BG is on the low end. Do I only give half hsi dose?

[Basic's Mom]

Base's BG was 124 at injxn time. Waited 20 minutes. It is still 124. His vet advised me that if it is between 100-150 to only give half of his dose. Is this what you would do? I haven't given him his a.m. shot yet. Waiting on an answer.

 

[Basic's Mom]

@Bron and Sheba (GA)

 

[Basic's Mom]

@Bron and Sheba (GA)

I have read where it says to hold injection if under 150 using SLGS. I won't be giving him his am injxn. He hasn't eaten and I know that is why it is low. Have no clue how to get him to eat more. This is an absolutely horrid situation to be in. I have no clue what I'm doing. Hope this was right according to group. Not sure when I'll be back on here today.

 

[Sienne and Gabby (GA)]

Sybil --

Skipping is a very reasonable choice since you and Basic are still new to feline diabetes. Just so you're aware, as you gain more experience, you will have other options (e.g., stalling, shooting a reduced dose).

 

[Basic's Mom]

Sybil --

Skipping is a very reasonable choice since you and Basic are still new to feline diabetes. Just so you're aware, as you gain more experience, you will have other options (e.g., stalling, shooting a reduced dose).

His vet recommended he get half. What I've read in here, states to skip. Again, no clue which to actually do for him. Again, terrible position to be in.

 

[Bron and Sheba (GA)]

Because you skipped the dose and he had ketones at diagnosis, I would make sure you test the Urine for ketones today if you can.
You mention he is not eating well. Do you think he could be nauseated? Is he normally a good eater?

 

[Basic's Mom]

Because you skipped the dose and he had ketones at diagnosis, I would make sure you test the Urine for ketones today if you can.
You mention he is not eating well. Do you think he could be nauseated? Is he normally a good eater?

I didn't know what else to do and no one responded quickly. I'm just doing what I can. Yes, before all of this he was probably too good of an eater. The only sign he showed was not eating. I've added notes to his SS. Not sure if he will urinate again today. Missed it this morning entering all of this.

 

[Bron and Sheba (GA)]

You haven’t done anything wrong. I am suggesting testing the urine for ketones as a precaution.
Do you think it is the change of food that he doesn’t like or do you think he is nauseated? You might like to ask the vet for some ondansetron or cerenia for nausea. It’s important that diabetic cats eat.. and especially cats that have had ketones eat well.
I am heading to bed (I live in Australia) but I’ll answer any questions tomorrow.

 

[Basic's Mom]

You haven’t done anything wrong. I am suggesting testing the urine for ketones as a precaution.
Do you think it is the change of food that he doesn’t like or do you think he is nauseated? You might like to ask the vet for some ondansetron or cerenia for nausea. It’s important that diabetic cats eat.. and especially cats that have had ketones eat well.
I am heading to bed (I live in Australia) but I’ll answer any questions tomorrow.

He is on cerenia. As noted, yesterday's attempt to get him to take the pill didn't go great. He got in out of his throat and drooled for about 30 minutes. Not fun. I have taken a screenshot of the anti nausea med someone else said to try that starts with an O. Don't know what else to do for my cat. This is truly a very helpless feeling. I know he is very hungry. He just cant eat.

 

[Bron and Sheba (GA)]

The name of the other anti nausea medication is ondansetron.
Have you tried different foods. If he is not eating enough, let him eat whatever he will eat as eating anything is more important than just eating low carb food with ketones in the picture.

 

[Basic's Mom]

The name of the other anti nausea medication is ondansetron.
Have you tried different foods. If he is not eating enough, let him eat whatever he will eat as eating anything is more important than just eating low carb food with ketones in the picture.

Okay. I'll try some dry food. Ive tried many different types of canned food. It has everything to do with him being ill. My cat has always ate almost any and every type of food put in front of him. Hell, he is refusing freeze dried salmon. I am a little concerned because he didn't get his insulin this morning what the dry will do to his BG.

 

[Basic's Mom]

The name of the other anti nausea medication is ondansetron.
Have you tried different foods. If he is not eating enough, let him eat whatever he will eat as eating anything is more important than just eating low carb food with ketones in the picture.

Thank you again for all the help. I am very grateful. I'm not trying to seem ungrateful or pissy, I'm just very stressed, overwhelmed, and just want to help my cat to the best of my ability. Finding out the vet advice isn't always the best has really stressed me because I didn't find this group until a week after his diagnosis. I am trying to relearn the things. It is just a lot of information one needs to retain while under tremendous stress. Again, thank you to each of you that are here helping all of us that feel like we are drowning in emotions and information. Ultimately, it isn't about me and my emotions, it is about keeping my cat healthy and alive.

