? Willow dosing help!

Kate & Willow

Kate & Willow

Member
Wondering if anyone can help me with figuring out the best route for Willow. Last night, as well as tonight, she had low PMPS numbers, much lower than usual. Last night I didn't shoot, fed her as usual, and retested her at +2 and gave her a token dose. She, as I predicted, bounced back and was high this morning. But tonight, I just tested her PMPS and she's low again. I'm wondering how I should proceed. As of right now, I'm withholding food for the next 30 minutes and will test again to see if her BG is rising. Any advice much appreciated! Thank you so much.
 
You are really doing a very thoughtful job with making these decisions. I do think, however, that her spreadsheet data indicates that tonight she could have received her regular dose (provided you could test a bit.)
 
Kate & Willow said:
I did not feed, stalled 30 minutes, tested again and she is now at 178.
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See … you did this just right. This tells us that she was at the end of her ProZinc cycle. The previous shot is wearing off and it will take approximately two hours before this evening’s shot will kick in. It was a good indication that the full dose would be appropriate.
 
Suzanne & Darcy said:
See … you did this just right. This tells us that she was at the end of her ProZinc cycle. The previous shot is wearing off and it will take approximately two hours before this evening’s shot will kick in. It was a good indication that the full dose would be appropriate.
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That is so very helpful- thank you. Great to know for next time.
At +2 she is at 189. Hoping it will be an okay cycle despite the token dose...
 
She did end up getting down to 106 @ +4, even with the smaller dose. Do you still think the full dose still would have been fine?
This morning, she did shoot right back up and AMPS was 406. Full dose given of course.
 
Next time you have a similar preshot number to last night, I would try a higher dose. You could start with 1.5 instead of 1. Of course, you would need to be able to get some tests.

I would like to see some green on that spreadsheet :D
 
Okay. We don’t have a lot of data with this preshot number, but last night’s information is very helpful. By the way, these lower preshot numbers are good. I think we are making progress. I would try a 1.5 or 1.75 dose tonight- depending on your comfort level. Can you test some tonight?
 
Yes, absolutely. That sounds great. I just checked BG again. 25 minutes later, up to 217 from 204. Maybe I could do a 1.6 since I'm using the conversion chart and get a few tests tonight? A +2 and +4 or do you recommend other times?
 
Kate & Willow said:
Yes, absolutely. That sounds great. I just checked BG again. 25 minutes later, up to 217 from 204. Maybe I could do a 1.6 since I'm using the conversion chart and get a few tests tonight? A +2 and +4 or do you recommend other times?
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Exactly! Great minds thinking alike here. Lol! Yes. Get a +2 for starters just so you can see if it’s much lower than preshot. If not then you should be in the clear. Still I would get a +4 to make sure all is well.
 
Willow won't eat this morning, I think her belly is a little upset. How long do I try to get her to eat before I skip the shot? AMPS was 299. Safe to shoot but she won't even get a few teaspoons in.
 
Suzanne & Darcy said:
Have you tried baby food (pure meat baby food?)
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She has not eaten. I've tried two different wet foods that she LOVES and even tried hand-feeding the dry. She is very alert and active but turns her nose at the food.
I don't have baby food on hand but I can get some of that today, for sure.
 
Does she do this often? Not eating or vomiting in the morning? Does she usually start eating later on?

I hate to lose ground. I probably would not skip her shot but would consider a small dose to hopefully keep her from climbing too high.
 
Suzanne & Darcy said:
Does she do this often? Not eating or vomiting in the morning? Does she usually start eating later on?

I hate to lose ground. I probably would not skip her shot but would consider a small dose to hopefully keep her from climbing too high.
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She doesn't do this often :/ her belly is also gurgly, if I put my ear up to her I can hear the gurgles.
I'd hate to lose ground too. We are now 1.5 hour past shot time.......
 
That’s awful. For your peace of mind — and since it’s getting late relative to her shot time, I would skip this dose. I hope she will feel better soon! I wonder what’s going on?
 
Thank you ❤️ I will definitely get some tests in today and keep you posted.
No idea what's going on but I'm hoping she just needs a little break to let her stomach calm down/reregulate and that she eats soon... I'll see how things go throughout the day before I consider a vet urgent care.
 
