7/29 Charlie - High numbers all day. Now Vomiting. Advice?

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charliesmom

charliesmom

Member Since 2012
7/29CharlyAM149+2.5 335+4 371+5 448+6 389+8 398 PM 362+3 367

2 mini black poops in litter box this morning. That's good because we have to stop the anti-diarrhea medicine today and I'm HOPING her system will get back to normal. Let's see. AMPS was quite low this morning. We shot .5 since we had another day where we shot at 7.4 earlier this week.

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Re: 7/29 Charlie AMPS 149

I'm so glad that Charlie is getting back to normal. She seems to clear the bounces really well too. Be sure to get plenty of tests in when you shot the lower numbers.

Cute pic! :-D :-D She looks like she wants to make sure you aren't gong to poke her again! :lol: :lol:
 
7/29CharlyAM149+2.5 335+4 371+5 448+6 389+8 398 PM 362+3 367

Can you explain to me what the bounces are all about? By bounce, do you mean when it shoots up real high all of a sudden, like just happened at the test I did now?

Shot this morning was done at 7:15am. Charlie was real good this morning when we first woke up (snuggling, hanging out on balcony, etc). Then she started hiding behind the couch again (not her normal behavior). So we tested again at +2.5 (9:45AM) and the BG came out at 18.6 (335 US metrics). To be sure our machine wasn't off, we retested and it came out at 17.9 (322 US metrics). Since then it has been going up in general.

We stopped the anti-diarrhea (finidiar) after last night's tablet. No diarrhea yet. We even found 1 long poop and almost celebrated again (sometimes it's the little things). Haha. :lol:

She has been acting pretty normal most of the day (not hiding, coming to us, sleeping in her chair, etc). Now after dinner she just decided to puke. Her numbers are still high too. What's going on, Charlie?

We are quite sure we didn't do a "fur shot".

She did get some extra food last night though. Our plan is to soon get her on the max 200 calories per day to get her weight to 4.5 kilos. At the moment, we are letting her system decide.

She did eat more than usual yesterday though. Morning: 1/2 can. Afternoon: full can while we were out. 1/2 can with dinner. We left a can of food out before bed. She ate it all. When I woke up at 2am, she was begging me for food so I left a tiny bit more of chicken (less than 1/4 can). She ate her normal breakfast at 7 just before her shot (1/2 can). Could this be all the food (even though all of it is low carb wet with less than 2% carbs)?

We weighed her yesterday and she's still at 5.2 kilos (where she was last Sunday when the ER vet tested her). So we have managed to keep her stable, which I guess is a good sign in some ways.

I think with the food, I'm just a bit scared when we leave the house. I want to leave out some wet food (1-2% carbs) so she has something in case she goes a bit low. Yesterday we only went out for a few hours but still. I didn't want there to be nothing for her there "just in case".

Also last night when we went to bed. Our normal routine is for her to sleep in the living room with the door closed. We sleep in the back in our bedroom and she usually wakes us up with cries at 7:30am when it's time for breakfast. This is how it has been for the past 6 years (pre-diabetes). The past 3 weeks or so, we've left the living room door open. When she was sick, she never even jumped in our bed during the night, and this was a way for us to sort of be around just in case anything bad happened and she wanted to come to us crying. Now, however, in the past 2-3 days she seems to be progressing well, and so last night for the first time, we closed the door and let her sleep on her own again. I guess this is why we left some extra food.

I know that she needs to lose weight in order for her to have the best progress and best chance of going off the juice, but I want that to happen in a stable, step by step way (once we're over the hump of the caninsulin, diarrhea/puking, ER visits, unstable urine tests, etc).

Can anyone explain why we would go from having 3 relatively normal days (with Charlie looking and acting much better) and then suddenly have a day like today -- where she still seems better, but where her numbers are so consistently high all day, even after the 2nd shot? Now she just puked (10pm). Will my girl ever feel better and normalize?
 
Re: 7/29 Charlie - High numbers all day. Now Vomiting. Advic

Hi Jill

I'm so sorry someone didn't get to you sooner. I show the post as 12:53 a.m. my time this morning and my guess is that when people started posting their kitty's info this morning, yours just got bumped down. You can always bump it to the top by opening it, clicking on "post reply" and just typing "bump" in the text box.

Charlie is bouncing off her blue numbers. It looks like she cleared a bounce last night after the +3 based on her AMPS this morning....and the next bounce that started today.

