Charly - not eating help!

DavidJ

DavidJ

Active Member
Charlys had two odd cycles yesterday and this morning she has not much appetite and ketones at 0.7

Shot her 1 unit this morning after a teaspoon of food. Hoping her appetite will pick up as insulin starts to work.

Should I increase her dose at next shot? Anything else I should be doing?
 
I’m concerned about what is going on with Charly. She does have these episodes where she doesn’t want to eat very much and she has high numbers. I feel like she was making good progress and then things got little bit wacky.

If she’s high in the morning, I probably would go ahead with a .25 unit increase as long as I could monitor her cycle.
 
DavidJ said:
I have no idea if what we have been seeing last few cycles is too much insulin or not enough?
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Hello, take everything I say with a large pinch of salt as I only have the experience with my cat and I may have been lucky, but it looks like not enough insulin during the last few cycles and I agree with Suzanne about increasing it to 1.25u. I would also keep the insulin dose steady for at least 3 cycles and until you start getting some consistent greens (it may even have to go to 1.5u for that).
 
thanks both. I didn't your messages until after am shot. It looked like she was shaping up for a good cycle today but she seems to be heading up again now.

shes had some strange cycles since reducing to 1 though. two succesive inverse curves where she was higher around nadir than at shot time. and then a very odd cycle where she dropped quickly and then shot up into black mid cycle. some ketones around this time and then off her food next day.

i'm a bit nervous about increasing because:

a) we had a very stressful afternoon last week when she dropped below 50 on 1.25 hence the reduction.
b) we didn't see these inverse curves earlier when she was on doses that were presumably not enough insulin. they were flat or shallow.
c) she dropped over 400 to 137 on 1 unit a few cycles back before bouncing back up to balck so it seems like 1 unit is potentially enough for low nadir

i'm inclined to give her a couple more cycles at 1. shes recovered well from whatever this latest not eating/ketone event is and seems generally happy and comfortable again

does that sound reasonable? or am i just not seeing that she obviously needs an increase?
 
Yeah I see what you mean and perhaps you are right to hold the dose steady at 1u for a couple more cycles and see what you get, but my guess is still that 1.25u looks a better fit.

In terms of the low nadir last week, I wouldn't worry too much if you get a brief nadir below 50 with no clinical signs of a hypo and the rest of the cycle is good, but that's only my personal/ignorant take. There is always the accuracy of the glucometers that we need to consider too.

I did come close to that with my cat too and also learned to shoot low PS numbers (<100), but obviously every cat is different and I had the libre sensor (not very accurate, but still very useful).

It may take some time, but I think you'll get there (mostly greens and ideally then a remission).
 
DavidJ said:
Charlys had two odd cycles yesterday and this morning she has not much appetite and ketones at 0.7

Shot her 1 unit this morning after a teaspoon of food. Hoping her appetite will pick up as insulin starts to work.

Should I increase her dose at next shot? Anything else I should be doing?
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I joined the group about when you did, so I am new. My cat Kobe has had ketones and lack of appetite too. Kobe was on Prozinc, but has responded well to Lantus. We switched in January after a trip to the hospital. Lantus has a longer duration for most cats and tends to produce a flatter curve. Kobe would not eat enough with his Prozinc shot to slow down the action of that insulin, so he would go low FAST and then bounce HIGH. Lantus has been a better fit for Kobe because he likes to graze. Kobe would not eat much when he was nauseated. He has prescriptions for Maropitant Citrate and Ondansetron for nausea. He also has a prescription for Mirtazapene Transdermal Ointment which is an appetite stimulant. I was instructed to make sure that I never gave an appetite stimulant to Kobe while he was nauseated. I also got a bag of sub q fluids from my vet. The vet made sure that fluids were safe for Kobe's heart. Fluids helped flush out ketones when they got a little high.

