*+10 BG reading "HI" + 598* what do I do? Agatha isn't eating AGAIN!

Discussion in 'Feline Health - (Welcome & Main Forum)' started by AggyBear, Mar 28, 2021.

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  1. AggyBear

    AggyBear Member

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    I'm at such a loss. This is the third time she has over the course of 2 or 3 days gotten nauseous and stopped eating and mostly stop drinking since she was diagnosed in January. She's definitely lost weight. This is day 4 with almost nothing. She's managed to get several treats down yesterday but nothing since.

    Can y'all please look at her chart and see if there's any pattern or telltale signs that maybe the cause of this? If in my power I want to prevent it. Been giving her Cerenia + Mirataz the last 3 days.

    Does anyone have trouble like this, like Aggy + I do?
     
  2. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Why have you stopped giving her insulin.?
    Are you testing for ketones in the urine.? This is very important if you are skipping doses of insulin.
    If you do not have any Ketostix please go out and buy some now and test the urine for ketones.

    Has Agatha been tested for pancreatitis? A fPL test is needed.
     
    Last edited: Mar 28, 2021
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  3. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Last edited: Mar 28, 2021
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  4. AggyBear

    AggyBear Member

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    I haven't been giving insulin bc either 1) she was below 200 and that's the "no shoot number" or 2) she hasn't eaten anything. Is this the right way to handle that situation?

    We've been through 2 previous cases of hepatic lipidosis + subsequential feeding tubes. I don't know if her health can handle another one?
    Is there a particular timing for this? Like giving the anti-nausea and then a certain amount of time later give the appetite stimulant? The vet only said to give both once a day.

    I have a box of the
    No. But I did get a box of the urine testing strips 2 months ago. I need to find out how to use them,

    Thanks in advance for your help! -Sammy + Aggy
     
  5. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Insulin is needed for other things apart from reducing the blood glucose. Not giving any insulin is taking a risk of ketones forming.
    I’m not a Prozinc user so don’t like to say how much to give so I’ll tag @Deb & Wink and @JanetNJ
    You have been giving insulin long enough to be able to reduce the no shoot number.
    If you get a number under 200.....stall, dont feed and post and ask for help. And test in 20 minutes.


    You also need to address the problem of Agatha not eating.
    You need to give the cerenia at least an hour before the appetite stimulant.
    You may need to get some a/d from the vet as it is easy to syringe feed. I would get onto this straight away before more problems arise from not eating.

    If you have a bottle of Ketostix, you need to collect a urine sample rom Agatha. Then dip the test strip into the urine and read it exactly 15 seconds later against the colours on the side of the bottle. Please post any result from that. Anything above a trace is of concern and you will need to contact your vet.

    The pancreatitis test is quite seperate to the ketones test. the vet needs to do the pancreatitis test but you can do the ketone test.
    If the pancreatitis test is positive that would explain the loss of appetite and a treatment could be started.
     
    Last edited: Mar 29, 2021
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  6. Pabs&Ro

    Pabs&Ro Member

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    So sorry to hear about poor Aggy not eating. It is such a massive worry and you feel so helpless.

    I have a constant battle with that as Pabay has waxing and waning pancreatitis. When I have major problems and I have no option but to get food in him I mash up his favourite food with warm water and put it in a 5ml entirely plastic syringe (not one with a needle). I cut off the top of the tip of the syringe if it is too narrow. I do not syringe it down his throat I syringe a blob or drip just inside his gums on his lower lip frequently. I don't restrain him so as not to stress him. The anti-sickness helps him keep down what little I can get into him.

    My life saver has been purina fortiflora pro-biotic. It has a smell or something that stimulates Pabay's appetite. It is the same stuff they put on kibble to make it attractive to cats.

    Don't be phased by the urine strips. Just dunk the tip in (in a well lit room), set the stop watch and read the colour (and repeat to be sure).
     
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  7. AggyBear

    AggyBear Member

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    I called and am going to pick up the a/d food right now! I will do my best with the syringe feeding. My poor baby is traumatized from doing this in the past but I'm going to try.

    I did give the Cerenia probably 2 hours before I gave Mirataz last night. I will continue to give Cerenia at least an hour before the Mirataz now.

    I have some of the Purina Fortiflora pro-biotic.

    I will do my best with the syringe feeding, if anyone can guide me with the no shoot number I would greatly appreciate it. This is a lot + I'm so thankful to have y'all!
     
  8. Pabs&Ro

    Pabs&Ro Member

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    You can only do what you can and what poor Aggy can tolerate. You are doing a great job. Good luck
     
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  9. AggyBear

    AggyBear Member

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    Is pancreatitis diagnosed with blood test + ultrasound? I want to help her but am limited financially. This is all scary. Thank you for your kind words! Is the pancreatitis secondary to the diabetes?

    She is weak, lethargic + feels warm.
     
    Last edited: Mar 29, 2021
  10. Pabs&Ro

    Pabs&Ro Member

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    I can only talk about what my vet did with pabay in the UK. Pabay got pancreatitis and gallstones. The former damaged his pancreas. Pabay then became diabetic.

    Vet did lots of bloods (no idea what except fructosamine) but pancreatitis and gall stones were confirmed on an ultrasound. Others in the US may have different experiences.
     
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  11. AggyBear

    AggyBear Member

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    I just left my baby with the vet. They'll call me when they find something out.
     
