Frustrating!!! Many Questions

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Good to see that Mao got a dose increase this morning. I think it was time, even though Mao was bouncing higher last night.

Interesting to see the lower numbers from yesterday morning at +7 and +8. Looks like Mao's nadir or low point might be a little later than the standard +6. Every kitty is unique, and Mao is showing us that.

Feel better Mao and start eating more. You're mamabean says you are too skinny.
 
Mao has been eating and drinking all day, it's hard to feed her small meals, since her numbers have been high today, she increased thirsty. I am going to get her BG tonight to see if the reading drops or not after pms. Thank you!
 
Thanks so much for getting those readings last night. It showed us that Mao can drop quite a bit, from the reds all the way down into the blue numbers. That's a big drop. I expect to see some bouncing, that is higher numbers, for at least a couple of cycles if not longer. You may need to hold this 0.75U dose a bit longer, to see if the bounce can clear. We usually tell people it can take up to 72 hours or 6 cycles to clear the bounce.

it's hard to feed her small meals, since her numbers have been high today,
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What do you mean? Do you not feed her as much when she is in those high numbers?

Even if her numbers are high, she still needs to eat. Since she is still unregulated, her body can't properly use the food that she does eat. That means, you may need to feed her up to 50% more than a normal or regulated kitty eats. She needs to eat more to stop her continuing weight loss.
 
You may need to feed 50% more food until she becomes regulated.

My cats eat from 0.5 to 1.0 ounce of canned food per pound of weight, depending on age and activity, and I leave food down most of the day.
 
OK, I'll hold the does.
I tried to feed her small meals through the day, but it's difficult because she wanted to eat big meal every time. You are saying I should let her eat until she feels full, should I free feeding?
 
Gradually increase the amount each feeding until she starts leaving some behind or she is at an ideal weight., neither too heavy, nor too thin.
 
When Max has pancreatitis I give him ondansetron and it really works for nausea. Many of us have found that Cerenia works well for vomiting but not as well for nausea. Some give both ondansetron and ondansetron. There is a good yahoo group for pancreatitis if you are interested. The yellow stool is suspicious for enzyme deficiency BUT I have found that when I change food Max's stool color also changes. Some cats do well on enzymes if they have a deficiency but others won't eat. Max's issue is chronic pancreatitis which I think led to his getting diabetes so I can't give first hand info except for that which has been going on for 4 years. I really recommend ondansetron. We also found that feeding small amounts often helps and feeding too much at one sitting can make them more nauseous. That is a lot of weight loss and I would be concerned about hepatic lipidosis (fatty liver disease) as well. The main treatments for pancreatitis are pain medication, nausea control, and fluids. With Max usually nausea control does the trick. I'm so sorry you are having these problems.

Elise
 
Thank you for the information Elise. My vet prescript Metoclopramide which is an anti-nausea medication yesterday, I talked to my vet to have the anti-nausea, but didn't know the ondansetron works well. I will try Metoclopramide fist to see how it works then ask for the ondansetron. I am also getting the enzyme for her to try. Mao has not vomited since she got the fluid at the vet two days ago, she is still skinny, not gained any weight; she went poop right after eating, and lot of stool, I have been searching online trying to find out what's the problem, and I am wondering if it's the food allergy. I am going to get the Nature's Variety Venison for her, and to see if it can solve the problem, also the yellow stool.
 
Did you ask the vet about exocrine pancreatic insufficiency? That causes frequent large puffy smelly pale coloured stools... and weight loss or lack of weight gain.
 
I did. My vet let me give Mao enzymes to see if it works. The vet didn't suggest to test her EPI because she's so sick, will do when she is getting better.
 
What ensymes are you giving and how much? When I started Bailey I had to work up from less than 1/8 teaspoon per 3oz can of food or he would get nauseous.