I am not telling you to switch Insulin or get these medications. I am too new to give advice like that. I would defer to what @Suzanne & Darcy recommends. I just had some ideas that helped my cat and thought I would offer them up in case one of them might help you and Charly. :)

Lesley
 
DavidJ said:
Charlys had two odd cycles yesterday and this morning she has not much appetite and ketones at 0.7

Shot her 1 unit this morning after a teaspoon of food. Hoping her appetite will pick up as insulin starts to work.

Should I increase her dose at next shot? Anything else I should be doing?
Click to expand...

I meant to ask if Charly is showing signs of nausea? Here are signs that I found on an old post made by @Suzanne & Darcy.

Signs of nausea include:
1. Sniffing food and walking away
2. Sniffing at food and licking lips and then not eating / walking away
3. Licking the surface of the food (like licking gravy off the top) and walking away
4. Teeth grinding/chatteringsounds.
 
Suzanne & Darcy said:
So she’s eating okay again today? I was thinking maybe of a pancreatitis flare up.
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yes eating very well again today. she was eating well again by pm cycle yesterday in fact. it was just the am cycle after that bounce from blue to black where she was very reluctant to eat and showing all the nausea signs lesley has listed above.
 
Kobe (Dean and Lesley) MO said:
I meant to ask if Charly is showing signs of nausea? Here are signs that I found on an old post made by @Suzanne & Darcy.

Signs of nausea include:
1. Sniffing food and walking away
2. Sniffing at food and licking lips and then not eating / walking away
3. Licking the surface of the food (like licking gravy off the top) and walking away
4. Teeth grinding/chatteringsounds.
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yes. all of these. what is that teeth grinding?!
 
It’s okay if you feel more comfortable holding the 1 unit dose a little longer. You know me, I’m not going to freak out on you if you don’t! She’s your baby. It definitely looks like something has been going on with Charly. At the last vet visit, her teeth were checked, correct? When she eats, she doesn’t turn her head to the side frequently, does she? Has she been outside catching anything?
 
DavidJ said:
yes eating very well again today. she was eating well again by pm cycle yesterday in fact. it was just the am cycle after that bounce from blue to black where she was very reluctant to eat and showing all the nausea signs lesley has listed above.
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I don’t think she appreciates the large swings in BG.
 
DavidJ said:
yes eating very well again today. she was eating well again by pm cycle yesterday in fact. it was just the am cycle after that bounce from blue to black where she was very reluctant to eat and showing all the nausea signs lesley has listed above.
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Other than nausea, I found the anti-emetic maropitant (Cerenia) to be very helpful with loss of appetite, restlessness and it even helped Foyi during his short bout of pancreatitis. The impact on restlessness was very remarkable, around an hour after taking it, he would stop being restless and have much better appetite and sleep and 24-36 hours after stopping it, the symptoms would start again.

I now always keep some maropitant handy as it seems to have analgesic effects too.
 
So if she starts showing those signs of nausea again, you should keep Cerenia or Ondansetron on hand. I think your vet would give you some because of the past pancreatitis.
 
Cerenia also has anti-inflammatory properties in the GI tract, which makes it useful for pancreatitis. Some cats with chronic pancreatitis need a daily dose of Cerenia for maintenance.
 
Suzanne & Darcy said:
It’s okay if you feel more comfortable holding the 1 unit dose a little longer. You know me, I’m not going to freak out on you if you don’t! She’s your baby. It definitely looks like something has been going on with Charly. At the last vet visit, her teeth were checked, correct? When she eats, she doesn’t turn her head to the side frequently, does she? Has she been outside catching anything?
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shes outside a lot these days as she seems generally to be feeling pretty good. i don't *think* shes caught anything lately because she has always brought her catches back home and she definitely hasn't done that in the last few days. yes teeth checked at last visit and yes there is some dental issue going on. and yes she turns her head to the side sometimes.
 
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Suzanne & Darcy said:
The teeth grinding is a strange sound they make when they don’t feel well — it’s kind of like the cat is chattering its teeth.You will think it’s strange if you hear it.
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yes i've heard it. she does that too when she is not eating. i was wondering what it is? i could never work it out. is it a grinding or a chattering?!
 
