Need some advise asap about BG test & first insulin shots / food changes

Discussion in 'Feline Health - (The Main Forum)' started by TanyaG, Dec 14, 2016.

  1. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    You might find that the needle becomes less effective at getting blood if you use it too many times. Some people use them only once and some (like me) use then 2 or 3 times. I use them twice and clean off the needle with alcohol in between.
     
  2. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    That's not just OK.....it's really wonderful!! Great response so far (and I'm really glad you went with the .75!)

    We usually don't suggest reusing them.....this is why
    syringe after 6 uses.jpg
     
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  3. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Thanks so much everyone that is great news im so pleased! Also she uribated in the bin with the non absorbent beads from the vets so I just quickly dunked in a ketone test strip. I'll retest later when I have more time as rushing to an appointment but for now this is what I got. Looks like no ketones but med/high glucose?
     

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  4. Chris & China

    Chris & China Well-Known Member

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    YEAH for no ketones!!!

    It's normal to have glucose spilling over into the urine at this point in the sugardance
     
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  5. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Just to add that urine was probably from an hr or several hrs ago.
     
  6. Critter Mom

    Critter Mom Well-Known Member

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    So relieved to see that ketone result. Inasfar as it's possible to judge from photo on a PC screen it looks to be negative.

    The positive glucose test indicates that during the time between the previous pee and this one Tinka's BG levels were over the renal threshold - the point where glucose starts spilling over into the urine - for some, if not all of that time (impossible to tell definitively hence the need to monitor BG levels to get a better picture of what a cat's levels are doing at different points in the cycle).

    Given that you know from your vets that Tinka has tested positive for ketones it's important to still monitor once (or better twice) a day for the time being to make sure she stays clear of them; they can develop very quickly and unexpectedly. It's safer to incorporate ketone testing into a kitty's daily monitoring routine - especially kitties known to be ketone-prone as they tend to be more vulnerable to developing them again.

    You are doing great, Tanya! I hope you will be able to get some decent rest for yourself today.

    :bighug:


    Mogs
    .
     
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  7. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Another YEAH for no ketones! This is turning out to be a wonderful day for you and Tinka!
     
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  8. TanyaG

    TanyaG Member

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    Yah for no ketones indeed! I hope nothing contaminated the test. Is it ok to use those non absorbent beads for a home ketone test?
     
  9. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I think you can rinse them off, remove excess water and reuse them.
     
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  10. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I'm with Kris. As long as you are getting a clean sample each time, I can't see why the beads would have any negative effect on the ketone test results.
     
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  11. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Hi all please advise I just tested Tinka's BG at 7:30pm 12 hours after first shot and it is 4.1
     
  12. TanyaG

    TanyaG Member

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    Dec 14, 2016
    I just called vet about the 4.1 reading and he said not to give more insulin and to feed her. Do I feed her regular canned or high carb? I have a higher carb freeze dried treats so I just gave her some of those and now her regular canned food which she's eating some. She's more interested in the freeze dried treats as they more like kibble. But she should go back and eat more canned as she's been eating better past few days. Is 4.1 too low? Do I need to be doing something to curve things or monitoring? Thanks!
     
  13. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Thank you Mogs for this info. I just got home now at 7:30pm and tested Tinka after the 12 hour shot this morn and her BG is 4.1. I wont give any insulin but what should I do to help her? Thanks!
     
  14. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    4.1 is a safe (and wonderful) number! It's the same as 74 in our scale

    Sorry nobody got back to you sooner....if you need to get our attention, change your subject line to something like "PMPS LOW...SHOOT??" ......That way we know you're looking for help now

    In the future, what we would usually suggest is stalling, DON'T feed and test again in 20-30 minutes to see if she's coming up on her own

    Can we get you working on your signature and spreadsheet tonight? If you need help, feel free to send me a private message by clicking on my name and choosing "Start Conversation"
     
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  15. Chris & China

    Chris & China Well-Known Member

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    If you've already fed her, that's all you need to do....just test again (I'd suggest in an hour since you just fed her) and let's see where she's at

    If she dropped below 50 (2.8) that's your "time to act" number.....then you'd want to give something high carb (like the Fancy Feast Gravy Lovers or a couple of drops of Karo/honey/syrup) to bring her up again
     
  16. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Hi Chris,

    Thanks I will do that next time:) The last time she was fed was 2pm as I'm feeding her smaller amounts 4 times a day so she was due to be fed so I was worried she was crashing. Next time I will stall then and retest. I will try to do the spreadsheet now thank so much:)
     
  17. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Thanks Chris, she is still eating. As she doesn't have much of an appetite she kind of eats for a bit then wants to go hide under the bed. I have to keep mixing the food up or adding hot water to make it more enticing. Do you think its ok by the way that I'm adding hot water a few times to canned food? Just concerned about bacteria now. Then she loses interest. I try stroking her and then she eats a bit more. She didn't eat much of the salmon canned so I just tried some rabbit now and she ate a little more. Usually she's a big eater and very food motivated so this is only past month or two like this which is why she's lost weight. So do i retest in an hour if she's still grazing or do I wait till later once she's been finished for a while? Thanks!
     
  18. Chris & China

    Chris & China Well-Known Member

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    It's all good....you'll get a good feel for how much of a "food bump" she gets!! It all helps for those times in the future when she's lower than you're comfortable shooting
     
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  19. Chris & China

    Chris & China Well-Known Member

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    it's fine....a lot of us add a little warm water to our food to increase the amount of water they're getting as well as making it smell better. Have you ever tried feeding her from a spoon or finger feeding? Some cats seem to eat better that way (China is one of them who likes to eat directly from a spoon)

    Test about an hour after she started eating
     
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  20. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Thanks ok great she started eating at 7:45pm and its 8:30pm now so I will test her in 15 mins? She ran upstairs to hide under the bed again. I'd say she ate about half her food. Should I be concerned by the lack of appetite still? I thought with the insulin today she'd feel a bit better and her appetite would pick up. She's eating but not as much as I'd like and it takes a lot of work to get to her to each much. Its just so unlike her. She doesn't like spoon feeding that much. She'll eat a little from my fingers. Mostly the taking her there and stroking her seems to help, but she just eats a little then wants to leave. It takes her prob 2-3 hours to finish a meal.
     
