Questions about newly diagnosed cat not eating and FreeLibre sensor problems

[user45992]

Hello,

I know we are supposed to keep questions in our new member post but a couple things have come up since I posted mine that I hope the more experienced people can answer and I didn't see a way to edit my subject line that might get more attention for answers.

My cat isn't eating today and his glucose is just showing as Hi on the FreeLibre3. My questions are:

1) Have any of you tried something like Verbac Rebound to help with appetite? My cat also has symptoms of pancreatitis along with the diabetes diagnosis and if he does have it, I think it'm impacting his appetite. I will also follow up with my vet but I was curious about other people's experinces or recommendations for supplements to help with eating.

2) I have gotten multiple notices that there is a sensor error between last night and tonight on the FreeLibre. Is that common and if so, do you know what causes it? One thing I found said it can happen with bouning levels which was more the case yesterday but since around 1:00 am, it's just been Hi so no changing glucose levels.

Thank you!

 

[Sienne and Gabby (GA)]

I've been around here for quite some time and I don't recall anyone mentioning Virbac Rebound. Generally, mirtazapine (Mirtaz), which is a prescription, is recommended as an appetite stimulant. If Gatsby has pancreatitis, it's likely he feels lousy and is in pain. Pancreatitis can be incredibly painful. It's likely impacting his appetite. This is a complication of pancreatitis and can lead to hepatic lipidosis (fatty liver). Your cat needs to eat -- I realize that sounds obvious but hepatic lipidosis can be a serious medical problem. Crumbling a protein treat (e.g., freeze dried chicken) on your cat's food may entice him to eat. This is a post on stimulating your cat's appetite.

I'm curious why you are not giving insulin twice a day. Cats have a faster metabolism than humans and while Lantus can be dosed once a day in humans, cats require dosing every 12 hours. Also, you don't want to be changing Lantus dosing too quickly. It takes about 5 - 7 days from the initial dose for Lantus to build up in your cat's system. From that point, depending on the dosing method you choose, the dose changes every 3 days or weekly. You may want to review the sticky notes on the Lantus board. They explain how Lantus works and there is a post on dosing methods.

 

[user45992]

I've been around here for quite some time and I don't recall anyone mentioning Virbac Rebound. Generally, mirtazapine (Mirtaz), which is a prescription, is recommended as an appetite stimulant. If Gatsby has pancreatitis, it's likely he feels lousy and is in pain. Pancreatitis can be incredibly painful. It's likely impacting his appetite. This is a complication of pancreatitis and can lead to hepatic lipidosis (fatty liver). Your cat needs to eat -- I realize that sounds obvious but hepatic lipidosis can be a serious medical problem. Crumbling a protein treat (e.g., freeze dried chicken) on your cat's food may entice him to eat. This is a post on stimulating your cat's appetite.

I'm curious why you are not giving insulin twice a day. Cats have a faster metabolism than humans and while Lantus can be dosed once a day in humans, cats require dosing every 12 hours. Also, you don't want to be changing Lantus dosing too quickly. It takes about 5 - 7 days from the initial dose for Lantus to build up in your cat's system. From that point, depending on the dosing method you choose, the dose changes every 3 days or weekly. You may want to review the sticky notes on the Lantus board. They explain how Lantus works and there is a post on dosing methods.

Thank you for the fast response! I have tried freeze dried chicken treats on his canned food and hasn't helped. Baby food hasn't worked either. He took a few licks this morning- enough for the hostipital vet to day I could give him a half dose of insulin- but wouldn't have more then that. I also just got a new food to try today. I hadn't thought of heating it up so I will try that with the foods I have for his evening meal. I kind of got him to eat a quarter of a churu earlier this morning but he was not happy about it and wouldn't finish it so that probably isn't a long term solution either.

He has both cerenia and mirataz and they haven't done much to get him to eat enough. My vet did call in a prescription for ondansetron on Thursday but that hasn't been filled by the pharmacy yet.

The insulin dosage is based on what the vet at the animail hospital observed while he was there and is based on how much he eats in the morning. WIth how stressed I was and how much information I was given, I don't remember what made her go with one a day and I don't see it in the documents they gave me when he was discharged. I am going to follow up with my primary vet first thing when they open tomorrow to talk about adding a second dose because one doesn't seem to be doing what it should. However, he was so, so stressed while he was hospitalized he wasn't really eating there either and was often sedated so I don't think they were able to get the full picture of his behavior. It was so bad for him, they sent him home slightly before they usually would because they though the stress and fear was counterproductive.

 

[Sienne and Gabby (GA)]

It sounds like the vet is truly sensitive to your cat's behavior! That's great. I'm really surprised that your pharmacy doesn't have ondansetron (Zofran). It's a human medication and widely used. It can be given with the Cerenia -- they are different pharmacologically and can work in tandem.

Did your vet rule out pancreatitis? It's not uncommon with diabetes. IDEXX has a Snap or Spec fPL test for feline pancreatitis. The Snap version can be done in the vet's office and looks like a pregnancy test. You get a "+" or "-" result whereas with the Spec version, it needs to be sent to IDEXX and you get a numerical result.

 

[user45992]

It sounds like the vet is truly sensitive to your cat's behavior! That's great. I'm really surprised that your pharmacy doesn't have ondansetron (Zofran). It's a human medication and widely used. It can be given with the Cerenia -- they are different pharmacologically and can work in tandem.

Did your vet rule out pancreatitis? It's not uncommon with diabetes. IDEXX has a Snap or Spec fPL test for feline pancreatitis. The Snap version can be done in the vet's office and looks like a pregnancy test. You get a "+" or "-" result whereas with the Spec version, it needs to be sent to IDEXX and you get a numerical result.

I was definitely not expecting it to take days. If I had known, it would have been worth the longer drive to the vet the day she prescribed it even with Chicago traffic! But the vet is closed today so now I'm hoping for the best with Walgreens.

Looking through the invoices from his primary vet and the animal hospital, I don't think they ran that test but I will be sure to confirm with the vet when I call tomorrow and tell them I want him tested for pancreatitis if he hasn't been. Outside of the glucose levels, his symptoms align more with pancreatitis than diabetes. Thank you again for your help and suggestions!