3/18 Eleanor AMPS 333 +5 475, Vet, Help

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Julie and Eleanor (GA)

Julie and Eleanor (GA)

Member Since 2012
Since I want to do SLGS, I was going to start posting on the Relaxed forum, but I need a bunch of eyes so here I am with you kind souls.
Eleanor's +5 this morning was 174, AMPS 333. She ate a couple bites and I shot, figuring I would feed her at +1 and +2. She threw up. I couldn't get anything else down her. Finally got some baby food but all I had was Gerber with cornstarch. I figured it would raise her some.
She would not eat on her own the past 24 hours, I'm just desparate.
I got together the money I had to get my cooler turned on for the summer (now I don't know what I'm going to do) and took her to the vet. The regular one is on vacation but I thought this one would be okay.
He said she could have IBS or Pancreatitis. He said the not eating is pain or nausea, could be low blood sugar, no said, I'm testing her. His answer was I'm not testing ALL the time so she could be dropping. He said to give 1 unit once a day because 1 unit twice a day is a high dose for some cats. He said she may not even really be diabetic.
Suggested Metronidizol, I think for nausea. Liquid with a sweetener in it. Cyproheptadine as an appetite stimulent 2mg every 12-24 hours. Bupronex for pain.
Sub Q fluids 100ml daily. He wants to make tests. I have no money and I left confused and almost in tears because I just don't know what to do. She was eating FINE until about two weeks after I started the Lantus. He said the Lantus can't be the cause. I'm not saying it is, but I want to know WHY this just started.
He said could be food allergy and the food makes her stomach hurt so she doesn't want it, said she has some redness in her ears (allergy), and her eyes were watery (I reminded him of her chronic URI thing). Wanted me to give her ZD (I think) food and Royal Canin Venison. Also suggested I give her DM because "she needs to be on low carb so she might be able to get off insulin". Silent scream.

Got home, Eleanor was hungry so I tested her and her bg was 475. Tested again 495. Okay, that was when I started crying. She ate 1/4 can FF Chicken Feast on her own.
Could she be that high from the stress of going to the vet, and maybe the baby food? She was at +5. She's guzzling water.
I've seen her sick and in pain, she had a recurring problem with blocked anal glands, they abscessed a couple times, her dental problems, her spinal injury, acid stomach - when she's ill - in pain, nauseated, she is immobile. She lies in one spot and doesn't move, doesn't respond. I've honestly thought she was dying.
That is NOT how she is now, she's up running around, playing, tormenting my other cat. She is NOT Eleanor in pain or nauseated.
I'm so confused because I think she IS nauseated...but I don't know. Maybe she is in pain.
Does any of this make sense to anyone? I'm so scared about that 475.
Does anyone have any suggestions?
 
Re: Eleanor 475, Vet, Help

Julie - BIG hug. Yes that could be stress and cornstarch. It's a number, breathe and step forward. I don't think it's the lantus either. Can't stay but had to remind you to breathe and give you a hug....
 
Re: Eleanor 475, Vet, Help

I'm mainly bumping you up for better eyes as well...
but I know that the few times Binks would throw up, it raised his bg as well.
I will leave it for the more knowledgeable folks to address, but I think you are seeing a combination of factors raising her level...
stress, vomiting, cornstarch...all could contribute.

We're thinking of you, and know you'll get some insightful input....

:YMHUG:

celi
 
Re: Eleanor 475, Vet, Help

Thank you Celi, I know one other time she threw up and I tested her, she was higher. After she threw up today right after her shot, I wondered if the PS 333 was the barf brewing.
She's eating a bit on her own again.
 
Re: Eleanor 475, Vet, Help

Ok. Deep breath.

What you are seeing is a bounce. Just to give you a context, Gabby has bounced from the 40s to the 400s. Almost every one of the cats here has bounced. Some are Olympic athletes when it comes to bouncing, others aren't even contenders.

So, what's a bounce, you ask. Fundamentally, this is the body's way of protecting itself from what it believes is hypoglycemia. When Eleanor dropped from 298 to 87, her liver panicked. Or, technically, her liver released a stored from of glucose along with counterregulatory hormones. The release of these elements causes BG levels to spike. It can take up to 72 hours for a bounce to clear.

