? 2/9 Vesper, AMPS 380, +2 336, +5 414, +8 401 - Still sick

Kelly and Vesper

Kelly and Vesper

Member
Yesterday's post: https://www.felinediabetes.com/FDMB...pmps-495-3-359-vomiting-please-advise.298193/

Vesper is still struggling this morning. She's not eating much, just snacking on some dry kibble every now and then (that's the only thing she's interested in). She's still on Cerenia and Odansetron and had Miratz last night.

She seems quite thirsty, and I don't know if that's a good thing or a bad thing after her two diarrhea episodes last night.

AMPS was 380. Negative for ketones this morning. I'm thinking we should go ahead with the 1.25 even though she's not eating much given her BG levels and that she's snacking on dry food?
 
Hi Kelly. I am sorry to read that Vesper is not well still. I think you were right in giving her 1.25 this morning, she was high and she's eating a little.
Is she dehydrated? Did you try pinching her skin to see if the fold stays?
I hope she will start feeling better today, lots of positive thoughts for you both :bighug::bighug::bighug:
 
Thank you for the responses. At what point should I try syringe feeding or forcing her to eat vs. just seeing if she starts to eat more on her own? I don't want to make things worse for her but also know how important it is that she eats.

She doesn't seem dehydrated, but I'm not the best at the pinch test. She does like the hydracare packets, but I'm almost wondering if those caused her diarrhea yesterday, so I'm hesitant to try those today.
 
I would offer her anything she will have to drink (including the hydracare or boiled chicken broth) and eat.
If you can syringe feed, I would try a little at a time. Did the Vet send you home with recovery A/D? That's easy to syringe.
Do you think you can get some meat only baby food? Also easy to syringe.
When is she due for odansetron?
 
Angela & Cleo said:
I would offer her anything she will have to drink (including the hydracare or boiled chicken broth) and eat.
If you can syringe feed, I would try a little at a time. Did the Vet send you home with recovery A/D? That's easy to syringe.
Do you think you can get some meat only baby food? Also easy to syringe.
When is she due for odansetron?
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We will buy some chicken broth and baby food and try that. I got her to eat 12 large kernals of dry food and then she resisted all other food. It was only about 1/8 cup. We gave her odansetron again about 30 min ago, and I'm desperately hoping it helps her.
 
Angela & Cleo said:
Make sure its broth only. Same thing with the baby food. No garlic no onions.

Good she ate some dry food.
Any diarrhea or vomiting today?
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Okay, will do. I will keep trying with the dry food too. No vomiting or diarrhea yet today, though it's possible she has a very small vomit last night (there was a small patch of dried foam on the floor, but I am not sure when it is from).
 
Update: I got her to eat a little bit more dry food, but she's probably only had 1/4 cup all day. She also ate about 1/2 of a delectable's chicken and bisque pouch and showed some interest in some party mix treats (I know those are awful). She did gag once while eating.

Her +5 BG was 414. I assume this is because she's eating mostly dry food that is 30% carbs?

What do I do if her appetite continues to be low? What are my options? Is she safe to stay at home as long as there are no ketones yet? If I take her in to the vet, they will need to sedate her fully (and she won't be eating for several hours while they do that). I know it might become necessary, but I also want to treat her as home as much as possible because she is far more comfortable here.

If she continues to snack at this rate, and mostly on carbs, should we stick with the 1.25 for her PM shot?
 
Angela & Cleo said:
How long ago did you give the odansetron? It can be given multiple times a day?

You're doing so well caring for her :bighug:
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She got it 4h 15m ago. I was going to give it to her in another 1h 45m. I am giving it every 6 hours. She is also due for cerenia in 45 min.

And thank you, I'm trying, and it's only because of the help I'm getting from all of you that I feel even remotely capable of trying. I am worried about her though :(
 
The ondansetron can be bumped up to 4 times a day. Dosing is 0.5-1.0 mg/kg per day. What is the dose?
Hopefully the Cerenia will help.
:bighug::bighug:
 
Kelly you are doing a great job caring for Vesper and you are getting lots of good advice.
I agree with Angela, keep giving the 1.25 units and let her eat whatever she will eat. Don’t worry if it is unsuitable for diabetics. That can be sorted out later. Eating anything is more important.
Would she eat a bit of scrambled egg?
Or some deli meat?
Or rotisserie chicken?
Or something with Parmesan cheese sprinkled in top?
Very pleased to see no ketones.
Has the diarrhoea stopped?
 
Angela & Cleo said:
The ondansetron can be bumped up to 4 times a day. Dosing is 0.5-1.0 mg/kg per day. What is the dose?
Hopefully the Cerenia will help.
:bighug::bighug:
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The tablets are 4mg, and the vet said we can do 1/2 tablet up to 3x a day. So I guess 2mg each dose, for a total of 6mg a day. She is just about 4.1kg right now. So does that mean we should be doing it fewer than 3x a day?
 
Bron and Sheba (GA) said:
Kelly you are doing a great job caring for Vesper and you are getting lots of good advice.
I agree with Angela, keep giving the 1.25 units and let her eat whatever she will eat. Don’t worry if it is unsuitable for diabetics. That can be sorted out later. Eating anything is more important.
Would she eat a bit of scrambled egg?
Or some deli meat?
Or rotisserie chicken?
Or something with Parmesan cheese sprinkled in top?
Very pleased to see no ketones.
Has the diarrhoea stopped?
Click to expand...
Thank you!! I am so grateful for the advice and support. We got a whole bag of new foods to try but so far she seems to only want liquids or dry food, no solid meat. I have not seen any diarrhea yet today, but I'm also not sure she's had a bowel movement. I will keep an eye out.
 
