5/22 Ruby AMBG 71/+8 74/PMBG 64 *Caturday!

[Katherine&Ruby]

Yesterday on All About Ruby.

I felt rather triumphant at having received a script for gabapentin from Ruby's IM yesterday, after exhausting other possibilities of making her feel more comfortable. Pain management was the last tool needed for my supportive care kit.

Fwiw, Butters does very well with 25mg gabapentin q8 for pain control.

Lyla, I stalked your thread before giving Ruby her dose, as I know you give it to Butters and the doctor prescribed 100 mg q12 for her and it seemed like much too much. I sprinkled a half a capsule in her food, rather than completely second guessing the expertise of her doctor, I thought. I found out that was waaaaaay too much! It didn't knock Ruby out but she was stumbling around like a drunken sailor. She likes to sit on the top edge of the sofa when I'm there so she can sniff my hair and give me head butts, but last night she nearly fell off...twice! Thankfully the sedation seems to have worn off this morning, and she came to wake me up for food as usual, ate well and seems brighter than yesterday. I did do some research on the dosage afterwards and some sites recommend 5-10 mg/kg, up to 100 mg, so 50 mg would not have been an unheard of dose to give. Given Ruby's CKD though, I should have been more cautious. Live and learn! Relieved she seems ok this morning.

Day 3 of a green start.

It's Caturday! I leave you with this bit of a cute kitty named Penny channelling Machiavelli (or is it Niestzsche?).

https://www.newyorker.com/humor/daily-shouts/penny-rejects-the-rules-of-man

 

[JaxBenji]

doctor prescribed 100 mg q12

FWIW I think I remember my vet saying they often prescribe 100mg q12 or q24 because that's how the capsules are manufactured. You may know this but you can get compounded pills of gaba in smaller amounts if you decide to keep it on hand long term. When I used it for Jax as pain management after his dental, I stuck with the capsules (mostly bc he was only on it short term), cut them open (small serrated knife worked best for me to get the end of a cap off), and made my own smaller amounts (50mg and 25mg) using empty gel caps. When we started gaba, I could put it in his food but even my "I eat everything cat" got wise to the bitter gaba so that's also why I moved to making my own capsules.

Hope Ruby keeps improving Have a wonderful weekend

 

[Summer and Susie (GA)]

Yesterday on All About Ruby.

I felt rather triumphant at having received a script for gabapentin from Ruby's IM yesterday, after exhausting other possibilities of making her feel more comfortable. Pain management was the last tool needed for my supportive care kit.

Lyla, I stalked your thread before giving Ruby her dose, as I know you give it to Butters and the doctor prescribed 100 mg q12 for her and it seemed like much too much. I sprinkled a half a capsule in her food, rather than completely second guessing the expertise of her doctor, I thought. I found out that was waaaaaay too much! It didn't knock Ruby out but she was stumbling around like a drunken sailor. She likes to sit on the top edge of the sofa when I'm there so she can sniff my hair and give me head butts, but last night she nearly fell off...twice! Thankfully the sedation seems to have worn off this morning, and she came to wake me up for food as usual, ate well and seems brighter than yesterday. I did do some research on the dosage afterwards and some sites recommend 5-10 mg/kg, up to 100 mg, so 50 mg would not have been an unheard of dose to give. Given Ruby's CKD though, I should have been more cautious. Live and learn! Relieved she seems ok this morning.

Day 3 of a green start.

It's Caturday! I leave you with this bit of a cute kitty named Penny channelling Machiavelli (or is it Niestzsche?).

https://www.newyorker.com/humor/daily-shouts/penny-rejects-the-rules-of-man

Good to know Ruby is feeling better today. I like the cartoon. Looks a little like Susie when I have been poking her a lot. Temptations always bring her out, though.

 

[Tina Marie (GA) and Jan]

Triumphant is right! I feel better this morning for Ruby. And you.
I hope the Gaba helps just right, once you find the correct dose. I have never given more than 50mg at a time (25 when enough), and never have seen a drunk looking kitty. Sure have heard about it though. Makes me think of something awful (she lost her kitty) a member went through, when a vet advised giving / or the script was written wrong . . .100mg q12 at least.

Go Ruby doo - we love you!

