Running a curve on a pet meter? (thread title updated)

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Bedina

Bedina

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@tiffmaxee, tagging you as I know you used Ondanstron with your boy.

Last night was bad not a good night. She couldn't settle and wouldn't eat or drink and her expression suggested to me that she may be done.

I don't know if she was in pain or if it was nausea. I had already reached out to inquire about Ondansetron and I got a text that they had filled that prescription.

She seems to have rallied (although with a higher BG this am), and now I'm considering next steps (I had planned a curve but I'm pushing that to tomorrow).

For those of you who have used Ondansetron/Cerenia, what kind of dosage for Cerenia/Ondestestron did/do you use?

With Ondansetron, did you have constipation issues? It' been necessary to keep her on Miralax, and any time she's gone off her food, she's been constipated.

Did Ondansetron help with appetite? Cerenia stops vomiting, but it has killed her appetite. I've added in Mirataz.

Thank you all so much.
 
I just started Ondansetron for pancreatitis for Howie as I couldn’t afford the Cerenia as a maintenance med. I got 60 4mg tabs from Chewy for $12 (generic). My vet prescribed half a tab every 12 hours or 1 tab every 24 hrs. They are so small so I’ve opted for once a day (Howie is also a horrible pill taker). One of the experts on here told me Cerenia is good if there is vomiting involved. Otherwise, Ondansetron is good as an anti-nausea. It’s only been a few days since I got it, but have not noticed any constipation issues so far. And I do think it’s helped with his appetite as he is finally back to eating in one sitting and not walking away constantly.
 
Bedina said:
I just was reading your thread here:

https://www.felinediabetes.com/FDMB...nsetron-for-pancreatitis.275597/#post-3058082

I should have searched better - it was an awful night with little sleep. Thank you for your response! At this point I'm leaning toward trying it as I believe we've hit a "nothing left to lose" point - her quality of life is starting to suffer.
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My vet did say that Cerenia has some pain med in it as well. So if you think she might be in pain, the cerenia/mirataz combo may be your better way to go if you can afford it (unless you’ve got another pain med in your mix already). If not, I don’t think there is any harm in trying the Ondansetron to see how she responds. Big hugs to you as you’re figuring this all out.
 
Howiesmom said:
My vet did say that Cerenia has some pain med in it as well. So if you think she might be in pain, the cerenia/mirataz combo may be your better way to go if you can afford it (unless you’ve got another pain med in your mix already). If not, I don’t think there is any harm in trying the Ondansetron to see how she responds. Big hugs to you as you’re figuring this all out.
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She's already on Cerenia and Mirataz, which is why I was so despondent last night - I thought we had figured this out. :(

Thank you again and the best of luck to you and your boy as well!
 
Bedina said:
She's already on Cerenia and Mirataz, which is why I was so despondent last night - I thought we had figured this out. :(

Thank you again and the best of luck to you and your boy as well!
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i'm so sorry she's not feeling well. :(
 
Actually, Cerenia has anti-inflammatory properties vs it being a pain med. With pancreatitis, it tends to be more of an inflammatory issue. If the vet hasn't prescribed a pain med like buprenorphine, I'd see what you can do to get some. Pancreatitis is incredibly painful.
 
Sienne and Gabby (GA) said:
Actually, Cerenia has anti-inflammatory properties vs it being a pain med. With pancreatitis, it tends to be more of an inflammatory issue. If the vet hasn't prescribed a pain med like buprenorphine, I'd see what you can do to get some. Pancreatitis is incredibly painful.
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She prescribed gabapentin but I’ll ask about the bupren. Thank you.
 
@Howiesmom Ondansetron should be given every 8 hours or every 12 hours depending on how often it’s needed. Once a day is not good enough since it won’t last 24 hours. You can start with 1/2 a 4mg pill x2 a day and increase up to 1 4mg pill x2 a day if needed.

I’m sorry to hear she wasn’t feeling well Bedina. gabapentin is not enough for pain. You def need bupe. I don’t understand why vets don’t prescribe it right away. I had to ask for it for Minnie since I could tell she was in pain.
 
Dosing of ondansetron is based on weight of cat. From table 9 in this paper, ISFM Consensus Guidelines: Diagnosis & Management of Feline Chronic Kidney Disease
the dose of ondansetron can be 3-4 times a day at 0.5-1.0 mg/kg of cat. For example, a 4 kg kitty would be around 8.8 lbs and get either a 2-4 mg dose. Ondensetron doesn't last very long, it has to be given more than once a day. I found ondansetron to be huge factor in getting back appetite.

Some kitties on ondansetron need to have Miralax all the time. If the lymphoma is treated and bowel inflammation goes down, that can help the situation.
 
Thank you for the dosing information! I wasn't able to give the ondansetron to her until 11:30 am so I've set an alarm for 11:00 pm (I gave her 1/2 a tablet to start). I've also updated the gabapentin, as it's what I currently have.
 
All, thank you so much for encouraging the Ondansetron - I think it's making a difference. She bit me on the backside this morning to demand breakfast, an obnoxious habit that hasn't made an appearance in months!