The bounce does not account for Eleanor vomiting. It may be that this is pancreatitis. Pepsid AC (famotidine) can be very helpful with the nausea associated with pancreatitis. The typical dose is 2.5mg (1/4 of a 10 mg tablet). Did the vet give you metronidazole (Flagyl) or metoclopramide (Reglan)? The former is an antibiotic and the latter is for nausea/vomiting.

As far as eating, most cats before they are diagnosed have a voracious appetite. This is because glucose is not getting into the cells. When they eat, the food is metabolized but it can't get into the cells because there is insufficient insulin to accomplish this process. As a cat begins insulin and numbers improve, appetite decreases.

I don't know if there is a food allergy or if there are environmental allergies. If Eleanor wasn't having problems with foods before, I'd be suspicious. On the other hand, it is allergy season. There are a number of options to help with environmental allergies.

I think trying to tackle one thing at a time will help you feel less overwhelmed. If it were me, I'd want to get Eleanor eating. Food trumps pretty much everything else. If you think she's nauseated, Pepsid may be very helpful. This is a link regarding pancreatitis that was written by a vet tech that used to be very active on the Board. Cyproheptadine can be helpful if she's not eating but it sounds like she's eating on her own. If this is pancreatitis, it is, in fact, very painful. Buprenex would be a good choice for treating the problem. It would also be helpful if you could get blood drawn for a spec fPLI -- this is the definitive test for pancreatitis.

ETA: The Gerber baby food is about 7% carb. It's not that high in carbs especially if Eleanor will eat it.
 
Re: Eleanor 475, Vet, Help

(((((Eleanor))))) I know how scared and frustrated you are. Can I suggest that you send a PM (private message) to Karrie and Maverick and ask for her advice? I can send it if you aren't familiar with that. Karrie is an expert on getting cats to eat and she helped us a lot with Zener. She might also suggest the Feline Assisted Feeding group on yahoo. We joined that when Zener had some major eating issues and we had to syringe feed him.

We are using cypro with Zener on occasion. Anne read that some people just use a sliver every 12 hours. Our previous vet's dosage was also high and he didn't need that much. Karrie recommends Ondansetron (general anti-nausea) along with the cypro because you don't want to stimulate the cat's appetite if she's also nauseous.

Buprenex was helping Zener eat after his dental but that seemed to be masking his motility problems.

Metronidizol is an antibiotic, probably for inflammatory bowel disease (IBD).

Stress from the vet visit can cause high BG.
Liz
 
Sienne, Eleanor had not eaten on her own for 24 hours, before that I was syringe feeding her to try to get enough food into her. She IS eating now, but couldn't that be because of her 475 bg? She was eating all the time at dx. I was very happy when her appetite started to decrease, but stopping altogether isn't what I was hoping for.
I've been giving her Pepcid twice a day.
He gave me liquid Metronidizol. It has a sweetener in it.
She had a negative spec fPLI in January. Vet said a cat can have a neg test and still have pancreatitis.

Liz, I asked about Ondansetron, as I had seen it mentioned here, but the vet ignored me.
I'll try to find Karrie and Maverick.

Randa, I had been testing for ketones up til about 3 days ago when she became extremely sneaky with her peeing. She goes under the bed now.
 
Oh Julie, I'm so sorry you are going through this, but so glad we have people on this board that are so knowledgeable and I hope their info helped. You know I'm here for moral support, other then that, I have no experience with any of this. You know you have my info. and I want you to use it anytime, ok, remember I am up till late… Hope Eleanor feels a little better for you and is eating.

:YMHUG: :YMHUG:
 
Likewise, I just want to let you know you and Eleanor are in our thoughts and prayers. You came to the right place for help!!
 
{{{hugs}}} to you, can't offer much advice, there are tons of people on here who can help you. Just know that you aren't alone and we have all dealt with (or are currently dealing with!) high numbers. Rupert has posted some 500+ this past little while.. but he too looks fine and happy and running around. Listen to Sienne, she'll give you good advice and ideas. As I"m slowly learning, even though those high numbers are hard to see, as long as there are no ketones, and as long as the kitty seems 'ok', this too shall pass. Take care. It will get better!
 
