Keep trying to regulate, or live with it?

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Casey update!

Her appetite seems a little up this morning. She wasn't interested in any of the cat food I set down, even with parmesan on it, but gobbled up some pieces of cooked chicken, so I guess that's a start! Her BG was 252. How does the appetite stimulant work? Is she going to become ravenously hungry, or is it just a slight boost? At least she's eating *something*, even though I know cooked meat isn't as good for cats as raw...

Would you guys recommend that I give her some Miralax? On the one hand I don't want her to become constipated, but on the other, since Miralax works by drawing water into the intestine I'm afraid it'll make her more dehydrated. Thoughts?

ETA: OK, right now she's sitting in meatloaf position next to her water bowl, with her head actually hovering over the bowl. What could this mean? I know it's a symptom of Feline panleukopenia, but she doesn't match the obvious symptoms (eg, bloody diarrhea). ???
 
ohiogal said:
Casey update!

Her appetite seems a little up this morning. She wasn't interested in any of the cat food I set down, even with parmesan on it, but gobbled up some pieces of cooked chicken, so I guess that's a start! Her BG was 252. How does the appetite stimulant work? Is she going to become ravenously hungry, or is it just a slight boost? At least she's eating *something*, even though I know cooked meat isn't as good for cats as raw...

Would you guys recommend that I give her some Miralax? On the one hand I don't want her to become constipated, but on the other, since Miralax works by drawing water into the intestine I'm afraid it'll make her more dehydrated. Thoughts?

ETA: OK, right now she's sitting in meatloaf position next to her water bowl, with her head actually hovering over the bowl. What could this mean? I know it's a symptom of Feline panleukopenia, but she doesn't match the obvious symptoms (eg, bloody diarrhea). ???

Hanging over a water bowl is a sign of a thirsty animal. Thirst will turn up in many symptom lists, including feline diabetes.
Meatloafing to me is often pain. Oh, not always, but when my Shadoe was having a pancreatitis attack which is painful, she was a meatloafer.

The appy stim I was giving to Oliver when he was very sick was to be given every 3 days.
Shortly after the pill was given, he wanted to eat, ate well, and with apparent appetite. He ate like normal on the first day, then ate a bit less the 2nd day, and by the time for the next dose, he had not been eating much. I gave him another pill and within hours, everything repeated.... his interest in food returned, and he ate.
I don't know about any mechanisms, but to me, it made him eat and I was happy.

With miralax, you need to add water to his food. If she won't eat souped food or is eating only chicken, then just mix the miralax into some water and syringe it into the corner of his mouth.
You do NOT want constipation, stretched colon, or megacolon.

Just curious but why are you suspecting feline panleukopenia?
 
I'm a complete newbie to this forum, my sweet girl just got diagnosed and I haven't even started insulin yet. However I'm so impressed with your commitment and love for
your cat. I hope casey gets better soon, will be following!
 
lesleymweick said:
I'm a complete newbie to this forum, my sweet girl just got diagnosed and I haven't even started insulin yet. However I'm so impressed with your commitment and love for
your cat. I hope casey gets better soon, will be following!

Lesley,
You have found yourself a good site, and I am glad you are posting before starting insulin because often some changes can be made to a cat's diet, and health, and there's a possibility of no need for insulin.

I wish you well with your girl. There are many knowledgeable people here who can help you.
 
Lesley,
You have found yourself a good site, and I am glad you are posting before starting insulin because often some changes can be made to a cat's diet, and health, and there's a possibility of no need for insulin.

I wish you well with your girl. There are many knowledgeable people here who can help you.Blue

Thank you Blue!! So impressed by the wealth of knowledge here. My Molly is a lucky girl to have this resource. Ohiogal, I will be pulling hard for you!!
 
Blue said:
Hanging over a water bowl is a sign of a thirsty animal. Thirst will turn up in many symptom lists, including feline diabetes.
Meatloafing to me is often pain. Oh, not always, but when my Shadoe was having a pancreatitis attack which is painful, she was a meatloafer.

The appy stim I was giving to Oliver when he was very sick was to be given every 3 days.
Shortly after the pill was given, he wanted to eat, ate well, and with apparent appetite. He ate like normal on the first day, then ate a bit less the 2nd day, and by the time for the next dose, he had not been eating much. I gave him another pill and within hours, everything repeated.... his interest in food returned, and he ate.
I don't know about any mechanisms, but to me, it made him eat and I was happy.

With miralax, you need to add water to his food. If she won't eat souped food or is eating only chicken, then just mix the miralax into some water and syringe it into the corner of his mouth.
You do NOT want constipation, stretched colon, or megacolon.

Just curious but why are you suspecting feline panleukopenia?

Oh, just because of the water bowl thing. Shortly after I posted she got up and moved anyway, so it turned out to be temporary!

Her appetite still hasn't really come back. The vet instructed me to give her 1/4 pill every couple of days, but that doesn't sound like much...I gave her 1/4 pill yesterday, should I give her another 1/4?

