Switching from vetsulin to prozinc: Part 15

My last thread was getting a little long so it's on to part 15.
http://www.felinediabetes.com/FDMB/threads/switching-from-vetsulin-to-prozinc-part-14.177429/

Smoky vomited again this morning after receiving his second dose of chlorambucil this week. I gave him cerenia last night, when can I give him another pill for the nausea/vomiting?

 

Cerenia is a once a day med isn't it? I know it comes in different dose tablets. Aside from vomiting is he showing other signs of feeling worse from the chlorambucil?

 

He seems nauseous and a bit lethargic. He also has stools that are formed but soft. He now has more diarrhea and has large amounts of feces. Cerenia is a once a day drug. I'm wondering if ondansetron might be better for him. The cerenia doesn't seem to be helping that much.

 

Ondansetron might be better. I believe it's used in people for nausea caused by chemotherapy.

 

I've not been getting much sleep lately. I live 1 mile from a small airport and people are out on weekends trying to get their pilots license. The small planes are flying around all day long so it's hard to get any sleep during the day.
I'm going to try and get a long catnap in somehow.

 

My vet did say I could try the ondansetron if the cerenia doesn't work.
The cerenia helps with the vomiting but not so much with the nausea.

 

Hi Lisa, has Smoky been given any Cyanocobalamin? The other version of B12. Does Fortiflora work to get his appetite going? Guessing the probiotic method, over just adding for making food tastier, would benefit Smoky more.
I'm sure you've done your share of research but I was trying to find some ideas to help Smoky . Found this article: http://veterinarycalendar.dvm360.co...l-lymphoma-proceedings?id=&pageID=1&sk=&date=

 

Smoky does get vitamin B12 injections weekly. I just started giving them last Monday. Thanks for the link to the article. Going to try and get some sleep while Smoky is sacked out in his bed.

 

Enjoy your cat nap

 

Smoky and I took a 2 hour cat nap. I put his lunch in his timed feeder just in case I overslept.
The little stinker woke up 30 minutes before it opened and is being finicky with his food.

 

Smoky BG back up to 214 for AMPS. I gave him 0.8 units and will try to get in a +4 test today. He is hiding again and his appetite is down. The ultrasound results show that the lymphoma is diffused throughout a part of his intestinal wall. He looks at me with this dull look in his eyes. I think I heard someone on here explain it as the light going out of their eyes. The vet said to give him the bupe every eight hours if he needs it that often. I'm so very sad for my boy that he feels so crappy lately. I think I may end up having to let him go soon.

 

I'm so sorry you''re going through this, Lisa. We're always here for you.

 

Thank you Kris. I was up late with my boy so it's time for another cat nap for both of us. He had his second dose of chlorambucil but I honestly am not seeing much difference so far.

 

I recall someone here commenting that it can take a while to show its effect. Still early ...

 

Smoky was 102 for +4 test.
He didn't want to eat anything for lunch. I managed to get him to eat about a teaspoon of HC food and HC gravy. I had to take my mom for a Dr appt so won't be back until about 3. I left some LC food out for him so hopefully he will eat that later.

 

I'm so sorry to hear that Lisa. Remember that we support whatever decision you make.

 

Thank you Rachel. It's good to know I have a supportive network of people here with me.

 

Hi Lisa,
Just checking to see how it's going.

 

Hi Kris
Smoky vomited quite a bit today. I called his vet who wanted me to bring him in again. I don't trust this vet too much. She is always wanting me to bring him in all the time. She never talks to him or me except to ask what his symptoms are.
I told the clinic I didn't want to stress him out unduly and vet told me to skip his dose of chlorambucil tonight. She called in a prescription for ondansetron since the cerenia doesn't help that much. I think it's the chemo drug making him so sick. He is a cat who rarely vomits so for him doing so for three days is odd. It started the day after his first dose of chlorambucil May 9 before bed.
I don't think his prognosis is that high and he has been this way since beginning of year.

 

I wouldn't trust a Vet like that either, what I hear is "bring me more money" . But as I have said before I tend to approach Vets and human doctors with a negative perspective. They have to prove to me the actually care about our well-being before I even get to neutral with them

I hope the Ondansetron helps him better than Cerenia. It's so difficult seeing our fur babies not feeling well

 

Smokys original vet since he was a kitten is a terrific vet. However, he is an old country vet who was unable to treat Smoky for his advanced medical issues. He is the one who called me with Smokys ultrasound results and explained them to me line by line after his current vet sent him a copy. He will be the vet that I take Smoky to when it is his time to go. He called me now and again to see how Smoky was doing even after I couldn't go there anymore.