 

[Katherine&Ruby]

FWIW I think I remember my vet saying they often prescribe 100mg q12 or q24 because that's how the capsules are manufactured. You may know this but you can get compounded pills of gaba in smaller amounts if you decide to keep it on hand long term. When I used it for Jax as pain management after his dental, I stuck with the capsules (mostly bc he was only on it short term), cut them open (small serrated knife worked best for me to get the end of a cap off), and made my own smaller amounts (50mg and 25mg) using empty gel caps. When we started gaba, I could put it in his food but even my "I eat everything cat" got wise to the bitter gaba so that's also why I moved to making my own capsules.

Hope Ruby keeps improving Have a wonderful weekend

Thanks, Susanne! I know the smallest amounts of gaba come in 100 mg caps, but the directions on the bottle say to give 100 mg every 12 hours. If she wanted me to give less, why didn't she say so? By the time I picked up the script it was after hours for the vet so I couldn't ask her to confirm. This is after I already second guessed her dosage of mirtazapine, and I'm still not giving Ruby what she thinks is safe because giving Ruby much less often works well for her. I should listen to my gut, always start small and work my way up.

 

[SashaV]

Woooooho, happy day 3!

Is gaba powder or small capsules inside?

 

[Katherine&Ruby]

Woooooho, happy day 3!

Is gaba powder or small capsules inside?

It's a very fine powder. I sprinkled it in Ruby's food and she ate it up.

 

[JaxBenji]

why didn't she say so?

because they don't know we will open up the capsule and divide it you of course lose a bit of accuracy doing this but my self-made capsules were close-enough for me.

 

[SashaV]

It's a very fine powder. I sprinkled it in Ruby's food and she ate it up.

Then you can divide further next time, fortunately
Before I came here, I never knew cats could have gaba...
Very practical since my dad is on it
But my vet always let me have pain meds at home, but "only" metacam. But I've been where you were yesterday, I needed morfin for a rabbit and the vet didn't want to prescribe it. I could get fluids, everything but the morfin I needed for him. I got it somewhere else

 

[SashaV]

because they don't know we will open up the capsule and divide it you of course lose a bit of accuracy doing this but my self-made capsules were close-enough for me.

On the other hand one could use a weight for fine tuning the dose.

 

[Katherine&Ruby]

because they don't know we will open up the capsule and divide it

Don’t they know what kind of crazy cat mom they’re dealing with here?

 

[Katherine&Ruby]

On the other hand one could use a weight for fine tuning the dose.

The lowest my scale goes is 1 gram. I was thinking of upgrading anyway to get something that would measure as low as .1 grams.

 

[Tomlin]

Dr Jessica Quimby, out of Ohio State U Vet Clinic, is actually doing the PK studies for gabapentin in cats & there is an awesome podcast where she discusses it. She did the PK study in healthy cats and was finishing up the data for older cats, with and without CKD. The 100mg dose is an anecdotal dose that has been being used and as everyone here has discovered, often way too much for cats with CKD (or even older cats) & also for use for pain vs one time dose to manage anxiety when going to the vet.

Here is the link to the podcast:
https://imgv2.scribd.com/podcast/44...girl-Veterinary-Continuing-Education-Podcasts

 

[tiffmaxee]

I’ve missed the last few days. Are you starting an OTJ trial? Has anyone given you the directions? Or is this an official let’s see what happens?

 

[carfurby (GA)]

Nice to see Ruby still in green. I hope you can find a good dose of the gaba that works for her.

 

[Katherine&Ruby]

I’ve missed the last few days. Are you starting an OTJ trial? Has anyone given you the directions? Or is this an official let’s see what happens?

I didn't intend to start a trial as I was simply freaked out about giving insulin with an iffy appy. When day 2 came around and she was still green and stayed low, I thought this was a possibility. I'm not following the usual process here for OTJ as I didn't go down in dosing the usual way, but Ruby looks like she is ready for it. Her BGs have been creeping up a little as the depot has drained but still staying between 50 and 80. I'm worried that she will spike again if she gets another flare, but we can deal with that when it happens. What do you think? Should I put in my thread title that I'm doing an OTJ trial?

