? 10-14 Pretty Girl AMPS 448 - STALLING PMBG 324

[JeanW]

Yesterday -

Pretty Girl doesn’t act too good. She had a good appetite though and ate plain turkey and some canned food. She’s drinking water like crazy.

I’m doing a 12 hour curve today. I truly believe I am killing her with this dose. Her eyes don’t look good. She is so much worse than she was on the half dose when she wasn’t eating much. I haven’t heard her purr in many days.

This is extremely discouraging and breaks my heart.

 

[Mandy & Rex (GA)]

Good morning. Have you considered something else is wrong? The symptoms I read today don't really go with diabetes. When was the last time she had a physical? I think she will need another increase, but let's see how the curve pans out.

 

[Olive & Paula]

Have checked the meter battery to make sure it's good? Is the meter coded for cats? If you have human meter double check with that.

Pretty Girl will feel crappy with high numbers. Olive did for months and still does (but for other reasons) we didn't know at the time.

Are you checking ketones daily at minimum? They can happen very quickly and Pretty could become very sick. Although not requiring high doses at this time, have you tested for insulin resistance (IAA)? Can you switch to TR in order to get some movement going, you can switch back later if you want to.

Possible pancreatitis, as it's common with diabetes. My 1st didn't lose appetite but boy did he have it. So you can't always rule it out because they are eating.

With my first kitty I was scared to death of TR, don't know why but I was. With Olive, I really had no choice she just wasn't responding much like Pretty. So I had to get over my fear of it for her. I didn't want her going into dka. Didn't know of her acro at that time. Now that we have response, she is actually between TR and SLGS.

Something to think about to get Pretty feeling better.

 

[JeanW]

Good morning. Have you considered something else is wrong? The symptoms I read today don't really go with diabetes. When was the last time she had a physical? I think she will need another increase, but let's see how the curve pans out.

She had a full physical 2 weeks ago.

The curve had to be changed tomorrow.

 

[JeanW]

Have checked the meter battery to make sure it's good? Is the meter coded for cats? If you have human meter double check with that.

Pretty Girl will feel crappy with high numbers. Olive did for months and still does (but for other reasons) we didn't know at the time.

Are you checking ketones daily at minimum? They can happen very quickly and Pretty could become very sick. Although not requiring high doses at this time, have you tested for insulin resistance (IAA)? Can you switch to TR in order to get some movement going, you can switch back later if you want to.

Possible pancreatitis, as it's common with diabetes. My 1st didn't lose appetite but boy did he have it. So you can't always rule it out because they are eating.

With my first kitty I was scared to death of TR, don't know why but I was. With Olive, I really had no choice she just wasn't responding much like Pretty. So I had to get over my fear of it for her. I didn't want her going into dka. Didn't know of her acro at that time. Now that we have response, she is actually between TR and SLGS.

Something to think about to get Pretty feeling better.

The battery meter is good. The meter is coded for cats. I don’t have a human meter

I’ve ordered a ketone meterbut it hasn’t arrived.

Bloodwork from the physical was good.

 

[JeanW]

I think the problem is that changing from .75 when she wasn’t eating to double that for her regular dose was too much at once. @Bobbie And Bubba

When I came home today she had thrown up again.

I’m considering doing a half dose for tonight’s shot. Clearly the increased insulin had made her quality of life go to He**

 

[Wendy&Neko]

I don't see the curve numbers on your spreadsheet, but unless you see something below 150, I would increase to 1.75 units. It's all these high numbers that are making Pretty Girl feel off.

Trust the dosing methods. Pretty Girl has been in this same dose for over two weeks and her numbers are still too high. If you linger at a dose that isn't good, their body gets used to higher numbers, and glucose toxicity sets in. Which means you'll have to increase even more to overcome it. Been there, done that.

 

[JeanW]

I don't see the curve numbers on your spreadsheet, but unless you see something below 150, I would increase to 1.75 units. It's all these high numbers that are making Pretty Girl feel off.