We use the term “bounce” to describe the increase in blood glucose (BG) levels precipitated by the release of counterregulatory hormones by the liver in response to BG numbers which the liver “recognizes” as lower than normal or in response to a steep drop in numbers.

When Charlie was first diagnosed with FD, her BG levels were probably high (over 200) and, depending on how long before you noticed she was polydipsic (PD) (excessive thirst) and polyuric (PU) (excessive urination), her body was getting acclimated to a higher BG and starting to recognize these higher numbers as “normal”.

The primary counterregulatory hormones released by the liver are glucagon and ephinephrine (there are others). Glucagon is secreted by pancreatic α-cells to increase plasma glucose levels by stimulating hepatic (liver) glucose production. Epinephrine raises plasma glucose concentration by stimulating glucose production and limiting glucose utilization. The result of the releases by these counterregulatory hormones can be immediate or delayed, quick or lengthy, depending on how much of each is delivered to the body.

Bounces are generally caused by either a rapid drop in BG over a short period of time (a “dive”) or by lower BG numbers to which the body has become acclimated. The BG does not have to be low as in hypoglycemic numbers. If a cat’s BG is typically at 300, a BG in the low 200s or below can initiate a bounce.

Bounces can take up to 72 hours to clear; however, when Charlie is clearing hers, she's not quite getting where we'd like to see her.

I think she needs a dose increase to .75u but you will need to be able to watch her carefully. If her number starts to come down again tonight so you get another blue AMPS, let her clear the bounce and then increase the dose as she starts back up.

I hope she feels better soon. Poor baby...if she's not continuing the vomiting, then I wouldn't get too worried but if she does it again, I'd call the vet.
 
Re: 7/29 Charlie- High numbers all day. Now Vomiting. Advice

We go to the vet today at 12:30 anyway so we will talk to her. I am concerned about increasing to .75 when it's not a weekend day and I wont be home so we can do the blood tests and monitor during the day. Is it ok to wait until next friday before we increase it?
 
Re: 7/29 Charlie - High numbers all day. Now Vomiting. Advic

How's Charlie doing?

Gabby went through a bout of vomiting and diarrhea. I'd have her on metronidazole and famotidine for a week, she'd be OK, and then a couple of weeks later it would repeat. After running every possible test, my vet had her on the metronidazole for about a month. Whatever bug she had, that finally cleared it up.

Did you switch Charlie's food all at once or did you transition slowly? Sometimes a rapid food switch can throw a cat's GI system off.

As for a dose change, I'd take things a bit more slowly. Charlie just bounced from a relatively low green on this dose. I'd wait for the bounce to clear before evaluating the dose and potentially increasing. If you are more comfortable with making dose adjustments on the weekend, that's fine. I think once we all have a better sense of Charlie's response to Lantus, we can think about increasing as early as a Friday evening so you have the full weekend to see how things are going.
 
Re: 7/29 Charlie - High numbers all day. Now Vomiting. Advic

After reading Sienne's post and looking at Charlie's SS again, as well as it being better for you, I agree with her that it's probably best to give Charlie a little more time at this dose.

I was just concerned that she was at a higher dose of caninsulin before she started getting into green. While I don't know how much lantus she will need, I felt you had a little room to
go up. But waiting is a better idea.

Hope the vet visit goes well.
 
Re: 7/29 Charlie- High numbers all day. Now Vomiting. Advice

@ Marge/Mike/Gracie: Thanks for the information. Better late than never. I thought that's what bounce meant but I'm not sure exactly how to deal with it yet. You said:

If her number starts to come down again tonight so you get another blue AMPS, let her clear the bounce​

I just read that now after getting her AMPS 10.8 (194 US numbers) and giving her .5
I hope by "let her clear the bounce" you didn't mean that I should not shoot because I already shot. AGH! Let's hope that since previously she had days where she also started around the same range, she'll be fine like she was on those days. My partner can't do a lot of tests today on her own (Charlie is getting more and more resistant and annoyed), but they will go to the vet at 12:30 so they can at least watch her a bit.

@ Sienne/Gabby/Gizmo - We pretty much made a dramatic switch with Charlie's food (hills dry a/d as of June 22 when she was diagnosed and then very shortly after moving to wet food 100%... with only a few days in between of both). See comments in her SS for details.

