9/19 Kitty Cat PM+10 469, AMPS 530, +6 353

Christina & Kitty Cat

Christina & Kitty Cat

Member Since 2020
Yesterday's thread

After our first trip to the greens and blues yesterday, we're back in the the reds.
About to be 6 cycles after hypo & reduction.
9/15 PM hypo, normal dose 1u
9/16 reduce to 0.5u
9/17 increase to 0.75u
9/18 reduce to 0.5u

history:
9/13 keytones small
9/11-9/13, 9/17 vomit
taking 1mg ondansetron every 8 hrs, 5mg famotidine every 24 hrs

today:
PM+10 469, 2 tsp LC + ondansetron
will be continuing with 0.5u
 
Morning Christina! Looks like Kitty Cat is bouncing. Hopefully he clears that soon and gets back to those blues.

Also for night, you could look at auto feeders to help spread out his dinner - they are an investment but I love mine (or I love the sleep mine helps me get ;)). Here's the info on mine (and a couple others use this one too - I think PetSafe5 is also used here but I don't believe it has icepacks and I wanted ice packs) -
I got the Cate Mate C500 - It has 5 compartments (1 open and 4 hidden) and ice packs. I ordered right from the manufacturer (link here) - I also ordered 2 extra ice packs in case I wanted to use it for AM and PM (so I'd just have to wash it out and put in new ice packs).
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JaxBenji said:
Morning Christina! Looks like Kitty Cat is bouncing. Hopefully he clears that soon and gets back to those blues.

Also for night, you could look at auto feeders to help spread out his dinner - they are an investment but I love mine (or I love the sleep mine helps me get ;)). Here's the info on mine (and a couple others use this one too - I think PetSafe5 is also used here but I don't believe it has icepacks and I wanted ice packs) -
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Morning Susanne! I've been confused about this for a while so thanks for bringing it up. I read somewhere that diabetic cats shouldn't snack or free feed, especially at night. But with all the tummy troubles Kitty Cat gets, I do want to space out his meals into smaller portions. How would auto feeding times affect testing times? If he snacks a little in the early morning with the auto feeder, does that affect his testing times? Does it need to be at least 2 hrs before AMPS?
 
From what I understand - and maybe someone more eloquent with words will chime in - but small meals help keep the pancreas calm and not over whelmed. I believe the advice of only feeding two meals is dated. Also, as you said, smaller meals help kitties with sensitive tummies - just like when we as humans don't feel good, we eat small meals because it's just easier on our body.

As for timing - you are absolute right to not have food out 2 hours before AMPS and PMPS. Most people do this by rotating the feeder to an empty section two hours before AMPS/PMPS (this is what I do - my shot time is 6:45 AM and my feeder goes to an empty section at 4:40 AM). As for timing of the other meals, I don't know if there's a solid method to it. I go to bed around +3/+4 so if I think it's a calm cycle, my auto-feeder will feed a snack at +6 and +8. If it's going to be an active cycle, then I stay up with alarms and feed myself :)

Maybe just saying what I do (specific to my cat Jax...so I wouldn't copy my decision making numbers :)) will give ideas:
  • PMPS - If he's >60, I feed half of his dinner- I took his dinner one night and measured by tablespoons - his dinner is ~6T. If he's <60, I do a smaller dinner and start giving him MC (again this is specific to him...I'm pretty aggressive with his #s and he doesn't have any additional conditions...that i know of ;)).
  • From PMPS to +3/+4 - I do a few tests and give "snacks" of dinner - usually 1-2 teaspoons and up to 1T. You can check my SS if you want.
  • I then divide up the rest of his dinner into the auto-feeder - it usually works out to the following:
    • +6 - auto-feeder gives 2t of dinner
    • +8 - auto-feeder gives another 2t of dinner - I also add 0.5t of MC because Jax is known for going lower for shot time (again, check my SS, especially for PMPS, where is just loves to see how low he can get for a shot lol).
  • +10 - auto-feeder rotates to an empty spot
  • AMPS - test and feed half of breakfast. During the day, I am the auto-feeder ;) but I would also use if we went out of town for the day or if I was using my pet sitter.
Hope that helps some :) Let me know if I can clarify anything. I'll see if I can find info on the small meals to back up what I said about the pancreas.
 