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  12. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I’m sorry Agatha is not better. Please let us know what the vet says and any updates. :bighug:
     
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  13. AggyBear

    AggyBear Member

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    I just picked Agatha up. Here's what the vet texted me:

    Hi Samantha. Agatha's bloodwork is not to bad. Glucose at 259. Kidney values were fine. She weighed 10.8 today. Her last weight was 13.2, so that is definitely down. Her temp was 103.1, which is fever and her cbc showed increased white blood cells, so it seems like she is dealing with infection. I do not find any obvious source for infection- so, has she been coughing, having diarrhea, sneezing, any other outward signs? (I told him no outward signs other than dried nose + crusty eyes and i felt she was warm). I am going to send home Veraflox. This is an oral antibiotic given once daily to cats. It is very broad spectrum. Keep up the insulin as you are, the supportive care such as fluids, cerenia, Mirataz, etc. I don't find anything else very remarkable other than the fever and white count. I don't find any obvious source for the infection. Syringe the a/d if she doesn't eat otherwise. Hope the abx will kick in and stop the fever so she will eat better for you.

    So now I need to get home + start the syringe feeding + medications (antibiotics, Cerenia, Mirataz, fluids). I got 8 cans of a/d. He said if she isn't eating on her own in a couple days I'd need to bring her back.

    Does anyone know where I can learn about the ProZinc adjusted no shoot numbers?
     
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  14. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Hi Samantha
    Thanks for the update.
    I’m glad Agatha has been started on an antibiotic. Be sure she gets is all.
    I think it is really important that you restart the insulin. Agatha has the three things for the recipe for DKA which you certainly don’t want her to get.
    The recipe is not enough insulin, not enough food and an infection or inflammation. so she is at risk of developing ketones.

    So first thing, try and get her to eat as much as you can. Food is very important.
    Keep up the antibiotic.
    Start some insulin. As I said I am not a Prozinc user so can’t really help you but I do know that she needs to start back on it.
    Test at least once a day for ketones in the urine and let us know the result please.

    When is the next dose due?

    I am going to tag @Deb & Wink and @JanetNJ again and I will also tag @Marje and Gracie

    In the meantime here is the link for Prozinc users. https://felinediabetes.com/FDMB/thr...-the-prozinc-basics-please-start-here.164995/

    Let me know how the food is going and the next shot is due.
    Bron
     
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  15. Deb & Wink

    Deb & Wink Well-Known Member

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    Those are very individual to each cat, and how your cat is doing on the insulin.

    Your SS indicates that Agatha's nose is very dried out and her gums are dried out. Classic signs of serious dehydration. You need to get fluids into her, either sub-q or by adding water to her food ASAP. Or you can try to give some water via a needleless syringe, like a feeding syringe. Be very careful to only give small amounts of water at a time via syringe, and aim it towards the sides of her mouth, so she doesn't aspirate it into her lungs. If you are not sure you would be able to syringe the water into her, then adding water to the food, to make a slurry would be better. That way, she is getting food and water at the same time.

    Have you been successful at all with assist feeding her? Do you have more sub-q fluids you can give at home?

    A cat not eating (or not eating enough), with an infection, no insulin, not drinking is in very serious trouble. The risk of ketones forming and possibly leading to DKA is very high.

    So you should NOT be skipping the insulin right now. She needs some insulin, even if she is not eating. You'll need to monitor her more. You should be monitoring her during the cycle more too, not just the pre-shot tests.

    How much insulin does Agatha need? I have no idea. No way to judge that without seeing how far she drops during the middle of the cycle. All I know is that Agatha DOES need insulin, even if she is in the yellow ranges at pre-shot, even if she is in the high blue ranges at pre-shot.
     
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  16. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Thanks Deb for replying!
     
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  17. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    If Agatha were my kitty, I’d be giving her 1.5u twice a day for any BG above 90, testing a whole lot more, and syringe feeding her to keep her BG stable. Testing is really critical to keeping her safe and getting as much insulin in her as you safely can. I’d try to get as m any calories in her and I wouldn’t worry about the carbs right now.

    You can test her, feed her, and then give insulin so you know food is in her tummy before you shoot. But it’s absolutely critical that you test her often depending on the BG...and that includes at night....so you can keep her safe.

    sending tons of healing light for her.
     
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  18. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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  19. Pabs&Ro

    Pabs&Ro Member

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    Pleased she's home and in the best place. Uti can knock out the effectiveness of insulin in my experience with pabay. Antibiotics should sort infection out. Hope Aggy improves quickly.
     
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  20. AggyBear

    AggyBear Member

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    I got her home yesterday evening, I got about ½ can a/d + water by syringe feeding, 1.5u insulin + the antibiotic. She was miserable but very weak so just let me without much protest. This morning she was walking on the bed to tell me she was needing something (which is huge improvement for only 1 night). She licked at the higher carb Friskies chunks + ate a few Greenies treats so gave another 1.5u insulin + Cerenia. Been at the water bowl, drinking little trickles. Her beard is completely soaked from sitting in the bowl. Gave Cerenia + just tested, BG was 333. I was able to test urine and it was a pink shade between 15/40 or small to moderate traces of ketones. I'm not sure what that indicates. She looks pretty ragged, I know y'all know the look! But I think she's feeling a bit better than yesterday. Thank you all for your kind words + straight forward suggestions. Is there anything I need to do going forward?
    This is regardless of food intake?
     
  21. Pabs&Ro

    Pabs&Ro Member

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    So pleased she has turned the corner. Great news. Hope she makes progress quickly.
     
