7/28 Max AMPS 467 +3 580 +4 543 6 470 +8 392 +10 486 PMPS 567

[Max & Lori]

Vomited again a small amount early this morning. Having problems with constipation lately. Only goes every 2, sometimes 3 days and it’s really hard. This is a change from all the diarrhea he’s been having for his IBD. Has not had any Loperamide in a while for that. My husband didn’t know he shouldn’t have laxatone so expect BG to go up. Eating well. Will probably dose increase to 6u tonight or tomorrow morning. Have tried egg yolk and adding water to his food. Any other suggestions?

 

[Max & Lori]

Called the vet and they advised 1/4 tsp Metamucil in every meal.

 

[Max & Lori]

My sweet boy Max ended up at the vets office today due to lots of vomiting and constipation. He was full of hard stool on X-ray; had enema, subQ fluids, Cerenia, and pain med; Max was dehydrated but no ketones. Diagnosed with pancreatitis per labs done earlier this week. Vet thinks he has had pancreatitis for quite a while. Will hold off on insulin increase at this time.

 

[Marje and Gracie]

I’m so sorry to hear Max is not well. He’s had a rough day. I’m very glad you took him into the vet. It might take a few days for him to feel better.
Sending him lots of white, healing light.

 

[Olive & Paula]

Lori,

I've dealt with all that except the ibd. I don't know if laxatone is the same, but lactulose (need script in the US) is safe for diabetics. it's not digested or absorbed, it sort of coats the intestines to help move things along. Miralax is also good , start at 1/8 tsp twice a day, mix with bit of water and add to food. Will take 24-36 hrs to start working. Might ask vet about cisapride, it helps motility when they go. It comes in a chewable treat from Wedgewood pharmacy. Vet must specify chewable. Metamucil will add fiber, just check the ingredients, there are many varieties of the brand. You want pysllium husk as only ingredient, some stores sell pysillium powder. It took many trials with my girl to get the right combo and doses that worked. Eventually, the cisapride twice a day, miralax every night and the husk 3-4 times a week, subq fluids 2-3 times a week, it kept Ollie moving. Ollie never had an enema and the longest she went without pooping was 3 days.

Pancreatitis, pain meds, cerenia, ondansteron are needed and could be for quite some time. Your vet should keep you supplied with the meds at home, long term. I was introduced with Ollie's lasting 6 weeks. After that if she started a flare I could give meds immediately and could keep it from getting out of control.

I see there is a heart murmur. Have you seen a cardiologist? Ollie had one also, yet cardiologist gave a limit as to how much subq fluid she could have in a week. I purchased an IV line with a chamber that could measure accurately. It helps hydrate and vet gave me injectable cerenia I could give in the fluids so it didn't sting as much. The pills were to stressful for my girl. She also got b12 in the fluids.

Face Book has a Feline Constipation group you might check out. Good information there.

I will let others advise on insulin dosage, since there is history of dka, you don't want to skip doses or hold to long.

 

[Wendy&Neko]

I hope the vet visit and treatments will help Max feel better. And good news on the no ketones.

Will hold off on insulin increase at this time.

No reason to hold off on the increase. Being in high numbers for so long will mean he's drinking and peeing more, and contribute to becoming dehydrated. You need water to help the stools to move. Getting him to better BG numbers as soon as you safely can will help him. If you don't see anything below 200 tonight, you can increase in the morning.

Here's the link to your post from yesterday.

 

[Butters & Lyla]

Butters also has constipation and I've had to take her to the vet for enemas and subQ. I empathize with what you're going through with Max. With Butters, she is still a work in progress with her vet and I trying to figure out what works but currently she is getting miralax (1/12 tsp) and cisapride (2.5mg) both q12. I have cisapride in pill form and they are so tiny that I can push one into a piece of soft cooked meat and she just eats it, or sometimes I coat it in butter and put it in a dish with some tiny pieces of meat for her to eat.

I also add quite a bit of extra water to her food, usually 2-3 tbsp per meal (she gets 6 - 8 meals every 24 hours). She has CKD that I have to take into consideration as well. I've found fiber hasn't really done much other than make her feel bloated. Every cat is different, of course.

And here is, imo, a wonderful website on feline constipation for you to read when you have time: https://felineconstipation.org/

Sending lots of healing vines to Max. I hope he feels better soon.

 

[Max & Lori]

@Butters & Lyla thank you so much for your advice. His vet only suggested Metamucil in every meal. I will check with his vet on the other suggestions you made. We had a rough evening. The Simbadol he was given for pain made him very agitated and he paced the floors all night. That is not like him at all. Hopefully that gets better as the day goes on and the injection wears off. The vet said the doses he sent home for me to give by mouth are much lower so he may be okay with the lower dose. I’m supposed to call him back tomorrow and let him know how he is. Thanks again.

