3/4 Gizmo - AMPS - 201 vomiting

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Rachel P

Rachel P

Member Since 2022
Morning y’all,

Gizmo ate her breakfast pretty fast this morning and I had only given her .1 because I had a weird feeling when I woke up about her today. Shortly after eating a ton, she puked it all up undigested. She hasn’t gone back to eat yet. Do I need to do anything special here like try to offer more food at a slower pace? Panicking because she hasn’t thrown up since her numbers have been getting better.

what’s the protocol with vomiting if there is one?
 
@FrostD i know you’re sick, so don’t worry if you don’t see this. She’s down to 115 @ +3.5. Idk if it’s the insulin or the vomiting, but I’m skipping for my trip. It’s gonna have to be that way I think until we can figure out what’s going on here. Maybe need to approach the vet about Lantus. Don’t know. But i just don’t think im comfortable doing anything while im gone.
 
Was the vomit like yellow bile? Or food like she ate too much or too fast? How does she seems otherwise?

It was not COVID, and I am healed thankfully lol it was like a one day flu, I've never had anything like that in my life. Really thought I was going to wake up like I was hit by a truck

I think skipping will be ok, I'd just encourage your husband to try to get one ketones test in if he can.
 
No, it was literally like slammed almost a whole can, walked 5 feet away from the bowl and yakked it back up. It wasn’t like an “I’m sick” throw up. When she’s sick sick, she howls loud before. It was like a pure regurgitation type. Very rare I see that, though, so still alarmed me. Then laid down on dining room table for 5 mins, went back and ate the rest and begged me for another hour and I kept doling it out a teaspoon at a time. It’s stayed down now.

She otherwise seems okay. When she’s in these low midday numbers, she’s much more tired than usual. She has been playing a **** ton the past few days, even by herself. I find her in a room with a spring toy just batting it around. This week some of her old behaviors have come back. Ever since this happened, she never wanted to be by me. Now she comes at 8pm to lay on my legs again. It’s nice.

maybe this .10 dose I did this morning seems okay to give while I’m gone. It didn’t seem as aggressive, but I did give DM around +3. Either this or the drop dose.

One good thing is he’s taking off Monday, so she will only be alone during the day Tuesday.
 
Suzanne & Darcy said:
Sounds like she ate too fast. I have a kitty that does the scarf and barf sometimes. Seems like she must be feeling a lot better -- all that playing :)
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Yes, every night we have to go around and round up the toys because otherwise she will get ahold of them and yowl downstairs for us to come down and throw them. She’s a piece of work.

yeah I bet it was, I just hate to give her the shot and then she turns right around and barfs. Scared me!
 
FrostD said:
Was the vomit like yellow bile? Or food like she ate too much or too fast? How does she seems otherwise?

It was not COVID, and I am healed thankfully lol it was like a one day flu, I've never had anything like that in my life. Really thought I was going to wake up like I was hit by a truck

I think skipping will be ok, I'd just encourage your husband to try to get one ketones test in if he can.
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PMPS was 189 even with the .10 dose this morning. I’m gonna try to do the .10 again since I can monitor tonight. This is so whack.
 
FrostD said:
I'm just glad it's working!
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Somehow, some way. I cant stop saying to my husband “can you imagine if we just left the vet that day and gave her 2 units this whole time and bought into not testing her?” I continue to be a aghast about the fact that I could very easily have been doing that and not knowing any of this. I really think she would have been dead.
 
These tiny doses are ridiculously hard. We just tried to do another .10 and the tiny little amount still came out after giving the shot. Any tips with that other than hard depressing the plunger and holding for as long as we can?
 
Rachel P said:
These tiny doses are ridiculously hard. We just tried to do another .10 and the tiny little amount still came out after giving the shot. Any tips with that other than hard depressing the plunger and holding for as long as we can?
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Unfortunately no, they're just a pain sometimes. I wouldn't sweat it, it's better than giving too much
 
FrostD said:
I do think this 0.1U will be safe while you're gone, unless something odd happens tonight. Your call
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I’m not sure what happened on the one tonight. How much she got, if any, I mean. We will see what goes on in the morning and I can test her up to +7 when I leave for airport.

yeah I think it is too. I still am strategically feeding the DM at the low points or right before, though. He will be able to do that on Monday just based off the average onsets and stuff like that, but probably not Tuesday. We shall see. I’ve been crying hysterically all night because I can’t stand to leave her :(
 
She'll be ok! Worst case he skips a shot and she's a little higher when you come back.
 
