Update:::When to worry?... Lou barely eating today.

[Amanda and a Loudogg]

Hello all,
My buddy Lou has barely eaten anything today. He's a grazer, so while he doesn't necessarily eat a bunch before I give insulin, he'll usually finish his meal after I've given his dose. He hasn't finished a meal and he's been sleeping nearly all day. He's maybe had 1.5 oz of food all day? Thankfully he's just started coming out a bit now since having a bit more to eat. I'm almost loathe to take away his food for the 2-hour window prior to the PMPS.

When he was diagnosed with that UTI with crystals in November he ate less and less over a few days before not eating at all. We had to take him to the ER that day since no vets are open around here on a Saturday. Our vet didn't have any openings until next Wednesday, but I got a call as I am writing this that they had a cancellation tomorrow! Huzzah!!

So even though we will see the vet regardless tomorrow, I still think it's worth getting your opinions on this situation. Have any of your kitties had a day where they just didn't feel like eating? In my limited experience with Lou not eating post-diabetes, good things do not follow. (It's only happened once.)

Things to note:

1. He has not been reacting well to his insulin lately. I am planning on talking to the vet about switching to another (Prozinc is my first choice).
2. I just upped his dose from 3.25 to 3.5 last night, so I wonder if that could be causing issues?
3. I plan on asking the vet to check his urine per his previous UTI diagnosis.

Is there anything else I should consider or ask the vet? I think I'm going to lower the dose for tonight's PM cycle in case he continues to not eat much. Do you think that would be the best course of action for tonight?

Thanks in advance!! (And I'm sorry about the book... I seem to always write you a book eh? )

 

[Sean & Rufus]

Hi! I don't have any advice, sadly, just curious as to why you want to go with Prozinc? I thought Lantus or Levemir were the good ones to go to. Good luck at eat your foods Lucius!

 

[Amanda and a Loudogg]

Hi! I don't have any advice, sadly, just curious as to why you want to go with Prozinc? I thought Lantus or Levemir were the good ones to go to. Good luck at eat your foods Lucius!

Thank you! They definitely are good choices. I love the freedom and flexibility of Vetsulin. I have to work 12-14 hour days on occasion, so my only concern with a depot insulin is not always being able to dose at the same time every day. So I figure Prozinc (being similar but gentler) may be a good place to start; however, I will make it work if my vet feels an L&L insulin would be better.

 

[Sean & Rufus]

Thank you! They definitely are good choices. I love the freedom and flexibility of Vetsulin. I have to work 12-14 hour days on occasion, so my only concern with a depot insulin is not always being able to dose at the same time every day. So I figure Prozinc (being similar but gentler) may be a good place to start; however, I will make it work if my vet feels an L&L insulin would be better.

Ah, gotcha! I had no idea those weren't depot insulins! Again, good luck

 

[Becky & Baby Girl GA]

Of course, I would ask if he’s running a temp but they usually check that. If he’s still not eating much I would stick on the low side...
also just make sure she examines his belly for any tenderness. Thats all I can think of at the moment. I sure do hope it’s just an off day. Baby has been sleeping more the last couple days & I wonder if the warmer weather we’re having makes a difference.? Best wishes for Lou & you. Keep us posted...

 

[Kris & Teasel]

It's good you have a vet appointment booked. Checking for a UTI and possibly signs of pancreatitis is a good idea. His insulin dose needs to go up and needs to be increased more quickly. He might have some glucose toxicity from being high-ish for an extended period of time. Overall, his reactions to Vetsulin aren't extreme - ie., nadirs <<<50% of PS.

 

[Amanda and a Loudogg]

Well, I'm super excited to note that he ate all of his PMPS meal! I only gave him 1/2 of a Sheba perfect portions tin (which is a bit less than 1/4 of a Fancy Feast can, so we usually only use these as mid-cycle meals). He actually ate it all and literally licked the bowl afterwards. Unfortunately while my husband and I debated over giving him more (we've already wasted so much food today), he walked off. While we are literally in the midst of an increase for him, I did err on the side of caution and gave him 2.75u insulin rather than the 3.5u he should have gotten. I can't even begin to explain how relieved I am that I was able to get into the vet tomorrow. I almost have a feeling he'll "bounce back" before them, but I'm going to bring him in anyway, even if he does.

It's good you have a vet appointment booked. Checking for a UTI and possibly signs of pancreatitis is a good idea. His insulin dose needs to go up and needs to be increased more quickly. He might have some glucose toxicity from being high-ish for an extended period of time. Overall, his reactions to Vetsulin aren't extreme - ie., nadirs <<<50% of PS.

Kris, I just increased him from 3.25u to 3.5 last night, and today was only the second cycle on the new dose. I've been worried about glucose toxicity, but I've been finding I haven't had a lot of time (i.e. days off) to increase frequently and test as much as I'd like. Depending on how he does tonight, would you still give him his full dose (3.5u) tomorrow morning as long as his BG is safe?

 

[Amanda and a Loudogg]

Well, he ate well enough last night and today to almost make a mockery of the vet visit. Unfortunately for him, the ruse didn't work and we still went today. The vet and I mostly talked about the issue of his unregulated diabetes. Thankfully she ran a chem panel and his numbers are fairly close to those ran in October 2017. I went ahead and dosed him at 3.5u and then apparently got a furshot, so that was bloody annoying. He's been in the 300s all day.

Interesting things to note from the vet visit:

1. My vet's first solution to the unregulated diabetes was to check him for acromegaly. She indicated he has the big head and protruding jaw that could be indicative of the issue. She was willing to run the test today.
2. She also offered to send me to a diabetes specialist at the University of Minnesota.
3. She was perfectly fine changing his insulin (glargine was her first option), and gave me a prescription.
4. She really didn't think he needs a dental (0-1 on the dental scale). She acknowledged that he may have issues that can't be seen without an x-ray, but she said there's generally some gingivitis in that case, which she didn't see.

I decided to wait on the IGF-1 test until I talked to my husband and you all. He's only at 3.5u right now and I thought we should consider testing when they get up to 5u. Part of me wants to test if she's so game, but I don't know if it's necessary at this point. We went ahead and scheduled a dental. They're about 6 weeks out, so we have time to change our minds if it comes to it. Ugh, oh Loudogg. I work doubles once a week for the next month, so I'm tempted to just keep at the Vetsulin, raising the dose when necessary until at least I'm off the doubles.