truly appreciated.
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You can use cerenia even if she's not vomiting. My civvie did 4 days of cerenia last week because she was very nauseous and zofran and mirataz just weren't doing it. I have some on hand just in case. I think you need a new vet....I get how hard that is when you're dealing with a sick kitty. My girl has had 5 so far.
 
Kahluasmom said:
You can use cerenia even if she's not vomiting. My civvie did 4 days of cerenia last week because she was very nauseous and zofran and mirataz just weren't doing it. I have some on hand just in case. I think you need a new vet....I get how hard that is when you're dealing with a sick kitty. My girl has had 5 so far.
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Thanks, I appreciate the confirmation. I figured I could give her Cerenia for nausea, now getting my vet to agree. This is our second vet and I must admit I’m not having much more luck the the first one. They seem very limited in dealing with diabetes and issues that come with that.
 
Ale & Bobo & Minnie (GA) said:
I believe you hold the strip under the urine for 15 seconds but there will be instructions on the bottle.
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No this is not correct Ale. With Ketostix, you dip the test strip into the urine or hold it under the stream of urine , just long enough
to get it wet, then you read it exactly 15 seconds after it gets wet. Read it against the colours on the side of the bottle. More than a trace needs vet attention.
Nauseated cats won’t want to eat. They don’t have to be vomiting to need cerenia or ondansetron
 
Bron and Sheba (GA) said:
No this is not correct Ale. With Ketostix, you dip the test strip into the urine or hold it under the stream of urine , just long enough
to get it wet, then you read it exactly 15 seconds after it gets wet. Read it against the colours on the side of the bottle. More than a trace needs vet attention.
Nauseated cats won’t want to eat. They don’t have to be vomiting to need cerenia or ondansetron
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I just had her back at the vet about an hour ago with equally disappointing results. The vet won’t give me any meds at all until he does a recheck of blood work, even though we did a FULL blood panel a month ago. He ordered another $350.00 blood panel to recheck everything. So now I have to wait another week for results and a call back. I did manage to badger him into a b12 shot, he argued she doesn’t have IBD so she didn’t need a shot, but I pushed that.

If I should frustrated and angry, I am! I was hoping for some sort of relief for her today but ended up having to fork out a ton of money for tests we literally just did.

Thanks for the clarification on the ketostiks, Cerenia still has to wait apparently.
 
1964catmom said:
I just had her back at the vet about an hour ago with equally disappointing results. The vet won’t give me any meds at all until he does a recheck of blood work, even though we did a FULL blood panel a month ago. He ordered another $350.00 blood panel to recheck everything. So now I have to wait another week for results and a call back. I did manage to badger him into a b12 shot, he argued she doesn’t have IBD so she didn’t need a shot, but I pushed that.

If I should frustrated and angry, I am! I was hoping for some sort of relief for her today but ended up having to fork out a ton of money for tests we literally just did.

Thanks for the clarification on the ketostiks, Cerenia still has to wait apparently.
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If I were you I would call the vet tomorrow & tell him she is puking whether she is or not, than maybe he will give you some cerenia. It's heart breaking that they don't just listen to us the ones whom knows our kitty's best! If you can ever get Ondansetron which is the best for nausea. It's a really good price on chewy, but your vet has to okay it since it's a prescription.
 
Chrispooky12 said:
If I were you I would call the vet tomorrow & tell him she is puking whether she is or not, than maybe he will give you some cerenia. It's heart breaking that they don't just listen to us the ones whom knows our kitty's best! If you can ever get Ondansetron which is the best for nausea. It's a really good price on chewy, but your vet has to okay it since it's a prescription.
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That’s a great idea, thanks!!
 
1964catmom said:
So now I have to wait another week for results and a call back.
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From https://www.felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.83108/

Texas A&M University (TAMU) in conjunction with IDEXX has developed the Spec fPL test. Some veterinarians use the SNAP fPL which only indicates normal or abnormal results. The more definitive test, the Spec fPL, requires that a blood sample be sent to TAMU or IDEXX. It is important to note that a 6 - 12 hour fast is required for the most accurate results. It is also recommended to simultaneously have the blood checked for cobalamin and folate levels as these can be low in a cat with pancreatitis and supplements can aid in recovery.