I don't think higher numbers would cause Eleanor to eat. Often, when a cat drops into low numbers (e.g., in the 50s or below) they want food. There could be any number of factors effecting Eleanor's appetite. The metronidazole comes in a pill form. If Eleanor is OK to pill, you can try that. There is a duck and pea allergy formula Pill Pocket that is fine for diabetic cats. Frankly, I would bring the liquid back and point out that it's inappropriate for a diabetic. (A vet in the practice I use did the same thing -- gave me a product with sugar in it. I didn't realize it until I got home. When I called, her reaction was that there wasn't much sugar in it. I replied asking if she would like be to give her diabetic child a couple of tablespoons of ice cream twice a day. She saw my point.)

The vet is correct -- if a pancreatitis flare is beginning or ending you may get a negative test.

If this is pancreatitis, Pepsid and bupe should help. If you trust your regular vet, would it be possible for you to call and talk to him on Monday? The vet you spoke with sounds like he was throwing out all sorts of possiblities. I thin you need an action plan.
 
Metronidazole is an antibiotic it has nothing to do with nausea. Metoclopromide/Reglan is often prescribed for cats but doesn't work well for nausea in cats but it does for dogs. That is unless nausea is due to low stomach motility - a symptom would be throwing up food many hours after eating it.

Nausea in cats can be vomiting but classic signs of nausea in cats are showing interest in food but just licking/sniffing and walking away, lip licking, lip smacking and teeth grinding. Cerenia is a drug used to control vomiting in cats, but not general nausea. General nausea - for just inappetance without vomiting - the best is ondansetron (found at costco for I hear good prices or $1/pill at thriving pets.com) Each 4mg pill is four doses. The sister version available from a vet is dolasetron. Pepcid also isn't an antinausea pill but can help with excess stomach acid.

Cypro - is good for a cat that already has an appetite - not complete anorexia. Vets often prescribe way too much of this. Its best to start with 1/8th of a pill and go up. You have to make sure you address nausea though or else it would be like giving you an appetite stimulant with the flu. It can lead to long term food aversion.

So if the vomiting persits, cerenia is the best option. If inappetance still lingers you can add ondansetron to this. We can help coach you on how to speak to your vet about this. Vets in the US often seem under-educated about nausea treatment in cats.

And one more thing you have in your tool box is assist feeding. I am a member of the Yahoo Feline Assisted Feeding Forum. It is a forum dedicated to assist feeding cats because of a cat's unique biology. Their livers do not process body fat well - body fat used for fuel to make up for not enough calories in food. Their livers clog with fat. This can happen in days with complete anorexia or over a few weeks with less than ideal calories. Also with a diabetic cat - not enough food/not enough insulin/ and infection are the combination for potentially fatal Diabetic Keto Acidosis (DKA). So Assist feeding means orally syringe feeding food (one you would not normally feed to avoid food aversion), finger feeding, spoon feeding, plop plop on the floor feeding, and even a feeding tube. Sryinge feed a food that is high in calories. Wellness Chicken has 200 calories a can. I think there are some kitten foods that are higher. If you join Yahoo Feline Assisted Feeding - there will be an auto file sent to you with instructions and tips for syringe feeding, and a great video on the home page of someone syringe feeding their cat.

You are in great hands here. I would trust the advice on this forum over a vets every single day. They are the diabetes experts - helping thousands of cats and are up on the latest literature. Most vets treat a handful of diabetic cats a year and not very well. They are not used to owners educating themselves. I had to fire Maverick's vet and we ended up finding a perfect vet. Long story there.

Sending big hugs.
 
Big hug :YMHUG:

I hope you and Eleanor have a better evening. I'm sorry your vet visit was so frustrating.

Lots of thoughts for you both.
 
Julie and Eleanor said:
Sienne, Eleanor had not eaten on her own for 24 hours, before that I was syringe feeding her to try to get enough food into her. She IS eating now, but couldn't that be because of her 475 bg? She was eating all the time at dx. I was very happy when her appetite started to decrease, but stopping altogether isn't what I was hoping for.
I've been giving her Pepcid twice a day.
He gave me liquid Metronidizol. It has a sweetener in it.
She had a negative spec fPLI in January. Vet said a cat can have a neg test and still have pancreatitis.

Liz, I asked about Ondansetron, as I had seen it mentioned here, but the vet ignored me.
I'll try to find Karrie and Maverick.