  21. Chris & China

    Chris & China Well-Known Member

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    Is the food new to her? Since one of the first things we usually do here is change foods, it can take some time to figure out which ones they like best

    Have you ever tried FortiFlora? It's a powder that comes in individual packets that contains the same stuff that they spray on kibble to make it taste so good....it works on a lot of cats when they're not too thrilled with the food. You can get it from some vets offices or it's available on Amazon
     
  22. TanyaG

    TanyaG Member

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    Dec 14, 2016
    She was on a home cooked diet the past year of cooked pork balanced with Hilary's blend and cod liver oil. Then we switched to cooked duck due to allergies to see if her skin improved. She ate both and enjoyed them, always begging for more and still hungry and a bit overweight. Prior to this she was on kibble and canned but mostly kibble. But she was enjoying home cooked and we transitioned her off the kibble pretty well. Then two months ago she got switched to raw and got constipated on raw duck feet treats. She lost her appetite for duck and we needed something novel which I couldn't source to home cooked. So vet switched her to Rayne rabbit canned and it all went down hill from there. She was enjoying but lost her appetitie and started losing a lot of weight. At first I thought it was because rabbit is lean and this one had no vitamins or minerals. It was probably the diabetes progressing though. Then we switched her to Rayne maitaince kangaroo and she loved it and first but the barely ate much and detiorated more. That was prob higher in carbs. I tried to bring back the home cooked pork as that was always something she loved but she barely ate that past few weeks either. I tried salmon to and not much interest. Chicken liver is her absolute favourite and she'll barely eat that too. I tried tuna and she'll eat a little, mostly just the juice. Yesterday I switched her to Instinct venison and again as its new it excited her and she ate better yesterday but by this morning she's losing interest. I switched to the salmon and again not eating much. I think its not because she's fussy as we haven't seen this behaviour before I think its cause she feels so lousy she's lost her appetite. Is that common for diabetes? Does insulin help appetite over time? I feel her eating is not as bad as say 2 days ago since switching to the instinct but its def less than what she should be eating and drinking and she's underweight now.
     
  23. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Ok so I just did another BG test at 8:53pm about an 1 hr / 1 hr 15 mins after I fed her. Her reading was 8.3 mmol/L. She'd only eaten about 1/3 - 1/2 her food when I just took the reading. The food did include some freeze dried treats from earlier that may not have been low carb like the rest of her food as I wasn't sure if she was crashing. What are your thoughts on that 8.3 BG? Thanks!
     
  24. Chris & China

    Chris & China Well-Known Member

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    Well she's gone from 74 to 150 after eating.....that's a pretty good sized food bump.....when you have your spreadsheet going, you'll want to put what you fed over in the "Remarks" column for future reference

    I'd get another test at +3 and see how she's doing
     
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  25. Chris & China

    Chris & China Well-Known Member

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    Usually we see unregulated diabetics eating a lot more than normal because their body can't process the food and get the glucose into the cells without insulin....think of insulin as a "key" and on every cell in the body there's a "lock"....without the key, the glucose can't get in and just stays in the blood (so you get high glucose numbers)

    If she likes your raw recipe, have you ever tried getting kangaroo meat? I think @Wendy&Neko used to use kangaroo so I know it's available in Canada (but not sure about where you live)
     
  26. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Great thank you, I shall begin to work on the spreadsheet after some dinner, I'm starved ;) Ok thanks I will test again, is that +3 hours from the PMPS BG or +3 hours since I did the last BG?

    Is it normal for diabetic cats to have appetite loss? Does this improve after some time on insulin? Thanks again so appreciate your help! :)
     
  27. Chris & China

    Chris & China Well-Known Member

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    Since we live all over the world, we have our own way of telling time here.....You have the AMPS (AM Pre-Shot) and PMPS (PM Pre-shot)....and after that, we use the "+ system"....so if you get a test 2 hours after the shot, it's +2.....if you test 5 hours after the shot, it's +5......all the way up to +11 and then it's time for the next cycle

    Since you didn't shoot tonight, instead of a PMPS, you'd have a PMBG (PM Blood Glucose) but the times still work the same......so +3 is 3 hours after the PMBG test
     
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  28. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Yes that makes sense. She use to be like that a bit overweight and always hungry so I'm sure she's had the diabetes for some time. Especially since she was on kibble for about 5 years before we switched her a year ago. So far she's only eaten a little raw but not liked it that much. She also had some digestive upset as she has leaky gut so switching to raw may have to wait a little while. Thats great to know there is a Canada contact for kanagroo thanks! I think right now the biggest issue is that she must be feeling really unwell not to have her usual appetite. She's not excited or enjoying all her usual favourite things. We she didn't eat the liver I knew something was wrong and thats when we took her to the vet. I'm just hoping the appetite improves soon as it really is a challenge getting her to eat.
     
  29. Chris & China

    Chris & China Well-Known Member

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    No, not really, but ECID (Every Cat Is Different).....it's possible that she doesn't feel good and just isn't feeling like eating. It may improve as she gets better regulated, but it's not a sure thing

    Is she acting nauseous at all? Sniffing at the food and then walking away (a lot of times licking their lips) is a big sign of nausea
     
  30. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Thanks for clarifying, I'm learning a whole new lingo ;)
     
  31. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Sorry Tanya. Just seeing that you had to skip the shot tonight due to lower BG at the pre-shot check. Glad Chris was here to assist. That was quite the cycle. That means Tinka earned a dose reduction of 0.25u, so if she is high enough for a shot in the morning, you should take her down to 0.5u. Since she's still not eating as well as she should, that might partially account for that lower reading and the reduction may not hold as her appetite improves but for now better to be conservative about dosing. Of course you can post for guidance in the morning. Start a new post and include a link to this thread at the top and use the ? prefix on the title and call the post Dosing Advice Needed or something similar to get timely assistance.
     
  32. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Its possible she may be nauseous as she does sniff a lot and comes to the food but then walks away. I'm not sure about licking her lips but definitely sniffing. They gave her an anti-nausea injection on Tues afternoon but I didn't notice an improvement in appetite with that. Perhaps we could try a different type? Is nausea a sypmptom of diabetes? Thanks!
     
  33. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Hi Linda thank you for your message. Yes that was quite the cycle. Ok great thank you I will drop her dose to 0.5u then. So only if her BG is above 11 do I need to administer a shot?

    I tested her ketones earlier at about 8pm just after her PMBG and they were normal on my strip and the glucose was normal too so I'm assuming that is at least good.
     
