3/1 - Gen, AMPS 181, PMPS 217

[Allie & Gen]

Last post

Hey friends! I hope you're having a very peaceful Sunday, with safely-surfing kitties.

I am noticing a troublesome pattern with Eugenides' eating habits that I'm not sure how to address. In brief: he's not doing great at eating his AM food, though he's eating up all of his PM meal, usually in the first few hours.

We're having a lot of days where he dives steeply first thing in the AM cycle, often hitting limes somewhere in the first half. (And then, sometimes bouncing.) When I'm home, I have to intermittently encourage him to go eat some more - by nudging him out of his napping spot, or sometimes even picking him up and carrying him to the dish. Sometimes bribing him by crumbling some treats (freeze-dried tuna, mostly) on top. When I've had a roommate home, but I'm away, I've had them give him MC (Hill's m/d glucosupport, leftover from when it was his primary diet; he generally eats it up right away, although it doesn't always keep his BG up for very long.)

I'm not sure why this would be. He's getting all his meds; ondansetron, gabapentin, and mirataz in the morning, and more ondansetron and gabapentin along with cerenia in the evening. I'm wondering if the mirataz is taking time to kick in, and that's why this is happening? But it's a once-a-day medication, and I thought it was supposed to be sort of in continuous action as long as you keep up application consistently. Am I wrong about that?

He also has been showing much less enthusiasm for fish-flavored wet foods (even though he adores freeze-dried tuna and minnows, and prefers tuna churus over chicken). He's had cod/sole/shrimp pure and ocean whitefish & tuna puree in his rotation for months, but now the only fish-based wet food he's willing to eat is the flaked tuna. (Feeding him all chicken does not guarantee that he's going to do a good job with his AM meal, however, as I discovered yesterday when I went on a late morning outing with a friend to enjoy the nice weather, only to wind up on the phone several times coaching my roommate through giving him MC after he hit LO on the Libre twice in the course of about an hour.)

The flavor part may be a moot point soon, as if/when we're able to rule out SCL (I'm hoping to schedule a biopsy in the next week or so), and proceed with IBD treatment, he's going to be moved to an all-rabbit diet. But the AM limes are getting to be a significant problem, since I'm not home during the day 4 days/week. I'm lucky that one or the other of my roommates has been home when that has happened recently, but they often aren't! One of them works on-site full time, and the other one is about to go abroad again for a couple of months for her own work. I need Gen to feed himself. I would be grateful for any ideas or perspective on the action of his meds, etc!

 

[xelo y sinver]

Let's see if someone with more experience can help you. @Gill & George @Wendy&Neko

 

[Allie & Gen]

Let's see if someone with more experience can help you. @Gill & George @Wendy&Neko

Not a bad idea @Sienne and Gabby (GA) @Christie & Maverick @tiffmaxee @Suzanne & Darcy

 

[Gill & George]

giving him MC after he hit LO on the Libre twice in the course of about an hour.)

I can't see this on the Ss

If he had a LO did you not reduce?

He's been on 1.75 for quite some time, he's hit lime green under 50 on three separate days, you could try reducing the dose. Technically as a long term diabetic you're looking for a drop below ,40 for a reduction (,if he gave you a lLO you should have reduced, as per recommended for TR)

I'd be inclined to drop him to 1.50. given the line greens and if you're having difficulty getting him to come up. Feeding kibble to bring him up when he is low is ok, but be cognisant that it may affect his BG for some time and when it's out of his system you may see a further dip. On TR he really should only be on wet except for energy.

 

[Allie & Gen]

On a mostly unrelated-to-diet note ... I just did my first Libre/blood test comparison. At +4.5, my glucometer (calibrated for human blood) read 62. The Libre read 53 (the dang alarm started going off again mid-poke).

That's not a huge difference. Hard to know how consistent it is, of course, from one comparison. I'll try to get more in the coming days, though I had a bit of difficulty drawing blood today; Gen's ear got poked three times to get that reading, and he is not a happy camper. Given his intensely adverse reaction to manual testing back in 2021 (after his initial diagnosis), to the point that my vet and I agreed it was making everything worse ... I intend to tread very carefully now that I'm seeing some success at occasional poking.

