Nutella - Pancreatitis

[Ralba]

About 3 days ago she started to get really reactive and growling during injection time, it made us not be able to shot for almost two days, now she seems worse, we tested yesterday night, ketone blood test it was 0.9mmol/l her BG was 400mg/dl, she was not eating at all, I went to the market and got raw chicken breast, which she ate a lot, we were able to inject since she was "weaker", BG lowered and ketones to 0.1mmol/l after 2 hours, this morning the vet came, we tested her BG 447, the vet suggested to give her liquid which she got really violent even being restrained, we decided not to give it, he said to increase her dosage to 1.5IU (from 0.75IU previously), he went to show us how to apply, when he did the tent she backed back and got violent, he was able to shot quickly but she was absolutely mad even with the U40 8mm syringe, during afternoon it seemed she was nauseous, now at night we feed her (raw chicken, she only eats this and drinks), time to shot again very agitated, I poked, but not sure if it was in, we could smell the prozinc on her fur, checked her numbers and are going up to almost 500mg/dl after 1 hour injection, I'll test in 30 minutes again, if BG is up should I re-shot? and how to handle her being so agitated even if we make a tend she is already turning and moving


still going up +2hrs 505mg/dl

 

[Suzanne & Darcy]

This is a very difficult situation. We never advise reshooting with a possible fur shot because you have no idea if any insulin got into her or not and you risk her going hypo. I am not understanding the ketones. Does she have ketones? Did you test via urine? Or do you have a blood meter. It was .9 on a blood meter? I had a blood meter that gave me a value in numerals. A lot of people use ketostix. The ketone test strips that I have seen have colors on them and say "trace" "small" "moderate" "large" like in the photo below. Which value is Nutella?

 

[Suzanne & Darcy]

I am surprised that the vet did not suggest either hospitalizing her or giving you something to sedate her so that you can give insulin and test. This could be dangerous for her to not get the insulin. Do they not use Gabapentin? That is what a lot of people will use to sedate their cats and make them less stressed and more cooperative when they have to take them to the vet and some people with feral cats on this Board have been using it so that they can shoot the insulin.

 

[Suzanne & Darcy]

I would keep testing her ketones as I was able (tonight). Keep her eating and drinking if you can (I see she already ate tonight? right?)

And I saw someone on another thread suggest putting a cat in an open box with a blanket in it to calm them. They did this to be able to give fluids under the cat's skin and suggested it to a person with a difficult feral cat -- to be able to give insulin. I do not know if you can pick her up and put her in an open box with high sides.

 

[Suzanne & Darcy]

Here is an excerpt about fur shots from the information on this forum about ProZinc dosing methods:

"For all dosing methods, the following points are extremely important:

• In the case of a fur shot (when you try to inject, but the cat moves, or you were tricked by thick fur, and the insulin ends up on the cat instead of in the cat): Never reshoot when this happens. There’s no way to know how much got into the cat so it’s too risky to do a second shot.
• Never give an extra shot because of high numbers. It is so hard to see our fur babies in high numbers. However, giving extra shots results in overlapping nadirs and are just too dangerous. Follow the protocol for increasing the dose, keep your kitty away from carbs, and be patient.

 

[Ralba]

This is a very difficult situation. We never advise reshooting with a possible fur shot because you have no idea if any insulin got into her or not and you risk her going hypo. I am not understanding the ketones. Does she have ketones? Did you test via urine? Or do you have a blood meter. It was .9 on a blood meter? I had a blood meter that gave me a value in numerals. A lot of people use ketostix. The ketone test strips that I have seen have colors on them and say "trace" "small" "moderate" "large" like in the photo below. Which value is Nutella?

We blood tested with a Wellion device, she had a 0.6mmol/L at PMPS which is at the attention area, the range goes up to 1.5mmol/L where the ketoacid starts, and internation is urgent, we didn't test her pee since we only got the blood device.

The vet indeed was bad, he was the one to diagnose but I guess he is no expert in diabetes or experienced, I'll bring her tomorrow to a vet nearby and monitor her numbers through the night, he didn't gave any meds or useful advice aside to put her on liquids which if was a possibility could be avoided giving proper insulin shots....