Also, I began giving her fluids yesterday, but only got 50ml in before she became restless and I had to take the needle out before she bolted and hurt herself. I got 50ml in today, but should I give her another 100ml or hold off till tomorrow?

Thanks for all the help, I really appreciate it!

PS Hi Lesley! Welcome to the forum. :-)
 
Follow the vet's instructions on the 1/4 pill. Cats are much smaller than us and drugs may work differently in them vs humans.
 
Just got a call from the vet - yep, it's pancreatitis.

They're going to keep her overnight to get some fluids and antibiotics in here, and we'll go from there. The vet seemed pretty confident that Casey will bounce back from this. The important thing is to get her eating and not throwing up.

Further bulletins as events warrant! Thanks for all the positive vibes and advice. I probably never would have thought to ask about the pancreatitis test if it wasn't for you guys!
 
I'm so glad you have a diagnosis. It's hard to get results when you just treat the symptoms without knowing what is causing them. Casey should be feeling better soon!
 
Maggies Mom Debby said:
I'm so glad you have a diagnosis. It's hard to get results when you just treat the symptoms without knowing what is causing them. Casey should be feeling better soon!

She is! :-D I just got a call from the vet, Casey's started eating again and they're getting fluids and other meds into her. I should be able to bring her home tomorrow afternoon. Huzzah!

Apparently pancreatitis isn't something they test for routinely when they have a sick kitty; it's something they actively have to be looking for. I sure am glad you guys are around, or else I'd still be sitting here feeding Casey appetite stimulants and wondering why they aren't working!! You guys are AWESOME! {{{hugs board}}}}
 
Wendy&Tiggy said:
Yay! So they are keeping her tonite?

Yes. They wanted to keep putting the fluids and meds in her, and monitor her progress through tomorrow to make sure things keep improving. So far so good! Apparently she's already eaten an entire bowl of food. :-D
 
What pain meds will you get to bring home? Get bupe because pancreatitis is VERY painful.
The fluids are something you can give yourself at home..... with pancreatitis, you should really give them for a few days. You will see an improvement in BG numbers. You can give 1/4 tab of pepcid AC 10mg BID; it will help with upset stomach. I am not sure why the need for AB; the problem is inflammation.... maybe you can ask if there is also an infection.

Did the vet tell you the result number? If not, it would be good to ask. Both of my cats had issues, but Shadoe had much higher numbers and more difficulties and pains, while Oliver had numbers that were mildly raised, in the grey area. I found that weekly B12 shots did alot to help Shadoe and she seldom needed the pepcid after needing it BID for months.
 
Blue said:
What pain meds will you get to bring home? Get bupe because pancreatitis is VERY painful.
The fluids are something you can give yourself at home..... with pancreatitis, you should really give them for a few days. You will see an improvement in BG numbers. You can give 1/4 tab of pepcid AC 10mg BID; it will help with upset stomach. I am not sure why the need for AB; the problem is inflammation.... maybe you can ask if there is also an infection.

Did the vet tell you the result number? If not, it would be good to ask. Both of my cats had issues, but Shadoe had much higher numbers and more difficulties and pains, while Oliver had numbers that were mildly raised, in the grey area. I found that weekly B12 shots did alot to help Shadoe and she seldom needed the pepcid after needing it BID for months.

Sorry, Blue, I'm obtuse - what's AB and bupe? I'm not up on the lingo...maybe you should use the whole word instead of the abbreviations around me! :-)

ETA: OK, I think I figured out one of them anyway - is AB antibiotics? She's still on antibiotics because her white blood cell count is still way up.
 
Casey's home! She's running around and meowing for attention, much more active than she has been! The vet gave me 'bupe' for pain control. Casey looks a lot better, and I'm encouraged to think that she's going to be OK. :-D Her BG was 199 this morning and she's been eating much better.

I'll keep everybody updated. Thanks for the positive vibes!
 
I just gave Casey her Buprinex, the vet gave it to me in syringes that I can just put into her mouth and squeeze to get the dose in.

Problem is, when I tried to get it into Casey's cheek, she jerked as I depressed the plunger and it went into her mouth instead.

Is that bad? I don't think I should dose her again, but I think she swallowed it instead of it going into her cheek.

How the heck do you do this? What cat is going to sit still while you inject something into their cheek pocket? And, don't they end up swallowing it anyway?? Can someone clue me in? Thanks!
 
I think they want it absorbed through the mucus membrane a bit hence the cheek pocket. Maybe try again tomorrow.

Also now that she is getting better and once she is eating better we should discuss next steps for controlling the diabetes. Can we get you on the tight regulation protocol now?
let me know
Wendy
 
Wendy&Tiggy said:
I think they want it absorbed through the mucus membrane a bit hence the cheek pocket. Maybe try again tomorrow.

Also now that she is getting better and once she is eating better we should discuss next steps for controlling the diabetes. Can we get you on the tight regulation protocol now?
let me know
Wendy

I'd like to make sure Casey is past this first. The vet wants to see her next week for a follow-up. I just took her BG and it was 232, so per the vet's instructions I gave her 5us. I'm going to watch to see how much she eats overnight and tomorrow. She also needs to regain some weight. She's down to 9.5 lbs, and she was 12 lbs last June.
 
