12/12 Smokey AMPS 254 +4 195 w/hold food and ins for 24hrs??

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Melanie and Smokey

Melanie and Smokey

Member Since 2010
Night numbers were crappy, but today is coming down again. May not get any more before PMPS. I've got to get some time in at work.

Went to the Vet with one of the other cats today and talked to her about Smokey's puking. She would like try withholding food (and therefore insulin) for 24 hours to see if that helps right the stomache situation. Obvious concerns about withholding food from a 14 yo cat who has already gotten skinny and is always hungry and withholding insulin for 24 hours when those last skipped shots caused problems enough. She hasn't puked since yesterday AMPS +4 (so 24 hrs), so I am thinking we wait at least until we see the puking return? Any opinions?

She is diagnosed with chronic (not acute) pancreatitis, liver disease, possibly triatitis with those two present. Before the first round of diabetes she weighed 14.8 pounds (in her pic in my avatar). She dropped down under 11 and we got her back up to just over 12 when we got her regulated. The pancreatitis took her down to the mid 11s and now she has slipped back under 11 again. The only meds she gets for the P and liver issues is Ursodiol. It is for the liver, but it seems to keep them both in check. She's never presented with ketones, but I don't check that diligently either because she's never shown signs of them.






yesterday http://felinediabetes.com/FDMB/viewtopi ... =9&t=58438
 
Re: 12/12 Smokey AMPS 254 +4 195 w/hold food and ins for 24h

Why not get an anti-emetic (e.g., ondansatron or cerenia) and feed Smokey something like baby food that's easy on the tummy? Here's my thinking... You have a cat that has a chronic, inflammatory condition that can effect BG levels and who's puking. The recipe for ketones is infection/inflammation, not enough insulin, and not eating. I would hate to see the vet's recommendation end up costing you thousands of dollars if you had to then deal with DKA.
 
Re: 12/12 Smokey AMPS 254 +4 195 w/hold food and ins for 24h

I agree 1000% with Sienne.

Also, I would never in a million years withhold food from a cat with possible liver issues. Maverick almost died from FHL and your cat has already lost weight.

I would really push hard to get your vet to prescribe at least Cerenia for vomiting for the short term and ondansetron for nausea for the long term. Liver issues can cause horrible nausea in cats. My dad had liver disease and told me what it felt like. Our cats can't talk.

Don't let the vet say that pepcid or metoclopromide can help nausea or vomiting. They don't for cats. Pepcid only helps if its due to stomach acid.

Here is a veterinary article on vomiting and nausea medications in cats: http://veterinarycalendar.dvm360.com/avhc/content/printContentPopup.jsp?id=676860

Ondansetron is the generic of zofran. It can be expensive at some places so call around. Costco I hear sells it very cheaply for the 4mg (non disolving pills only) and you don't have to be a member. A 4mg pill is four doses of 1mg given every 12 hours. Some local smaller pharmacies may sell it even cheaper.
 
Re: 12/12 Smokey AMPS 254 +4 195 w/hold food and ins for 24h

Thanks for all the info. I go back in on Wednesday with 2 other cats, I will talk to her again. So far we have not found any new puke since the last time I noted in my spread, Sunday at noon I think.

Her BGs are starting to swing too. Seeing blues during the day, but hubby said PMPS was over 300 again.

Vets reasoning on withholding food first was to see if it was something in the tummy since we've checked everything else recently and repeatedly. She knows that I don't want to add more meds unless we have to (she also understands we do what we have to without question so they are not shy about prescribing if they feel its needed). Smokey is not a piller so everything needs to be compounded to a liquid (and you thought just the zofran pills could get expensive Karrie :shock: ) and she gets so sick of the meds that she hides and we try to balance QoL with medicating.

I just want all this nagging problems to leave my poor girl alone.
 
Re: 12/12 Smokey AMPS 254 +4 195 w/hold food and ins for 24h

((((Melanie)))) I want these issues to go away for you, too. I don't have any experience in this area, but I see that you've gotten some good advice. I can send some healing vines, so they are going out to Smokey tonight. I hope she'll feel better very soon.

Ella & Rusty
 
Re: 12/12 Smokey AMPS 254 +4 195 w/hold food and ins for 24h

I can imagine the cost of compounding. Ouch.

The pills may be able to be hidden in some good stuff like chicken breast though. Have you been able to sneak any pills by her? My dog is an expert at finding pills in food.
 
Re: 12/12 Smokey AMPS 254 +4 195 w/hold food and ins for 24h

Cerenia can be given as an injection - but I don't know if it can be given subq or if it has to be in the muscle. Keep it in mind if she keeps vomiting. I think another medicine - anzemet or something like that may be an injectible also - similar to ondansetron.
 
Re: 12/12 Smokey AMPS 254 +4 195 w/hold food and ins for 24h

Sometimes it helps to do mini meals, if you're not already doing something like that. Less likely to stretch irritated stomach lining and provoke vomiting.

Ask the vet if some of the meds have subQ versions. Maybe see about a small pain patch for the pancreatitis?
 
Re: 12/12 Smokey AMPS 254 +4 195 w/hold food and ins for 24h

Thanks for the hugs Ella, I needed those. Yesterday was a breaking day. Kind of had enough of all the crap hittin' the kids with Smokey just not needing all this at her age, and Tiger's dental issues not clearing up, and Mittens' I-hate-my-tail issues getting worse. It was one of those nights to just break down.

Smokey has become the master of not taking pills as she got older. She is like someone cracking sunflower seeds backwards. In goes a nicely hidden pill and seconds later out comes a clean one, or worse, a half hour later we find it in another room. Pill guns/pushers are a fight, so we just bite the bullet and get it compounded. I am on a first name basis with the pharmacist at the compounding pharmacy :lol: because Mittens needs everything in a plo gel or liquid if it can't go into an ear gel because he won't eat treats, people food, or cat food with anything added to it. The only thing he's ever eaten besides straight cat food is lettuce!

Cerenia can be given as an injection
is this the one that burns? There was one they gave Peanut in the ER that was just terrible. She ripped open my hand and just went crazed like she was feral (she was very sick). They didn't bother telling us it would burn until after they'd tried giving it. I thought it was that one. I don't ever what to see that reaction in one of my cats again.

Right now the puking has went down. Only sign of once in the last 48 hrs and I am assuming it was her, no confirmation. We do do mini meals and the leftovers are out for free-feeding, though I am trying to reduce the free-feed. She eats small amounts quite a bit (another reason I worry about no food for a long period of time, she doesn't like going 4 hours without food).
 
Re: 12/12 Smokey AMPS 254 +4 195 w/hold food and ins for 24h

If she goes through another bout of this, I'd really think about baby food. Most cats love the stuff and it's really easy on the tummy.
 
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