1/19 Asia AMPS 477, +3.75 479 PMPS 349

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Stacy & Asia

Stacy & Asia

Member Since 2017
http://www.felinediabetes.com/FDMB/threads/1-18-asia-no-shot-12-79-1-25-104.189804/

Skipped shot last night, Asia isn’t eating reliably still, just a bite here or there, pretty sure she is nauseous. Waiting for vet office to open in an hour. Don’t want to skip another shot, but not sure what to shoot since food is an issue. It could take hours, if not days to get this number down with Lantus, or she could dive and it could be a low number within a few hours.

Dose recommendations welcome.

Surprisingly she did eat most her overnight food.
 
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I'm not sure about the dose. Hopefully you can get something from the vet that will help her be able to eat. If you have to shoot late, can you work your schedule back? Maybe you can shoot after you hear from the vet. Sending prayers.
 
Amy&TrixieCat said:
Many vetty vines for sweet Asia....it is a good sign that she ate well overnight! We'll be watching for updates....feel better, Asia!
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Thanks!

I’m hoping she did, although it would be odd considering her not finishing one bowl of food yesterday or again so far today. Civvie *could* have eaten her food, but I’ve never seen Toki go near it before. They do eat the same food.
 
Gill & George said:
Like Amy I am hoping that eating her food overnight is a good sign.

Sorry I only saw this now. FWIW good job on shooting the 1u.:bighug::bighug::bighug:
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Thanks, Gill! I couldn’t leave her that high, it’s been ages since I skipped a shot but I’m pretty sure her pancreas is toast and I wasn’t hopeful to see anything other than a black number this morning, honestly. Now I just hope she doesn’t do anything tricky and instead comes down slowly.

With sleep and the gift of hindsight, I now see why I struggled so much with her numbers yesterday. It took a bit to sink in that she wasn’t really eating because when they look like they are eating, or eat a bite and trying to eat, frequently, it’s not as obvious as just refusing to eat. All I know is I threw away a ton of her food yesterday and that is not typical at all these days. It may take her an hour or two to eat her food, but I rarely end up throwing any out.

Waiting for a return phone call from vet, they opened 50 minutes ago but he wasn’t in yet.
 
When cats aren't eating, it's usually OK to give them "some" insulin. Vets typically recommend a half dose for cats being fasted for anesthesia. Insulin is used for more than just countering carbs in food. However, if you do shoot anything, there's a good chance you'll have to monitor, so good choice last night. You both probably needed the sleep. Asia will come down. :bighug: Test for ketones when you can. When Neko was off her food, I would typically give full dose, unless she was dancing lower numbers, cause I could always syringe feed. And sometimes I would just plain offer higher carb food. I know you have problems with getting into Asia's mouth, so that's not as much an option for you.
 
Wendy&Neko said:
When cats aren't eating, it's usually OK to give them "some" insulin. Vets typically recommend a half dose for cats being fasted for anesthesia. Insulin is used for more than just countering carbs in food. However, if you do shoot anything, there's a good chance you'll have to monitor, so good choice last night. You both probably needed the sleep. Asia will come down. :bighug: Test for ketones when you can. When Neko was off her food, I would typically give full dose, unless she was dancing lower numbers, cause I could always syringe feed. And sometimes I would just plain offer higher carb food. I know you have problems with getting into Asia's mouth, so that's not as much an option for you.
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She might eat a bowl full of FF gravy if offered, she won't touch the "meat" in it though. I'm not sure that's better than only eating a couple bites of real food though. If you eat a bowl full of sugar, does that really count as eating?

Will stalk the LB. I offered her a smorgasbord of all the foods I had on hand last night, most MC/HC. I put parm and catnip on various foods. Same response a lick or a nibble and then walk away. think she very much wants to eat and is just nauseous for whatever reason.

Called the vet back, think they forgot about us, hope I will hear back soon.
 