 

[Max & Lori]

@Butters & Lyla thank you so much for your advice. His vet only suggested Metamucil in every meal. I will check with his vet on the other suggestions you made. We had a rough evening. The Simbadol he was given for pain made him very agitated and he paced the floors all night. That is not like him at all. Hopefully that gets better as the day goes on and the injection wears off. The vet said the doses he sent home for me to give by mouth are much lower so he may be okay with the lower dose. I’m supposed to call him back tomorrow and let him know how he is. Thanks again.

Oh and he does have an appointment at the specialty center to see a cardiologist and have an echo. The vet arranged that for us even though he says his murmur is mild right now. He’s only getting small amounts of sub Q fluids.

 

[Marje and Gracie]

@Butters & Lyla thank you so much for your advice. His vet only suggested Metamucil in every meal. I will check with his vet on the other suggestions you made. We had a rough evening. The Simbadol he was given for pain made him very agitated and he paced the floors all night. That is not like him at all. Hopefully that gets better as the day goes on and the injection wears off. The vet said the doses he sent home for me to give by mouth are much lower so he may be okay with the lower dose. I’m supposed to call him back tomorrow and let him know how he is. Thanks again.

I’m all about natural so I would suggest a little bit of raw egg yolk. Egg yolk powder from FoodFurLife is also excellent to help with motility.

Simbadol is more commonly known as buprenorphine, and IMHO is one of the best pain meds for cats. Did they give it to you in needleless syringes so you can squirt it in his cheek pouch? It has a wide dosing range so you could start with half of what they tell you and then increase if need be. I find vets often prescribe many pain meds at the top of the range when half works and has less side effects.

 

[Olive & Paula]

The site for constipation Lyla have is the one I was thinking of. I thought it was a Facebook page.

Is the Simbadol for pain because of the enema? Is he on any pain for the pancreatitis? That's very painful. If not ask about Buprenorphine it's the choice pain med for it. Yes it's a controlled substance and yes vet can order a supply of it for you, if they won't give you some from their stock. I used to get 60 ml from vet. I believe Roadrunner is the pharmacy for that.

Has anyone mentioned giving pure pumpkin. Libby's brand is good. Not the pie filling one though. The pure pumpkin one. You can freeze in ice cube tray and then put in ziplock baggie and take out as needed. One cube was good for 3 days with Ollie. Just mix in food. My girl did not like the store brand.

Now that he is cleaned out the hard part starts, keeping him that way and finding what works for him.

Getting the glucoses down will go a long way to helping. If cardiologist approves of subq fluids, that will really help with hydrating and some meds can be given with the fluids and will be less stress than trying to pill multiple times a day.

It can get pricey at first getting all you need. Once it's figured out, Its not so bad at all.

 

[Max & Lori]

I’m all about natural so I would suggest a little bit of raw egg yolk. Egg yolk powder from FoodFurLife is also excellent to help with motility.

Simbadol is more commonly known as buprenorphine, and IMHO is one of the best pain meds for cats. Did they give it to you in needleless syringes so you can squirt it in his cheek pouch? It has a wide dosing range so you could start with half of what they tell you and then increase if need be. I find vets often prescribe many pain meds at the top of the range when half works and has less side effects.

Good morning. Yes he did prescribe the ones in the needle less syringe to squirt in his cheek. I think what I’m gonna do is give half of it tonight. He is still wired right now. Neither one of us have slept. It’s crazy. Husband had to hold him down for me to check his BG and give insulin. I’ve never seen him act like this. I’ve ordered the egg yolk powder when you mentioned it earlier. Waiting for it to arrive, should be any day now!

 

[Max & Lori]

The site for constipation Lyla have is the one I was thinking of. I thought it was a Facebook page.

Is the Simbadol for pain because of the enema? Is he on any pain for the pancreatitis? That's very painful. If not ask about Buprenorphine it's the choice pain med for it. Yes it's a controlled substance and yes vet can order a supply of it for you, if they won't give you some from their stock. I used to get 60 ml from vet. I believe Roadrunner is the pharmacy for that.

Has anyone mentioned giving pure pumpkin. Libby's brand is good. Not the pie filling one though. The pure pumpkin one. You can freeze in ice cube tray and then put in ziplock baggie and take out as needed. One cube was good for 3 days with Ollie. Just mix in food. My girl did not like the store brand.

Now that he is cleaned out the hard part starts, keeping him that way and finding what works for him.

Getting the glucoses down will go a long way to helping. If cardiologist approves of subq fluids, that will really help with hydrating and some meds can be given with the fluids and will be less stress than trying to pill multiple times a day.

It can get pricey at first getting all you need. Once it's figured out, Its not so bad at all.

