5/8 PM - Dose Advice Needed

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Wulfwin

Wulfwin

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Rain has not had any insulin since Friday (5/6) morning due to eating issues (see http://www.felinediabetes.com/FDMB/threads/5-6-pm-shot-or-no-shot-advice-needed.157392/) and my not being able to monitor her on Saturday and today. I sent off a Spec fPL on her and it came back yesterday slightly high (reference range 0-3.5, she was 3.6). I talked with my vet and I gave her a dose of buprenorphrine last night for possible pancreatitis pain. Last night I was still having eating issues with her (could only get her to eat some science diet A/D - the first time she voluntarily ate wet food!) so I skipped her dose last night and this morning since I still wasn't able to monitor her and wasn't comfortable with how her appetite was. Tonight she was acting super interested in food (she tried to grab my peanut butter sandwich and run off with it), but I was having problems getting her to eat anything. Finally about 20 minutes ago she suddenly decided to eat the remainder of Jason's latest meal of low carb Fancy Feast (again voluntarily eating wet food! :woot:). It was probably about 1.5 oz. She's had access to dry food, but I haven't seen her eat any since Friday night. I tested her BG immediately after she finished eating and she's 255. Given that her carb intake is lower (I suspect significantly) than normal and she hasn't had any insulin for a few days, I'm not sure what dose of insulin to give her tonight. Any suggestions? I should be able to monitor for most of her cycle tonight as I'll be up late working.
 
Well,I would be cautious. She has remained in decent ranges with no insulin. And there is always the problem of her choosing not to eat.

Maybe 0.1 or 0.2 and monitor carefully, being ready to guide the numbers up with food?

It's exciting she is eating!
 
Should I skip the dose tonight and see how her eating goes? See if I can continue to keep her eating the fancy feast, maybe pull the dry food for tonight? Obviously her choosing not to eat again is my biggest concern since she's been so inconsistent, but I'm also not sure if the change in food (since she wouldn't eat any of the novel protein foods I tried, of course) is going to trigger her vomiting. I have noticed that she seems to be itching her ears more tonight than normal. If you think I should try a dose, I'll probably try to give 0.1.

I refused to move and barely breathed the entire time she was eating the Fancy Feast because I didn't want her to stop!
 
So I decided to try to see if Rain would eat more Fancy Feast before I made a decision about the shot. She tucked right into the same flavor (tender beef and chicken) and ate about half the can. I tested her again just now when she finished and she's at 179 (so a little more than 2 and a half hours since she ate the first amount and tested a 255). I going to skip the shot tonight and try pulling the dry food for now (she doesn't seem to be interested in it anyway). I'll see if I can keep her going on the wet food for now and re-evaluate in the morning.
 
Good call. Interesting. One of the tests to see if the pancreas has started to work again is to feed, wait and see if the bg goes up or down. Going up is normal for a diabetic. Going down after food is one of the first signs that the pancreasijg might be "waking up"

A good sign but can be a little nerve wracking. The pancreas working is a step in remission (anti jinx) but it doesn't wake, start to work and continue on. We think it wakes up in starts and fits - working for a while, then resting, then working. You support it with small frequent meals. It may make a cycle last longer than 12 hours, may bring the levels lower than normal etc.

It can also be that wet food may make that difference in bringing her levels into more normal ranges. I would continue to be cautious when dosing, erring on the lower side of doses and monitoring carefully.
 
'Nerve-wracking' - good description! I unfortunately had an unexpected emergency this AM so I wasn't able to give her any insulin, but she's still eating the FF like it's the best thing next to packing tape (packing tape is Rain's all-time favorite thing to chew/eat). She's getting fed about every 6 hours or so, same time as Jason (he needs frequent feeds or he'll puke). She acts like she's feeling great. I'll see how she is tonight; if she's over 200, I'll probably try 0.1 and see where that takes us. I'm hoping she's still feeling/eating this good tomorrow when the bupe dose will be worn off for sure.
 
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