? testing +5 76, no insulin in 12 hours.

Hey guys! So I just tested my candi girl for her pmps and she was at 70. I gave her some food and retested 30 mins later and she went up to 96. We use alphatrak and were on vetsulin 0.25u bid. Shes also on methimazole 5mg bid, clavamox(2ml bid; day 8 of 14), cerenia, a probiotic and mirataz q 3 days. I skipped the shot. Shes been having pretty low numbers while being on the antibiotics which has always happened due to not eating normally. No history of ketones or dka. I tested +5 and she was back down to 76. She has had no insulin in over 12 hours. Should I keep testing? This is the first time she went this low without insulin. I'm kinda thrown for a loop.

 

this is her labs from 2/11 and 2/14

 

If you did not give insulin this cycle there is no need to test any further, but I would give her another snack

I am not a vetsulin user so can’t help you with the dose moving forward. I will tag @Critter Mom and @JanetNJ for you.
I will also tag @Marje and Gracie for the path results.

 

It's looking like she produced enough of her own insulin after the feed to bring numbers down again. Even the food bump is comfortably in the normal range.

What percentage of her normal food intake is she eating, Becca? The response you're observing could potentially be remission (anti-jinx).


Mogs
.

 

Maybe like 1/3 of her normal intake? Still drinking. This morning she was 102, I skipped the insulin and fed and left food out, low carb of course . I cane home for lunch from work and did a +7 and she tested 95. I'm guessing that is what's happening. I'll test this evening and see where she is and go from there. I'm terrified of the dka. I hate skipping insulin however I tested her this am for ketones and it was negative. I guess I'll continue to test that too if I keep skipping. I just want to make sure shes not goin to go into dka if I'm skipping. Is there criteria that would give me a clue if that could happen with out keto sticks testing?

 

This is what worries me, Becca. I don't know whether the reduced food intake might be influencing numbers, but the main concern, IMO, is that she's not getting enough calories. The underlying infection plus inadequate calories is not a good combo. Her numbers are, thankfully, in a good range but from what I've read here, while it's less likely there'd be a ketone issue because of that, there have been reports of some cats in low numbers throwing ketones. To the very best of my knowledge, all you can do is monitor daily for them.

The other worry about a cat not getting enough is the possibility of issues with the liver. The best I can suggest to you is that you contact the vet *ASAP* about the antibiotic causing significant eating difficulties. I don't know whether ondansetron might help in addition/instead of the Cerenia or whether they might be able to do something on the antibiotic side of things. I used to get the vet to give amoxicillin via injection when Saoirse needed them. One dose lasted three days so I had to either take her in to the surgery or ask the vet to do a house call.

I think you really need to get Candi back eating normally. How many more days has she to go on the antibiotic course?


Mogs
.

 

She will have 6 days left after tonight. Her last dose will be Sunday morning.
I've tried almost everything. I'm having to force her methimazole by mixing it in tuna water and syringe feeding her. So I need to ask for ondansetron? I have been giving her the cerenia q 24 hours since monday. She just had a UTI so bad she was passing clots. She even had to go to the er vet on the 14th because the conveina didnt work that thursday and the UTI came back with avengence.

 

I know, poor love. Is her pee back to normal yet? I hope so. (((Candi)))

I think it would be worth asking the vet about, Becca. They work differently in the body. With a suitable size of dose, ondansetron can be given every 8-12 hours (e.g. 1mg q8h or 2mg q12h for a 10lb cat). The two meds can actually be used in tandem. You might want to double-check with the vet if it's safe to use ondansetron and mirtazapine at the same time. I really do think it best for you to contact the vet for advice on the poor appetite and what they might be able to do to help.

Is Candi getting enough fluids? Dehydration can exacerbate eating problems. Also, could you get more food into her by syringe feeding? I don't know what else to suggest to you, Becca. Sunday's a long way away when your little one can't eat properly. I feel for you.


Mogs
.

 

just tested her and she tested 74...i cannot give insulin that low. Also she ate the most I've seen her eat at lunch today yet she is at 74. I guess I will have to syringe feed her. The vet stated she was not familiar with mirataz. But I hope they can do something. She barely ate tonight. I know she has to be hungry. She keeps coming to me. We will probably be going in for a check up tomorrow. I'm emailing tonight to maybe schedule something or talk to someone. I just feel we can't win. If I were to syringe feed her you think have a can of fancy feast will be enough? Like she didn't even eat enough for me to feel comfortable to give her antibiotic. I want to cry.

 

Oh, Becca... I've been in similar circumstances and my heart really does go out to you. It is incredibly distressing - and frightening - when you can't get your cat to eat.

Cyproheptadine is another appetite stimulant. It's gentler in action than the mirtz but you can give it up to twice a day so you've got more control. The trouble is with the meds causing a GI upset, often it's the nausea, not lack of appetite, that causes reluctance to eat.

