? 4/12, Falafel AMPS 178 +2 212 +4.5 144 +6 113 +8 73 +10 90 PMPS 92 - dose increase?

Discussion in 'Lantus / Levemir / Biosimilars' started by thornmallow__, Apr 12, 2024.

  1. thornmallow__

    thornmallow__ Member

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    Previous: https://felinediabetes.com/FDMB/threads/4-11-falafel-amps-131-2-203.288660/

    Re: Falafel, she threw up 1 more time so I gave her 4mg Cerenia (vomit and Cerenia at PM+11), and she just threw up again (around AMPS). Vet opens in about 3ish hours so will be calling them right away!

    I give Falafel Purina FortiFlora as an appetite stimulant, but someone mentioned a while ago that this is not a good probiotic because it only has one strain.

    Questions:
    1. I think tonight I will give Cerenia and Zeniquin in the same gel cap to prevent the nauseau. Is this ok?
    2. Anyone have recs for probiotics?
     
    Last edited: Apr 12, 2024
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  2. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    How many doses of Zeniquin has she had? What does the vomit look like? Is she willing to eat? Could anything else be causing her to vomit like this? When did she last eat?

    S. Boulardii is a good probiotic that we use - especially for diarrhea.
     
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  3. thornmallow__

    thornmallow__ Member

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    Mar 1, 2024
    This is her 2nd dose of Zeniquin at 12.5mg. I’ve been giving it around PM+3.

    - The first round of vomit had a hairball and food (liquidy). The second 2-3 rounds of vomit also had liquid food. These all happened around PM +5 in quick succession.
    - Then the next round of vomit happened at PM +11, this was clear with white foam. I gave the Cerenia and she vomited again like 10 mins after, this was also clear with white foam.

    She is not willing to eat right now, I think she’s still nauseous because she will sniff her food and then turn her face away. She last ate last night at PM +3. Now I’m thinking I didn’t give her enough time after eating before giving the Zeniquin?

    I can’t think of any other reason she could be vomiting. Since she had the hairball, I’m wondering if that triggered the round of vomiting, like she was already nauseous from the Zeniquin and that set her off?
     
  4. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    Do you have Ondansteron? Foamy vomit could be acidity from long gaps between meals. Did she not eat anything after PM +3 last night?
     
  5. thornmallow__

    thornmallow__ Member

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    Mar 1, 2024
    I’m reasonably sure she did not eat anything after PM +3. I noticed she doesn’t eat at night in general - during the day I leave out 1.5 cans of food and come home to an empty bowl, but I’m lucky if she finishes an entire half can at night. I usually baby her and try to get her to eat by bringing the bowl to her, sprinkling FortiFlora, etc., but tonight I just went to sleep.

    I do not have Ondansteron, is that better for acidity and nausea than Cerenia? I’m WFH today so when I call the vet I can ask them to give me both. Currently for as-needed meds I have one tablet of Cerenia (good for 4 doses) and plenty of Mirtazapine.
     
  6. thornmallow__

    thornmallow__ Member

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    Mar 1, 2024
    She just ate a little!!
     
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  7. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    Cerenia is good for vomiting although it works for nausea as well. Ondansetron is used for nausea.

    It's good she ate. Try and tempt her with a different food?

    I would go ahead and give her the shot since you can monitor.
     
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  8. thornmallow__

    thornmallow__ Member

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    Oops I forgot to update but I ended up giving the shot!

    I will keep that medicine in mind when talking to the vet today. Can I give the Cerenia in the same gel cap as the antibiotic?

    Have you had success with catnip btw? I have some and I read it can be good for digestion issues.

    Also, added a bit more water to her food and now she’s eating well :)
     
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  9. Staci & Ivy

    Staci & Ivy Well-Known Member

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    Oct 2, 2022
    Aww poor baby. I hope she’s feeling better, Z. Sorry to hear about the vomiting. And very glad to hear she ate for you. Sending warm wishes for Falafel to feel better :bighug::cat::bighug:
     
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  10. thornmallow__

    thornmallow__ Member

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    Thanks, Staci <3

    Okay I spoke with a vet tech. They said to let her eat, give Cerenia, then wait an hour before giving the Zeniquin. So I'm thinking do PMPS like normal, give Cerenia at PM+2, then Zeniquin at PM+3. Then force myself to stay awake til at least PM+4 for a bit of monitoring before snoozing!

