3/12 Kiwi, bouncing, & clear foamy vomit

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Kiwi F

Kiwi F

Member Since 2012
Last condo: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=65715

I just wanted your opinion on Kiwi's overall progress during the last few days. We've stuck with the .5u dose for 8 cycles now, but his bg has bounced around quite a bit... and stayed pretty high during the day yesterday, testing as high as 451 (although he was more stable during his PM cycles). A couple times, he tested significantly higher after his AMPS, and I am wondering how that might have happened... usually he goes down after getting his insulin.

Also, Kiwi has been vomiting small amounts of clear or foamy vomit, for the last 3 days. Most have been quite small (an inch or two in diameter), but a couple have been larger. Most have happened within an hour before his breakfast and AMPS (and a few happened during the night). The largest spot was food-colored, and happened after a mid-cycle meal. All together, I think he vomited 10-12 times. What might be causing this? Is this likely related to his diabetes? Should I be concerned? Could it be related to his bouncing bg numbers?

Thanks for all your help,
Kim and Kiwi
 
Re: 3/12 Kiwi, AMPS 239 - but bouncing

I have no dosing exerience, unfortunately, and I hope that someone that does have dosing experience can drop by your condo soon to answer your question. Hoping for a less bouncy day for you both. Have a great day!
 
Re: 3/12 Kiwi, AMPS 239 - but bouncing

funny-cat-pictures-not-one-of-these-cats-could-answer-the-riddle.jpg


Bumping you for dosing advice because I'm stumped :lol: :lol: :lol:
 
Re: 3/12 Kiwi, AMPS 239 - but bouncing

Bouncing is very normal for cats in the starting phase on Lantus and Kiwi is doing just that. That is what is happening when his BG goes higher after his shot, he is bouncing from the blue numbers. Bounces can last for 72 hours so Kiwi is actually doing quite well in that regard. The general guidelines recommend holding the starting dose for 5-7 days (10-14 consecutive cycles). Chances are that Kiwi is going to need a bit more juice but I would hold off on that for another day or two and then seek advice here before you do it because you want to make sure you're not increasing during a bounce.

I know that clear foamy vomit indicates something specific but I can not for the life of me remember what that is (it has been a long night for me sorry). Could you update your original subject line with 'clear foamy vomit?' Someone that knows about it will see it straight away then and come along and let you know what it could be but I don't think it's related to the bouncing.

What could help someone that comes along to advise you further about that is to note his feeding schedule. I think some cats vomit like that if they haven't been fed for a while but don't take my word for that one my brain is a bit fuzzy on it.
 
Re: 3/12 Kiwi, AMPS 239 - but bouncing

wow, kim, you've done a great job getting all those tests in!

he's definitely bouncing. you see that nice little blue 157 2 days ago in the afternoon? then see how the numbers rose up after that to an *ouch* 451 24 hrs later? that's the bounce. his liver let loose stored sugars and hormones, and now you wait for it to clear. it can take up to 3 days, although the 239 this morning looks optimistic, like maybe it's starting to clear out. some cats clear the bounce quickly, some take the full 3 days.

for now, you should probably hold the dose and let's check is again in another day or so. he should come back down and yes, he might need another smidge of insulin, but this isn't too far off right now. we don't increase a dose during a bounce because of safety reasons.

are you feeling a little more comfortable with all of it yet?
 
Re: 3/12 Kiwi, AMPS 239 - but bouncing

Thanks, you all (and thanks for the pic, Kim).

It does seem like a good idea to leave him at this dose for now, and give him time to stabilize. I will post before we change anything.

Right now he's eating his biggest meals at shot time, and smaller meals 6 hrs later (+6 AM and +6 PM). He doesn't seem to want to eat more often than that.

If anyone knows anything about the vomit, please let me know.
 
Re: 3/12 Kiwi, AMPS 239 - but bouncing

thanks for re-mentioning the vomit. that's a lot of something. would you re-edit your subject line of the first post here and add "vomiting?" or something like that so people with that experience can help you with it? i haven't dealt with that, but i don't think we should ignore it.

there are some people who feed their cats just a little bit around +9 because the cat seems to get nauseous if it doesn't eat for too long. you could try that. also if the cat has an acid tummy, some people give some pepcid to calm the stomach acid.

i'll let others with more experience offer their ideas, though.
 
