Snuggie update - cab dose and insulin dose questions

Jay Dee

Jay Dee

Active Member
Hi all,

Update on Snuggie!

He’s been acting 95% of his pre-diabetes and acro Dx self, his latest trick is that he’s back to sleeping in the bed some nights with us! He hasn’t done that in close to a year.

His latest dose increase to 10u on Monday this week hasn’t yielded any greens and very few blues. It’s been 6 cycles so I think it’s time to increase. Should I go to 10.5 or 11? @Wendy&Neko @Suzanne & Darcy ?

He saw the vet yesterday and we discussed increasing his cabergoline dose. The vet is calling me back with his suggested dose, however I just saw @Larry and Kitties say in another post that his one cat took 2.5 mo to show improvement on cab and it’s only been 1.5 mo for us.

So here’s my question re cab - I’m horrible at math and units and conversions so please go easy on me: his current dose per the label from Wedgewood says “50 mcg/ml” and we give 1ml every 48 hours. Snuggie previously weighed 11lb but is up to 13lb now. What would be a good target dose and frequency?

As for the rest of his vet appt, he’s doing great. His CKD values are stable or improving (I’ll post labs in my SS over the weekend - just no time this week) and he’s 100% improved from where he was during our scary few weeks back in March. Yay!
 
11# is 5 kg and you are giving 1ml which is 50 mcg. That equates to 10 mcg/kg. One standard dose is 10mcg/kg and usually that is once daily. My Snuffles started at 10mcg/kg daily last December. Now dose is a little lower since he has gained some weight. I wouod increase to once daily if your vet agrees. If he does goo maybe increase to 10mcg/kg daily based on weight then.
 
Great report on Snuggie!

13 lbs = approximately 5.9 kg, so his new dose based on weight would be 59 mcg up from 50. I agree with Larry that you might want to try once a day dosing first. If you don't do once a day (more common), using the current compounded liquid you'd go to 1.2 ml. The extra 9 mcg is approximately 20% of 50.

Sorry we didn't get to you in time on the insulin dosing. You can try the 10.5 now, but if you don't see green in six cycles I'd take it up by 1 unit.
 
I was going to chime in on the dosing of cab... but had a family crisis ... and Wendy has already shared the math with you... so I'm good with that! :) Snuggie's former dose of 50 mcg per day (1 mL) was appropriate (at 10 mcg per kg.) for his former weight, but he could take a little more now, as suggested above, or you could try the daily dosing instead, as also suggested.

I'm REALLY happy to hear about Snuggie being happier and more like his old self. That's what it's all about!
 
Oh, and another thing... this will be later when you need to refill. You may want to request that they increase the concentration/strength of the Cabergoline when you get a refill. My Cab was 200 mcg/mL and yours is 50 mcg/mL. I only had to give Darcy .4 mL and he was 15 lbs. Maybe it's easy to give Snuggie liquids and you don't care. Darcy was no problem to medicate at all, so it wasn't a big deal, but I liked giving him less liquid med when I could. Just an idea. I think Larry might have his concentration even stronger.
 
Thank you all - not only for the replies but for sparing me the math :joyful:

I appreciate all the input and time you put into helping me and everyone here!

We went to 10.5 but will head to 11.5 if no greens in 6 cycles.

I’m waiting to hear back what the vet recommends re the cab and will discuss these options too. I’d like to work with what I have onhand now but do like the idea of a stronger liquid when we refill so he needs less - he loves the flavor but less liquid would be wonderful !!

thanks so much - y’all rock!! :bighug::bighug::bighug:
 
Quick update - vet suggested increasing cab to 1.5 ml every other day and check back with him in 3 weeks or so on progress.

he didn’t mention daily cab, and said his research suggests it’s safe every other to every third day but if y’all have literature that suggests it’s ok daily please pass along!

He is also going to ask about a more concentrated compound at next refill - thank you @Suzanne & Darcy (and I hope your family crisis has resolved!)

thanks again everyone! <3
 
Yes! We are rolling on blues now; PMPS, midcycle, and AMPS. Could be the new dose of cab, or insulin, or the fact that we landed at the vet on Friday after a stint of vomiting and shivering, and I couldn’t get a urine sample to test for DKA, and he got a shot of cerenia. All seems to have started improving from then. Either way I’m a happy mama!
 
Well he just chased down and made lunch of a grasshopper that found its way into the house - hopefully it’s not poisonous and won’t raise his BG! My guess is he got some exercise chasing it!
 
We had a PM cycle nadir of 61. I gave him some MC and went back to bed. AMPS today 177, I can monitor him. If we go below 70 again (his reduction point) I’ll try for a dose decrease.

he threw up his breakfast again today so he got a cerenia tab and some pepcid. Poor boy has been constipated since his grasshopper incident.
 