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  22. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Hi Samantha,@AggyBear
    I am very concerned Agatha has ketones in the urine.
    Please ring the vet straight away and tell him she has a trace/moderate ketones in the urine. This is important. Ketones cannot be ignored.
    Ask the vet if you can bring her in to get some subQ fluids and ask him if you can give the subQ fluids at home.
    Ketones can progress to DKA very quickly if not treated.

    You also need to be doing these things
    • Offer food every 2 hours. If she will not eat syringe feed her. Food is extremely important and helps stop ketones. She needs to be eating 1 1/2 times what she normally eats.
    • It doesn’t matter what she eats at the moment. Dry food is OK. She must eat and often.
    • Don’t skip any insulin doses
    • Test BG at least 2 times during the cycles as well as preshot. More tests if the BG drops
    • Encourage drinking.
    • Test for ketones at least twice a day at the moment
    • Change the subject line to “trace to Moderate ketones in Urine” to alert people.
    • Post frequently with her progress and if you are concerned, we will be watching for updates.
    • You can feed higher carb food to keep the BG higher because giving the insulin is very important. Post and ask for guidance with this if unsure what to do.
     
    Last edited: Mar 30, 2021
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  23. AggyBear

    AggyBear Member

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    I have SubQ I've been using, I keep track of usage in the SS. I was going to give her some this evening but instead just gave 150ml right now. She's eating some pureed higher carb Friskies now.
    He said to give fluids but didn't specify how much daily until she's eating regularly again. How much fluid do you recommend?

    I'll scoop the litter box + put the plastic baggy back in there to catch the urine.
     
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  24. JanetNJ

    JanetNJ Well-Known Member

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    The rule of thumb is 10 ml per pound. You said he was about 10.8 lbs, so I would do 100 ml. per day.
     
    Last edited: Mar 30, 2021
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  25. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Give the subQ fluids each day. Make sure the previous fluids have been fully absorbed before giving more.
    I agree with 100 ml a day
     
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  26. JanetNJ

    JanetNJ Well-Known Member

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    Hi... So those times you didn't shot she was really close to 200. So let's say you get a number at shot time that's close.... I would stall for up to an hour and retest and see what you get. If it's raised to over 200 go ahead and shoot her regular dose. If it's close but not quite there like 175-200 id reduce a bit... Maybe to 0.75-1... Be more cautious of you can't test. The reason is so important is because infection + poor eating is just begging for ketones.

    I used a ketone blood meter. The reason is ketones hit the blood first, and frankly it's more convenient than waiting for them to pee. You use it the same you would a bg meter.
     
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  27. JanetNJ

    JanetNJ Well-Known Member

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    Also at this point it's more important that she eat rather than worry about the carbs in it. If she will eat higher carb food on her own than give that.
     
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  28. AggyBear

    AggyBear Member

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    Ok, I'll move forward with 100ml fluid daily until she's eating normally. I have no idea where the infection is or what it's from, but with my not giving insulin those chunk of days, did I hurt her pretty badly? Like, did I cause this?

    I just got ⅓-½ can of a/d in her syringe feeding + 2nd dose of antibiotics. She's resting now and I'll test, feed and shoot in about 2 hours.
     
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  29. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    If you could get a BG test done now, we will be able to see if it is rising at PMPS if she is a bit lower than normal.
     
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  30. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    You might want to talk to you vet about getting a prescription for ondansetron. For many cats it works much better than Cerenia for nausea. You do have to give it more often, about every 8 hours for the pills.
     
  31. AggyBear

    AggyBear Member

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    At 9:46pm BG 359. She is warm to the touch.
     
  32. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    That’s good you got the +11 BG. Looks like she will be fine to get the 1.5 units at PMPS.
    Try and get as much food into her as she will tolerate. Think of the food as a medicine when it comes to ketones.
    Good idea of Wendy’s to ask for ondansetron.
    I’ll be around for the next 7 hours so please keep us updated.
    Any luck getting another ketone test yet?
     
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  33. AggyBear

    AggyBear Member

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    As of 12:35am, not enough urine for another test but I hope in the morning she'll have peed again. It appears her appetite is coming back slowly but she is weak. I'm going to try to get some sleep. I have some ondasetron a friend gave me but will need to figure out dosage for her.
    This is helpful and I'll refer back to it.

    I appreciate + love y'all for your attention + care to help me + my baby girl!
     
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  34. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Please set the alarm to feed her during the night. Don’t leave her all night without giving her at least a couple of snacks or syringe feeds.
     
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  35. AggyBear

    AggyBear Member

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    Yes! I will! Just set the alarms.
     
  36. JanetNJ

    JanetNJ Well-Known Member

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    Consider getting a ketone blood meter. They sell them on amazon. Then you don't have to wait for pee. I use the keto MOJO but there are lots of brands
     
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  37. AggyBear

    AggyBear Member

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    Hey there, today was a long day in taking care of Agatha. She felt warm but I took her temperature + it was in the normal range (think 101.8? I'm in bed and don't want to get up to check, I will tomorrow). I have been unable to get a 2nd urine sample. I would like to have the ketone blood meter but I just don't have money right now. All my notes are in the SS. In the little over 48 hours I've seen good improvement, especially today with her appetite + eating more willingly. Just wanted to give y'all an update <3 Sam + Aggy
     
    Last edited: Apr 1, 2021
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  38. Pabs&Ro

    Pabs&Ro Member

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    Oh Sam - you are doing so well. Really feel for you and Aggy. :bighug:
     
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  39. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Thanks for the update Samantha.
    I’m so glad you are seeing improvements.
    Try and get that urine sample as we need to know what the ketones are doing. That’s important.
    How much is she eating do you think?
    Are you still having to syringe feed?
    Are you able to get any tests in during the pm cycles? Even one would be good. We need to see how low the dose is taking Agatha so we can look at increasing the dose if she doesn’t start to drop a bit lower.
     