We did try a second shot a few minutes ago, which was with even two persons impossible, she became basically feral and tried to twist her body in all ways possible, I sincerely don't know how much should we push if we she is so uncooperative and the vets won't help us, at the end she will be resented with us and unhappy

 

[Suzanne & Darcy]

We blood tested with a Wellion device, she had a 0.6mmol/L at PMPS which is at the attention area, the range goes up to 1.5mmol/L where the ketoacid starts, and internation is urgent, we didn't test her pee since we only got the blood device.

The vet indeed was bad, he was the one to diagnose but I guess he is no expert in diabetes or experienced, I'll bring her tomorrow to a vet nearby and monitor her numbers through the night, he didn't gave any meds or useful advice aside to put her on liquids which if was a possibility could be avoided giving proper insulin shots....

We did try a second shot a few minutes ago, which was with even two persons impossible, she became basically feral and tried to twist her body in all ways possible, I sincerely don't know how much should we push if we she is so uncooperative and the vets won't help us, at the end she will be resented with us and unhappy

Yes. It does sound really awful. And she is being put under so much stress. I wish I had something helpful to add. .6 ketones are not that bad... don't freak out... if you look at my spreadsheet you will see that my cat (blood meter) had high ketones a lot over 3.0 a lot and over 4.0 sometimes. When his glucose numbers went down, the ketones went down. He did have DKA at one point (hospitalize for a week,) but even though he had high ketones he did not go into keto acidosis again because it was an infection that caused him to go into DKA. High numbers alone and high ketones won't necessarily be enough to cause a DKA. Having said that, it is a big concern and you will monitor it, I am sure. I'm not even sure how you are getting those blood tests for ketones if she's so difficult. I'm really feeling sad for you about this.

 

[Ralba]

Yes. It does sound really awful. And she is being put under so much stress. I wish I had something helpful to add. .6 ketones are not that bad... don't freak out... if you look at my spreadsheet you will see that my cat (blood meter) had high ketones a lot over 3.0 a lot and over 4.0 sometimes. When his glucose numbers went down, the ketones went down. He did have DKA at one point (hospitalize for a week,) but even though he had high ketones he did not go into keto acidosis again because it was an infection that caused him to go into DKA. High numbers alone and high ketones won't necessarily be enough to cause a DKA. Having said that, it is a big concern and you will monitor it, I am sure. I'm not even sure how you are getting those blood tests for ketones if she's so difficult. I'm really feeling sad for you about this.

thanks for the message!

We will be monitoring and making sure she drinks lots of water, she only allow us to get the ear blood since she like back ear scratches and chin ones, but the rest of her body was usually a no-no, don’t touch paws, don’t touch back or belly, I’ll keep you posted, here is almost midnight

 

[Suzanne & Darcy]

 

[Ralba]

Morning update, another complicated morning, she was hungry and I gave her some chicken, we waited and took her to another vet, he checked her and saw that she was in pain specially near her back, giving Meloxicam and saying to use only if we see her weak, or irritated, her BG was 433 one hour after insulin, he applied insulin without much problem in the scurf, now BG is at 348, but she lethargic, didn’t eat much and vomited probably due to the Meloxicam.

Our main concern is this lethargy and she drank a ton of water, there is also the worry about the BG control, it seems it’s not going low enough, and anything above 400 is building up Ketones, not sure if I need to change to tight control

 

[Suzanne & Darcy]

Morning update, another complicated morning, she was hungry and I gave her some chicken, we waited and took her to another vet, he checked her and saw that she was in pain specially near her back, giving Meloxicam and saying to use only if we see her weak, or irritated, her BG was 433 one hour after insulin, he applied insulin without much problem in the scurf, now BG is at 348, but she lethargic, didn’t eat much and vomited probably due to the Meloxicam.

Our main concern is this lethargy and she drank a ton of water, there is also the worry about the BG control, it seems it’s not going low enough, and anything above 400 is building up Ketones, not sure if I need to change to tight control

I would definitely consider changing to Tight Regulation or as we call it with ProZinc, the Modified ProZinc Method. Have you read about it? I'll attach the dosing methods sticky here. You probably already read it.
https://felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/

 

[Ralba]

I would definitely consider changing to Tight Regulation or as we call it with ProZinc, the Modified ProZinc Method. Have you read about it? I'll attach the dosing methods sticky here. You probably already read it.
https://felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/

thanks Sussane&Darcy! I’ll be checking these resources, I’ve seen it during my initial forum reads but it was a while ago! Fingers crossed Nutella get better.