Randa, I had been testing for ketones up til about 3 days ago when she became extremely sneaky with her peeing. She goes under the bed now.
Click to expand...

I think that you did the right thing in being concerned about Eleanor not eating and then vomiting. It is good that she is eating now. If she is not eating, you are able to syringe feed her to help calories in, which is very good, and you also got her to take the baby food, which was good. Keeping food going in is very important. Keep trying her favourite things.

The vet has made some suggestions about food. I think that two of the suggestions (ZD and Venison) were made due to suspicions that food sensitivities could cause inflammatory bowel disease (IBD) or perhaps even the ear allergies. These kinds of diets contain "novel" animal and vegetable proteins that cats may not have been previously been exposed to and formed allergies to. Adding in DM doesn't make a lot of sense, as that contains the allergy causing proteins. In the short term, before you start changing foods, if that is what you wish to do, I would first want to see her reliably eating her favourite foods. You would hate to cause her appetite to be hurt further by trying out new foods she may not like. So think about those foods when things settle down.

The vet is trying a lot of different things at once. Sometimes that makes it hard to tell what is working out of all of the different things being tried.

I like the recommendation above that keeping her eating is the main thing.

Continuing with the Pepcid AC may keep her more comfortable.

Metronidazole (Flagyl) is an antibiotic, but it is one which is particularly effective in treating GI inflammation, so it may help with the suspected IBD. If inflammation is reduced overall in the GI tract, it could also help with the suspected pancreatitis. It will only be once you give it that you are able to tell if there will be an impact on her BG's. You may be pleasantly surprised. We will have to see what happens with that.

According to your last posts, I get the impression that she is eating and playing. Very good signs. She may not need the cyproheptadine yet. If you suspect nausea, an appetite stimulant should not be given until the nausea is under control. If you do give cyproheptadine, start with a very small dose (I would try less than what you were prescribed, and monitor for effect, before working up to the prescribed dose. Some cats get very vocal and restless on that drug, so start low with it and work up.

If Pancreatitis is suspected (and without a lot of diagnostics, it is difficult to say what is going on because IBD and Pancreatitis can have similar presentations), both fluids and pain meds can help.

Buprenex for pain is a good treatment for Pancreatitis. Again, the doses that vet prescribes often zone the cat right out, so you may wish to start on a much lower dose than originally prescribed and then work your way up to the prescribed dose, or until you find an effective dose (do not exceed the prescribed dose). Do you have Buprenex that goes in the mouth? Be sure that you give that in the cheek pouch to be absorbed by the membranes; do not give it to be swallowed. Or the vet may have given you needles to inject it.

Fluids are good for Pancreatitis, and may help with a cat who is dehydrated from vomiting. Guzzling water could mean she is dehydrated. Could also be a sign of pain. Pancreatitis is painful.

I am afraid that I don't give dose advice. I would be inclined to continue the Metronidazole (unless you find the effects on BG are not tolerable). The vet can give you another form. Metro is bitter, which is why you have a sweetened formula.

I would use the fluids as prescribed.

I would continue with the Pepcid.

I would continue encouraging her to eat, and assisting her with eating.

I would only try a low dose of cyproheptadine if she still won't eat, but remember it is best not to use this appetite stimulant if you feel the cat is nauseous.

You really have not been given a medication to combat nausea. Ondansetron is good, or some shots of Cerenia may do the trick. If you go back, try to ask the vet for Ondansetron or Cerenia injections.

You are on top of the situation and doing the right things.

I was typing while others were at the same time, so forgive me if I am repeating information.
 
Thanks everyone for replying. I appreciate your help.
Today was only the second time in a couple weeks that Eleanor vomited, both times were after she had gone too long (for her stomach) without food. I fed her at +5 and should have gotten a bit into her at +9 but I was asleep and just didn't wake up. I woke up at +11, knew she needed something in her tummy but hoped she'd be okay until her +12 test. She wasn't.
so from what you've said here, since her problem is, I guess, nausea rather than vomiting, I should try to go with the Ondansetron rather than the Cerenia.
I'll call in the morning and see if I can talk to one of the other vets about that.
 
(((((julie))))) sending hugs to you, and wishes for a good appetite to eleanor.

you've gotten great advice from others - i just wanted to let you know we care.
 
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