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  40. JanetNJ

    JanetNJ Well-Known Member

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    So glad she’s feeling a bit better. Take care of yourself.
     
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  41. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    @AggyBear
    Hi Samantha, how is Agatha?
    Is she eating any better?
    And have you been able to get any more tests in for ketones.
    We get concerned when you don’t post, please give us an update.
     
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  42. AggyBear

    AggyBear Member

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    @Bron and Sheba (GA) Thank you for messaging me! I had a fragmented morning. I was startled awake when water splashed all over me because Agatha must have tipped it over a couple hours before I was supposed to wake up. I haven't been able to get another urine sample but I keep trying! Every few hours I check + scoop + replace the plastic baggy. Maybe I need to try different method?

    Agatha continues to slowly get better. She's been jumping on the bed + laying on the kitchen mat near the counter where I feed her + those 2 things mean "I'm hungry! Feed me!" Also rubbing against the furniture (+ scratching it!!!) shows she's feeling a bit better. Her appetite is returning + nausea I think is subsiding. I found a way to trick her to eat more: 2 days ago she was only wanting to eat these soft Blue Buffalo treats so I got 2 flavors + a bag of Greenies. Since yesterday I've alternated between the 3 kinds + that kinda works. She even started to lick at the Friskies this evening. She got about 60ml a/d at 12:45pm + insulin then. I don't know exactly how much she's eating but I will continue to syringe feed until she's eating fully on her own. My sister helped me take care of her while I was away at work (and will tomorrow too). I'll pick up the food now and test in about 2 hours (will syringe feed if didn't eat on her own). I will aim to get a couple tests in the PM cycle to help determine if she'll need a bigger dose.

    I hope this info is helpful in y'all supporting us + suggesting how to move forward. I wish there was a way I could thank you better! -Sam + Aggy
     
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  43. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Thanks for the update Sam. Just seeing her improve is all the thanks we need!
    I’m glad you feel she is improving. Are you continuing with the antinausea and appetite stimulant routinely at the moment?
    We really need to see another urine test and see if she still has ketones. That is really important. That is one of the ways we can tell if she is improving and if she needs more insulin.
    Are you able to put a large spoon or a small plastic container under her when she pees or even the test strip?

    Looking at her BGs they are not coming down at all. I will tag @JanetNJ to see if she thinks we could increase the dose.
    Please come back online before you given the dose so we can tell you what to do Sam please re the dose
     
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  44. AggyBear

    AggyBear Member

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    Yes, Cerenia, Mirataz + fluids + antibiotics daily! I will come back before I feed. Will be in about 1½ hours.
    Everytime I go to send an update I grimace bc I know this is so important. I will try to make an even bigger area of plastic in the litter box + will keep an eye for her next trip to the box. I've been offering treats + food about every 2 hours and usually she eats a handful of treats.
     
    Last edited: Apr 1, 2021
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  45. AggyBear

    AggyBear Member

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  46. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Sorry just seeing this. Let me look
     
  47. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Yes feed her.
    Are you going to be able to test during this cycle?
    If so I would increase the dose to 1.75 units
     
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  48. AggyBear

    AggyBear Member

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    Yes I will be able to test. I'll feed her now. Just out of curiosity, is your name Bron (is that short for something? Does GA mean general administrator?
     
    Last edited: Apr 2, 2021
  49. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Yes. My name is Bron. Short for Bronwyn
    GA after a cats name means the cats has ‘gone ahead’ or ‘guardian angel’.
     
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  50. AggyBear

    AggyBear Member

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    What a pretty name! Thank you Bron for all your help. I'll keep you posted <3
     
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  51. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    It is a pleasure to help you. :)
     
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  52. JanetNJ

    JanetNJ Well-Known Member

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    I would increase to 1.75 now that she’s eating better as long as you can test.
     
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  53. AggyBear

    AggyBear Member

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    PM +5 381, +8 533, +9 566. I don't understand what's happening! Her BG keeps getting higher. I managed to get 3 PM tests. She seems to be drinking more water in the last day. I'm going to try to feed her.

    I know getting that urine sample is very important but I just can't catch it! What do I need to be doing to help her?

    Do I give more insulin even if it hasn't been a full 12 hours? I feel panicky bc these things are so urgent + I don't know how to act.

    Edit: she ate a very small amount of Friskies + some treats. I put her in the bedroom with food, water + rigged a different setup in hopes of catching a urine sample.

    Do I need to get to the vet today? I cancelled work so I could depending on what she needs. Is there anything he can do for her?

    Edit 2: 11:20am got a tiny sample of urine, tested twice, both negative!
     
    Last edited: Apr 2, 2021
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  54. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    Sorry, I'm not over-familiar with Agatha and don't have the time to read through all the posts, but as long as there are no ketones, you should be okay. For today, you'll just have to wait out the numbers. Do not give extra insulin. The numbers will start to come down, I promise. The Greenies are high carb but I do understand that it is more important for her to eat right now.
     
