4/14 Fistuk AMPS 130, +2 139, +6 99, +8 133, +10 178 PMPS 167, +3 173, +6 137

[Fistuk & Shelly]

https://www.felinediabetes.com/FDMB...-88-3-5-88-7-130-pmps-65.300032/#post-3264500

Good morning

Fistuk vomited @+7 pm the water and 2mg food I gave him at +3pm.

He got 8mg Cerenia @+7, @+8 40ml SQ +4mg of food.

This morning he's still on a reduced dose - 0.4U. Ate 15g.

He's lethargic but not apathetic. He told me he wanted to come up to our bed. Then I created the tent he likes and he had enough energy to crawl onto Robert's blanket that he loves the fabric.

Waiting for 8am to call our home vet as well as the nearby clinic to ask what could be done. A friend would help us cover the costs.

I'm concerned about his electrolytes blanched getting off with all the vomiting and of ketones.
@Bandit's Mom do you still think I could get by with just doing blood tests and keep him at home, as long as he keeps the food in?

So far it took him a few hours until he vomited.

We stopped the AB 3 cycles ago. Since, he vomited only once during the AM cycle yesterday and once through the PM cycle. But we also gave him less food.

Have. great day

 

[Fistuk & Shelly]

I asked yesterday what the concentration of the buprenorphine was.

I asked the surgery vet for this information, her reply: 0.14 ml of Buprenorphine 0.3mg/ml stretched with a bit of NaCl.

I may get this wrong, but if the recommended dose for this concentration is 0.02ml per kg of body weight his dose should have been 0.07

 

[Bandit's Mom]

We stopped the AB 3 cycles ago. Since, he vomited only once during the AM cycle yesterday and once through the PM cycle. But we also gave him less food.

Looks like he's vomiting less?

The other reason I found for my civvie vomiting was from stomach acid build up from long gap between meals. I used to give famotidine (2mg once every 2 days) and that would help. I needed to give it only one or two doses.

I'm concerned about his electrolytes blanched getting off with all the vomiting and of ketones.
@Bandit's Mom do you still think I could get by with just doing blood tests and keep him at home, as long as he keeps the food in?

You could start with a blood panel and take it from there. That's what I used to do.

 

[Fistuk & Shelly]

Looks like he's vomiting less?

I would say so. And he's only vomiting food, not bile... and strange that he's voting at the same time, @+7

I used to give famotidine (2mg once every 2 days)

That's a good idea!

You could start with a blood panel and take it from there. That's what I used to do.

That's giving me some confidence

Just spoke to our vet. She said that he's still probably in recovery from the surgery and maybe there's a pancrease issue
But she could come so I'll keep you posted

 

[Fistuk & Shelly]

@Bandit's Mom is ringer acetate the same as ringer lactate?

I just noticed that the last SQ our vet gave me has ringer acetate written on it. Is it still ok to give?

Vet suggest 40ml SQ every 6 hours.

 

[Bandit's Mom]

I just noticed that the last SQ our vet gave me has ringer acetate written on it. Is it still ok to give?

No, the two are different. A google search tells me that one has acetate and the other has lactate. Not sure if they are replaceable. From a Google Search:
"Ringer's lactate and Ringer's acetate are intravenous crystalloid solutions used to restore fluid and electrolyte balance, but they differ in their composition and metabolic effects. Ringer's lactate contains lactate, which is metabolized by the liver, while Ringer's acetate contains acetate, which is metabolized in both the liver and peripheral tissues. Ringer's acetate is preferred in some clinical situations, such as liver dysfunction or when a more rapid metabolism of the anion is desired."

Vet suggest 40ml SQ every 6 hours.

This is way too much fluids! I would do 50ml twice a day for now. He is what 4.5-5 kgs?

 

[Fistuk & Shelly]

He is what 4.5-5 kgs?

he is not down to 3.5kg!