It sounds like acid tummy. Mookie has it, too, and if he doesn't have anything to eat halfway through the night (around 3:30am on our schedule), he'll vomit a small amount of clear, sometimes foamy, liquid in the morning. He's had an acid tummy for a long time --even before he had diabetes. We give him 1/4 of a 10mg tablet of human Pepcid AC once a day in a pill pocket, and combined with regular snacks, he doesn't vomit anymore.
 
Hi Kim,

I'm sorry to hear about the vomiting. I put a shout out to Kerrie/Maverick - she is very knowledgeable on the subject of tummy upsets and strategies that help.

How is Kiwi otherwise? Is he eating his usual amount? any lethargy?

Do you have ketostix and if so have you checked his urine recently for the presence of ketones?
 
Vomiting white foam can be related to a number of issues (kidneys, pancreatitis, ibd, and others Im sure). My cat used to vomit white foam in the weee hrs of the a.m. It was typically due to stomach acid from having an empty tummy too long. Some things that could help with it include raising food bowls, and making sure they are fed before you go to bed. I had to make sure Latte ate at least every 4-6hrs or she would vomit. You could also talk with your vet about giving pepcid before bed.

If this is a new problem, I would highly suggest at least calling your vet. Even better, getting Kiwi in to run some labs.
 
Kiwi has thrown up something similar in the past, but not regularly. At the time, the vet didn't seem concerned. But now that its happening so often, I want to make sure we're not missing anything new. He had lots of labs a couple weeks ago, when his FD was diagnosed, and everything else was okay at that time. We've been doing ketone urine tests at home. We haven't caught him 'in the act' for a couple days, but all the past tests have been negative.

He's been eating every six hours, although his meal late at night is smaller than the others. If we feed him an extra time at night, and the vomiting stops, would that indicate its an acid problem?

As for how he's doing... for the past week, he's been doing a lot better... running and playing, and grooming more. I do think that today he's slept more, and seems kind of worn out. If that is still going on tomorrow, I'm going to worry. And I'm trying hard to get that ketone test. His bg was back down again this afternoon, and I'll be testing him again shortly.
 
Any dental issues? Is he on any other medications? Constipated?

Do you know how to check for hydration in a cat? Vomiting (even the foamy stuff) can cause dehydration, which would make him more sluggish.

Would Kiwi eat on his own in the middle of the night? Could you set a timed feeder with a small amount of food that opens a few hours after you go to bed? Not sure how well that would work in relation to YOUR wake up time and his shot.

I would never hesitate to at least call my vet if I ever had concerns and needed a little more guidance on what to do. Just give 'em a ring. :mrgreen: I bet they would help you!
 
Carolyn and Randa are right on. Clear, foamy liquid is acid tummy. If you don't have a copy of the bloodworm from the vet, I would get it and double check the values especially creatinine, BUN, and phosphorus. I think it is also a good idea to talk to your vet. The Pepcid AC 10 mg ( do not get Pepcid complete or the 20 mg) as Randa said will help. I have a kidney kitty and he gets 1/4 of the 10 mg be fore bed and we also feed him really late at night and early in the morning.

It is not normal for a kitty to have tummy acid and Carolyn has indicated some of the things that can cause this so it's a starting point to ask your vet.

I also agree that I wouldn't be surprised I'd we will need to throw a little more insulin in the mix when he's not bouncing.

Great job on testing and shooting regularly! :-D :-D
 
Vomiting white foam can be related to a number of issues (kidneys, pancreatitis, ibd, and others Im sure). My cat used to vomit white foam in the weee hrs of the a.m. It was typically due to stomach acid from having an empty tummy too long. Some things that could help with it include raising food bowls, and making sure they are fed before you go to bed. I had to make sure Latte ate at least every 4-6hrs or she would vomit. You could also talk with your vet about giving pepcid before bed.
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Always best to ask a vet so they are informed. It might have them relook over the blood work for other flags like Carolyn mentioned.

