? - 6/20 Vesper, AMPS 183, +5 90 | Feline Diabetes Management Board

? 6/20 Vesper, AMPS 183, +5 90

Hi all,

We haven't checked in awhile, and I hope you all are doing well. (special hi to @Laurie & Petey who checked in recently)

Vesper has been doing amazing. She will be turning 14 in ten days, is back up to 11lbs 3oz (after falling to 8.5 lbs during her DKA episode in January), and seems to be fully adjusted to budesonide. We haven't seen any indication that her pancreatitis is flaring, and her diabetes seems to be well-controlled (knock on wood).

We could use advice on a few things, however.

(1) Vesper's nadirs have been around 50 pretty consistently (though we admittedly need to do more night checks). I'm wondering if we should reduce her dose to 1.5?

(2) Although my husband and I are able to administer Vesper's insulin and check her glucose, it is officially impossible for us to find a catsitter who is able to care for her (aside from one woman who can do the injection most of the time as long as her husband assists her in chasing/holding Vesper down, but they cannot do glucose checks). Vesper is *extremely* aggressive, and her aggression has only increased since we've started doing glucose checks over the last few months. We have tried absolutely everything: using treats she loves, wild animal gloves, hiring trained vet techs, doing it with meals, doing it without meals. It's officially a lost cause. This is problematic for us, as we are required to travel fairly frequently (we live in Seattle with our toddler and all of our family, including elderly parents, live far away--in Vermont and Arizona). Traveling internationally is also our most cherished family activity. Boarding Vesper is also not an option, because vets have to fully sedate her in order to handle her. In light of all of this, I'm wondering a few things:

-- After recently traveling for an overnight, Vesper went 36h without insulin because the new catsitter was unable to inject her. When we checked her glucose upon return yesterday, it was at 214. What are we to make of that? I'm somewhat encouraged it wasn't worse but don't want to get too complacent. Basically, I'm just trying to judge how long she can go without insulin before needing urgent vet care, because it is bound to happen again at some point despite our best efforts.

-- We have an upcoming trip in July where we will be leaving for 10 days. The one catsitter able to administer insulin will be watching her, though her husband is only to help for part of the time, so I'm not sure Vesper will get her insulin consistently. How problematic would it be if she gets her dose most days but not all? How much should we reduce her dose for the sitter?

-- Any other suggestions?

We have traveled with Vesper occasionally (she has flown cross country 4x) but cannot do it every time, given that our relatives have dogs etc. We also obviously cannot do that for international travel. We will still do it when we can, but traveling also stresses her out too (the trip to Vermont involves 2 flights and takes 14h), so we're trying to find a balance. Anyone want to be a petsitter in Seattle? ;)
 
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Glad to hear all is well! 🤩🤗

My first thought was can the pet sitter administer gabapentin an hour or two before shot time to better the chances of being able to shoot?

I do have some friends in Olympia that are cat whispers and had a diabetic cat as well. I can ask them but Seattle might be too far.
 
Glad to hear all is well! 🤩🤗

My first thought was can the pet sitter administer gabapentin an hour or two before shot time to better the chances of being able to shoot?

I do have some friends in Olympia that are cat whispers and had a diabetic cat as well. I can ask them but Seattle might be too far.
I've wondered that too, but I haven't been able to find gaba in a small pill form. Vesper does not easily take large pills, capsules, or liquid meds. We can only get her to take the budesonide because it is small and she'll tolerate it in a pill pocket. Do you know if it's possible to get gaba in a smaller, compact version?

You're very sweet to ask your friends. Totally understand that Seattle is too far!
 
I've wondered that too, but I haven't been able to find gaba in a small pill form. Vesper does not easily take large pills, capsules, or liquid meds. We can only get her to take the budesonide because it is small and she'll tolerate it in a pill pocket. Do you know if it's possible to get gaba in a smaller, compact version?

You're very sweet to ask your friends. Totally understand that Seattle is too far!
I use a liquid form that smells really sweet but doesn't affect BG. Mixed it with his food no problem at all. Gaba is really bitter so it's hard to mask otherwise.
 
