? 9/15 Squeaky, AMBG 307, +7 = 98 ?????

[Jan D & Squeaky]

He hardly ate anything yesterday, a little in the morning, a little in the afternoon. Even less between PMBG and insulin.

Yes he looks like he's feeling lousy and he didn't look great all day yesterday. When his numbers are in the 300s, he looks like that. The insulin doesn't seem to be bringing the numbers down.

I have two things in my tool box. One is a food that he likes, it is chicken .... which he is allergic to and will probably cause him to have diarrhea. The other is called Mirtazipine and it is an anti-nausea and appetite stimulant.

He basically hasn't had anything to eat since just a little before his insulin shot last night, 10 hours ago.

We are now 30 minutes away from our 2-hour window of fasting before his next insulin shot. I need someone to coach me what to do here, I don't yet understand the mechanics of all of this. What should I do?

We have two days now with mid-cycle BGs. Spreadsheet: Squeaky's spreadsheet - Google Drive

Thanks so much.

 

[Jan D & Squeaky]

Okay he ate three little pieces of cooked beef, then he was done.........

Got him to eat 4 little pieces of pan seared sirloin cooked to perfection, then he got up and had a bunch of water.

I'll try giving him more, but I take it this is enough? Still trying to understand the mechanics of all this.

No, he wouldn't eat any more. So I will. Wow it is delicious.

So where can I read something about how diabetic cats need to eat? Knowing though, that this cat has IBD and pancreatitis, food allergies, etc.

He is really drinking a LOT of water again. Vet told me they do that when their sugar is too high. Help?

Should I try to give him some of the chicken food that he is allergic to?

 

[Jan D & Squeaky]

Okay so we are 1-1/2 hours away from next BG and eating and insulin. What if he doesn't eat?

 

[tiffmaxee]

How does he react to mirtazapine? If it works for him you can give some. He needs to get insulin. It takes at least an hour for it to kick in so if he eats a few teaspoons even and more with mirt you should be fine. Can you syringe food if necessary? Do you gave any baby food, Gerbers 2nd ham, turkey, or beef? Most love it and it’s easy to syringe or finger feed.

 

[Tracey&Jones (GA)]

Squeaky looks like he is into a bounce from that blue yesterday. Jones was the same, it didn't take much for him to feel bad and not want to eat much.

From my experience, Jones did better with the prednisolone in an even dose each day. So instead of doing 1 day on and 1 day off - wonder if your vet would be open to just giving a lower dose each day? I found with Jones it helped keep his BG's a little more steady which helps with the nausea as well.

From your notes in your SS I would say he is nauseated, if you have any Cerenia on hand I would try that and see if he is willing to eat in a couple of hours. The IBD and pancreatitis can cause nausea as well, so it like a triple whammy. Jones was on it every day as his chronic pancreatitis was so bad without it he would just vomit. My vet was open to me playing around a bit to see what worked best for him as long as I kept her in the loop.

And no to the chicken food! For food, Jones was on the Rawz Turkey and Turkey Liver. High calorie, no gums and low carb. Have you seen the ibdkitties.net website? They may have some suggestions that may help.

 

[tiffmaxee]

Would you please change the 911 to a ?? That way if anything happens you can put it back.

 

[Jan D & Squeaky]

Would you please change the 911 to a ?? That way if anything happens you can put it back.

Thanks done. What does GA mean?

 

[Jan D & Squeaky]

Squeaky looks like he is into a bounce from that blue yesterday. Jones was the same, it didn't take much for him to feel bad and not want to eat much.

From my experience, Jones did better with the prednisolone in an even dose each day. So instead of doing 1 day on and 1 day off - wonder if your vet would be open to just giving a lower dose each day? I found with Jones it helped keep his BG's a little more steady which helps with the nausea as well.

From your notes in your SS I would say he is nauseated, if you have any Cerenia on hand I would try that and see if he is willing to eat in a couple of hours. The IBD and pancreatitis can cause nausea as well, so it like a triple whammy. Jones was on it every day as his chronic pancreatitis was so bad without it he would just vomit. My vet was open to me playing around a bit to see what worked best for him as long as I kept her in the loop.

And no to the chicken food! For food, Jones was on the Rawz Turkey and Turkey Liver. High calorie, no gums and low carb. Have you seen the ibdkitties.net website? They may have some suggestions that may help.

Thanks I gave him 4 mgs of cerenia last night. He hates being pilled; it did not go well and he had some foaming at the mouth. However he wasn't feeling well all day and didn't eat much all day. The cerenia did not seem to help.

The vet is pretty clueless, sad to say. She suggested 2.5 first day and zero second day, he had vomiting and diarrhea both from that. So I bumped it back up to 1.25 on the second day. I wrote a message to the vet asking about switching to a different med, budesonide, to manage his inflammation. Still ..... waiting..... for..... answer.....