 

[Sienne and Gabby (GA)]

Sybil -- you're not coming across as pissy! We truly understand. Most of us have been in your shoes at one time or another. We want to try to problem solve with you. Managing your cat's diabetes is hugely overwhelming at first. It does become routine after a couple of weeks.

Just as an FYI, the instructions regarding skipping are directed to a cat that hasn't had ketones or other health issues. We consider ketones an exception to pretty much every rule. However, having ketones is different than a cat that was diagnosed with diabetic ketoacidosis (DKA). the latter is an emergency. That said, ketones can develop into DKA suprisingly quickly.

FWIW, Basic is in good numbers. While lower numbers are great to see, still keep getting ketone tests. Lower numbers reduce the risk of ketones developing but if Basic has some infection/inflammation brewing (which I'm being attentive to since you're saying your kitty's behavior is "off"), it's a risk for ketones. (Ketones result from not enough calories, not enough insulin and an infection or inflammation.)

 

[Basic's Mom]

Sybil -- you're not coming across as pissy! We truly understand. Most of us have been in your shoes at one time or another. We want to try to problem solve with you. Managing your cat's diabetes is hugely overwhelming at first. It does become routine after a couple of weeks.

Just as an FYI, the instructions regarding skipping are directed to a cat that hasn't had ketones or other health issues. We consider ketones an exception to pretty much every rule. However, having ketones is different than a cat that was diagnosed with diabetic ketoacidosis (DKA). the latter is an emergency. That said, ketones can develop into DKA suprisingly quickly.

FWIW, Basic is in good numbers. While lower numbers are great to see, still keep getting ketone tests. Lower numbers reduce the risk of ketones developing but if Basic has some infection/inflammation brewing (which I'm being attentive to since you're saying your kitty's behavior is "off"), it's a risk for ketones. (Ketones result from not enough calories, not enough insulin and an infection or inflammation.)

Okay. Thank you. So, for future knowledge (when ketones is present) , would he get half of a dose when BG is low or a full dose?

Yes, I've had the strips. I just keep missing him and missing it this morning sent me over the emotional edge.

I just saw in his ER write up that they gave him an antacid injection and long lasting antibiotics with his subQ fluids, antinausea, and appetite stimulant before we left. It also states elevated liver enzymes. They also mentioned underlying issue could be pancreas. His new vet didn't have any of the test. She has ordered me one. I was going to wait until he stabilizes more for that, but would like your (anyone's) opinion (should I do now or hold off). Also, if I keep missing his urine, I need to have them test for ketones, right?

I just want to do right by my cat. I have to be his advocate, clearly.

Thanks for the kind words. It means a lot.

 

[Ale & Bobo & Minnie (GA)]

I’ll let others answer your dose question, but wanted to share some tips for pilling I’ve found work well every time.

I wrap the pill in a super tin layer of pill pocket. Not a whole pill pocket, not even half, I grab a tiny bit and wrap it around the pill. It helps it slide down their throat because it’s oily and it also prevents the pill from dissolving in their mouth so they don’t taste the bitterness, which is what causes the foaming at the mouth. You can also do the same thing with frozen butter. Wrap the pill in a tiny ball of butter and put it in the freezer. The trick here is that the butter will start to melt pretty fast once you hold it in your fingers so you have to be fast about it. If they’re food motivated, you can wrap it in a small ball of Easy Cheese and see if they’ll eat it what way. Minnie used to but not Bobo. I use the pill pocket trick with him. Sometimes he’ll spit it out but it’s still wrapped in the pill pocket so I can just pill him again.

You can also get a piller from chewy like this one that has a compartment in the back for water so when you push the plunger, the water makes sure the pill goes down:
https://www.chewy.com/dp/136745?utm_source=app-share&utm_campaign=136745

 

[Sienne and Gabby (GA)]

There's all of what Ale suggested. I also keep blank gel caps at home. For any pill, I stuff them in a gel cap. It's flavorless and prevents foaming.

You can also purchase a ketone meter. It's identical to a glucometer except it measures ketones. There are a couple of brands that test both for ketones and glucose but use different strips. The strips are pricey but it makes it LOTS easier than trying to stalk your cat to the litter box.