@Staci & Ivy - remind me what the usual discrepancy is for you between the glucometer and the Libre? I really should have been keeping track of other people's findings on this.

 

[Allie & Gen]

I can't see this on the Ss

If he had a LO did you not reduce?

He's been on 1.75 for quite some time, he's hit lime green under 50 on three separate days, you could try reducing the dose. Technically as a long term diabetic you're looking for a drop below ,40 for a reduction (,if he gave you a lLO you should have reduced, as per recommended for TR)

I'd be inclined to drop him to 1.50. given the line greens and if you're having difficulty getting him to come up. Feeding kibble to bring him up when he is low is ok, but be cognisant that it may affect his BG for some time and when it's out of his system you may see a further dip. On TR he really should only be on wet except for energy.

I've been listing LO as ~40 and HI as ~400 ... I prefer having numbers on the spreadsheet for consistency, even if they're approximate/indicating a range. Apologies for the confusion.

Yes, I was thinking I would reduce since this is the third lime in a short period. I haven't done it for just one below-40 incident for a couple of reasons: 1) his food intake seemed to have more to do with the numbers than the dose, and 2) the Libre is known to give false lows, so I tend to be a little cautious about reacting to its readings.

Not sure what you mean about kibble; he's been on an all-wet diet since mid/late January. The Hill's m/d glucosupport is canned wet food (it comes in both wet and dry).

I'll do the reduction tonight, but I think the AM appetite thing is still a concern and could use some help addressing it.

 

[xelo y sinver]

Honestly, my cat sometimes has trouble eating the same thing all the time. I try to change his food often, and I spend all day looking to buy different flavors of low-carb food. I also add low-carb hydrolyzed food to his meals. The most important thing is that he eats, no matter what his blood sugar level is; he has to eat. This is just my humble opinion based on my experience with my cat.

 

[xelo y sinver]

You can heat their food; some cats prefer warm food. Or perhaps you could make a mousse-like consistency; you could mash it and make it more liquid. You have to try things out. I had a cat who died; she had liver problems and stopped eating, even with Mirataz. I tried everything, even baby food. I went crazy trying to get her to eat. Perhaps these tips I mentioned above will help you.

 

[Allie & Gen]

Honestly, my cat sometimes has trouble eating the same thing all the time. I try to change his food often, and I spend all day looking to buy different flavors of low-carb food. I also add low-carb hydrolyzed food to his meals. The most important thing is that he eats, no matter what his blood sugar level is; he has to eat. This is just my humble opinion based on my experience with my cat.

I have had Gen on a rotating diet of 4-5 flavors of wet food since I transitioned him to a low-carb diet, and I use a number of different toppers to help make it appetizing (FortiFlora--just for the flavor--freeze-dried rabbit, freeze-dried tuna and sometimes freeze-dried mackerels).

He doesn't have a history of being especially picky (apart from the fact that he has demonstrably always hated salmon, for some reason). He was on a single flavor of wet food (the Hill's m/d glucosupport, it was prescribed and I was unaware of the carb issue at the time), along with a single type of dry food, for 3-4 years without complaint.

He's on anti-nausea meds and an appetite stimulant because of (probably) pancreatitis-based inappetence which started in mid-January. The appetite stimulant really should be enough to get him to eat.

Unfortunately, because of his GI issues, my vet and internalist want me to switch him to one single food (rabbit, canned/wet, just one brand) for at least 4-6 weeks. I can bake some of it up into treats, but they've been insistent that he not eat one single other food item once we start that. I'm postponing in order to get an intestinal biopsy so I can rule out single-cell lymphoma (), but assuming that it is ruled out, I will then need to commence the very restricted diet. So unfortunately, bringing in random variety isn't going to be an option, and I need to figure out why he suddenly doesn't seem to be responding normally to the mirataz (+ anti-nausea meds).

