? 03/20 Raven AMPS 322 +3 257 +6 165 +8 214 - Upcoming Ultrasound/fasting

[SophieFRA]

Hi all, the higher numbers on same dose (1.75 u) continue with AMPS at 322 today. Still assuming this is due to increased appetite and food intake of new frozen raw duck food. My tentative plan is to increase to 2us on Wednesday morning which would be 7 days after dose reduction. However I won't be able to do a full curve before that because I'll be at work. But I've been gathering a lot of data throughout the day over the last few days and it seems pretty safe unless his appetite is hampered again. Any thoughts on this?

Still battling diarrhea although bowel movements have definitely slowed down and there is the slightest hint of shape to them. I started adding slippery elm yesterday, in addition to increasing the Jarrow probiotic supplement. (1 capsule for breakfast and dinner and 1 capsule split up between snacks during the day).

I received a call from Raven's vet today and they asked me to drop him off Friday morning 7:30 am EDT for an abdominal ultrasound. They said he has to fast for 12 hours and that they would recommend giving him half of his normal does of Lantus in the am before dropping him off. Is that in line what you'd recommend. No concerns here? Thank you! @Margaret (and Pearl) @Chris & China (GA) @Bandit's Mom?


https://www.felinediabetes.com/FDMB/threads/319-raven-amps-305-2-258-4-253-6-248-pmps-287.275473/

 

[Bandit's Mom]

However I won't be able to do a full curve before that because I'll be at work. But I've been gathering a lot of data throughout the day over the last few days and it seems pretty safe unless his appetite is hampered again. Any thoughts on this?

A curve is suggested for caregivers following SLGS who cannot get more than preshot tests and the rare spot check. You are testing more than enough to know how low this dose is taking him. He looks good for a dose increase on Wednesday - unless he responds to the threat of a dose increase, which cats here have been known to do!

I received a call from Raven's vet today and they asked me to drop him off Friday morning 7:30 am EDT for an abdominal ultrasound. They said he has to fast for 12 hours and that they would recommend giving him half of his normal does of Lantus in the am before dropping him off. Is that in line what you'd recommend. No concerns here?

What time does he get insulin? How does the vet expect a diabetic cat on insulin to be fasted 12 hours? I am also wondering about the shot for the previous night.

 

[Wendy&Neko]

I've had 3 cats now who have had ultrasounds for GI issues. The diabetic one, Neko, was not fasted. Partly because decision was made morning of visit to give a U/S. Follow up ultrasounds she also was not fasted. She also had full dose because she had eaten. I would call the vet clinic back again, remind them Raven is diabetic, and ask if there is a different protocol for feeding before with diabetics. There should be. If fasted, a half dose of insulin is pretty standard.

Another probiotic that's good is Visbiome - it's formulated for IBD. It's a general probiotic. Is the Jarrow the s. boullardi?

 

[SophieFRA]

I've had 3 cats now who have had ultrasounds for GI issues. The diabetic one, Neko, was not fasted. Partly because decision was made morning of visit to give a U/S. Follow up ultrasounds she also was not fasted. She also had full dose because she had eaten. I would call the vet clinic back again, remind them Raven is diabetic, and ask if there is a different protocol for feeding before with diabetics. There should be. If fasted, a half dose of insulin is pretty standard.

Another probiotic that's good is Visbiome - it's formulated for IBD. It's a general probiotic. Is the Jarrow the s. boullardi?

Yes that‘s the one. I did remind the vet that he‘s diabetic and that‘s what they told me in response to that. Regular shot with food pm, no food after 10pm and half a dose without food in the morning. So you would not recommend fasting him? It‘s making me very nervous. Thank you!

 

[SophieFRA]

A curve is suggested for caregivers following SLGS who cannot get more than preshot tests and the rare spot check. You are testing more than enough to know how low this dose is taking him. He looks good for a dose increase on Wednesday - unless he responds to the threat of a dose increase, which cats here have been known to do!


What time does he get insulin? How does the vet expect a diabetic cat on insulin to be fasted 12 hours? I am also wondering about the shot for the previous night.

He gets insulin at 6:45 am and pm. Yes I expressed by concerns but the vet said there should be no food in stomach for ultrasound. It‘s making me nervous…

 

[Bandit's Mom]

He gets insulin at 6:45 am and pm. Yes I expressed by concerns but the vet said there should be no food in stomach for ultrasound. It‘s making me nervous…

I had to take Bandit for an ultrasound once and the vet didn't insist on fasting. In Raven's case, I would not fast for 12 hours because that would mean that he doesn't get food after his PM shot. Even for dentals, one doesn't fast 12 hours. I would shoot tonight and feed him for the first 4 hours of the cycle. I'm sure, an 8-9 hour fast is more than enough.

Do you have any idea when they will be done in the morning? I'm not sure I would give him insulin in the morning without food.

@Wendy&Neko

 

[Wendy&Neko]

Did you talk to the vet in person, or the front desk person? More than once I had to ask the front desk staff to go back and talk to the vet and remind him/her that Neko was diabetic. Then the instructions changed.