For your vet to test for pancreatitis, he can order a Spec fPLI. A blood sample is sent to IDEXX. She does not need to have the other version (Snap fPLI) in the office. Most vets send out blood samples to a commercial lab. The pancreatitis test is no different. My vet sends all of my cat's labs to IDEXX and only runs labs in the office if they are doing a procedure and need to monitor at the moment. If your cat has pancreatitis, it needs to be treated. Pancreatitis is incredibly painful. This is a link to our Primer on Pancreatitis.

 

[Basic's Mom]

I’ll let others answer your dose question, but wanted to share some tips for pilling I’ve found work well every time.

I wrap the pill in a super tin layer of pill pocket. Not a whole pill pocket, not even half, I grab a tiny bit and wrap it around the pill. It helps it slide down their throat because it’s oily and it also prevents the pill from dissolving in their mouth so they don’t taste the bitterness, which is what causes the foaming at the mouth. You can also do the same thing with frozen butter. Wrap the pill in a tiny ball of butter and put it in the freezer. The trick here is that the butter will start to melt pretty fast once you hold it in your fingers so you have to be fast about it. If they’re food motivated, you can wrap it in a small ball of Easy Cheese and see if they’ll eat it what way. Minnie used to but not Bobo. I use the pill pocket trick with him. Sometimes he’ll spit it out but it’s still wrapped in the pill pocket so I can just pill him again.

You can also get a piller from chewy like this one that has a compartment in the back for water so when you push the plunger, the water makes sure the pill goes down:
https://www.chewy.com/dp/136745?utm_source=app-share&utm_campaign=136745

Thank you. I will get some pill pockets and just wrap a thin layer around to coat. I already ordered a piller that had a lot of positive cat review. I didn't see the way with water reservoir. If these remedies don't work, I will order that one. Thanks again.

He normally is very food motivated. I couldn't entice him with his favorite treat right now.

 

[Basic's Mom]

There's all of what Ale suggested. I also keep blank gel caps at home. For any pill, I stuff them in a gel cap. It's flavorless and prevents foaming.

You can also purchase a ketone meter. It's identical to a glucometer except it measures ketones. There are a couple of brands that test both for ketones and glucose but use different strips. The strips are pricey but it makes it LOTS easier than trying to stalk your cat to the litter box.

For your vet to test for pancreatitis, he can order a Spec fPLI. A blood sample is sent to IDEXX. She does not need to have the other version (Snap fPLI) in the office. Most vets send out blood samples to a commercial lab. The pancreatitis test is no different. My vet sends all of my cat's labs to IDEXX and only runs labs in the office if they are doing a procedure and need to monitor at the moment. If your cat has pancreatitis, it needs to be treated. Pancreatitis is incredibly painful. This is a link to our Primer on Pancreatitis.

Thanks for info on ketone meter. I may end up getting one.

Link you attached was incredibly informative. I took a lot of notes. I'm beginning to lean more on the side of issues with his pancreas. I understand he also has an issue with his sugar. Just waiting to find out if the pancreas is causing the issue with the diabetes or vice versa. I will not accept the other pancreas test either. I will also ask about the 2 levels mentioned in that post too.

The information and individuals helping others here are absolutely invaluable. Every cat owner should be aware this group.

Thank you very much.

 

[Bron and Sheba (GA)]

My Sheba used to get pancreatitis and the first symptom was always loss of appetite and she was a very food motivated kitty.
Finding out if Basic has pancreatitis will enable you to treat it properly.
The treatment is antinausea medications, pain medications (because it is a very painful condition) and sub Q fluids.
Please keep us updated and let us know when you get a urine ketone test

 

[Basic's Mom]

My Sheba used to get pancreatitis and the first symptom was always loss of appetite and she was a very food motivated kitty.
Finding out if Basic has pancreatitis will enable you to treat it properly.
The treatment is antinausea medications, pain medications (because it is a very painful condition) and sub Q fluids.
Please keep us updated and let us know when you get a urine ketone test

I have all of the info I've learned written down. I will be his advocate and voice. I definitely will update immediately about the ketone strip and what the vet and I discuss and go from there.

When we speak tomorrow, I'm going to suggest the changes in meds (anti nausea (the ondansetron) and adding pepcid and possible starting some pain meds to see if he gets some relief, even before results, because a day on pain meds wont hurt him if he doesn't need them and will really help him if he does need them) and I really think he should have more subq fluids. While I see him drinking, I just want to be sure he is hydrated. He really wants to eat. He gets excited and rubs my leg still, he just walks away after a few bites. It is breaking my heart, but I'm sure it is bothering him more. Everything I've read has me leaning towards that. We are going on 3 weeks with no pain meds, if he, in fact, does have pancreatitis. From his numbers today, without him having insulin this morning, I am thankful I didn't up his insulin by 2 U per day.