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  55. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    Yay! on the negative ketone tests! I would still try to get another one later today, and twice a day when you can, for a while.
    I actually moved my cat's litter box to the center of my living room where I hang out, when I really needed a ketone test. I would wait quietly until he started peeing and then get up and put a little cup under him once he started the process of peeing.
    I eventually got the blood ketone meter (NovaMax Plus) by calling all the pharmacies around. They had the meter, but didn't have the strips, but said they could have them in 24 hours, so I ordered them and got them the next day. The blood ketone tests are so much easier to check, at any time.
    I'm glad you raised the dose. I would just keep on doing what you are doing with the fluids, anti-nausea and appetite stimulant meds, and the syringe feeding to when needed to get his needed calories into him.
    How is he feeling and acting?
     
  56. AggyBear

    AggyBear Member

    Joined:
    Jan 9, 2021
    I won't give extra dose! I was waiting to hear from anyone, wringing my hands. I syringe fed 60ml a/d + gave 1.75u of insulin. Going to let her rest and in a couple hours will test. Thinking along the lines of getting her to eat anything, I gave her maybe 2 tsp ice cream last night. That couldn't have caused such a spike in BG numbers, could it?

    She doesn't look well, you know the tired, ragged look? That's what she looks like today. Trying to drink water, but getting her beard/chest fur all wet.

    Those are massive skills! I set up the baggies again to get another sample.
     
  57. AggyBear

    AggyBear Member

    Joined:
    Jan 9, 2021
    3:10pm BG tested but didn't have enough blood + it came up 258, tested again 3:12pm BG 290.
     
  58. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Sam
    Well done getting the urine test. Great no ketones.
    Yes ice cream will raise the BG as it’s high carb ...all that sugar in it! Also aren’t the treats high carb.?
    Make sure you test often now you have raised the dose again.
    Keep feeding frequently. You are doing a great job with Agatha.
    When you write in the remarks column or the thread you have given food at 2 pm for example, could you write +6 or+10 instead please. We all live in different time zones and when you say a time it means nothing to me. Thanks!
     
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  59. AggyBear

    AggyBear Member

    Joined:
    Jan 9, 2021
    @Bron and Sheba (GA) will writing the time this way work?

    11:20am urine test negative for ketones (tested twice), 12pm /AMPS 60ml a/d + 1.75u, +3/3:12pm BG 290, +5/6pm BG 339, ate a little bit of Friskies + treats + gave Veraflox + Cerenia- put on balcony for sunshine, +9/9:48pm BG 460 + gave 100ml fluids, +11/11pm urine test negative for ketones, PMPS / 12:30am BG 456, ate a little bit kibble, boiled egg + drank water. *will test in a couple hours/+3+4*

    She's eating some on her own but not enough. I shouldn't have given that little bit of ice cream.

    How often + how much is to be syringe fed when they aren't eating anything on their own?
     
    Last edited: Apr 3, 2021
  60. Pabs&Ro

    Pabs&Ro Member

    Joined:
    Aug 16, 2020
    In my experience it is hard to get too much food in when syringe feeding unless they are very eager for food in which case they would probably eat on their own. I can't advise on dose. I have tagged deb incase she can help as you could really do with it. @Deb & Wink
     
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  61. AggyBear

    AggyBear Member

    Joined:
    Jan 9, 2021
    She's very much not eager to be syringe fed. Poor girl let's me do it although after I've gotten to about 40ml she starts not tolerating well.
     
  62. Pabs&Ro

    Pabs&Ro Member

    Joined:
    Aug 16, 2020
    You could try weighing the syringe to give yiu an idea how much you are managing to give her?
     
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  63. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Sam
    To tell us the times things happened or BGs you just write +3 BG 290 or +11 negative ketones, then we know exactly where in the cycle it happened. Everything is relative to when the insulin was given.
    That is OK that she ate the ice cream. When you are trying to get her to eat, anything is OK.

    What you are giving her at the moment....ice cream, treats and the a/d is higher carb but that is OK. We just need to get food into her. And it will raise her BGs a bit but that is OK in the short term as long as the ketones are negative.
    Did she eat some boiled egg? ....that is great. Egg...scrambled, boiled or poached is perfect meal for cats.
    How much of the a/d are you giving each time? You write in the SS you gave 60 mls on one occasion. Do you give that much each time?
    And how many times a day?
    How much food is she eating on her own at the moment?
     
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  64. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    How are her teeth? Will she eat plain chicken on her own? Will she drink on her own?
     
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  65. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    I used to count how many syringes it took to feed one can of food, and then divide the number of syringes by the calories in the can. That gave me how many calories were in each syringe. I took my cat to a feline nutritionist and was told to try to give him about 230 calories per day, but every cat is different and to fight off ketones you need as much food as you can get into him, thus the ice cream was okay.

    Sometimes you can only do 40ml. Then let him rest, and try for another 40ml in an hour or so. Go slowly, and try to slowly build up how much he will tolerate at a time.
     
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  66. AggyBear

    AggyBear Member

    Joined:
    Jan 9, 2021
    +7/7:42am BG 530, drinking lots of water, ate some egg w/ mayo, negative ketones, +9/9am 60ml a/d.

    Her teeth are fine as far as I know. However, she acts like she can't grab things with her teeth much. I do not think she's in pain but just an "eating style"? She really does well with pate and I even mix some water with that to get her to eat it but that's if she's eating good. As for water, I know she's drinking on her own although I cannot be sure how much because much of her face and chest hair get sosking wet in the water bowl and she creates a trail everywhere she goes.

    I add only a little water with the a/d to syringe so it'll stream easily. I have been doing 60ml twice daily in addition to offering treats + pate (the pate she won't eat much of, I'll have to buy more of the expensive soft treats).

    What a great idea. I'll do this with the next can.