I'm trying for a curve today. I do recognize that the process was designed for a human meter rather than a pet one; we're still using the pet meter as my wonderful consulting vet/friend is an strong advocate of them and she's being hugely supportive, which I deeply appreciate (I'm also having some technical difficulty with the human meter --it errors out a lot, even when it appears to have a sufficient blood droplet. It may be poor technique on my part). I will likely to transition to a human meter, however, once I've finished the strips I've stocked.

I have collected some dual numbers and will continue to do so throughout the day, so that I have a general idea of how they compare, but I was wondering if anyone has run a curve strictly using a pet meter.

The numbers where I've managed to collect on both meters (note: not today) look like this:

Pet; Human
322; 217
264; 190
246; 202
209; 172
204; 154

Of course, there's a variance with both meters that isn't accounted for.

I'm curious to see if she ends up being on the ideal dose for now. If she drops below 200 on the pet meter, that should equate to below 150 on the human meter.

Curve day numbers here.

https://www.felinediabetes.com/FDMB...s-248-2-316-4-263-pet-meter-curve-day.276508/
 
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ondansetron made a huge difference for Minnie so I’m glad to hear it’s working for her too.

Can you input the numbers into the spreadsheet when you have a chance? Just out of curiosity, I’d love to know the reason your vet friend is such a fan of pet meters. Will you ask and report back? All vets used human meters before pet meters were invented so I’d love to know what now they all encourage pet meters.

now that she’s on Lantus, looking at the numbers above, I’d think she needs an increase. Are you going to post on the Lantus forum as well?
 
this is from the protocol sticky note:

  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases.
 
Ale & Bobo & Minnie (GA) said:
ondansetron made a huge difference for Minnie so I’m glad to hear it’s working for her too.

Can you input the numbers into the spreadsheet when you have a chance? Just out of curiosity, I’d love to know the reason your vet friend is such a fan of pet meters. Will you ask and report back? All vets used human meters before pet meters were invented so I’d love to know what now they all encourage pet meters.

now that she’s on Lantus, looking at the numbers above, I’d think she needs an increase. Are you going to post on the Lantus forum as well?
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Ale, I even forgot the Mirataz last night and it didn't seem to make a difference. :)

Also, I apologize; my post was misleading. The comparison numbers above are not from today's readings; they're just comparisons of times I've managed to capture both one right after another, using both meters. Her curve numbers for today are current in her spreadsheet, but on the pet meter only. I've tried twice to also get a human meter reading but both have errored out.

If her pet meter nadir readings drop below 200, my prediction is that they'll be sub-150 human meter equivalent. I'll try to capture both human and pet meter readings at +6 through plus +9, even if it means a second poke.

EDIT: Also dropping this here for my future reference; it's the AAHA link on running a curve using a pet meter.
 
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Howiesmom said:
I just started Ondansetron for pancreatitis for Howie as I couldn’t afford the Cerenia as a maintenance med. I got 60 4mg tabs from Chewy for $12 (generic). My vet prescribed half a tab every 12 hours or 1 tab every 24 hrs. They are so small so I’ve opted for once a day (Howie is also a horrible pill taker). One of the experts on here told me Cerenia is good if there is vomiting involved. Otherwise, Ondansetron is good as an anti-nausea. It’s only been a few days since I got it, but have not noticed any constipation issues so far. And I do think it’s helped with his appetite as he is finally back to eating in one sitting and not walking away constantly.
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Once a day is not likely to help enough. It lasts 6-8 hours. I got good results with every 12 hours and was able to do away with an appetite stimulant. When Max did not get enough ondansetron I needed cyproheptadine as well. That’s my go to Appy stimulant or Zyrtec. I did notice some constipation with ondansetron and added a teaspoon of pumpkin twice a day and miralax which solved that.

I’ll be back with the dosing guide.
 
tiffmaxee said:
Once a day is not likely to help enough. It lasts 6-8 hours. I got good results with every 12 hours and was able to do away with an appetite stimulant. When Max did not get enough ondansetron I needed cyproheptadine as well. That’s my go to Appy stimulant or Zyrtec.
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Thank you, @tiffmaxee! I did yesterday at 11:30am, 8:30 pm, and 6:30 am (1/2 a tablet). I'll aim for no later that 6:30pm today for the next dose.
 
I'll say this about the pet meter - I find it much easier to get a reading with one than with a human meter. I tried to get both at +8 and gave up.
 
I believe the human meter requires a slightly larger sample but honestly, I get it first try 90% of the time and by now I can tell visually when I don’t have enough blood. If I insist and try anyway, that’s usually when I get an error message. I remember that’s what most folks said to me back when I went from the freestyle to the ReliOn. Freestyle requires same sample size as pet meters.
 
Has anyone noticed an increase in BGs with Ondansetron? Howie’s has been significantly higher (for him) since starting it and I’m not sure if I can attribute it to that or perhaps his tumor pulsing with his acro. I’ve already done one dose increase. Thanks to all who have chimed in with proper dosing. I was following my vets orders as I had nothing else to go by or question.
 
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