I have the directions:

• If he/she is green at your normal test times, no need to test further until the next "PS" time; just feed small meals and go about your day.
• If he/she is blue at your normal "PS", feed a small meal and test again after about 3 or 4 hours. If his/her number is lower 3-4 hours after a meal, then the pancreas is working!
• Post every day so we can monitor your progress and see if any tweaks are needed. He/she may have a sporadic blue number. Don't panic but post before you decide whether to shoot so we can have a discussion. After 14 days of no insulin, we have a party!!
• Sometimes the trial doesn't work the first time and we have to give a little more support in the form of resuming insulin. It's not the end of the world if that happens; we just give him/her the support needed. Our goal is a strong remission and it's better to take our time to get that than to rush into remission just to have it fail later on.
• Once he/she is through the trial successfully, you enter a new phase. Your cat is still diabetic but has now become diet-controlled. Continue feeding low carb food in the manner successful for your kitty. If you decide to change his/her feeding schedule, let your meter be your guide to the best times to feed.

Avoid medications with sugar in them and steroid medications unless they are medically essential. Continue testing blood glucose weekly for the first month and then monthly forever. It's a good idea to weigh him/her monthly. Weight should remain stable. If he/she seems "off" or sick, or is showing signs of diabetes (excessive drinking, eating, urinating, weight loss), test his/her blood glucose right away. Keep the teeth and gums clean and healthy; dental issues can bring a cat out of remission. If you see rising blood glucose numbers, it's time for a visit to the vet!

 

[tiffmaxee]

Being as I am a little superstitious, let me talk to a few others to see if we stick with unofficial a bit longer since she was on the drop dose just a day. She won’t be the first to go OTJ in an unusual way. I’m glad she’s feeling better.

 

[Katherine&Ruby]

Being as I am a little superstitious, let me talk to a few others to see if we stick with unofficial a bit longer since she was on the drop dose just a day. She won’t be the first to go OTJ in an unusual way. I’m glad she’s feeling better.

I'm a little superstitious about it as well and want to proceed with caution since Ruby's situation is complex with all of her concurrent issues. If her condition does not improve, scoping might be in the picture very soon and who knows what that will do to her glucose levels. A weekend in the hospital put her in the pinks again. As Wendy said yesterday, Ruby's pancreas has been functional while on insulin, but not to the point where we'd be confident about a strong remission. I do want that for her. And me.

 

[tiffmaxee]

I didn’t see Wendy’s post. She’s one I was checking with for an opinion. I do agree with her. Nothing wrong with holding the insulin to see what happens. She very well could need scoping. I know it’s been in the table for awhile

 

[Katherine&Ruby]

I didn’t see Wendy’s post. She’s one I was checking with for an opinion. I do agree with her. Nothing wrong with holding the insulin to see what happens. She very well could need scoping. I know it’s been in the table for awhile

What @Wendy&Neko said was "Ruby's pancreas looks like it's already been sputtering for a while," but she didn't say "not to the point where we'd be confident about a strong remission," I added that. I am unsure as I don't have enough experience to know. Maybe @Sienne and Gabby (GA) or @Marje and Gracie are around and can weigh in, too.

 

[Katherine&Ruby]

Dr Jessica Quimby, out of Ohio State U Vet Clinic, is actually doing the PK studies for gabapentin in cats & there is an awesome podcast where she discusses it. She did the PK study in healthy cats and was finishing up the data for older cats, with and without CKD. The 100mg dose is an anecdotal dose that has been being used and as everyone here has discovered, often way too much for cats with CKD (or even older cats) & also for use for pain vs one time dose to manage anxiety when going to the vet.

Here is the link to the podcast:
https://imgv2.scribd.com/podcast/44...girl-Veterinary-Continuing-Education-Podcasts

Thanks for that podcast! It was really interesting to hear the vet say that doses of gaba can go as low or as high as needed. I can see why one would need 100 mg to calm a fractious, fearful cat, but ECID I guess and it's really about experimenting for your particular cat and the need that it's addressing. 100 mg for a one time dose might be ok for a vet visit or a long car ride, but if a senior, more frail cat needs it chronically for OA or have it for a few weeks to manage a flare, a smaller dose seems to be the right way to go. Wish I'd heard this yesterday!

 

[Wendy&Neko]

Most cats down to 0.1 units have at least a sputtering pancreas, doesn't mean it's fully functional yet. Be interesting to see where she is when the depot is fully drained.