I have used it before in my cats — either as a solution mixed with water or where I took some from SEB capsules that I had and put the contents into smaller sized capsules for my cat. That one is tricky because it’s such “fluffy” stuff. You need a pill compactor to squash down the contents into the gelatin capsule.
If you happen to have any regular strength plain (no extra ingredients other than Famotidine) Pepcid AC you can give 1/4 of an original strength (10 mg) tablet. If you have any Cerenia at home it may be a good idea to give that first though, to stop the vomiting — since she even vomited treats.
 
Suzanne & Darcy said:
Any better?
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No :/ She still has not eaten and has just been sleeping. I have a friend dropping off some meat baby food in a few minutes. I'm going to try that, and if she doesn't eat, I think I should take her to the veterinary urgent care here. Our regular vet has short hours on Saturday and is already closed for the day. I'm worried she might have pancreatitis or needs anti-nausea meds or something...
 
She also just got up to vomit again- this time it's just white foam...
She IS drinking water, at the very least.
 
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Kate & Willow said:
No :/ She still has not eaten and has just been sleeping. I have a friend dropping off some meat baby food in a few minutes. I'm going to try that, and if she doesn't eat, I think I should take her to the veterinary urgent care here. Our regular vet has short hours on Saturday and is already closed for the day. I'm worried she might have pancreatitis or needs anti-nausea meds or something...
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It’s possible she has pancreatitis. I hope not though. They could give her a Maropitant (Cerenia) injection (which burns so they should buffer it with some fluids when they give it) and send you home with some Cerenia. Then lots of fluids and pain meds if needed (hopefully Buprenorphine.). Have you ever given sub-q fluids at home? They could show you how. Hopefully she won’t need any of this.
I find Gerber Ham Baby Food is the most popular.
 
Suzanne & Darcy said:
I’m sending all kinds of good thoughts your way. I’m am concerned. Let me know what happens.
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I appreciate that so much. Thank you ❤️ I will keep you updated.

Suzanne & Darcy said:
It’s possible she has pancreatitis. I hope not though. They could give her a Maropitant (Cerenia) injection (which burns so they should buffer it with some fluids when they give it) and send you home with some Cerenia. Then lots of fluids and pain meds if needed (hopefully Buprenorphine.). Have you ever given sub-q fluids at home? They could show you how. Hopefully she won’t need any of this.
I find Gerber Ham Baby Food is the most popular.
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I just tried to give her the Gerber Ham baby food and she turned her nose away. Right now she has a buffet of 5 different foods. Still won't eat. She hasn't eaten since last night. I hope it's not pancreatitis, too. We had a cat, Lorenzo, that had CKD and we gave him fluids at home, so luckily I do know how to do it if needed. He also had a bout of pancreatitis, an ulcer at one point, and went through the thyroid iodine treatment. He had a lot of issues but lived to be 19.
I hope it's not anything awful...
I'm worried about her. She is my absolute everything.
 
It’s such a worry. I hope you can get decent care at the urgent care vet. I really think you should take her. Has she been using the litter box regularly? No sign of constipation? She could not have eaten anything unusual like a plant or a foreign object?
 
Suzanne & Darcy said:
It’s such a worry. I hope you can get decent care at the urgent care vet. I really think you should take her. Has she been using the litter box regularly? No sign of constipation? She could not have eaten anything unusual like a plant or a foreign object?
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We are at the urgent care vet now! Right now she's getting bloodwork and a urinalysis just to check everything and once we see those results in ~30 minutes, as long as everything's normal, proceed with Cerenia, Zofran, and fluids. Her physical exam was great- heartrate, temperature, stomach all are normal. I decided to proceed on the testing just for peace of mind and they do it all on site. She didn't poop today but had a great, normal poop in the box this morning. I don't think she's constipated but definitely her belly hurts.... ugh. We'll see!!
 