  34. TanyaG

    TanyaG Member

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    Dec 14, 2016
    I have just taken Tinka's BG +3hrs 45min since her PMBG and it is 12.6 mmol/L. So thats risen quite a lot then?
     
  35. TanyaG

    TanyaG Member

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    Dec 14, 2016
    I'd get another test at +3 and see how she's doing[/QUOTE]

    Hi Chris, Tinka's PMBG +3.5 hrs is 12.6 mmol/L. So thats back up pretty high then considering she was 4.1 at her PMBG and she was 13.3 at AMPS. That will probably be my last BG for the night as we heading to bed shortly do you think thats ok?

    I don't think I'm doing such as great job with pricking her ear. I'm free handing and she keeps pulling her head when I prick her. Sometimes its not enough blood even with pumping it a bit so then i have to do it a second time which I feel awful about. You can see a lot of the places where we have pricked her today where there is some dried blood on her ears. I feel so bad:( She keeps looking at us nervously like we going to poke her again, poor baby. Is there info on here on how I can do it better? Is a lancet device easier to use? I just need to find a bigger size guage then. Currently I'm using syringe tops from vet - they called Terumo needle and its a 25G x 5/8". Is that a good size to use? Sorry for all the questions;) Thanks for your help!
     
  36. Chris & China

    Chris & China Well-Known Member

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    If it's above 200 (11.1) yes, you shoot....if it's below, you stall, don't feed and post for help....make sure your subject line is clear ...something like "STALLING, NEED HELP!!!" works....LOL

    That's great!! Means that since she last peed that her glucose pretty much stayed below renal threshold which is really good since kidneys are the hardest hit organ with diabetes. Renal threshold is the point where the kidneys can't handle the glucose any more and it spills over into the urine

    It's not a surprise considering she went as low as she did today and you skipped the shot tonight....that's 227
    .
    Whether you reduce or not will depend on which dosing method you choose.....the Tight Regulation Protocol or the Start Low, Go Slow method
    It makes a difference on dosing advice we'd give you. TR is the only protocol that's been published in a veterinary journal so it has a lot of science behind it, but it requires you be able to test a little more often than SLGS. It also gives the best chance at remission. We've had cats go OTJ (Off The Juice) on SLGS, but it's much more common on TR because you adjust the dose more often in response to the numbers you're getting.

    Some of the basic differences are:

    TR...dose adjustments can be made as often as every 3 days (6 cycles)...this is most effective because if they're staying in numbers we don't like, we can increase more often
    SLGS...dose adjustments are made once a week....this can be hard on the caretaker IF the cat is "stuck" in high numbers very long

    TR...reductions in dose are given if they drop below 50 on a human meter, 68 on a pet meter
    SLGS...reductions are given if they drop below 90 on either meter

    TR...You'll want to get the 2 PS tests and at least one other test....preferably at least 2 other tests.....One somewhere between +4 and +7 on the AM cycle and a "before bed" test on the PM cycle...if you can only get 1, the "before bed" test is most important since most cats go lower at night
    SLGS...You still must get the 2 PS tests in, and then do a curve once a week (testing every 2 hours for 12 hours or every 3 hours for 18 hours)

    I think considering this was her first dose, you'd be smart to go ahead and reduce to .5 tomorrow.....it usually takes 5-7 days for the depot to fill and to see how the starting dose is going to do, but with that big a drop today, I think it's best to start a little lower than the .75 for now
     
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  37. Chris & China

    Chris & China Well-Known Member

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    That's totally normal at first....you might want to use cotton pads or a folded up Kleenex to apply pressure for awhile after the poke to help the blood clot. Her ears will "toughen up".....also, as you poke more, new capillaries grow in and make it easier to get blood....we call it "learning to bleed"

    Are you warming her ear first? That's very important, especially at first.....and especially if it's cold out!! A little Polysporin with pain relief ointment smeared on thinly afterwards will help with healing too.

    Actually yes, that's a good size.....the lancet device may be helpful, but it takes some getting used to (for both you and the cat).....a lot of us freehand it instead of using the device. If you DO want to try it, if the lancets came with the device you have, they're probably 33 gauge which is very tiny.....We suggest using 25-28 gauge for "new" ears since it makes a bigger hole

    Here's where you should be poking.....along the edge, not directly on the vein.....there are very few pain receptors along the edges so it's not hurting her....she's just not used to having her ears fooled with so much. She will get used to it!!.....just make sure she always gets some kind of reward...whether you get blood or not! We say to try 3 times and if you still haven't got it, take a break and try again in a few minutes.
    sweet spot diagram.PNG
     
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  38. TanyaG

    TanyaG Member

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    Dec 14, 2016
    This is super helpful thanks so much!! Warming her ear only a little with a large wheaty bag so need to make a smaller rice one tmrw. Will post her AMPS test result in the morn before dosing:) good night :)
     
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  39. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Thank you for this info. So which one do you think would be best for Tinka the TR or SLGS? I like the sounds of the better options for remission with TR option and I'm committed to doing 4 tests a day. So if I drop to 0.5u tmrw morning can that work for the TR method? If she's anything above 11.1 then should I go ahead and shoot with 0.5u or do I need to post her AMPS result first? Thanks!
     
  40. Chris & China

    Chris & China Well-Known Member

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    Yes....usually we'd say not to reduce until she actually dropped below 50, but considering today was her first dose, I think it's best to go ahead and start at .5 instead and plan on holding that dose for several days and then we can re-evaluate (sure am glad you didn't go with the 1U dose!)

    If she's above 200 (11.1), go ahead and shoot the .5.....I'd plan on getting a +2 if you can too

    We've seen the +2 test can be a really good predictor for what the rest of the cycle is going to look like (some cats are better with +3)

    If the +2 is about the same number as the PS, it's usually going to be a pretty normal cycle....gradually down to nadir and then gradually back up to the next PS

    If the +2 is higher than the PS, that can indicate the beginning of a bounce....those are the cycles where it's usually going to be OK to take a break from poking so much (or get some sleep!)