 

[Allie & Gen]

You can heat their food; some cats prefer warm food. Or perhaps you could make a mousse-like consistency; you could mash it and make it more liquid. You have to try things out. I had a cat who died; she had liver problems and stopped eating, even with Mirataz. I tried everything, even baby food. I went crazy trying to get her to eat. Perhaps these tips I mentioned above will help you.

Thanks! I appreciate the tips, and I've tried some of them. The reason I'm focused on the meds right now is that I'm addressing the specific change I'm seeing in recent days.

I tried things like warming the food, different consistencies, different enticements, etc when he was initially having trouble eating. The meds were working, and he's still eating very well at night. So I'm trying to figure out what has changed that he's not eating well in the AM only.

(I used to give him the mirataz at a different time of day. That's part of why I'm wondering if giving it right before his AM meal is the issue. The low morning appetite doesn't entirely correlate with the change in med schedule, so I'm not sure.)

@Albert & Xander - any thoughts on timing wrt mirataz? I know Xander responds very well to even tiny amounts, so I think there are different issues here, but.

 

[xelo y sinver]

Okay, I understand now that you've explained it. Maybe it's the effect of the medication? How many hours before does it take effect? Perhaps the time you change the medication has something to do with it. If he eats well at night, do you wait the same number of hours? It's very complicated when they have several things going on; you don't know what might be affecting them, but even a small change makes them react differently. I hope he gets better. Let's see if someone else can give you some more advice.

 

[Albert & Xander]

@Albert & Xander - any thoughts on timing wrt mirataz? I know Xander responds very well to even tiny amounts, so I think there are different issues here, but.

Hey! I'm sorry to hear Gen's still not eating that great. Hope you had a great weekend despite that.

Xander's actually having a struggle eating day today too. Usually I give him the mirataz dose at 4pm (+7) and notice that he starts eating a little better by snack time 2 hours later but it really seems to kick in the most 5-6 hours after I give it to him. Every cat is different but it seems to keep Xander eating well for at least 2 days if not more.

I remember reading that Brianna and Xander would split his dose and give it to him twice a day. That might be worth a try.

What dose of Ondansetron and cerenia are you giving?

 

[Albert & Xander]

Also Xander has randomly decided to change his preferences in flavor. He used to be wild about the FF turkey, but now doesn't care for it. He used to not care for chicken/liver but now its his primary flavor

 

[Allie & Gen]

Xander's actually having a struggle eating day today too. Usually I give him the mirataz dose at 4pm (+7) and notice that he starts eating a little better by snack time 2 hours later but it really seems to kick in the most 5-6 hours after I give it to him. Every cat is different but it seems to keep Xander eating well for at least 2 days if not more.

Hm, interesting. Well, the mirataz I give Gen definitely does not seem to last him 2+ days right now. But this does make me think switching up the timing might be a good idea.

I remember reading that Brianna and Xander would split his dose and give it to him twice a day. That might be worth a try.

That's ... a really good thought, and I might.

What dose of Ondansetron and cerenia are you giving?

Ondansetron - 2mg every 12 hours
Cerenia - 8mg every 24 hours

(These are the doses the vet gave me; I haven't done any weight calculations etc)

 

[Albert & Xander]

I've seen Wendy post the by weight dosage for ondansetron here before, I can't remember what it is. But the dosage looks in line with what my vet prescribed:
-Ondansetron 1/2 to 1 full tablet every 12 hours (4mg tablet)
-Cerenia - 1/2 tablet (24mg)

 

[Allie & Gen]

I've seen Wendy post the by weight dosage for ondansetron here before, I can't remember what it is. But the dosage looks in line with what my vet prescribed:
-Ondansetron 1/2 to 1 full tablet every 12 hours (4mg tablet)
-Cerenia - 1/2 tablet (24mg)

My ondansetron tablets are the same as yours, and I was told to give 1/2 tablet every 12 hours (hence 2mg). But my Cerenia tablets are 16mg; I was told to give 1/2 tablet every 24 hours, making it 8mg. How often do you give Cerenia?