The vet was just here. She gave him 60ml SQ. Last time he had SQ was +7pm, 40ml. So that's 6 hours ago.

She also recommended 8mg Cerenia every 24h, not 12h like @Wendy suggested - what's your experience?

She gave me food to give him that cats like, it's liquid and she suggest that it's best he eats something and has something in his stomach but she said she doesn't know if it works for diabetes.
I checked the analytics and it looks like 36%
ash 0.8%
fat 4.5%
fiber 0.3%
protein 4.1%
moisture 84.7%

I said I'll keep it and let her know or I give it back if I don't use it.

She suspects pancreatitis. She said that according to the head CT the surgery vet conducted he had (middle I think) ear infection. She reckons he'll need AB, that his immune system is not strong enough to fight it by itself

 

[Bandit's Mom]

She gave me food to give him that cats like, it's liquid and she suggest that it's best he eats something and has something in his stomach but she said she doesn't know if it works for diabetes.

What is the name of the food? Has he vomited today? Don't change too many things at once or you won't know what works. I would keep up the probiotics, Ondansetron/Cerenia, subq fluids (not as much as suggested by your vet) and try Famotidine.

I know how hard it is! Bandit had a kidney infection in 2021 and she refused to eat after vomiting for 36 hours after getting that wrong dose of Clavamox. For days, if not weeks, we were constantly shoving stuff in her mouth - Ondansetron, Famotidine, B vitamins, etc - it felt like we were torturing her. She also hated the subq fluids. It felt like it took forever, but she made a full recovery.

Keep a different food that you syringe feed and a different food to offer him to eat on his own. They invariably get put off by the food they eat when they are seriously unwell.

 

[Fistuk & Shelly]

What is the name of the food?

Don’t remember and I’m at work. But I think you’re right and I didn’t want to give it bc of that reason so I’ll keep it off and as you suggested look for a different food for him so he’s not out off by the ine he’s vomited

no vomiting today!! Paws crossed

Famotidine

What is this? Do I need the vet to prescribe? And what is the proper dose?

do you give cerenia every 12 or 24 hours?

why do you think giving 40-60ml SQ every 6 hours is too much?

I know how hard it is! Bandit had a kidney infection in 2021 and she refused to eat after vomiting for 36 hours after getting that wrong dose of Clavamox. For days, if not weeks, we were constantly shoving stuff in her mouth - Ondansetron, Famotidine, B vitamins, etc - it felt like we were torturing her. She also hated the subq fluids. It felt like it took forever, but she made a full recovery.

Thank you for sharing that. It’s very helpful to here because yes it feels like we’re the Turing him when he just wants to retreat to sleep and he’s so weak. He’s giving a good fight


thank you for your support and guidance. As always you’re saving us when it feels like we’re about to drown here.

I feel very encouraged after the vet visit. she managed to draw enough blood. We’ll have the results tomorrow and we can take it from there.
She said that for the pancreatitis there’s nothing much to do besides giving the

 

[Bandit's Mom]

no vomiting today!! Paws crossed

That's great! Paws and everything crossed that it was the antibiotic causing the vomiting and he stops now. How is his appetite?

What is this? Do I need the vet to prescribe? And what is the proper dose?

Famotidine is for acidity. If he is no longer vomiting, then don't worry about giving it.

do you give cerenia every 12 or 24 hours?

We don't have this in India, so I have no clue about it. Will tag @Wendy&Neko for advice.

why do you think giving 40-60ml SQ every 6 hours is too much?

That is a lot of fluids for a 3.5 kg cat! Fluids have to be processed by the kidneys and can put additional strain on them. You don't want overhydration. I would not give more than 100ml a day. You could break that up into 50ml twice a day.

She said that for the pancreatitis there’s nothing much to do

Often it is just managing the symptoms/episodes. Have you seen this primer on pancreatitis?
https://www.felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.79693/

 

[Fistuk & Shelly]

That's great! Paws and everything crossed that it was the antibiotic causing the vomiting and he stops now. How is his appetite?