Not sure whether I've suggested this before but have you tried offering Candi some cat-safe baby food (meat and broth only, no onions, garlic, chives, spices, etc.) Some cats will take that when they won't touch anything else. Here's a list of suitable products, plus additional suggestions on how to get a kitty to eat:

Persuading your cat to eat

I think any food you can manage to get her to eat would help, Becca. I hope the vets will be able to do something tomorrow. Be sure to let us know how you get on.

(((Becca and Candi)))




Mogs
.

 

I mix her methimazole in baby food. Now she wants nothing to do with it. I might have to switch. I have emailed the vet for tomorrow. Hopefully she will be able to help. Thank you. I've cried and good cry and tried to get her to eat more. Her appetite is there with the ointment mitaraz I put on her ear. She even meows at me like shes hungry but I have 18 cans of fancy feast canned cat food sitting in my fridge, all which WERE her favorites and now she denies.

 

If the opened food is still fresh why don’t you freeze the left over canned food for later. I used to do that and label in with number of carbs.

 

Hi Becca,

How are you and Candi doing today? Any joy with the vet?

Been thinking about you today but I've not been online much. I was wondering whether the vet might be able to give Candi the 3-day antibiotic injections that Saoirse got. She only has 5-6 days of the course remaining. Even if you had to take her to the vets for the jabs, you should only need two visits to finish out the course.

I really hope things are better for the two of you today.

(((Becca and Candi)))




Mogs
.

 

They have been opened too long or else I would have! I never thought of that! Thank you!

 

Hey Mogs! Thanks for checking in...sorry its taken me some time to get back. I took her to a new vet and she decided instead of me jumping vet to vet to go to the NC State Vet School. I dont have the money for that. Aside from that she has starting eating better. We stopped the insulin 2/21 pm dose. Right now I'm just tracking when I'm checking her bg, so thats why there is times on there. We stopped the antibiotic after day 9, so on the 10th day no antibiotic. I hope we got rid of the infection. The vet said the only injectable antibiotic was conviena that she supplies. So we agreed to stop the antibiotic and the insulin per her normal vet. Her T4 feb. 11th was high again so we increased her methimazole from 2.5mg bid to 5mg bid and recheck in 3 weeks, so hopefully that will take care of the T4. But I spot checked her bg today around 7 hours after the first bg test(which was 93) and she was at 66 without insulin. So I tried to feed her a snack which she ate a little bit of and took up food for 2 hours and did a pm bg check and it was 83. So while her numbers are looking good, she is no where near eating what she used to. Her regular vet seems to think that her appetite was due to the increase in her T4. But when everything was under control she was eating at least whole can a day. She barely eats a third of a can now. So she has a ways to go but it seems to getting better. I'm still testing because I just feel I need to watch the bg. Her regular vet said if she wasn't eating more by thursday then i need to schedule an ultrasound to see if there any obstructions keeping her from eating, so crossing fingers she gets to eating normally. Sorry for the long story! thanks again for checking in!
Here's a pic just because she a cutie!

 

@Critter Mom SHE FINALLY ATE A FULL MEAL IN ONE SITTING!!! I AM SO HAPPY!!! and vet said she might be in remission!!!

 

Yay!!!!

Thank you so much for letting me know, Becca. I know only too well how deeply distressing it is when a cat can't eat properly, and I am so pleased and relieved for you. Both of you.

Clavamox and equivalent products really do a number on the digestive system. Lúnasa had two pretty much back-to-back 30-day courses of the stuff (30-day! ) and I had the devil's own job trying to get food into her. Towards the end of the second course she was struggling so badly - even though she was getting ondansetron - I had a word with the vet and we let her finish the course a few days early. Thankfully she had had enough to clear up the UTI.

Not sure whether this might be of help to you in the future, but I went back over Saoirse's records and the 3-day injectable amoxicillin she got was called Betamox.

https://imedi.co.uk/betamox-la-150-mg-ml-suspension-for-injection

Sending scritches for Candi and some for you.


Mogs
.

 

Oh no! 30 days?! That must have been awful! I will definitely ask around for that, it sounds so worth it! Thank you for looking it up for me! I'm so sorry you had to go thru that mogs! She goes back in next week for a test on her thyroid to see where she is at and to see if we can decrease her methimazole. We might just have to stay on the 5mg dose bid instead of the 2.5mg bid but I will also ask about that injectable antibiotic and ask them to somehow check if they can check to see if the UTI is gone. Thank you so much! She is a very very sweet girl that I would not trade for anything! Thank you for checking on us and thinking of us and giving us information! You guys have been the best, I couldnt get this far without this support group and the facebook one. Again thank you so much! I have even bought myself some tiramisu for this entire ordeal and I got candi a fancy feast tuna fillet (almost 1 ounce and she inhaled it!)

Thank you again!