DavidJ said:
yes. all of these. what is that teeth grinding?!
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I have not experienced the teeth grinding with Kobe. He just did the first 3 things on the list. The Maropitant Citrate helped with the nausea so that I could rub a little appetite stimulant in his ear. The appetite stimulant should not be given to a nauseated cat. The Maropitant Citrate is very bitter and can cause drooling and frothing at the mouth. Horrible to see any time but particularly when you are trying help kitty to eat. Another member recommended getting tiny empty gel caps to put the Maropitant Citrate into so that Kobe didn't have to taste the bitter pill. Made all the difference. Here's what we bought
 
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Kobe (Dean and Lesley) MO said:
I have not experienced the teeth grinding with Kobe. He just did the first 3 things on the list. The Maropitant Citrate helped with the nausea so that I could rub a little appetite stimulant in his ear. The appetite stimulant should not be given to a nauseated cat. The Maropitant Citrate is very bitter and can cause drooling and frothing at the mouth. Horrible to see any time but particularly when you are trying help kitty to eat. Another member recommended getting tiny empty gel caps to put the Maropitant Citrate into so that Kobe didn't have to taste the bitter pill. Made all the difference. Here's what we bought
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Kobe (Dean and Lesley) MO said:
I have not experienced the teeth grinding with Kobe. He just did the first 3 things on the list. The Maropitant Citrate helped with the nausea so that I could rub a little appetite stimulant in his ear. The appetite stimulant should not be given to a nauseated cat. The Maropitant Citrate is very bitter and can cause drooling and frothing at the mouth. Horrible to see any time but particularly when you are trying help kitty to eat. Another member recommended getting tiny empty gel caps to put the Maropitant Citrate into so that Kobe didn't have to taste the bitter pill. Made all the difference. Here's what we bought
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I always put Cerenia into a size 4 gelatin capsule (as I think I mentioned to David before. It is horribly bitter and will cause terrible drooling (and a mad cat) if they taste it. I can easily get it into the back of my compliant cats’ throats without them tasting it, but I still gel cap it anyway. In fact, there aren’t a lot of meds around here that I don’t put into a gelcap. Everything from Prednisolone to heart medications (an absolute MUST for Clopidogrel) and many other meds. None of them taste nice. I have gelatin capsules from size 2 through 5.The only one I don’t usually gelcap is Ondansetron (a very effective anti-nausea medication) because it’s supposed to be an orally dissolving tablet (but you must be able to put that one in the back of their throats as well because they flavor it with some kind of strawberry vanilla or similar (since the kind I buy is a human med designed to dissolve in the mouth.)
 
I buy my gelatin capsules from Amazon as well. Either the XPRS brand or the Capsuline brand. I don’t know what’s available in the U.K.
 
DavidJ said:
yes i've heard it. she does that too when she is not eating. i was wondering what it is? i could never work it out. is it a grinding or a chattering?!
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It’s not the same as when she’s looking at a bird or vole or chipmunk is it? That would be an excited chatter. The other one is usually done only in relation to food when I have seen/heard it.
 
Suzanne & Darcy said:
I buy my gelatin capsules from Amazon as well. Either the XPRS brand or the Capsuline brand. I don’t know what’s available in the U.K.
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They are both available on amazon UK.

I tried them all and nothing works, I can only give him pills with a syringe/popper. He is such a good boy, I still have all my fingers.
 
fpa said:
They are both available on amazon UK.

I tried them all and nothing works, I can only give him pills with a syringe/popper. He is such a good boy, I still have all my fingers.
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Oh, I definitely use a pill shooter for giving the pills. It’s just easier all around. But I still put the meds into a gelcap. They fit into and shoot out of the pill shooter much more easily.
 
I think you should have gone ahead with the full increase today to 1.25 units. When we are dealing with numbers as high as she’s getting, a little fattening of the dose isn’t going to be enough. Have you tried giving her pain medication (I think the vet gave you Gabapentin?) to see if it makes a difference in her numbers? Otherwise, I would consider taking her back to the vets to see if anything else/new or worsening of something you already know about is happening.
 