 

Sounds like a wonderful vet! It's too bad he wasn't able to treat these issues for you. I hope the ondansetron helps...let us know.

 

I hope the ondansetron helps. Unfortunately it sounds like this vet has all the compassion of a chunk of stone.

 

I pick up the ondansetron tomorrow. I just want to try and alleviate any pain or discomfort he is feeling

 

Smoky was 121 for PMPS, not sure if that's due to him eating less or not.
At least he doesn't have to deal with getting a shot tonight

 

You can both get a good night sleep tonight . Little break for both of you

 

I gave him the bupe last night and tonight. I may need to give it to him every 8 to 12 hours soon. He seems to be hurting more these days and the bupe really helps him. I've not been wanting to admit it but he has very little quality of life these days.

 

Oh Lisa! I'm so sorry to hear that. Know that you have our love and support.

 

If the bupe helps, I'd say go ahead and give it for now.

 

Thanks everyone for all your support.
It really does help.

 

Smoky amps was 159 and that's with a steroid last night and a little HC wet food for a treat. I wish he were doing as well in other areas.

 

Oops his BG was 149 not 159 this morning. I gave him 0.5 units plus left food down for him. I couldn't edit my previous post for some reason

 

Smoky BG up to 183 for PMPS. Oops, I left the dry kibble for my roommates cats down all day. think I shld give 0.6 units. Thoughts on that,? I don't want his BG to skyrocket later. He feels bad enough w/o adding that to the mix.

 

Whoops! I think that's fine, Lisa. just because.

 

Lol....I bet Smoky didn't mind at all! And really not a bad number considering he dined on contraband today!

 

Smoky BG at 136 for PMPS on 5/20 and that was at +13 hours.
I skipped his shot tonight. I could have given him 0.5 units but am really too tired to stay up and monitor. He needs a break too at this point.

 

It sounds like that was a good decision. And Lisa, I just read about your appointment with the vet in June. I'm so sorry. Sending you and Smoky our love, and prayers for peace.

 

I think you both need and DESERVE a break.

 

Smokys BG was 143 for am. I don't want to skip a shot twice though. I think if I give him 0.5 units he will be OK. Would it hurt him to skip a shot twice or not? I'm home today to watch him. He weighs 7 lbs 10 oz this morning by the baby scale I have at home. He weighed 7 lbs 14 oz last week on Sunday night. It's not good that he still seems to be losing weight.

 

I skipped his shot for am cycle since I fell back to sleep again and just woke up. Smoky is curled up in his bed and looks comfy so didn't have the heart to take him out for a shot.

 

I think that's perfectly fine Lisa. I know skipping sucks, but he is in lovely, healing numbers either way.

 

Smoky BG at 183 for PMPS tonight. I don't think that's too bad. He hasn't had any insulin for 36 hours now. I'm thinking 0.5 or 0.6 units for tonight's dose? He is busy eating his dinner so will give his shot after that.

 

That sounds good. And you're right - not bad for 36 hours without insulin! It's great to hear that he's eating well tonight, too!

 

I didn't think to ask the ER vet if it's OK to give him the prednisolone tonight. I mean since he had too much of the ondansetron already. He also gets his vitamin B12 shot before bed tonight, it's once a week for that.

 

Smoky seems to be getting worse fairly quickly. The chlorambucil is making him sick, he has vomited at least twice a day after taking it. This happens for a few days following the dose as well. The ondansetron doesn't help with the vomiting at all, just the nausea. The cerenia worked far better for vomiting.
It's scary to see him going downhill even though he is being treated for the cancer.

 

Smoky just made me smile I forgot to turn off the timer on his automatic feeder. He has a bowl of food out already but jumped out of bed and ran to the feeder to see if he had any food in there. I didn't put any in there today since I am home from work. He gave me this " where's my food look" so I just had to put food in there for him.

