11/8 Remi PMPS 61, +0.15 81,+2 85, +4 108

Hi everyone

This morning has been a nightmare. I work up and shot him at the usual time but he didn't seem interested so much in his food. I didn't worry too much as I know that as long as they eat within two hours it will be okay. He didn't look in such good condition but at that time in the morning. I wasn't really thinking too much. I gave him his Zantac and ondansetron and left him alone.

Anyway he hadn't eaten by +1 so I showed him his food and he promptly throw up liquid everywhere. So I gave him a quarter of an old cerenia tablet that I had along with some miralax and yesterday his poo seemed much harder than before and I wonder if he was constipated. I waited half and hour and then showed him the food again and he just threw up the liquid again. So at this point we have no food on board and it is +2.5

So I waited for thirty minutes and then retested and he was at fifty so I decided to make up his royal canin convalescence sachet and add homey to it. I syringed that into his mouth and it is now 10minutes on and will retest in another 10 minutes.

I think that if he keeps it down I will give another 5ml syringe along with his ondansetron as I am not sure if he kept that down.

He isn't in the meat loaf position or hiding but he obviously either has an upset stomach or is constipated. He started the potassium supplement kaminox two days ago and has been doing really well. It has a little bit of iron in it and as I said before when he went to the toilet it was much more formed than before, or maybe the supplement just upset his tummy as I think potassium supplements can do and I did give him a slightly increased dose yesterday. I won't give it to him today.

I really can't afford to take him to the emergency vet. Just yesterday I spent a lot of money buying allergenic sheets for the pillows, bed,etc to help his asthma. I just can't believe he was so good yesterday but today he has been so sick.

Any thoughts or help gratefully received. Does any one know how long it takes for tablets to be dissolved in the tummy?

Yesterday

AMPS 70
+2 61
+4 65
PMPS. 90
+2 59
+4 61

Re: 11/8 Remi AMPS 104, +2 63, +4 50-being sick

I'm sorry that Remi isn't feeling well. The iron can be constipating for sure. Cerenia pills can take anywhere from an hour to two hours to work based upon my cats. I would offer small amounts of food often and test every 30 minutes. If he drops under 50 you need to give him some honey or karo. I would put a few drops on his gums if he isn't eating. Since he likely hasn't hit nadir yet if he doesn't hold food down and drops at all I do think you need to take him to a vet.

Re: 11/8 Remi AMPS 104, +2 63, +4 50-being sick

Hi.

Thanks for your reply. I have been giving him the royal canin and honey and it has bought his numbers up. 3.0. Will convert
Over in a second. He seems to feel nauseous every time he goes to the toilet for a wee. I do wonder if he is constipated.

Will retest in twenty and post up all the numbers. So far he has has twenty ml of the liquid food and probably five drops of honey.

Re: 11/8 Remi AMPS 104, +2 63, +4 50-being sick

Does he have pancreatitis? I see you are giving him ondansetron. How much dues he get and how often? It can be given every 8 hours if necessary. Have you ever given him Miralax for constipation? I give Max 1/8 teaspoon every day. If Teminis badly constipated it might not be strong enough though.

Re: 11/8 Remi AMPS 104, +2 63, +4 50-being sick

I wish I could stay up with you but my back is killing be and its 2:38 in the morning here. I need to try and sleep. Someone on the east coast should be in soon.

Re: 11/8 Remi AMPS 104, +2 63, +4 50-being sick

He does have pancreatitis but normally I just give 1/8 of a tab twice a day to tide him over. This morning I gave him a quarter but not sure it was fully absorbed before he was sick. Was thinking about giving him some more at lunchtime. Another quarter maybe.

Yes with the change to wet food he hasn't needed miralax but yesterday I noticed his poo was a lot harder and darker again and though it might be the kaminox. Don't worry you go onto bed I will be okay.

Will write figures outin a second. Just trying to sort house out and a visitor is coming in a bit but at +5.45 he is 3.2.

Re: 11/8 Remi AMPS104,+2 63,+4 50,+4.45 45,+4 58,+4.45 54,+5

So I ended up giving remi 30 ml of royal canin sachet with honey. He didn't throw it up but equally he isn't his normal self. It is like night and day from yesterday when he spent hours cleaning himself and laying happily on my lap.

