Agatha's Dosing- change needed? + other questions

Hi everyone, it's been a while since I posted. Trying to figure everythingout. Agatha has gone through two different bouts of not eating. The whole nausea/not eating cycle feels like the chicken and the egg, which came first question. With Cerenia, Mirataz, SubQ fluids + lots of BeechNut meat baby food, she's eating normally now + seems to not be drinking at such an alarming rate (so at the moment she's not getting any of those medications). I also switched her from Petsulin to ProZinc (the vet also upped 1 unit to 1½ units). Some days she looks like she feels awful + a distant look in her eyes and lays in front of the water bowl with her chin in the water; other days she's her normal, serene calm beautiful house lioness self. It's been extremely stressful trying to juggle all responsibilities + other people's opinions on medical treatment I get for or administer to my cat. Seeing her drink so much water + the litter box looking like a swimming pool of urine after only 1 day is scary + disheartening and at various points I've felt I can't go on like this. Every day looking at my baby wondering if she will eat or not, if there's anything I can do differently to help her, wondering how much longer I will have her with me. It's morbid did hate it.... so, I have a couple questions + didn't know if I should make several posts or if 1 was better.

1) Her BG numbers seem high to me. I know several weeks of not eating well was likely a setback but I had hopes her BG numbers would start to lower by now. I've tried keeping thorough notes I'm her spread sheet. Should I change her dosing?

2) Will I always have to test her twice a day? The vet told me when she was diagnosed that I would need to test twice daily for a while, then once a day, then only sometimes. I understand the danger of giving insulin without testing. But at what point do you not have to test at this frequency?

3) She's been extremely particular in that if all else Falls she wants BeechNut meat baby foods. They are so expensive! $1/2½oz jar which is only 1 meal. Does anyone else make meat meals at home? I also give her Friskies pate but I'm in Texas with the bizzare winter storms and have been stuck at home so can't get to the store. The BeechNut foods are literally just meat + broth. I made her chicken thighs, livers + water + she liked it but I need to add way more water next time. Do cats stop eating + drink so much water bc their BG gets so high they get nausea? The vet said the next diagnostic step would be a $400 ultrasound of her belly to look for a growth/cancer/etc but that he didn't think she wasn't eating bc of a reason like that, that he thought it was diabetes related.

I've had Aggy almost half my life. She's been by my side through everything + I want to help her feel as best as she can. Thank you all very much for any advice in advance! -Sam + Aggy <3

(((I realized only after originally posting it was in the ProZinc board, so I reposted here. I hope that's ok.)))

 

You need to test before every shot, and then in both cycles to find the optimal dose for her.
So until she's in remission you can't test less. And twice a day isn't enough.
My vet told me the same, but if we don't test between shots we would be missing the perfect doses and reductions as they come..

 

Thank you, I need to learn how to test between shots + how those BG numbers will correspond to dosing.

 

This might be helpful. You can look at other people's spreadsheets and see when we test.

 

According to Diabetes UK, humans can experience nausea due to hyperglycaemia or hypoglycaemia. I know that our little ones can't tell us how they feel so we have to rely on our own observations to try to fathom out what might be happening. Have you noticed any correlation in Aggy not wanting to eat and being in high numbers? Tracking her appetite in the spreadsheet remarks each day might help you spot any pattern.

Pancreatic inflammation, ketosis and kidney issues are some other things can also make a cat feel nauseated. Has your vet tested Aggy for pancreatitis? How are her kidneys functioning? Are you monitoring her urine daily for ketones? Testing for ketones is a good general safety precaution, especially for cats in higher numbers, but because she has been hanging out by the water bowl I very much recommend you do so. You can get the urine test strips at pharmacies or anywhere that sells supplies for diabetics. Some helpful links:

IDEXX feline pancreatitis treatment guidelines

FDMB ketone primer

Tips for collecting and testing urine samples

Provided it's not contraindicated, ondansetron can be given as a daily maintenance med for management of nausea. Maybe have a chat with the vet to see if they might be willing to prescribe something to help Aggy to eat better while you're investigating the underlying cause? Note: if pancreatitis is in play, during a flare buprenorphine may also be needed to help a cat keep eating.

As Sasha mentions above, realistically you need to test Aggy at minimum three times a day: two preshot tests and at least one mid-cycle round the typical nadir period for Prozinc to help shed light on how low the dose is taking her (and ideally a 'before bed' test on every PM cycle to see how the dose is working and check to assess whether she'll be safe while you're asleep, especially when she starts getting into a better range). If you can get into the habit of doing the mid-cycle tests it will quickly become part of Aggy's routine. If you have logistical difficulties with the daily mid-cycle tests then running a curve once a week would at least be some bit better of a guide. Without the mid-cycle tests, it's not really possible to suggest a safe dose adjustment because there's no way to know how low the current dose may be taking Aggy. Unfortunately there's no way of getting around this. The only other alternative would be to pay your vet to run a curve. The BG levels might well be stress-influenced but it's better than nothing.

I know so well what that's like, and I really feel for you, Sam. I know how difficult it can be, but try to just take each day as it comes, and breathe a little deeper any time Aggy's eating well.


Mogs
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Thank you so much for the helpful information! She hasn't been tested for pancreatitis. The vet said her blood work done on day of diagnosis showed her kidneys working well. When she stopped eating the first time I got the urine test strips but didn't use them. I will definitely need to look at the links you sent on how to get a sample.

You said re: testing I need "at least one mid-cycle round the typical nadir period for Prozinc." When is that?

 

That's typically around +5.
In both cycles. But it varies. You need to test more to find it.

 

Hi there, I completed a curve test in the last couple cycles + a few mid-cycle tests.

 

I finished some several more days with mid-cycle testing, if you can look at it when you get a chance. Thank you!

 

Did you put them in your spreadsheet?
You still need to test more, let's say in a week, you need to cover the 24 hours, or the 22 columns. Test different times every day in different cycles.
Do a +2, +6 and +9 tomorrow AM cycle.
Do a +4 PM cycle.
Next day a +3 and +8, then +5 PM cycle.