Here's a short explanation on small meals from @Wendy&Neko - link
Many of us feed several small meals instead of one large one, for a couple reasons. One, it's easier on the healing pancreas not to have to deal with a huge amount of food at once. Human diabetics (who don't heal), also do more smaller meals. Two, you can use food strategically to influence how the numbers change. If you have a kitty that likes to drop hard at onset (when the insulin takes effect), it can help slow the drop to give them a small meal before onset to slow the drop. See how Henri dropped about 80 points at onset today? A small meal about +1 or +1.5 might have slowed that drop a bit.
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SUPER HELPFUL THANK YOU! Kitty Cat has mild pancreatitis and GI inflammation so I definitely want to do what I can to help that out. I also need to measure out his meals in tsp. I've been guessing with the "half can, just under maybe" but it's getting harder to keep track of. I'll measure out his meals in tsp. Since he needs to GAIN weight, I need to make sure he doesn't start eating less without me noticing.

I guess I shouldn't be giving this snack and pill at PM+10... I did it ~15 mins early so maybe it won't affect AMPS numbers. I'll wake up earlier tomorrow. He only has one more day of ondansetron anyway.
 
Christina & Kitty Cat said:
SUPER HELPFUL THANK YOU! Kitty Cat has mild pancreatitis and GI inflammation so I definitely want to do what I can to help that out. I also need to measure out his meals in tsp. I've been guessing with the "half can, just under maybe" but it's getting harder to keep track of. I'll measure out his meals in tsp. Since he needs to GAIN weight, I need to make sure he doesn't start eating less without me noticing.

I guess I shouldn't be giving this snack and pill at PM+10... I did it ~15 mins early so maybe it won't affect AMPS numbers. I'll wake up earlier tomorrow. He only has one more day of ondansetron anyway.
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You are okay with your snack/medicine at +10 as long as kitty cat eats it right up - a few minutes early is perfect. You just want to keep food up for two hours before your preshot reading so you know your reading isn’t food influenced (If food influenced then your reading would be higher and could mislead you on if it’s safe to give insulin).
 
He definitely ate it right up. hangry little beast!
AMPS is 530, gave a soupy 8 tsp LC breakfast and shot 0.5u
Hoping it goes back down soon. Will be interesting to compare to the last time he was in the 500s preshot when he first got the 0.5u reduction following hypo since I'm still figuring out what a bounce looks like
 
I would get more ondansetron. I found with Max it was better to slowly taper after a pancreatitis bout. If he started to eat less increased so if 3 times a day I tried 2 times for a few days. If good I went to one. If I stopped to soon I only needed to restart. I kept some on hand at all times.
 
tiffmaxee said:
I would get more ondansetron. I found with Max it was better to slowly taper after a pancreatitis bout. If he started to eat less increased so if 3 times a day I tried 2 times for a few days. If good I went to one. If I stopped to soon I only needed to restart. I kept some on hand at all times.
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I do think it would really help. They only gave me enough for 6 days on a really low dose. Hospital refused a refillurefill he comes in for another $210 consultation which I really want to avoid. Maybe the primary vet will prescribe. Any advice on asking for prescriptions if the vet refuses?
 
AM+2 425 so I feel like it's gonna be a full day of reds...
I'm planning how I'm going to space his meals out for today/tomorrow while I still have the meds. Have to call the vet on Monday for a RX. I wish they had just given me more ondansetron instead of the famotidine. They actually said to me "he doesn't really need this so if you skip it, it's not a big deal" but they were already on the bill since they had it inhouse.
 
