Senvelgo- Lucys downfall

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I noticed that it was posted that there was little information on how Senvelgo works. So I figured I would just post about how Ms Lucy is tolerating it. Currently she has had 3 doses. First dose given in evening so the next morning I noticed her BS have already dropped to 201 without overnight food. This is a great number for her. During that day she did drink a lot, appetite appeared normal, lots and lots of urination. She also slept all day. She seemed in better spirit though. I checked her BS that evening and it was 213 and this was after food. I also checked her ketones and it was still trace to nothing. 2nd dose given. Followed up with vet who said that a small trace of ketones was normal on first day and also the urination because her body is trying to get rid of all that stuff. She did say that there should be no rise in the ketone levels though so I will stay in top of that. This morning she was awake and was ready to go. Good energy, good appetite but lots of urination during the night. Am BS 206. Weight up just a few ounces. Unable to test ketones today she was to sneaky. Drinking normal, did eat more today but not ravaging like she was, poops smooth, and urinates normal. She has been very sleepy but doesn't hide. I noticed today that she groomed herself and her tail was happy. She also had some fun at the window. Pm BS 201.Gave 3rd dose.
 
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Thanks for the update. Keep on with those tests, including the ketones tests. Sounds like Lucy is doing well so far. :)

We really appreciate hearing the detail of this journey with Senvelgo. We haven't seen much about it, so you are helping a large community.
 
Wendy&Neko said:
Thanks for the update. Keep on with those tests, including the ketones tests. Sounds like Lucy is doing well so far. :)

We really appreciate hearing the detail of this journey with Senvelgo. We haven't seen much about it, so you are helping a large community.
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Yes she is doing better. I just want to help out as much as I can. I was so scared and you guys helped me much. If I can give anyine piece of mind about this...i surely will.
 
Senvelgo is a liquid once a day dose. You give it by weight. I was told as long as I can keep her carbs below %15 that was acceptable for the Senvelgo. Also Miss Lucy had no ketones in her urine when this was prescribed and had not been on insulin before...that is very imporant.

Just a note::::I firmly believe that temptation treats caused diabetes in my cat. I did not read the box and was giving her probably 10 a day. It was fun to watch and play with her and then treat her for it. But in my opinion these are bad.

This morning good- same as last night. Lots of urination, good appetite and has continued to gain a few ounces. BS 238 with "small" amount of ketones showing-not good.
Called vet- spoke with Dr who was concerned but said to check again in about 2 hours. This time I checked and it showed "trace"-better. Vet called back. (She seems experienced with this.) She said the body is not used to what's happening and will excrete a larger amount of ketones at times. ***She said if ketones do show up as "small" consistently on TWO tests to stop the Senvelgo and go back to the lowest carb food until we can get back to the vet.*****But since it went back to"trace" amount and was "trace" again at bedtime...Miss Lucy is still okay. Senvelgo given. (The vet is comfortable with these statements and continuing the meds because and only because Miss Lucy is not showing symptoms. There would probably be a different plan if your cat was truly sick with side effects showing)She said to keep checking at least 3x a day until I return for checkup. She also said the company that sales this medicine will refund the unused portion and give a credit on insulin if a change is needed so this is something you could ask for if you get in that situation.

Last night when given the meds some spilled out of her mouth and I think today's numbers show that. BS @ bedtime was 251 after food.
 
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I’m sorry I haven’t been back here in a while…I’m glad you have a great new vet and that Miss Kitty is feeling better.

did they repeat her bilirubin? I’m asking because if I understood it was elevated at 2.0 and the prescribing info for svenglo says not to start when bili more than 0.5. See animal safety warnings here: https://docs.boehringer-ingelheim.com/SENVELGO_oral_solution_PI.pdf

You may want to consider getting a meter to test blood for ketones. The strips are pricey so perhaps just for testing if there’s a hard to read urine strip or for testing if she’s not feeling well. When Methos was on Bexacat his vet wanted spot blood checks or if any sign he wasn’t his usual self. the blood sugar isn’t anywhere near as important as ketones. Because of how SGLT2 drugs work the BG is going to be normal very soon after starting. But it’s extremely important to track ketones. This is because the drug prevents the kidneys from readsorbing glucose so miss kitty will pee out any excess in her blood. But it doesn’t help her use the glucose before it gets to her kidneys—for that she needs insulin either made by her pancreas or provided from injection. If miss kitty can’t make enough insulin on her own she will go into DKA (start burning fat for energy) even with a normal BG number.

