9/1 Naomi AMPS skipped dose +11 108 PMPS 120 +1 109 +2 79, +3,5 78, +4 80, +5 78, +6 97

https://www.felinediabetes.com/FDMB/threads/8-31-naomi-amps-90-5-62-pmps-68-2-36-3-70.234425/

Hi everyone!

I skipped the morning dose and her BG has not increased. Maybe because she's not eating well.

What do I do? Give her insulin?

She's having Zofran every 8 hours starting from today

 

Get another test in an hour. Is zofran helping at all? You might need to syringe feed her more until she feels better. Do you have a digital baby scale to weigh her? If not it’s something to buy. I know you are starting it 3 times a day today but has she had it before. Poor baby.

 

She had it about two weeks ago, not sure if it helped it was for a couple of days if I remember well.

Yesterday she had two doses, today two doses already plus one more later. Tanya's site says 1mg twice or three times a day.

It's so frustrating not to get help from your vet. I can't believe i'm relying on sites and forums, on people at the other side of the world to get some help. And at the same time I'm grateful

 

I don’t think that’s a big enough dose. I’d try 2 mg if your vet agrees. When Max started in it I want giving enough so he needed an appetite stimulant. Once my vet increased the dose I didn’t need the appetite stimulant. Back then it was only given twice a day. They now know the duration isn’t very long. So if 3x at 1mg doesn’t help ask your vet about an increase. It’s so hard to manage CKD plus FD plus pancreatitis.

 

My vet had told me to give 2 mg once a day. Also had given her 200ml sq fluids.
Another thing she did is she asked me to give her the injectable form of vitamin B complex orally. And I did so. Then the flare started and she stopped eating. So, I don't know....

I'll try 2 mg twice a day starting tomorrow.

What about insulin? It's 120 now

 

If I remember right, we were trying to drain the depot a little with the skip?

 

I started work, won't be home in the mornings, I skipped this morning because she's not eating well

 

I'm not sure about the shot in this case. @tiffmaxee?

 

Now we are in the PM cycle
I can stay home to monitor if u think she should have some insulin

 

Will she eat? Can you syringe if necessary? She has gone up so I would shoot if you can but you might need to be home for several hours.

 

Yes, that's not a problem

She just ate 1tbsp Sheba

Just to confirm 3.75, is that right?

 

The problem with twice a day zofran is it might only work to get her to eat about 30-45 minutes after dosing and will likely fade in a few hours.

 

Yes.

 

Will cerenia work?

 

It’s worth a try. Some need both cerenia and zofran but ask your vet. If okay you could try twice a day zofran and once every 24 hours cerenia. But again check with your vet. I do think 200ml fluids is a lot. Hopefully it wasn’t all at once. Check to make sure the pouch is totally gone before giving more.

 

Cerenia and zofran work differently.

 

Haven't started sq at home yet, but I will soon

Vet gave her 200 ml all at once

 

Are you adding the meds or any supplements to her food that might make her not want to eat it?

 

Cerenia every 24 hours.

Pill or injection?

 

No I pop the pills in her mouth.

Zobaline, d manose, corn silk are given orally too.

Sometimes I put aluminum hydroxide in her food. Not every day because I don't know how much to give and if it interacts with Zofran and supplements. Vet had told me to give 2 caps a day. Each cap is 475 mg, but I don't give that much. When I use aluminum hydroxide that would be 1 cap maximum

 

Well, the injection works better and faster BUT IT STINGS! I gave it once to two cats and just couldn’t do it. With Max I tried. Once. I was afraid he would then run from insulin shots. If you start fluids and put it in the port I’m told it won’t sting. Or put it in the fluid pouch. Again I never tried. Call me chicken. The pills do work but at a larger dose usually. It can be dose .50-1 mg per pound I believe. Max was 17 pounds and my vet said 8 mg.

