? 3/28 Max PMPS 104 -- Confused - pls help?

Giomax

Giomax

Member Since 2018
Last thread: http://www.felinediabetes.com/FDMB/threads/3-26-max-amps-335-sick-boy-ketones.212403/

Any ideas why his pre-shot number is so low? His numbers have been extra weird lately. I'm feeding him Friskies in gravy tonight to keep him from going too low. A 5+ unit depot makes me nervous. Testing again in an hour.

Max had another ultrasound yesterday after a bad flare up. Vet said his pancreas is all messed up--cystic and inflamed. He thinks Max has had bouts of pancreatitis before without me realizing and it's damaged his pancreas. Vet thinks that may be why Max has been challenging to regulate on insulin. He said he doesn't think it's pancreatic cancer, but still not certain without biopsies and such which I can't afford right now. We're just gonna kind of wait and see if he gets better or worse. He also diagnosed Max with IBD.

For management we're doing insulin (obviously), Pepcid, probiotics and milk thistle every day. Every other day he gets a dose of Cerenia just to try to avoid any bad vomiting episodes like we had the other night. And once a week I'm giving him a B-12 injection. Buprenex will be given as needed.
 
Also, he's been being a lot more picky about his food lately, I assume because he hasn't been feeling good. I feel like the most important thing is to make sure he eats. Is it ok to feed him the junky food (higher carb w/ gravies) if it gets him to enjoy eating?
 
Giomax said:
Also, he's been being a lot more picky about his food lately, I assume because he hasn't been feeling good. I feel like the most important thing is to make sure he eats. Is it ok to feed him the junky food (higher carb w/ gravies) if it gets him to enjoy eating?
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What about small amount Clean Protein dry (4-5% carbs) crumbled up and put on top of wet food? Company will send free samples.
 
Looks like he is on he rise this cycle.

To answer your question : To get him to eat is paramount. Give him whatever he will eat right now.

If the doc suspects IBD, the first thing I would do is to eliminate chicken. That is the #1 thing that a lot of cats are allergic to. Then after 3 day of no chicken, see what the numbers show. That is what I did recently when Bubba was showing an allergic reaction to food/foods ( turns out he was allergic to chicken and pork )

Looking at his SS, you need to stop switching up the dose. If you are following SLGS, then you hold a dose for one week and then do a curve. ( unless of course if he goes under 90 since you are following SLGS) You are switching it up erratically. Just in the last few days, you only held the 5 unit dose 4 cycles then gave 5.5 one cycle and then went back to 5 units. Prior to that, you gave 6 units for a few cycles before changing. A dose needs 4-6 cycles to fill. Prior to that is not letting the dose get stable.

If you need assistance with the dose, please post with a question mark and something like dose advice so the peeps can help you.

My advice would be to hold the 5 unit dose for a full week unless he falls under 90 since you are following SLGS. And then go from there.
 
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@Bobbie And Bubba

Ugh, I know I've been switching up the dose. Knew I would get yelled at by you guys! Haha. Thanks for the advice. I'm just so extra confused with all the other health stuff he has going on and how that'll affect his dosing and his numbers. I work full time as well and I'm not able to be home with him during one of his cycles, so that puts me on edge too.

Max was on the rise because I fed him some gravy food. I'm going to test again on the hour to see how he's doing.
 
Giomax said:
Max had another ultrasound yesterday after a bad flare up. Vet said his pancreas is all messed up--cystic and inflamed. He thinks Max has had bouts of pancreatitis before without me realizing and it's damaged his pancreas. Vet thinks that may be why Max has been challenging to regulate on insulin. He said he doesn't think it's pancreatic cancer, but still not certain without biopsies and such which I can't afford right now. We're just gonna kind of wait and see if he gets better or worse. He also diagnosed Max with IBD.
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IBD cannot be diagnosed by ultrasound alone. Ultrasound can narrow down bowel thickening to one or IBD or small cell lymphoma (SCL). You do need either an endoscopy or surgical biopsy for differential diagnosis. Getting a GI panel, including folate and B12 testing may be a good idea. But since you started B12 without a test, that test wouldn't be worth doing now. Don't let the SCL scare you, many such kitties go into remission for years, if treated properly. On the other hand, food pickiness can be seen with IBD.

If you think it might be IBD, eliminating chicken for 3 days is not the way to do it. Many things can trigger an IBD flair. Chicken, beef, and fish are all common allergens. 3 days is not long enough to eliminate a particular protein. And it might not even be the protein that is the problem. Some kitties react to wheat (very common in gravy foods) or gums, often used for thickeners. Novel proteins might be worth a try. Probiotics can also help. Check out https://www.ibdkitties.net/

PS: you don't need to give gravy for those lovely blues. Nice surf tonight.
 
Wendy&Neko said:
IBD cannot be diagnosed by ultrasound alone. Ultrasound can narrow down bowel thickening to one or IBD or small cell lymphoma (SCL). You do need either an endoscopy or surgical biopsy for differential diagnosis. Getting a GI panel, including folate and B12 testing may be a good idea. But since you started B12 without a test, that test wouldn't be worth doing now. Don't let the SCL scare you, many such kitties go into remission for years, if treated properly. On the other hand, food pickiness can be seen with IBD.

If you think it might be IBD, eliminating chicken for 3 days is not the way to do it. Many things can trigger an IBD flair. Chicken, beef, and fish are all common allergens. 3 days is not long enough to eliminate a particular protein. And it might not even be the protein that is the problem. Some kitties react to wheat (very common in gravy foods) or gums, often used for thickeners. Novel proteins might be worth a try. Probiotics can also help. Check out https://www.ibdkitties.net/

PS: you don't need to give gravy for those lovely blues. Nice surf tonight.
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Vet told me about the B-12/folate test and the specific pancreatitis tests you guys talk about. It'd be over $300 for all the tests though and we've decided that they're not really necessary. We're just going to treat as if he does have IBD (since he has all the symptoms and bowels looked all messed up in ultrasound) and give him the B-12 supplement since a little extra B-12 won't hurt him anyway. Same for the pancreatitis test. We know from the ultrasound that his pancreas is angry and inflamed, so we're just going to treat for p-titis...which is what we'd do for a positive test result anyway.
 
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