Sienne & Marjorie: Think we will keep her at .5 until we know from the vet if she has a urinary tract infection (and needs an antibiotic) or not. If the bladder comp (holistic urinary tract infection stuff) worked, then her #'s in her urine should be stabilized. If not, we'll ask for a full urine culture & sensitivity test and the antibiotics. Then ... after that drama is over ... we can think again about her numbers.

We may not have a lot of tests this week (will try to do a couple each evening but not so many in the days probably). If you have thoughts on what times we should test each evening (to get a scattering of data), let us know. Probably we'll do 1 PMPS and 1 test after that each night.

Thanks Anne, Liz & Zener for looking out for us. cat_pet_icon
 
Re: 7/29 Charlie - High numbers all day. Now Vomiting. Advic

charliesmom said:
@ Marge/Mike/Gracie: Thanks for the information. Better late than never. I thought that's what bounce meant but I'm not sure exactly how to deal with it yet. You said:

If her number starts to come down again tonight so you get another blue AMPS, let her clear the bounce​

I just read that now after getting her AMPS 10.8 (194 US numbers) and giving her .5
I hope by "let her clear the bounce" you didn't mean that I should not shoot because I already shot. AGH! We may not have a lot of tests this week (will try to do a couple each evening but not so many in the days probably). If you have thoughts on what times we should test each evening (to get a scattering of data), let us know. Probably we'll do 1 PMPS and 1 test after that each night.
Click to expand...

What was meant by let her clear the bounce is that you don't increase the insulin dose while kitty is in a bounce. This can be dangerous because the bounce may clear and kitty may end up going lower than hoped.

Please ensure you do test at AMPS as well, you need to test before you shoot everytime. You probably didn't mean that would be one of the tests you'd be missing but I thought I'd better mention it just in case - saftely first!

The most important time to get another test in is around nadir. I'll have a peek at Charlie's ss in a minute and see if I can tell you when that might be for Charlie.
 
Re: 7/29 Charlie - High numbers all day. Now Vomiting. Advic

Vyktor,

You look a lot like me and I think you're cute. Saw that you got to the falls. Can you show me the road home?

Thank you for your note today. All of this help is making my mommy feel better.

Charlie
 
Re: 7/29 Charlie - High numbers all day. Now Vomiting. Advic

ANN & TESS:
- What do you mean by "Charlie clears her bounces well." What is a good way to clear bounces? What is a bad way?

- We will certainly get plenty of tests if we ever shoot the low numbers. If you look at our SS, you can see that we did a TON over the weekend.
Tough on us. Tough on Charlie. But we're giving it our best shot (no pun intended) whenever we can. ;-)


MARJORIE & GRACIE:
- Thank you for being the first to respond to this overall thread to get us some feedback. We were worried yesterday, and since we're in a different time zone than most of the people on here, feedback is always helpful to us and appreciated (whenever it comes in).

- Charlie was first diagnosed officially on June 22nd. We noticed the excessive drinking and peeing in early June. Who knows how long she was having high BG numbers prior to that? So bounces could be a logical consequence.

- She was in fact at a higher dose of caninsulin, but I personally believe it was a little bit of a mistake by my vet to move her up to 2.5 units at the beginning of June, and then to keep her at 2. At that time, we weren't home testing, and Charlie was insanely stressed whenever we took her to the vet, so probably our vet thought she needed to be at a higher amount of units than actually needed. I'm not sure, but I can tell you that each time we have lowered the dose thus far, it has been at the advice of people on this board (or our new vet), and it has resulted in something positive (less puking/less hiding/less lethargy/etc). So I'm not sure she needs to be back up to those higher levels. Perhaps, we will need to increase slightly (.75 or 1 unit?) but even for that, I'd like to eliminate some variables, have a bit of data to back it up, and be sure there isn't something else driving the increase in numbers.

- Urine test at the vet today showed Charlie STILL has high leukocytes. The vet has decided to put her on antibiotics today
(clavubactin 50 / 12.5). The plan is to give her 2 units a day for the next 7 days, and to retest her urine next Monday. My vet's perspective is that the increased numbers could also be caused by infection, and if this is the case, it should clear in a couple of days and also her numbers should look better in her next urine test. Let's see how it goes. There was no urine culture & sensitivity test done to diagnose this or prescribe this. I was not there so I guess I have to go with the flow and hope for the best at this stage. We can demand this at a later stage if this, too, does not work.