 

The binder needs to be given with every meal to work so you can open the capsule and add at each meal. If you pill it you can get empty gel caps and divide it that way. It needs to mix with the phosphorus in the food to work so must be given together.

 

I mix it with her food but she won't eat all at at once which means every time she eats she will have some binder too. Is it OK with supplements and medications? Does it interact with them?

 

Can I ask sth?

I see that next to the title there's a pair of glasses. Other people don't have it. Does that mean something? Also Naomi's photo is next to Alice's photo? I watched that thread yesterday. Have I done something?

 

Yes. It’s fine. It just binds with the phosphorus. I would giving with an antibiotic.

As I recall no issue with supplements. Double check tanyas on antibiotics. Thi May be helpful.
http://www.iris-kidney.com/pdf/002-...ent-recommendation-pdfs-cats_070116-final.pdf

 

Did she eat any after +1. She’s come down so get her to eat. Get a +2.

 

Just checked.
+2 79
Hasn't eaten since PS
I'll try again now

 

http://www.felinecrf.org/phosphorus_binders.htm#aloh_interactions

Looks like I’m right about two hours away from antibiotics to be safe.

 

OK
Zofran is not an antibiotic so I guess it's alright to be given before food with binder

 

Yes. Is she eating? It will take about 20-45 minutes for zofran to start working.

No problem with zofran.

 

No she's not eating

Just gave her 2mg Zofran

 

Can you syringe at least 10 cc please. Have honey and h.c Food on hand just in case. Offer her any food she likes. She must get food.

 

Yes, I'll try again with something different. If I have no luck I'll syringe feed her

 

She ate 1full tbsp sheba.
25 min after Zofran. I'll try again.

 

Update please. It’s very early in the cycle. If she continues to drop and won’t eat you will need to rub honey on her gums.

 

Sorry I was with Naomi

 

Thank you. It’s very important to get her to eat small amounts every hour and test hourly. I’m glad she ate on her own.

 

Not on her own. I spoon feed her. I grabbed one really large spoon, I don't know what u call it, we use for the soup, and put 1tbsp food mixed with water. I have to put in front of her and hold it there . She licks, then she bites, then she turns away. I have to repeat that again again so she can finally finish it

 

Will she eat straight out of your hand?

 

Haven't tried that. It's got some water in it. I'll try that and put a pad underneath

 

How about nice fresh fish? Most cats love it.

 

She loves it, she had some a few days ago, but it's bad for her kidneys, isn't it? Don't know if she would eat it now , I can buy some tomorrow

 

Some fish are high phosphorus that is true. But when insulin in on board and she's turning down food you need some go to foods she loves. If the appetite continues to be a big problem her insulin will likely need to be decreased. Her high phosphorus is one reason she feels yucky that is true. I never knew until a neighbor had kidney disease how high salmon is.

 

Do u think I should try with medications, or give up and give her fish?

 

Good she didn’t drop more. The site and/or my internet are sketchy. It would be great to test hourly and offer small amounts of food until past nadir. If she surfs here you can back off. I’ll keep checking back but wanted a game plan in case we can’t communicate.

 

If the nausea medication works and you can bring down her phosphorus that would be best. You do need a few go to foods if you can find some to temp her for times like this. Remember that zofran takes about 20-45 minutes to work so space it out so it’s on board when she really needs to eat. Two times would be AMPS and PMPS. My go to foods were baby food and a few high carb ones. You could try boiling chicken and putting in a food processor or cook chicken livers. A little of that a couple times a week is good for her but not more than that.

 

I' m not going to bed until +5 or maybe +6. When I do I'll set the alarm like last night. I was up every hour. I only missed +10 and +11 I think

 

I’m hoping you won’t need to be up all night. Let’s see if we can keep her surfing and get you to bed by +5-6 and if necessary grab a +11.5. The site is super slow.

 

No I'm wrong. Just checked. Missed some more

 

Do u think we could change the PMPS a bit earlier? It's 00:10 and in a little bit I'll do a +4.

