01/25 Lucifer “Lucy” AMBG 291 +1 298 PMPS 333

Red83

Red83

Member Since 2023
Yesterday

Shot time is coming up 9:40 am Pacific. I think Lucifer has not eaten in 13.5 hours. Timed feeders went off 5:40 hrs ago but I have 2 cats and no way of knowing if he ate any or if he let the other cat eat it all. He has been given a low dose sedative (7:20) and anti-nausea meds (8:10). I gave the sedative as a routine anticipation of his shot time (currently being used to make the whole thing less traumatic). He was slightly lethargic pre-sedative (potentially due to minor lingering effects of sedative 12+ hrs ago). Really worried about the not eating and trying to tell myself he will inevitably and the anti-nausea will help.

With SLGS do you give the shot anyway if his numbers look good even though he has not eaten/is not eating?

Re-reading protocol not finding a definitive answer… And I guess I will post his # when I have it.

I gave the anti-nausea in the hopes it could stimulate his appetite before the sedative took full effect, but I think the sedative is already hitting full force. I did not give the anti-nausea med earlier because it is once per 24 hours and I have been trying to wait for a time that is sane for my life (not mid-sleep). I am seeing the sedative and waiting on anti-nausea meds as mistakes jeopardizing his health and am having a hard time letting go of that.

Some good news is I succeeded in many well-tolerated home tests while he was out yesterday and even one this morning without sedative, so maybe I short-circuited the learning/training curve for both of us on that one.

edit: Now I am remembering maybe I can just stall another couple hours until he eats to shoot if needed. I keep feeling like shot time is “do or die” hence high anxiety but I guess stalling a few hours is not all that bad, although disruptive. Right?
 
Red83 said:
Some good news is I succeeded in many well-tolerated home tests while he was out yesterday and even one this morning without sedative, so maybe I short-circuited the learning/training curve for both of us on that one.
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Very well done, happy to hear the testing is going well now. Hope he keeps this up, good Lucy boy :cat:. I seen in your other thread you made a "Kitty Burrito" lol. That can work well for some cats too! Good stuff.
(Sorry, Im not qualified to comment on the dosing time, or waiting a few hours before shooting, especially with the sedative/anti-nausea meds)
 
Thank you Melinda :) I don’t think you have any need to apologize. Thank YOU for knowing your areas of expertise and for the support. Every little bit is much appreciated. Congrats on your transition to LC FF, hope to get there soon!!


tiffmaxee said:
If you can get sone ondansetron it would be easier to give as you can give it every 8-12 hours. It worked well for my cat. Can you assist feed him if his BG drops?
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I will get some at the vet today. Yes every 8-12 would be more helpful for sure, thank you for explaining, makes it easier for me to pester the vet.

I have not assist fed before but I am open to anything and will read up now. One concern is it seems his throat/esophagus has been swollen/irritated, I would just need to know he is swallowing ok and getting it down. Thank you for the prompt to read up on that.

edit: I am not sure I feel comfortable shooting if he is not eating simply because in the past he has had BG nose dives….

edit2: His reading is 291. Reading through SLGS protocol again now on how to proceed (was doing TR but switched) while trying to entice eating. Very thirsty
 
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Pre shot reading 291 due 1 hour ago, 298 now, kitty not eating/hasn’t eaten for 15 hrs.

If anyone has some advice about any route to proceed that is relatively safe even if not optimal, please let me know. I am having a hard time thinking because my health has degraded.

“Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.”

I having a hard time understanding whether it is relatively safe to give a reduced dose because he has pretty much only ever been on 2.5/2.25.

I.e.
Is it safest to wait until he eats to shoot?
Should I be trying to assist feed him? (Will 15 hour fasting cause ketosis?)

I think we do not want to skip because DKA, and also want to give a good dose due to DKA.

edit: I reached my vet and got her guidance. I am syringe feeding so we can get his insulin shot in.
 
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I’m glad you are syringe feeding and are giving the dose of insulin. You definitely don’t want to be skipping with recent DKA. what dose of insulin did you give?
I’m wondering if the sedation you are giving him is making him too drowsy to eat.
Are you testing for ketones in the urine today?
you should be able to get Hills a/d from the vet which is a recovery food and easy to syringe feed. Cats also seem to like it so it might tempt him to eat.
 
Thanks for checking in.

I gave his usual dose 2.25 after seeing a raise in BGs to 333 after successfully feeding a small meal via syringe (4x meals/day, 2 small and 2 medium). I did test for ketones 2am negative yay! Thank you for the heads up on the diet! I will be at the vet today soon and will pick up the other anti-nausea med too.