To understand this, there are toy boats (glucose) floating downstream. To pull them out (use glucose in the body) you use a net (insulin), and there’s a narrowed part of the stream that creates a bottle neck slowing the boats so you can pull them out (normal kidney).

On an SGLT2 the kidney stops readsorbing glucose letting it all be peed out. In our analogy we open the narrow area so the boats are now all racing away. If you have a broken net, or worse no net (decreased or no insulin production) then you can’t pull any boats out of the stream ( use the glucose) I hope this is clear as I’m dictating not typing

at any rate I hope miss kitty continues to improve. If they didn’t repeat her bilirubin you may want to carefully review the drug insert I linked and discuss with your vet, who sounds really on top of things—I’m not a vet I just am going off the insert so she may have additional info.
 
Overnight Miss Kitty had 2 regular urinations and a poop. Am BS was 213.Today her appetite was good and she was able to pace herself to eating portions even though I have the food laid out to feed freely. She also drinks out of her water bowl now and doesnt follow me to the sink. She had 2 normal urinations throughout the day and they were not large like they were previously. She is still resting a lot but she is not lethargic. She gets up wonders around the house plays and then goes back to bed. Today has probably been her best day. The urine test for ketones showing trace to none. I hope this progress continues. I will say that the key to getting urine is to sneak up after they have started peeing because prior to somone providing that information for me ...I wasn't able to get the sample. ( Today I did have to put a camera in her room to see when she was going because she became aware of what I was doing and wouldn't go when I was watching....such a smart kitty.)
Pm BS was 258 after eating so she is staying in the 200 for now. She was happy eating the friskies grill pate today and that was a first because she has not liked the pate at all. Her weight is up from 6.68 to 7.40...yay! She is gaining. He back legs are still really skinny but any weight gain is a plus. Vet did say she had no muscle wasting just weight loss.
 
SmallestSparrow said:
I’m sorry I haven’t been back here in a while…I’m glad you have a great new vet and that Miss Kitty is feeling better.

did they repeat her bilirubin? I’m asking because if I understood it was elevated at 2.0 and the prescribing info for svenglo says not to start when bili more than 0.5. See animal safety warnings here: https://docs.boehringer-ingelheim.com/SENVELGO_oral_solution_PI.pdf

You may want to consider getting a meter to test blood for ketones. The strips are pricey so perhaps just for testing if there’s a hard to read urine strip or for testing if she’s not feeling well. When Methos was on Bexacat his vet wanted spot blood checks or if any sign he wasn’t his usual self. the blood sugar isn’t anywhere near as important as ketones. Because of how SGLT2 drugs work the BG is going to be normal very soon after starting. But it’s extremely important to track ketones. This is because the drug prevents the kidneys from readsorbing glucose so miss kitty will pee out any excess in her blood. But it doesn’t help her use the glucose before it gets to her kidneys—for that she needs insulin either made by her pancreas or provided from injection. If miss kitty can’t make enough insulin on her own she will go into DKA (start burning fat for energy) even with a normal BG number.

To understand this, there are toy boats (glucose) floating downstream. To pull them out (use glucose in the body) you use a net (insulin), and there’s a narrowed part of the stream that creates a bottle neck slowing the boats so you can pull them out (normal kidney).

On an SGLT2 the kidney stops readsorbing glucose letting it all be peed out. In our analogy we open the narrow area so the boats are now all racing away. If you have a broken net, or worse no net (decreased or no insulin production) then you can’t pull any boats out of the stream ( use the glucose) I hope this is clear as I’m dictating not typing

at any rate I hope miss kitty continues to improve. If they didn’t repeat her bilirubin you may want to carefully review the drug insert I linked and discuss with your vet, who sounds really on top of things—I’m not a vet I just am going off the insert so she may have additional info.
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I understand what your saying. It makes sense. I will follow up with vet on Monday but as of today the urination has significantly reduced. So maybe we are okay for the moment . Thanks for the info.
 
