10/19 Ernie AMPS 16.1, PMPS 9.1

[Aimz123]

After some advice. Relative newbie here. Today was the first day I managed to get a curve done. Ernie is meant to be on 1.5 Lantus am/pm. The past few nights we have not given his pm shot as per instruction from vet to not shoot if under 10. We are using the AlphaTrak 3 and are located in Australia.

We have been using the SoloStar pen and now the JuniorStar. Long story but my elderly mother who helps me out cannot use a syringe.

Wondering if someone can advise whether we really should be trying to give a tiny shot when under 10? I’m concerned he will hypo in the night as his PM shot time is 10pm.

 

[Bron and Sheba (GA)]

Aimee, I’m sorry I didn’t get to you sooner but I see you gave 0.5 units. Was that with the syringe?
Did you leave some food out for him?
It was good to see the curve. If you can possibly get a test in any day around the +4 or +5 or +6 or +7 or +8 mark, that would be great.
Every day is not necessarily the same, so seeing some tests in on different days will tell us a lot more.

 

[Aimz123]

Aimee, I’m sorry I didn’t get to you sooner but I see you gave 0.5 units. Was that with the syringe?
Did you leave some food out for him?
It was good to see the curve. If you can possibly get a test in any day around the +4 or +5 or +6 or +7 or +8 mark, that would be great.
Every day is not necessarily the same, so seeing some tests in on different days will tell us a lot more.

Hi Bron

All good! I used the syringe I had and looked at some posts on the Facebook group to figure out where 0.5 was which I figured was just under the first line which is usually 1 unit. Food is always left out for him as he grazes. I gave him some treats which he ate already too: He hasn’t eaten a lot today so they were higher carb treats.

Will try tomorrow to get some random spot tests so we can see whether results are similar particularly now that I’ve managed 0.5 tonight for the first time rather than just skipping.

Thanks for taking the time to check in! Sorry I’m a needy newbie atm!

 

[Bron and Sheba (GA)]

Hi Bron

All good! I used the syringe I had and looked at some posts on the Facebook group to figure out where 0.5 was which I figured was just under the first line which is usually 1 unit. Food is always left out for him as he grazes. I gave him some treats which he ate already too: He hasn’t eaten a lot today so they were higher carb treats.

Will try tomorrow to get some random spot tests so we can see whether results are similar particularly now that I’ve managed 0.5 tonight for the first time rather than just skipping.

Thanks for taking the time to check in! Sorry I’m a needy newbie atm!

You aren’t a needy newbie at all. We expect all new members to need help. You did well and I’d love to see some more mid cycle tests!

 

[Bron and Sheba (GA)]

 

[Aimz123]

You aren’t a needy newbie at all. We expect all new members to need help. You did well and I’d love to see some more mid cycle tests!

Thanks for the diagram that helps! I definitely gave the correct amount then according to that.

Will get some mid cycle tests tomorrow to compare against. Hopefully we’ll be able to find the correct dose to have him on eventually! Will keep you posted, thank you!

 

[Wendy&Neko]

Hello and welcome to you and that sweet orinch boy to the LBL forum. Some comments and questions from me.

First, how long has he been on the prednisolone? Some cats find they can switch to budesonide, which is also a steroid but more locally acting in the gut. The benefit of budesonide is that it often doesn't impact blood sugars, but still helps gut inflammation. My Neko was on budesonide and it'd didn't impact her blood sugar. Some cats on pred have gone off of insulin with the switch. Note, a smaller percent of cats still have some impact on the BG with budesonide.

Second, and more a housekeeping note. The majority of folks here knowledgeable enough to help with dosing are in the US or "speak" US numbers for blood sugars. Plus the server is in the US, so it's our convention on FDMB. I'm in Canada, so I'm bilingual. Anyway, if you can write the blood sugar data in form of mg/dL numbers, you'll get more help. The spreadsheet does the conversion of numbers for you.

 

[Aimz123]

Hello and welcome to you and that sweet orinch boy to the LBL forum. Some comments and questions from me.

First, how long has he been on the prednisolone? Some cats find they can switch to budesonide, which is also a steroid but more locally acting in the gut. The benefit of budesonide is that it often doesn't impact blood sugars, but still helps gut inflammation. My Neko was on budesonide and it'd didn't impact her blood sugar. Some cats on pred have gone off of insulin with the switch. Note, a smaller percent of cats still have some impact on the BG with budesonide.

Second, and more a housekeeping note. The majority of folks here knowledgeable enough to help with dosing are in the US or "speak" US numbers for blood sugars. Plus the server is in the US, so it's our convention on FDMB. I'm in Canada, so I'm bilingual. Anyway, if you can write the blood sugar data in form of mg/dL numbers, you'll get more help. The spreadsheet does the conversion of numbers for you.

Thanks Wendy! He has been on Prednisolone since January this year full time. Prior to that he was on and off the pred while we figured out if he could live without it. His vomiting got pretty bad so that’s why he’s on it now at 0.7ml once a day.

The vet does not think Budesonide would be beneficial to him and I’m not sure whether it’s because of the multiple ultrasounds he has had which shows the thickening in a certain area. They weren’t keen and they’re a cat only vet with internal specialist on hand. It was the actual specialist who performed his ultra sound too.

I’ve noticed tapering off from 0.8 to 0.7 seems to have possibly brought on nausea it’s either due to this or his idiopathic cystitis issue which I think is easing off now that I’ve been giving him Gabapentin with the Budesonide. He’s on Zofran twice a day too.

