12/05 Chewie AMBG 68/+13 86/ BCS 5 units/ +2 102/ +4 93/ +6 104/ +8 107/ PMPS 101

Virginie & Chewie (GA)

Virginie & Chewie (GA)

Member Since 2022
Yesterday

So Chewie was low overnight - 88 at +6, fed her half a pouch of LC, then 77 at +10, didn’t feed her but gave her half the tube of tuna churu.
She is now at 68 at AMPS, and I am not feeling good shooting her at that number when she has been feeling so crappy the past two days. She is brighter and hungry this morning and came downstairs, but still I don’t want to risk a hypo episode.

Can someone advise on a big chicken dose? Should I give her half? Does her being acro and such a large dose make a difference?
 
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She is at 86 now. Sorry this took so long, she hates testing now, and tried to hide when she saw me coming with the meter.
Realistically, would be better to be able to test only every couple of hours as opposed to every hour, she has become so mad about it!
 
It's not much of a food bump. But if she is eating well and you can monitor, would you be comfortable shooting the full dose?
If not, you could shoot half the dose say 5U as a BCS, but the higher depot will continue to affect the first part of the cycle.
 
Since there is no guarantee that she will be eating well given the past couple of days, I think I'll go for the BCS.
Shoot now and test in an hour? Should I give her food with the shot? She is a typically a late onset gal, I generally don't see a significant dip until +3.
 
Virginie said:
Shoot now and test in an hour? Should I give her food with the shot? She is a typically a late onset gal, I generally don't see a significant dip until +3.
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Yes, feed her with the shot and an an hour after. Get a +2 (2 hours from current shot time). Let's give her a break from tests since she hates them so much. Save them for post-onset.
 
I'm glad I did only 5 units. Took a lot of coaxing to get her to eat about 1.5 tbsp of her favorite kitten food that she normally devours.
She is getting really needle-shy too: she ate a tiny bit but kept glancing at me between bites, but then seemed less anxious and ate some more after I gave her the shot.
She has been the same with her beloved test-time churu. Sometimes she won't even take a lick until the poke is done. Poor baby.
 
Virginie said:
I'm glad I did only 5 units. Took a lot of coaxing to get her to eat about 1.5 tbsp of her favorite kitten food that she normally devours.
She is getting really needle-shy too: she ate a tiny bit but kept glancing at me between bites, but then seemed less anxious and ate some more after I gave her the shot.
She has been the same with her beloved test-time churu. Sometimes she won't even take a lick until the poke is done. Poor baby.
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Poor Chewie, they do seem to go through waves of "fed-upedness" of treatment - I can 100% sympathize....it's very stressful and hard emotionally. Hopefully she feels better soon. :bighug:
 
Thanks Amy, it sure seems like it. That's partly why I don't want to get her in very low greens where I would have to test every 30min... I also don't think she'll ever get OTJ with her acromegaly, so we can be a little more conservative and just aim for decent numbers in a window where she feels her best.
 
Bandit's Mom said:
Yes, feed her with the shot and an an hour after. Get a +2 (2 hours from current shot time). Let's give her a break from tests since she hates them so much. Save them for post-onset.
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I gave her ondansetron and cerenia half an hour ago, just in case. Just now at +1 got her to eat about a tablespoon of food mixed with warm water. She is in her hidey hole, but seemed to be doing ok.
Will test in an hour and see where she's at.
 
102 at +2

Had to drag the cushion out of the carrier to get her head out. She refused churu, so resorted to a glycoflex treat as bribe/reward.
I'll get a different flavor of churu after work, in case she just associates tuna with poking now :confused:
 
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Post butter snack face. She even made some mini biscuits when I petted her and cooed at her.
 

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Well, the relief was short-lived. She is more active and more responsive, but wouldn't touch any of the 5 LC cans I opened (including her latest favorites), nor the raw food, nor the churu. In the end she ate maybe 3 bites of MC (Fancy Feast in gravy), and then backed away from the plate like she was suddenly super nauseated. She had 1/2 tab of ondansetron and 1/4 tab cerenia this morning, this shouldn't be happening :(

I know it could be her kidneys, her heart, her liver/pancreas or any number of things affected by acromegaly and diabetes. I just don't want to put her through all the additional poking and prodding. She is done with it. The way she eyes me suspiciously when I enter a room to check if I have a syringe or a meter breaks my heart. I will be watching her closely as always, but we are trying to prepare emotionally for the fact that she may be readier than we thought to let go of her poor broken body.