 

[Ralba]

quick comment, her belly is a bit bloated from all the water, anything I can do? I guess she drank way more water and her body is still processing.

now sleeping, BG tested +7 and its at 391mg/dl pretty high for 1.5IU compared to the past, I should keep this dosage and monitor right at least a week

 

[Ralba]

PMPS updated, higher than we would like, she blacked out the latest hours, I tested her BG and all good, I guess she is just tired from all the recent events, got the shot in the scurf, no ideal due to absorption etc etc but better than miss, I'll test +3 and keep you all posted, lately day shot didn't brought her to blue levels, hopefully this night shot get blue but not too blue

edit, did a +2 test, BG is currently at 362mg/dl, hopefully we get it below 200s, she is eating a more complete food (Royal Canin Recovery ultra fine pate), still lots of water and pee

last update of the night, +4 @ 310mg/dl, I suspect she is with high pressure, there is too much blood coming out when picking her ear, ate well the new food, drinking and peeing quite a bit

 

[Ralba]

I would definitely consider changing to Tight Regulation or as we call it with ProZinc, the Modified ProZinc Method. Have you read about it? I'll attach the dosing methods sticky here. You probably already read it.
https://felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/

Hi!

Quick question, her BG for now is not getting higher, I tested +9 and it’s coming straight “low”, currently at 307mg/dl, I read about pancreatitis flaring up for some even and making BG a mess along with other symptoms, any recommendations if it keeps going lower for PS? She is currently at 1.5IU for 4 cycles, with bad response (always going up to 400s range)

 

[Suzanne & Darcy]

I think you did the correct thing to increase her dose this morning. It should be safe because her preshot was very high, and also her nadirs are quite high so doing a full .5 increase is warranted. She was flat in the pinks last night. I see what you mean.

 

[Ralba]

I think you did the correct thing to increase her dose this morning. It should be safe because her preshot was very high, and also her nadirs are quite high so doing a full .5 increase is warranted. She was flat in the pinks last night. I see what you mean.

Another day another adventure, after going to two vets we went to an emergency clinic, recommended by some people here in the city and I can say that we found finally someone that is helping us properly

the bad part, blood test was a blood and pee bath, she was extremely nervous they tried 3 locations, she hates needles, she stressed A LOT so much that she peed, front leg, impossible absolute nono, rear legs, one didn't bleed, the other one she didn't even felt and we got the three vials for the testing
the good part, results shows that something seems wrong in her liver, the rest looks perfect, her blood pressure seems normal 150/something even with big eyes.

doctor thinks she have an inflammation or infection due to liver figures Monday we do an ultrasound in her belly, and maybe gastritis, she gave also an injection for nausea which worked wonders, after 2 hours she ate for the first time in the last three days the regular pate!

she will be taking vet gastril once a day before eating to protect her stomach from excess acid
and an ear paste to increase appetite when needed

glad to say she is doing fine, aside from the trauma

BG during blood sample with +6 hours was about 110ml/dl

I'll upload the test results in case someone want to check

 

[Suzanne & Darcy]

I’m very happy that you got some real help! I’m surprised they did just get blood from the jugular vein in her neck. It’s very fast. But I am glad she feels better after the nausea medication. I’m thinking it was a Cerenia injection. That will wear off in 24 hours. They should have given you either Cerenia (Maropitant) to take home or Ondansetron (Zofran). I would have gone for Cerenia as it’s anti inflammatory as well as anti nausea and could help.

 

[Ralba]

I’m very happy that you got some real help! I’m surprised they did just get blood from the jugular vein in her neck. It’s very fast. But I am glad she feels better after the nausea medication. I’m thinking it was a Cerenia injection. That will wear off in 24 hours. They should have given you either Cerenia (Maropitant) to take home or Ondansetron (Zofran). I would have gone for Cerenia as it’s anti inflammatory as well as anti nausea and could help.

during next appointment on Monday I'll ask about these names, I think they want to understand what is going on in the liver before start reducing any inflamation, they gave me Mirataz to increase her appetite, but it's pretty tricky, lots of precautions to use.