It’s complicated with the IBD as all cats who have it are a bit different to the other. Mine seems to lose appetite and atm that seems to be picking up again so I’m trying to figure out if it’s due to the prednisolone reduction, cystitis or transition of food. So complicated. I don’t want to have to keep giving him Mirtazapine either. He’s been off that for over a week and has been ok. It’s possible he didn’t eat much yesterday because here in Melbourne we suddenly got a hot day and he possibly just wasn’t that hungry due to the heat.

 

[Wendy&Neko]

I had another cat with idiopathic cystitis (diagnosed one week after Neko's FD), and it didn't impact his appetite. Later on he had to go on prednisolone for small cell lymphoma, but by that point he didn't have any more cystitis episodes. The move to an all raw diet (really and LC with low phosphorus) with plenty of water added to his food helped.

Managing multiple conditions is hard! Glad you've got access to an IM vet to help.

 

[Aimz123]

I had another cat with idiopathic cystitis (diagnosed one week after Neko's FD), and it didn't impact his appetite. Later on he had to go on prednisolone for small cell lymphoma, but by that point he didn't have any more cystitis episodes. The move to an all raw diet (really and LC with low phosphorus) with plenty of water added to his food helped.

Managing multiple conditions is hard! Glad you've got access to an IM vet to help.

I wish he would take to wet food but he’s a free grazing kibble eater. I’ve tried watering down fancy feast pate, trying all sorts of wet food etc but he only licks the liquid up and licks the chunks but doesn’t eat them. I was trying long before he had diabetes too but can’t get him to shift from it. He’ll just starve himself if I withhold the kibble too. Atm we’ve got a transition happening to a low carb kibble so hopefully he’ll eventually take to it fully. Got to be careful with transition coz of his IBD. Raw probably isn’t going to work for him.

Hoping to be able to just get the dosing right so he can have a better run. Did the idiopathic cystitis last long with your cat? Did you give him anything specific to get rid of it? The vet said he may be nauseous because his bladder is inflamed and it hurts.

 

[Wendy&Neko]

Have you ever tried freeze dried raw? Lots of protein options there, and you can slowly add a bit more water to it to hydrate it.

Did the idiopathic cystitis last long with your cat? Did you give him anything specific to get rid of it?

He had multiple episodes, but they typically lasted 3-5 days and stopped getting them after a year. He'd get pain meds (buprenorphine), Cerenia for it's anti inflammatory properties, something for his lining of his bladder walls (details to follow), and a couple times he got something to relax his urethra spasms. Longer term, in addition to diet, I added glucosamine chondroitin, which is supposed to strengthen bladder wall lining, and/or Cartrophen injections which do the same thing, but better. One vet had me try hyaluronic acid (brand Hyaflex) which again is similar idea.

Other things to help were weight loss (I brought him home from the shelter at a "fluffy" 17 lbs), Feliway diffusers where he hung out. Cystitis kitties are often nervous ones. And encouraging as much water drinking as you can, possibly a fountain? The right mix of water in his food, plus the above, was key to stopping the episodes from returning.

 

[Aimz123]

Have you ever tried freeze dried raw? Lots of protein options there, and you can slowly add a bit more water to it to hydrate it.

He had multiple episodes, but they typically lasted 3-5 days and stopped getting them after a year. He'd get pain meds (buprenorphine), Cerenia for it's anti inflammatory properties, something for his lining of his bladder walls (details to follow), and a couple times he got something to relax his urethra spasms. Longer term, in addition to diet, I added glucosamine chondroitin, which is supposed to strengthen bladder wall lining, and/or Cartrophen injections which do the same thing, but better. One vet had me try hyaluronic acid (brand Hyaflex) which again is similar idea.

Other things to help were weight loss (I brought him home from the shelter at a "fluffy" 17 lbs), Feliway diffusers where he hung out. Cystitis kitties are often nervous ones. And encouraging as much water drinking as you can, possibly a fountain? The right mix of water in his food, plus the above, was key to stopping the episodes from returning.

I have tried freeze dry raw treats but at that time it was chicken which he can’t have anymore as an IBD cat. I’ve actually got some freeze dry raw lamb treats I got from the vet that I was going to give as a treat after his shots so I’ll see how he takes to them.

It must be Prazosin for the relaxation of his bladder spasms. I had a long discussion with the vet about this and they use to administer this up till last year when research came out to show that cats that get given this are more likely to have reoccurring cystitis symptoms so they’ve stopped prescribing that now. He’s had cerenia but I don’t think he needs that atm luckily.
We have buckets of water everywhere because for some freak reason he’s taken to wanting to drink out of those. He has a fountain which he use to guzzle from but since being diagnosed he hasn’t touched it or the Pyrex jug he use to love. There are feliway plugs all around the house too lol.

I’ll keep trying to wet down the FF pate in the hope he takes to that. Thanks for all the info on the cystitis! He’s had it for about three weeks now but I think it’s getting better so I’m going to start withdrawing the Buprenorphine next week very slowly then the Gabapentin will slowly be withdrawn. Finally the Zofran.

 

[Wendy&Neko]

Yes, it was Prazosin, but only an emergency weekend vet prescribed that. Did I mention that my guy always chose the weekends, when most vets are closed, to have his episodes? The Cerenia was not for vomiting, but for it's anti inflammatory properties. My guy didn't need anything for appetite, so no Zofran.