    Tonight is a new night!!

    Also trying to do a complete 12 hr curve for Falafel's 0.25U dose. I think we have been ready for an increase for a few cycles now, but life keeps getting in the way!
     
    Last edited: Apr 12, 2024
  11. thornmallow__

    thornmallow__ Member

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    I think Falafel honestly does better when I'm not around, at this point. A couple mins ago I noticed she was drooling and breathing shallowly. BG was at 72. Now, it's been 5 minutes that I've been petting and watching - and she's back to normal!

    Last weekend (or maybe it was the weekend before that) I took her to the ER for these symptoms and everything came back normal.

    She's stressing me out!!
     
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  12. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    I hope Falefel will feel better, some people sprinkle a little Parmesan cheese on the wet food to entice them to eat
     
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  13. Gravy and Vicki

    Gravy and Vicki Member

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    Mar 19, 2024
    I hope Falefel feels better and you get some rest too. It's scary when they get sick.
     
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  14. thornmallow__

    thornmallow__ Member

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    Mar 1, 2024
    Ok. I think now with the 12 hour curve almost done, we do need a dose increase.

    But:
    - We had so many problems with the Zeniquin, then the drooling today.
    - Cat sitter is coming bc I will be gone from AM +7 to PM+4 tomorrow.
    - Sunday I will be gone from AM +2 to AM +4ish.
    - Monday PMPS will be handled by the sitter (this would be her 2nd time ever coming).
    - Tuesday PMPS will be handled by my sister.

    With all these upheavals I am thinking sticking with 0.25U is safer, but can someone push me to be brave if that’s what Falafel needs? After so long at 0.1 and 0.25, 0.5U seems so high!!
     
  15. thornmallow__

    thornmallow__ Member

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    Hmmm… with PMPS 92 I think I will stick with 0.25U. I probably won’t get sleep otherwise.

    Maybe we’ll be ready for an increase next weekend, I’m home all day Friday and Saturday and only gone for half the day on Sunday!
     
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  16. Staci & Ivy

    Staci & Ivy Well-Known Member

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    Sounds like the safe answer since you won’t be able to monitor closely. But wonder what others will advise. :bighug::bighug:
     
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  17. thornmallow__

    thornmallow__ Member

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    Thanks Staci. She’s also not eating much so I think I’ll have to skip the Zeniquin tonight too.
     
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  18. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Getting a good probiotic will really help her. I like Visbiome, but there is also Proviable (for cats), RenewLife - a human probiotic. Did you get a new probiotic. s. boullardi is good for diarrhea, but another probiotic would be better for nausea due to the antibiotic. Remember to give the antibiotic and probiotic a couple hours apart.

    With TR, we don't hold doses that long. But lets see if her nadirs drop any more. She could use an increase if she continues to only see fleeting greens.
     
  19. thornmallow__

    thornmallow__ Member

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    Mar 1, 2024
    Crap. I knew I was screwing up TR with this plan. The Zeniquin is really throwing me off and not being able to monitor as much as I would like… I will check back in about increasing Sunday night. I should be able to monitor the latter half of her cycle then. I have to get more comfortable leaving out HC for her when I go to work I think.

    For the Visbiome probiotic, I see two kinds. Should I stick with the original? Falafel tends to struggle with vomiting and constipation, not diarrhea. I also ordered Churu treats (never tried those before) in case she doesn’t like the flavor of these.
    https://visbiomevet.com/products/visbiome-vet-constipation-care-packets
    https://visbiomevet.com/products/visbiome-vet-packets

    I didn’t realize how expensive all this was :’)
     
  20. Staci & Ivy

    Staci & Ivy Well-Known Member

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    Sending good eating vibes to Falafel :bighug::bighug::bighug:
     
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  21. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    I have a kitty with IBD, which is why I give Visbiome as it's made specifically for IBD. In Canada I can only get the packets, but I think the capsules are an easier way to go for dosing. It is pricey, lots of people have used Renew Life which is cheaper and works if not dealing with IBD.

    Churu is a great way to give meds! Though I just give the powder mixed in with food.
     
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