Suzanne & Darcy said:
I think you should have gone ahead with the full increase today to 1.25 units. When we are dealing with numbers as high as she’s getting, a little fattening of the dose isn’t going to be enough. Have you tried giving her pain medication (I think the vet gave you Gabapentin?) to see if it makes a difference in her numbers? Otherwise, I would consider taking her back to the vets to see if anything else/new or worsening of something you already know about is happening.
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yes thanks for the nudge. i really appreciate that you tell me when you think i've definitely got something wrong.

i'm thinking at the moment it could be uti? she's been producing very small amounts of urine and also going in unsual places the last few days. i'm going to get a sample to the vet asap and if that's negative will take her in for bloods again.

will increase to 1.25 tonight. we've got gabapentin somewhere but i'm not sure how old it is. does it go out of date? i will look through the cat medicine cabinet.
 
DavidJ said:
yes thanks for the nudge. i really appreciate that you tell me when you think i've definitely got something wrong.

i'm thinking at the moment it could be uti? she's been producing very small amounts of urine and also going in unsual places the last few days. i'm going to get a sample to the vet asap and if that's negative will take her in for bloods again.

will increase to 1.25 tonight. we've got gabapentin somewhere but i'm not sure how old it is. does it go out of date? i will look through the cat medicine cabinet.
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I suppose that depends upon how old it is! If it is a capsule or tablet it should be good for some years. If liquid then, you already know, it doesn’t keep long.
 
Oh, so maybe she does have a UTI. I have been looking for several days at her spreadsheet and it just “looks “ to me like something has been derailing her numbers and progress— so I suspected a health issue. That’s what I was trying to say yesterday. And I think you probably suspected something as well since her cycles were coming along so nicely and then just seemed to go completely wonky.
 
I didn't know what was going on but I was thinking/ hoping it was just her metabolism out of whack after 4 lime green episodes in about 10 days. The last one in particular felt a bit hairy when she was alternating between floppy and vomiting. My best guess was she was bouncing hard from this...
 
DavidJ said:
I didn't know what was going on but I was thinking/ hoping it was just her metabolism out of whack after 4 lime green episodes in about 10 days. The last one in particular felt a bit hairy when she was alternating between floppy and vomiting. My best guess was she was bouncing hard from this...
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Bounces can last for six cycles, although Charly’s past bounces have not lasted that long. I didn’t see any extended bouncing on her spreadsheet because on subsequent cycles she was coming down into better numbers — what I mean is … the last lime green was on March 20, but by the evening of the 22nd she was down into blue and yellow. At the end of that evening she went into black and hasn’t really had anything other than pink, red or black since (except one yellow.)
 
yes, i was thinking she had bounced again on pm cycle of 22nd just as she was clearing the first bounce - iewhen she went from blue to black. that seemed very odd mid cycle. and like you say she has been pink red and black ever since.

and i thought perhaps she had been clearing that bounce since. i was thinking/hoping/(praying!) she would come down after one of yesterdays flat cycles. unfortunately i slept through the second half of last nights cycle!
 
Yup and had it tested. High glucose! Nothing else hugely remarkable apparently, but a few things a bit borderline. Waiting for chance to discuss with vet what those few things might be.
 
Yes it's turning into a very good day for her. Hoping for a gentle rise towards PMPS so I can both shoot the full dose and get a good night's sleep!
 
DavidJ said:
I'm thinking if she's above 150 to give full dose?

Maybe 1 unit if she's 100 - 150?
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Great numbers today! I'd only do a full dose >150 if you are able to monitor her overnight (which wouldn't be fair for either of you).

Personally, I'd try and stall tonight for up to 1 hour in case there is a late rapid rise and if the PS is still <150, I'd shoot 0.5u as I wouldn't want to risk an unmonitored hypo during the night (or be stressed about it!).

Just my take obviously.
 
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