Sunday morning Miss Kitty got up with little to no energy. She ate very little but her BS was 90 so I was pleased with that. Her drininking was normal. Throughout the day I noticed she was hiding and standing in a closet. Sleeping all day. Now this was a total different attitude from previous days. She also didn't want to urinate either. I put her in the box and she would go but she wouldn't voluntarily go to box.I was gone most of the day and when I checked her ketones that night they were moderate level which explains her behavior. I did not give her the Senvelgo and gave her higher carb food. I literally stayed up all night holding her and watching her because I knew what was coming because the sweet people on here told me the Senvelgo was probably not a good idea. I weighed her and she had lost weight from not eating much all day. She also began to stumble around. It hit her hard and quick. Monday morning came and I called the vet and took her in. They took her back and gave her fluids but because she was so weak she did not make it. I said should I have gone to the emergency vet and she said that she wouldn't have made it any way. Now I keep wondering what else I could have done different. That I probably should have done what the friends on here said to do by getting her insulin instead. But I just like many people went the easy route. The vet was shocked how quick it shut down her system. She also felt bad for prescribing it and actually refunded my entire visit. After reading and blaming myself for her death. I read many journals and articles regarding this drug. Only 1 out of 3 cats make it when taking this medicine. If your willing to be the 1 whose cat survives then go ahead and use Selvago but just know that your cat could be the other 2/3 who don't. Wished I didn't give it to her but I keep telling myself that maybe she had other issues...idk but my girl is gone. Please pray for us tonight as she has been in my bed for 13 years since I found her as a kitten in a box. Just heartbroken. I will keep the app on my phone if anyone has questions because I do not want this to happen to anyone else. I'm not sure it should actually be on the market
 
I’m so very sorry for your loss. Please don’t blame yourself. Your sweet girl was already a very sick kitty. You’d done so much trying to get her better including being her advocate through many vet visits. Her lab work was already out of wack in some places, and why was never determined—the decision you made on her medicines may have made no difference at all. You gave her comfort right up to the end, it sounds like her last days with you were some of her favorite things. You could have been giving her shots and sticking her ear and she may not have had any different result. There was someone here a month or two ago that spent the last 12 hours with their sweet girl doing a glucose curve —that makes me sad.

Please be gentle with yourself.
 
SmallestSparrow said:
I’m so very sorry for your loss. Please don’t blame yourself. Your sweet girl was already a very sick kitty. You’d done so much trying to get her better including being her advocate through many vet visits. Her lab work was already out of wack in some places, and why was never determined—the decision you made on her medicines may have made no difference at all. You gave her comfort right up to the end, it sounds like her last days with you were some of her favorite things. You could have been giving her shots and sticking her ear and she may not have had any different result. There was someone here a month or two ago that spent the last 12 hours with their sweet girl doing a glucose curve —that makes me sad.

Please be gentle with yourself.
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Thank you so much for those kind words. It really does make me feel better.
 
Oh no! I am so sorry to read this update. :bighug::bighug::bighug::bighug:. You did everything you possibly could to help Miss Kitty.
 
I am so very very sorry to read that you have lost your beautiful beautiful Lucy. I understand the crushing loss and my heart goes out to you. :bighug: You tried your best, but your vet failed you in my opinion (it sounds like ignorance or misunderstanding of the Senvelgo). It is not your fault. That won’t help the pain and loss, I know, but we tend to trust what the professionals tell us to do. They also can make mistakes. We (on this Board) have already seen too many losses of cats taking Senvelgo and Bexacat. Again, I am so so sorry. She will be in your heart forever.
 
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I am so sorry for your loss but I so appreciate you sharing your full experience. I have been following your story as we navigate our treatment options.
 
Wow, that was a shockingly fast decline. My heart goes out to you—I am so sorry. :bighug:

Thank you for sharing your experience with us. It adds to the collective knowledge base here to hear all stories, good and bad. As heartbreaking as your loss is (and I feel your pain), I hope knowing that Lucy’s experience might help future diabetic cats gives you one small glimmer of light in an otherwise gut wrenching situation. Rest peacefully, Lucy, you were loved.
 
Thanks y'all so much for your kind words! You are right it was a super fast decline. It was almost as if she got better and the got worse. There really didn't seem to be any other visible issues other than her weight loss so it was definitely a shock. The vet was blown away at how quickly the situation went downhill. Good thing was I did see the signs. Friday she was pretty good..Saturday she didn't have the same energy and the ketones showed up and Sunday basically no energy and the ketones were moderate level. So glad I was testing for ketones. I just thought I had more time. I really think a kitty has to be physically able to tolerate this med. and have a hearty appetite. She just did not. Plus if she had been diagnosed back in August when I took her to the first vet maybe she would have had a chance. Here it is November and I finally got a vet to listen.i would say to someone that takes this med. Once ketones show up as small you may have a day or maybe two before it's to late to fix.
 
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