If no food in the AM, you could do a half dose, but timing of when the procedure will happen is important. Neko had a late onset and nadir, even more so on Levemir, so I could get her in and scoped and back home before the shot took effect. So I had no problem giving full dose. She also ate raw which is processed pretty quickly. Looks like Raven onset's sometime between +2 and +3, so with a 6:45 shot time, so full dose wouldn't work for you. Since Raven has gotten down to 101 on this dose, I wouldn't shoot full dose in the AM.

It also depends whether the vet thinks they might have to sedate or do anaesthesia - if kitty is fractious. Neko had a bit of "attitude" at vetty, but never had to be completely put under. If anaesthesia is needed, then yes on reduced food.

Since shot time is 6:45, I think you'd have no problem even feeding up to midnight. Most vets are OK with that instead of 10pm. The question is what do do in the AM.

 

[Margaret and Pearl (GA)]

@SophieFRA I would call and ask vet in general if there is a time the ultrasound technician comes. There is no use fasting him from 8pm night before if sonographer doesn’t come till afternoon of the next day. No idea if your vet will have a guesstimate.

I bet it’s the same traveling sonograoher who comes to Pearls clinic. If so the report will be great. Important to have empty stomach since GI are the issues and need to be able to be imaged.

For us, sonograoher usually comes right at 8am. So I feed Pearl her last meal 8-10pm. 10 latest. I don’t drop her off. I wait in car and by 9:30 she is back with me.

If Raven eats at 6:45pm, then you can feed him till 10 easily, and that’s for an expected early arrival by sonograoher. I usually skip Pearls AM insulin, but she responds very very easily from a skipped dose. I know some people shoot partial but I don’t feel comfortable doing that without food on board. The night before I do give the full dose. If Raven has early NADIRs this will probably also be ok. But I defer to others totally on shooting partials and skipping for the ultrasound prep.

I would also be vigilant finding out when he is finished at the vet. Sometimes they let the ultrasound kitties just sit around which is so irritating.

Does this help?

 

[SophieFRA]

Did you talk to the vet in person, or the front desk person? More than once I had to ask the front desk staff to go back and talk to the vet and remind him/her that Neko was diabetic. Then the instructions changed.

If no food in the AM, you could do a half dose, but timing of when the procedure will happen is important. Neko had a late onset and nadir, even more so on Levemir, so I could get her in and scoped and back home before the shot took effect. So I had no problem giving full dose. She also ate raw which is processed pretty quickly. Looks like Raven onset's sometime between +2 and +3, so with a 6:45 shot time, so full dose wouldn't work for you. Since Raven has gotten down to 101 on this dose, I wouldn't shoot full dose in the AM.

It also depends whether the vet thinks they might have to sedate or do anaesthesia - if kitty is fractious. Neko had a bit of "attitude" at vetty, but never had to be completely put under. If anaesthesia is needed, then yes on reduced food.

Since shot time is 6:45, I think you'd have no problem even feeding up to midnight. Most vets are OK with that instead of 10pm. The question is what do do in the AM.

Thank you so much for this detailed response. I spoke to the vet directly. She is not my usual vet at this practice but she‘s the one who saw Raven when I took him in for a last minute appointment two weeks ago after his first serious bout of diarrhea and vomiting. So they said she has to schedule it. She‘s a little more laissez faire than my preferred vet but definitely still considerate. She said she didn‘t know what time the sonographer would be in but I definitely will follow up to clarify that and to scoop him as soon as he‘s done.

Raven is an absolute angel so I doubt they will have to sedate. He‘s so sweet and patient.

 

[SophieFRA]

@SophieFRA I would call and ask vet in general if there is a time the ultrasound technician comes. There is no use fasting him from 8pm night before if sonographer doesn’t come till afternoon of the next day. No idea if your vet will have a guesstimate.

I bet it’s the same traveling sonograoher who comes to Pearls clinic. If so the report will be great. Important to have empty stomach since GI are the issues and need to be able to be imaged.

For us, sonograoher usually comes right at 8am. So I feed Pearl her last meal 8-10pm. 10 latest. I don’t drop her off. I wait in car and by 9:30 she is back with me.

If Raven eats at 6:45pm, then you can feed him till 10 easily, and that’s for an expected early arrival by sonograoher. I usually skip Pearls AM insulin, but she responds very very easily from a skipped dose. I know some people shoot partial but I don’t feel comfortable doing that without food on board. The night before I do give the full dose. If Raven has early NADIRs this will probably also be ok. But I defer to others totally on shooting partials and skipping for the ultrasound prep.

I would also be vigilant finding out when he is finished at the vet. Sometimes they let the ultrasound kitties just sit around which is so irritating.

Does this help?

Thank you so much Margaret! Super helpful as always. They couldn‘t give me more detail on timing but I‘ll follow up tomorrow and/or Thursday to get more details.