8/20 Sibon AMPS 194 - Appetite and vomiting

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Elinor & Sibon

Elinor & Sibon

Member Since 2017
Hi everyone, my cat was diagnosed on July 13th (just recently) and we've started with Humulin NPH and Freestyle meter. Last week we went to a specialist who switched us to Lantus and Accu-Chek Performa and she provided me with instructions on the administered doses. Yesterday I did my first curve with the Lantus and I was supposed to give her an update today but apparently she won't be at work until next week.
She recommended that I start with:
BG 160-200 : 0.5 unit
BG 200-300: 1 unit
BG 300+: 1.5 unit
I read that kitties adjust to Lantus only after 3-6 days, but there are a few things I'm concerned about, and I'd appreciate any advise you can give me:
1. I know that you're supposed to be consistent with the amount of units you inject, but she advised to start with these instructions and then we'll get a better idea after the first curve. I think his numbers from yesterday show improvement. What do you think?
2. He has a loss of appetite for the past 3 days. Before that he would eat about 2.5 cans of Fancy Feast per day. Now I'm lucky if he cleans his plate from only 1 can per day. His drinking is the same. It has substantially decreased since starting with the insulin. Could it be that his appetite is normalized now, or is ~1 can of FF not enough?
3. He started to vomit every day. Never solid food. He usually vomits 4-5+ hours after eating so it's liquid. Sometimes the colour of his food, sometimes transparent.
The vet ignores his vomiting for the moment since his CKD is only stage 2 and he doesn't show any other symptoms other than that. She said we will deal with that after the diabetes is regulated.

For the past 2 weeks he's been urinating twice to three times per day and poops once per day, so I'm happy with that.

What are you thoughts?
 
Welcome. Lantus likes consistency so the dosing your vet suggests worries me. Please read the yellow stickies to better understand the depot. Both protocols most of us follow call for increases/decreases in .25 increments. Jumping around like your vet suggests will usually lead to BG numbers all over the place. It's best to find a dose you can shoot every 12 hours unless a reduction is earned by dropping low or if your cat doesn't get good numbers on a dose after 6-14 cycles depending on which protocol you use. The vomiting could be stomach acid. Do you gave a copy if the labs that you could post? How often are you feeding? Many cats do best getting smaller amounts of food over the first 6 hours of the cycle and a snack if needed no later than +9-10. That might help eliminate the vomiting. Pick up food two hours before insulting n she your test results aren't food influenced. If the vomiting doesn't stop by feeding more often I would ask your vet if he thinks a pancreatitis test is a good idea.
 
@tiffmaxee Thanks so much for your reply.
I had read the stickies but the problem is I work full time and live alone.
His AM shot is around 7:30-08:00 and I leave for work at 08:45. I return around 19:00 in the evening.
I was willing to follow the vet's recommendation of giving 0.5 units if the numbers are low because I was afraid he would go hypo while I'm gone. I honestly don't know which dose is best to stick to regularly if I'm not around during the day...
Concerning the food, I leave him frozen fancy feast, usually the amount of 0.5-0.75 of a can which he doesn't finish anymore by the time I get home.
 
By the way, the last tab of my spreadsheet contains his labs. We got another test last week but I've yet to be contacted by the vet.
 
Hi Elinor - I agree with @tiffmaxee's suggestions. I have found that the vomit characteristic of empty stomach (acid) vomiting is clear foam - when Murphy has pancreatitis issues, it is liquid and the color of his food - looking at your labs, was the potassium really 28.1 in early July
 
Carol & Murphy said:
Hi Elinor - I agree with @tiffmaxee's suggestions. I have found that the vomit characteristic of empty stomach (acid) vomiting is clear foam - when Murphy has pancreatitis issues, it is liquid and the color of his food - looking at your labs, was the potassium really 28.1 in early July
Click to expand...

Ah you're right! I mistyped that. His potassium was 5.4.
I have to admit I don't know the first thing about pancreatitis. According to Google he should also have diarrhea, low temperature and be dehydrated? His poo is soft ever since we switched to Fancy Feast and the vet checked for the other two and didn't conclude anything..
I'm at a loss.
 
Pancreatitis can be subtle - sometimes the only symptoms are loss of appetite, and vomiting. Murphy has chronic pancreatitis, and never had diarrhea with it (until this current episode)- this article may help you or for more, check out ibdkitties.net
 
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Hi and welcome, My Marvin appetite did change a lot once diagnosed. He would be a cat that just gobbled up all his food at once. Once dx, he would not eat much either, I was lucky to get him to eat 1.5 cans a day and he is a big cat. I don't know if it's was the switch to wet food, or that he just wasn't himself. It took a while to get him to eat, some days or weeks were better than others. He eats better now, and has become a grazer. I think he was addicted to dry and wet reacts differently, so he may feel full faster. If he does have other pancreatitis, I would think that would affect his appy a lot.

Oh yea, I also switch him right off dry to wet, that probably did not help him.

Hope Sibon starts feeling better soon.
 
The labs look pretty good. I think pancreatitis could be the issue. How much does he weigh? Has he lost a lot of weight? That's not enough food for most cats. Is he a very small cat? Not eating enough can lead to hepatic lipidosis which is very serious and you don't want that. He needs to eat a minimum I'd 3/4 of the usual amount of food.

Here's a good article on pancreatitis.

http://cms2.netnews.cz/files/attach...Treating-and-Managing-Feline-Pancreatitis.pdf

My Max had chronic pancreatitis for several years. His only constant symptom was inappetence. Only a few times did he gave diarrhea. Not eating enough can definitely lead to dehydration. Not eating well can be a sign of nausea. Whenever Max was off his food I treated that with the human drug ondansetron or cerenia, a vet med.

I totally understand not wanting him to go low while you are away. For that reason the SLGS protocol is worth looking at. If my cat I would probably start with a low dose like .50 or .75 every 12 hours for a week and then do a curve at home. The high numbers you see could be from going low and then bouncing. I think 1.5 is too much at this time. I see his BG was normal on July 30. How long had he been off dry food? For some cats just getting off dry can lead to remission.

BTW, Just in case he's not liking canned food have you tried different flavors and foods?
 
@tiffmaxee He weighs 5.5-5.6kg. He always weighed the same, never suffered a weight loss. He's a regular sized cat.
He's been off the dry food since July 17th, 4 days after the vet's diagnosis.
I'm trying not to look at his numbers prior to the Lantus and Accu-Chek meter because these are what I use now and rely on them.
He's running up to me every time I open a new can or even pick up his bowl from the floor, he doesn't look like he's no liking it.
You're saying it's not possible that the change to Lantus caused this?
 
I think that eliminating dry food is helping to get into better numbers. I think jumping around with the doses is making it impossible to tell what a good dose for him is. Cats often get really hungry when the BG is high. Many get hungry when it drops too low. Pancreatitis can cause cats to become inappetent. If he acts hungry but won't eat he is likely nauseous. I'm not saying he has pancreatitis. It's just one possibility. I'm not a vet. It's just been my experience that when a cat stops eating there is something really wrong and if they go too long BG without enough food they can get very sick very fast. A nauseous cat doesn't always vomit. I'd call your vet tomorrow and discuss what you observe.
 
It's not likely the change to Lantus caused the inappetance, though I suppose it's not impossible. I agree with Elise about the constant changing in dose making it hard to see what a good dose is. We find consistent dosing is best.

What flavour of Fancy Feast is he eating? I would keep track of the proteins and see if there is an allergy. Beef and fish are common allergens. If he is running up to eat, but not eating, that might be some nausea. I agree a discussion with the vet would be good.
 
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