12/2/24 WATSON AMPS 285L/271M; +1-334; +2-391; +3-333; +4-379

Rosie Lass

Rosie Lass

Active Member
I need some advise today. Watson is FINALLY getting to see the internist for an ultrasound tomorrow for his 5 months of loose stool.

He has to fast for 12 hours, and only gets 1/2 dose of insulin tomorrow morning.

MY QUESTION IS THIS: He will get his dinner tonight at 9:30 and be able to graze until 10:15, then all food will disappear. He is used to having a little food out overnight to snack on and since that isn't going to happen would I also give him a little less insulin tonight? He gets his shots at 10:15am & pm.

I'm worried that he will be getting a dose tonight, then no food, and another 1/2 dose in the morning after not having anything to eat.

If at all possible can someone give me guidance before tonight's dose? Thanks so much!

@Diane Tyler's Mom GA
@Sienne and Gabby (GA)
@tiffmaxee
@Wendy&Neko

https://www.felinediabetes.com/FDMB/posts/3223749/
 
I never had to fast Neko for a GI ultrasound. In fact, some U/S were not planned, just happed as part of a IM vet visit and she'd had her full breakfast. Cat's don't need anaesthesia for an ultrasound, some need sedation. You were given an anaesthesia protocol for feeding, for a non diabetic cat! Call back the vet, and if this was just the front desk staff giving instructions, remind them Watson is diabetic and to double check with the IM vet. If they still insist, then you could "accidentally" leave some food out overnight. And tell them in the morning that he got into another cat's food. For Neko's first anaesthesia (2012) I was worried about her going low, when I was told she shouldn't eat after midnight. I asked about her going low, and they said I could feed if needed then, just to tell them how much. I fed her MC at PMPS time, to boost her up.

Even for anaesthesia, there are updated protocols now for diabetic cats. Neko was allowed to eat up to 6AM before dentals, and that was 10 years ago! See the second post in this thread: Info on Dental Procedures (including pictures)
 
Hi Rosie, I'm glad Wendy suggested "accidentally feeding Watson".

The only thing I can tell you is that in my recent experience I was fasting Ivy for labwork. I gave 1/2 dose the night before and 1/2 dose in the morning (WITH NO am FOOD) and she dove while at the vet into scary numbers on her Libre.
She had no breakfast to combat the insulin from the morning dose. (I had given her about 2 TBSP of food at +8 overnight and her labs were at +4 in the morning.)

It wasn't a good experience for me or Ivy. I took food with me to the vet and had to have them give her some while they had her in the back drawing blood. (since I was watching her on the Libre on my phone).

The next time I went I gave 1/2 dose the night prior and zero insulin in the morning (while fasting her) and she stayed in yellow on her Libre. She recovered quickly after that day.

Just my experience of no food and giving insulin. I hope all goes well tomorrow!!:bighug::bighug::bighug:
 
Wendy&Neko said:
I never had to fast Neko for a GI ultrasound. In fact, some U/S were not planned, just happed as part of a IM vet visit and she'd had her full breakfast. Cat's don't need anaesthesia for an ultrasound, some need sedation. You were given an anaesthesia protocol for feeding, for a non diabetic cat! Call back the vet, and if this was just the front desk staff giving instructions, remind them Watson is diabetic and to double check with the IM vet. If they still insist, then you could "accidentally" leave some food out overnight. And tell them in the morning that he got into another cat's food. For Neko's first anaesthesia (2012) I was worried about her going low, when I was told she shouldn't eat after midnight. I asked about her going low, and they said I could feed if needed then, just to tell them how much. I fed her MC at PMPS time, to boost her up.

Even for anaesthesia, there are updated protocols now for diabetic cats. Neko was allowed to eat up to 6AM before dentals, and that was 10 years ago! See the second post in this thread: Info on Dental Procedures (including pictures)
Click to expand...
@Wendy&Neko Thank you so much for reply. I did call the veterinary hospital and they did say feed and shoot as we normally would. I appreciate your prompt reply and Watson appreciates it because now he can have snacks overnight
 
Staci & Ivy said:
Hi Rosie, I'm glad Wendy suggested "accidentally feeding Watson".

The only thing I can tell you is that in my recent experience I was fasting Ivy for labwork. I gave 1/2 dose the night before and 1/2 dose in the morning (WITH NO am FOOD) and she dove while at the vet into scary numbers on her Libre.
She had no breakfast to combat the insulin from the morning dose. (I had given her about 2 TBSP of food at +8 overnight and her labs were at +4 in the morning.)

It wasn't a good experience for me or Ivy. I took food with me to the vet and had to have them give her some while they had her in the back drawing blood. (since I was watching her on the Libre on my phone).

The next time I went I gave 1/2 dose the night prior and zero insulin in the morning (while fasting her) and she stayed in yellow on her Libre. She recovered quickly after that day.