    If the +2 is lower than the PS, that's your "Early warning" that tells you that you should plan on getting more tests in during that cycle

    Only if she's below 200 so that you can have someone signed on to watch out for you
     
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  41. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    Hi and welcome from the other side of the Rockies. I just got Chris's tag on the raw meats. I used to feed my Neko premanufactured raw food, including kangaroo. The manufacturer is Red Dog/Blue Kat Deli. They are made in BC. I don't know if you can get them in Banff, but they are sold in Calgary. I've seen a couple of other local raw food manufacturers sell kangaroo too. Plus I can get plain kangaroo at the local exotic meat butcher and I've even seen it for sale in the local Save On Foods grocery store. If she's off raw at the moment, there is a new brand of canned cat food called Koha that now is available in Canada, and they have a kangaroo pate that I believe is low carb. (also brushtail and other novel proteins). Ziwipeak is a good quality low carb canned food with rabbit, venison, and lamb options. Interestingly enough, both of those options come from New Zealand.

    It does sound like she might have nausea if she is sniffing and turning away from the food. If she got an injection, it was probably Cerenia and it lasts for 24 hours. You can also get Cerenia pills for administration at home from the vet. Another alternative is a medication called Ondansetron (Zofran) that can be given up to 3 times a day. But be warned it's really expensive in Canada. You get it from a human pharmacy with a script from the vet. Nausea by itself is not a symptom of diabetes, but there could be an underlying condition, pancreatitis is one example, often associated with diabetes and that can cause nauesa.

    If she likes tuna, you can get bonita flakes (dried tuna) and sprinkle them on the food. You can get them sometimes at pet food stores, or at asian grocery stores. I've also been known to sprinkle crumbled low carb freeze dried treats on top to get my furkids eating.
     
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  42. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Thank you SO much Chris for this informative response it's super helpful! I'll go with the o.5u if she's above 11.1, else I'll stall and post. I will try my best to get a +2 test tmrw and feedback :) Good night, chat soon:)
     
  43. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Hi Wendy thank you for this info:) It's super late here and got to be up early to take my fur baby's AMPS. I'll will write to you tmrw as would love to chat more about this. Thank you, good night ;)
     
  44. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Hi Tanya,

    Sorry I wasn't around last night to reply to your post (I'm in the UK) but you were in great hands with Chris.

    Tinka's responded really well to her insulin.

    Here are some helpful links for the eating issues:

    Nausea, vomiting and inappetence - symptoms and treatments

    IDEXX pancreatitis treatment guidelines (nausea is a big issue for pancreatitis kitties and there's very helpful info in this document)

    Crumbling freeze-dried treats on top of food can make it more appetising. While it's good to add some water to wet food, adding too much water can put a cat off (bit like soup that has been watered down to much is pretty tasteless to us, perhaps?)

    Ondansetron is an excellent med for managing nausea symptoms. It's usually dosed at 1mg BID for a 10lb cat but when nausea is more pronounced a dose of 2mg BID can work much better. It can take a day or two for the full benefit to appear. Cerenia in addition to the ondansetron over the first couple of days can work well.

    The other thing to watch for is any issue with gut motility. Because high BGs can affect the nervous system some cats can have motility problems which may then cause nausea. Is Tinka pooping well (frequency, stool consistency)? If she's slightly constipated or her stools are dry then addressing this may help with the nausea. If poor gut motility is an issue then treatment for a day or two with metoclopramide (Reglan) can help to restore better regularity. (Reglan is not a good med for cat nausea per se - they don't have many of the receptors it targets so not a substitute for Cerenia or ondansetron - and it is not a safe medication for long-term treatment because it has potentially harmful and irreversible side effects relating to dopamine and the nervous system).

    If constipation is at the root of the nausea it needs to be addressed first. Otherwise ondansetron and Cerenia will be ineffective.

    If an appetite stimulant is needed cyproheptadine is gentle with greater dosing control than mirtazapine (and it doesn't carry a risk of inducing serotonin syndrome).


    Mogs
    .
     
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  45. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Hi Chris, Tinka's PMBG +3.5 hrs is 12.6 mmol/L. So thats back up pretty high then considering she was 4.1 at her PMBG and she was 13.3 at AMPS. That will probably be my last BG for the night as we heading to bed shortly do you think thats ok?

    I don't think I'm doing such as great job with pricking her ear. I'm free handing and she keeps pulling her head when I prick her. Sometimes its not enough blood even with pumping it a bit so then i have to do it a second time which I feel awful about. You can see a lot of the places where we have pricked her today where there is some dried blood on her ears. I feel so bad:( She keeps looking at us nervously like we going to poke her again, poor baby. Is there info on here on how I can do it better? Is a lancet device easier to use? I just need to find a bigger size guage then. Currently I'm using syringe tops from vet - they called Terumo needle and its a 25G x 5/8". Is that a good size to use? Sorry for all the questions;) Thanks for your help![/QUOTE]

    One suggestion that might help if she likes to pull her head away: sit on the floor and put Tinka between your knees with her facing your feet and sitting upright. Now raise your knees and cross them to enclose her in that little space but don't squeeze her. Her head will be around the height of your raised knees and you can use your leg/knee position to restrain her head more or less as needed.
     
    Last edited: Dec 16, 2016
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  46. TanyaG

    TanyaG Member

    Joined:
    Dec 14, 2016
    Thank u Mogs. Will reply more soon. Just took Tinka's BG her AMPS and it is 17. Which is higher than yesterday's start which was 13.3. Do I still drop the dose to 0.5u?
     
  47. TanyaG

    TanyaG Member

    Joined:
    Dec 14, 2016
    Hi Chris
    Just took Tinka's BG her AMPS and it is 17. Which is higher than yesterday's start which was 13.3. Do I still drop the dose to 0.5u?
     
  48. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Hi Tanya, I think I would still stick with the 0.5u despite the higher pre-shot number. She had a very good drop yesterday but if she isn't eating well, you do not want to push this too fast. For now, until you know Tinka's appetite is improving, I'd be inclined to stay with the Start Low Go Slow method of dosing and she earned a reduction yesterday based on that method. Having skipped the shot last night, the higher AMPS is not unexpected at all so no worries. Once Tinka's appetite improves, you can switch over to Tight Regulation if you want to.
     
