01/29 Lucifer AMPS 400 +1 440 +7 321 +8 315

Red83

Member Since 2023
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Hey all, sorry for the delay on this update. It's been a harrowing few days and I finally feel like I can breath a little.

I think we might be out of the woods (although I have felt that before). We have progressively unearthed more and more underlying issues, starting with diabetes, culminating now in diabetes, asthma, epilepsy, tongue ulcers, and possibly pneumonia. We have been to the ER 4 times and the vet 6 times in the past month.

After a new Libre install 01/25, the monitor never worked properly so I rushed to get another installed 01/26. He stopped eating 01/25 and when he came home from the ER 01/27, he was so weak he could barely stand, and could not walk at all. I pumped him full of fluids and food day and night, and very thankfully he woke up, left off the bed, and made a mad dash for the food bowl yesterday morning when he finally began eating on his own again. Yesterday he ate 2x the protein and calories in a day than before he was sick!

I think that tongue ulcers were the primary culprit behind his not eating because the 1st time he ate again was after the Ondansetron, Mirtazapine, and Cerenia had worn off. (But it's good to have them on hand and they may have helped us anyway.)

Some lessons learned which you all might already know but were new to me:
  • Ondansetron and Cerenia can be given together. They have different mechanisms of action.
  • Convenia was offerred by the vet (1-2 week antibiotic one-time injection) and after reading on the internet, that was a huge gamble and probably should be avoided in the future (actually lasts 6-8wks and if something goes seriously wrong, no plan B)
  • Make the vet look in his mouth if he's not eating. Maybe the ulcers could've been spotted sooner.
  • When syringe feeding, it is easier to blend the food with as little water as possible (as long as it gets to milkshake consistency). Then when you are filling syringes, jam the tip of the syringe into the bottom of the container of blended food repeatedly while pulling on the syringe plunger to fill it easier.
  • If your cat is non-compliant or averse to injections or home testing, ask your vet about using low doses of gabapentin and completely changing your routine to train a more positive experience. The first night I tried home testing, he was very aggitated when I touched his ears at all, but with gaba by the next day I could home test him anywhere, anytime, without him seeming to care at all.
  • Your mileage may vary but my cat seems to make strong associations between places and negative events pretty easily (1 or 2 negative events), which made it really hard to feed him. So I started doing negative things (giving him meds he doesn't like) and syringe fedding in 1. locations he never sleeps/we never interact in like the hall, and/or 2. changing the location every time.
  • Edit: After thorough research of apps for tracking his insulin, BG, food, meds, and other notes (with pretty charts), Diabetes:M has turned out to work really well, be free, and be able to import/export data from Libre, Apple Health, etc.
Hope we have all the underlying issues figured out and it's smooth sailing.
 
Last edited:
Yesterday

Hey all, sorry for the delay on this update. It's been a harrowing few days and I finally feel like I can breath a little.

I think we might be out of the woods (although I have felt that before). We have progressively unearthed more and more underlying issues, starting with diabetes, culminating now in diabetes, asthma, epilepsy, tongue ulcers, and possibly pneumonia. We have been to the ER 4 times and the vet 6 times in the past month.

After a new Libre install 01/25, the monitor never worked properly so I rushed to get another installed 01/26. He stopped eating 01/25 and when he came home from the ER 01/27, he was so weak he could barely stand, and could not walk at all. I pumped him full of fluids and food day and night, and very thankfully he woke up, left off the bed, and made a mad dash for the food bowl yesterday morning when he finally began eating on his own again. Yesterday he ate 2x the protein and calories in a day than before he was sick!

I think that tongue ulcers were the primary culprit behind his not eating because the 1st time he ate again was after the Ondansetron, Mirtazapine, and Cerenia had worn off. (But it's good to have them on hand and they may have helped us anyway.)

Some lessons learned which you all might already know but were new to me:
  • Ondansetron and Cerenia can be given together. They have different mechanisms of action.
  • Convenia was offerred by the vet (1-2 week antibiotic one-time injection) and after reading on the internet, that was a huge gamble and probably should be avoided in the future (actually lasts 6-8wks and if something goes seriously wrong, no plan B)
  • Make the vet look in his mouth if he's not eating. Maybe the ulcers could've been spotted sooner.
  • When syringe feeding, it is easier to blend the food with as little water as possible (as long as it gets to milkshake consistency). Then when you are filling syringes, jam the tip of the syringe into the bottom of the container of blended food repeatedly while pulling on the syringe plunger to fill it easier.
  • If your cat is non-compliant or averse to injections or home testing, ask your vet about using low doses of gabapentin and completely changing your routine to train a more positive experience. The first night I tried home testing, he was very aggitated when I touched his ears at all, but with gaba by the next day I could home test him anywhere, anytime, without him seeming to care at all.
  • Your mileage may vary but my cat seems to make strong associations between places and negative events pretty easily (1 or 2 negative events), which made it really hard to feed him. So I started doing negative things (giving him meds he doesn't like) and syringe fedding in 1. locations he never sleeps/we never interact in like the hall, and/or 2. changing the location every time.
  • Edit: After thorough research of apps for tracking his insulin, BG, food, meds, and other notes (with pretty charts), Diabetes:M has turned out to work really well, be free, and be able to import/export data from Libre, Apple Health, etc.
Hope we have all the underlying issues figured out and it's smooth sailing.
I will tag some members for you