 

[Katherine&Ruby]

Most cats down to 0.1 units have at least a sputtering pancreas, doesn't mean it's fully functional yet. Be interesting to see where she is when the depot is fully drained.

Thanks, Wendy. We've been at it this long, so I want to do this right. Putting on those stretchy patience pants again.

 

[Suzanne & Darcy]

The lowest my scale goes is 1 gram. I was thinking of upgrading anyway to get something that would measure as low as .1 grams.

Yes. You can buy the gram scales. Amazon sells them.

 

[Butters & Lyla]

I have only ever been given gabapentin in 25mg capsules for Butters, even though she was originally prescribed 50mg q8. I guess maybe here it is 100mg or 25mg capsules? IDK. I can't wrap my head around your vets prescribing 100mg because the capsules come in this size when they only want to prescribe 50mg.

Anyhow, I'm so glad you decided not to give her the full 100mg. It was terrifying when I gave Butters 50mg, too. I thought she was going to tumble right down the stairs into the basement because she was also stumbling around banging into things.

I have this scale and love it: https://myweigh.com/product/triton-t3-rechargeable/
All of the head shops sell them and of course amazon. This one is accurate down to 0.01 gram, so perfect for weighing meds and splitting powder in capsules. Its capacity is 500 grams, though, so I can use it for much more than just that.

 

[Katherine&Ruby]

I have only ever been given gabapentin in 25mg capsules for Butters, even though she was originally prescribed 50mg q8. I guess maybe here it is 100mg or 25mg capsules? IDK. I can't wrap my head around your vets prescribing 100mg because the capsules come in this size when they only want to prescribe 50mg.

Anyhow, I'm so glad you decided not to give her the full 100mg. It was terrifying when I gave Butters 50mg, too. I thought she was going to tumble right down the stairs into the basement because she was also stumbling around banging into things.

I have this scale and love it: https://myweigh.com/product/triton-t3-rechargeable/
All of the head shops sell them and of course amazon. This one is accurate down to 0.01 gram, so perfect for weighing meds and splitting powder in capsules. Its capacity is 500 grams, though, so I can use it for much more than just that.

I didn't want to go back to AMC to get the meds as it's an hour commute and back, so the vet called it in to a local CVS and the 100 mg cap was the smallest they had. Glad I had that experience, now I know never to do it again! I did speak to Ruby's primary vet today and I got bupe that they put into syringes. I am to give .25 mls of it each time. I might just give her half to see how she does. I'm learning!

Does bupe have a bitter taste? I've never successfully squirted anything into Ruby's mouth before. Does Butters tolerate it well?

Thanks for the link to the scale. Will come in handy for measuring out gaba and the meal completing powders.

 

[Butters & Lyla]

I didn't want to go back to AMC to get the meds as it's an hour commute and back, so the vet called it in to a local CVS and the 100 mg cap was the smallest they had. Glad I had that experience, now I know never to do it again! I did speak to Ruby's primary vet today and I got bupe that they put into syringes. I am to give .25 mls of it each time. I might just give her half to see how she does. I'm learning!

Does bupe have a bitter taste? I've never successfully squirted anything into Ruby's mouth before. Does Butters tolerate it well?

Thanks for the link to the scale. Will come in handy for measuring out gaba and the meal completing powders.

With Butters, I can give her the full dose that the vet prescribed 0.14mL q8 but 0.5mg/mL is the concentration...stronger than what I see others use. Maybe it isn't processed through the kidneys like the gabapentin? IDK.

No it doesn't have a bitter taste that I can detect. But rather than squirt it into Ruby's mouth, squirt it into her cheek pouch and then rub her cheek lightly. Bupe is absorbed through the skin. I usually insert half the dose, rub her cheek, let her lick and swallow, and then repeat. Butters generally doesn't tolerate me doing anything to her other than what she wants, but that quirk aside, she has no issues with tolerating the bupe. Whereas she now runs away when she detects the smell of the antibiotic.

 

[Our Dolly Girl (GA)]

Yesterday on All About Ruby.

I felt rather triumphant at having received a script for gabapentin from Ruby's IM yesterday, after exhausting other possibilities of making her feel more comfortable. Pain management was the last tool needed for my supportive care kit.