- Thanks for all the info on the "bounces". Still learning, so this is helpful. Maybe this was the cause of high BG #'s again? Either way, it should clear eventually if so. Let's wait and see.

SIENNE & GABBY:
- Looked up the 2 drugs you gave your little one was on to cure the diarrhea and vomiting. Those seem to be antibiotics and anti-ulcer type things. If it worked for you, maybe the antibiotic can also work for us. We're hopeful.

- We will post numbers daily until the weekend. Hopefully by then you can give us advice on whether or not to increase the dose. If, in fact, the bounce will clear in a few days, then we could have a few days of "normal" stats by TH or FRI.

VIKTOR'S MUM:
- Sorry I referred to you as his mom. Silly us. We didn't realize you were from Australia (where kitties get to chase chickens in the yard! How Cool!) We shall correctly call you "mum" from now on. :-D

-We didn't mean we will stop doing the AMPS and PMPS. For SURE we will always do those before each shot. It is our goal to also do tests in the evenings, but we need to find the balance over time, as I don't want to overdo it either. We were told that the right balance was to test at AMPS, PMPS, and +3, +6, +9. We will do as much as many as possible but we both work during the days and we will not stop sleeping at night, so we need to find the balance. We are highly committed though.

ALL:
Charlie is very thankful to have so many knowledgeable, helpful, responsive new friends. She is one lucky cat.
 
Re: 7/29 Charlie - High numbers all day. Now Vomiting. Advic

Pepsid (in the US or generically, famotidine) is an stomach acid blocker. It is not specifically used to combat nausea unless a cat is throwing up due to an acid stomach. There are other meds that are better to address nausea (e.g, ondansatron or maropitant are the generics). What medication is used really depends on what the cause of the problem is.

Did the vet have a reason for not doing a cystocentesis along with a culture and sensitivity? Charlie has been dealing with this long enough that I would think the vet would want to target the specific bacteria. Looking at a urine sample that hasn't be collected under sterile conditions means you don't really know if the sample was contaminated by the cat's fur, the container, etc.

I wholeheartedly agree that you need to find a balance with respect to testing. What I would say is don't lock yourself in to testing at +3, +6, and +9 only. Getting spot checks at other times (instead of at +3, +6, or +9) helps to fill in the blanks on your SS.
 
Re: 7/29 Charlie - High numbers all day. Now Vomiting. Advic

I was at work today so I wasn't able to go to the vet myself. I didn't get to ask the vet to do the culture & sensitivity test, and she didn't mention it so I think my partner decided to trust our vet's judgment and go with the "less intrusive" approach to start with. Any test done in the Netherlands is extremely expensive. For reference, we have spent 1300 Euros just in 1 month alone, and we really can't afford to continue with expensive tests until they are absolutely critical.

It's clear that the culture & sensitivity test would have been the more preferred way to go (due to being able to prescribe the specific antibiotic that would work best against the bacteria, if there is some). I assume our vet just made some assumptions (3 urine tests so far have confirmed similar results over a 2 week timeframe. The urine tests have been done by us in controlled environments and taken to the vet (covered) within an hour of being done. I need to call the vet to ask her, but I imagine she prescribed this particular antibiotic since:
- Test results came out similar so many times (even after we tried the holistic treatment that usually works for them)
- It is specially used for the treatment of a range of issues (skin, urinary, respiratory, mucosal and enteritis infections).
- She seems to be doing things in phases, starting with the least intensive for Charlie since she's a high stress cat & especially hates vet visits .
- Charlie is already feeling 100% better compared to (previous vet/previous insulin type/etc). Every day she seems to visibly look and act much more normal. She just vomited last night and had a few bounces, so we know something is "off".
- Charlie wasn't with my partner at the vet today (this was recommended by the vet since Charlie has been under so much stress lately)
- Due to the expenses we've had thus far, we also need to be pragmatic.

I have a personal feeling that this was not a urinary tract infection since Charlie didn't show those symptoms (peeing outside the litter box / straining / crying when she peed / etc).

I guess next Monday if Charlie still shows leukocytes in her urine, we have to ask ourselves if the culture & sensitivity test should be done, or if other tests need to be done to confirm what could be worse (cancer/kidney disease). Let's hope this course of antibiotics does the trick as we are very worried.
 
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