 

[Gill & George]

Yes, I was thinking I would reduce since this is the third lime in a short period. I haven't done it for just one below-40 incident for a couple of reasons: 1) his food intake seemed to have more to do with the numbers than the dose, and 2) the Libre is known to give false lows, so I tend to be a little cautious about reacting to its readings.

Yes there is always that concern with the libre that it's a false low. Assuming you're at home , and it's not your room mates, can you double check with a regular human meter?

Not sure what you mean about kibble; he's been on an all-wet diet since mid/late January. The Hill's m/d glucosupport is canned wet food (it comes in both wet and dry).

My bad I mis read glad he's only on wet.

 

[Albert & Xander]

My ondansetron tablets are the same as yours, and I was told to give 1/2 tablet every 12 hours (hence 2mg). But my Cerenia tablets are 16mg; I was told to give 1/2 tablet every 24 hours, making it 8mg. How often do you give Cerenia?

I actually haven't given cerenia since early January when he had that pancreatitis flare and i've never given him the ondansetron yet. His low eating hasn't really dipped extremely low or shown obvious signs of nausea so the mirataz has seemed to manage it well.

Or do you mean dose frequency wise? it was prescribed to take every 24 hours as needed

 

[Mary & Jude]

I had to give Jude his Mirataz and Ondansetron about one to two hours prior to feeding/shooting time so that it would be working at feeding time. If I gave it (especially the Mirataz) to him just prior to his meal, it would start working far after I gave the shot, which put us in the same situation you're in.

Also, something I noticed with Jude is that sometimes he was just too groggy from the med (gaba + prazosin + Ondansetron + Mirataz) to get up and eat. Of course, if that were the cause of him not eating in the a.m., you would think it would be the same for the p.m. (except that by the p.m., he might just be super hungry, so he pushes himself a bit more to get to the food bowl).

 

[Allie & Gen]

Yes there is always that concern with the libre that it's a false low. Assuming you're at home , and it's not your room mates, can you double check with a regular human meter?

So yes, I did actually check him earlier today - the Libre was reading 53 at the time, and the regular meter gave me 62. Not a huge difference, but a difference.

(I'll just note that Gen has historically had such severe, adverse reactions to home blood testing that it's something I hold very much in reserve. (In fact, this is only the fifth test I've successfully managed to take! So I don't have a baseline right now for how much variance I get with him and a Libre. I'm hoping to build one over time.)

ETA: And of course, this isn't an option when I'm not home, which has been the case for the last couple of LO incidents (yesterday and Thursday). Trying to have my roommates do a test, even if one of them were home, is absolutely a non-starter on both Gen's and their respective parts. The trust, comfort level, sufficiently strong stomach/comfort with blood etc are not there.

My bad I mis read glad he's only on wet.

No worries at all. It did take some time to wean him off the dry, but I understand the stipulations of the dosing methods, so we were on SLGS until I'd made that change successfully and it was sticking.

 

[Allie & Gen]

I had to give Jude his Mirataz and Ondansetron about one to two hours prior to feeding/shooting time so that it would be working at feeding time. If I gave it (especially the Mirataz) to him just prior to his meal, it would start working far after I gave the shot, which put us in the same situation you're in.

Yeah, I was worried about this. There is very little chance that I will ever be able to consistently have 2-3 hours available in the morning before work. My sleep problems and my job simply won't permit that. I'm hoping that if I start giving Mirataz in the evening, it'll still be active 8 or so hours later. :/

Did you give MIrataz twice a day?

Also, something I noticed with Jude is that sometimes he was just too groggy from the med (gaba + prazosin + Ondansetron + Mirataz) to get up and eat. Of course, if that were the cause of him not eating in the a.m., you would think it would be the same for the p.m. (except that by the p.m., he might just be super hungry, so he pushes himself a bit more to get to the food bowl).

I don't think Gen gets groggy from his meds ... certainly, 50mg of gabapentin isn't enough to do much at all if I give it to him and then try to perform some procedure he objects to. But that's worth trying to observe more closely. I imagine that effect isn't immediate, either?

 

[Gill & George]

So I don't have a baseline right now for how much variance I get with him and a Libre. I'm hoping to build one over time.)