I will retest her in a couple of hours, and if she is still low and won't touch wet food or lick gravy, is it ever ok to give a few kibbles? or better to rub some honey on her gums instead?
 
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Virginie said:
She is at 86 now. Sorry this took so long, she hates testing now, and tried to hide when she saw me coming with the meter.
Realistically, would be better to be able to test only every couple of hours as opposed to every hour, she has become so mad about it!
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What I've done with sam to get him fine with testing is to bring him to our testing spot, touch his ears/warm them up while giving him a treat and then don't actually test. I've done this maybe a dozen times; now when he sees the meter he doesn't try to run, he just isn't thrilled. the main thing he dislikes though is me warming up his ear with a pill bottle (he hates it even more with the cloth). But he doesn't mind testing as much anymore.
 
Virginie said:
Can someone advise on a big chicken dose? Should I give her half? Does her being acro and such a large dose make a difference?
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I'm glad you only did half dose. With all cats it's ECID, even more so with larger dose cats. I usually suggest people with acros start a BCS as 1/2 dose and see how that works. For Neko, I eventually settled on 2/3, unless I was deliberately draining a dose that took her really low.

I think maybe it's time to talk about guidelines when on cabergoline. When/if cabergoline starts to impact them, it can happen like the proverbial ton of bricks (meaning dose plummeting), or not. Really ECID. But it's best to be cautious. Today I think is dose 9 of cab? I've seen people with cats on it every day start to see impacts on day 10, so you might be right about there.

If this is cabergoline doing it's thing, here are some things to consider. It's OK to break the protocol rules on reductions, raise the reduction point, do back to back reductions, a larger reduction than normal, or reduce just because you think it's necessary. Whatever works for you and Chewie. You will get a feel for it, but caution first, and go back up in dose later if you were wrong. I suggest a reduction point of 70, which is what I used for Neko when her SRT really started kicking in. I'll note the 68 this morning.

After reductions, a depot draining BCS, or a skip is a good idea. Note to any lurkers, the above is only for Virginie and Chewie, which are very special circumstances.

OK, onto the food. Have you seen this post? Suggestions on How to Stimulate Kitty's Appetite Honestly, the best food for a cat is the one they'll eat. If you need to temporarily feed something that isn't good for a diabetic, so be it. Just be warned that cats will sometimes decide they don't want to switch back. So proceed with caution. If you do feed the dreaded kibble, maybe Dr. Elsey's or other low carb?

I wonder if she might have pancreatitis? How much does Chewie weigh? What were her doses of ondansetron and Cerenia today? They are often underdosed, as I found from experience. :(
 
Thanks for the reduction info @Wendy&Neko - I was going to tag you about her evening dose. Since Chewie is not really eating today (she only ate breakfast and tiny additional bites) should I give 5 units again tonight (assuming I can get dinner into her)?
Just now I tried again every LC food, every treat, every crappy Fancy Feast I have in the house, and she only took one bite of MC FF.

She weighs about 5.6kg (so 12.3lbs). This morning she got 2mg ondansetron and 4mg cerenia, then I gave her another 2mg ondansetron an hour ago. I also just gave her gabapentin (25mg). It seems to be knocking her out lately, but didn't want to risk her being in pain without it.
I suspect it's GI-related. Could be pancreatitis I guess, although she has shown no vomiting or meatloafing posture. Maybe the new food she likes doesn't agree with her, maybe that and the cab together is messing with her tummy...? (It has been gurgling a lot lately)

I'm not at the point of trying to syringe feed yet, I'll grab some more MC foods at the store tonight, and a bag of Dr Elsey's just in case. I'm honestly trying to make decision with hospice care in mind - prioritizing her well-being day by day, and the quality rather than the quantity of time she has with us. So if she has to eat kibble, so be it.
 
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She is holding steady at 104 at +6, courtesy of the few bites of MC. She took a couple of small licks at the churu. I'll try giving her proper food when I get off work in a couple of hours. Her belly was gurgling loudly the entire time I was warming up her ear and testing her.
 