PMPS: 474ml/dl kept 2IU will monitor +3 but she ate well solid food, I offered the ultra fine pate and she wanted the "old" food that has bigger chonks, everyone will sleep well tonight.

as always, Nutella and me are really thankful for the tips and information!

 

[Suzanne & Darcy]

Very good! Cerenia is a medication that is to reduce nausea and vomiting. It does also have some helpful anti-inflammatory effects but its main use is for nausea and vomiting. Some people use one tablet daily for their cats if they have a condition that causes nausea and inappetence. It is helpful in pancreatitis and kidney disease and other things as well. Cerenia is not a strong, full body anti-inflammatory like a steroid (like Prednisolone). It is a medication that helps cats to feel like they want to eat. It is probably what they injected her with today.

 

[Suzanne & Darcy]

Regarding Mirataz, be careful how much you use. The instructions on the box tell you to put a strip of 1 1/2 inches on the cats ear. That is usually too much and can make that cat kind of crazy. I have found that using about half the amount of the strip that is shown on the box is better. I have had cats who only needed about half of the amount on the box every second day and not every day. You will know if it is too much for her because she will become very vocal and she may become very restless or even aggressive with other cats in the household if the amount of Mirataz is too much for her. Normally it is recommended to get rid of the nausea before giving an appetite stimulant because if the cat is nauseated and also wants to eat because of an appetite stimulant, it can cause food aversion where they hate certain foods. It’s like you feel like you want to vomit but also have the appetite stimulant making you hungry. Anyway, I am happy to hear that she wanted to eat for now! That is wonderful news. I hope she will continue to eat. I’m also hoping for answers and for good things for Monday’s ultrasound.

 

[Ralba]

Very good! Cerenia is a medication that is to reduce nausea and vomiting. It does also have some helpful anti-inflammatory effects but its main use is for nausea and vomiting. Some people use one tablet daily for their cats if they have a condition that causes nausea and inappetence. It is helpful in pancreatitis and kidney disease and other things as well. Cerenia is not a strong, full body anti-inflammatory like a steroid (like Prednisolone). It is a medication that helps cats to feel like they want to eat. It is probably what they injected her with today.

I'll ask about this, lately the is not vomiting anymore or seems nauseous but its good to have something so we can avoid she get in the stage she was.

Regarding Mirataz, be careful how much you use. The instructions on the box tell you to put a strip of 1 1/2 inches on the cats ear. That is usually too much and can make that cat kind of crazy. I have found that using about half the amount of the strip that is shown on the box is better. I have had cats who only needed about half of the amount on the box every second day and not every day. You will know if it is too much for her because she will become very vocal and she may become very restless or even aggressive with other cats in the household if the amount of Mirataz is too much for her. Normally it is recommended to get rid of the nausea before giving an appetite stimulant because if the cat is nauseated and also wants to eat because of an appetite stimulant, it can cause food aversion where they hate certain foods. It’s like you feel like you want to vomit but also have the appetite stimulant making you hungry. Anyway, I am happy to hear that she wanted to eat for now! That is wonderful news. I hope she will continue to eat. I’m also hoping for answers and for good things for Monday’s ultrasound.

many thanks for the tips we were a bit concerned of using it, as of now we are not going to give since the she is eating like a lion, amazing, the effect of Saturday injection should already weared off, we'll keep it again just in case but your point about eating while nauseous makes total sense

today belly inspection and hopefully proper treatment to whatever is happening

another strange thing is her numbers, yesterday and today morning her BG was pretty low, in the 200s, we gave 0.75u instead of 2u, and it just maintained around 200s range, it went up a little, came down a little and then went up a lot during evening to 400s range, then we gave the full shot

 

[Ralba]

Update, most likely diagnosis is pancreatitis, they did a blood test to check for it with the refrigerated blood from Saturday and got confirmation that there is inflammation, got a cerenia pill in case the get nauseous and we’ll continue giving the stomach medication which is working, no vomits in the morning when we wake up, her apetite decreased a little but the other was too hungry, since we compared to the other cat

the only worry is the night BG numbers that are quite high, yesterday AMPS was close to 200 and PMPS 420, it’s a big difference

 

[Suzanne & Darcy]

Update, most likely diagnosis is pancreatitis, they did a blood test to check for it with the refrigerated blood from Saturday and got confirmation that there is inflammation, got a cerenia pill in case the get nauseous and we’ll continue giving the stomach medication which is working, no vomits in the morning when we wake up, her apetite decreased a little but the other was too hungry, since we compared to the other cat

the only worry is the night BG numbers that are quite high, yesterday AMPS was close to 200 and PMPS 420, it’s a big difference

Well, you already know that inflammation will elevate BG. She may need (1) something for pain control (2) Cerenia, because it can really help with the inflammation (3) fluids - or try to just add water to her food to make it more moist since she's too difficult to give fluids to.