I wouldn't worry especially if it's tough on him, historically when folk have tried to do meter comparisons they've found it impossible to see a pattern.
I'd work more about the lo and checking if that is really low..

I hope he gets over his pancreatitis soon and starts eating normally. Tough about the suspected SCL /IBD hope that he gets his appy back if you need to go down the exclusion diet root.
Not something I've had to explore.

 

[Mary & Jude]

Yeah, I was worried about this. There is very little chance that I will ever be able to consistently have 2-3 hours available in the morning before work. My sleep problems and my job simply won't permit that. I'm hoping that if I start giving Mirataz in the evening, it'll still be active 8 or so hours later. :/

Did you give MIrataz twice a day?

Yes, twice a day.

I don't think Gen gets groggy from his meds ... certainly, 50mg of gabapentin isn't enough to do much at all if I give it to him and then try to perform some procedure he objects to. But that's worth trying to observe more closely. I imagine that effect isn't immediate, either?

Jude gets 1ML of liquid (compounded) Gaba twice a day. I think it's the combination of all the meds together--the Ondansetron, Gaba, and Prozasin (anti-spasmodic)--that make him groggy. I also give him Cystease, which has l-tryptophan (relaxes him) in it. His grogginess has adjusted over time; I don't think he's as affected by the meds now as he was in the beginning.

Also, I give Jude 4 mg of Ondansetron every 8 to 12 hours, when needed. When he was really inappetent, every 8 hours was imperative to knock out the nausea. Remember, though: Jude is 18.2 lbs.

 

[Allie & Gen]

Also, I give Jude 4 mg of Ondansetron every 8 to 12 hours, when needed. When he was really inappetent, every 8 hours was imperative to knock out the nausea. Remember, though: Jude is 18.2 lbs.

Hm, good to know. With my work schedule, 8 hours would be a squeak, but I could manage 9 or 10. Maybe it would be worth trying that.

Gen was 12lbs last time I was able to weigh him, and I think he's gained more weight since. (I've been trying to get him back up to his 15lb ideal weight). Jude's still a bit bigger, though!

 

[Wendy&Neko]

I have a couple ideas about timing of meds. First, give the ondansetron as soon as you get up. I like to make sure it's on board and working before giving Mirataz. Neko it would take 20-30 minutes, current kitty 30-40. You don't want to give an appetite stimulant to a nauseous can, as that can create food aversion. Thanks for posting his weight again. Dosing is by weight, and some vets give you dosing suggestions based on the injectible which is half that of the oral. He could easily get 4 mg. Too little ondansetron was a problem for Neko, cause at the time I didn't know the correct amounts. Yet one more thing about ondansetron, it can be given 3-4 times a day, which can make a difference. On days you are home (or can get home for lunch), can you experiment with giving it to him 3 times a day instead of 2.

Mirataz, I presume you are cleaning his ears before application of a new dose? I'm currently giving it in the evening, but that's just what my schedule worked out as, and current kitty has alway eaten most of her calories in the PM.

Have you ever tried giving Cerenia in the AM? It should be 24 hours but that's the only med difference I can see.

Regarding food, have you tried him on that rabbit food from the vet? Do you know he'll like it? A classic IBD sign is being picky and liking lots of variety of foods. Which is why I have to have at least two different proteins in rotation. It is good to start with one though. Have you considered trying a commercial rabbit formula for now, just to see if he'll tolerate it? Or even like it? Good to have a backup, regardless. I know your vet was on about cleanliness of big manufacturers process, but I knew someone who did cleaning duties for a cat and dog food product made locally. He showed me what he did between food runs and end of day. It was a LOT! They had multiple proteins running through their lines so they were very careful about cross contamination.

For Gen's health sake, I'd try to get rid of the fish in his diet. There are too many conditions tied to a fish heavy diet. Dr. Pierson on catinfo.org recommends fish not be part of their main diet. There are too many forever chemicals found in fish and they tend to be higher in phosphorus, which isn't good should kidneys disease occur.