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  49. TanyaG

    TanyaG Member

    Joined:
    Dec 14, 2016
    Hi Linda thank you I have gone ahead with 0.5u. I will test again +2 and report back. So with tight regulation you wouldn't drop the dose then? Yeah her eating is not where I'd like it to be. She ate a bit better this morning though. Last night was only about half though. I just spoke to the vet and he wasn't impressed I dropped to 0.5. But that's my decision. He also suggested again that I can give her a 0.5 shot tonight without pre testing her BG. I would never do that, so dangerous. So glad I found you all on this forum! I asked for an anti nausea med but he says it's not nausea as she didn't respond to the one anti nausea injection they gave her a few days ago. He said she's probably formed a habit with food not being so nice as she feels unwell. I still would hv liked to try a different anti nausea though. My vet is sully more open to ideas but she's away for a few weeks. I asked for an appetite stimulant though and he says I can give Remron. Not sure if that's good or if I should try this for her? Thanks!
     
  50. TanyaG

    TanyaG Member

    Joined:
    Dec 14, 2016
    Thank you Mogs. I spoke with the vet this morning. I'm not really agreeing with much he says as he wants me to give Tinka her PM shot without doing a PMPS which too me is crazy to shoot blind. He asked how I was even able to do o.5u. I said by slowly twisting the syring you can get a drop out at a time, which I learnt from the video Chris shared;) He's a nice vet just pretty relaxed about dosing and BG testing. My vet will be back in s few wks so hopefully she's more on board, but regardless I'm so happy we went with all your advise to give 0.75u yest instead of 1u as Tinka may hv dropped to low then. With regards to the loss of appetite I do feel it could be nausea causing this due to the sniffing. I asked the vet is we can give her something for nausea but he said no he doesn't think it's nausea as she had one injection with I think it was cerenia on Tuesday but I didn't notice an improvement. Perhaps it wasn't given for a long enough period as I think the injection only lasted 24 hrs? I asked if we could give her something else but he says if Cerenia didn't work it's not nausea. I don't necessarily agree though Cause maybe it just wasn't used long enough or maybe a different kind would work better. Can ondanestron be bought without a script or not? The vet says she's probably gone off her food out of habit because she feels unwell from the diabetes. It's possible but if she's nauseas I would have liked to try something for a few days. I then asked if we could do try an appetite stimulant and he said I could pick up a script for Remron. What are your thoughts on that?

    Her bowel movements are currently good. In the past she's had constipation which def made her off her food but not for a little while. Last week one stool was a bit hard and then with food changes that went a bit loose for a few days. Since switching to Instinct canned 95% protein this Wed they have seemed more normal and consistent. Not hard, but maybe a little bigger.
     
  51. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Remeron is another name for mirtazapine. And seems to be the go-to appy stimulant vets prescribe first in Canada. It's always a good idea to get nausea taken care of first, then go for an appy stimulant. Nothing worse than feeling you have to eat and not feeling well. With Neko, often she would eat once the nausea was taken care of. Try asking the vet if you can get a prescription for ondansetron. Cerenia and ondansetron attach to different nausea receptors. One may work where the other doesn't. And yes, cerenia only lasts 24 hours. If you do need to go to an appy stimulant after trying nausea control, ask the vet if you can try cyproheptadine as per Mogs post above. Some cats have strange reactions to mirtazapine.
     
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  52. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    It has certainly been my experience that a Cerenia injection's nausea-reducing benefit peters out in 24 hours or less.

    I also don't agree with your vet. Ondansetron is a very effective medication for treating nausea in cats. Certainly in Saoirse's case I have found that it was more effective than Cerenia for her (though ECID - every cat is different); a dose of Cerenia might help her to eat provided I was able to give her some encouragement whereas with ondansetron once the effect kicked in she would tend to eat quite readily under her own steam. (Note: Cerenia may be more effective at helping with vomiting issues than ondansetron and it may provide some pain relief/anti-inflammatory benefit.)

    Not all vets are very familiar with ondansetron. I learned about it here but it took a bit of persuasion with my vets to get an Rx for it. Saoirse was the first patient at the practice to be treated with it. While our main vet was aware of ondansetron's potential to treat nausea part of his reservation about prescribing it was cost: the wholesalers used by the practice only offered Zofran, the branded version of ondansetron, which is very expensive - nearly £100 for 30 tablets. Fortunately I learned on Tanya's site about generic ondansetron which costs less than £10 for 30 tablets. (For anyone in the UK following this thread, Bristol Laboratories generic ondansetron seems to suit cats better than other generics. I found that other generics caused greater problems with constipation than the BL version. Pharmplex in Nottingham (online) is a good source for the BL generic; it can be problematic getting hold of the BL version from the likes of Boots, Morrison's and independent local chemists.)

    Cerenia (maropitant) and ondansetron work differently in the body.

    https://en.wikipedia.org/wiki/Maropitant

    https://en.wikipedia.org/wiki/Ondansetron#Pharmacodynamics


    Some members here have found that they can work quite well in combination. Here's a useful post on the subject:

    http://www.felinediabetes.com/FDMB/...ast-yesterday-help.166040/page-3#post-1796242

    NB: As touched on briefly above ondansetron can be somewhat constipating. In Saoirse's case I was able to address this by adding a little canned plain pumpkin to her meals. There is very useful information on bowel health at the following site:

    www.felineconstipation.org

    Good to hear that Tinka's bowel movements are healthy and regular. It's something worth monitoring because diabetes can affect gut motility (neuropathy). If the BMs start tending toward dryness and she becomes less regular it's good to take action to address the issue sooner rather than later; constipation can make a kitty feel crummy and the problem can see them become quite lethargic.


    Mogs
    .
     
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  53. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Thanks so much Wendy this is really helpful, I will ask my vet for the ondansetron rather than the remeron. Hopefully he complies!
     
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  54. TanyaG

    TanyaG Member

    Joined:
    Dec 14, 2016
     
  55. TanyaG

    TanyaG Member

    Joined:
    Dec 14, 2016
    Thank you Mogs we will contact vet and request a script for ondansetron then instead of the Remron. When we go to the pharmacy to pick it up do we just request the generic ondansetron their? What generic should we ask for? Or do you usually have to get it from the vets? Unfortunately Tinka won't eat pumpkin I tried it in the past. But I do have miralax for constipation if she gets constipated from the ondansetron? or I can try give her some coconut oil if she'll eat it? Thanks!
     
  56. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    In Canada, you need to get your vet to write a prescription for ondansetron and take it to a human pharmacy. Unless you vet clinic is associated with a clinic that has a cancer specialty, they likely will not stock it. It is also available in injectible form, which is really handy if kitty won't eat or is vomiting, (and cheaper) but I nevet managed to find a source for that. Be prepared for sticker shock. Each pill is around $4, but you dose either 1/2 or 1/4 tablet at once. Make sure you get a good pill cutter if you don't have one already.
     