Kate & Willow said:
We are at the urgent care vet now! Right now she's getting bloodwork and a urinalysis just to check everything and once we see those results in ~30 minutes, as long as everything's normal, proceed with Cerenia, Zofran, and fluids. Her physical exam was great- heartrate, temperature, stomach all are normal. I decided to proceed on the testing just for peace of mind and they do it all on site. She didn't poop today but had a great, normal poop in the box this morning. I don't think she's constipated but definitely her belly hurts.... ugh. We'll see!!
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Zofran! I love that. Most times I have to do a lot of convincing to get people to get Zofran from their vets — or more likely the vets aren’t familiar with using Zofran so they won’t write an Rx for it. It can be so much more effective for nausea (although it can be constipating.)
 
Suzanne & Darcy said:
Let me know whenever you can what they say. I know you have your hands full.
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We are home! The good news is that her bloodwork and urinalysis all came back normal. The vet was thrilled at the results. No pancreatitis, no ketones, no infection, kidney & liver values all normal. I have those results printed out and am going to add them to my SS. She also gained a little weight and is back to her pre-dx weight. She got the Cerenia, Zofran, and fluids there. They also sent me home with some Zofran pills they split up for me to give the next couple days and then as needed. We are home and she is already asking to eat, so I'm feeling hopeful that she will eat dinner as normal in about an hour when it's time for her routine. I really liked this urgent care, it was my first time there. They were super knowledgable with the diabetes and so kind.
The hard thing is that since she didn't have insulin this morning, you can really see the neuropathy. Her glucose was 422 at first, then bloodwork showed 499. Oof.
Hoping everything goes as normal for dinner + insulin soon!
 
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That’s such great news about all her bloodwork, etc. the weight gain is superb! I hope she ate well for you. I see she started out red, but I am happy to see that the insulin dose took her down to yellow a bit later on. I hope you are resting now. Talk to you tomorrow.
 
Suzanne & Darcy said:
That’s such great news about all her bloodwork, etc. the weight gain is superb! I hope she ate well for you. I see she started out red, but I am happy to see that the insulin dose took her down to yellow a bit later on. I hope you are resting now. Talk to you tomorrow.
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She ate great last night! This morning I could not get her to take the Zofran but she ate breakfast and is very alert. A yellow PMPS as well, which was a happy surprise.
 
Suzanne & Darcy said:
I wonder what in the world was wrong with her? She’s doing pretty well so far today. Blue! I hope for more.
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This poor girl. We went back to the urgent care this afternoon. Everything went normally this morning. Around 1pm she woke up from a nap and I noticed she had discharge coming from her eyes. It got pretty bad over the next hour or so and she was weak getting up. Her back legs were clearly feeling bad. And her poor eyes were so goopy. Took her in right away. They think the weakness in her legs is likely her neuropathy... I was very concerned about the eye discharge happening simultaneously. The doctor thinks they're likely not connected. And that maybe the stress of the emergency visit yesterday, missing insulin, etc was a lot on her body. So they landed on conjunctivitis. They gave us Terramycin ointment, I had them administer it right away while we were still there and then I'll give it to her in the morning/evening. The vet also prescribed a small amount of Gabapentin for me to try for her nerves... I'm hesitant but very curious about the effects it has on nerve pain from diabetes. I'm willing to do anything to help her. Tonight she ate dinner and we did the full dose of insulin. She had a yellow PMPS again which feels like progress. I'm wiping her eyes for her when she needs. She's acting like herself but just depressed. She's had a rough few days.
 
Poor Willow. She has had a few rough days. Stress really does affect them. I’ve seen it in my own cats. Eye problems especially. What is really effective for helping eye discharge is Viralys L-lysine powder mixed in food. I even use it in my ferals and it keetheir eyes healthy.

If she has neuropathy, are you giving her Zobaline for her neuropathy? It’s very effective.
 
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Suzanne & Darcy said:
Poor Willow. She has had a few rough days. Stress really does affect them. I’ve seen it in my own cats. Eye problems especially. What is really effective for helping eye discharge is Viralys L-lysine powder mixed in food. I even use it in my ferals and it keetheir eyes healthy.

If she has neuropathy, are you giving her Zobaline for her neuropathy? It’s very effective.
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Yes, she's been having Zobaline daily since December 14th. So it hasn't been terribly long but she has been consistently getting 1 3mg tablet per day. I give it to her in the morning and notate it in the spreadsheet in the notes. I'll look into the L-lysine! I think my Mom gives that to her FHV cat.
 
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