FrostD said:
She'll be ok! Worst case he skips a shot and she's a little higher when you come back.
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Well, I’m back. My husband tried every day to give her a shot. I called him on FaceTime and watched. She wailed and screamed and hissed at him and ran away and hid. Big time no. Told him to just skip as to not stress her worse.

and guess what? Got home at midnight. Skipped 5 doses. She’s 116. Wow.
 
Too funny, poor husband and poor Gizmo. Well, let's see how she does! Shes still a bit above normal range, but at this point all you'll be able to try is a drop dose
 
She ate a ton this morning and she’s 109. She’s incredibly happy I’m home, bunny kicking everything and running around the house at break neck speeds. I skipped again. At what number do you think you’d restart the drop dose?
 
Honestly, as long as she's above 100. Normal range can go up to 120, but nearly all non-diabetic cats (or cats in remission) are under 100 majority of the time. Take a look at my spreadsheet, you'll see I've never gotten a BG over like 90 except when he was ill.

Now, there will be a bit of difference between human meter and AlphaTrak. So you would try the drop dose when you can monitor, and do that until she goes below 68. Once she goes below 68, that's it, that is the best you can safely do for her on ProZinc.

At that point we do an OTJ (off the juice trial) - 2 weeks without insulin, still testing. Ideally, nearly all green before calling it remission
 
FrostD said:
Honestly, as long as she's above 100. Normal range can go up to 120, but nearly all non-diabetic cats (or cats in remission) are under 100 majority of the time. Take a look at my spreadsheet, you'll see I've never gotten a BG over like 90 except when he was ill.

Now, there will be a bit of difference between human meter and AlphaTrak. So you would try the drop dose when you can monitor, and do that until she goes below 68. Once she goes below 68, that's it, that is the best you can safely do for her on ProZinc.

At that point we do an OTJ (off the juice trial) - 2 weeks without insulin, still testing. Ideally, nearly all green before calling it remission
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So in other words, the goal is to try to get down to non diabetic cat levels? Aren’t these numbers really good, though? Or I guess not considering I didn’t intend to stop? This makes me incredibly nervous just based on the ProZinc history. I wonder if switching insulin would make this more attainable?
 
Rachel P said:
So in other words, the goal is to try to get down to non diabetic cat levels? Aren’t these numbers really good, though? Or I guess not considering I didn’t intend to stop? This makes me incredibly nervous just based on the ProZinc history. I wonder if switching insulin would make this more attainable?
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Yes. We have found here that the best/strongest remissions come when they are in non-diabetic numbers before discontinuing insulin - while slowly titrating down the dose to keep them safe.

Yes her numbers are great!

ProZinc is hit or miss with how well you can achieve all green, as you can see. If a drop dose drops her below 68, well then your hands are mostly tied. You do have the option to feed slightly higher carbs to keep her above 68, but still give the other numbers time to come down overall. But with Gizmo, that may a difficult task lol

Lantus, semglee, and Levemir are generally flatter insulins, and can help when ProZinc does this sort of rock-and-a-hard-place thing. But it's a gamble, there's no guarantee.

I would give the drop dose a good try and see how she does. If it doesn't work, I'll ask one of our moderators for her thoughts.
 
Sounds good. I’m going to try to get up the courage to do it but may be a day or two until you hear from me. Gotta recoup from vacation until I feel like I can really monitor as closely as I should.
 
FrostD said:
Yes. We have found here that the best/strongest remissions come when they are in non-diabetic numbers before discontinuing insulin - while slowly titrating down the dose to keep them safe.

Yes her numbers are great!

ProZinc is hit or miss with how well you can achieve all green, as you can see. If a drop dose drops her below 68, well then your hands are mostly tied. You do have the option to feed slightly higher carbs to keep her above 68, but still give the other numbers time to come down overall. But with Gizmo, that may a difficult task lol

Lantus, semglee, and Levemir are generally flatter insulins, and can help when ProZinc does this sort of rock-and-a-hard-place thing. But it's a gamble, there's no guarantee.