 

My current vet called me to go over various treatment options for Smoky. I told her I am planning on having him put to sleep on June 9. She asked me didn't I want to try different treatment options for him first? I said he is miserable and has very little quality of life. She said if I decided not to try all the options on him that was my decision to make. She is the one who told me he probably had 6 months to a year with aggressive treatments. I don't like the tone of voice she was using with me. I am doing the best I can for my boy and she made it sound like I was giving up on him.

 

Wow. Your current vet sounds like a complete jerk!!! Don't you listen to a thing she says. You are NOT giving up on Smoky...you are trying to give him the best life you can. When I let my girl go, it was because she was so sick and miserable and my vet straight up told me that I could try treatment...but it wouldn't work. The kindest, best gift I could give her was to let her go and be at peace.

She's right about one thing. It's YOUR decision to make...not hers. She isn't there with him every day. If his quality of life is gone, why would you continue to fight? You aren't giving up...you've given him a wonderful life full of love, laughter, snuggles, treats, and sunshine. You're now just giving him the chance to rest. If he's ready, and it sounds like he IS, it is the only kind thing to do. I've been there and I can tell you that while it HURTS, I have never once wished that I didn't let Gypsy go. I miss her and I always will, but I remember how miserable she was and how much she WANTED me to let her go. And it was possibly the most peaceful and beautiful moment as I held her and said goodbye. I'm grateful I was able to be with her and remember it, and I'm grateful I let her finally have relief from pain and sickness and misery.

Lisa, don't listen to that jerk. You're making the right decision for Smoky because you're making it out of love. And know that you have us, and we support you.

 

Thank you for your kind words Rachel and sharing your story about your girl.
Smoky is tired of fighting and being sick all the time. I have tried chemo drugs and all kinds of meds and they help but not all that much. The bupe and cerenia seem to help him the most. He is now losing interest in his food and for him that's a big deal. He seems to look forward to getting the pain meds. I think he figured out it makes him feel better. He runs to his chair when he sees me get out the syringe for him.
His old vet told me right out that even with treatment he wld not get better. He would recommend having him put to sleep if it were his cat. He has been seeing Smoky for 12 years since he was a kitten so I trust him and his professional opinion.

 

Amen to everything Rachel said. Exactly that. All of it. The decision you've made is an act of love.

 

The others here have said it all. You're doing what's right for Smoky and we support you completely.

 

Lisa be careful with that cat book link. May be sincere but that person just joined and has only advertised the sale of that book.

 

I thought about that as well. Thanks for bringing it up to me.

 

Smoky seems to have taken a turn for the worse. He was laying on his side in the hallway this morning. The vet thinks he has fluid building up in his abdomen.
I may need to take him in sooner than I had planned to. I made an appt for May 30 for his old vet to see him. I'm prepared to have him put to sleep the same day which seems likely.

 

I'm so sorry you have to see him like this, Lisa.

 

Smokys old vet was able to see him today. He thinks he will be OK until June 9 which was my original date to bring him in for euthanasia. He said to call him if Smoky gets worse and I need to bring him in sooner.

 

Lisa, I'm so so sorry you're having to go through this. I'm glad the old vet sounds willing to work with you and do what it takes.

 

Oh Lisa! I'm so sorry! Thank goodness for your old vet. He sounds like a really wonderful person.

 

He is a great guy, he didn't even charge me for the visit! He knows how hard this is for me. All the techs say Smoky is one of their favorites. I'm just so sad that this wonderful vet couldn't help him with his advanced health issues.

 

Smoky was 199 for PMPS which is not bad for 24 hours without insulin.

 

Smoky doesn't want to eat his regular low carb wet food. He was 153 for PMPS 30 minutes ago. I might be able to get him to eat a little high carb food. I don't know if I shld give him a shot or not?

 

If he doesn't eat don't give him a shot, but if he eats some food, and especially if it's higher carb food, you could probably give him a shot and be okay. It looks like you've given 0.5 on similar numbers.

 

At this point, Lisa, I suggest you feed him what he wants to eat and dose around it.

 

He was walking around crying so I think he is in some pain. I gave him some bupe and he is hiding under the ottoman. I ended up not giving him a shot tonight. The vet at the cat clinic called in a prescription for more bupe for him. I'll be picking that up tomorrow. I explained that I had made the decision to just let him go and needed the pain meds until June 9. I'm surprised she agreed to my request. I gave him some liquid budesonide instead of the pred in pill form since his stomach is bothering him.