Wendy&Neko said:
As per this article: (2016) ISFM Consensus Guidelines: Diagnosis & Management of Feline Chronic Kidney Disease
dosing of Cerenia is 2 mg/kg (or about 1 mg per lb) for pills, once per day. Ondansetron is 0.5-1.0 mg/kg up to 4 times per day. Chewie could get double the Cerenia (or more if you had 24 mg pills and could half them), and double the ondansetron dose as well.
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Wow, thank you for that. Her old vet was adamant that I give Wicket (her brother) only 1/4 pill of cerenia (and he's heavier than Chewie!), another case of not being up to date with the research... so grateful that you knew that.
So she got about the right dose of ondansetron after I added the second one, but I'll give her a second dose of cerenia right away (I have 16mg tabs, they are very easy to cut in half or 4). I also re-ordered 3 boxes of it since I only have 3 tabs left.
 
Wendy&Neko said:
Neko was underdosed on both. She got 4mg Cerenia too. :( Having another kitty with SCL, I'm determined not to short change now. Ondansetron is better for anti nausea, though a bit ECID, so make sure she gets that right. Chewie could get 4mg of ondansetron each time.
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I'm sorry you had to find that out the hard way with Neko :(
I'll be sure to give Chewie a full tab of ondansetron every time now, and half a tab of cerenia (8mg - or would it be better to give 3/4, 12 mg?)

As for insulin - same BCS tonight?
 
Wendy&Neko said:
I'd wait and see where she is closer to PMPS. When you skip/BCS, often the first half of the cycle is still pretty good because of the depot. If she zooms up, you might feel differently.

As for Cerenia dosing, start with 8mg and see if it helps.
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Sounds like a plan. I'll update when we are closer to PMPS. Thank you :bighug:
 
107 at +8
Still wont eat anything, except two pieces of ultamino kibble (the only kibble I had on hand, I ordered a bag of Dr Elsey’s that is coming tomorrow). Belly gurgling very loudly still.
 
Syringing her warm water mixed with a tiny bit of food for taste and slippery elm. She must be dehydrated, not having moved from her cat tree for the past 6+ hours.
 
Sorry to see Chewie continues to feel off. It’s so hard with acros and can be so consuming. :(

How is her breathing today? As you know, acros can have heart issues, and with cabergoline newly on board (and remembering Melissa’s/frostd experiences), I’m hoping you can also rule out any issues related to fluid buildup.
 
Thanks @Diane Tyler's Mom and @JL and Chip

I am hoping that she is just having a bad GI reaction to the new food and/or the cabergoline, and treating supportively, giving her a chance to get it out of her system overnight. My fear of course is that it’s either fluid build up due to heart issues or the cab, or pancreatitis, or her kidneys… the truth of the matter being that with her back injury and impaired mobility, she already was having a hard time before she even got diagnosed with diabetes. She hasn’t been the same cat since. She was soldiering on until this past week, but if she doesn’t want to do it anymore, I will respect that. She hates hates hates the car and the vet, and the needles and the meds. If she had an easily manageable condition that “just” required dedicated nursing, no problem, I have been doing that with her brother and my IBD cat for years. But acro is devastating and attacking her body from everywhere. It just doesn’t feel right to put her through more tests, more treatment, just to get a few more months. If she doesn’t bounce back from this, we will keep her comfortable and spoil her as much as we can for as long as she will let us, then give her her wings. I owe her that, to let her go when she is still with it, before she suffers more. It’s been an agonizing line to tread, between hope and resignation and grief :(
 
Fluid build up should be noticeable with increased respiration rate. I checked Neko's periodically if she seemed off, and it was an indicator for her. Can't remember if I've mentioned resting respiration rate with you = number of complete in and out breaths per minute, when cat is at rest. I used my phone timer. Normal is 20-30, but high 20's was abnormal for Neko who usually ran in the low 20's.

If the cabergoline is starting to work, it should fight back against some of the acro symptoms. And could hold it off for more than a few months. Amethyst has passed the 4.5 year mark, though she was a much younger kitty when she started it.

Having an acro kitty is definitely an emotional roller coaster. :bighug:
 
I was just going to respond. I don't have any experience with high doses, but the BCS this morning would've drained the depot some so you could give the full dose. Maybe take a reduction (assuming she may have earned one if you'd shot the full dose this morning). But if you aren't comfortable, you could stay with 5U.
 
Bandit's Mom said:
OK. She will recover. She has no history of ketones, right? You can then shoot at your usual time tomorrow morning.
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Thanks Bhooma, no she has no history of ketones.

Wendy&Neko said:
Sleep well tonight. Paws crossed for improved appy for Chewie tomorrow. :bighug:

You could have done the 5 unit dose too as she didn't zoom up. Tuck that away for next time.
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Good to know, thanks Wendy! What dose should I plan on tomorrow morning?
 
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