I would give the drop dose a good try and see how she does. If it doesn't work, I'll ask one of our moderators for her thoughts.
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Also, wonder what would happen today and tomorrow if I drop her down to 0% foods I have instead of the 2%-3%. Interesting experiment maybe too.

It’s just so curious to me why these numbers without insulin are lower than the others.
 
Rachel P said:
Also, wonder what would happen today and tomorrow if I drop her down to 0% foods I have instead of the 2%-3%. Interesting experiment maybe too.

It’s just so curious to me why these numbers without insulin are lower than the others.
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I think it's a combination of a lot of things, but primarily it means her pancreas is working fairly well. I suspect your initial dose would have been lower with the timing of meals etc straightened out, or rather the necessary decreases would have been sooner. Hindsight, yadda yadda, not important. Looks like her pancreas just needed a bit of a nudge in the right direction. Possible something else underlying that sort of cleared up (was she in steroids? Can't remember). How long has it been since she's had GI issue? Were her asthma attacks pretty frequent? I wonder if she's having a lull from that too

I would not drop to 0% carbs, they do need some carbs (and actually, very often, numbers are worse on zero carb) - https://www.felinediabetes.com/FDMB/threads/feeding-lowest-zero-carb-vs-lower-carb-foods.144220/
 
FrostD said:
I think it's a combination of a lot of things, but primarily it means her pancreas is working fairly well. I suspect your initial dose would have been lower with the timing of meals etc straightened out, or rather the necessary decreases would have been sooner. Hindsight, yadda yadda, not important. Looks like her pancreas just needed a bit of a nudge in the right direction. Possible something else underlying that sort of cleared up (was she in steroids? Can't remember). How long has it been since she's had GI issue? Were her asthma attacks pretty frequent? I wonder if she's having a lull from that too

I would not drop to 0% carbs, they do need some carbs (and actually, very often, numbers are worse on zero carb) - https://www.felinediabetes.com/FDMB/threads/feeding-lowest-zero-carb-vs-lower-carb-foods.144220/
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good info on the carbs, thanks! Hadn’t seen that before.
Yeah, she was on steroids. Very large injectable doses of depomedrol and kenalog in November and end of December. They told me the depo could take at least 8 weeks or more to wear off. the vet has always purported that this would go away when that went away, just needed to be supplemented with insulin until we got there. But that should be far gone now.

Agreed on the meal timing, etc. I was so hung up with getting the rest right, that could have been much sooner. Live and learn.

the GI issues that were occurring at the beginning of February never returned. That was constipated, vomiting, then diarrhea from miralax and lactulose. They never came back after you guys got me going on the probiotics. She pretty much poops daily now, or less than every 24 hours. It’s incredible, she has never done that her whole life. It’s always been 2-5 days unless sick.

I’m actually taking her into vet on Friday because I have a suspicion about her teeth. She only has about 8 left, the front mini ones and some molars. She has a very bad history of resorptive lesions and had most of her teeth removed a year or so ago. I’m wondering if maybe the remaining teeth could be starting the resorption process, but I can’t get back there to see. She occasionally tilts her head oddly when she gets a big bite, which is reminiscent of the FORLS of earlier days. I want to see if they can get a look at them. Could be a contributing factor.
 
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FrostD said:
I think it's a combination of a lot of things, but primarily it means her pancreas is working fairly well. I suspect your initial dose would have been lower with the timing of meals etc straightened out, or rather the necessary decreases would have been sooner. Hindsight, yadda yadda, not important. Looks like her pancreas just needed a bit of a nudge in the right direction. Possible something else underlying that sort of cleared up (was she in steroids? Can't remember). How long has it been since she's had GI issue? Were her asthma attacks pretty frequent? I wonder if she's having a lull from that too

I would not drop to 0% carbs, they do need some carbs (and actually, very often, numbers are worse on zero carb) - https://www.felinediabetes.com/FDMB/threads/feeding-lowest-zero-carb-vs-lower-carb-foods.144220/
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the asthma attacks were maybe 2-3 times a week when we did the steroids. I do still see it here and there (notes on the spreadsheet). It’s not as frequent as it was back then, but definitely still happens any given week. The litter change I did a week or two ago seems to be helping a lot. Was using incredibly dusty Fresh step, now we are using tidy cats free and clean (1000x less dust). She won’t give up the clay litter (I tried) but it does seem to be helping with the frequency of the coughing fits and general congestion.
 