I am still unsure what is up with him possibly a bad reaction to the supplement kaminox?

So far today we has

AMPS 104 (1 unit given- minimal interest on food) given ondansetron and Zantac and miralax
+1 tried to show him food-he threw up the liquid. No obvious tablets in the liquid
+2 63 (gave 1/4 of an old cerenia I had)
+2.5 showed food-he threw up
+3 50 (gave 5ml liquid food with added royal canin )
+3.45 45 (gave 10ml liquid food with more honey)
+4 58
+ 4.45 54 (gave more liquid food and honey and miralax )
+5 106

So he is just resting now. I plan to give him more ondansteron in a bit and then leave him alone. I just hope that he recovers a little by tonight. But what if he doesn't eat again. I am not keen to leave him without his insulin and not eating. I am happy to give him the royal canin without the honey instead of his normal food so does that mean I can give him his insulin tonight?

Re: 11/8 Remi AMPS104,+2 63,+3 50,+3.45 45,+4 58,+4.45 54,+5

He has earned a reduction of .25 because he dropped under 50. When you post his PMPS NUMBER put a ? in the first the subject bar and dosing advice to find out how to dose then. I would ask your vet about possibly upping the dose of nausea medication. I give Max 2mg of ondansetron 2 times a day when needed. The oral Cerenia is not always well absorbed it has been proven so I thinknyou ate right about that.

Re: 11/8 Remi AMPS104,+2 63,+3 50,+3.45 45,+4 58,+4.45 54,+5

Thanks for your reply. But wasn't that low number just because he hadn't eaten much? Does that still count? He still isn't well. He hasn't thrown up again but is just sat in the meatloaf position on the bed

Re: 11/8 Remi AMPS104,+2 63,+3 50,+3.45 45,+4 58,+4.45 54,+5

For safety reasons when a newly diagnosed cat falls under 50 you need to take a reduction according to the protocol. I'm not at all comfortable giving dosing advice and we know ECID so ask for advice before your pm shot and see what the dosing advisors say. Actually I would mend your subject bar with a ? and ask for dosing advice now. That gives time for the advisors to see your post and reply before you have to shoot. I'm looking at all that green on your ss and if I were an advisor would reduce. You can go right back up if the reduction doesn't hold. See what Wendy, Marje, Julie or others more experienced have to say on the subject.

Re: 11/8 Remi PM dosing advice needed

Thanks once again

Okay so I need some advice about how I should proceed tonight. Remi's was in fine fettle yesterday but today woke up off colour. I gave him his 1 unit but then couldn't get him to eat al all and in fact he threw up two times. By +3 he got low and so I resorted to giving him royal canin convalescence sachet with added honey. I didn't give quite enough and so he dropped below 50. I contained to feed him until +12 with the same stuff but am not sure how to proceed tonight.

Remi is currently curled up in bed and I am not sure exactly what the issue is. Maybe the new potassium supplement flared his pancreas or upset his tummy and maybe the iron in caused some constipation. I really don't know and am worried about tonight. I will give him some more ondansetron about an hour before his dinner/shot time but I think I will continue to feed him the royal canin as I do to want to risk him throwing up again. Do I still give the one unit or because he went low do I drop to 0.75 even though the drop may have been exaggerated because of lack of food? I don't want to not give anything and his numbers to go sky high again..

Any advice gratefully received.

Re: 11/8 Remi PM dosing advice needed

I suspect you need to give Remi the anti-nausea meds about 30 min. before he eats. You may also want to talk to your vet about getting the ondansatron in the injection form. (It's a subcutaneous injection just like insulin.) Do you need a prescription for Remi's meds? The advantage of the injection form is that he can't throw it back up. Also, at least here in the US, it's a lot cheaper than the tablets.

I think this is a judgement call on the dose. I would see how Remi is doing at shot time and what the numbers are looking like. Does Remi have a history of ketones? If so, I'd hold the dose and if you need to give HC, I'd consider adding HC early. Given the pancreatitis and appetite issues, you may need to feed a higher carb food in order to make sure you are able to get insulin and food into Remi so ketones don't appear. If he doesn't have a history of ketones, you have more latitude to reduce the dose.