I had that problem with the oncologist for my lymphoma kitty. I thought pills were so expensive. Turns out if you get an RX and buy at a pharmacy either brick and mortar or online and buy larger quantities they are cheaper. Seeking just a few meant big bucks for them. A good place to look for prices is Good RX.
 
We passed 48hrs of no vomiting, a win for Kitty Cat. Also got the Life Essentials -- thanks for the suggestion, Elise!
I gave small soupy portions throughout the day which I think helped him calm down for testing time. Usually by the time I test, he's super hangry and it's so hard to get a good prick. Or maybe he's just calmer today because I'm calmer...
AM+4 335 * 4 tsp LC with water
AM+6 353 * 8 tsp LC with water + ondansetron
AM+8 362 * 8 tsp LC with water
AM+10 417 * holding until dinner
Will shoot 0.5u again
 
I hope you can get a ketones test soon, especially with him in high numbers. I'm still worried the dose is low.

I can't remember if I gave you the link to this paper, which includes a table showing dosing of ondansetron. See page 232 in the paper. Kitty Cat would be about 3.5 kg, dose is 0.5-1.0 mg/kg 3-4 times a day. If the vet squawks on dose, show them the paper. I learned the hard way and under-dosed Neko's based on vet's suggestion.:( Paper came out after that. Famotidine is Pepcid AC, you can get it an any pharmacy if it was doing anything for him.

Another link for you is this post by Jill on When to Feed, When Not to Feed. She has a couple good posts there. Of note is the urban legend on not feeding for two hours before preshot. It's true for new people only until you know your kitty, and not important if kitty is high. Jill has a comment about this for recent DKA kitties too. Although you weren't there, it was closer than we like. (which is not anywhere near).

Yeah on the 48 hours no vomit (anti jinx).
 
I wasn't watching whenever he peed today so I'd come back to the litter box and go "noooooo!". But I'm determined to get a ketone test tonight...
Wendy&Neko said:
Kitty Cat would be about 3.5 kg, dose is 0.5-1.0 mg/kg 3-4 times a day.
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Okay so should be at least double what he's getting now.. Thanks for the paper, will definitely show this to the vet.
Wendy&Neko said:
Famotidine is Pepcid AC, you can get it an any pharmacy if it was doing anything for him.
Click to expand...
I don't know if it really does anything, but I have a lot of it already.
Wendy&Neko said:
Another link for you is this post by Jill on When to Feed, When Not to Feed. She has a couple good posts there. Of note is the urban legend on not feeding for two hours before preshot. It's true for new people only until you know your kitty, and not important if kitty is high. Jill has a comment about this for recent DKA kitties too. Although you weren't there, it was closer than we like. (which is not anywhere near).
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Ahh this looks like all great info, thanks for sharing. Will get through it after his shot which is due in a few! brb~
 
You can stick with 0.5 to try to see what happens, but you need to really try to get those ketones tests. If it's becoming hard to do, you may with to invest in a blood ketone meter. The other thing that'll help with dosing is deciding if you want to follow TR or SLGS, and put whichever you decide in your signature.
 
Wendy&Neko said:
You can stick with 0.5 to try to see what happens, but you need to really try to get those ketones tests. If it's becoming hard to do, you may with to invest in a blood ketone meter. The other thing that'll help with dosing is deciding if you want to follow TR or SLGS, and put whichever you decide in your signature.
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Right, I will be diligently watching the litterbox. Also need to go over the TR/SLGS docs.
I got distracted today with some home renovations so I missed several opportunities for a urine test. The blood ketone meters look expensiveeee and getting blood is already hard for me. Just need to be more alert for the urine tests.
 
Okay, I read through the sticky multiple times over. I will go with TR. I'm home and have the time for it. I tested a lot more the last few days and I'm determined to keep getting better at it. I've been feeling so lost since his diagnosis but I trust all of you and will power through for however long it takes to stop being scared.
 