His BGs are really starting to improve. I'm sorry about the breakfast vomiting though. How long since he had a BM? I hope not more than a few days. It's possible he's dehydrated. The vomiting could make it worse. You could increase the amount of fluids to 100 mL for a few days. Check with your vet if that makes you uncomfortable. Snuggie is a big boy, right? He's only getting 50 mL daily, right? I know only too well how dehydration can play into constipation. So I wouldn't let it go too long before trying some other things to get him to poop.
 
Suzanne & Darcy said:
His BGs are really starting to improve. I'm sorry about the breakfast vomiting though. How long since he had a BM? I hope not more than a few days. It's possible he's dehydrated. The vomiting could make it worse. You could increase the amount of fluids to 100 mL for a few days. Check with your vet if that makes you uncomfortable. Snuggie is a big boy, right? He's only getting 50 mL daily, right? I know only too well how dehydration can play into constipation. So I wouldn't let it go too long before trying some other things to get him to poop.
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It’s been since Sunday. He definitely squirms at 50 but we could do 50 @2x a day to get more fluids into him (he’s 13lb now - sheesh!). He’s getting pumpkin and miralax and I do add water to his food… vet will be calling back about his urine c&s hopefully today (just a check to make sure the nasty uti from may is clear) so I can ask. I want to avoid an enema!
 
Jay Dee said:
It’s been since Sunday. He definitely squirms at 50 but we could do 50 @2x a day to get more fluids into him (he’s 13lb now - sheesh!). He’s getting pumpkin and miralax and I do add water to his food… vet will be calling back about his urine c&s hopefully today (just a check to make sure the nasty uti from may is clear) so I can ask. I want to avoid an enema!
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He'll probably go soon. So he gets restless when you do the fluids? Do you have to do it alone or do you have help. I could do Darcy by myself because he was just good as gold, but my other cats... not so much! One trick we have used is to have the other person (in my case usually my daughter) feed little pieces of kibble (Dr. E's clean protein nowadays) to the cat in question when they start to get restless. Another trick with a different cat was to give wet food with Forti-Flora on it (because she loved Forti-Flora) also, we've given baby food ... something to keep them eating and happy while getting fluids. This only works if they still have an appetite. Also, we have given little pieces of deli ham (my store does have low sodium deli ham)... I'm trying to think what else... we've done so many different things over the years with this menagerie!
 
Oh and if this happens more often than you'd like, you may want to get your vet to order Lactulose from a compouding pharmacy. In some cats where the Miralax doesn't work, the Lactulose does. Kiss on the top of the head to Snuggie!
 
We tried feeding him during fluids but that made things worse LOL! My hubs does the fluids usually. He sits still well enough til we get to 50mL then definitely protests. I mentioned this to his vet the other day and he said he just may get uncomfortable with that much fluid under his skin depending where it flows to. He also has a fatty mass on one side that seems to get uncomfortable more easily and quickly. But I’d have no problem doing 50mL 2x a day for a few days. He may not like it but I’m sure he’d rather poop!
Thanks for the tip on lactulose, rhe miralax doesn’t seem to be doing much.
 
Do you warm the fluids before you give them?
I suppose it is possible that he just doesn't have that much space under his skin and it gets uncomfortable. Just make sure that the previous 50 mL has absorbed before doing additional (check for fluid bump or squishiness).
 
We used to but he caught onto the ritual and the sounds, and would hide. He didn’t seem to tolerate any more or better when they were warm, we realize our best bet is to catch him when he’s drowsy. I think he maybe tenses up and has less space the more tense he is, and if he’s super chill he doesn’t get really tense until the last 5mL or so, so we have better luck. Ahh the joys!! Sighhhh…

ETA: we were able to give him 100mL in one session. Interestingly he had been on Normosol-R up til now and this time they only had LRS, and he didn’t seem to mind it. Could be complete coincidence but I’m glad we were able to give him so much!
 
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Jay Dee said:
We used to but he caught onto the ritual and the sounds, and would hide. He didn’t seem to tolerate any more or better when they were warm, we realize our best bet is to catch him when he’s drowsy. I think he maybe tenses up and has less space the more tense he is, and if he’s super chill he doesn’t get really tense until the last 5mL or so, so we have better luck. Ahh the joys!! Sighhhh…

ETA: we were able to give him 100mL in one session. Interestingly he had been on Normosol-R up til now and this time they only had LRS, and he didn’t seem to mind it. Could be complete coincidence but I’m glad we were able to give him so much!
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That's great. You'll have to see if the Ringers makes any difference on another day, too. Now waiting for poop.
 
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