Not great. or none existence. He's politely not refusing syringe feed every two hours

That is a lot of fluids for a 3.5 kg cat! Fluids have to be processed by the kidneys and can put additional strain on them. You don't want overhydration. I would not give more than 100ml a day. You could break that up into 50ml twice a day.

aha ok!! will do

Often it is just managing the symptoms/episodes. Have you seen this primer on pancreatitis?
https://www.felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.79693/

I have but I've just gone over it again....

I was thinking about asking the vet for a B12 injection. Fistuk has been receiving 5mg B12 methyl more or less since diagnosed. You recommended it to me and we were on it immediately and we saw quite immediate change in his neuropathy. There were times I felt he needed 10mg a day and we decreased we it looks unnecessary anymore.
So perhaps we should consider giving him a shot because of the anemia? I think the vet said today that the anaemia is not so concerning

For pain - should I continue giving the metamizol? there's now chance in the world that I'm using dupe again! Metamizol worked well for him and I can certainly see he's in pain

Appetite stimulant - Martizapin never worked for him. Tried in the past after DKA, tried now again it doesn't move the needle an inch :/


Bhooma, do you think we should still give him a reduced dose tonight?
I think I'm inkling to, because the last thing I need now is to manage lime episode....

I haven't slept now for three night so we need to factor that as well. Last night I set the alarm to wake up at 2am (+7) to test and feed him and I now recollection of shutting the thing off! I woke up because Fistuk had a vomiting internal clock of vomiting at 2am and 2pm

 

[Staci & Ivy]

Oh Shelly I am glad you saw the vet but so sorry to read Fistuk is still struggling and you are managing with little sleep. It's so very hard to do with no sleep.
I am praying for you both to stay strong and help him recover and gain back his strength!

Sending lots of love and healing vines!

 

[Fistuk & Shelly]

Shall I go back to 0.7U?
@tiffmaxee @Wendy&Neko @Angela & Cleo @Bandit's Mom

 

[Fistuk & Shelly]

Oh Shelly I am glad you saw the vet but so sorry to read Fistuk is still struggling and you are managing with little sleep. It's so very hard to do with no sleep.
I am praying for you both to stay strong and help him recover and gain back his strength!

Sending lots of love and healing vines!

Thank you, Staci

 

[Bandit's Mom]

Shall I go back to 0.7U?
@tiffmaxee @Wendy&Neko @Angela & Cleo @Bandit's Mom

Yes. I think you can.

 

[Fistuk & Shelly]

Update:
First day without vomit
Fistuk is very weak. He hasn't yet peed today.
Had a total of 100mlSQ for AM cycle
His nose is pink again, rather than ghost white
He's on 4gm Ondansetron every 6 hours.
I haven't given Cerenia after 12 hours (last dose was +7PM last cycle). The vet was pretty certain about 24 hours dose and in light of the latest incident I chose safety over anything else

I hope someone can advice on the dose, I'm really in two minds about it

 

[Fistuk & Shelly]

Yes. I think you can.

THANK YOU
First day without vomit

 

[Helen + Noogi]

Very pleased to hear Fistuk hasn't vomited today. That should give him the opportunity to build up his strength a bit.
I know you are doing everything to can for him. Sending love and healing vines to you all

 

[Charlie'sMom22]

I’m so relieved to hear he hasn’t vomited today and that his nose is pink again. Sending more healing vibes and hugs. C’mon Fistuk!!

 

[Bandit's Mom]

First day without vomit

What a relief! Anti-jinx!

 

[Fistuk & Shelly]

What a relief! Anti-jinx!

YES! And... new problem - he's drooling. He had some drooling at +6 when DH gave food and Ondansetron. It then stopped quickly.
He started drooling supper. He got another dose of Ondasetron.