Bron and Sheba (GA) said:
Kelly you are doing a great job caring for Vesper and you are getting lots of good advice.
I agree with Angela, keep giving the 1.25 units and let her eat whatever she will eat. Don’t worry if it is unsuitable for diabetics. That can be sorted out later. Eating anything is more important.
Would she eat a bit of scrambled egg?
Or some deli meat?
Or rotisserie chicken?
Or something with Parmesan cheese sprinkled in top?
Very pleased to see no ketones.
Has the diarrhoea stopped?
Click to expand...

She just laid down hovered her face over her water bowl for quite awhile, which was very concerning. The only other times she has done that are when she was about to go into DKA. She is currently showing no interest in food, even the lickable foods, but hopefully that will change when the anti-nauseas kick in. But I'm wondering, at what point do we need to take her in to the vet? Are we okay keeping her home if her urine is negative for ketones? Or could she still possibly go into DKA? Just wondering at what point this isn't sustainable at home. Any advice?

Also, my husband is desperate to increase the Lantus dose tomorrow, given that her numbers have only increased today. Is that not an option?

One more question: should we add in gabapentin? Is there any chance that would help?
 
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It might be worth while getting her electrolytes checked. I’m just concerned she’s not eating and is hovering over the water bowl. But I know she will need sedating. Why don’t you ring the vet and talk to him.
Another cerenia injection might be an option as well if you have not given the oral dose today. Or some imi ondansetron.
Why do you want to add in gabapentin? Do you think she has pain?
If there are no ketones I would not increase dose of insulin today.

Is she lethargic?
 
Bron and Sheba (GA) said:
It might be worth while getting her electrolytes checked. I’m just concerned she’s not eating and is hovering over the water bowl. But I know she will need sedating. Why don’t you ring the vet and talk to him.
Another cerenia injection might be an option as well if you have not given the oral dose today. Or some imi ondansetron.
Why do you want to add in gabapentin? Do you think she has pain?
If there are no ketones I would not increase dose of insulin today.

Is she lethargic?
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Maybe I can avoid full sedation by giving her gabapentin. I'll try that, and then try to get bloodwork done at the vet. I am also concerned about her electrolytes. The hovering by the water and the food refusal is very consistent with her prior DKA episodes. I'd say yes, she's lethargic, but still spicy. I just don't even know what to do anymore if this is DKA. It will be the 3rd one in 2 weeks.
 
Kelly and Vesper said:
Maybe I can avoid full sedation by giving her gabapentin. I'll try that, and then try to get bloodwork done at the vet. I am also concerned about her electrolytes. The hovering by the water and the food refusal is very consistent with her prior DKA episodes. I'd say yes, she's lethargic, but still spicy. I just don't even know what to do anymore if this is DKA. It will be the 3rd one in 2 weeks.
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There might be something underlying that is stopping her fully recover. Maybe the pancreatitis has flared up a bit. Whatever is happening you are catching it early.:bighug::bighug::bighug:
 
Bron and Sheba (GA) said:
There might be something underlying that is stopping her fully recover. Maybe the pancreatitis has flared up a bit. Whatever is happening you are catching it early.:bighug::bighug::bighug:
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I hope so. I feel so defeated, and I don't know how much longer we can afford these hospitalizations. We have spent $20k in the last two weeks alone. I just need her to stabilize.
 
Kelly, I'm so sorry to hear about Vesper. You guys are going through a very rough patch. You are doing a wonderful job caring for little Vesper.
When my non diabetic cat went into hunger strike and was puking very often just couple months ago I rushed her to the ER and they gave him 3 medications which worked very well for him.
Cerenia 12 mg - anti-nauseant every 24 hours. I think you are giving Vespa this med.
Omeprazole 10 mg every 24 hours - antacid.
Mirrazapine 2 mg - appetite stimulant (every 24 to 48 hours if needed)
The combination of all these 3 medications worked for us.
Hope Vesper will feel better soon. It's so hard to see them unwell.
Wish you best of luck. Fingers and paws crossed here for Vesper.
 
Bron and Sheba (GA) said:
We all are hoping things will settle down. You are wonderful parents to her. :bighug:
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Thank you for saying that. We decided to wait until tomorrow morning to take her in. She is laying on a heating pad and seems happy on the gabapentin. She ate another Delictables "bisque" and a few bites of food, so we gave her insulin and reapplied her appetite stimulant. If no improvement tomorrow morning, we will get her blood checked.
 
AYDA & PASHA said:
Kelly, I'm so sorry to hear about Vesper. You guys are going through a very rough patch. You are doing a wonderful job caring for little Vesper.
When my non diabetic cat went into hunger strike and was puking very often just couple months ago I rushed her to the ER and they gave him 3 medications which worked very well for him.
Cerenia 12 mg - anti-nauseant every 24 hours. I think you are giving Vespa this med.
Omeprazole 10 mg every 24 hours - antacid.
Mirrazapine 2 mg - appetite stimulant (every 24 to 48 hours if needed)
The combination of all these 3 medications worked for us.
Hope Vesper will feel better soon. It's so hard to see them unwell.
Wish you best of luck. Fingers and paws crossed here for Vesper.
Click to expand...
That's really helpful information to have, thanks for letting me know. Glad to hear it worked well for your kitty. And thank you for the good luck wishes. We'll keep everyone posted. This is such a wonderful community.
 
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