Just my experience of no food and giving insulin. I hope all goes well tomorrow!!:bighug::bighug::bighug:
Click to expand...
@Staci & Ivy Thanks, Staci, I did call and they said feed and shoot him as normal so I’m relieved
 
@Wendy&Neko
Well that was a $250 waste; the IM doc wouldn’t do the blood work or ultrasound because he hadn’t fasted. She said that eating can affect the results of what she’s looking for.
She’s also not a fan of the website because it was created by a doctor and not just a vet and she said it is outdated; she doesn’t feel like .25 dosages should be used because they are inaccurate. That changes should be done by .50.
She also says that a dose should be held for 30 days instead of seven and that a curve should be done once a month. She’s also not a proponent of Libre’s because the numbers can be so drastically different than an actual blood draw. She feels that numbers in the 200’s to 300s would be acceptable as long as he is not showing symptoms as far as appetite, water consumption, appetite or playfulness. He has to go back on Friday (After fasting) and have his ultrasound. They’re also doing some bloodwork to test his B12 and folate levels and a fructosamine test and a cystocentesis rest. She feels the possibilities could be irritable bowel or lymphoma
 
I'm so sorry the IM vet is so out of date, and that you got charged $250 after the vet hospital said it was OK to feed! Any other IM vets in town you could get a referral to? This vet clearly doesn't get it in regards to treating diabetic cats. And has probably never had one of her own. 9 years ago, Neko's IM and the ultrasound vet specialist did not need her to be fasted to look at her GI system. And the IM respected what I was doing with her blood sugar. That's the kind of relationship you want with a vet. You've been handling Watson's diabetes for a year and a half now. That's a lot of experience.

I'm worried that if you have do get a diagnosis of either small cell lymphoma (SCL) or IBD (inflammatory bowel disease) you will have a vet that won't follow current best practices for either of those conditions. Both conditions are treatable. The cat snoozing on hubby right now has both conditions, for over 6 years. She's in remission from SCL. IBD is something you just have to live with and manage.

Watson does not need a fructosamine test - save your money. The B12/folate actually don't need to be fasted either. They would be if combined with the TLI test which does need fasting. But it is good to find out his B12 level if he has either of those GI conditions as a number of those kitties have low B12. They cystocentesis is for a urinalysis - it won't help diagnose SCL or IBD, but is a good piece of data to have if he hasn't had one recently.
 
Oh Rosie I’m so sorry you had such a bad experience today.
I would never give 1/2 unit increases at a time. Just not cautious or safe (in my opinion).

My original vet at the time of Ivy’s diagnosis wanted me to increase her by an entire unit at a time. (I knew nothing about feline diabetes, but it just felt wrong in my bones and I wouldn’t do it). And she didn’t think I needed to test her either. :banghead:
That’s part of how I ended up at this forum because I started researching because I knew I wasn’t getting the right information from an outdated vet. ***She’s no longer my vet.

Sending you and Watson big hugs of support. :bighug::bighug::bighug::bighug:
 
@Wendy&Neko @Staci & Ivy
So tonight Watson will get his dinner early and be done with food by 8:45pm (I'll be staving all of them overnight, lol) I'll shoot him at his regular 10pm time, thinking maybe I'll do .25 less than normal.
No food or insulin in the morning but I'm taking his food and insulin with me so he should be able to eat and get a.m. shot around 10 like usual, fingers crossed. Once I get him in his carrier I'll feed everyone else :-) There are a couple more IM vets but they are at the same facility so I'm sure I would get the same advise. She did send me a 7 page review of everything she went over. The only thing I'm considering doing is holding his doses a bit longer than 7 days, that part seems reasonable; any thoughts on that? Wendy, once he get a diagnosis I will be following up with our regular vet on treatment plans. Thank you both for your help!
 
You get enough data to know that he's not getting close to the range he needs to be in. He need an increase. The only slight concern is that he seems to getting into blues every 5th cycle lately - tonight is cycle 5 since the last ones. The blues are high enough that it shouldn't be an issue.

I wouldn't hold his doses any longer than you are now. He seems to be developing some glucose toxicity from time spend in higher numbers. The solution is more insulin, not staying at a dose that isn't regularly giving him nadirs in the 90-149 range.
 
Rosie Lass said:
@Wendy&Neko @Staci & Ivy
So tonight Watson will get his dinner early and be done with food by 8:45pm (I'll be staving all of them overnight, lol) I'll shoot him at his regular 10pm time, thinking maybe I'll do .25 less than normal.
No food or insulin in the morning but I'm taking his food and insulin with me so he should be able to eat and get a.m. shot around 10 like usual, fingers crossed. Once I get him in his carrier I'll feed everyone else :) There are a couple more IM vets but they are at the same facility so I'm sure I would get the same advise. She did send me a 7 page review of everything she went over. The only thing I'm considering doing is holding his doses a bit longer than 7 days, that part seems reasonable; any thoughts on that? Wendy, once he get a diagnosis I will be following up with our regular vet on treatment plans. Thank you both for your help!
Click to expand...
Sending lots of good wishes for you and Watson! Please let us know how it goes tomorrow, Rosie :bighug::bighug::bighug::bighug:
 
Wendy&Neko said:
You get enough data to know that he's not getting close to the range he needs to be in. He need an increase. The only slight concern is that he seems to getting into blues every 5th cycle lately - tonight is cycle 5 since the last ones. The blues are high enough that it shouldn't be an issue.

I wouldn't hold his doses any longer than you are now. He seems to be developing some glucose toxicity from time spend in higher numbers. The solution is more insulin, not staying at a dose that isn't regularly giving him nadirs in the 90-149 range.
Click to expand...
@Wendy&Neko
so as I suspected would happen, he had hypo during the night. so as I suspected would happen, he had hypo during the night. The alarm went off five different times. The lowest the libra showed was 51 but the blood meter showed 71. I know under normal circumstances I would drop his dose .25 but since he did not get dinner, I’m not sure if that makes a difference or not. What is your opinion?
 
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