I just gave him 8mg of Cerenia. He's still drooling a bit. He really really doesn't want to eat. After one or two syringes his breathing becomes heavy and faster

 

[Wendy&Neko]

I asked the surgery vet for this information, her reply: 0.14 ml of Buprenorphine 0.3mg/ml stretched with a bit of NaCl.

I may get this wrong, but if the recommended dose for this concentration is 0.02ml per kg of body weight his dose should have been 0.07

Doing the math 0.14 ml x 0.3 mg/ml = 0.042 mg of buprenorphine is what he got. So that's less than 0.07. The recommended dose is in mg per kg.

Dosing for cats is 0.01 to 0.04 mg per kg of cat. I think you said he's 3.5 kg? So that is 0.035 to 0.14 mg would be the range for Fistuk. He got on the low end of that range.

For Cerenia, dosing is every 24 hours.

 

[Wendy&Neko]

On your post of yesterday, I said the following:

Your Cerenia dose is too low. You can give 2 mg/kg per day.

I know you are feeling a lot of stress and worry now. Take a deep breath, and take your time when reading. Fistuk is counting on you.

 

[Fistuk & Shelly]

On your post of yesterday, I said the following:

I know you are feeling a lot of stress and worry now. Take a deep breath, and take your time when reading. Fistuk is counting on you.

Thanks for your care.
Thank you for your help

 

[Fistuk & Shelly]

For Cerenia

Wendy, could it be possible that the drooling is a reaction to the Cerenia?
Last summer he caught a virus and a vet gave him Cerenia injection. He had Cerenia tablets before and didn0t have any reaction to them. But the Cerenia injection triggered an ongoing drooling that stopped only after I stopped the Cerenia.

 

[cecile & bella]

I am happy to read that he is showing some improvement, I hope the drooling will stop soon too. You must be exhausted.
I am thinking about you a lot

 

[Fistuk & Shelly]

I am happy to read that he is showing some improvement, I hope the drooling will stop soon too. You must be exhausted.
I am thinking about you a lot

Thank you, Cecile

 

[Laurie&Petey]

Very glad to read he's making progress. You're both fighting very hard to get to the other side of this.

 

[Wendy&Neko]

Wendy, could it be possible that the drooling is a reaction to the Cerenia?

How did you give the Cerenia? It is bitter and can cause foaming if they taste it. I always gave in a gel cap, or now I'm using transdermal maropitant. Excess drooling is listed as a possible side effect from what I can see. But not something I've personally seen. Seems to be more a dog thing.

Drooling is also a sign of nausea.

 

[Fistuk & Shelly]

How did you give the Cerenia?

I give it always in a syringe of food so he doesn't taste it.

Drooling is also a sign of nausea.

I didn't know that. That makes more sense. When he drooled as a side effect to the Cerenia injection is was non stop and quite bad

 

[Fistuk & Shelly]

Poor Fistuk just vomited. By the quantity it looks like the food I gave him @+8.5.
He's now completley exhausted. At least he managed to keep the food yesterday the whole day

I hope that the blood results will through early this morning

 

[Fistuk & Shelly]

Poor Fistuk just vomited. By the quantity it looks like the food I gave him @+8.5.
He's now completley exhausted. At least he managed to keep the food yesterday the whole day

I hope that the blood results will through early this morning

Bhooma, shall I give him reduced dose again?
I don't know how much food I'll be able to give him right after he vomited. But now I'm really concerned about ketones but I don't have a blood meter to test and he hasn't peed since yesterday morning
@Bandit's Mom

 

[Wendy&Neko]

How long ago since he last showed ketones?

 

[Fistuk & Shelly]

He had a total of 60g of food yesterday AM + PM cycle which is a total of

How long ago since he last showed ketones?

Sep 4 2023

 

[Fistuk & Shelly]

He had a total of 60g yesterday (AM & PM cycle) which amounts to 578 cal - normally he gets about 105g a day, 935 cal