 

[Staci & Ivy]

On a mostly unrelated-to-diet note ... I just did my first Libre/blood test comparison. At +4.5, my glucometer (calibrated for human blood) read 62. The Libre read 53 (the dang alarm started going off again mid-poke).

That's not a huge difference. Hard to know how consistent it is, of course, from one comparison. I'll try to get more in the coming days, though I had a bit of difficulty drawing blood today; Gen's ear got poked three times to get that reading, and he is not a happy camper. Given his intensely adverse reaction to manual testing back in 2021 (after his initial diagnosis), to the point that my vet and I agreed it was making everything worse ... I intend to tread very carefully now that I'm seeing some success at occasional poking.

@Staci & Ivy - remind me what the usual discrepancy is for you between the glucometer and the Libre? I really should have been keeping track of other people's findings on this.

When I get a LO on the Libre, “usually “ Ivy is 60-100 or so.
Sometimes, if I’ve fed her some HC 15-20 minutes prior, I test her and Libre says LO, but she’s 135-150 on a handheld meter (hence Libre delay, she’s already going up but Libre hasn’t caught up. I checked Libre 15 minutes later and sure enough she was 43-50, which corresponds to when I took the blood test 15 minutes prior).
Kind of confusing, but sometimes I can see what happened.

I hope Gen feels and eats better
Seems maybe you need Ondansetron more often than 2x a day? I think I would try that to see if that helps

 

[Suzanne & Darcy]

My ondansetron tablets are the same as yours, and I was told to give 1/2 tablet every 12 hours (hence 2mg). But my Cerenia tablets are 16mg; I was told to give 1/2 tablet every 24 hours, making it 8mg. How often do you give Cerenia?

Cerenia is only to be given every 24 hours. How much does Gen weigh? Re: Ondansetron, 2 mg is a low dose unless your cat is really lightweight like my poor boy who now has dropped below 6 lbs. and gets 2 mg (half of a 4 mg. Orally dissolving tablet/mini melt.) Regardless, Ondansetron can be given every 8 hours or even every 6 hours but only in the most severe cases.

 

[Allie & Gen]

I have a couple ideas about timing of meds. First, give the ondansetron as soon as you get up. I like to make sure it's on board and working before giving Mirataz. Neko it would take 20-30 minutes, current kitty 30-40. You don't want to give an appetite stimulant to a nauseous can, as that can create food aversion. Thanks for posting his weight again. Dosing is by weight, and some vets give you dosing suggestions based on the injectible which is half that of the oral. He could easily get 4 mg. Too little ondansetron was a problem for Neko, cause at the time I didn't know the correct amounts. Yet one more thing about ondansetron, it can be given 3-4 times a day, which can make a difference. On days you are home (or can get home for lunch), can you experiment with giving it to him 3 times a day instead of 2.

Unfortunately coming home on my lunch break is difficult - the ride back and forth takes up half my break time, barely giving me any time to eat, pill the cat, and run. (And that's when the roads are clear and I can ride my bike, which I mostly haven't been able to do for weeks because of all the snow.) It's an option for urgent situations but not an everyday thing. I can certainly experiment with giving him ondansetron 3 times a day on days when I'm home (like Wednesday), but maybe I shouldn't increase the dose and the number of administrations all together? I'm going to start by increasing the dose to 4mg, twice a day, starting tomorrow, and see how that goes.

Mirataz, I presume you are cleaning his ears before application of a new dose? I'm currently giving it in the evening, but that's just what my schedule worked out as, and current kitty has alway eaten most of her calories in the PM.

Yes, I am cleaning his ears (he hates it), though I'm often a little worried about whether it's all coming off. :/

Have you ever tried giving Cerenia in the AM? It should be 24 hours but that's the only med difference I can see.

I haven't ... I could try switching, but that would mean he only had a 12-hour interval between doses that one time (say, if I give it to him tomorrow morning, having just given it to him tonight).

