10/23/14 Keiko's home ...

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KeikosHuman

KeikosHuman

Member Since 2014
Thank you all. Keiko came home last night. He is eating pretty well. BG 411 at +5 (308 human meter). Waiting for him to do post hospital number 2 in the box (he needed an enema at the vet while he was there). Now giving Laxatone and extra fluids. He has been sleeping most of today. After the first strange reading at the vet, the meters were matching (according to the vet) and if off they were off within allowable range.
Any advice about colace? It comes as a gel capsule 50 mg. I can't imagine how to give this to him. I've been reading the constipation site link that was posted the other day- very helpful and a lot of information to sort through. I hope Laxatone is enough but I went ahead and bought pediatric suppositories in case.

Thanks for you vines and good thoughts. You are fantastic!

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Thanks for that important heads up. This does have sugars in it! Bought it from my vet's office and will return it. :o
 
so glad keiko's home! you must be relieved!

people give butter and coconut oil to help with hairballs/constipation. I can't recall what colace does, the mechanism that makes it works - i'm thinking it's a salt, isn't it, that draws water to the colon, maybe? did the vet say anything about fiber? lots of people give pumpkin (plain canned) or squash to increase the fiber intake. my vet suggested oat or wheat bran, which i bought in bulk for pennies at the grocery store. I tried oat bran and it didn't help punkin (it was to help alleviate diarrhea) but it might be worth a try for keiko. i don't recall the dosage, although it's probably in Punkin's ss somewhere. i want to say it was 1/8 tsp once a day to start with.

if you're not adding water to his food, add as much as he'll tolerate and still eat it. i add quite a bit to my cat's, like maybe 1/2 can of food and 1/4 can of water added to it.

for giving him the colace, you might be able to put it in smaller gelcaps - you can buy empty ones at any pharmacy. Elise/Max has experience with this and can suggest a size. I'm sure others do too, but you might ask her what she suggests. i have no idea if it has a flavor, but if it's not bad, you might be able to sprinkle it into his food.

lots of people have cats with constipation issues, so if you put "constipation help?" in your subject line it will get the right people here to give you advice on it.
 
Hi. Julie mentioned you might want info on gel caps. I haven't had any luck getting them small enough at pharmacies here but I have bought them from thrivingpets.com. They sell them in packages of 100 and they are pretty cheap. I have used size 3-5. The smaller the number the larger the gel cap. They charge way too much for the 5's and they aren't much smaller than the 3's and 4's that I use. I have gone as far as size l but rarely use them. They are perfect for combining pill pieces so that they aren't tasted. I can fit 1/4 a pepcid, 1/2 a amlodipine and 1/2 a ondansetron in a size 3 easily. I use small plastic funnels that I bought for $1.49 to fill them with powder pieces.

Other things to try for constipation are baby food squash and plain pumpkin not the pie kind. I use 1/4 a teaspoon of miralax every day for Max. It is odor and tasteless and I mix it in a little baby food which I use as a chaser for his amlodipine. I hope this helps and that Keiko is feeling better.

If you go to capsuline.com they have a chart that shows you the size of the gel caps and how much they hold.
 
Colace is a stool softener. It's frequently prescribed for humans when you've been taking other medications (e.g., opiates for pain) that cause constipation.

You definitely want to give Colace in a gel cap. It's very bitter. Unless you want Keiko to start foaming, give the Colace in a gelcap.
 
I just read that someone gets NOW gel caps ordered from the company from her local health food store. She last paid only $8.50 for 1000 and since the rep comes in weekly there was no shipping charge. You can't beat that!
 
I wanted to respond to your pm here. You asked about how you would increase if you are going by the protocol.

With an AT, it's likely to be easiest for you to refer to this page on the Roomp Rand Dosing & Testing Protocol. Table 3 in the link uses AT numbers. The only change is that in the last update, they lowered the number from 80 to 68 as being the line where you begin to give carbs, and where a cat needs a dose reduction. So if Keiko goes below 68, then you would break out the carbs and at the next shot you'd reduce his dose. The 68-160ish range on an AT is considered to be normal numbers, so that's the goal for a cat to become tightly regulated and to hopefully, allow their pancreas the opportunity to heal.

While you're learning how to adjust the dose, I'd encourage you to post at least every 3 days and we can take a look at Keiko's BG tests and help you interpret them. Right now I'd suggest you increase Keiko by 0.5u to 5.5u. He's consistently over 300, and according to the guidelines, you would look at the past 3 days of nadirs and see what range a majority of them fall into.

It's really typical for cats to need to go up in dose (the increasing-the-dose-phase) until they hit a breakthrough dose. While that's happening it's not uncommon to not see much change in the blood sugar, but when you get to the sweet spot in dosing, all of a sudden you'll see his begin to respond. Right now I'd re-evaluate his dose every 3 days. When a cat is in high numbers they get used to them, and then you have to give even more insulin to overcome the Glucose Toxicity. It doesn't help to hold a dose too long unless a cat's in normal numbers.

Cats stay in the "Increasing the dose" phase until their nadirs are in normal numbers. Drops below 68 mean that you decrease the dose.

NOTE: The BG numbers referenced below are on human glucometers.

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Reducing the dose:
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. See additional notes in the next paragraph about drops into the 20s and 30s. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

Please do not let yourself become complacent or blasé about drops into the 20s or 30s.
If kitty drops into the 20s, a full reduction of 0.25u (or 0.5u if kitty is on a higher dose) is strongly recommended.
If your cat drops into the 30s, a full reduction of 0.25u is recommended. There are very few exceptions given for caregivers who have collected years of data and KNOW their cat's response to the combination of insulin and food backwards, forwards, and inside out.
Caregivers whose kitties have "High Dose" conditions may find the need to reduce in whole units or more.
Please ask for advice.

If anyone suggests otherwise, they are putting your cat at risk! Our kitties are not just numbers. They are living beings who trust us to look out for them. The TR Protocol is an aggressive method in itself. The modified version of the protocol is slightly more aggressive.

Keeping YOUR cat safe is the #1 priority of the FDMB.
Let's keep all our kitties in the Lantus Tight Regulation ISG safe by suggesting and taking appropriate reductions.

If an attempted reduction fails, go right back up to the last good dose as soon as you see kitty's numbers trending upwards. You don't have to hold the reduced dose for a certain number of cycles before taking the dose right back up. The guidelines listed under the topic "Increasing the dose" do not apply to a failed reduction.

Please use common sense in this situation. The "last good dose" is not the dose that just dropped kitty into the 20s or 30s. You want to resume momentum by finding a dose in-between the dose that dropped kitty too low and the reduced dose.
Since 2006 we've encouraged those practicing Tight Regulation to attempt reducing the dose from 0.25u to 0.1u before stopping insulin completely. During a two week OTJ trial, you want to see mostly green numbers (under 100) with only a few random blue numbers between 100 - 120 to help ensure a strong remission.
Click to expand...

Hope that helps a little bit. Keep posting and we'll keep helping you figure it out!
 
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