Hello... again

Hello all - it has been awhile since I have been on this forum and I am back again to try and get my darling Sushi back into remission for the second time. I have recently started the spreadsheet to help ppl here have more info to help. When she was initially diagnosed she was just past the threshold of being diabetic and we started at 2 units x day for a week and then gradually lowered to 1 unit x day - after 6 months the vet said she was almost in remission and lowered her to 1/2 unit x day, and then months later she advised 1/2 unit 1x day. She was good enough after 3 months to stop insulin all together! But after moving home for several months (Sushi came with me) to take care of my mom, Sushi started showing signs of pain and high blood sugar again. Read here.

Since the last post we have moved back to Minneapolis and she has been bouncing between 150-275 for the last 6+ months. I normally will give her 1 unit of Lantus, twice a day with her 10% or lower Fancy Feast Pate food. I was using a vial of Lantus that a friend purchased on Craigslist for awhile, and although the vial was dated as good until 10/2020, it seemed to be less effective in the past 6 months. As of 10/14 (beginning of spreadsheet) I am using a new pen that I received from my mother that is diabetic.

My concerns are:

1) She is in pain, not always but seems to be worse when she has high bs.
2) She has dropped a little weight.
4) She vomits frequently 2-4 days a week usually with hair in the vomit, but not always. She did get into a bad habit of eating my houseplants quite ferociously when she was high... but continued to vomit more then previously but less then when she was attacking my plants after I put them all out of her reach.

I brought all of this up to my vet - which was roughly less than a year ago - and the vet didn't know what was causing the pain and vomiting, but she didn't have any other conditions besides the diabetes. The doctor gave me anti nausea medication and a B vit supplement, neither seemed to help.

I am not able to afford bringing her to the vet right now, but I want to work to get her as close to remission again while I am saving for the vet. I was wondering if anyone had advice on what her pain might be coming from and why she is vomiting more often?

 

Bree, I expressed my concerns about pancreatitis, and I will say again, I am not experienced in this area. Your report of vomiting and pain just were red flags for me. I wouldn't venture to say for sure that this is what's happening.
Here is some information on pancreatitis:
http://www.felinediabetes.com/FDMB/threads/a-primer-on-pancreatitis.83108/

Tagging some members for advice and input
@Marje and Gracie
@Bron and Sheba (GA)
@tiffmaxee
@MrWorfMen's Mom

 

No worries, I understand and appreciate that you are sharing your experiences with me! I'm going to read up on it and see what I can do until I can get her to a new vet.

 

Perhaps smaller, more frequent meals with added water might help with getting liquids into her, plus cut down on any extra gastric juice build up that might also be contributing to the vomiting?

 

Hi Bree

Sorry you have to be back. Before I address pancreatitis or dosing, could we fix a couple of administrative things first? On her SS, upper right corner, “current insulin” would be Lantus and to the right of that, “dosing method” would be either SLGS or TR. In your signature block, the entire signature information is linked instead of just the SS. If you can navigate back to the signature block, click on the hyperlink and cut the SS link; then highlight only “Sushi’s Spreadsheet” in your signature block, then click on the hyperlink again, and paste the SS link into it, that will isolate just her SS to the link and not everything in your signature block. Thanks!

As you have surmised, it isn’t normal for a cat to vomit like she is doing; in fact, the current research shows that the old adage, “well, cats vomit; that’s what they do” is no longer valid. Cats should not vomit. Oh sure, a long haired cat might throw up a hairball but if it’s more than once every few months, there’s an issue.

There is no way to diagnose if pancreatitis is even potentially the issue without a blood test which is described in the post that Lou linked for you. Sure, you can treat symptoms but why spend the money to do that if you could be treating the wrong condition? There are many other health issues that cause vomiting and weight loss so you are just shooting in the dark with treatment if you can’t at least get closer to what’s going on. I know you said you can’t afford to take her to the vet; how can you afford not to? Any condition she has will get worse if not identified and treated. What are some of the potential issues that can cause her symptoms: pancreatitis, liver inflammation, hyperthyroidism, IBD; that’s the tip of the iceberg and they aren’t treated the same way. Ideally, you really need a superchem/CBC with a tT4.

I can tell you that her symptoms are not directly due to the diabetes. She “could” potentially have mild, chronic pancreatitis which could have brought her out of remission.

Insofar as dosing advice, you are hopping her dose around way too much. We don’t determine the dose based solely on a PS number. Having no tests at night means you are missing half your data. Regardless of whether you are doing SLGS or TR, we recommend that, at a minimum, you get (to the greatest extent possible):

• AMPS
• a +2 or “out-the-door” test in the a.m. cycle
• an “in-the-door” test in the a.m. cycle
• PMPS
• a +2
• a “before bed”

Remember that you have to build the depot with lantus so we recommend the starting dose be held 5-7 days unless she drops below 40 (she is not a newly diagnosed cat) if you are doing TR. If you are doing SLGS, you will hold the starting dose for a week and then do a curve; if she drops below 90, you would reduce the dose.

If you are doing SLGS, her starting dose would have been 0.5u assuming all dry food is out of the picture. For TR, the starting dose would have been 0.25u/kg of her actual weight if she’s underweight.

 

Thank you for responding with really great info. Although I don't understand some of the short hand you are referring to... I checked the glossary and can't find TR, but I don't think I'm doing SLGS (slow and low) now, I was in the past and now I test myself. If there is a document explaining this and the "AMPS..." I would be grateful.

As far as not having data for the evening, I do have it in the spreadsheet?

And right now I am unemployed and have a hard time feeding us both, so while I appreciate that you are being a strong advocate for my cat I hope you can understand that it only adds shame and really isn't something I don't already feel and worry about. But I appreciate you non-the-less!

 

I certainly do not mean to make you feel shamed and so sorry if I did. Have you checked into care credit? How about Diabetic Cats in Need? They can often help with insulin and diabetes supplies and, sometimes, with vet bills.

TR is Tight Regulation. The post regarding TR is in the same post as Start Low Go Slow. My apologies on that as well. I shouldn’t have assumed that because you’d been here before that you were aware of TR.

Insofar as pm cycle data, I only see the P.M. preshot and no tests after that. AMPS is A.M. preshot. Those are the tests you take before you shoot.

 

Hi Bree and Sushi
Sorry you are having to deal with FD again.

I agree with what others have said.
When does the vomiting occur?
Is it shortly after food intake or later?
How often do you feed Sushi? As Idjits Mom said, offering smaller more frequent meals may help.
My Harry was regurgitating his meals and I got a large plate and spread it around the plate to make him slow down and now he rarely vomits.

Do you have the house plants outside or still inside.?
Harry and my previous FD kitty Sheba are/were both ferocious plant /flower eaters. Many of them are toxic and will cause vomiting. I just had to get rid of all my indoor plants and flowers because no matter where I put them, they managed to get to them.

I would also encourage you to try and get some tests in during the PM cycle and to hold the dose for 5 to 7 days unless she drops low as Marje mentioned above.

I am sorry you are going through difficult circumstances at the moment.
Sushi is very lucky to have you!
Keep asking questions. We are very happy to help.