Refusing medicine

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Missy's Mum

Missy's Mum

Member Since 2013
I recently posted looking for new home. Meanwhile went to low cost mobile vet unit. Liver high so they wanted to give fluids. Gave her 1 acepromozine to calm her down 1hr before (usually very aggressive at vet). They gave prescription for denamerin 1hr before feed for 1month. 1ml clavamox for 7 days and need to give pedialite. Was told no insulin for 2 days then glucose test.
She is still woozy and pupils white showing under the influence. Wanted to give her denamerin now she spat it out. Crushed it, didn't fit properly into dropper but after I put some in her mouth with pedialite, she frothed but continued walking around. Didn't seem hypoglycemic. Is that throwing up? Did I try to give it too soon.
Was told the effect of tranquilizer wears off 2-3 hrs later. 2.45pm she got tranquilizer.
Not sure what to do next.
 
He said 2 days no insulin bc of medicine than come in for glucose test and see what next. Spoke of possible hospitalization to monitor glucose for 1week. I asked if I could do that. He is not receptive to on-line support. Wants all numbers called in to him. Doesn't mind if I try glucose test myself, but was very rude. His attitude is just do as you are told and stop asking questions. I have not yet done ear prick glucose test. He said any time of day is fine and not related to food. That didn't match what I am reading here. If no insulin is given bc of meds, does it really make no difference when in day the glucose is tested?
I am worried and need help. No one adopting her yet. Can't leave her like this. Got to do something. Freeking out.
When do I give her medicine? How? Not eating now is messing up 12 hr schedule. How long does woozy from tranquilizer last for ?
 
I am sorry, but I am not sure I understand what you are asking.

Are you currently testing your cat's glucose levels (BG)?
Do you have a meter so that you can test?

If you are testing, there is no need to bring the cat to the vet and leave her there for a week to get tested and "regulated". That won't ever happen. It takes more than a week for a cat to get regulated and the only way to do it successfully is if the cat is in her home environment. Being in a cage in the vet's office is stressful and not ideal situation.

I don't understand why if her BG levels are above the normal range, you would not continue to give insulin, why is the vet telling you not to give insulin?

When you gave her the denamarin, did you cover the pill with anything - like a piece of pill pocket, deli meat or cheese? Or did you just give it to her as is? It is possible that it is a very bad tasting drug and caused her frothing at the mouth. Some drugs do that and it's best to wrap the drug when possible.

It sounds like you are giving a pill and not liquid correct? Do you have any deli meat, cheese, chicken, even tuna? I would try covering the pill in something like that and then when you pill her - aim to get it into the back of throat, follow with a couple syringes of water to make sure it goes down and not get spit out. You can also massage the neck to make sure she swallows.

If you are willing, we can help you learn to manage her diabetes in a cost effective, affordable manner. Are you willing to give it a try?
 
The administrator of the vet mobile just advised me on how to force the pill down her. She is not allowed it with food. It has to be 1hr before food. Going to try that now. Want to go in person to target to pick up a glucometer rather than wait for shipping to arrive. But that won't be today. The vet said no insulin for 2 days because of the denamerin which is to lower the liver value which I guess doesn't work with insulin. Maybe it couteracts. He was so unclear. Got impatient and said something about liver and sugar production.
 
Well when the vet said no food with the pill, I don't think that if you use some to cover the pill it will hurt anything.

Let's see if someone here may understand about liver and diabetes. I don't know enough about the subject. In the meantime, if you have the phone number for the vet, I'd call and ask the vet to give you an explanation so that you understand what he/she means. After all, you are paying for their service, you need to understand and a good vet will take the time to explain it.

If you have a walmart nearby, you can go there and pick up the glucometer, strips and lancets. They sell the Relion brand (people have gotten confirm) I think they make several different ones. I've seen that several on this board use the CONFIRM. The relion meters are the least expensive meters and strips available.
 
Thanks for responding. I managed to force pill down while she was towel wrapped. Wish I had time to wait for walmart shipping.I doubt overnight cheeper. Its an hour away from me. I can only use train, no car.Target also has cheep one. Easier and faster to get that one. Saw it on review list from2013. Not sure which lancet or lancingdevice to get from target. Don't understand guage differences. What's easier higher or lower number lancet? So overwhelmed by list of choices. Does anyone have info specific to target? Or duane reade if that's cheeper. Both easier and more accessible to me.
 
The meter will come with a lancet device. If you choose to use the device (I prefer not to use them and instead poke free hand only with the lancet), then you want to get lancets that will fit the device. Usually the meter will come with 10 lancets.

