? Bitsy 24 hr Curve/Need Dosing advice

Discussion in 'Lantus / Levemir / Biosimilars' started by Debra Pratt, Dec 20, 2020.

  1. Debra Pratt

    Debra Pratt Member

    Joined:
    Aug 27, 2020
    Please see the attached spreadsheet to see her recent curve. I started out and was only going to do a 12 hr curve every 2 hrs; but wanted to also see how her sugar failed at night, so I tested every 3 hrs throughout the night. Confused as to why her sugar is so high this morning. No ketones! But her eyes are really dilated and she is not happy being touched. She is still in recovery from Pancreatitis and/or gastritis. Looking for advice on what to do with her dosing. Thank you in advance!
     

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  2. Bandit's Mom

    Bandit's Mom Well-Known Member

    Joined:
    Oct 18, 2019
    Your previous post - https://www.felinediabetes.com/FDMB/threads/bitsy-dosing-advice.240180/

    Based on the curve, she is due for an increase to 2.25U. She is bouncing from the low numbers she saw yesterday AM. Pain/inflammation/infection can also elevate numbers. Is she getting any pain meds? I see that she is on metronidazole. Why is that? When is the last time she had LB action?

    I am going to tag @tiffmaxee to help with the pancreatitis/gastritis.
     
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  3. Debra Pratt

    Debra Pratt Member

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    Aug 27, 2020
    They gave her the metronidazole and Pro Pectalin to help with diarrhea. No they don’t have her on a pain med I am unsure why that is. Something about if she was eating and drinking she may not need it.
     
  4. Bandit's Mom

    Bandit's Mom Well-Known Member

    Joined:
    Oct 18, 2019
    Has the diarrhea stopped? Metronidazole can constipate. How long have they asked you to keep her on it?
    How is her appetite? From your description, it looks like she is in pain.
     
  5. JaxBenji

    JaxBenji Well-Known Member

    Joined:
    Jul 10, 2020
    Hope Bitsy feels better soon :bighug: On 12/17 PM, I think you skipped insulin because she was at the vet, right? If so, next time you are in your SS, can you put "NS" (no shot) in the units cell just so it's clear you skipped (versus forgetting to input the units...which I've done too :p). Each time there is a skip, it impacts the insulin depot and may impact the advice you receive on increasing/decreasing.

    Good job on testing and getting those curves :bighug: Hope you can catch a nap or at least some :coffee:
     
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  6. Debra Pratt

    Debra Pratt Member

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    Aug 27, 2020
    Yes the diarrhea has stopped. Bottle says to use for the next 5 days. She is eating as normal; thankfully. Is there anything I can do to help with pain? Can a diabetic cat have CBD oil?
     
  7. Debra Pratt

    Debra Pratt Member

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    Aug 27, 2020
    Dose wasn’t missed it was done by the vet. Just forgot to input how much they gave.
     
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  8. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    So this is her third day on metronidazole? Has she pooped since the diarrhea stopped?
     
  9. Debra Pratt

    Debra Pratt Member

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    Aug 27, 2020
    Hmmm, you know I am not positive; but now that you mention that I don’t think she has. I was so focused on getting her to eat I didn’t pay attention to if she has pooped.
     
  10. Bandit's Mom

    Bandit's Mom Well-Known Member

    Joined:
    Oct 18, 2019
    OK. Just keep a watch? Bandit was on metronidazole for diarrhea last month and she didn't go for more than 72 hours after!
    Elise (@tiffmaxee) will be along soon and help you with your questions on pain meds and pancreatitis.
     
  11. THH & Snowcrash (GA)

    THH & Snowcrash (GA) Member

    Joined:
    Aug 28, 2020
    What meds exactly did the vet give you for her at discharge? Do you have any cerenia for her?

    I agree that it sounds like she's in pain. That will spike her numbers and may make her not want to eat again later. Usually buprenorphine and/or gabapentin are given for pancreatitis at my vet. Cerenia can sometimes have some pain relieving qualities for pancreatitis, but often that alone isn't enough.
     
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  12. Debra Pratt

    Debra Pratt Member

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    Aug 27, 2020
    She was given metronidazole and Pro Pectalin. I have mirtazipine and cerenia from a previous visit.
     
  13. THH & Snowcrash (GA)

    THH & Snowcrash (GA) Member

    Joined:
    Aug 28, 2020
    I would give the cerenia at the dose previously prescribed. Some cats with pancreatitis need to stay on it longterm; my 2 cats with pancreatitis are on it daily.

    I think Pro Pectalin is to stop diarrhea? If so, since she hasn't had a bowel movement in 3 days now, I would probably try stopping that one and see how she does.
     
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  14. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Hi. It’s very important to watch the litter box. Both medications you were given are for diarrhea. When I was given metronizadole my vet warned me that once I saw normal stool to stop it and that Max then might not go for a day or two. If you continue with it he can get backed up requiring an enema. Are you giving pills or liquid? The pills are better for cats. So if she’s constipated I would call your vet and ask about this.

    Max had chronic pancreatitis and the first sign was inappetence so I always had cerenia and ondansetron on hand. He rarely would vomit so I mostly used ondansetron. I was able to use nausea meds as needed but some can’t eliminate them.

    I agree that an increase is needed but this first needs to be resolved.
     

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