I'm happy it's not something with her liver then! All her liver enzymes in her bloodwork are good?

She's very cute, I'm happy to see her photograph. I hope she keeps eating.

@FrostD what do you think about the higher nighttime numbers? As more night tests are filled in, I'm wondering if she's not just bouncing a little from the daytime numbers that she's not used to. Look at today's (March 14 a.m.) cycle. She went blue and then red fairly quickly. Also, the pancreatitis is not helping matters. And she went lime green on .75 units yesterday. Her dose is kind of all over the place.

 

[Ralba]

Well, you already know that inflammation will elevate BG. She may need (1) something for pain control (2) Cerenia, because it can really help with the inflammation (3) fluids - or try to just add water to her food to make it more moist since she's too difficult to give fluids to.

I'm happy it's not something with her liver then! All her liver enzymes in her bloodwork are good?

She's very cute, I'm happy to see her photograph. I hope she keeps eating.

@FrostD what do you think about the higher nighttime numbers? As more night tests are filled in, I'm wondering if she's not just bouncing a little from the daytime numbers that she's not used to. Look at today's (March 14 a.m.) cycle. She went blue and then red fairly quickly. Also, the pancreatitis is not helping matters. And she went lime green on .75 units yesterday. Her dose is kind of all over the place.

I’ll do that, add extra water and change the food source as I think she might have some allergy related to something, she is currently eating chicken wet food but I think about changing to lamb, I did try and she liked.

About numbers we are really confused, I’m thinking on stalling AM shot and try extend night nadir, you can see that morning we give her .75 and evening a full shot, so don’t jump too high, about cerenia we got 2 pills only, we were instructed to give 1/4 a day if she don’t eat, so I want to avoid using it unless necessary, yesterday she vomited, no food just saliva, but she ate a few hours before so it got processed, her hunger reduced a bit, she is eating more normally

we will continue monitoring her and updating you here

She is a cutie indeed! Funny fur decisions lately but nonetheless , poor girl her belly is trimmed to the skin now

 

[Suzanne & Darcy]

The vomiting of just saliva (empty stomach) usually means she has an acid tummy. Giving 1/4 of a Famotidine tablet (1/4 of a 10 mg tablet so 2.5 mg) in the morning can really help. Or did your vet say to use Omeprazole? Either is okay, but I have always used Pepcid (Famotidine) and found it to be safe and effective. Hopefully, this would only be something she needs occasionally.

 

[Suzanne & Darcy]

Last night you got a blue number!!!

 

[Ralba]

The vomiting of just saliva (empty stomach) usually means she has an acid tummy. Giving 1/4 of a Famotidine tablet (1/4 of a 10 mg tablet so 2.5 mg) in the morning can really help. Or did your vet say to use Omeprazole? Either is okay, but I have always used Pepcid (Famotidine) and found it to be safe and effective. Hopefully, this would only be something she needs occasionally.

we are currently giving:

vetGASTRIL is based on a sucrose sulphate complex with non-absorbable aluminum hydroxide gel to protect the gastric mucosa

she don't like it much, the vet said to give it for 5 days, 30 minutes before eating so her belly gets protected.