Trust the dosing methods. Pretty Girl has been in this same dose for over two weeks and her numbers are still too high. If you linger at a dose that isn't good, their body gets used to higher numbers, and glucose toxicity sets in. Which means you'll have to increase even more to overcome it. Been there, done that.

Thanks for your response and the information. I struggle with being the parent of a diabetic kitty because I am terrified all the time.

I moved the curve to tomorrow.

When I got home it appeared she threw up again and now won’t eat anything at all. PMBG is 324.

What should I do?

 

[JeanW]

She just threw up again.

ETA Shw seemed to feel very slightly better after the last throw up but hasn’t eaten not a single bite and clearly still feels yucky.

 

[Wendy&Neko]

How long past preshot? Have you tried feeding a small amount of something else? She's really still quite high. You could give at least a half dose. Any chance you could assist feed? Or try some yummy different food? If Neko wasn't up to eating, I syringe fed a bit. Usually getting a bit of food in her tummy got her eventually eating. Insulin onset isn't for a couple hours after the shot.

 

[JeanW]

How long past preshot? Have you tried feeding a small amount of something else? She's really still quite high. You could give at least a half dose. Any chance you could assist feed? Or try some yummy different food? If Neko wasn't up to eating, I syringe fed a bit. Usually getting a bit of food in her tummy got her eventually eating. Insulin onset isn't for a couple hours after the shot.

Now 2 hours past preshot. I’ve tried 4 different things.

What would qualify as yummy different food? I’ve tried 2 canned foods and the never fail turkey and never fail treats. I’ve never syringe fed. Do I need special syringes?

(I’m having to unlearn a lot of wrong info taught to me by a series of different vets. One of which is if they don’t eat you don’t shoot. I thought I learned from you recently to shoot half dose if they ate a little but what if they don’t eat?)

She always eats so I’ve never dealt with this.

What should I do at this point?

 

[Wendy&Neko]

What you do depends on how strict you are about your schedule tomorrow. If you need to keep the AMPS at the same time tomorrow, then you skip. If you have some flexibility to shoot a couple hours later and work your way back on time, that gives you other options.

I am surprised vets say don't shoot if they don't eat. Cats undergoing anesthesia (so can't eat), get a 1/2 dose typically. And with a cat in high numbers, not feeling great and littly appy, I would want to make sure you get a ketones test in tonight, especially if you don't shoot.

 

[JeanW]

What you do depends on how strict you are about your schedule tomorrow. If you need to keep the AMPS at the same time tomorrow, then you skip. If you have some flexibility to shoot a couple hours later and work your way back on time, that gives you other options.

I am surprised vets say don't shoot if they don't eat. Cats undergoing anesthesia (so can't eat), get a 1/2 dose typically. And with a cat in high numbers, not feeling great and littly appy, I would want to make sure you get a ketones test in tonight, especially if you don't shoot.

I can make my schedule flexible if need be.

I tried a 3rd kind of canned food. I doubt she will eat. She just threw up again.

 

[Wendy&Neko]

Have you tested for ketones lately?

 

[JeanW]

Have you tested for ketones lately?

Not in 2 or 3 days. I don’t have a ketones meter yet so have to wait for her to pee. Ready to test if she does.

 

[Wendy&Neko]

Maybe test her BG again. Been a couple hours? Then it's your call if you want to shoot and move your preshot schedule.

 

[JeanW]

It’s been 3 hours.

Give me some guidelines - a half dose?

 

[Wendy&Neko]

Can you test again?

 

[JeanW]

Can you test again?

Yes. She’s finally sleeping peacefully though.

But I will get her up and test her.

 

[JeanW]

Yes. She’s finally sleeping peacefully though.

But I will get her up and test her.

362 at about 3.5 past usual preshot time.
She felt well enough to put up a fuss about me getting her up and testing her.