    After her PM insulin she ate a little bit of previous higher carb kibble I've saved, a couple treats and a tiny amount of the egg. I meant to test her earlier than now but didn't wake up.

    60ml twice a day in addition to other food offerings. She sniffs + licks a little bit but not much on her own.

    I hope I answered everyone's questions. -Sam + Aggy
     
    Last edited: Apr 3, 2021
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  67. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    You are doing a wonderful job. I've only had to assist feed a few times, and I understand how much work and stress it is. She's very lucky to have you. Have you ever tried forti flora on the food?
     
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  68. AggyBear

    AggyBear Member

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    Jan 9, 2021
    Thank you for your kind words. I have the Fortiflora and when eating normally she's eaten it several times. Right now it's not tempting her, she won't eat it or on top of Friskies.
     
  69. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    It's probably been mentioned before, but have you thought about trying Ondansetron (Zofran) in place of or in addition to the Cerenia?
     
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  70. AggyBear

    AggyBear Member

    Joined:
    Jan 9, 2021
    Hi Dyana, I have 14- 8mg pills of ondansetron a friend gave me back in January.

    Agatha weighed 10.8lbs on Monday. Do you know the dosage would be for her, mg per pound? Is it a much stronger, effective medicine than Cerenia?

    Edit: I saw a website that said .11mg per pound which would be 1.18 for her weight. I don't think breaking it into eighths would work well?
     
    Last edited: Apr 3, 2021
  71. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    Can you call your vet to call in a prescription for you, or tell them you have some and want to try them but want to know what dose to give? I am not a vet, so I can not tell you what dose to give.
    FWIW: My cat J.D. was prescribed 1mg BID when he was 10 pounds. My cat Ginger is 11 pounds and was prescribed 2mg SID. One of the side effects is sleepiness, so when Ginger didn't seem as active, I switched her to 1mg. as needed. My pills are 4mg per tablet, so either a half (2mg) or a quarter (1mg). I know they are tiny, at least the 4mg are.
     
  72. AggyBear

    AggyBear Member

    Joined:
    Jan 9, 2021
    My sister has 4 mg tablets of ondansetron but they are the dissolvable kind with a sweetener, I think aspartame. Can I give this to her?

    AMPS/2:27pm BG 433, tried eating Friskies but not much, syringe fed 60ml a/d (almost ½ can) (2 hours late in getting insulin to her), +3 BG/5:02pm 415, left in room with food, treats + water.
     
    Last edited: Apr 3, 2021
  73. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Have you tried Fancy Feast instead?
     
  74. AggyBear

    AggyBear Member

    Joined:
    Jan 9, 2021
    I haven't. I'll get some tonight. Fancy Feast pate.

    I don't what this means but she's been urinating on towel I have outside the litter box. Peeing on towel + in box.
     
  75. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    The zofran (ondansetron) I gave Sheba in Australia has aspartame in it. I just looked it up.
    I had the 4 mg wafers and gave her 1/2 wafer. You just need to be sure that your hands are dry because the wafer will stick to your fingers if not.
    You just need to put it on the tongue and it will stay there.
     
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  76. AggyBear

    AggyBear Member

    Joined:
    Jan 9, 2021
    Thank you, I'm so glad I could get what she needed. I got a 24 variety pack of FF pate and will offer again tonight but if she doesn't eat it I will syringe feed another 60ml a/d and then give insulin.

    . +10/11:44pm BG 532, gave 2mg ondansetron dissolvable + Veraflox, didn't want FF pate, negative ketones, gave 100ml fluids. *Update: PMPS/2:25am BG 397, only ate tiny amount of FF pate, had to syringe feed 60ml a/d (approx=½ can), in bedroom overnight w/me w/ water, kibble + FF pate.*
     
    Last edited: Apr 4, 2021
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  77. Pabs&Ro

    Pabs&Ro Member

    Joined:
    Aug 16, 2020
    Really hope you see some improvement overnight. You are doing such a great job for aggy. I guess you have tried squeezing the gravy out of food and giving that. Will be thinking of both of you and sending good vibes during our day.
     
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  78. AggyBear

    AggyBear Member

    Joined:
    Jan 9, 2021
    Thank you so much for your encouragement! I have tried so many things with the wet foods to get her to eat, including that with the gravy. Blending to puree, adding water, adding broth, adding Fortiflora, adding bonito flakes, adding fresh chunks of meat.
     
  79. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Have you tried canned sardines in water...no added salt?
    What about plain cooked chicken ?
    bbQ chicken ....the inside bits with no salt or the stuff they put on the skin?
     
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  80. Pabs&Ro

    Pabs&Ro Member

    Joined:
    Aug 16, 2020
    It's expensive and exhausting trying to get our treasures to eat. The only other suggestion I have is Atlantic cod or Atlantic pollock. Pabay will eat these boiled in water. He will not eat haddock salmon or any fish from the Pacific (including Pacific pollock). I don't want to send you on a wild goose chase - you are already diing well above and beyond any other cat carer.
     
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  81. AggyBear

    AggyBear Member

    Joined:
    Jan 9, 2021
    I wasn't able to check Aggy's BG during the night, I was so exhausted. Now at +10/11:57am BG 598. The reading before that said "HI" + I have never seen that before. She's going from water bowl to water bowl. She only had access to water, FF pate + a bit of not LC kibble.

    I'm so scared for her. Should insulin be raised at her next cycle 2 hours from now? I know I'll to have to syringe feed. Should I be offering treats? The only ones I have are HC + she won't eat them.