Last night you got a blue number!!!

it was after she waked me up vomiting in the middle of the night, I got worried if she was too low and tested.

we got some other blues, but she is getting more difficult to shot again, I'm not sure if it's the food that is making her get worse, I'll switch to another protein source

she is still hungry and no nausea, but maybe pain is returning, I got 8 days worth of cerenia (2 caps), not sure if I should start giving her if she still eats

about the liver her ALT (Alanine aminotransferase) numbers are high, they did some extra testing and vet said it was an inflammation most likely causing it, there were a few other comments:

her gallbladder thickness is about 1.7mm while the normal is 1.0mm

the is something she suspected to be a cist in her pancreas, it was not possible to identify via ultrasound, it looked like a black round shape

 

[Ralba]

Update, morning shot was ok, again big numbers, but going down during day, we gave her the cerenia yesterday night, her apetite is not 100%, I changed her food, from Chicken to Lamb and she is eating more, got a few gastro foods to check her interest but so far not much, she like the current brand but different protein source, I got also Turkey to test as well and a paste to improve her gastrointestinal function, no vomit today, a bit more pee than ideal but hopefully she will be under control

 

[FrostD]

I suspect the wonky numbers/big swings right now are related to the pancreatitis. I do think there may be an element of lack of duration, and yes sometimes a bounce depending on the cycle. Hope she feels better soon! I hate pancreatitis

 

[Suzanne & Darcy]

That gallbladder thickness is concerning. Not sure about the pancreatic spot. I have had vets see a lot of “odd” things on ultrasound that they weren’t sure about. Some I have had biopsied and they turned out to be nothing. This was the case with my Darcy’s liver - spots that were seen on ultrasound and aspirated with a needle and sent to a pathologist and they were nothing important at all. Also sometimes we didn’t do anything and did a subsequent ultrasound later on and the “spot” was gone. Ultrasound is great but it is sometimes not very revealing.

 

[Ralba]

I suspect the wonky numbers/big swings right now are related to the pancreatitis. I do think there may be an element of lack of duration, and yes sometimes a bounce depending on the cycle. Hope she feels better soon! I hate pancreatitis

yeah, her PS numbers are quite high, but a high dose wont resolve as she is getting a low nadir, I suspect 80s with 1.75IU, I'd like her to put some weight too as she is still too thin and not eating as much as I would like, we will try Mirataz to see if she drinks/eats more as she is drinking less too

That gallbladder thickness is concerning. Not sure about the pancreatic spot. I have had vets see a lot of “odd” things on ultrasound that they weren’t sure about. Some I have had biopsied and they turned out to be nothing. This was the case with my Darcy’s liver - spots that were seen on ultrasound and aspirated with a needle and sent to a pathologist and they were nothing important at all. Also sometimes we didn’t do anything and did a subsequent ultrasound later on and the “spot” was gone. Ultrasound is great but it is sometimes not very revealing.

as I mentioned what worries us is the ever-higher PS number, we're reaching 500 easily, and even with proper food and insulin, her nadir is good and low but once insulin wear off it goes up again, lately she is quite agitated and injecting is not as easy, we resumed cerenia after a short break

 

[Suzanne & Darcy]

yeah, her PS numbers are quite high, but a high dose wont resolve as she is getting a low nadir, I suspect 80s with 1.75IU, I'd like her to put some weight too as she is still too thin and not eating as much as I would like, we will try Mirataz to see if she drinks/eats more as she is drinking less too



as I mentioned what worries us is the ever-higher PS number, we're reaching 500 easily, and even with proper food and insulin, her nadir is good and low but once insulin wear off it goes up again, lately she is quite agitated and injecting is not as easy, we resumed cerenia after a short break

It does sound like she really needs that Cerenia. Not surprising. I have known people with cats that have chronic pancreatitis and they use Cerenia every day.

I do not know if it is even an option for you to consider, but if you were to be able to change to Lantus insulin, it would be a good thing. Lantus is a "depot" insulin and is designed to give much flatter curves without so many highs and lows. I hate to mention this as I don't know if it's a possibility for you where you are -- or with your current vets.

 

[Ralba]

I’ll ask about it, it seems high BG is here to stay if her pancreatitis don’t get under control it will be the way,

Thank you!

 

[Suzanne & Darcy]

How is Nutella doing?

 

[Ralba]

Hi! All ok, she is a bit energetic lately, and really hungry, which makes injecting the insulting harder than usual, we have to feed her and then wait for her to lie down as it's easier to make the tend and apply.

We asked about Lantus, but the vet mentioned she is taking ProZinc for too short for a switch asked to monitor for the following days and make a 2-hour curve in one or two weeks to see how her body is reacting

PS is always about 400-450mg/dl and she is not taking 1.5IU as we were giving 1.75 IU and her BG went too low.