Regarding food, have you tried him on that rabbit food from the vet? Do you know he'll like it? A classic IBD sign is being picky and liking lots of variety of foods. Which is why I have to have at least two different proteins in rotation. It is good to start with one though. Have you considered trying a commercial rabbit formula for now, just to see if he'll tolerate it? Or even like it? Good to have a backup, regardless. I know your vet was on about cleanliness of big manufacturers process, but I knew someone who did cleaning duties for a cat and dog food product made locally. He showed me what he did between food runs and end of day. It was a LOT! They had multiple proteins running through their lines so they were very careful about cross contamination.

Gen currently gets some Stella & Chewy's freeze-dried rabbit, so I know he likes that. Obviously I can't be completely sure it will carry over to the prescription wet food, but I'm optimistic.

My vet was specifically referring to a study where a variety of single-protein cat and dog foods were tested; I think it may have been this one (but haven't confirmed with her). They used a PCR test, to identify different sources of animal protein and found an over 50% instance of cross-contamination, so while a given factory may be thorough, there's evidence that at least some aren't thorough enough. I haven't been able to locate the names of the manufacturers from the study, and it seems like it was a fairly small sample, but I think she wants to start with an excess of caution, and it's an approach I respect. (I figure that I'll do it her way, and if we can get Gen stabilized and take care of his dental etc, then I can look into expanding his options.) Er, and when I say "she," I mean my vet and the internal medicine specialist she works with.

Regardless, I'm not going to start transitioning his diet until after I can get a biopsy and results for that.

For Gen's health sake, I'd try to get rid of the fish in his diet. There are too many conditions tied to a fish heavy diet. Dr. Pierson on catinfo.org recommends fish not be part of their main diet. There are too many forever chemicals found in fish and they tend to be higher in phosphorus, which isn't good should kidneys disease occur.

Gen's apparently going to insist I get rid of the fish regardless! I am still giving him some canned flaked tuna, but today I'm trying him on the chicken & beef pate as part of finding alternatives for variety. (Sticking with Fancy Feast while I wait for the biopsy.)

Thanks as always, Wendy.

 

[Allie & Gen]

When I get a LO on the Libre, “usually “ Ivy is 60-100 or so.
Sometimes, if I’ve fed her some HC 15-20 minutes prior, I test her and Libre says LO, but she’s 135-150 on a handheld meter (hence Libre delay, she’s already going up but Libre hasn’t caught up. I checked Libre 15 minutes later and sure enough she was 43-50, which corresponds to when I took the blood test 15 minutes prior).
Kind of confusing, but sometimes I can see what happened.

Interesting. It's going to take me some time to gather data! The difference between the Libre and blood test I did today was much smaller than you've seemed to get.

I hope Gen feels and eats better
Seems maybe you need Ondansetron more often than 2x a day? I think I would try that to see if that helps

Thanks. I think I'm going to start by trying to increase his dose at 2x per day, because work takes me away from home for at least 8-9 hours 4 days/week, and sometimes a bit longer. I couldn't really give him the med 3x/day at evenly spaced intervals.

 

[Allie & Gen]

Cerenia is only to be given every 24 hours. How much does Gen weigh? Re: Ondansetron, 2 mg is a low dose unless your cat is really lightweight like my poor boy who now has dropped below 6 lbs. and gets 2 mg (half of a 4 mg. Orally dissolving tablet/mini melt.) Regardless, Ondansetron can be given every 8 hours or even every 6 hours but only in the most severe cases.

Gen weighed 12lbs a couple of weeks ago. (I need to borrow my roommate's scale so I can do another weigh-in.)

 

[Wendy&Neko]

Regardless, I'm not going to start transitioning his diet until after I can get a biopsy and results for that.

Transitioning diet now will have no impact on the results of the biopsy. In fact, if he has good results from a totally transitioned diet, you might not need to get that biopsy. Though I guess it's possible he could have both IBD and SCL (like my current kitty). That is much less common.

I read the paper, the research was done it Italy. Two of the foods were Italian (possibly Farmina?) and the rest "international", I suspect European, not North American. I would be interested in a study of the so call "vet prescription" food to see what their contamination results are. Most of the "vet" novel protein diets are made by companies that make products with multiple proteins, meaning it's possible to do cross contamination in the process. The other possibility listed in the paper is in the food source, which is even harder to control. FYI if you make your own cat food, you have good control over protein source at the manufacturing site (your home).