Why is there a GA on your thread title? GA means your cat has passed away(guardian angel or gone ahead.) God forbid that your Vesper should die.
 
I've wondered that too, but I haven't been able to find gaba in a small pill form. Vesper does not easily take large pills, capsules, or liquid meds. We can only get her to take the budesonide because it is small and she'll tolerate it in a pill pocket. Do you know if it's possible to get gaba in a smaller, compact version?

You're very sweet to ask your friends. Totally understand that Seattle is too far!
We crush the gaba and put it in our cats food and she doesn’t even notice.
 
Hi Kelly, Vesper is looking so good! Congratulations!

I'll let someone else more qualified address the issues related to not shooting every 12 hours.

You've probably thought through most of these ideas, but can your vet recommend a sitter who is able to test/shoot?

Like Laurie, I also have a close friend in Olympia who has connections in Seattle. My friend, though I would trust Jude's life with her, would likely not be able to travel to Seattle to test/shoot because of her job, but I can check to see if she knows of someone that she would trust, explicitly. Let me know.

Finally, have you considered a CGM for Vesper? That way, the only thing the sitter would need to be concerned with is shooting which, to me, is much easier than testing. If this is something you might want to learn more about, I can tag some folks on here who are pros with CGMs to answer questions for you.
 
Some great suggestions from @Laurie & Petey @Bellas_mom_2020 @Mary & Jude Wedgewood is my compounding pharmacy as well and we get Cleo's gaba in chewable Chicken Flavored treats.
I would add that about 2 days before your trip, post for a vacation dose. There are a few nadirs in the low 50s that I would want to avoid since testing is problematic.

Have you tried feliway diffusers and/or spray? Cleo was very difficult to test in the beginning (and sometimes still now :rolleyes:). There are also some options for herbal calming remedies which shouldn't interfere with the IBD.

I don't mean to be critical, but you're not testing enough (understandably so with Vesper's temperament) to follow TR. My concern is that those higher preshots are from under 50 lows in the prior cycle. SLGS would be safer and less stressful. With SLGS you hold the dose for 7 days/14 cycles then perform a curve, unless the BG falls under 90 then you would reduce by 0.25. You have been at this for awhile, so you could try custom dosing meaning that you would lower your reduction point from 90 to 80 or 70 as an example.
 
Thirding a compounding pharmacy for chicken flavored tablets - crushed and mixed into food it's not even noticed! I think if it's not flavored it's bitter, so it makes sense that it otherwise didn't work.

Also seconding a suggestion for a CGM - simply not being able to manually test (whether at all or reliably) is the perfect purpose for them and it's what I've always had to do. Sometimes the ideal simply isn't feasible for everyone, and that's okay.
 
Hi Kelly, I believe Stokes compounding pharmacy has a tiny gabapentin pill, too.

I agree with the CGM (Libre sensor) suggestion also in this case.
But, it’s something you would want to try ahead of the time you need it to get familiar with how it all works. There’s a bit of a learning curve.
I wouldn’t wait until the day before to start that process for sure.

Glad to see you and Vesper are doing well and glad you’re here with us! 🐈‍⬛💕😻❤️‍🩹
 
Sorry for the lack of response! I am still figuring out the new board and thought I'd get email notifications, so I didn't know that more of our friends had posted. We have tried a CGM twice, and both times she was able to remove it within two days. Also, both times they had to fully sedate her under full anesthesia to even put them on. We did not try adding a surgery shirt, but she hates those SO much, and I worry it will stress her out more. I will give it more thought though, because it would be nice if we could make a CGM work for a petsitter.

And thanks all for the compounding pharmacy suggestions. I have emailed my vet to ask about chicken chewable tablets or fish liquid. Fingers crossed!!

@Angela & Cleo-- I can follow up on a new thread, but I'd like to talk more about TR vs SLGS. I think I need to read up on both of those and understand them a bit more to figure out what's best for us.

@Mary & Jude --Thank you so much for your offer to contact friends in Seattle. I will let you know if we get to that point.

Really appreciate everyone in this community!
 
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