 

[Suzanne & Darcy]

How is the adorable Nutella doing now? I am happy to see that, despite the high preshot numbers, you seem to be getting some blue and green numbers during the middle part of the cycle.

 

[Ralba]

How is the adorable Nutella doing now? I am happy to see that, despite the high preshot numbers, you seem to be getting some blue and green numbers during the middle part of the cycle.

hello! she is doing well, we did a curve for the vet, since we want to switch to latus and keep her numbers on the lower side, she seems to have put some weight I believe 100-150g (she was 2.4kg, now is around 2.5kg) and it a bit more beefier, her bones are less visible, we tried to give the mirataz but she was a bit crazy for 1.5 days, so no more

got some zoomies the other day and she is following us here and there, not only sleeping all day

 

[Suzanne & Darcy]

It's very good news that she gained weight. Yes, you may recall I warned about the Mirataz. In my cats, I only give 1/2 or even less than the "prescribed" dose (the length of the strip of ointment). And many times I only give it every second day and not every day.

Also, there is an antidote to the "seratonin syndrome" that causes the cats to get crazy if they get too much Mirataz. Cyproheptadine acts as an antidote to Mirataz and will calm them right down. Cyproheptadine is an antihistamine that is also frequently given to cats as an appetite stimulant and can work quite well in some cats without causing the seratonin syndrome. I once had a cat who went kind of nuts on Mirataz, but in her case it wasn't the meowing, it was that she started to beat up on the other cats in the household! That's when I learned about not giving her very much and never have given my cats that much again.

But it sounds like she's feeling better and is gaining some weight on her own. We can definitely help you here if your vet approves the switch over to Lantus.

 

[Ralba]

It's very good news that she gained weight. Yes, you may recall I warned about the Mirataz. In my cats, I only give 1/2 or even less than the "prescribed" dose (the length of the strip of ointment). And many times I only give it every second day and not every day.

Also, there is an antidote to the "seratonin syndrome" that causes the cats to get crazy if they get too much Mirataz. Cyproheptadine acts as an antidote to Mirataz and will calm them right down. Cyproheptadine is an antihistamine that is also frequently given to cats as an appetite stimulant and can work quite well in some cats without causing the seratonin syndrome. I once had a cat who went kind of nuts on Mirataz, but in her case it wasn't the meowing, it was that she started to beat up on the other cats in the household! That's when I learned about not giving her very much and never have given my cats that much again.

But it sounds like she's feeling better and is gaining some weight on her own. We can definitely help you here if your vet approves the switch over to Lantus.

thanks for sharing, we stopped giving an it passed, but now we had another situation, on Tuesday she started to pee in different locations, after some time she was not peeing anymore just holding position, we took her to the vet immediately and she sampled some pee, high infection cells in the microscope, it seems she has now cystitis, we were given antibiotics for 5 days, and she got injection with antibiotics and antiinflammatory, she is eating plenty but her infection don't seem better so far any experience with this situation, we did everything we can now we need to wait the antibiotic work and reduce the infection, her bg is cycling normal and the vet gave us the recipe for the lantus but asked for us to wait her situation stabilize before switching

 

[Suzanne & Darcy]

I think it’s a good idea to wait before doing the switch to Lantus. Has she responded yet to the antibiotics? Any improvement in her condition? If she hasn’t then it’s likely that the particular type of bacteria that she has are not responding to those antibiotics and that she needs a different one. They should have done a culture to see the exact organism and make sure that it’s the right antibiotic to kill it. They may still have to send the urine out to a laboratory to see what grows in a culture. Or they can try a different antibiotic, I suppose. But poor Nutella is suffering discomfort in the meantime.

 

[Ralba]

I think it’s a good idea to wait before doing the switch to Lantus. Has she responded yet to the antibiotics? Any improvement in her condition? If she hasn’t then it’s likely that the particular type of bacteria that she has are not responding to those antibiotics and that she needs a different one. They should have done a culture to see the exact organism and make sure that it’s the right antibiotic to kill it. They may still have to send the urine out to a laboratory to see what grows in a culture. Or they can try a different antibiotic, I suppose. But poor Nutella is suffering discomfort in the meantime.