Why can't your vet do a SNAP fpl test? It doesn't give a precise number result but if abnormal can save the time it takes for the more specialized test and get the treatment earilier.
Just my 2.7 cents (in Canadian funds).
 
Bron and Sheba (GA) said:
No this is not correct Ale. With Ketostix, you dip the test strip into the urine or hold it under the stream of urine , just long enough
to get it wet, then you read it exactly 15 seconds after it gets wet. Read it against the colours on the side of the bottle. More than a trace needs vet attention.
Nauseated cats won’t want to eat. They don’t have to be vomiting to need cerenia or ondansetron
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Good to know thanks!
 
You may need to educate your vet that Cerenia was initially developed to treat motion sickness in dogs. Motion sickness does not always mean vomiting. This is a link to information on treating nausea in cats. I would also ask your vet if he's ever had or knows anyone who's had pancreatitis. It's painful. Pain meds, such as buprenorphine is typically indicated.
 
Thank you for all the replies! I have been busy with Twig and haven’t gotten time to reply until now.

I got Twig’s results back and now the vet is saying she does not have pancreatitis because her liver enzymes and pancreatitis blood test ( no idea what that was ) were normal. So last month they were high, this month normal.
I’m utterly confused at this point. She is still showing no interest in food, eating some but not much, and now I’m being told she’s fine!! Can she have pancreatitis issues if her blood is normal now? I feel like she still feels really crappy!

Any further i stores would be very much appreciated for this frazzled cat mom!
 
Did you get the antinausea meds? You need to pester your vet until you do. A diabetic cat that is not eating is at risk of ketones which can be life threatening and require a stay at a er hospital.
 
Ale & Bobo & Minnie (GA) said:
Did you get the antinausea meds? You need to pester your vet until you do. A diabetic cat that is not eating is at risk of ketones which can be life threatening and require a stay at a er hospital.
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I just got back from the vet for the second time this week. She is not pooping easily or often, peeing is fine. All her tests came back good but she still is not loving food. She IS eating a bit but not a ton yet. I was given a months worth of B12 shots, an appetite stimulant and will give her Miralax (sp?). From there he wants her back in a week and we will do an belly X-ray if things don’t turn around. Honestly I’m getting a little worried she may have a tumour since everything seems normal but her eating and pooping. I’m also going to get some aloe juice to see if that helps her stomach. No anti nausea meds yet, I think pulling my own teeth would be easier! He says she isn’t throwing up so she doesn’t need it. ‍♀️
 
The apetite stimulant alone won’t help. I think someone said it here earlier but a nauseated cat won’t eat with it without the apetite stimulant. If I were you, I’d call the vets office and get the prescription for both ondansetron and Cerenia. I would not give up until they gave it to me. It’s what she needs right now.

Anti nausea and vomiting are 2 different things. A nauseate cat may not vomit but it also won’t want to eat. Just tell him you want to try it to see if it helps. It’s your cat and you have to advocate for it. My vet was resistant at first too but I strongly reminded him that this is my cat and all the research I’d done indicated ondansetron was a good option and I wanted to try it. And guess what? I was right and it worked
 
I can't talk at all about diabetes or dosing effects, but do know a little about kitty pancreatitis.

What has worked for me is cerenia, DEFINITELY. oral (pills) did not work so I give my cat injections. I have just found that Wedgewood pharmacy does compound cerenia into a transdermal (smear on ear) so I have it to use. Very excited about that! Also, subq fluids .extremely helpful. Sometimes buprenex for pain. I found the transmucosal just tranqed out the kitty but the shot really helped. And mirtazapine for appetite. I do this as a transdermal also. Have to deal with nausea (cerenia) or they won't eat and that's definitely not good. There's more stuff but that's my main tool bag. Some use antibiotics but I havent.

I will say for an easy second opinion, vetster offers online vet appts pretty much around the clock. I've had EXCELLENT luck, and if in your area, the vet can prescribe.