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FrostD said:
I think it's a combination of a lot of things, but primarily it means her pancreas is working fairly well. I suspect your initial dose would have been lower with the timing of meals etc straightened out, or rather the necessary decreases would have been sooner. Hindsight, yadda yadda, not important. Looks like her pancreas just needed a bit of a nudge in the right direction. Possible something else underlying that sort of cleared up (was she in steroids? Can't remember). How long has it been since she's had GI issue? Were her asthma attacks pretty frequent? I wonder if she's having a lull from that too

I would not drop to 0% carbs, they do need some carbs (and actually, very often, numbers are worse on zero carb) - https://www.felinediabetes.com/FDMB/threads/feeding-lowest-zero-carb-vs-lower-carb-foods.144220/
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Also, when the constipation and all that jazz starts and I took her and we got the big diagnosis, the liver levels were not good. I kind of want to repeat that Friday and see what’s going on there. They did write in her chart at the time of diagnosis that they suspected it was precipitated by steroids and hepatic lipidosis or pancreatitis.
 
Rachel P said:
She definitely is. AMPS is 70. I asked her if she’s been getting into the ProZinc in the fridge behind my back.
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This is awesome! Just keep doing your spot checks - the usual preshots, and then 2-3 hours after she eats if you can manage
 
FrostD said:
This is awesome! Just keep doing your spot checks - the usual preshots, and then 2-3 hours after she eats if you can manage
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I’m bursting with joy inside, trying to maintain some skepticism LOL. but I’m absolutely freaking out ecstatic. She was wildly hungry this morning and ate like 4.5 ounces of food. I think she’s just so not used to feeling this low. She’s been absolutely dashing around the house, more playful than I’ve seen her in 10 years, kid you not. I’m shocked to see that 78 after the big breakfast. Will keep checking!!!

i hate that I don’t even know you - I want to send you all her baby pictures and a giant basket of presents. None of this was possible without you….
 
Rachel P said:
I’m bursting with joy inside, trying to maintain some skepticism LOL. but I’m absolutely freaking out ecstatic. She was wildly hungry this morning and ate like 4.5 ounces of food. I think she’s just so not used to feeling this low. She’s been absolutely dashing around the house, more playful than I’ve seen her in 10 years, kid you not. I’m shocked to see that 78 after the big breakfast. Will keep checking!!!

i hate that I don’t even know you - I want to send you all her baby pictures and a giant basket of presents. None of this was possible without you….
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I promise you I'm just as happy as if they were my own babies! If ever there was a time to cooperate Gizmo, it's now you crazy girl
 
Oh look she has the little chest star like Mr Kitty!

Hahaha that's the one thing Mr Kitty has never done, the typical knock everything off counters/tables.

It is such a relief when they start acting like cats again, I cried the first time he got the zoomies and came into bed with me
 
FrostD said:
Oh look she has the little chest star like Mr Kitty!

Hahaha that's the one thing Mr Kitty has never done, the typical knock everything off counters/tables.

It is such a relief when they start acting like cats again, I cried the first time he got the zoomies and came into bed with me
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Yup, little bow tie :) I know. I missed her so much.
 
FrostD said:
Oh look she has the little chest star like Mr Kitty!

Hahaha that's the one thing Mr Kitty has never done, the typical knock everything off counters/tables.

It is such a relief when they start acting like cats again, I cried the first time he got the zoomies and came into bed with me
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Went to the vet today, she was 119 over there (naturally) and came home back in the 70s. He echoed no more insulin for now, and if it comes back, we will consider something more gentle. He said to call him if it starts coming back near 130-150.

he also asked me if other cat diabetes clients he has can call me if they need support. LOL. Funny to hear that coming from him now.

nothing weird with her teeth. She gained a few ounces and has maintained her weight. So, I guess I consider this my OTJ trial.
 
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