If anyone reads this and can advise me how to approach the vet with my new plan, SLGS and the other info. I don't want to seem rude or confrontational. She has really helped him to the best of her ability whereas the other 2 vets he saw suggested I spend 10k or put him down. I don't have a problem being assertive, I just don't want to offend her.

Thank you very much for all of your help.

 

[Bron and Sheba (GA)]

Basic really does sounds as if he is nauseated and I’m sure would benefit from anti nausea meds. Just tell the vet you would like to give him ondansetron as you are sure he is nauseated as he is usually such a good eater, and he want s to eat but can’t.
You could show the vet the SLGS dosing method and say this is what you would like to follow.
You can print a copy off from HERE to show the vet. She might like to have a copy to keep.
Also just say you would like to try pain meds again to see if that helps Basic. Let us know how you get on.

 

[Sienne and Gabby (GA)]

FYI -
SLGS is something developed here. The vet won't know what you're talking about unless the vet is familiar with FDMB.

I would let the vet know that you've done copious amounts of reading. Mention places like the Cornell feline health center, the American Animal Hospital Assn, links to vet journals.

 

[SpotsMom]

I would let the vet know that you've done copious amounts of reading. Mention places like the Cornell feline health center, the American Animal Hospital Assn, links to vet journals.

100% this! Spot’s vet didn’t start coming around until I presented her with research. Then she started doing her own research and now she’s firmly on my (his) side. I even gave her access to his spreadsheet so I don’t have to take him in for fructosamine checks anymore. Most vets want what’s best for our pets just as much as we do, so present it in the right way and you’ll change the way they see things!

 

[Basic's Mom]

Basic really does sounds as if he is nauseated and I’m sure would benefit from anti nausea meds. Just tell the vet you would like to give him ondansetron as you are sure he is nauseated as he is usually such a good eater, and he want s to eat but can’t.
You could show the vet the SLGS dosing method and say this is what you would like to follow.
You can print a copy off from HERE to show the vet. She might like to have a copy to keep.
Also just say you would like to try pain meds again to see if that helps Basic. Let us know how you get on.

FYI -
SLGS is something developed here. The vet won't know what you're talking about unless the vet is familiar with FDMB.

I would let the vet know that you've done copious amounts of reading. Mention places like the Cornell feline health center, the American Animal Hospital Assn, links to vet journals.

Thank you. I was pretty frantic yesterday. Was trying to provide her info about how I want his dosing, the type of pancreatitis test I wanted, etc. and where I found the info. And I think I approached everything wrong. We spoke about it today and I apologized. I know she cares and is there to help. I am just at my wits end while I'm witnessing my cat's health deteriorate before my eyes. I'm only seeing improvement in his health today. I've been going to the vet since 9/22. I wasn't patient or kind when speaking with her. I want him better and while I know she does too, we just aren't viewing things the same. I know in time, I will be able to present this information to her differently and she will be receptive to hearing it. I won't waver on his insulin plan though. I'm trying my best to do what is best for my cat no matter how hard all of this is.

Again,
Thank you

100% this! Spot’s vet didn’t start coming around until I presented her with research. Then she started doing her own research and now she’s firmly on my (his) side. I even gave her access to his spreadsheet so I don’t have to take him in for fructosamine checks anymore. Most vets want what’s best for our pets just as much as we do, so present it in the right way and you’ll change the way they see things!

Thank you. I was pretty frantic yesterday (not an excuse). Was trying to provide her info about how I want his dosing, the type of pancreatitis test I wanted, etc. and where I found the info. And I think I approached everything wrong. We spoke about it today and I apologized. I know she cares and is there to help. I am just at my wits end while I'm witnessing my cat's health deteriorate before my eyes. I'm only seeing improvement in his health today. I've been going to the vet since 9/22. I wasn't patient or kind when speaking with her. I want him better and while I know she does too, we just aren't viewing things the same. I know in time, I will be able to present this information to her differently (I could only provide her with a link, I don't have a printer) and she will be receptive to hearing it. I won't waver on his insulin plan though. I'm trying my best to do what is best for my cat no matter how hard all of this is. I never thought I'd be giving my cat fluids at home, or him being poked on constantly and his paw swollen from his IV, forcing medicine and food down him. It is all a lot to take it at once.

Again,
Thank you