My PMPS used to be 18:00, but after stalling and feeding one or two afternoons it moved almost 2hrs later.

 

You need to get enough sleep. We don't want you getting sick.

 

First day at work today and I couldn't open my eyes!

 

You might need to with to SLGS or else just be less aggressive than TR. If you get sick you can't help Yanna. Just saying......

 

If Naomi ate well I could do TR
5:00 and 17:00 . By the time I would go to bed I would have got at least a +7.
It's the mornings that worry me.
Will she be well controlled in SLGS?

 

It's possible but not as much as with TR. That being said while people do it and work, I couldn't have done it while working. With her other issues you have to think about what gives both of you a decent quality of life. Just my opinion. I know some go OTJ this far out but the only thing I would have done differently was not be as aggressive with Max after a year. He still got kidney disease being well under renal threshold and never went OTJ. Again it's my personal opinion FWIW.

 

I saw your SS. Very well controlled!
I'll skip her morning dose for a few days as long as her bg is not too high.
I'll consider changing to the other method. I have not an option. She has to be safe

 

Again, I am not in any way trying to influence you. I just know how hard it is to manage CKD and diabetes. I wasn’t working but I did need to be helping care for my mom which of course was my number one concern.

 

I totally understand. I see it myself. Thank you.

 

do you see any signs of another pancreatitis attack?

 

Possibly. It's like back in June when she stopped eating.

This time started after giving her CBD. I don't know if it has to do anything with it.

In June had started after taking the injectable B complex vitamin in the vial orally. Have u ever heard of it? To take the liquid in the vial orally when it is supposed to be injected?

 

The inappetence alone could be from pancreatitis but also from CKD. That’s the question. His phosphorus is pretty high.

 

Never!

 

fluids would help both.
never had a cat with panc. in humans fluids are pushed.

 

Max didn’t get them until CKD. I think with his numbers daily fluids are needed too.

 

Why did my vet told me to do this?
It was written in the vial injectable, and she told me to give 2ml orally. Naomi fought back, drooling. It had an awful smell that couldn't go out even after washing your hands, hair etc.

I really think that caused her her flare. She was diagnosed with pancreatitis in May, but this happened when the vet ordered more exams. She had no symptoms at all, her appetite was excellent. We were surprised when the test came back positive.

 

Very possibly the cause. There is a liquid oral B complex. It tastes awful. I like pills. If injected it stings.

 

We're going to the vet on Friday for tests. I'll get the supplies and start

 

When did she last eat? Has she eaten at least 3/4 of normal?

 

After the initial purchase of supplies check the drug stores and also pharmacies on line. It might be cheaper. It is in the US at local drug stores.

 

She has eaten about half of what she should have.

But I see she's more comfortable by the way she's sleeping, and she purrs when I go near her.

 

This is good. If she stays up without food I think you should be able to sleep in an hour. Do you have the pill form of a BComplex? You didn’t repeat the oral did you? Do you have buprenorphine or anything else for pain? When you see your vet ask for some as pancreatitis can be painful. Will that be two hours without food?

I’d like to see her be over 120 to stop testing.

 

I gave it 3-4 times before her flare.

Unfortunately there is no buprenorphine accessible in Greece. We have medrol, but I think is not as safe as bup. for a CKD cat. Maybe I'm wrong here.
I can get pills of b complex.

She ate 10 min ago 1 tbsp kd

My alarm is ready. It's 3:10 now. I will be up 4:30, 5:30, 6:30 then have some coffee.

Can we do the PMPS earlier tomorrow so I will have 6-7 hours ahead of me to test and still get a sleep?

 

If she’s high enough you don’t need to get up every hour. This is crazy! Go to sleep for at least a few hours since she’s surfing and she ate

 

Go to sleep!

 

I'm already at work!

 

Took my notes with me to update
Have a good night!

 

I see you skipped. I hope the medication helps Naomi and she starts eating well.