Re: 11/8 Remi PM dosing advice needed

Thanks Sienne

His blood glucose at +8 was 95

No he hasn't ever had ketones and I am paranoid about him getting them now. I still can't work out what went wrong. If the only thing that has changed is the supplementation do you think that would be a possible cause?

I was actually going to give the ondansetron about 45 minutes before food time and then not even offer him his normal wet. He really isn't right still. Hardly wants to walk anywhere won't look at me, etc :!:

Re: 11/8 Remi PM dosing advice needed

I have been able to control Max's nausea by giving him the ondansetron twice a day in pill form but a larger dose. He gets 2mg. How much are you giving? Some need up to 4mg and it is safe. I would either try the injections or consider giving a larger dose and ask your vet what he/she thinks. Also many find cerenia works better for vomiting and ondansetron for nausea. I know a lot about pancreatitis since Max has had it for about 5 years but am not yet comfortable with FD. I'm glad Sienne came on board to guide you. I'm sending feel better vines to Remi. It can take a lot of time and patience to figure out what works best for pancreatitis but usually once you figure it out you know what to do should there be future bouts. May I suggest you join the yahoo support group of p'itis? I'll send the link in a minute. Stacey and Maureen have helped me and taught me all that I know.

https://groups.yahoo.com/neo/groups/Fel ... pport/info

Re: 11/8 Remi PM dosing advice needed

Thanks. I am actually already a member if that group and yes they are great. As remi's last flare was a couple of years ago I don't post very often but still get their daily digests. I think I follow the usual treatment protocol except I don't give sub q's

I was hanging onto the hope that maybe it was constipation but I guess not. Normally I give remi 1mg of ondansteron twice a day but tonight I will up it to 2 mg. I wish I had some pain killers as he is in some discomfort but will phone the vets and ask if I can have some tomorrow. I really don't want him to be sick Again today as that always seems to make him worse so I think I will give the royal canin as it is piqued and can be syringed easily. Anything else I should be doing? Last time I had a bottle of buprenex and remi was also put on antibiotics as the liver was involved and he began jaundiced -cholangihepatitis.

Would you agree to best avoid the potassium supplement for now?

Re: 11/8 Remi PM dosing advice needed-PMPS 61

His PMPS reading is 61 . So I am inclined to reduce his dose to 0.75 units

He just went for a wee and then sat down in the little tray. Is that constipation?

Re: 11/8 Remi PM urgent dosing advice needed-PMPS 61

You are doing everything you can do. I do think more bupe might be a good idea. Are you giving him miralax? Max needed it when on ondansetron and then everything was fine until FD. Now I give him 1/8 a teaspoon every day. Many give it twice a day. Do you have any canned 100% pumpkin? A teaspoon of it once or twice a day might help. It works for both constipation and diarrhea strangely enough. Yes, I would avoid the potassium for now until this all gets sorted out. I don't like that he is sitting in his box and yes I think it could be constipation. When did he last poop? I also might consider not giving the insulin tonight but that is just me and I hesitate because I am not experienced enough to advise. Can you stall and see if he comes back up? The only thing is you need to stall without food so you know whether he is coming up on his own or because of the food. How long before he is due for his insulin?

Re: 11/8 Remi PM urgent dosing advice needed-PMPS 61

Overall, how is Remi feeling now? Is he still not eating? Throwing up? Yes, his behavior could be constipation, but it could also be other things, too, like a UTI or a p-titis flare. Unfortunately it's just impossible to tell for sure what's going on without a vetty exam.

In any event, Remi definitely earned a reduction yesterday no matter what; however, I'm inclined to agree with Elise about stalling and possibly considering skipping tonight, depending on if Remi is eating reliably and if he's throwing up at all.

Re: 11/8 Remi PM urgent dosing advice needed-PMPS 61

Hi

He has it anytime in the next 10 minutes. I would prefer to give him so something as I don't want to get into the ketone territory. I can retest in 10 mins and she where we are. I was going to assist feed him tonight.