I think I'm also going to ask for a B12 shot, she was not eating well last January and had a host of GI issues and the B12 shot seemed to give her a boost and get her going in a positive direction. Does that seem like a good idea? I know he would only have the cyano and not the methyl and that's not as great for the kidneys, but not eating and being in black and reds also not great for the kidneys. :bookworm:
 
Can she have a shot of Cerenia for her nausea? I didn't know cyanocobalamin was bad for kidneys. I used to give J.D. shots of it weekly. He stayed in stage 2 and didn't get worse.
Did you try all meat baby food?
 
Dyana said:
Can she have a shot of Cerenia for her nausea? I didn't know cyanocobalamin was bad for kidneys. I used to give J.D. shots of it weekly. He stayed in stage 2 and didn't get worse.
Did you try all meat baby food?
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I didn't try meat baby food, but I did try Tiki cat Velvet mousse which is the same consistency as baby food and she likes it. I don't think food choice is the issue, I can tell she wants to eat.

I'm sure cyanocobalamin is fine, I'm just being particular because I would put Asia in the "significantly impaired" category. My statement was made based on a human study:

"Cyanocobalamin is an artificial form of vitamin B12, which has to be converted into methylcobalamin before the body can use it. In the process, a tiny amount of cyanide is produced. This amount of cyanide is so small that it is considered to be harmless, but a human study, B vitamin therapy for homocysteine: renal function and vitamin B12 determine cardiovascular outcomes(2013) Spence JD Clinical Chemistry and Laboratory Medicine51(3) pp633-7, found that "high-dose cyanocobalamin leads to accumulation of cyanide in patients with renal failure. B vitamin therapy is beneficial in patients with good renal function, but harmful in patients with significantly impaired renal function (a glomerular filtration rate <50). It seems likely that in patients with renal impairment, methylcobalamin should be used instead cyanocobalamin."
 
I just got back from the vet, just me this time, Asia didn't have to go. Dr S drew me up a dose of injectable cerenia to take home and give to Asia, which I've done. He can order me a bottle of it to inject at home but it won't come until Tuesday. In the meantime he is getting some compounded for her in a liquid (free of sugar and artificial sweeteners) that should be available tomorrow. Wish me luck on that, my bet is it ends up mostly on me or the wall.

I also got a shot of b12 that I will give her shortly, the cerenia was such a large amount that I wanted to give it a few to dissipate before the b12. I got quick dissolve tabs of ondansetron to give if the cerenia doesn't do the trick. I think I could put it on a dot of gravy and she will eat it up, I don't recall them having much of a taste.

She's eaten one mini meal today, which is great, but by this time, she typically would have had 4-5x that amount. She's sleeping by the head of my bed instead of the foot and she's not purring, both are pretty serious tells that she is not feeling well at all.

Dr S thinks her nausea is because of her kidneys. IF this is nausea at all, could also be teeth stuff, it's hard to tell if the licking is a mouth disturbance or nausea because it's a known issue. Usually, though, when her teeth have bothered her, she paws at her mouth and that isn't happening. And she eats in spite of her teeth bothering her.

Oh, and gold star for me, I was able to speak to the vet on the phone and in person without bursting in to tears. It's an accomplishment! :p
 
Stacy & Asia said:
I just got back from the vet, just me this time, Asia didn't have to go. Dr S drew me up a dose of injectable cerenia to take home and give to Asia, which I've done. He can order me a bottle of it to inject at home but it won't come until Tuesday. In the meantime he is getting some compounded for her in a liquid (free of sugar and artificial sweeteners) that should be available tomorrow. Wish me luck on that, my bet is it ends up mostly on me or the wall.

I also got a shot of b12 that I will give her shortly, the cerenia was such a large amount that I wanted to give it a few to dissipate before the b12. I got quick dissolve tabs of ondansetron to give if the cerenia doesn't do the trick. I think I could put it on a dot of gravy and she will eat it up, I don't recall them having much of a taste.

She's eaten one mini meal today, which is great, but by this time, she typically would have had 4-5x that amount. She's sleeping by the head of my bed instead of the foot and she's not purring, both are pretty serious tells that she is not feeling well at all.