The Simbadol is the brand name for the
buprenorphine and it’s for pancreatitis pain. He gave me a bag of it in needle less syringes. I’ve tried the pumpkin but he didn’t care for it. I don’t think I bought Libby’s though. Thank you.

 

[Butters & Lyla]

To Marje's point, I also prefer to try natural remedies but they unfortunately don't always work. I exhausted pretty much all of the natural remedies with Butters's previous vet (who was a naturopath as well) that she and I could think of, including egg yolk powder and raw egg yolk. At one point she was even on some homeopathic remedies, but so far it is the miralax and cisipride that are working best for her, I think. At least for right now. I used to give her canned pumpkin daily and still do sometimes, but I find it can make her bloated, as does pysillium.

Butters's vet had recommended I give her 25mg gabapentin for pain if I think pain is stopping her from having a bowel movement. She is quite sensitive to gabapentin so 25mg is plenty for her. I have given it to her on occasion and I think it has helped her.

Again, just throwing out some thoughts on what I've done for Butters so you have some ideas if needed down the road. Her vet and I stick with a plan for a while before we make any changes, or he might suggest just a small tweak if needed.

Interesting about Max's reaction to Simbadol. Butters had a very similar reaction when I was first giving her oral bupe for pancreatitis pain and it freaked me out. She paced constantly for days! I had to adjust the dose (take it down) and the pacing went away. I've since discovered that injectable bupe works much better for her than the oral. So much of this is trial and error!

 

[Max & Lori]

I agree! It's making me crazy for sure.

 

[Summer and Susie (GA)]

Hi Lori. Welcome to this site. You will get so much incredible help from all the fine folks here. Poor Max does have a lot issues but so many people here have had to deal with them as well so you are going to get some great advice. I see you are from the great state of North Carolina. Haven't been to the east coast but just love the mountains in Western North Carolina. I look forward to following your post and watching your boy get better.

 

[Max & Lori]

@Summer and Susie thank you! I’m learning so much here. I’m glad I found this site. I had no idea that so many cats are affected by diabetes. Max is a pretty complicated cat with all of his issues and I am hoping and praying that we can get him better. I love the beach and the mountains too. The only thing I find here in NC that’s unfortunate is that vets in my area are not up to date on all of this data that I read here and I’m finding it very difficult to convince my vet that I want to follow the recommendations of the people with so much experience with feline diabetes here. I suppose there are others who are in similar situations. Thanks for the welcome!

 

[Summer and Susie (GA)]

@Summer and Susie thank you! I’m learning so much here. I’m glad I found this site. I had no idea that so many cats are affected by diabetes. Max is a pretty complicated cat with all of his issues and I am hoping and praying that we can get him better. I love the beach and the mountains too. The only thing I find here in NC that’s unfortunate is that vets in my area are not up to date on all of this data that I read here and I’m finding it very difficult to convince my vet that I want to follow the recommendations of the people with so much experience with feline diabetes here. I suppose there are others who are in similar situations. Thanks for the welcome!

Hey, you are not alone with the vet advice. I think a lot of vets just don't get a lot of training with the diabetes and the folks on this site have extensive knowledge through experience. My one vet said it would be okay if Susie got numbers in the 200s. Well, I know that is not true. My other vet (from the same office) said I should keep her numbers in the low 100s. I would love to get Susie in numbers in the low 100s all the time. I would be happy with that. Listen to the good folks here and try to convince your vet that you are getting the best advice through people that have lived with their kitties having this disease. This is their passion - as well as all the other medical issues that can come up with our furballs. We look out for one another

 

[Max & Lori]

@Summer and Susie Thank you so much for your support. I really do love this group and super nice people like you who always help make me not feel so alone in this. It’s so hard.

 

[Olive & Paula]

Its not just NC where vets don't have much experience. Years ago, the Dr at the ER said they like to keep cats glucose in the 300's. Can you imagine that. Needless to say I did not use them for Primary care which they did.

This is all a steep learning curve. It does get better. Is will all fall into place in time. Keep posting and asking questions. You are never alone.

 

[Max & Lori]

I think my little Maxie boy finally found a comfy spot.

 

[Max & Lori]

 

[Max & Lori]

I hope the vet visit and treatments will help Max feel better. And good news on the no ketones.

No reason to hold off on the increase. Being in high numbers for so long will mean he's drinking and peeing more, and contribute to becoming dehydrated. You need water to help the stools to move. Getting him to better BG numbers as soon as you safely can will help him. If you don't see anything below 200 tonight, you can increase in the morning.

Here's the link to your post from yesterday.

I increased this evening @Wendy&Neko. We were having a rough time this morning.

 

[Olive & Paula]

View attachment 61967

Very comfy indeed.