 

Poor thing. I agree, just feed him whatever he wants...don't worry about carb level anymore. Since you've made the decision, I think you can just let him have whatever he wants/will eat and dose around it. Hope the bupe helps.

 

He came running out for his HC food so I ended up giving him 0.5 units of insulin. He was going to town on the Friskies gravy lovers with beef.

 

Once again, making him comfortable might in turn make you a little more comfortable, and enjoy the rest of your time together
We're here with you

 

Smoky BG at 186 for PMPS tonight. It's not too bad considering the NS this morning.
I'm giving him the prednisolone later as it seems to help with the inflammation.
Is 0.6 units too much of a dose? I'm trying to coax him to eat enough for a shot. I don't want his BG to go too high causing him to feel worse from high blood sugar.

 

I think 0.6 u can work.

 

How do I know how much he needs to eat for it to be safe to give him insulin? I gave him some bupe about 45 minutes ago. His normal shot time is about 30 minutes from now. He usually responds to the bupe in about 2 hours.

 

You've given 0.6U on similar numbers too .

 

I've read on some of the older posts that they just need to eat enough to show you that they are willing to eat. Then you just keep an eye on them and make sure they eat a little more before the +2 onset.

I've also read 1-2 tablespoons.

 

He ate about 1/4 of a small can so far. I have HC food to give him later if he needs to eat more. I'll give him 0.5 units tonight

 

Sounds good, Lisa.

 

I gave Smoky the prednisolone last night and he vomited it back up about 45 minutes later. Half of the 5mg pill was still there. I called the vet who said to give him half a mL of the liquid budesonide and see how he does on that.
He ate about half of a small can of food this morning, also gave him some bupe thus morning. My mom is there today to coax him to eat more later.

 

Smoky is still losing weight very quickly.
He is down to 7 lbs and I'm not sure how much nutrition he is getting from his food. The thickening of his intestinal walls from the lymphoma is causing problems with his digestion. He ate about 7 oz so far today. I'm afraid he won't make it until June 9 and I'll have to see if I can get him in on Tuesday or Wed next week. I don't know what to do here.

I can take him to the ER vet but they are strangers and I don't know if they follow the humane procedure of euthanasia. My old vet sedates them first before giving the final shot plus he knows them.

 

Oh Lisa, I wish we could all be there with you!

 

Oh Lisa. I think that if you ask, anyone will offer sedation. However, I think I might just wait and see if you can get it next week if you feel it's time to let him go now. Does your old vet by chance accept calls after hours? He might be willing to offer an opinion or maybe order something stronger for pain relief?

 

My old vet doesn't take after hours calls. This vet does do emergencies during work hours. He said to call him if I need to bring Smoky in right away. I wouldn't have to wait for an appt. Smoky did eat more after his pain meds kicked in a little. I think he gets worse at night. I'm debating on whether to give him insulin tonight or not. His BG was 158 and right now he is resting comfortably on my bed. His childhood vet said to just assess him each day and go from there.

 

Forgive me if this is too bold or improper but before you take Smoky in for that visit, I would think it's ok to give him his favourite meal / snacks and lots of hugs and kisses before he goes . He will already leave knowing how much you loved him , that is unmistakable

 

His vet said to give him whatever he wants to eat for now and just dose around his BG. He has been eating a little bit of HC food and it hasn't affected him too much yet.

 

I agree entirely. Give him anything he wants...dose around it but don't worry too much about it. Anything he enjoys/wants/likes, I say give it to him.

Did you decide to give him a dose? I think it would be fine to give or to skip.

 

I skipped his shot tonight. He was resting on my bed which is something he rarely does anymore. I didn't have the heart to disturb him to give him a shot.

 

How are you doing, Lisa?

 

I'm doing OK Kris. Smoky was bugging me this morning. He had jumped into the window and was pawing at the blinds. He wanted to sit in his window and sun himself. I gave him 0.8 units on a BG of 196 in am. He had eaten almost a 3 oz can of food this morning. He is back in his window again now. I was about to get in a +4 test but he just ate about 15 minutes ago.

 

I hope he continues to have a better day today.

 

I just gave Smoky a +4 test and am wondering if I shld check again later.

 

Hmmm...I might. Just to make sure that he doesn't drop too low.

 

Should I get in a +5 or +6 test? It would be food influenced either way.