    Edit: +11/12:54pm BG HI, 2mg ondansetron. Syringe fed 60ml a/d. Leaving in bedroom with 3 foods + water. Have to run errands, will be back to test BG soon.
     
    Last edited: Apr 4, 2021
  82. Pabs&Ro

    Pabs&Ro Member

    Joined:
    Aug 16, 2020
    @Wendy&Neko @Marje and Gracie

    Sam,

    I am so sorry to hear Aggy is so poorly still. I have tagged two moderators to see if they can help. Urgent dosing advice needed please Wendy and or Marje. Sam's situation with Aggy is pretty desperate. Please can you assist with urgent dosing advice.

    Also sam you could post under the prozinc forum asking for dosing advice.

    Sam I am not confident giving you dosing advice. I do hope the moderators can help. The time difference with Bron in Australia means she might not pick this up. I hope someone gets back to you soon.
     
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  83. AggyBear

    AggyBear Member

    Joined:
    Jan 9, 2021
    Last edited: Apr 4, 2021
  84. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Sorry, I'm not much help on Prozinc dosing. It be good to update the spreadsheet so people know you shot already. If she's on an antibiotic, Veraflox, you might want to consider adding a probiotic to her food, a couple hours apart from when you give the Veraflox. Antibiotics can mess with tummy flora, and that can make her feel unwell and not want to eat.

    Have you figured out how many calories she's getting a day yet? She should be getting close to if not a complete can of a/d. It's 180 calories per tin.
     
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  85. AggyBear

    AggyBear Member

    Joined:
    Jan 9, 2021
    I'm so sorry, in my panic I got the info to The forum first and forgot about SS. It is updated. I'm syringe feeding 60ml twice a day plus offering other treats and pate. Each 60ml syringe is half a can of a/d.
     
  86. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Good to know you are getting at least one can in per day. I used to find it easier to split my feedings into several smaller amounts, so syringing six times per day but less at once. Otherwise either me or the cat ended up wearing a lot of it. :p

    You can give the ondansetron, 2 mg dose, at least 3 times per day. It doesn't last a long time in a cat.
     
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  87. AggyBear

    AggyBear Member

    Joined:
    Jan 9, 2021
    I will add the foriflora to her feedings, as she won't eat on her own.
     
  88. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Fortiflora isn't a great probiotic, it's a single strain. There are lots of human ones that can be used too. Just make sure you give it two hours apart from the antibiotic.
     
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  89. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I'd increase the dose, to try and get those high BG levels down.

    I think that a 0.5U increase may even be needed, since the nadirs are only down in the high yellow BG range right now.

    Part of the high BG's can be attributed to the higher carb food. BUT don't worry about that, as it's more important to get Aggy eating ANYTHING, than it is to ge``t her eating a lower carb food. Please keep syringe feeding her as you are doing, as much as you need to.

    Perhaps think about splitting those syringe feedings into smaller meals. So she doesn't get too full at one sitting.

    I had to assist feed Wink, and was feeding him at least 6-8 times a day, small amounts each time, and going really slowly. It could take 15-20 minutes or more to get a meal into him. Probably 1 ounce of food each time.

    Feeding tubes save lives. I could not do that with Wink, because of his heart problems, because the feeding tube insertion required sedation, and he would not have tolerated or survived that.

    Dehydration can make a cat (or human) not want to eat. So keep up the hydration too.
     
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  90. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Sam, it’s been over a week since you have been to the vet with Agatha and she is not really making much progress with her eating. Are you able to take her back to the vet to get her checked again to see if the infection she had is resolving or has resolved and maybe you need to look at a feeding tube so she can get all the nutrients she needs. There may be something else the vet could do or prescribe to help things along.
    You are doing a great job but it’s hard when they won’t eat. The feeding tube would only be short term and is much less stressful for you and Aggie than syringe feeding.
     
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  91. AggyBear

    AggyBear Member

    Joined:
    Jan 9, 2021
    She's is at 1.75u; this increase would bring it to 2.25u, is that correct?

    I will continue syringe feeding with at least 1 can a/d + 100ml fluids daily.
     
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  92. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Correct
     
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  93. AggyBear

    AggyBear Member

    Joined:
    Jan 9, 2021
    I will call him in the morning to see if he thinks I need to bring her in + what could be done.

    She has had hepatic lipidosis twice + feeding tubes twice (2014 + 2018). She's 14 now.

    I would appreciate more than ever right now to get opinions on what treatment Agatha may need. If this is a one-time thing, her having an infection from an unknown source, and that's what made her stop eating then I want to continue helping her to get through this.

    The week's prior to her stopping eating, there were many AMPS numbers I didn't give insulin when I was misinformed about what I thought was my "no shoot number" (I thought it was 200 when another suggested 90 was my new no shoot number). I have no idea if my actions affected her getting some sort of infection which doesn't really make sense or if it messed her up with not eating/nausea.

    This is really difficult for me to put into words that I hope are coherent. I have been very upset and distraught over what's best for her.

    I have heard so many beautiful stories on this forum of cats doing well and thriving despite diabetes. I want this for my girl. She's been by my side side I was 16. I know it has only been 3 months since her diagnosis but it has felt like an eternity. I don't know if it's normal for diabetic cats to continually have issues not eating and requiring the supportive care to get their appetite back on track?

    Everyone's situation is entirely different, but how do you know if or when it is time to say goodbye?