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  57. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Remeron is the brand name for mirtazapine. Some cats get on well with it but I don't like it for a number of reasons:

    1. It carries the risk of inducing serotonin syndrome, a potentially life-threatening condition. (For info, the antidote is cyproheptadine).

    2. It is usually administered at a tiny dose once every three days in cats. You can end up with a kitty utterly crazed with hunger for the first 36 hours but then need to do a great deal of coaxing at meal times for the following 36 hours until it is time to give the next dose.

    3. Mirtazapine can cause anywhere from moderate to severe behavioural alterations in cats. It's nicknamed meowzapine on FDMB because it can cause a marked increase in vocalisation in many cats (moderate side effect) but it can also cause cats some cats to display severe agitation and aggression.

    4. Mirtazapine is an extremely powerful psychotropic drug. I have PTSD and it was prescribed for me some time ago. I have been prescribed umpteen psych meds since I developed the condition, some of them quite heavy-duty and all of which had some side effects - some mild, some not so mild - but none of them could hold a candle to the awful side effects I experienced as a result of taking this med. I stopped taking it after only the third dose because it affected my mental state and nervous system so badly that I genuinely thought I was going to become completely unhinged (no hyperbole). Without a doubt it stimulated my appetite but it caused I also developed GI issues and peripheral oedema (my normally very trim ankles swelled up like balloons).

    5. Saoirse received one dose of mirtazapine when she had her first pancreatitis flare because it was all the vet had available at the time, she hadn't eaten anywhere near enough for several days and consequently was at risk of developing hepatic lipidosis. After experiencing the adverse effects of the drug myself I was not happy about Saoirse receiving it and if it had not been a life-threatening emergency I'd have waited until I could secure some cyproheptadine for her. The mirtazapine got Saoirse eating but within a couple of hours of dose administration she became borderline psychotic; she was like a completely different cat. The whole experience was very distressing for both of us.

    Provided it's not contraindicated for a particular cat (and as long as it works) I consider cyproheptadine to be a better med for managing poor appetite. An antihistamine, it doesn't carry the risk of inducing serotonin syndrome or the unwelcome behavioural side effects that may accompany treatment with mirtazapine. Cyproheptadine's appetite stimulant effect is milder; on cypro the cat wants to eat more frequently but other than that tends to exhibit fairly normal hunger behaviours levels cf. the crazed, prolonged hunger that mirtazapine may induce - especially in the hours immediately following administration of a mirt dose). The cypro appetite stimulant effect wears off relatively quickly. This is not a disadvantage; an appropriate dose of cyproheptadine can be given 2-3 times a day which means that you can fine tune the level of appetite stimulant effect to match a cat's specific needs.

    One note of caution: some vets may prescribe too strong a dose of cyproheptadine. It can take as little as 1/8 of a 4mg tablet (10lb cat) to provide adequate appetite stimulation for many hours. If the dose is too high for the cat it may become sedated (rather than a little drowsy) or show signs of depressed mood. If such side effects are observed, reducing the dose - sometimes to just a tiny crumb - may be just enough to get all the benefits and minimise or eliminate the side effects.


    Mogs


    EDITED TO ADD:

    IMPORTANT SAFETY NOTE!

    Possible Adverse Drug Interaction


    Tanya's Site has a warning that using both ondansetron and mirtazapine at the same time may increase the risk of inducing serotonin syndrome. See following link for further details:

    http://felinecrf.org/nausea_vomiting_stomach_acid.htm#ondansetron

    .
     
    Last edited: Dec 16, 2016
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  58. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    :eek:

    Is that for the generic or for Zofran, Wendy?


    Mogs


    (And sending you some :bighug::bighug::bighug: - you're in my thoughts and prayers.)

    .
     
  59. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    NB: Ondansetron treats nausea (alternative/adjunct treatment is Cerenia); Remeron = mirtazapine - used to stimulate appetite (alternative is cyproheptadine).

    IMPORTANT SAFETY NOTE:

    I've added a little more info to one of my earlier posts on this thread (see above). Tanya's Site has a warning that simultaneous treatment with ondansetron and mirtazapine may carry an increased risk of inducing serotonin syndrome.

    For information, I only treated Saoirse simultaneously with ondansetron and cyproheptadine.

    I'm in the UK. I get a written Rx from our vets and fill it at a human pharmacy. On the written Rx my vet has to specify that only Bristol Laboratories ondansetron is to be dispensed (otherwise the pharmacist would be free to substitute another ondansetron version at his discretion). I don't know whether the BL generic is available in your part of the world. Perhaps you could enquire of your local pharmacist as to which generics are available in your part of the world.

    Miralax works well to soften stools. Slippery elm bark may also be worth investigating as it, too, can help with constipation (and diarrhoea/nausea).


    Mogs
    .
     
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  60. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    BTW if your vet refuses to accept from you that ondansetron is a good anti-nausea med here is a legitimate professional reference which recommends it as an appropriate and effective treatment option for managing nausea in cats:

    IDEXX Laboratories - pancreatitis treatment guidelines


    Mogs
    .
     
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  61. TanyaG

    TanyaG Member

    Joined:
    Dec 14, 2016
    Thank you Mogs:) My hubby is waiting for the vet to call him to request the ondansetron. I've given him all this info so hopefully the vet agrees. Do you know what the generic name is that BL gives you? I will speak to the pharmacist to see if they can give us that one if it's available. So with other generic types is there risks of side effects?

    Should we be looking at the root issue of the nausea/loss of appetite too rather than just the symptoms? Can nausea/loss of appetite just be from the root cause of diabetes and them feeling unwell? If not if there is another sickness going on would that have shown up in her blood work or do we need to do another test for that? For example pancreatitis of hepatic lipidosis? Vet said her pan tease was fine but I think we discussed that her ALB was pretty high. Just wondering if I need to be addressing this too.

    I do think the ondansetron is a good idea and I def won't put her on the remeron or any appetite stimulant. THe only other prescription med she's on outside of the insulin is steroids. She's currently on 1/8 tablet once a morning. Hope the Ondansetron is OK to take with steroids? Thanks so much for all your help ur all so wonderful!!!
     