The way to decide the gauge to get is this way. The lower the gauge number, the thicker the lancet, the higher the gauge number the thinner the lancet.

When starting out, it's best to get a thicker lancet - such as anything from a 26-29 gauge, should be fine. If they don't have that, then get the closet you can to it - such as a 30 or 31 gauge.

Make sense now?
 
good - please ask questions, especially for anything you don't understand. there are no dumb questions here, this is a safe zone for questions....there is a lot to learn and we use terminology that can get confusing. I've been here four years and still am learning new things and don't understand it all.

We have lots of tools, tips and tricks for just about anything and are happy to share.
 
I would ask your vet "why". He must have some reason.

There are no known drug contraindications with Denamarin. Denamarin is simply SAmE and Silymarin (milk Thistle). I used to by Marin for my dog until I realized I could find liquid forms from supplement stores (with no alcohol) making it easier to dispense than a pill.

But I would check with the Vet and point blank as the reasoning. They may have one...I just don't know what it would be.
 
Yey missy is getting in lots of fluid. Keeping topping up her food. She loves food soooo much even if she is not happy with the taste, she keeps coming back for more. No choice that's her only food. I bet it taste better than the non edibles she has tried. Manage to force pill down 2times, when she is tightly bound in a towel. Poor thing don't like doing it, but gotta do it.
 
It may help to give a low carb treat or enjoyable activity after pilling to reward her.
 
Missy's Mum said:
Yey missy is getting in lots of fluid. Keeping topping up her food. She loves food soooo much even if she is not happy with the taste, she keeps coming back for more. No choice that's her only food. I bet it taste better than the non edibles she has tried. Manage to force pill down 2times, when she is tightly bound in a towel. Poor thing don't like doing it, but gotta do it.
Click to expand...
missy eating is great! let her eat. food is like medicine for the liver. increasing the amount of water she's getting will help with her kidneys.

my diabetic kitty was in acute liver and kidney failure of an unknown origin several years ago and was so bad she was not expected to live. her problems began in march of 2010. she had been in remission prior to that. her treatment then, as well as a couple of relapses that year, are documented on her 2010 spreadsheet (link in my signature).

it doesn't sound like missy is near as sick as alex was (she wouldn't eat, was lethargic, and was vomiting in addition to everything else), but you might want to ask your vet if administering subcutaneous fluids at home is appropriate for missy's condition.

making sure alex ate, getting sub-q fluids into her, and denamarin helped immensely. she was also on metronidazole for infection. she was given ursodiol after an ultra sound confirmed inflammation of the bile ducts, pancreas, and gall bladder. ursodiol thins the bile in the ducts and is known to help with inflammation in the surrounding organs. i'm not suggesting these drugs are appropriate for missy... only mentioning them in case the subject comes.

your vet is right. denamarin should be given on an empty stomach at least an hour before a meal. the pill is to be given whole... not cut or crushed or it loses efficacy. initially i followed with a small treat to positively reinforce the experience.

at first i had a little trouble pilling alex, but over time it got easier. i'd sit on the floor with my legs straddling her body with ankles crossed to prevent a rear escape. i'd syringe a couple millimeters of water into the side of her mouth (to wet her mouth and throat) by placing one hand over her head/mouth and used the other hand to pry her mouth open to place the pill as far back into her mouth as i possibly could. sometimes it took a few attempts. the faster i could do this... the better. i immediately followed this with 5 - 6 millimeters water to wash the pill down her throat. you want to make sure the pill doesn't get stuck in her esophagus.

there's no problem with giving denamarin while receiving insulin. alex continues to get denamarin and ursodiol to this day to support her liver. all attempts to wean her off have failed, but that's just alex. ECID.

hope this helps a little and good luck!
 
Thank u soo much. So good to hear similar story. Missy only got subtraeous fluid at vet once. Now she is getting a little less than 1cup pedialite per day. I never expected to get so much down her. But mixed in with food really working. Pilling getting easier only bc we are focusing on the humor of how stubborn and feisty she is. She is still tough. Didn't know I could give a treat with denamerin. Although with glucose test she grabs the treat and runs away. Become better at grabbing her and towel wrapping her, holding in a tight spot and then giving treat. I break up the freeze dried cod so is not getting much of it. Her insulin was 72 for 2 days then 70 and today 66.
I am wondering it is ok to not go to the vet and just call in the glucose readings to the administrator. The vet did say come in 2 or 3 days, but that was for advice based on their glucose reading. Since I managed it alone, I have not gone in. I hope that is ok. The administrator is very knowledgable but not a vet. The vet has a terrible bedside manner and does not explain anything properly.
Yesterday she spat up a little which is unusual was concerned but not throwing up. It may have been a little too much pedialite. So I gave a little less at next feeds. Now schedule a little later in day actually easier for me. She eats around 9 and has snack around 4-5. Actually getting better sleep now. Phew.
 