Hi! So she is responding well to the antibiotics, her belly is being affected a bit, we are giving some probiotic to help with the flora, and she is having frequent visits to the restroom, she is eating well and lately we are having to reduce her dosage quite fastly, since she is getting green numbers often, we were 1.75iu a week ago but since her bg is reaching 50-60 during nadir we are lowering 0.25 every time it hits the limit, today we are going to give her 1.00iu since 1.25iu was enough to get her to 60mg/dl, she is energetic, going crazy over paperboard boxes and running here and here, so I would say antibiotics are working

 

[Ralba]

another update, vet visit, we stopped antibiotics and she is getting worse again (the Cistitis), they did an abdominal pee sample to check for bacteria and we are waiting for the results, still giving her prozinc, any recommendations for the switch to lantus?

 

[Chrispooky12]

Hi I'm sorry Nutella isn't feeling well. My boy started showing signs of cystitis & some of the good people on here suggested starting him on cosequin & getting a Feliway plug in or collar. I got some cosequin & a Feliway plug in & he has been peeing normally now & was almost immediately after starting the cosequin. I decided not to get a new refill on the Feliway diffuser due to lack of money but he's still gets one cosequin every morning & he's still doing great.

 

[Ralba]

Hi I'm sorry Nutella isn't feeling well. My boy started showing signs of cystitis & some of the good people on here suggested starting him on cosequin & getting a Feliway plug in or collar. I got some cosequin & a Feliway plug in & he has been peeing normally now & was almost immediately after starting the cosequin. I decided not to get a new refill on the Feliway diffuser due to lack of money but he's still gets one cosequin every morning & he's still doing great.

Hi Chrispooky,

well it happens, lets see if we get some direction from the bacteria culture in a few days, this would help us to get a proper antibiotic, we have already the feliway for some time, so nothing to add but I'll check for the cosequin, never heard of it, I guess I should probably hold the insulin change for now, but she is spending quite some hours at +400 BG and this is probably giving these bacteria food and worsening the situation, I already got the lantus, but we didn't find the U-100 in store, so we ordered online, I'll keep you guys/gals posted

 

[Suzanne & Darcy]

I guess the antibiotics were stopped too soon?

 

[Ralba]

I guess the antibiotics were stopped too soon?

Maybe? The vet said she was taking a good wide spectrum antibiotic, 5 days 2x a day, she wanted to get the sample and see what kind of bacteria is still there because she don’t want to keep without knowing what’s in there as the antibiotic kill everything basically, we are waiting for the lab result

 

[Suzanne & Darcy]

Maybe? The vet said she was taking a good wide spectrum antibiotic, 5 days 2x a day, she wanted to get the sample and see what kind of bacteria is still there because she don’t want to keep without knowing what’s in there as the antibiotic kill everything basically, we are waiting for the lab result

I definitely agree with the culture. I mentioned that before when they first took her urine and then prescribed the antibiotic without culturing it. I don't blame them really... I have done it before and saved money with success... but it doesn't always work. And now I'm concerned about the antibiotic interfering with the culture? How many days had she been off of the antibiotic before they took more urine to be cultured? Hopefully, it was at least a few. There are some organisms that need a longer course of antibiotics than 5 days to be eradicated. I just hope she's going to be feeling better soon.

 

[RGarcia]

Hello! I'm Nutella's mom and Ralba's wife. She was off for two days when we took her to the vet. They found E coli in the culture and prescribed 10 more days of the same antibiotic. She is doing okay, no more peeing everywhere and looking in discomfort. We haven't changed the insulin yet, as the vet told us we need to get the infection under control before doing it.

She is eating very well and has a lot of energy. Yesterday she was playing with toys and running after the other cat like she used to do in the past. I guess that's good?

 

[Suzanne & Darcy]

Hello! I'm Nutella's mom and Ralba's wife. She was off for two days when we took her to the vet. They found E coli in the culture and prescribed 10 more days of the same antibiotic. She is doing okay, no more peeing everywhere and looking in discomfort. We haven't changed the insulin yet, as the vet told us we need to get the infection under control before doing it.

She is eating very well and has a lot of energy. Yesterday she was playing with toys and running after the other cat like she used to do in the past. I guess that's good?

Oh, that's very good to hear. I'm happy that she is feeling better. Playing with the other cat is very good indeed! Thank you for the update!