After coming out of this “crisis,” here’s my working hypothesis: I think I put too much emphasis on the sedation as an issue. What is really happening is I am not getting enough sleep/self care time/was in a medical crisis before all this. Unfortunately when I’m down I tend to cope by looking for fault in my actions. Lucifer had appetite issues before the sedation came into play and you all have pointed out other evidence of nausea. (Also, the sedation doses I give are well below what the doc said they use for even a mildly agitated cat. I will still ask the vet.) The sedation has been necessary to avoid having to literally get on top of and pin down my growling cat for procedures, and has brought us 1. very well tolerated inhaler use 2. very well tolerated home testing and 3. Well tolerated injections. So maybe I was throwing the baby out with the bath water…

TLDR: I am sleep deprived and winging it the best I can. Thank you so much for everyone’s guidance! Hopefully today and tonight will be uneventful (food and Libre install).

edit: Being able to successfully end confidently home test has turned this from a serious nightmare to definitely more manageable. TY for the help!! At least if he gets low I can syringe feed.
 
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I’m glad things are becoming more manageable. It is very hard when things seem out of control.
Make sure you look after yourself as well.
I’m reassured with another negative ketone test. Thanks for putting that on to the remarks column of the SS.
And really good you gave him his full dose of insulin.
Try and get as much food as he will tolerate into him if you can. As you know it is food and insulin that will keep the ketones at bay. And fluids help as well.
Do you think he is well hydrated?
 
Red83 said:
I am sleep deprived and winging it the best I can.
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Oh yes!... the sleep deprivation and self care.... I think we've all been there, that will sort itself as you go. I too was off my head, and realizing I kept missing taking my own blood pressure meds! lol Who knew??
But as for winging it?. Well.... you're not anymore..... you are being methodical about it, learning and improving things each day. Baby steps get us all there. You are doing great Alex. As you said, testing is better little by little, injections are easier little by little... And now knowing you can syringe feed to keep him in safe numbers? What a success. You deserve a treat too! Give yourself a nice hot bubble bath, a glass of wine or chocolate or something? Hoomans need treats too! ;)
 
Just a quick note about the instructions in the SLGS dosing guidelines on shooting lower numbers. There is the first part that starts "Until you collect enough data to know how your cat will react" and then a section further down that starts "With experience, you may find that lowering these thresholds may work well for your cat." The good thing about having that Libre for a while is that it allowed you to gather all sorts of good data about what happens when you shoot lower numbers. People who have been on SLGS for a while eventually can shoot as low as 90 for a preshot. You aren't there yet, but just to give you an idea of what an happen in the future. Unfortunately Lucy hasn't been too cooperative in giving you a "normal" preshot value yet.

By the way, ondansetron can actually be given up to 3-4 times a day if needed, but hopefully that won't be necessary. If it's difficult to pill him with that, you can actually get an injectable which may or may not be easier depending on the cat.

I will note, you've been doing an awesome job testing him so far!
 
When my Jackson was just home from the hospital after DKA/diagnosis he didn’t really want to eat right. I had SO much trouble with nosedives and then high spikes due to not enough calories in him. My vet finally gave us a tube of Mirtaz (appetite stimulant/anti nausea). It worked wonders. It’s still been a long few months trying to get Jackson anywhere near regulated… still isn’t really, though in better ranges… but at least it got him eating and helped forestall both the nosedives and ketones. It’s just a gel that is rubbed in the bare skin of the ears, so easier than pilling! And once he felt better, after about a week he didn’t need it anymore.

EDIT: I just looked back at yesterday’s post, and realized you’re already using mirtazipine. So never mind! As for having a Libre, my opinion is: don’t be ashamed at needing to use it. Jackson also really hates having his ears pricked - I can get a couple tests a day without a fight if I push it, but that’s about it. So despite the cost (and I admit that is somewhat painful) I’ve made the decision to have him longer term on the Libre - at least until he’s frequently in the range it can’t read. It’s not exactly accurate once you drop into green numbers - but I have learned that it’s predictable in its variances, and have started a short-so-far chart (which you can see in a tab on Jack’s SS) for verifying what those variances are at different points down the scale. Which makes it more useable at least for SLGS, though not TR (impossible to get a reading under actual BG 80, which Libre reads as 40). But if the choice is to get shots in him without a battle, or to have to fight every shot and pill because of the ear pricks, I’ll skip the pricks if I can. There’s no alternative to the shot itself like there is the testing.
 
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Hey all, thank you so much for your responses. I know I posted a response to this but the gremlins must have eaten it up. I posted a new thread for today instead. REALLY appreciate the shares and support, I could not have gotten through all this without you!!
 
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