Wendy
 
Pancrezyme, it's a vet's prescription, I have not received it yet, it's on the way and don't know how much to give. Should I give her 1/8 teaspoon per 3oz food too? I changed her food to venison today and her stool color turned to brow, still pooped 6 time a day.
She has been lethargy, don't know if the bounce will be clear tomorrow or not. Checked ketone tonight, the color matched the trace, should I worry?
 
Depends what the pack and vet says but I would start low and work up. Let me know when the enzymes comes in and we can chat.

Is this the first time you have ever tested for ketones? You tested within 30minutes of her peeing right?

Trace isn't great , but anything more than that is a vet trip. For now though try and get more fluids into her.

Wendy
 
Ok feed her and mix extra water into it . You could also give her the water from a can of tuna or chicken broth (no onions ) or even water mixed with a very small amount of milk (like 1/4 cup water and 1 tsp milk). You want to flush those ketones out.

I would also consider increasing her dose to 1 unit. She is high, we aren't seeing enough blue or green.

Wendy
 
Let us know. And try and get another ketone test when she pees next. Anything over trace is very serious.

You could also add a drop of olive oil to her water bowl. She will try and lick at it and drink at the same time. No more than a drop though or she could get diarrhea.
 
OK.
Is it time to give her 1U, or should I wait for the bounce to clear? there were no nadirs, bouncing for two days. But the trace is a problem.
 
Shoot through the bounce.
The glucose needs to come down, especially if there are trace ketones.

Have you visted either of the Lantus forums yet?
Tight Regulation has a protocol which has gotten many cats off insulin. You'll need to test 3 to 4 times a day - both pre-shots, mid-cycle in the nadir range when possible, and a before bed test. It looks like your're testing at least that much.
Relaxed Lantus is for those following the Start Low, Go Slow protocol, or those whose schedules don't work well with Tight Regulation (or whose cats have not read the book on how to be a diabetic!)
 
If nadir blood glucose concentration>300mg, increase every 3 days by 0.5. Mao was bouncing for three days, the nadirs were >300 or no nadirs. The "nadirs" are the numbers after bouncing, the real numbers after the bouncing clear, right? I am confusing.

Cats with a history of developing ketones that remain >300mg after 24-48 hours, increase by 0.5U, the ">300mg" talks about the nadirs? include bouncing? Mao was treated her ketoacidotic crisis month ago.
 
Nadir = lowest test value between shots, usually in the +5 to +7 hours after the shot.

If bouncing and not lower than 50 mg/dL on a human glucometer (80 mg/dL AlphaTrak) at nadi, shoot through the bounce.

I think you're ready to start posting over in Lantus Tight Regulation.
Post there following the instructions for a daily post
- Subject: cat's name, date, and glucose levels
- edit the first post's subject as you update with tests

You'll get lots of feedback specific to using Lantus.
 
I don't know how to move over the Subject to the Lantus Tight Regulation, maybe I can just start a new subject there. Thank you for the explanation, I don't need to wait for the bouncing to clear for increasing the does next time.
 
Metoclopramide (Reglan) is not a good nausea medication for cats. It does help motility. I wasted time using it for my nauseous lymphoma cat. The drugs of choice for cats are ondansetron which you can get at Costco for a good price, cerenia, and anzemet which needs to be injected. I used ondansetron for my lymphoma/CRF/pancreatitis cat and have used it for Max who has chronic pancreatitis for 4 years now. When he gets the right dose he is able to eat when having an attack. I have a link somewhere which explains why Reglan doesn't work for cats well. If you want me to search for it please let me know.
 
Thanks for let me know. I haven't given my cat any of it, she has not vomited for 4 days. Thank God! I am going to ask my vet for ondansetron, my cat Mao did not have any test for pancreatitis, I think there is a possibility because she pooped lots and lost too much weight. My vet prescript the pancrezyme to put Mao on trail to see if it works on her. I don't know Mao will eat it or not, it costs quiet bit ($98). If it works, I will talk to the vet to switch to injection. Do you give the injection to Max, or the vet does?
 
Pancreazyme is not injectable.
It mixes with the food in the GI tract to help it digest.
 
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