@Bron and Sheba (GA)

@tiffmaxee

@Suzanne & Darcy
 
  • Ondansetron and Cerenia can be given together. They have different mechanisms of action.
  • Convenia was offerred by the vet (1-2 week antibiotic one-time injection) and after reading on the internet, that was a huge gamble and probably should be avoided in the future (actually lasts 6-8wks and if something goes seriously wrong, no plan B)
  • Make the vet look in his mouth if he's not eating. Maybe the ulcers could've been spotted sooner.
  • When syringe feeding, it is easier to blend the food with as little water as possible (as long as it gets to milkshake consistency). Then when you are filling syringes, jam the tip of the syringe into the bottom of the container of blended food repeatedly while pulling on the syringe plunger to fill it easier.
  • If your cat is non-compliant or averse to injections or home testing, ask your vet about using low doses of gabapentin and completely changing your routine to train a more positive experience. The first night I tried home testing, he was very aggitated when I touched his ears at all, but with gaba by the next day I could home test him anywhere, anytime, without him seeming to care at all.
  • Your mileage may vary but my cat seems to make strong associations between places and negative events pretty easily (1 or 2 negative events), which made it really hard to feed him. So I started doing negative things (giving him meds he doesn't like) and syringe fedding in 1. locations he never sleeps/we never interact in like the hall, and/or 2. changing the location every time.
Thank you for your input. I am glad that Lucy is improving.

I would not stop the Ondansetron yet. I would continue it for a bit longer. I know you think it was the tongue ulcer, but the Ondansetron is most likely helping. Most post DKA kitties have some nausea…some more than others.
Edit: After thorough research of apps for tracking his insulin, BG, food, meds, and other notes (with pretty charts), Diabetes:M has turned out to work really well, be free, and be able to import/export data from Libre, Apple Health, etc.
I don’t understand this statement.

I know you reduced the dose on night of 1/28 because you needed to sleep but chopping and changing the dose will only mess with the BG numbers. Lantus likes consistency…Because he was bouncing from the low green BGs in the am cycle, it was most unlikely he would drop low. Also with a recent history of DKA we don’t want to be giving reduced doses of insulin unless it is warranted by a reduction earned.
If you are unsure, or need to sleep, I would post and ask for advice.
It is great you are getting negative ketones in the urine.
Because of the recent history of DKA you need to be feeding lots of snacks during the day and evening as well as the 2 main meals.

I also note that in the signature you say you are feeding 27% carbs wet food. Is that correct?
 
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Hey Bron, thanks for all your good points about Ondansetron, etc.!

RE: "I don’t understand this statement." -- I track my cat's diabetes, food intake, etc. using a smartphone application on my iPhone called Diabetes:M. I spent 5+ hours researching and trying different applications which all seemed to have their flaws, so I thought I'd share since I finally found a gem. I am a techie so maybe I was looking for features others aren't interested in (like automation, so I don't have to manually enter in BG values from my monitor).

That one-time reduction was a bit of a special case. I did not want to reduce his dose, and I was (too much really) aware that it would cause fluctuations in his BG. Unfortunately, my sleep deprivation has been one of the primary causes in the degradation of his health and mine, and he has a tendency to hit low numbers at night which leads to serious loss of sleep. Factoring in the dose time moving up 45 minutes and the transition to very low carb foods, it was clear at the time that a small reduction was best for us. Thanks for pointing out the bounce. I hope things become more stable quickly for the sake of all of our health!

My signature/his food is outdated. Thank you for asking! I have fed 5+ different foods just to get him to eat, and despite 10+ hours of research haven't found a food to feed him regularly. I'll update it to something that hopefully makes sense.
 
My signature/his food is outdated. Thank you for asking! I have fed 5+ different foods just to get him to eat, and despite 10+ hours of research haven't found a food to feed him regularly. I'll update it to something that hopefully makes sense.
Are you still giving Ondansetron?
 
Yes, when I saw your post about continuing to give it, I started him back up on it. I think I may pick up some Mirtaz too. His wet cough seems to be related to not wanting to eat too. I hope the antibiotics work (I think that’s what they use for pneumonia). His appetite isn’t what it was the 1st day eating again, so sage advice.
 
OK, thanks for letting me know! I have an appointment Thursday. On your recommendation I will contact them today to ask if we should come in more urgently.

He had a cough at the ER and the vet asked if it was new. I said he had a cough for weeks so no, but when I got him home and heard him cough I realized the cough being WET was new. I called the vet back and the tech was not all that helpful (“you can always bring him back in for a recheck”). Last time we discussed pneumonia about 01/02 I believe they said we try antibiotics, which we did go ahead and give him 01/27, so it could be a matter of painfully waiting to see the effects kick in.
 
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