Pepcid AC - original - not extra strength, complete etc. 1/4 of a 10mg tab one hour before the first feeding or before evening feeding if the problem is at night. You can get empty gelcaps from the pharmacy - size 3 or 4 (4 is smallest). Or in a small piece of pill pocket (I don't know if this has carbs though). You don't want pepcid getting stuck in the throat/esophagus as it can cause issues.
 
I just found a hairball that was his... maybe it was having trouble coming up. I'll still talk to the vet.

I don't think the auto-feeder will work because I have two other cats that are little piggies, and would not hesitate to start a riot over a bowl of food. We've already resorted to feeding the other two at night, because they were going crazy smelling Kiwi's food. Is four times a day enough to keep his bg stable? We keep it evenly spaced... every 6 hrs, with less than an hour variance, only at the night feeding... the other three are exact.

Does anyone know a good way to check his teeth? He hates opening his mouth, and no matter how hard I've tried, I've never gotten a good look. He had a dental (and extraction) two years ago, but I can't remember them checking his mouth when we were there this last time (about the diabetes). Any ideas? We can't afford a dental visit at this point.

Did anyone see Kiwi's PMPS? He might be done bouncing already.

You guys are great. Thanks for all your help.
 
That's the lowest PS you have shot to date :-D
Good job!
Can you get a +2 on that ?

Hope the hairball was the culprit but all the same - let the vet know.

Regarding the feeding, if 4 times a day is what you can manage, see how it goes. I don't know how a timed feeder would work with more than 1 cat.

Dentals are pricey. Unfortunately the only way to get a good look into a cats mouth is under anesthesia.

Does he have bad breath?
 
Unfortunately, I didn't see the request for a +2 until now (although I almost got one anyway... so I must be starting to catch on. Too bad I didn't do it). I guess I spoke too soon about the bounce, thinking it was over. He was up a lot at +5 (one hour before eating). He tested 325. I thought it might be wrong (or maybe I just didn't want to tarnish his night time numbers with anything above a yellow), so I tested again, and got 270.

Questions: What number do I put in the spreadsheet, if he tests 325 and 270, within minutes of each other? And should I be getting a third test, if they are that different? I didn't want to poke him a third time, but I wanted to know what was up. Also, for the first test, there was very little blood, and I gave it a little more time than usual to bleed (and squeezed a bit... is that allowed?) I didn't want to re-poke him, but maybe I should have (I ended up doing it anyway). The second poke was perfect... the right amount of blood, right away. Does that make the second one more accurate? Or doesn't it matter? As for the bounce, and the 72 hr period, when does that start in our case? Also, am I correct to assume we should wait to do a curve until things settle down (or at least give it more time to)? And, are there any other test times I should try to get, that would help interpret his data?

Thank you so much. Everyone here is so great. I don't know what I'd do without you all.

Kim and Kiwi
 
Hi there :cool:
Kiwi F said:
I guess I spoke too soon about the bounce, thinking it was over.
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I think Kiwi had a new bounce, from that lovely 148.
Kiwi F said:
Unfortunately, I didn't see the request for a +2 until now
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A wise rule of thumb is that when shooting your lowest PS ever, make sure and get those early checks. Ideally, +1 and +2
if I had to pick one under last nights circumstances, I would have gone with the +2.
You will have other opportunities at shooting lower than ever before ;-)

As far as the 2 different numbers on the back to back tests, I'm not sure that they are different enough to cause concern.
The only time I ever immediately repeated a test is if I got a number that was WAY out of context
It's OK to squeeze a bit when trying to get a good drop - Kiwi will let you know if it's not.

if you are up for a curve, I would try and do it the next time you get a pretty PS :-D

For test times, (other than PS) take a look at your ss and try to get some random spot checks where you see those 'wide open spaces'. You don't have to get them all in one day. For example you could get an AM+7 one day and an AM+9 the next.
then before you know it - no more 'wide open spaces' :-D

You guys are doing a great job of getting in the groove !
 
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