  62. TanyaG

    TanyaG Member

    Joined:
    Dec 14, 2016
    Ok so Tinka's approx +7 reading is 12.9 mmol/L. So that's gone up slightly. Is that ok? She's not dropping as much as yesterday which in one way I assume is good so she can likely get her insulin tonight after checking her PMPS.

    However she didn't go into the normal 4-9 mmol/L range is that ok? She's actually eating better today for first time in months. She finished her breakfast and lunch! Hope she keeps this is for dinner and her last meal before bed. If not the vet is giving us a script for Ondansetron which I'm really pleased about! Will be good to have it just incase her appetite is still off. Also she's not hiding under the bed and seems a bit more herself yah! :)
     
  63. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    It's early days for you and Tinka. Her dose will likely have to be adjusted upward slowly. Have you read the two Lantus protocols, SLGS and TR? Which one are you planning to follow? I would be a good idea for you to post on the Lantus forum asking for advice.
     
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  64. TanyaG

    TanyaG Member

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    Dec 14, 2016
    The vet said he believes the ondanestron generic is called Zolphan (not sure of the spelling). Will speak to pharmacist to compare prices. Does anyone know if Zolphan is a good one or used it before? Thanks!
     
  65. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    The correct name is Zofran. Ondansetron is the generic version and, apparently, quite a bit cheaper.
     
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  66. TanyaG

    TanyaG Member

    Joined:
    Dec 14, 2016
    Thanks Kris I will have a look for the Lantus protocols. Do I just search for Lantus or where is best to find these? We are currently working on our spreadsheet:) I'm not sure which protocol to follow. I like the concept of the better rates of remission on TR. But want to make sure Tinka is safe. I'm open to doing either. Not sure which is best for her this is all so new..thoughts?
     
  67. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    If you go down the list of forums to the specific insulin forums, you'll find the Lantus/Levemir groups. There are Stickies in there to read. Those people can give you good info about maximizing Tinka's chances of remission.
     
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  68. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    The drug itself is called ondansetron. The branded version of ondansetron is Zofran and IIRC it is manufactured by GlaxoSmithKline.

    Various other pharmaceutical companies manufacture their own generic versions of the drug under licence. To the best of my knowledge all of them are just called 'ondansetron'.

    In the UK there are several versions of ondansetron produced under licence by various manufacturers. Bristol Laboratories manufactures the one that I've found to be less constipating. I don't know whether or not it would be available in your part of the world. Perhaps if you ask your local pharmacist they might be able to advise on which manufacturers produce the ondansetron available in your country.

    That's a question for your vet. If s/he isn't sure then again your local pharmacist may be able to advise you on potential drug interactions/contraindications for simultaneous treatment with ondansetron and the steroid Tinka is currently receiving. (Historically I have found pharmacists to be much more knowledgeable than vets when it comes to looking for more detailed information about medications; it is their specialism, of course!)


    Mogs
    .
     
    Last edited: Dec 16, 2016
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  69. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Ah right thank you for clarifying :)
     
  70. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Thank you that makes great sense :)
     
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  71. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Excellent plan. Having a squirrel stock of anti-nausea meds, etc., at home is invaluable because you can tackle nausea issues as soon as symptoms appear. By doing so it tends to resolve much quicker and, in my experience at least, significantly reduces the risk of a kitty becoming completely inappetent.


    Mogs
    .
     
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  72. TanyaG

    TanyaG Member

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    Dec 14, 2016
    So update on Tinka her PMPS was 13 mmol/L at 7:30pm. I gave her 0.5u insulin at 7:45pm. I will test again +3 and +4. Do you I need to set an alarm for over night or not? Does that depend on her +4 results? Pretty exhausted but if I need to I will.

    Her eating has improved a lot today, she had eaten almost all of her 3 meals so far and has one more to go. Not drinking much though but I'm adding water to her canned. She's been showing more interest in food too in general which is so great. I did notice though her stools were a bit constipated. I have put a little coconut oil out to see if she eats that. If not I may add miralax to her food but I am concerned it may put her off eating.

    Also what dose must I give tmrw AM if her AMPS is above 11.1, do I stick with 0.5 or what is best? Thank you!
     
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  73. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    You're just starting Lantus so you have to hold the dose 5 to 7 days.
     
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  74. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
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  75. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    Here is a list of potentially available ondansetron in Canada. http://www.rexall.ca/articles/drugs/?q=ondansetron

    Pharmacies do not carry all brands. They will have the brand name and one generic (the one they get the best deal on or the one designated by the provincial drug plans).
     
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  76. TanyaG

    TanyaG Member

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    Dec 14, 2016
  77. TanyaG

    TanyaG Member

    Joined:
    Dec 14, 2016
    Thank you for your msg:) My vet sent my script to Rexall and Banff for the generic odansetron. I'm not sure which Ondansetron it is but the price was really expensive $128 for 30 tablets. As I don't need that many and I'm not even sure they'll work for Tinka so I asked if I could get less. He said for 5 tablets it would be like $52 which is just over $10 a tablet which is super expensive! What quantity and price did you get yours for? I may try to find them cheaper at another pharmacy.
     
  78. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    You can get them from Marks Marine Pharmacy in Vancouver for a lot less so I'd shop around

    Here's Odansetron at Marks
     
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  79. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Thank you thats great to know, I shall def shop around ;)
    Cant believe how much cheaper it is than rexall's here thats crazy! I could order double the amount plus expedite still for less! Hopefully I can find some here though. Have you used them with good success? I see you China struggled with weight loss in the beginning too. Did she have loss of appetite? Tinka's appetite has picked up so much today its amazing and she's much more social:) Hoping I wont have to use these but I'd like them on hand in case.
     
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  80. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    No, China was eating like a horse but still losing weight....that was one of the things that sent us to the vet for the diagnosis.....I was really thinking she was probably hyperthyroid so when she came back diabetic, I was shocked

    If you click on the link to China's profile in my signature, you'll see where she started

    Now she's uhhhh...."too fluffy" and we're trying to get her to lose weight again!!
     
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  81. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Great link!

    @TanyaG - FYI, I only recognise one generic on the list - Teva. It was a tad constipating (pumpkin helped Saoirse with this but I got her back on the Bristol Laboratories generic very quickly).


    Mogs
    .
     
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  82. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Glad to read that Tinka's eating better! And, better again, that she's feeling brighter. (((Tinka)))

    :bighug:


    Mogs
    .
     