 

[Suzanne & Darcy]

Gen weighed 12lbs a couple of weeks ago. (I need to borrow my roommate's scale so I can do another weigh-in.)

So he should be able to take the full 4 mg. tablet of Ondansetron every 8 hours if every 12 isn’t helping.

 

[Suzanne & Darcy]

I can certainly experiment with giving him ondansetron 3 times a day on days when I'm home (like Wednesday), but maybe I shouldn't increase the dose and the number of administrations all together? I'm going to start by increasing the dose to 4mg, twice a day, starting tomorrow, and see how that goes.

I think you have a good plan there!

 

[Staci & Ivy]

Transitioning diet now will have no impact on the results of the biopsy. In fact, if he has good results from a totally transitioned diet, you might not need to get that biopsy. Though I guess it's possible he could have both IBD and SCL (like my current kitty). That is much less common.

I read the paper, the research was done it Italy. Two of the foods were Italian (possibly Farmina?) and the rest "international", I suspect European, not North American. I would be interested in a study of the so call "vet prescription" food to see what their contamination results are. Most of the "vet" novel protein diets are made by companies that make products with multiple proteins, meaning it's possible to do cross contamination in the process. The other possibility listed in the paper is in the food source, which is even harder to control. FYI if you make your own cat food, you have good control over protein source at the manufacturing site (your home).

I was thinking the same thing about making your own food.
You eliminate all risk of outside contamination.
It’s not as hard as it seems.

 

[Staci & Ivy]

Interesting. It's going to take me some time to gather data! The difference between the Libre and blood test I did today was much smaller than you've seemed to get.

One more thing… as you said the difference in meters was smaller.
Ivy had that too. Libre LO, handheld 60 (bit I feel that just means she simply was flat and hadn’t bumped up that time).
You never know which sensation is going on. But with my bigger data spread, I knew I’d fed her and “suspected “ that’s what happened when I saw that larger spread.

 

[Allie & Gen]

Transitioning diet now will have no impact on the results of the biopsy. In fact, if he has good results from a totally transitioned diet, you might not need to get that biopsy. Though I guess it's possible he could have both IBD and SCL (like my current kitty). That is much less common.

I'm hesitant to spend 4-6 weeks trying to treat one issue while potentially leaving the real one unaddressed? That said, I just got off the phone with the animal hospital, and they've scheduled Gen for his initial consult with their internal medicine unit in a couple of weeks. That's further out than I was hoping, and of course, they won't do the biopsy without a separate first appointment. That would be a long wait, so I've put through an order for the new food, and we'll be working on the transition after all.

I read the paper, the research was done it Italy. Two of the foods were Italian (possibly Farmina?) and the rest "international", I suspect European, not North American. I would be interested in a study of the so call "vet prescription" food to see what their contamination results are. Most of the "vet" novel protein diets are made by companies that make products with multiple proteins, meaning it's possible to do cross contamination in the process. The other possibility listed in the paper is in the food source, which is even harder to control. FYI if you make your own cat food, you have good control over protein source at the manufacturing site (your home).

I was thinking the same thing about making your own food.
You eliminate all risk of outside contamination.
It’s not as hard as it seems.

Making Gen's food from scratch may be a possibility at some point in the future, but I'm not going to do it for a diet trial; there are too many variables wrt my time, my poor executive function (/cognitive disability), access to reasonably affordable materials, etc.

Also, to be clear, my vet is the one with the major cross-contamination concern. I'm less convinced, especially as the research (that I've been able to find) seems thin. That said, this is a case where I intend to follow doctor's instructions to the letter, at least for the duration of this initial trial. It's kind of like following one of the dosing protocols here; in order for my vet and her internal med colleague to assess him in this context, I am sticking to their protocol. Once they've assessed the results, I will investigate a broader range of options (like customizing for an individual cat). But first, I will work with them on their terms.

I'm filing away all the diet-related suggestions and tips I'm getting from all of you lovely people!