I could try the mirtazapine for nausea and appetite. Maybe I will just do it. Doesn't require a pill. Perhaps I could use some of that everyday instead of the cerenia?

Oh, the chicken food contains: Chicken, chicken broth, dried egg, sunflower seed oil, and vitamins. But it might stimulate his IBD and cause diarrhea. We recently took him off chicken, and his diarrhea improved.

 

[Jan D & Squeaky]

How does he react to mirtazapine? If it works for him you can give some. He needs to get insulin. It takes at least an hour for it to kick in so if he eats a few teaspoons even and more with mirt you should be fine. Can you syringe food if necessary? Do you gave any baby food, Gerbers 2nd ham, turkey, or beef? Most love it and it’s easy to syringe or finger feed.

Thanks for the helpful response. I could run to the store and buy some baby food. I could make my own but he probably wouldn't like it. I will try the mirtazapine. By "it takes at least an hour for IT to kick in" are you talking about the insulin? Thanks.

We have never syringed food. I didn't know it was a thing. Egads.

 

[Jan D & Squeaky]

How does he react to mirtazapine? If it works for him you can give some. He needs to get insulin. It takes at least an hour for it to kick in so if he eats a few teaspoons even and more with mirt you should be fine. Can you syringe food if necessary? Do you gave any baby food, Gerbers 2nd ham, turkey, or beef? Most love it and it’s easy to syringe or finger feed.

How long does it take for the mirtzapine to work?

 

[Chris & China (GA)]

What does GA mean?

"Gone Ahead" or "Guardian Angel"....it's used when a kitty has passed

 

[tiffmaxee]

The insulin won’t kick Insulin about an hour or two. Sorry I wasn’t clear.

 

[Tracey&Jones (GA)]

Jones didn't do well with budesonide but my CKD kitty with IBD did!

Jones was a severe case. He got the Cerenia every day in the morning and an appy stim as well. Mirtz made him crazy but I found cyproheptadine worked really well and was better in the sense I could give it every day and it had a gentle action vs. the mirtz - which he ate like a lion day 1 and by day 3 wouldn't eat.

I think you will find food can help a lot with early IBD. I would pass on the chicken - get used to reading labels as it is in a lot of cat food even if it is down the list! Try turkey, duck, fish...I think you said beef worked. Maybe try some novel protein ones - venison maybe. Go slow with your changes. A tsp at a time. Raw is also a suggestion if he will eat it.

Here is the trick, IMHO, you first need to get the nutrients into the body (he needs to eat), then you need his body to absorb them (need to get that inflammation down in the bowels and pancreas and stop the diarrhea) then you need to have the right amount of insulin so his body can unlock that energy/nutrients so his body can function. You feed and medicate so he can be stable enough so you can work out the right insulin dosage (adjust as needed). You may have to feed a higher carb food...so be it...you adjust the insulin accordingly. It may take a bit to find the right balance.

May I suggest you get some vegetable capsules - size 4. You can put 1-3 meds in there and only have to give 1 "pill". Especially with the Cerenia - no more foaming! By cutting up the pills I could fit the cerenia, steriod, cypro all in one. It worked for me but Jones was easy to work with. I hope if the pilling process is easier then maybe Squeaky will get easier?

Mirtz should work in an hour or so.

 

[Jan D & Squeaky]

How does he react to mirtazapine? If it works for him you can give some. He needs to get insulin. It takes at least an hour for it to kick in so if he eats a few teaspoons even and more with mirt you should be fine. Can you syringe food if necessary? Do you gave any baby food, Gerbers 2nd ham, turkey, or beef? Most love it and it’s easy to syringe or finger feed.

Just looked at the Mirtazapine box. It says discard within 30 days of first use. I used it once, in January or so. Throw away? Or actually, still good?

 

[tiffmaxee]

That’s the pills or transdermal?

 

[tiffmaxee]

Back before these pet drugs my vet had me give cyproheptadine which is a human antihistamine. Just a sliver worked for Max and another very sick kitty I gave 1/4 a 4 mg pill. When Max had a mild uri I asked my vet if zyrtec would help. He said to give 1/3-1/4 a regular strength pill. It helped him and increased his appetite as it’s also an antihistamine. One allergic girls was scratching and made her ear bleed so I decided to try 1/4 a Zyrtec and it helped her plus increased her appetite. She doesn’t need that side effect though, lol. All this to say perhaps run this by your vet.

 

[Jan D & Squeaky]

That’s the pills or transdermal?

Transdermal, to put on the ear. Thanks in advance.

 

[tiffmaxee]

Transdermal, to put on the ear. Thanks in advance.

I would be afraid to use it unless your vet says ok. If anything it might not be as potent I would think but I’ve never used it so no clue.

 

[Jan D & Squeaky]

Jones didn't do well with budesonide but my CKD kitty with IBD did!

Jones was a severe case. He got the Cerenia every day in the morning and an appy stim as well. Mirtz made him crazy but I found cyproheptadine worked really well and was better in the sense I could give it every day and it had a gentle action vs. the mirtz - which he ate like a lion day 1 and by day 3 wouldn't eat.