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  83. TanyaG

    TanyaG Member

    Joined:
    Dec 14, 2016
    Thank you Mogs! Can insulin be constipating? I've noticed Tonls is s little constipated past day or so buy I'm thinking its from the dryness of the freeze dried treats and just still not drinking that much. I'm trying to reduce the treats but I'm using them as rewards of her BG tests and we doing a lot of them currently. Also sprinkling over her food to encourage appetite. So I added a little miralax into her food, only cause I know she's fussy with pumpkin.

    Is there a list of low carb foods somewhere on the forum? I checked out the Binky's lost and the info is so great but I can't find any of Tinka's foods on the list. I'm currently feeding her Instinct 95% protein which I'm assuming is the now carb but it does have peas & carrots in plus pumpkin listed further below etc. Hoping its no more than 5% carbs but I'm not sure.
     
  84. TanyaG

    TanyaG Member

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    Dec 14, 2016
    Thanks Mogs me too! She woke me at 6:40am which is earlier than normal, purring and asking for food:) Had to make her wait till 7:30am to do her AMPS which was 15.4. Fed her then gave her 0.5u at 8am. Do the BG's & shots get easier over time? I still struggle thinking I'm hurting her. The shot we actually doing pretty well, but the BG's we often poke through and don't get enough blood. I guess it's just practise. Warming her ear def helps:)
     
  85. TanyaG

    TanyaG Member

    Joined:
    Dec 14, 2016
    Great to hear she picked up weight! I looked at her profile she is so cute! I better watch Tinka's weight too she looks like she's picking up which is good as she's still underweight but I can see how if she keeps eating well I'll have to watch her calorie intake. I see you feed natures variety frozen raw, was that hard to transition to? Do you mix it with canned or feed separately? I'll def keen to transition to raw once she's stabilised if she'll eat it hopefully.
     
  86. TanyaG

    TanyaG Member

    Joined:
    Dec 14, 2016
    Great thank you I will hold her dose of 0.5 then for 5-7 days :)
     
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  87. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    It's important that you go read those Stickies on protocols to use with Lantus, Tanya. Sorry to sound like a nag ... ;)
     
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  88. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Here are some things you can do to help us help you and Tinka, Tanya:

    It would be very helpful to readers of your posts if you could go into your signature and add details about Tinka like:
    • her age
    • date of diagnosis
    • any other health problems she has/meds she's on
    • insulin you are using
    • what glucose meter you are using at home.
    This way, you won't have to keep answering the same questions about these basics.

    I would also strongly encourage you to set up a spreadsheet for Tinka so viewers of your posts can see her BG data and be better able to offer advice. You can find instructions for the SS on the main page's list of forums in the "Suggestions and Tech Support" forum.

    You have several threads running right now and this one is very long. I think it would be helpful to run only one thread in the main health forum at a time and make a new one once you're getting beyond a few dozen posts. This is the place to post an initial summary about your kitty or to ask specific questions that you want more attention on - eg. something you need to know right away or, especially, a 911 emergency notification. There are info stickies about all of this listed in the forums on the main page. I know it's a lot to take in all at once but you want to get the best bang for your buck while you're on here. :)

    The best place for you to post for insulin advice is in the Lantus forum. Those are the folks who can give you specific info on any aspect of Lantus.

    Sorry if I sound bossy - don't mean to. I just want you to know how things work so it's easier for you. :cat:
     
    Last edited: Dec 17, 2016
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  89. TanyaG

    TanyaG Member

    Joined:
    Dec 14, 2016
    Thanks Kris, I will try and work on adding those details into my signature and putting my numbers into my spreadsheet. To be honest it's been a exhausting wk. I've not slept much and trying to find out all this info and care for Tinka along with my own chronic health issues and busy schedule has been a real challenge. So much to learn and want to make sure I'm helping Tinka in the best way but also trying to find the balakce of caring for myself cause iv not been doing much of that this week. I started on the Lantus forum this morning reading the stickies thanks so I will post in there soon. I will start a new thread if there are further discussions on this thread. Thanks so much for all your help it's much appreciated:)
     
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  90. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Take your time getting all this organized, Tanya. I know how overwhelming it is and I sincerely apologize if it's felt like I'm pressuring you. :)
     
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  91. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I know what that's like, Tanya. I feel for you.

    :bighug::bighug::bighug:

    The early days after Dx can be utterly overwhelming but things will get better as you start developing a routine that works for you and for Tinka. Promise.

    You're doing great. :)

    :bighug:


    Mogs
    .
     
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  92. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    There is a more up to date list for manufactured foods and their carb counts here. Not all brands are available in Canada, but the majority are.

    @Critter Mom - The Canadian price I quoted earlier was indeed Zofran. I only bought a few tablets at a time and was lucky enough to receive the legacy of more from another kitty.

    Tanya - good to see you've got the spreadsheet up and linked. Once you get the numbers in there, we'll be able to give you suggestions on dosing and maybe even ideas on when to test. Most cats have patterns to their blood sugar numbers, and once you learn those, it helps you predict when you have to test, and most important, when you can take a break. For now, it's good to get a handle on when her onset is (insulin actions starts, usually around 2-3 hours after the shot), and when the typical low point, or nadir is in the cycle. We figure out dosing based mostly on that low point. And yes, to reiterate Mogs, the first couple of months are like information overload and exhausting, but it does get better and we'll help you to help Tinka however we can. :bighug:
     
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  93. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Tinka has beautiful markings! :)
     
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  94. TanyaG

    TanyaG Member

    Joined:
    Dec 14, 2016
    Thank you Mogs I appreciate your words of encouragement! :)
     
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  95. TanyaG

    TanyaG Member

    Joined:
    Dec 14, 2016
    Thank you so much Wendy appreciate all your help and support too! @Chris & China actually helped me with my signature and spreadsheet which is super helpful! Going to input my numbers right now. That will be really great to get more suggestions on dosing and testing thereafter:) Thank you!
     
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  96. TanyaG

    TanyaG Member

    Joined:
    Dec 14, 2016
    Thank you Kris, yes she's a very pretty girl! I have updated my signature and spreadsheet :) She hasn't had much noted reduction today from AMPS to +6. Let me know your thoughts. I can take her BG again at +10. I will start a new thread.
     
    Last edited: Dec 17, 2016
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