Dr S thinks her nausea is because of her kidneys. IF this is nausea at all, could also be teeth stuff, it's hard to tell if the licking is a mouth disturbance or nausea because it's a known issue. Usually, though, when her teeth have bothered her, she paws at her mouth and that isn't happening. And she eats in spite of her teeth bothering her.

Oh, and gold star for me, I was able to speak to the vet on the phone and in person without bursting in to tears. It's an accomplishment! :p
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Good for you!

I know how disturbing it is when they just stop caring much. Not eating and sleeping in the wrong place, often in the meatball position is just plain heart breaking. However, TiTI came out of it, and so do many kitties. Overcoming the nausea is the big deal here. :bighug::bighug::bighug::bighug:
 
Doodles & Karen said:
Thought I read that she seemed to feel worse after fluids? I know they listened to her heart but did they do a chest X-ray when she was there ?
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He did not, he thinks her heart sounds great and that would be overkill at this point. I’m sure he will do one if I insist. My thing is less I think it’s evident that she has a heart problem that will show up right now and more I feel like these fluids may be on the way to triggering one? She just seems off after fluids and the few times before CKD that she’s needed them, they perked her up a good bit. This is a new and weird breathing thing that comes and goes, but I’ve noticed it after fluids. Dr S isn’t too worried because it isn’t rapid:

 
Stacy & Asia said:
He did not, he thinks her heart sounds great and that would be overkill at this point. I’m sure he will do one if I insist. My thing is less I think it’s evident that she has a heart problem that will show up right now and more I feel like these fluids may be on the way to triggering one? She just seems off after fluids and the few times before CKD that she’s needed them, they perked her up a good bit. This is a new and weird breathing thing that comes and goes, but I’ve noticed it after fluids. Dr S isn’t too worried because it isn’t rapid:

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My cats tend to waddle after fluids, and even though they're feeling better, they thoroughly resent the process. I watched the video, and what it looks like to me is like there might be some pressure on her middle. Was she lying on the side that had the fluids?
 
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prayers from Myagi's home! Feel better soon Asia! :bighug::bighug::bighug:
 
Kathy and TiTi said:
My cats tend to waddle after fluids, and even though they're feeling better, they thoroughly resent the process. I watched the video, and what it looks like to me is like there might be some pressure on her middle. Was she lying on the side that had the fluids?
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The fluids were absorbed at this point, and no, they stay on top right where I put them until they are gone.
 
Stacy & Asia said:
My thing is less I think it’s evident that she has a heart problem that will show up right now and more I feel like these fluids may be on the way to triggering one?
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Yes that is the thought and I've seen it happen to a few members. I wasn't going to bring it up again but since you mentioned Asia seems to feel yucky after the fluids and is having appy issues it triggered my paranoia again. Hopefully she's just a bit off from the busy days you both have had and the cerenia/ B-12 does the trick.

ETA: I really can't tell from the video. I knew Doodles very well especially being hawk eye on him 24/7. His CHF/ HCM was genetic and advanced so obviously I didn't have a clue before his dx.
 
Remember that high phosphorus levels can make them very nauseous. It’s come down a tiny bit but it’s certainly still in the range that can cause nausea.

I’m glad you’ve also got the cerenia and you got to see the vet. It’s good he is responding to your needs in regard to your sweet girl.

Sending tons more vines of every type.
 
Marje and Gracie said:
It’s possible the 1.5u just gave her a swift kick. I was interested in your observations because I often felt the same way about Gracie’s cycles. It was if she was on a mission to get to a specific number no matter how I tried to manage it. I interpreted that’s her depot was just really full.

Sending many vines and white light. I hope she’s better tomorrow. :bighug::bighug::bighug:
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Gracie did that too, huh? Was that alternated with periods of surfing in greens, or did she just take the greens and run downhill with them? Going to look at her SS in a few and answer my own question.