I think you will find food can help a lot with early IBD. I would pass on the chicken - get used to reading labels as it is in a lot of cat food even if it is down the list! Try turkey, duck, fish...I think you said beef worked. Maybe try some novel protein ones - venison maybe. Go slow with your changes. A tsp at a time. Raw is also a suggestion if he will eat it.

Here is the trick, IMHO, you first need to get the nutrients into the body (he needs to eat), then you need his body to absorb them (need to get that inflammation down in the bowels and pancreas and stop the diarrhea) then you need to have the right amount of insulin so his body can unlock that energy/nutrients so his body can function. You feed and medicate so he can be stable enough so you can work out the right insulin dosage (adjust as needed). You may have to feed a higher carb food...so be it...you adjust the insulin accordingly. It may take a bit to find the right balance.

May I suggest you get some vegetable capsules - size 4. You can put 1-3 meds in there and only have to give 1 "pill". Especially with the Cerenia - no more foaming! By cutting up the pills I could fit the cerenia, steriod, cypro all in one. It worked for me but Jones was easy to work with. I hope if the pilling process is easier then maybe Squeaky will get easier?

Mirtz should work in an hour or so.

Thanks.

 

[Sue and Luci]

Just stopping by to visit some condos at the end of my work day...

I couldn't figure out what your question was/is still? Something about dosing in two hours...I presume that was answered earlier today? If so, you can remove the '?' from in front of your title.

I also couldn't find a previous history - copy/paste url from last post into this post...or was there one from yesterday?

Hope things are coming together for you. Keep getting data - every bit of data that you collect is like putting the pieces into a puzzle...soon a pattern will emerge and that'll help you a lot as you go forward.

 

[Jan D & Squeaky]

Sorry for confusion, I will get back to you.

New question, his sugar levels are swinging wildly! This am 307, +7 is 98! What do I need to know about this???????

 

[Sue and Luci]

Sorry for confusion, I will get back to you.

New question, his sugar levels are swinging wildly! This am 307, +7 is 98! What do I need to know about this???????

Take a look at some other spreadsheets...

You can look at mine... plenty of others ..

Ups and downs are pretty normal...

 

[Jan D & Squeaky]

Take a look at some other spreadsheets...

You can look at mine... plenty of others ..

Ups and downs are pretty normal...

So that means tomorrow will swing up and he'll have a bad day? Of course I will do PMBG and if it's under 100 no insulin..... Anything else to consider?

 

[Jan D & Squeaky]

Just stopping by to visit some condos at the end of my work day...

I couldn't figure out what your question was/is still? Something about dosing in two hours...I presume that was answered earlier today? If so, you can remove the '?' from in front of your title.

I also couldn't find a previous history - copy/paste url from last post into this post...or was there one from yesterday?

Hope things are coming together for you. Keep getting data - every bit of data that you collect is like putting the pieces into a puzzle...soon a pattern will emerge and that'll help you a lot as you go forward.

Thanks and yesterday I tried to cut and paste something and messed everything up. So I'm not sure what or how. Better not do it for the moment!

 

[Sue and Luci]

So that means tomorrow will swing up and he'll have a bad day?

Please post a new condo today and we can talk about what you mean by 'he'll have a bad day' . See you later!

 

[Jan D & Squeaky]

Please post a new condo today and we can talk about what you mean by 'he'll have a bad day' . See you later!

Thank you for your loving care, Sue.

 

[Jan D & Squeaky]

Please post a new condo today and we can talk about what you mean by 'he'll have a bad day' . See you later!

Sue, I will post as soon as I get back. What I mean by bad day is just what is happening. His sugars shot up to over 300 and he's hiding in the closet, like a limp rag. AT LEAST this morning, he is eating when I hand-feed him.

A good day, he's sleeping on the sofa (best), or under my computer desk.

 

[Juls and Billy]

Do start a new thread when you get back. In the Lantus section, it's easier for helpers to help if there's a new thread every day.

Looks like Squeaky is bouncing a bit. This is perfectly normal. Blood sugars don't stay the same all day. They tend to be highest pre-shot and lowest at nadir. But look at that lovely green number! That's what you want to pay attention to, the low numbers are what tell you how Squeaky is doing and when dose needs to be changed. That green is showing Squeaky is making great progress. But his body is not used to lower numbers yet, so it will release stored sugar and make the numbers high again-- that's bounce. Bounce will clear itself, no need to adjust dose.

I did notice you said you wouldn't give insulin if under 100. This early in the journey, it's suggested that you don't give insulin if BGL is under 200 on a human meter. If pre-shot BGL is under 200, you can stall. (wait 20 minutes without feeding and test again) or give a token dose (25% of normal dose) or skip shot.

Do re-read Lantus dosing protocols. It looks to me like you might be needing to reduce Squeaky's dose soon.