Wendy&Tiggy said:
Keep testing her, even five units could be too much now.

OK, I will. Her BG this morning was 292 (she'd already eaten, though, so that might have driven the number up), and she's eating like a champ. Yay! I'll keep giving her 5us and then do a curve over the weekend and see where we're at. She's already pooped twice since she got home, so it looks like the plumbing is in working order!
 
[OK, I will. Her BG this morning was 292 (she'd already eaten, though, so that might have driven the number up), and she's eating like a champ. Yay! I'll keep giving her 5us and then do a curve over the weekend and see where we're at. She's already pooped twice since she got home, so it looks like the plumbing is in working order![/quote]
Yeah!!!! :RAHCAT
 
Maggies Mom Debby said:
What great news!!! Give that cutie pie a scratch behind her ears from me!

I sure will! :smile: I still have to get the hang of giving her the Buprinex, though. Trying to get her to hold still long enough for me to get anything into her cheek is tough! She chewed on the syringe just as I was injecting this morning, and it went into her mouth again. If anybody has any tips, I'm all ears! I don't want her to be in pain, and this is the stuff that's supposed to help with that...
 
Another reason for squirting the bupe into the cheek is so you don't get any in the lungs from aspiration.
In the cheek, it can be swallowed safely.
 
The bupe will work fine orally..... some people give buprenex injections as well, but I am sure you will see a happier Casey with the oral. Just aiming for along the side of the throat is good, and holding the head loosely but securely will help you get the bupe closer to the cheek pocket. It sure isn't easy to give anything orally, and the first time for squirting in the mouth, with bupe, maybe was surprising to Casey.

The AB is great.... it sounds like you have a couple problems going on - did the vet say when you need to come back to see if the WBC is better?

Testing as usual is important now because pancreatitis will have a tendency to raise BG somewhat, but you can't count on it to be the cause of that much of a dose increase.

Now that you have the pancreatitis dx, be on the lookout for the signs again as many cats have recurring issues. Not eating and sitting in a meatloaf position are pretty classic outward signs, and if you start to have eating issues again, you can give 1/4 tab pepcid BID and it will help to settle the stomach enough to get a cat to eat again. I used to give Shadoe her pepcid first thing in the morn, before shot and food, so that she would be settled.... mornings were worse because she had not eaten much overnight.

You can add extra water to the food as well and it will help like giving fluids... should Casey start acting 'off' again, you could talk to the vet about having fluids to give at home.... it's cheaper for you and kinder on Casey to get treated and not have to be bundled up and taken to the vet when sick.

You are right to put aside any sort of regulation until you have the pancreatitis issues cleared and a confirmation that the AB have cleared up whatever was giving Casey the lousy WBC. Acting better right after coming home is a good sign, but it's a common one after getting fluids and then some bupe to knock out the pain. It'll take a few days, so wait until all the AB have been taken and then see where Casey is.
 
Thanks, Blue! And thanks everybody, for the support! I'm taking Casey back later next week for a follow-up.

Casey is still doing pretty well, she's eating really well (cleaned her plate last night!). Blue, what food should I be giving her for the pancreatitis? Of course the vet says DM is the best, but I'm skeptical about that. Right now she eats the 9 Lives patés (like Super Supper, Tuna in Sauce, Turkey and Giblets, etc.)
 
Casey update! :-)

Everything is going very well. She's eating like a race horse, gaining some weight back, and doesn't seem to be in any pain or anything.

What's really freaky is that Casey's BG numbers have gone down dramatically in the past two days - yesterday her AM was 157, and today it was 111! What's up with that? She's eating fine, doesn't seem to be having any trouble, so now I'm wondering why her numbers are going down? Anyone have any ideas? Is this another problem, or is it a Super Bowl Day miracle??? I updated her spread sheet if anyone would like to take a look. Thanks!
 
Wendy&Tiggy said:
Maybe because the pancreatitis is improving? Keep a close eye on her nadir - her insulin dose might need to be brought down.

Do you want to start posting on Lantus TR now? http://felinediabetes.com/FDMB/viewforum.php?f=9

That could be it I suppose, but I didn't think the pancreatitis improving would cause her numbers to be lower than they've been since I started taking her BG last year. Is that usual? I just figured they'd go back to the levels they were before she got it.

I'll start with the Lantus stuff after I take her to the vet for the followup. Thanks!
 
maybe she had a wonky pancreas for a while? Can you do a + 5 , +6 or +7 today? Would like to see how low she is dropping...
 
Wendy&Tiggy said:
maybe she had a wonky pancreas for a while? Can you do a + 5 , +6 or +7 today? Would like to see how low she is dropping...

I couldn't do any of those today because I was at work, but her +9 was 198. And boy, was she hungry when I got home! I put down her snack and she ate it like she hadn't seen food in a week!

I'd like to know what her nadir is right now too, and also what her AM is tomorrow morning. Stay tuned, I guess!

ETA Her AM BG was 147. I gave her 4u.
 
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