I wish there was a nerdier explanation for this depot stuff. I totally understand how it works on paper and about it filling up. What I don't get, assuming she had an overfull depot, is why so very high after a skipped shot? Can the entire depot be depleted in just a few hours like that? Does it depend on how high/low the dose is how fast it depletes? Or is it a timed situation and her body only grabs so much insulin at set intervals and she just couldn't get enough from the depot to maintain better numbers, like yellows or pinks?

I'm honestly unsure now if 1.5 was too much, I actually think that it was, but uncertain because in light of it taking me several hours to realize she just wasn't eating her normal amount of food, it's not at all surprising the cycle played out like it did. No matter how much momentum, I'm positive yesterday's am cycle was like that because of lack of sustaining food.

Question, was planning to shoot 1.25 tonight assuming she's eating here and there. I don't think she's going to get anywhere close to 50 given that she's at 374 right now, but of course it wouldn't be unheard of. Thoughts?
 
Stacy & Asia said:
What I don't get, assuming she had an overfull depot, is why so very high after a skipped shot?
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She did dip into the 30's perhaps that triggered a delayed bounce which was compounded by the delayed shot?. If she's in discomfort with then that may also be contributing.

Who knows which or if any:confused:
 
Gill & George said:
She did dip into the 30's perhaps that triggered a delayed bounce which was compounded by the delayed shot?. If she's in discomfort with then that may also be contributing.

Who knows which or if any:confused:
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I didn't even consider a bounce, that could be, discomfort also a big factor for sure. I haven't skipped shots in a long time, but almost every single fur shot or skip, black eye! :blackeye:
 
Doodles & Karen said:
It's hard with an off appy. I'd either stay with the 1u for consistency or go back to 1.25 for consistency. Doodles was not a good eater but I was always confident about being able to get something in his mouth with a syringe if needed.
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I’m going with the 1.25 depending on her number.

Even if Asia were lethargic I think she’d muster every ounce of energy she could to fight syringe feeding/pilling/going in her mouth (and she has done). :rolleyes:
 
I just saw you got your labs back. I am so sorry her CKD numbers are worse. I did see huge variability in Yum's CKD labs last fall---one was shockingly bad and the next one much better. Does she drink much water? The subq fluids are so important for the CKD, it's such a complication that you are worrying about her heart. Since Yum has a murmur (which the cardiologist said was nothing), my vet said if Yum needed fluids she would hold her and monitor her heart after their administration (at least the first time). Could they do that to quantify what is happening with Asia? I suppose fluids elevate BP. Best wishes for managing the CKD and the BG and the heart worries all at the same time.
Glad she ate some tiki cat. Cerenia is good stuff.
 
MJW said:
I just saw you got your labs back. I am so sorry her CKD numbers are worse. I did see huge variability in Yum's CKD labs last fall---one was shockingly bad and the next one much better. Does she drink much water? The subq fluids are so important for the CKD, it's such a complication that you are worrying about her heart. Since Yum has a murmur (which the cardiologist said was nothing), my vet said if Yum needed fluids she would hold her and monitor her heart after their administration (at least the first time). Could they do that to quantify what is happening with Asia? I suppose fluids elevate BP. Best wishes for managing the CKD and the BG and the heart worries all at the same time.
Glad she ate some tiki cat. Cerenia is good stuff.
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Thank you, MJW. I’m a fan of Cerenia so far, she’s eating decently well!

She drinks some water, a lot less now that I add so much to her food, which makes sense. It’s really soupy and she likes it that way so much that sometimes she gets a good bit of the water and the food that’s left isn’t floating in it and she meows at me to add more water before she’ll eat it.

I’ve never left her anywhere like a vets office before with the exception of when she was spayed and when she had her teeth extractions. We used to have a vet that came to our house for dozens of years so just going to a vets office is very foreign and distressing to her, more so now than it would have been if that were her routine all along. It wouldn’t have been so bad years ago but I think she would just feel terrible and very scared if I did that.

I’m also afraid she will catch something if I leave her at the vet. Toki has been to a vet only once (besides for her surgery) for idiopathic anaphylaxis and she caught some awful sneezing respiratory thing.
 
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