2.1.24-Luke PMPS 400 with trace ketones

[Kristen ardito]

Previous post for continuity: https://felinediabetes.com/FDMB/threads/12-11-luke-amps-337-3-276-4-300-7-371.284484/

Hi: I was not able to find information in the Ketones FAQ about whether a potential option for dealing with trace Ketones is increasing the insulin dose. Is that an option or should I hold his current dose one more day and keep on the recommended dosing schedule? https://docs.google.com/spreadsheet...J6i1YwaWDO6BjMV84AlH2RnqXg/edit#gid=258379912


He has had an increased appetite for the past 3 days and his BG numbers have been consistently high as well but today was the first time I saw any signs of Ketones.

I know that I am to continue to monitor closely, add fluids to his meals and feed more often.

In addition, I saw a post on the Facebook forums where someone said their cat gets Cerenia and Zofran every day and Mirtazapine every 3-5 days and I'm wondering if anyone here could provide me with some info on these drugs so I can ask my vet. For background: Luke has chronic IBD. His stools have been horrid the past week. Like clear the house horrid. I'm unfamiliar with the symptoms of pancreatitis but am wondering what to look for there as well.

Thanks in advance!

 

[Tiger(GA) and Ruth]

Hi Kristen, I am not an advisor on this board, just here for moral support. However, I would recommend you put a Question Mark in your Title to draw more eyes on this post. I am tagging a couple of people that do advise and hopefully they can answer your question. @tiffmaxee , @Wendy&Neko

My experience with pancreatitis was inappetance, lying in the meatloaf position, I could tell my Tiger was in pain. My vet kept her hospitalized for a day and a half. She was given fluids, Cerenia, and Ondansetron to help with the nausea. I can't see any benefit of only giving those meds every 3 days, my vet said to give Cerenia once daily and the Ondansetron twice. You will want to check with your vet on this. And also I would call my vet regarding those ketones .

Marje @Marje and Gracie wrote an excellent post on pancreatitis:
https://www.felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.79693/

 

[Wendy&Neko]

I would increase the day after tomorrow. With TR you can increase after six cycles if the numbers are all above 200, which they are. I don't see any test data the night of the 31st after PMPS, so I'd be reluctant to suggest a quicker increase when with only three full cycles of data so far.

Trace ketones are OK at home, but I'd monitor a couple times a day to see if it goes higher, in which case a vet call is in order.

someone said their cat gets Cerenia and Zofran every day and Mirtazapine every 3-5 days and I'm wondering if anyone here could provide me with some info on these drugs so I can ask my vet. For background: Luke has chronic IBD. His stools have been horrid the past week. Like clear the house horrid. I'm unfamiliar with the symptoms of pancreatitis but am wondering what to look for there as well.

Mirtazapine is an appetite stimulant that can be given every day. It's best if you can get Mirataz, the transdermal version as that's a more gentle onset and less likely to have side effect. If kitty has kidney disease you might back off to every other day.

How much Cerenia are you giving and how much does he way? (some vets underdose). Similarly, how much ondansetron? It can be given 3-4 times a day. The section on nausea treatment in this article gives the dosing: (2016) ISFM Consensus Guidelines: Diagnosis & Management of Feline Chronic Kidney Disease I would give antinausea before the appetite stimulant.

 

[Kristen ardito]

Thank you. I’m not actually giving him any of those meds but had read a post on the Facebook forums where someone who had a cat with IBD mentioned those meds. He is not nauseous as far as I can tell and is eating fine.
I’ll hold the dose for one more day and keep a close eye on him tomorrow and continue to check for ketones.

the only symptom that I’ve observed in the past 3 days that correlates with the timing of the high BG is that his stool has been very stinky. I don’t know if that’s a sign of pancreatitis but will read the link you sent. Thank you!!!!!

 

[tiffmaxee]

Sometimes they can have diarrhea with pancreatitis. Over the 7 years Max had it he had it once and it went away after a couple of days. SBoularrdi with moss can help if he has diarrhea. That can come with IBD though as well. Max always became lethargic and inappetent with pancreatitis. I used ondansetron for that.