Anyway, learning a lot about the diabetes connection .... I hope your sweet girl is feeling better!
 
A lot depends on what the vet is calling a test for pancreatitis. In the "old" days, the vets would test for lipase to diagnose pancreatitis. It's not a reliable test. It's been replaced by a feline lipase immunoreactivity test (fPLI) which can either be a blood test that's sent to a lab -- usually IDEXX since it's their test -- or in the office with a test that's much like a pregnancy test -- you get either a "+" or "-" as a result. While it's the gold standard test now, if it's too early or if it's past the peak of the active period, you may not get a positive result.

A couple of other thoughts... Is Twig still taking an antibiotic? If so, it may be upsetting her stomach. It sounds like the vet did not do a cytocentesis and culture and sensitivity to deal with the UTI. It's possible that the antibiotic that was prescribed wasn't specific to the bacteria causing the UTI. You may need to make sure the UTI has cleared. If the antibiotic is playing havoc with your cat's system, a probiotic may help.

If you have switched Twig to a low carb, higher protein diet, she will not be pooping as much. That's normal with a switch to a species appropriate diet. However, it also sounds like she's constipated. Adding water to her food and giving Miralax should help. Also, if the diet switch is recent, not all cats take to a change in food (well, a change in pretty much anything since they are creatures of habit) wholeheartedly and it may throw their GI system off for a while.
 
Sorry again for the late reply, it is all Twig all the time right now.

She FINALLY pooped the other night and threw up. I called the vet and he still will not give her anything. He says that throwing up once is no reason to medicate. She hasn’t pooped since. Tbh, I’m beside myself right now I’m so worried.

As far as her appetite, she seems to want to eat but can’t. Realizing I’m on my own right now with a vet, until I get into to see someone else, I bought Miralax as per suggested and I also bought her some inner leaf organic aloe juice. I read somewhere on this page that it helps. I’m desperate right now. If anyone knows the amount for a 7.6 kg cat I’d appreciate that.

Thanks to everyone for helping through this, it’s insanely stressful and I hate seeing her so miserable.
 
I'm so sorry! It's so stressful!
So, by no means a vet ...just a weirdo on the internet, but one who has been through pancreatitis!
You need good data: pics (ultrasound, X-ray, something) , bloodwork

one of my kitties looked like crap, no poop, vet blew me off. Finally (bc I was a pest .my cat is NOT ok) another vet at the practice ran X-rays and said GET TO THE ER CLINIC NOW. so, a 1.5 hour drive later, we get to the ER vet who does get pics and says giant mass in lower intestine had burst and ruptured the in intestine. They did emergency surgery right then.

So, pics are good. Current blood work is good.
She may need fluids (to help poop if nothing else), pain relief (gabapentin, buprenex), anti nausea (cerenia or other), and appetite stim (mirtazapine, cyroheptadine, something). Mostly so you feel like there is a plan and not like you are left twisting in the windagain, I'm really sorry
 
Lilitiger2 said:
I'm so sorry! It's so stressful!
So, by no means a vet ...just a weirdo on the internet, but one who has been through pancreatitis!
You need good data: pics (ultrasound, X-ray, something) , bloodwork

one of my kitties looked like crap, no poop, vet blew me off. Finally (bc I was a pest .my cat is NOT ok) another vet at the practice ran X-rays and said GET TO THE ER CLINIC NOW. so, a 1.5 hour drive later, we get to the ER vet who does get pics and says giant mass in lower intestine had burst and ruptured the in intestine. They did emergency surgery right then.

So, pics are good. Current blood work is good.
She may need fluids (to help poop if nothing else), pain relief (gabapentin, buprenex), anti nausea (cerenia or other), and appetite stim (mirtazapine, cyroheptadine, something). Mostly so you feel like there is a plan and not like you are left twisting in the windagain, I'm really sorry
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Omg that’s awful!!! I’m sorry your kittie went through that.

Yes I feel this has gone on long enough, she needs SOMETHING to help her. He has a real aversion to giving her medication for some reason, she clearly needs to be looked at properly.

Thanks for the information.
 
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