Hm, PM+2 is 463. I'm gonna stick around to see if it goes any lower...
I can't tell if today was a good day or not with such high numbers. This is now going into the 8th cycle since hypo and the first dose change. Are these high numbers concerning for today even without ketones present?
 
Go to sleep, he's not on the move tonight. Take advantages of the times he lets you sleep. And awesome on the ketones test result!

If you are following TR, he would not have earned a reduction from 0.75 units to 0.5 units. He's still high from bouncing. Not much you can do about that. If the ketones stay negative, you have room to breathe.

One comment, if he didn't actually show hypo symptoms, which I seem to remember he didn't, we call it a low numbers event. Cats that show hypo symptoms can be more sensitive to insulin, so it's good to make that distinction.
 
Lol thank you Wendy for the peace of mind <3
Also noted on hypo vs low numbers event. I'll adjust my language so I don't cause unnecessary concern. There's already so many other things to be concerned about!
 
Christina & Kitty Cat said:
I wasn't watching whenever he peed today so I'd come back to the litter box and go "noooooo!". But I'm determined to get a ketone test tonight...
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Saran wrap is your friend!

Tips for Collecting Urine Samples



Wendy&Neko said:
One comment, if he didn't actually show hypo symptoms, which I seem to remember he didn't, we call it a low numbers event. Cats that show hypo symptoms can be more sensitive to insulin, so it's good to make that distinction.
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For information, Kitty Cat did show signs of lethargy on that night after the lowest BG readings.


Mogs
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Critter Mom said:
For information, Kitty Cat did show signs of lethargy on that night after the lowest BG readings.
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He's been lethargic everyday since Dx and prior UNTIL ~9/18 I've noticed he's a lot more active recently.
But would lethargy be a sign of hypo if he wasn't any more lethargic than he already usually was?
 
PM+10 474
Due for shot in 2 hrs. It's only been 4 cycles of consecutive 0.5u so according to TR, I'm sticking with it at least one more day before considering an increase?
 
Christina & Kitty Cat said:
He's been lethargic everyday since Dx and prior UNTIL ~9/18 I've noticed he's a lot more active recently.
But would lethargy be a sign of hypo if he wasn't any more lethargic than he already usually was?
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Thanks for the clarification, Christina.

High BG levels can make a cat lethargic, and so can a hypo. The scenario you describe is indeed possible, another reason why home testing is so important because you'd be able to determine whether the cat was in low numbers.


Mogs
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Hi Christina! When you have time, I recommend starting a new thread for today (and link to this one) and ask for clarification on dosing for your next cycle. A lot has changed in these past few days (Kitty Cat is eating & not vomiting, ketones are testing negative, etc.). I don't know enough to give dosing advice :) so I'd get input from the veterans who will also consider the other conditions of Kitty Cat :bighug: Hope you have a wonderful day!
 
She’s decided on TR so an increase tomorrow morning is likely going to be your next step. The high this morning might signal the bounce is clearing but unless something crazy happens I would increase to .75 in the morning. I’m hoping you can get your hands on some ondansetron for tomorrow. I always had some on hand. See you on the new condo for today Christina.
 
tiffmaxee said:
She’s decided on TR so an increase tomorrow morning is likely going to be your next step. The high this morning might signal the bounce is clearing but unless something crazy happens I would increase to .75 in the morning. I’m hoping you can get your hands on some ondansetron for tomorrow. I always had some on hand. See you on the new condo for today Christina.
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I just didn't know if she could increase tonight since the reduction to 0.5 wasn't earned. Back to minding my own business lol.
 
JaxBenji said:
I just didn't know if she could increase tonight since the reduction to 0.5 wasn't earned. Back to minding my own business lol.
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She could but I always like to do that in the morning. I’m still not convinced she didn’t have an active hypo. So far negative ketones. If even a trace I would say increase tonight as long as you have had enough sleep to monitor.
 
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