    I want to do my very best for Agatha, but to be very honest it feels like I am in a losing battle right now. I'm not financially in a position to take long term care if all these complications continue. I do not have good health and I struggle brutally with my mental health (depression, anxiety, dissociation). I am also in the middle of transitioning antidepressant medications so I don't even know if I'm thinking straight about all of this.

    I respect all of you and trust your opinions and appreciate you very much. This is about all I can figure out at the moment tonight and as everyone is in different time zones I thought I should get it sent as soon as possible. -Sam + Aggy
     
    Last edited: Apr 4, 2021
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  94. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    ((((Sam))))
    It is very hard when our beloved cats are sick. If only they could talk.
    When cats stop eating like Aggy, it is usually something doing it, such as pancreatitis or an infection somewhere. Some cats get over it quickly and some cats take longer.
    Do you know if the vet did a fPL test for pancreatitis. He didnt mention it. You are doing almost everything needed to help pancreatitis except she may need some pain meds if it happened to be that. The vet said most of the blood work was good including the kidneys so that is really good.
    The vet did say to bring her back if she hadn’t started eating, didnt he? Maybe ring him. I do understand the financial side of things and vet are expensive.

    It would be good to know if the infection had resolved.
    It isn’t a good idea to stop giving insulin as that can bring on its own problems. Sometimes you have to give a reduced dose and that’s OK.
    Im sorry if you were given conflicting advice. If you are unsure always post again and tag someone.

    What are her favourite foods? Any particular canned foods? Dry foods? Cooked chicken, meat, minced meat?.
    Have you seen this link https://www.felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/

    I wouldn’t give up yet. Sometimes it can take a while for them to get their appetite back. Ask the vet for some more ondansetron and cerenia, ask about the fPL test for some pain meds. We are here to support you for as long as you need us.
    Try and make sure you are getting enough sleep if you can as that is just as important.
    :bighug::bighug::bighug:
     
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  95. AggyBear

    AggyBear Member

    Joined:
    Jan 9, 2021
    He definitely said to bring her back if she wasn't eating good on her own in a couple days and it was be a week tomorrow. He did not mention the fPl test. Is that a blood or urine test? Do you have any approximation of how much that test might be? Either way I want to get it done for her.

    I think I took what I read in the beginners guide to explaining how to give insulin. The first time I saw a lower number I didn't know what to do so the second day when it happened again I looked up about those lower numbers and the original post I saw said if it was below 200 to not shoot. I really wish I had asked.

    I've studied that link like the Bible! I'm pretty sure I tried all of those things. She was never a picky eater but also I unfortunately never strayed from giving her anything but kibble. She was never really interested in human food before. She wasn't picky but now that she's dealt with so much nausea since the diabetes I would have no clue how to entice her with food. The last time she stopped eating in February the only thing that would work was the baby food BeechNut. Right now she will only readily eat soft cat treats.

    This gives me so much hope. Even if it's just for tonight. It is exactly what I needed to hear, to not give up.

    I will ask for that test + whether he thinks it's pancreatitis and if pain meds. So ondansetron + Cerenia can be taken together- is it like a double whammy for anti-nausea?

    Y'all have helped me so much so far. I cannot thank you enough. I will keep you updated. <3 -Sam + Aggy <3
     
  96. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    It should not be expensive. There are two tests you can get done. The fPL Snap which is done in the vet office and only takes 10 minutes to get a result and it will tell you yes/no if she has pancreatitis. In Australia this test costs around $50 I think...I haven't had it done for about 5 years
    The other test is the fPL Spec and is sent out to laboratories and will tell you a number as to how bad it is. It takes a couple of days and it is more expensive.
    I think just finding out yes or no is sufficient so I would go with the fPL Snap

    Just keep trying different foods. Any she wont eat...freeze the rest of the can in a small container for later so its not wasted. I used to do that when Sheba would not eat. Would she eat the gravy foods do you think? Or the dry?


    I had Sheba very sick at one point and I really thought it was the end. The vet gave her a medication for pain and she was a different cat.
    She used to get pancreatitis and was usually a great eater but couldn't eat with pancreatitis.
    I have seen many cats here on the forum struggling to eat after having an infection, pancreatitis, hepatic lipidosis etc. Some cats bounce back quickly but many don't and need the support for longer. Some a lot longer.

    Cerenia and ondansetron work on different pathways in the body and when one doesn't work, the other one often will.
    Yes they can be given together because of the different pathways in the body.
    Cerenia is given once a day.
    Ondansetron can be given 8 hourly if needed.

    We are really happy to help you and just want to see Aggie back to her former self eating well!
    You know you can tag any of us at any time. Just put a @ in front of our name like this @Bron and Sheba (GA) and a box will come up for you to choose a name.
    Give Aggie a big hug from me and hang in there and make sure you get some rest too:bighug:
     
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  97. Pabs&Ro

    Pabs&Ro Member

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    Aug 16, 2020
    Sam, oh poor you and Aggy.
    1. Pain relief: a good idea as pancreatitis is so painful. Gabapentin works well for Pabay as it gives pain relief and it is an appetite stimulant.
    2. Sound advice from deb and wink on dosing.
    Everyday must seem like an eternity for you wrestling with these decisions and caring for yourself and Aggy. Sending hugs and positive thoughts from us. :bighug:
     
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  98. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    I think ondansetron can be given up to 3 times per day (every 8 hours). I asked Wendy to confirm.
     
  99. AggyBear

    AggyBear Member

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    Jan 9, 2021
    Thank you all so very much. We are headed to the vet now and will get the fPl snap.
     
  100. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Last edited: Apr 5, 2021
    Reason for edit: correct page #
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