Lyla, I stalked your thread before giving Ruby her dose, as I know you give it to Butters and the doctor prescribed 100 mg q12 for her and it seemed like much too much. I sprinkled a half a capsule in her food, rather than completely second guessing the expertise of her doctor, I thought. I found out that was waaaaaay too much! It didn't knock Ruby out but she was stumbling around like a drunken sailor. She likes to sit on the top edge of the sofa when I'm there so she can sniff my hair and give me head butts, but last night she nearly fell off...twice! Thankfully the sedation seems to have worn off this morning, and she came to wake me up for food as usual, ate well and seems brighter than yesterday. I did do some research on the dosage afterwards and some sites recommend 5-10 mg/kg, up to 100 mg, so 50 mg would not have been an unheard of dose to give. Given Ruby's CKD though, I should have been more cautious. Live and learn! Relieved she seems ok this morning.

Day 3 of a green start.

It's Caturday! I leave you with this bit of a cute kitty named Penny channelling Machiavelli (or is it Niestzsche?).

https://www.newyorker.com/humor/daily-shouts/penny-rejects-the-rules-of-man

Hi Katherine, I’ve been missing in action so finally I had a chance to peek in on you and Ruby. Thank you for the cute cartoon I’ve been reading about your adventures with Gabapetin. I have pre filled syringes to squirt in Dolly’s mouth before vet visits. I just checked the mg and yes, 100mg. I refused to give it to her, half a syringe and Dolly would be knocked out for two days. Her new, probably temporary vet, said it’s a great med for arthritis in cats but they don’t handle it very well, isn’t that the truth? . Dolly can have, one pre filled 12mL syringe of Buprenex every 8 hours. I taste every med Dolly gets before I give it to her, it’s sort of tasteless. She handles it very well, no walking into walls or falling off the couch.
I only give it to her when she looks like she is suffering, a guess at best. She semi limps favoring her right hip and was walking sooooo slow, so painful to watch. I have to squirt it in her mouth, she is stronger than I am and moves her head away, turns her neck back and forth, making it impossible to aim anywhere, I just shoot. The Adequan injections she started a week ago is a huge success. She is walking so much better.

Looks like Ruby is over insulin, her numbers are beautiful. I just hope she is feeling better, eating better. I’m not totally up to date on anything today, I just hope things are better. Sending loving, healing prayers and a bunch of hugs

 

[Katherine&Ruby]

Hi Katherine, I’ve been missing in action so finally I had a chance to peek in on you and Ruby. Thank you for the cute cartoon I’ve been reading about your adventures with Gabapetin. I have pre filled syringes to squirt in Dolly’s mouth before vet visits. I just checked the mg and yes, 100mg. I refused to give it to her, half a syringe and Dolly would be knocked out for two days. Her new, probably temporary vet, said it’s a great med for arthritis in cats but they don’t handle it very well, isn’t that the truth? . Dolly can have, one pre filled 12mL syringe of Buprenex every 8 hours. I taste every med Dolly gets before I give it to her, it’s sort of tasteless. She handles it very well, no walking into walls or falling off the couch.
I only give it to her when she looks like she is suffering, a guess at best. She semi limps favoring her right hip and was walking sooooo slow, so painful to watch. I have to squirt it in her mouth, she is stronger than I am and moves her head away, turns her neck back and forth, making it impossible to aim anywhere, I just shoot. The Adequan injections she started a week ago is a huge success. She is walking so much better.

Looks like Ruby is over insulin, her numbers are beautiful. I just hope she is feeling better, eating better. I’m not totally up to date on anything today, I just hope things are better. Sending loving, healing prayers and a bunch of hugs

Thanks for the visit, Adrienne, and for sharing your experiences with these drugs with Dolly. I've never given pain killers to a cat so all of this is very new to me and frankly I don't know if it helps. Ruby's eating today, so that's all been fine, but she's been acting a bit listless and the sedation of the pain meds doesn't seem to make it better. I just want my sweet kitty back. I'm happy not to be giving insulin and hope Ruby can stay steady like this. Very heartened to know that the Adequan is working wonders for Dolly, and look forward to a time when she is jumping around again. Warm hugs. Good night!

 

[Diane Tyler's Mom GA]

Beautiful greens again, Sorry about Ruby walking like a drunken sailor, poor baby. I
hope the pain meds work.
Sending prayers for Miss Ruby ♥