6-30-24 Leroy AMPS 158, questions (long post)

squeem3

squeem3

Very Active Member
The last few months have been crazy (for me) and there's been nothing new with Leroy's numbers so we went into lurk mode. Now we're back:facepalm:

Short version: Leroy went to the ER Wednesday night because he wasn't feeling well and was admitted for diagnostics and treatment. Diagnosis: IBD flare up. He came home yesterday afternoon.

The discharge paperwork mentions trying Toujeo U300 insulin to better control bgs with a once daily injection. I've searched the boards but found little info on the insulin. Any thoughts on this insulin? How do you measure a U300 insulin with a U100 insulin syringe? Is there a conversion like with U40 insulin? I'll obviously discuss with the vet at the appointment.

Leroy's had IBD flare ups before while on pred but he would just be meatloafing and be quiet. This is his first flare up on budesonide and not what either of us want to go through again. Is the budesonide not helping with the IBD? Food hasn't changed at all. Hopefully he doesn't have a new sensitivity to rabbit :nailbiting: There's no other novel protein commercial raw food I can feed him. I'd make raw from scratch but I don't have the freeze space and no space for a stand alone chest freezer.

Dumb question - why can't you use a q tip to apply Mirataz to the ear? Or the back of a small plastic spoon?

Leroy was getting 0.5 units BID during his stay at the vet hospital. They were testing him with an AlphaTrak. He's back on his normal dose of 1.5 units. I asked the vet if it was ok to go back up to 1.5 units or stick with the 0.5 units and gradually go back up. He said as long as Leroy has a good appetite it was fine to go back to 1.5 units.

Leroy is just getting the folic acid and potassium supplement along with insulin and budesonide at the moment. The gabapentin and Mirataz and Cerenia are only if needed.

Spreadsheet is up to date with the blood work results from Wednesday's ER visit and a list of current meds. I have to get the more recent blood work results from the vet's secretary tomorrow.
 
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Toujeo is a good option for high dose cats, not so much for smaller doses. There are no U-300 syringes - you can only use the pen. We have had very few people use it, one person did it by accident (foster insulin donation). Thankfully that cat was acro not regulated yet and survived the triple dosing.

I've heard that budesonide might not be as even an action as pred. Not sure if that's why the flare up. Maybe the dosing needs to be increased a bit. The worst flare my IBD girl had was when we were tapering the pred down and she told me that was a no-go. Is Leroy getting probiotics (like Visbiome) and prebiotic such as psyllium husk fiber? My cat also had low potassium at the time which led to slow motility (ileus). Fluids also helped her. Maybe ask the vet about that?

Miritaz - I've only used the finger tip glove things to apply. I imagine it would absorb into a Q tip and you wouldn't get as much in him.

Sending many healing vines for Leroy, hope he can come home soon.
 
Leroy came home yesterday afternoon. He's doing ok so far. Still unusually quiet but his appetite is good without Mirataz and and he's taking all his pills just fine. The potassium tablet is huge, almost nickle size. I have to cut it into quarters so they're small enough for Leroy to eat. He's had no gabapentin today and doesn't seem to need it for pain purposes or just to chill out.

We did briefly increase the budesonide to 2 pills once a day but that just made Leroy pee more and bgs crept up.

I've tried probiotics and digestive enzymes in the past but they never made any difference for Leroy.

I didn't want to stress Leroy out anymore today with bg checks. PMPS was 166. Hopefully we'll see more blues now. He hasn't had many in awhile, maybe because his IBD was slowly flaring up?

Tomorrow is call the vet's secretary to give her an update and get copies of all the additional blood work and tests that were done. Hopefully I won't need to bring Leroy or anyone else to the ER this week :nailbiting:
 
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