ideally, you don't want to give a treat/any food with denamarin, but sometimes you just have to do what you have to do. it didn't take alex too long to get used to getting a pill everyday. hopefully, missy will get with the program and you'll be able to do away with the treat. the way i look at it is giving a small low carb treat was better than not being able to get the pill in her at all. :-D

why don't you just try calling her numbers in first? tell them her numbers (which are great!). let them know how she's doing. ask if they still want to see her to examine her anyway or perform any diagnostic testing. of course, if you think she needs to see the vet then by all means, bring her in. however, if she starts vomiting or anything else changes, you'll definitely want to bring her in.

fwiw, just my thoughts...
 
Thabks. Feel more confident with this site to help. They say test every few days rather than daily. This makes more sense.
 
you're welcome. :mrgreen:
this site has been a godsend... and not just for treating my diabetic. i've learned and continue to learn things which are beneficial to all four my cats. there's such a wealth of knowledge here...
 
Are all flavors of friskies pate ok for diabetics? Or only listed flavors that others in this site have used?
Local fam $ store stocks only selected flavors of pate. Can I get any of them?
I think its salmon pate and the chicken liver pate
 
The ones listed at Cat Info should be OK (link is in right column near top). And ask the store if they can order the poultry multipacks - those are all OK, and bundle 3 different flavors together.
 
I don't understand the food chart. If anyone knows if all friskies pate are ok or at least if there are some to avoid that would help. Today's glucose 29 before am worried so tried again right after am and it rose to 120 feel better knowing it went up. What does 29 mean?
 
It looks like the board is a little slow this morning. I must leave now. Be patient there will be help soon. This post will bump your thread up.
jeanne

PS I hope that 120 reading held steady if not...Please read this:

viewtopic.php?f=28&t=61799

I'm sure by the time I'm done with this you will already have help...

jeanne
 
Thank u. I dontknow about maching I am not home now. I didn't calibrate the glucometer and only realized that later. Got it from target. Do I need to run by the store or is there another way to calibrate the machine. I have other pharmacy's and human dr's around my area. I will try run home to check on her and read instruction manual. Got work now. Maybe I can step out.
 
Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- the lowest level pre-shot for ProZinc, PZI, or other non-depot insulins.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as mid-cycle data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
Missy's Mum said:
I don't understand the food chart. If anyone knows if all friskies pate are ok or at least if there are some to avoid that would help. ...
Click to expand...

Let's help you understand it so you don't need to ask.

At the very top of the file are the column headings.
The 1st names the food, which is grouped by brand.
Then there are 3 columns for protein (P), fat (F), and carbohydrate (C).
Find the C column on the page listing the food you want to check.
If it is under 10 (%), you may feed it.

Check your understanding:
Go to the Friskies section.
Find the Turkey and Giblets pate.
What number do you find in the C column for carbohydrates?
Is it below 10(%)?
 
Missy's Mum said:
Thanks printed food list to help me shop.
5pm glucose 68 before snack.
Click to expand...

What time do you give insulin when you give it?

And if she's not over 200 mg/dL at shot time, I wouldn't give her any insulin.
 
5.30am missy got her snack around 5 hrs after supper. 6.40am she tested as 67. Is that too low for after food? She gets 1/4can friskies twice a day. I take off some of the meal amount and leave for snack. Usually test before food. Misscomunication with my husband today and didn't realise she was fed already. Yesterday she was 29 before am. How long before and after food should I test to get clearer picture? Is she a little low? She is NO longer on insulin. This morning is the last of her clavamox. She gets denamerin hour before supper and drinks pedialite. Hope no vet needed
 
Missy's Mum said:
5.30am missy got her snack around 5 hrs after supper. 6.40am she tested as 67. Is that too low for after food? She gets 1/4can friskies twice a day. I take off some of the meal amount and leave for snack. Usually test before food. Misscomunication with my husband today and didn't realise she was fed already. Yesterday she was 29 before am. How long before and after food should I test to get clearer picture? Is she a little low? She is NO longer on insulin. This morning is the last of her clavamox. She gets denamerin hour before supper and drinks pedialite. Hope no vet needed
Click to expand...

Any time you get a number below 30, test again. It could be meter variance (+/-20% from 'true' number), faulty strips, or a bad meter.

If she is not on insulin and has no other medical problems, numbers in the 30s may happen. Because she has something going on with her liver, I'd be inclined to check with the vet.
 
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