He hasn't thrown up since the this morning but I. Don't feed him in the afternoon anyway. I thought he seemed a little brighter tonight.

Going to retest and see. I should be able to syringe feed him okay. Why does this always happen over the weekend!

Re: 11/8 Remi PM urgent dosing advice needed-PMPS 61

He's coming up now and is at 81 so will go ahead and give 0.75 units and will syringe feed him

Keep your fingers crossed.

Re: 11/8 Remi PM urgent dosing advice needed-PMPS 61

Ok - please keep us posted!!

Re: 11/8 Remi PM urgent dosing advice needed-PMPS 61

I do think that should be fine. Fingers and paws crossed. I'd get a +1 and +2 and see where it takes you because you will have the depot from the 1.0 working and it might take a few cycles to see if it is the right dose.

Re: 11/8 Remi PM urgent dosing advice needed-PMPS 61

Thanks for keeping an eye on me. I hate it when he is so ill. I get obsessive checking on him, looking at his eyes. I can't eat properly or think about anything else. I just hope it doesn't progress like last time but hopefully I caught it early and if need be I will throw the kitchen sink at it.

He is sat on the sofa now swaddled in a warm blanket.

Re: 11/8 Remi PM urgent dosing advice needed-PMPS 61, +o.15

Your welcome. You need to wait at least 20-30 minutes after eating to test to give the food a chance to see what it will do. Since I have a lot of data for Max I tend to check at +1 and +2 when he is lower than usual and if higher I wait until +2.5. You don't know yet about Remi but I think it does take at least 20-30 to see what the food will do and onset is usually between 2-3 for lantus. You are doing great!

Re: 11/8 Remi PM urgent dosing advice needed-PMPS 61, +0.15

Cheers

I just retested him at +1 and he is 85. So the food has risen him slightly and ofcourse I am giving what I would consider a high calorie food so am not surprised. Although it might affect his +2 readings I am going to give him another 10 ml as I want to make sure he has enough calories today and if I wait he might not.

Will still retest just after +2

Re: 11/8 Remi PM dosing advice needed-PMPS 61, +0.15 81,+2 8

It is fine to feed a little hourly. I do that with Max. It is not just the calories you are keeping track of but also the carbs. For example I gave Mac some 9% instead of 3 of 4% last because I dudnt want him to go too low like last night. I'm about to check now to see what that did for him.

So I tested Max and he dropped to 53. I clearly made the right call not to leave him this morning and the 9% might be enough but I'm not sure so I just gave him a spoonful of hc food and will check in 30 minutes or so.

Re: 11/8 Remi PM dosing advice needed-PMPS 61, +0.15 81,+2 8

Um I haven't worked out the carb content of the sachets but they must be high. At this moment I just don't want remi to be sick again and so am too afraid to try showing him his normal food. If I can just get him through to tomorrow I can take him to the vets and get him sorted and then I will get him back on track. I have to be so careful with remi's food as his has IBD.

Re: 11/8 Remi PM dosing advice needed-PMPS 61, +0.15 81,+2 8

I understand. You can always add karo or honey to the food if he drops too fast just like if he gets too low.

Re: 11/8 Remi PM dosing advice needed-PMPS 61, +0.15 81,+2 8

It's gone the other way and his blood glucose is now 119. Ofcourse that is about 1 hour after eating the high carb food. I might leave it for another hour and then see if he would eat some low carb food. Now I am getting worried the high carb is going to send him sky high! You can't win :roll:

Re: 11/8 Remi PM dosing advice needed-PMPS 61, +0.15 81,+2 8

if he's not able to eat the low carb it was fine to give him the high carb. you want to keep him eating, so that was a good choice. If his numbers go higher because of it that's ok - they'll come down when he's able to go back to LC.

It looks like you've gotten plenty of advice. If so, would you edit your subject line when you've got a chance? that way if you have a new question you can put it back in there & it will get noticed.

I hope Remi's perking up by tomorrow! It's scary when our little ones feel crappy.

Thanks Julie

His +4 reading is 108 and although he hasn't eaten for the last couple of hours I guess this is number is down to both the high carb food and the lower dose. I will probably just feed him a little again and go on to bed with him so thankyou to everyone who has helped get me through today.