ETA She threw up again while I was in the other room. But she looks better than she has in the last 8 hours or so.

 

[Bobbie And Bubba]

Jean, I am so sorry she is not feeling well and throwing up for a lot. The higher numbers can make them feel really icky so getting those numbers down is a good idea. After you shoot insulin, there is about a 2 hour period before the insulin starts to kick in, so if you shoot, you have that time to get her to eat some. Even if they eat 1 tbsp. of food at a time.

Were you able to get the baby food? If so did she like it?

Also, when was the last time she had some BW done? Did they test for thyroid. She is at the average age that cats can develop it.

Here is a list of things that Jill put together to try when kitties are off their feed to get them to eat.

To Get Kitties to Eat

-making a buffet to give him choices
- heating food in microwave for a few seconds just until warm

sprinkle food with :
- forta flora -- a probiotic you can get at vets or online. is very smelly and cats love the taste of it.
- parm. cheese
- smashed crumbles of dry food
- bonito tuna flakes
- halo chicken treats -- crumble into dust over food
- poor a little water from tuna in water over food ( I use low sodium/no sodium added as other kinds in water has veg. broth in it and I assume that means onions, which are toxic to cats-- check labels)
-powdered oregano. yep sounds weird . but some cats like it and it will entice them to eat.

other ideas of foods to offer your kitty to stim appy:
- trader joe tuna for cats
-baby food -- beechnut turkey and broth or chicken and broth. they have no onions or other additives. some babyfoods have onions . please read labels if you can't find beechnut.
- kentucky fried chicken
- deli turkey /chicken
- plain cooked ( boiled or baked ) chicken breast
-canned chicken for people (watch the label that their are no onions)
- chicken broth -- low sodium

I hope this helps.

 

[JeanW]

Jean, I am so sorry she is not feeling well and throwing up for a lot. The higher numbers can make them feel really icky so getting those numbers down is a good idea. After you shoot insulin, there is about a 2 hour period before the insulin starts to kick in, so if you shoot, you have that time to get her to eat some. Even if they eat 1 tbsp. of food at a time.

Were you able to get the baby food? If so did she like it?

Also, when was the last time she had some BW done? Did they test for thyroid. She is at the average age that cats can develop it.

Here is a list of things that Jill put together to try when kitties are off their feed to get them to eat.

To Get Kitties to Eat

-making a buffet to give him choices
- heating food in microwave for a few seconds just until warm

sprinkle food with :
- forta flora -- a probiotic you can get at vets or online. is very smelly and cats love the taste of it.
- parm. cheese
- smashed crumbles of dry food
- bonito tuna flakes
- halo chicken treats -- crumble into dust over food
- poor a little water from tuna in water over food ( I use low sodium/no sodium added as other kinds in water has veg. broth in it and I assume that means onions, which are toxic to cats-- check labels)
-powdered oregano. yep sounds weird . but some cats like it and it will entice them to eat.

other ideas of foods to offer your kitty to stim appy:
- trader joe tuna for cats
-baby food -- beechnut turkey and broth or chicken and broth. they have no onions or other additives. some babyfoods have onions . please read labels if you can't find beechnut.
- kentucky fried chicken
- deli turkey /chicken
- plain cooked ( boiled or baked ) chicken breast
-canned chicken for people (watch the label that their are no onions)
- chicken broth -- low sodium

I hope this helps.

Thanks for the reply and all the great info.

I did get the baby food but no she didn’t like it.

Complete BW was about 2-1/2 weeks ago and again about 3 weeks before that. All was good except for the BG and kidney just barely in the high range. I will have to review it again to see if they tested thyroid.

I haven’t been able to test for ketones - the meter hasn’t arrived and she hasn’t peed in the designated spot.

I expect we will go to the vet hopefully today. It means I will probably have to take her to the city 3 hours away as the local vet says giving fluids is not in her interest - wrong! That is clearly what she needs.

Do I shoot as long as she eats the tiniest amount?